An understanding of the cytokine cascade in a rheumatoid joint has led to the development of new therapeutic options, including drugs targeting tumor necrosis factor-alpha (TNF-alpha). The safety profile of these agents in patients with hepatitis-induced liver disease, however, remains a concern because of risks associated with immune suppression. To examine the effect of three different TNF-alpha antagonists, infliximab, etanercept, and adalimumab, on serum transaminases and hepatitis viral load in patients with rheumatoid arthritis (RA) and concurrent hepatitis B (HBV) or hepatitis C (HCV).
View Article and Find Full Text PDFRheumatoid arthritis (RA) and multiple sclerosis (MS) share similar pathophysiologic processes but coexistence of both diseases in the same patient has rarely been described. We describe the case of a 32 year old woman with rheumatoid arthritis treated with 12.5 mg of methotrexate once a week and 1 mg folic acid who developed paresthesias of her upper and lower extremities.
View Article and Find Full Text PDFTumor necrosis factor (TNF)-alpha antagonists successfully modulate the pathogenesis of rheumatoid arthritis (RA). However, little is known about the effect of TNF-alpha blockade on the histology of chronic viral hepatitis. We describe the cases of two patients with RA, one with concurrent chronic hepatitis B virus and the other with hepatitis C virus infection who, as part of their evaluation, underwent liver biopsies while undergoing treatment with a TNF-alpha antagonist.
View Article and Find Full Text PDFLimited information exists on treatment of rheumatoid arthritis in a patient with coexisting human immunodeficiency virus (HIV) infection. We report a case of a patient with rheumatoid arthritis who then became HIV positive. His HIV viral load was controlled with antiretroviral therapy, but he continued to have active rheumatoid arthritis despite therapy with hydroxychloroquine, sulfasalazine, and corticosteroids.
View Article and Find Full Text PDFRosai-Dorfman disease (RDD), also known as sinus histocytosis with massive lymphadenopathy, is a clinically benign, frequently chronic, painless lymphadenopathy. It can also involve extranodal sites. We describe a 37-year-old man with a recent diagnosis of systemic lupus erythematosus and antiphospholipid antibody syndrome who had lacrimal gland and orbital involvement and nodal and extranodal sites with RDD.
View Article and Find Full Text PDFActinobacillus ureae, formerly known as Pasteurella ureae, is a rare human pathogen. We describe a case of septic arthritis and abscess formation caused by this unusual organism in a patient with rheumatoid arthritis, who was being treated with tumor necrosis factor-alpha inhibitors.
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