Rheumatoid Meningitis a Rare Extra-Articular Manifestation of Rheumatoid Arthritis: Report of 6 Cases and Literature Review.

Objectives: Central neurological manifestations of rheumatoid arthritis (RA) like rheumatoid meningitis (RM) are rare, little known and have a high rate of morbi-mortality.

Methods: We described six cases of RM that were directly related to RA activity after exhaustive assessment.

Results: They were mainly women, aged of 50 to 69.

[Rheumatoid arthritis : cardiovascular and pulmonary manifestations].

Rheumatoid arthritis (RA) often affects extra-articular structures. Treatments used for arthritis are often also effective on the extra-articular manifestations, but exceptions are numerous, particularly for cardiovascular and pulmonary problems. Cardiovascular disorders mainly include complications related to atherosclerosis : they are probably the main contributor to the increased mortality observed in RA, must be specifically taken into account and largely determine the choice of treatments used to treat RA.

[Risk factors and prophylaxis of Pneumocystis jirovecii pneumonia in HIV-negative patients].

Pneumocystis jirovecii (formely carinii) pneumonia (PcP) affects immunosuppressed patients. Cotrimoxazole prophylaxis has proven to be effective and its indications in HIV patients are well established. In non-HIV patients, the prognosis is poorer and diagnostic tests are of lower sensitivity.

A 64-Year-Old Woman with Chest Pain, Limb Weakness, and Endometrial Cancer.

Necrotizing autoimmune myopathy (NAM) is a rare subgroup of idiopathic inflammatory myopathies (IIM). This pathology usually affects proximal limb muscles and in some cases the myocardium. Patients usually display proximal limb weakness.

Low pre-treatment B-cell counts are not a risk factor of infection in patients treated with rituximab for autoimmune diseases: An observational study.

Objectives: Rituximab (RTX) is increasingly used in patients with refractory rheumatoid arthritis (RA) and other severe autoimmune diseases (AID). In practice, many clinicians are reluctant to prescribe RTX in patients with low B-cell counts because of the presumed risk of infection. The aim of this study was therefore to investigate whether B-cell counts before treatment or retreatment with RTX predict the occurrence of infections.

Methotrexate in chronic-recurrent calcium pyrophosphate deposition disease: no significant effect in a randomized crossover trial.

Introduction: Calcium pyrophosphate deposition (CPPD) may cause severe arthropathy, major joint destruction and treatment options are limited. The aim of this study was to test the therapeutic efficacy of methotrexate (MTX) in chronic or recurrent CPPD arthropathy.

Methods: Patients with CPPD arthropathy were randomized to receive either weekly subcutaneous injections of 15 mg/week of MTX or placebo (PBO) for three months, in a double-blind, crossover randomized controlled trial.

[Diagnostic imaging for atraumatic shoulder pain].

Shoulder pain is a common cause of consultation in primary care medicine. A detailed history and a carefully carried out physical exam allow to orientate the diagnosis towards an intrinsic or extrinsic cause and to the differential diagnosis. Rotator cuff injury is the most frequent affection.

[Joint manifestations in connective tissue diseases].

Joint manifestations are common and often constitute the first symptoms or signs of a connective tissue disease, which should be carefully looked for, according to the clinic, in particular with ultrasound and the research of autoantibodies. Articular manifestations are often severe and must be treated accordingly. In lupus, one can distinguish non-deforming non-erosive arthropathy, Jaccoud's arthropathy (deforming non-erosive) and erosive arthropathy (rhupus).

Classification, diagnosis, and management of idiopathic inflammatory myopathies.

The detection and characterization of a large array of autoantibodies, including at least 8 different antisynthetase, anti-SRP, -200/100 (HMGCR), -Mi-2, -CADM-140 (MDA5), -SAE, -p155, -MJ (NXP-2), and -PMS1, frequently associated with distinct and well-defined clinicopathological features, allowed for significant improvement in the definition and diagnosis of idiopathic inflammatory myopathies (IIM). Classification remains difficult, with lingering divergence between the different specialties involved in IIM care, but several categories clearly stand out, including dermatomyositis (DM), overlap myositis (OM), polymyositis, necrotizing myositis, and sporadic inclusion body myositis (s-IBM). Biopsy and histological analysis remain crucial, particularly in the absence of autoantibodies, to accurately specify the diagnosis and rule out mimics such as muscular dystrophies and metabolic myopathies.

Rheumatoid meningitis occurring during adalimumab and methotrexate treatment.

Rheumatoid arthritis is well known for multiple extra-articular manifestations. Here, we present a case of chronic rheumatoid meningitis occurring during treatment with methotrexate and the tumour necrosis factor (TNF) alpha antibody adalimumab. Nine and seven months, respectively, into the course of these two treatments, a 59-year-old Caucasian lady with mild, early, seropositive rheumatoid arthritis developed headaches and psychomotor retardation followed by seizures.

Impact of synthetic and biologic disease-modifying antirheumatic drugs on antibody responses to the AS03-adjuvanted pandemic influenza vaccine: a prospective, open-label, parallel-cohort, single-center study.

Objective: To identify the determinants of antibody responses to adjuvanted split influenza A (H1N1) vaccines in patients with inflammatory rheumatic diseases.

Methods: One hundred seventy-three patients (82 with rheumatoid arthritis, 45 with spondylarthritis, and 46 with other inflammatory rheumatic diseases) and 138 control subjects were enrolled in this prospective single-center study. Controls received 1 dose of adjuvanted influenza A/09/H1N1 vaccine, and patients received 2 doses of the vaccine.

EULAR recommendations for calcium pyrophosphate deposition. Part II: management.

Objectives: To develop evidence-based recommendations for management of calcium pyrophosphate deposition (CPPD).

Methods: A multidisciplinary guideline development group of 15 experts, representing 10 European countries, generated key propositions for management of CPPD using a Delphi consensus approach. For each recommendation research evidence was searched systematically.

European League Against Rheumatism recommendations for calcium pyrophosphate deposition. Part I: terminology and diagnosis.

Objectives: To agree terminology and to develop recommendations for the diagnosis of calcium pyrophosphate deposition (CPPD).

Methods: The European League Against Rheumatism (EULAR) CPPD Task Force, comprising 15 experts from 10 countries, agreed the terms and recommendations for diagnosis of CPPD using a Delphi consensus approach. Evidence was systematically reviewed and presented in terms of sensitivity, specificity and positive likelihood ratio (LR) to support diagnosis; ORs were used for association.

Anti-apolipoprotein A-1 IgG predicts major cardiovascular events in patients with rheumatoid arthritis.

Objective: To determine whether anti-apolipoprotein A-1 (anti-Apo A-1) IgG are associated with major cardiovascular events in patients with rheumatoid arthritis (RA).

Methods: We determined anti-Apo A-1 IgG levels and the concentrations of cytokines, oxidized low-density lipoprotein (LDL), and matrix metalloproteinase 1 (MMP-1) MMP-2, MMP-3, and MMP-9 in sera from 133 patients with RA who did not have cardiovascular disease at baseline, all of whom were longitudinally followed up over a median period of 9 years. A major cardiovascular event was defined as a fatal or nonfatal stroke or acute coronary syndrome.

[Chondrocalcinosis and calcium pyrophosphate (CPP) crystal deposition disease in 2010].

Chondrocalcinosis may be asymptomatic or take three classical forms (acute recurrent inflammatory, chronic inflammatory, with osteoarthritis). Apart form that, CPP crystal arthropathies can mimic several rheumatic diseases, including polymyalgia, septic arthritis and spondylodiscitis. Several conditions can predispose to chondrocalcinosis, including hemochromatosis, hyperparathyroidism, familial hypocalciuric hypercalcemia, hypomagnesemia and treatment with tacrolimus or diuretics.

International position paper on febuxostat.

This position paper aims to clarify the presumed place of febuxostat in the management of gout patients. Since this novel xanthine oxidase inhibitor is now available, an international group of gout experts decided to formulate an international consensus statement. This statement presents the place for this new xanthine oxidase inhibitor in the treatment of gout which may contribute to optimize treatment of gout patients in Europe and worldwide.

Influence of cytokine inhibitors on concentration and activity of MMP-1 and MMP-3 in disc herniation.

Introduction: Spontaneous resorption of disc herniation (DH) after sciatica is well documented. The matrix metalloproteinases (MMP)-1 and MMP-3 are enzymes potentially involved in this process. Glucocorticoid injections are commonly used for treatment, and other anti-inflammatory molecules like tumor necrosis factor (TNF) inhibitors are under clinical investigation.

Magnetically retainable microparticles for drug delivery to the joint: efficacy studies in an antigen-induced arthritis model in mice.

Introduction: Conventional corticosteroid suspensions for the intra-articular treatment of arthritis suffer from limitations such as crystal formation or rapid clearance from the joint. The purpose of this study was to investigate an innovative alternative consisting of corticosteroid encapsulation into magnetically retainable microparticles.

Methods: Microparticles (1 or 10 microm) containing both superparamagnetic iron oxide nanoparticles (SPIONs) and dexamethasone 21-acetate (DXM) were prepared.

Anakinra is a possible alternative in the treatment and prevention of acute attacks of pseudogout in end-stage renal failure.

We describe the case of a 71-year-old man with recurrent pseudogout attacks affecting multiple joints. He had end-stage renal failure that contra-indicated the use of non-steroidal anti-inflammatory drugs and was resistant to therapy with glucocorticoids. Based on the recent findings that interleukin (IL)-1beta is involved in crystal-induced inflammation, the patient received anakinra, a specific IL-1 inhibitor, in order to treat an acute attack of pseudogout.

Clinical experience with mycophenolate mofetil in systemic autoimmune conditions refractory to common immunosuppressive therapies.

Objectives: Standard therapies against inflammatory rheumatic diseases consist of immunosuppressive drugs with high toxicities and many side effects. Except in the treatment of systemic lupus erythematosus with renal involvement, controlled studies with mycophenolate mofetil (MMF) are lacking in other autoimmune and inflammatory systemic diseases. Here we describe our clinical experience with MMF in several unusual indications.

Elevated levels of tumor necrosis factor-alpha in periradicular fat tissue in patients with radiculopathy from herniated disc.

Study Design: Case-control study.

Objective: To determine whether inflammatory cytokines [tumor necrosis factor (TNF)-alpha, interleukin (IL)-1beta, IL-6 and IL-8] are elevated in tissues intimately surrounding involved nerve roots of patients suffering from radiculopathy form herniated disc (HD).

Summary Of Background Data: Proinflammatory cytokines are postulated to play an important role in radiculopathy from HD.

Treating difficult crystal pyrophosphate dihydrate deposition disease.

Calcium pyrophosphate dihydrate deposition disease is a common and potentially severe metabolic arthropathy. Early disease (in patients View Article and Find Full Text PDF