Rheumatologic complications of vitamin A and retinoids.

Retinoids are synthetic derivatives of vitamin A. They are administered primarily for dermatological conditions, such as psoriasis, acne, and disorders of keratinization. Toxicity has proven a significant problem with long-term administration of the retinoids.

Drug-related myopathies.

Myopathies produced by drugs are of vital concern and often confused with other more frequently diagnosed causes, such as the inflammatory myopathies of polymyositis/dermatomyositis and myositis secondary to toxic agents, metabolic and endocrine abnormalities, genetic predisposition, malignancies, and infections, particularly viruses. The drug-induced causes of myopathy warrant special emphasis because they are often overlooked, resulting in misdiagnosis and improper care.

Heart disease in systemic sclerosis.

Primary cardiovascular manifestations of SSc include pericardial disease, myocardial disease, conduction abnormalities, and cardiac arrhythmias. Significant cardiac abnormalities are present in more than half of SSc patients at autopsy. As the frequency of subclinical cardiac involvement is now appreciated and noninvasive cardiac diagnostic modalities continue to improve, the ability to detect early asymptomatic involvement in SSc has improved.

19S IgM rheumatoid factor-7S IgG rheumatoid factor immune complexes isolated in patients with rheumatoid arthritis.

Sera of 12 patients with rheumatoid arthritis (RA) who had positive IgM-rheumatoid factor (RF) tests were separated by use of immunoabsorbent columns (goat anti-human C3 [alpha HC3] and rabbit anti-human C1q [alpha HC1q]) and polyethylene glycol (PEG) precipitation-protein A affinity chromatography to isolate their immune complexes (IC). The isolated fractions were assayed for 19S IgM RF and 7S IgG RF by enzyme-linked immunosorbent assay (ELISA). The sera were further analyzed by preparative isoelectric focusing (IEF).

International experience with diclofenac in rheumatoid arthritis.

Rheumatoid arthritis, although not the most common of the rheumatic diseases, is potentially the most disabling. For this reason, it is considered the principal disorder for determining the therapeutic effectiveness of any new antirheumatic agent. Diclofenac sodium, a nonsteroidal anti-inflammatory drug, has been studied extensively in international clinical trials since the early 1970s.

Ulcerative colitis with arthritis and vasculitis.

A child with ulcerative colitis is described in whom many unusual complications of the disease occurred. Arthritis was present and preceded the onset of the colitis. The patient also developed vasculitis, hepatitis, pleuritis, pericarditis, cryoglobulinemia, and disseminated intra-vascular coagulopathy.

Hidden 19S IgM rheumatoid factor in adults with juvenile rheumatoid arthritis onset.

Forty-eight adult patients with juvenile rheumatoid arthritis (JRA) (onset before age 16 years) were evaluated at the age of 17 years or more for the presence of hidden 19S IgM rheumatoid factors (RF), i.e., 19S IgM RF that can be detected by the complement-dependent haemolytic assay in the IgM-containing fraction after separation of the serum by acid gel filtration.

Hidden and classical 19S IgM rheumatoid factor in a juvenile rheumatoid arthritis patient.

Hidden 19S IgM rheumatoid factors (RF), i.e., 19S IgM RF which can be detected in the IgM containing fraction after acid gel filtration of serum, are found in 59-68% of patients with juvenile rheumatoid arthritis (JRA).

Use of the HEp-2 cell substrate in the detection of antinuclear antibodies in juvenile rheumatoid arthritis.

Presence and titer of antinuclear antibodies (ANA) were determined in 217 juvenile rheumatoid arthritis (JRA) patients, by indirect immunofluorescence using HEp-2 cells as substrate. Positive ANA titers (greater than or equal to 1:40) were present in 131 (60%) of the JRA patients. All 3 JRA onset types demonstrated increased percentages of ANA positivity compared with healthy children.

Precipitation of 19S IgM rheumatoid factor-IgG circulating immune complexes in patients with juvenile arthritis by polyethylene glycol and separation by immobilized protein A.

Immune complexes (IC) in sera and synovial fluid (SF) from patients with juvenile (rheumatoid) arthritis (JA) were isolated by making use of polyethylene glycol (PEG) to precipitate IC and then using staphylococcal protein A to separate the IC. The isolated IC were compared to IC in sera analysed by sucrose density gradients and measured by the C1q solid phase assay (ClqSPA). Isolated IC from sera of 10 of 16 JA patients demonstrated significant 19S IgM rheumatoid factor (RF) titres in their acid elutes utilizing the haemolytic assay.

Autoantibodies in juvenile arthritis.

Sera from 104 children with JA with different onset-types of disease were evaluated for 19S IgM RF by the LFT , hidden 19S IgM RF by the hemolytic assay, ANA by HEp-2 cell substrate, and levels of IC by the C1qSPA . Their relationship to active disease was determined. Classical 19S IgM RF were detected by the LFT in only seven patients.

HLA antigens in black and white patients with juvenile arthritis: associations with rheumatoid factor, hidden rheumatoid factor, antinuclear antibodies, and immune complex levels.

HLA typing for -A, -B, -C, -DR, and -MT antigens and simultaneous studies for the presence of 19S IgM rheumatoid factor (RF), hidden 19S IgM RF, antinuclear antibodies (ANA), and immune complexes (IC) were performed on 24 black and 80 white patients with juvenile arthritis (JA) of different onset types. HLA-DRW6 (p less than 0.05) was associated with pauciarticular onset and early onset pauciarticular black patients.

Synovial fluid lactic acid in septic and nonseptic arthritis.

We determined lactic acid levels by the lactic dehydrogenase method in synovial fluid of 41 patients with various rheumatic diseases, to test the concept that significantly elevated values were diagnostic of septic arthritis. Nine patients had septic arthritis, 15 rheumatoid arthritis (RA), and the remainder miscellaneous conditions. In another 9 patients with different rheumatic diseases, including 1 with septic arthritis, synovial fluid lactic acid was determined by both the lactic dehydrogenase and gas-liquid chromatography methods.

The tight-skin mouse: physical and biochemical properties of the skin.

The tight-skin (TSK) mouse has unusual structural skin properties. These include increased thickness of the dermis, increased tensile strength, and increased adherence to subcutaneous tissues. We have investigated several physical and biochemical characteristics of skin from the TSK mouse and compared them to the normal mouse.

Glycosaminoglycan content in skin of the tight-skin mouse.

The tight-skin (TSK) mouse has cutaneous changes similar to those found in the skin of patients with progressive systemic sclerosis (PSS). Previous studies have shown that both have common abnormalities in skin thickness, dry weight, and hydroxyproline content. In this study, glycosaminoglycans (GAGs), major components of the ground substance, were quantitated in skins from TSK mice and compared with age-matched normal mice.

Separation and characterization of immune complexes containing 19S IgM rheumatoid factor-IgG in juvenile arthritis.

Sera from 10 patients with juvenile arthritis (JA), 2 seropositive and 8 with hidden rheumatoid factor (RF), were subjected to affinity chromatography on a rabbit anti-human IgM column. Material retained by the column was eluted sequentially by 1M NH3 and 0.1M glycine-HCl buffer, pH 3.

Longitudinal study of the presence of hidden 19S IgM rheumatoid factor in juvenile rheumatoid arthritis.

Complement-fixing hidden 19S IgM rheumatoid factor (RF), i.e., 19S IgM RF that can be detected in the IgM-containing fraction by the hemolytic assay after separation of the serum by acid gel filtration, was evaluated serially (3 or more evaluations) over a 4-year period in 26 children with juvenile rheumatoid arthritis (JRA) correlating its presence with disease activity.

Immune complexes in juvenile rheumatoid arthritis: a comparison of four methods.

Fifty-three children with juvenile rheumatoid arthritis (JRA) were tested for immune complexes (IC) by 4 different methods, Clq solid-phase assay (ClqSPA), 2% polyethylene glycol precipitation assay (PEGPA), Raji cell assay (RCA), and the conglutinin assay (KA). Seventy-nine % of JRA patients demonstrated elevated IC levels by at least 1 method. Fifty-eight % of the JRA patients have elevated levels of IC by ClqSPA, 50% by the RCA, 37% by the KA, but 0% by the PEGPA.