The predictive value of the HLA shared epitope for severity of radiological joint damage in patients with rheumatoid arthritis. A 10 year observational prospective study.

Objective: To evaluate the clinical importance of the RA "shared epitope" (SE) as a prognostic marker of radiological severity and extension of the disease to large joints in patients with rheumatoid arthritis (RA).

Methods: Eighty-two patients who met the American College of Rheumatology criteria for RA with a disease duration < 2 years at presentation were included in the study. Radiographs of hands, wrists, feet, shoulders, elbows, hips, and knees were taken at study entry and 8-10 years later.

Comparison of tenoxicam and bromazepan in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled trial.

Fibromyalgia is a painful syndrome of non-articular origin, predominantly involving muscles, and the commonest cause of chronic widespread musculoskeletal pain. The diversity of therapeutic programs for patients with fibromyalgia reflects both the lack of a known pathophysiology for this disorder and the low efficacy of the current therapies. We studied the efficacy of tenoxicam and bromazepan in the treatment of patients with fibromyalgia.

Mixed systemic amyloidosis in a patient receiving long term haemodialysis.

A 64 year old woman had been receiving haemodialysis for 11 years. She had a history of chronic renal failure, caused by probable chronic pyelonephritis, and dialysis arthropathy. She died of acute pulmonary oedema and haemorrhage.

Pseudotumoral amyloidosis of beta 2-microglobulin origin in the buttock of a patient receiving long term haemodialysis.

A 52 year old man who had been receiving haemodialysis for 13 years, with a history of renal tuberculosis, right ischial tuberculous osteomyelitis, and dialysis arthropathy, developed a soft tissue tumour in his left buttock. Histological analysis, immunohistological staining, and electron microscopic examination of the surgically removed tumour showed massive deposits of beta 2-microglobulin (beta 2-M) amyloid. This case shows the expanding clinical spectrum of this type of amyloidosis, and it is suggested that amyloid infiltration should be considered in the differential diagnosis of gluteal tumours in these patients.