Journal of Rheumatic Diseases.2017;24(3):169-170. doi:10.4078/jrd.2017.24.3.169
Journal of Rheumatic Diseases
1994 to Present ISSN: 2093-940X
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Hypereosinophilic Syndrome Associated with the Onset of Rheumatoid Arthritis: A Case Report.
Journal of Rheumatic Diseases.2017;24(3):165-168. doi:10.4078/jrd.2017.24.3.165
Idiopathic hypereosinophilic syndrome (HES) is a disorder characterized by the sustained overproduction of eosinophils and multiple organ damage. Rheumatologic manifestations of HES are infrequent, but persistent eosinophilia is observed in approximately 10% to 40% of patients with rheumatoid arthritis (RA). This finding may be a result of the RA itself and is often associated with active disease and the presence of extra-articular features. We describe the case of a 48-year-old man affected by HES who subsequently developed RA. Both HES and RA responded rapidly to the corticosteroid and methotrexate therapy. In this patient, the initiation of RA and HES was related, suggesting a common pathogenetic link between these two diseases.
Arthritis, Rheumatoid* ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome* ; Methotrexate ; Middle Aged
Arthritis, Rheumatoid* ; Eosinophilia ; Eosinophils ; Humans ; Hypereosinophilic Syndrome* ; Methotrexate ; Middle Aged
A Case of Neutrophilic Myositis.
Journal of Rheumatic Diseases.2017;24(3):161-164. doi:10.4078/jrd.2017.24.3.161
Neutrophilic myositis is a very rare disease histologically characterized by neutrophil infiltration of muscle tissues. We report a case of a 47-year-old man who presented with acute onset of severe swelling and pain on his left shoulder with high fever. He was initially suspected of having cellulitis, but intravenous antibiotics did not improve his symptoms. Similar swelling and pain then developed on both calves. Investigations with magnetic resonance imaging of the lower legs and muscle biopsy led to a diagnosis of neutrophilic myositis. High dose glucocorticoid dramatically improved his symptoms within days. Clinicians need to be aware of this rare disease as a cause of acute febrile myositis mimicking infection.
Anti-Bacterial Agents ; Biopsy ; Cellulitis ; Diagnosis ; Fever ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Myositis* ; Neutrophil Infiltration ; Neutrophils* ; Rare Diseases ; Shoulder ; Sweet Syndrome
Anti-Bacterial Agents ; Biopsy ; Cellulitis ; Diagnosis ; Fever ; Humans ; Leg ; Magnetic Resonance Imaging ; Middle Aged ; Myositis* ; Neutrophil Infiltration ; Neutrophils* ; Rare Diseases ; Shoulder ; Sweet Syndrome
Journal of Rheumatic Diseases.2015;22(1):34-38. doi:10.4078/jrd.2015.22.1.34
Renal lupus vasculitis is a rare vascular lesion complicated with systemic lupus erythematosus (SLE). We report an unusual case of true renal lupus vasculitis with antineutrophil cytoplasmic antibodies (ANCA)-negative pauci-immune glomerulonephritis in a patient with SLE. A 32-year-old woman presenting with hematuria and overt proteinuria was admitted to the hospital. She had been diagnosed with SLE at 16 years of age and treated with prednisolone, hydroxychloroquine, and methotraxate. A kidney biopsy revealed 42 glomeruli with ischemic wrinkling, and segmental loop necrosis with fibrin deposition. Prominent inflammatory cell infiltration of interlobular arteries and afferent arterioles with severe necrosis was demonstrated. No electron-dense and immune deposits in the glomeruli were observed by immunofluorescent and electron microscopy; in contrast, those in the renal vascular wall showed a full-house pattern. Antiphospholipid antibodies and ANCA were negative. The patient was treated with monthly intravenous cyclophosphamide pulses and high dose steroid, and showed good response on further follow-up.
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antiphospholipid ; Arteries ; Arterioles ; Biopsy ; Cyclophosphamide ; Female ; Fibrin ; Follow-Up Studies ; Glomerulonephritis* ; Hematuria ; Humans ; Hydroxychloroquine ; Kidney ; Lupus Erythematosus, Systemic* ; Microscopy, Electron ; Necrosis ; Prednisolone ; Proteinuria ; Vasculitis*
Adult ; Antibodies, Antineutrophil Cytoplasmic ; Antibodies, Antiphospholipid ; Arteries ; Arterioles ; Biopsy ; Cyclophosphamide ; Female ; Fibrin ; Follow-Up Studies ; Glomerulonephritis* ; Hematuria ; Humans ; Hydroxychloroquine ; Kidney ; Lupus Erythematosus, Systemic* ; Microscopy, Electron ; Necrosis ; Prednisolone ; Proteinuria ; Vasculitis*
Carpal Tunnel Syndrome Associated with Tophaceous Deposition in Flexor Digitorum Tendons.
Journal of Rheumatic Diseases.2015;22(1):29-33. doi:10.4078/jrd.2015.22.1.29
Carpal tunnel syndrome is the most common peripheral entrapment neuropathy. We report on the first Korean case of carpal tunnel syndrome induced by tophaceous deposition in flexor digitorum tendons of a patient with chronic gout. A 63-year-old male suffered from numbness, decreased sensation over both median nerve distribution, and weakness of thenar muscle for 3 years. Physical examinations revealed positive Tinel's sign and Phalen's test and thenar qjmuscle atrophy was found on both hands. In nerve conduction study, there was no action potential of the sensory and motor of the bilateral median nerve. Ultrasonography showed increased cross-sectional area of median nerve due to tophaceous deposition in flexor digitorum tendons in the carpal tunnel. Dual-energy computed tomography showed diffuse multifocal green color coding tophaceous deposition within the carpal tunnel. His neuropathic symptoms improved after injection of triamcinolone into the carpal tunnel and administration of oral medication including non-steroidal anti-inflammatory drugs and colchicine.
Action Potentials ; Arthritis, Gouty ; Atrophy ; Carpal Tunnel Syndrome* ; Clinical Coding ; Colchicine ; Gout ; Hand ; Humans ; Hypesthesia ; Male ; Median Nerve ; Middle Aged ; Neural Conduction ; Physical Examination ; Sensation ; Tendons* ; Triamcinolone ; Ultrasonography
Action Potentials ; Arthritis, Gouty ; Atrophy ; Carpal Tunnel Syndrome* ; Clinical Coding ; Colchicine ; Gout ; Hand ; Humans ; Hypesthesia ; Male ; Median Nerve ; Middle Aged ; Neural Conduction ; Physical Examination ; Sensation ; Tendons* ; Triamcinolone ; Ultrasonography
Tophaceous Gout Misidentified as Inflammatory Polyp in External Auditory Canal.
Journal of Rheumatic Diseases.2015;22(1):25-28. doi:10.4078/jrd.2015.22.1.25
Gout is an inflammatory disorder in which urate crystals are deposited in the joints or soft tissues causing severe inflammation and pain. Urate crystals usually deposit in the joints, and sometimes in the extra-articular sites. A 67-year-old woman visited the otolaryngology clinic due to otalgia and discharge from the ear. She had experienced recurrent arthritis in the left second metatarsophalangeal joint from five years ago. She visited the otolaryngology clinic of our university hospital due to persistent inflammation in the ear canal despite treatment with antibiotics. An otoscopic examination showed a polyp-like mass near the eardrum. Computed tomography scan of temporal bone showed thickening of the eardrum and increased soft tissue density in the external ear canal. On histologic examination the polyp was finally found to be a urate crystal mass. She is now in a good state with urate lowering therapy. We report on a Korean case of tophaceous gout in the external ear canal that was misidentified as an inflammatory polyp.
Aged ; Anti-Bacterial Agents ; Arthritis ; Ear ; Ear Canal* ; Earache ; Female ; Gout* ; Humans ; Inflammation ; Joints ; Metatarsophalangeal Joint ; Otolaryngology ; Polyps* ; Temporal Bone ; Tympanic Membrane ; Uric Acid
Aged ; Anti-Bacterial Agents ; Arthritis ; Ear ; Ear Canal* ; Earache ; Female ; Gout* ; Humans ; Inflammation ; Joints ; Metatarsophalangeal Joint ; Otolaryngology ; Polyps* ; Temporal Bone ; Tympanic Membrane ; Uric Acid
Correlation of Cardiothoracic Ratio and Right Ventricular Systolic Pressure in Systemic Sclerosis.
Journal of Rheumatic Diseases.2015;22(1):19-24. doi:10.4078/jrd.2015.22.1.19
OBJECTIVE: This study was designed to assess sequential association between right ventricular systolic pressure and cardiothoracic (C/T) ratio of chest radiography in systemic sclerosis (SSc) patients and inferred pulmonary arterial hypertension by increased C/T ratio and right ventricular systolic pressure. METHODS: Twenty-eight consecutive patients with confirmed SSc (22 females, 6 males; mean age 51.1+/-2.1 years), with a mean time of 91.0+/-6.7 months from SSc diagnosis, were prospectively included in the study. C/T ratio was obtained by chest radiography with an interval of two years. The first C/T ratio was taken at diagnosis and second C/T ratio was taken at the time of enrollment. The enrolled subjects were agree to undergo echocardiography and measurement of brain natriuretic peptide. RESULTS: In 24 SSc patients with normal right ventricular systolic pressure, 10 SSc patients had increased C/T ratio, the other four SSc patients with increased right ventricular systolic pressure by echocardiography, had increased C/T ratio all together. In four SSc patients with increased right ventricular systolic pressure, one patient had resting dyspnea, taken cardiac catheterization and confirmed as pulmonary hypertension and the other three patients had no clinical symptoms. The increased right ventricular systolic pressure is related to the increase of C/T ratio (>0.55) in chest radiography (p<0.05) and increased brain natriuretic peptide in blood (p<0.05). CONCLUSION: The increase of C/T ratio (>0.55) in chest radiography was associated with increased right ventricular systolic pressure measured by echocardiography and inferred a role in early detection of asymptomatic pulmonary arterial hypertension in SSc patients.
Blood Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Dyspnea ; Echocardiography ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary ; Male ; Natriuretic Peptide, Brain ; Prospective Studies ; Radiography ; Scleroderma, Systemic* ; Thorax
Blood Pressure* ; Cardiac Catheterization ; Cardiac Catheters ; Diagnosis ; Dyspnea ; Echocardiography ; Female ; Humans ; Hypertension ; Hypertension, Pulmonary ; Male ; Natriuretic Peptide, Brain ; Prospective Studies ; Radiography ; Scleroderma, Systemic* ; Thorax
Diet and Folk Medicines for Rheumatic Diseases.
Journal of Rheumatic Diseases.2015;22(1):10-18. doi:10.4078/jrd.2015.22.1.10
Notwithstanding recent advances in the field of treatment of rheumatic diseases, patients still have a significant interest in complementary and alternative medicine for various reasons. The purpose of this review is to investigate the effect of certain dietary components or folk medicines on the pathogenesis or outcome of rheumatic diseases. The data used in the study were mainly selected from the references searched by MEDLINE. Among the variety of dietary components and folk medicines investigated, omega-3 fatty acid, alcohol, and vitamin D showed negative correlation with the risk of rheumatoid arthritis. Specifically, omega-3 fatty acids appeared to be somewhat helpful for treatment of rheumatoid arthritis. Although some of the items showed a positive effect through this study, it failed to establish definitive evidence for the overall effect of diet and folk medicines in rheumatic diseases. In the future, further understanding of mechanisms and clinical utility should be acquired through numerous systematic and scientific research studies.
Arthritis, Rheumatoid ; Complementary Therapies ; Diet* ; Fatty Acids, Omega-3 ; Humans ; Medicine, Traditional ; Rheumatic Diseases* ; Vitamin D
Arthritis, Rheumatoid ; Complementary Therapies ; Diet* ; Fatty Acids, Omega-3 ; Humans ; Medicine, Traditional ; Rheumatic Diseases* ; Vitamin D
Journal of Rheumatic Diseases.2015;22(1):4-9. doi:10.4078/jrd.2015.22.1.4
Meta-analysis is a statistical tool for combining the results of different studies on the same topic, providing a precise estimate of the effect size and increasing statistical strength, which is particularly important when the strength of the primary study is limited because of a small sample size. Properly conducted meta-analysis provides an invaluable link between past and future studies by quantitatively synthesizing evidence while minimizing bias. Recently, because studies on meta-analysis have been published increasingly, there is a need for rheumatologists to understand meta-analysis. In order to help rheumatologists in use of a meta-analysis, the author describes the basic steps in statistical analysis of a meta-analysis: 1) search for presence of between-study heterogeneity, 2) performing statistical analysis of meta-analysis, 3) checking publication bias, 4) search for causes of heterogeneity, and 5) interpreting and presenting meta-analysis results.
Bias (Epidemiology) ; Meta-Analysis as Topic ; Population Characteristics ; Publication Bias ; Sample Size
Bias (Epidemiology) ; Meta-Analysis as Topic ; Population Characteristics ; Publication Bias ; Sample Size
Korean Epidemiologic Study of Polymyalgia Rheumatica.
Journal of Rheumatic Diseases.2015;22(1):1-3. doi:10.4078/jrd.2015.22.1.1
Country
Republic of Korea
Publisher
Korean College of Rheumatology
ElectronicLinks
http://www.jrd.or.kr/Editor-in-chief
Jae-Bum Jun
rheumatism1@korea.com
Abbreviation
J Rheum Dis
Vernacular Journal Title
ISSN
2093-940X
EISSN
2233-4718
Year Approved
2009
Current Indexing Status
Currently Indexed
Start Year
1994
Description
The Journal of Rheumatic Diseases (JRD) is an official journal of the Korean College of Rheumatology published in both Korean and English. This journal's title has been changed from "The Journal of the Korean Rheumatism Association" in 1994 ~2010. This journal covers all aspects of rheumatic and musculoskeletal diseases and publishes peer-reviewed articles. JRD is published by Medrang, and is available online via http://www.rheum.or.kr. Both clinical and basic researches are welcome, as are new findings on the epidemiology, pathogenesis, diagnosis, treatment, and prevention of diseases
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