The association of variant mannose-binding lectin genotypes with radiographic outcome in rheumatoid arthritis.

Objective: To investigate the possible association of mannose-binding lectin (MBL) genotypes with the outcome of rheumatoid arthritis (RA).

Methods: MBL genotypes and plasma concentrations were retrospectively determined in 140 RA patients who were selected from a major cohort followed up prospectively for up to 32 years.

Results: MBL-insufficient patients (those with 2 defective structural MBL alleles or with 1 defective allele combined with a low-expression variant of the normal allele) had unfavorable outcomes.

Inflammatory patterns in rheumatoid arthritis estimated by the number of swollen and tender joints, the erythrocyte sedimentation rate, and hemoglobin: longterm course and association to radiographic progression.

Objective: To investigate the association of individual plots and time-integrated values of repeated measures of inflammatory variables with radiographic outcome in rheumatoid arthritis (RA).

Methods: In 112 patients with RA, examinations of joint swelling and joint tenderness of 68 joints, and measurement of hemoglobin (Hb) and erythrocyte sedimentation rate (ESR) were performed each year for up to 22 years after the first visit. For each of these 4 variables, the patients were divided arbitrarily into 5 characteristic subgroups by means of inspection of individual plots of longitudinal observations of the variables and divided into 5 other subgroups according to 20% percentiles of the cumulative mean values of the variables.

Radiographic progression in rheumatoid arthritis: a long-term prospective study of 109 patients.

Objective: To investigate the long-term radiographic course as a mathematical function of disease duration in individual patients and in a group of patients with rheumatoid arthritis (RA).

Methods: In 109 patients with RA, radiographic examinations of 46 diarthrodial joints were performed at regular intervals of 1-3 years, for up to 30 years after disease onset.

Results: Five main types of progression were identified: 1) a rare type (<1%), with no radiographic progression at all; 2) a type with a slow or moderate onset, but an increasing progression rate (9% exponential growth type and 30% linear type); 3) a type with a moderate-to-fast onset and a stable progression rate (the square-root type; 11%); 4) a type with a fast onset, but a later decreasing progression rate (the first-order kinetics type, 30%); and 5) a type characterized by slow onset, then acceleration and later deceleration (the sigmoid type, 20%).

Mannan binding lectin in rheumatoid arthritis. A longitudinal study.

Objective: Low serum levels of mannan binding lectin (MBL) are associated with increased risk of recurrent infections. We determined whether there was an association between serum MBL levels and the course and prognosis of rheumatoid arthritis (RA).

Methods: MBL was analyzed in sera from 99 patients with RA who were included in a longterm prospective study.

On the course of seropositive rheumatoid arthritis during and after long-term gold therapy.

The purpose of the present study was to get an estimate on the course of seropositive RA in 93 patients, who had been in chrysotherapy for at least 3 years up to 13 years. The study was observational with assessment once a year by the same physician. After one year the median number of swollen joints had decreased from six to two (p = 0.

The course of erythropoietin in patients with rheumatoid arthritis with normal and low blood-hemoglobin. A longitudinal study.

A consistent elevated level of erythropoietin was found in eight patients with R.A., who continuously for 10 years had a low hemoglobin (< 8 mmol/l) compared with nine patients with R.

Seropositive rheumatoid arthritis in monozygotic twin sisters carrying HLA-DR4 or DR4 associated with B27.

We have followed 3 pairs of monozygotic twin sisters with seropositive rheumatoid arthritis (RA) since 1966, 1971 and 1975. RA developed in the probands at the age of 25, 39 and 21 years and in the cotwins 37, 8 and 19 years later, respectively. Two pairs, Nos 1 and 3, were discordant when first seen.

Selenium in rheumatoid arthritis. A historical prospective approach.

Time-dependent changes in serum selenium concentrations were studied in 28 patients with rheumatoid arthritis and the concentrations were related to disease activity. The mean length of the observation period was 7.3 years and a mean of 6 analyses was performed for each patient.

Lack of antikeratin antibodies in patients with palmoplantar pustular eruptions and arthropathy.

Assessment of antikeratin antibodies (AKAs), using an indirect immunofluorescence technique with rat esophageal keratin as antigen, was performed in 14 patients with arthropathy and palmoplantar pustular eruptions, six of whom also had psoriasis vulgaris. Twelve patients had seronegative spondyloarthropathy. They were all AKA negative.

Autometallographic demonstration of gold in rheumatoid synovial tissue.

A new autometallographic method for the detection of gold was applied to synovial tissue obtained by synovectomy from 30 patients with chronic arthritis. Granules staining for gold were visualized in biopsies from 26 patients previously or currently treated with gold, but not in biopsies from untreated patients. Location of macrophages was confirmed, and in half the biopsies fibroblast-like cells were also stained.

Neutrophil chemotaxis in patients with pustulotic arthro-osteitis.

The chemotactic response of peripheral blood polymorphonuclear leukocytes (PMNs) to N-formyl-methionyl-leucyl-phenylalanine was determined in four groups of persons (I) 19 patients with pustulosis palmoplantaris (PPP) and skeletal disorder (pustulotic arthro-osteitis); (II) 15 patients with a similar anterior chest wall involvement, but no PPP; (III) 9 patients with PPP, but without skeletal involvement, and (IV) 69 healthy adults (controls). The chemotactic activity of PMNs was found to be significantly increased in groups I-III, and patients with a similar osteoarthropathy, but no PPP compared with the controls. Furthermore the patients with pustulotic arthrosteitis had enhanced chemotactic activity compared with the patients with PPP only.

Sternocostal joint swelling--clinical Tietze's syndrome. Report of sixteen cases and review of the literature.

Sixteen patients with painful tender swelling in the region of the sternocostal joint (SCJ) are reported and analysed against the background of a review of 106 previously reported patients with Tietze's syndrome. Seven patients fulfilled all the diagnostic criteria for Tietze's syndrome. The radiographic findings and/or the history of these patients suggested that local strain generated by respiration is a pathogenetic factor.

Waaler Rose titres may decrease but increase again during chrysotherapy.

In 62 patients with seropositive rheumatoid arthritis, treated with gold compounds, the relationship between serological and clinical response was analysed, based on data on the rheumatoid factor (RF) titre, ESR, number of swollen joints and joint tenderness, through 3 years. Three groups were distinguished. The RF titre became normal in 19, remained elevated in 22, became normal and subsequently again elevated in 21.

Skeletal disease, arthro-osteitis, in adult patients with pustulosis palmoplantaris.

A follow-up study of 13 patients with pustulosis palmoplantaris (PPP) and skeletal disease is reported. A prolonged and fluctuating course occurred in all patients. Nine patients had anterior chest wall involvement with erosions or ankylosis of the sternoclavicular, first sternocostal and/or manubriosternal joint together with sclerosis and often hyperostosis of adjacent bones, ossification/calcification of the first costal cartilage, and in 7 patients of the costoclavicular ligament.

Glutathione peroxidase activity in patients with rheumatoid arthritis and in normal subjects: effects of long-term selenium supplementation.

The effects of dietary supplementation with selenium were studied in 6 patients with severe, active rheumatoid arthritis (RA) and in 6 healthy control subjects. Initial concentrations of Se in red blood cells and in serum, and the activity of the Se-dependent enzyme glutathione peroxidase (GSH-Px) in red blood cells, serum, and granulocytes were significantly lower in RA patients compared with controls. During Se supplementation, however, the differences in Se levels and in GSH-Px activity between the 2 groups disappeared, except that, in RA patients, GSH-Px activity in granulocytes increased but remained significantly lower than in controls.

Radiographic visualisation of seropositive rheumatoid arthritis in carriers of HLA-B27.

A group of 11 B27-positive, seropositive patients with rheumatoid arthritis was compared with 11 matched B27-negative seropositive patients. The radiographs of all limb joints, the sacroiliac joints, and the cervical spine were read blindly. Ten patients in each group were radiographed 2-6 times during observation periods of 3-13 years; one patient in each group was only examined once.

Radiographic findings in patients with clinical Tietze syndrome.

Thirteen patients with similar painful tender swelling in the region of the sternocostal joint (SCJ) are reported. X-ray tomography revealed changes which might explain the swelling in 11 patients. Three patients had anatomical variants of the sternum.

Monarthritis of the manubriosternal joint. A follow-up study.

Six women and three males, who initially had seronegative monarticular arthritis of the manubriosternal joint (MSJ) were followed for a mean period of 7.1 years (range 0.8-17 years).

Sclerosis and hyperostosis of the manubrium sterni.

Seven females and one male with almost identical sclerotic and hyperostotic changes of the manubrium sterni are reported. The clinical course was prolonged and characterized by intermittent periods of exacerbation followed by improvement. Malignancies, bacterial inflammatory processes, and Paget disease, which were first suspected, could be excluded.

Pericarditis in rheumatoid arthritis. A clinical and radiological study.

The annual incidence of clinically manifest pericarditis was found to be 0.34% in 157 females and 0.44% in 77 males with rheumatoid arthritis, observed for a mean time of 5.

Sclerotic changes of the sternal end of the clavicle.

Five adult females with swelling, tenderness and similar sclerotic changes of the sternal end of the clavicle are presented. They were recognised during a 10-year period, suggesting that the condition is rare and may be misdiagnosed. In three patients strain of the sternoclavicular joint seemed to be an aetiological factor.