Persistent normalization of serum levels of uric acid in a gouty patient after administration of cyproterone acetate.

In this article we describe a gouty caucasian male patient who had high levels of serum uric acid since 1970s. Serious adverse reactions to allopurinol discouraged its administration. We prescribed cyproterone acetate (CA) because of severe prostatic hypertrophy, associated with a suspect small cancer.

Aortic involvement in ankylosing spondylitis.

Patients with ankylosing spondylitis (AS) may develop cardiovascular manifestations ranging from asymptomatic forms to life threatening conditions. The most important cardiovascular manifestation of AS is aortitis, which frequently involves the aortic root and the ascending aorta leading to valvular insufficiency. The extension of the subaortic fibrotic process into the interventricular septum may cause conduction abnormalities that represent the second common cardiovascular manifestations occurring in AS patients.

Hepatitis C virus infection in Italian patients with fibromyalgia.

We evaluated the prevalence of hepatitis C virus (HCV) infection in Italian patients suffering from fibromyalgia (FM), in comparison with patients affected by non-HCV related rheumatic degenerative disorders. Consecutive patients with FM and a statistically comparable group of patients suffering from peripheral osteoarthritis (OA) or sciatica due to L4-L5 or L5-S1 herniated disc were tested for HCV infection with a third-generation microparticle enzyme immunoassay (MEIA). In the positive cases, a third-generation recombinant immunoblot assay (RIBA) confirmatory test and serum HCV-RNA test were performed.

Acute myositis in a patient with systemic sclerosis after the administration of darbepoetin alpha.

We first describe the onset of acute myositis in a patient suffering from systemic sclerosis after the administration of darbepoetin alpha for renal failure-related anemia. Therapeutic implications and risks are discussed.

Purpura and serum mixed cryoglobulinemia in psoriatic arthritis.

We here firstly describe the case of a psoriatic arthritis associated with cutaneous purpura and lower limbs weakness. The presence of type III mixed cryoglobulinemia in serum was the only possible detected cause. Discrepancies with the hepatitis C virus-related mixed cryoglobulinemia picture are discussed.

Pharmacological management of undifferentiated spondyloarthropathies.

Among undifferentiated spondyloarthropathies (uSpA) are included incomplete forms or early phases of definite seronegative spondyloarthritides and cases of spondyloarthritides that remain undifferentiated. The treatment of all spondyloarthritides is more conditioned by the disease localisation, number of involved districts and severity of inflammation rather than by the subtype of the spondyloarthritides itself. Specific studies focused on the pharmacological approach to uSpA are scarce.

Severe hypertriglyceridaemia in idiopathic (non-HCV-related) mixed cryoglobulinaemia.

We describe a 28-year-old male patient in whom the development of idiopathic mixed cryoglobulinaemia (MC) with typical clinical manifestations such as polyarthralgia, weakness, purpura, and Raynaud's phenomenon was associated with a remarkable increase in serum triglycerides (TG). Prednisone administration was effective in classical cryoglobulinaemia symptoms and also in dyslipidaemia. Infective, autoimmune, and haematological disorders are often related to cryoglobulinaemia and it has been analysed that some of them also show an increase in TG.

Non-rheumatoid erosive arthritis associated with type I hereditary angioedema.

Hereditary angioedema (HAE) is an autosomal dominant disease that causes recurrent attacks of non-pitting edema of soft tissues, without pruritus. This disorder can also affect internal organs. The cause of HAE consists in quantitative or qualitative defective production of C1 inhibitor (C1-INH).

Hepatitis C virus infection in psoriatic arthritis.

Objective: To evaluate the prevalence of hepatitis C virus (HCV) infection in patients with psoriatic arthritis (PsA), compared with patients affected by non HCV-related rheumatic degenerative disorders.

Methods: One-hundred consecutive subjects with PsA, and a statistically comparable group of 100 consecutive patients with peripheral osteoarthritis (OA) or sciatica due to L4-L5 or L5-S1 herniated disc were tested for HCV infection with a third-generation microparticle enzyme immunoassay (MEIA). Positive cases were submitted to a third-generation recombinant immunoblot assay (RIBA) confirmatory test.

Management of hepatitis C virus-related arthritis.

In recent years, hepatitis C virus-related arthritis (HCVrA) has been recognised as an autonomous rheumatic disorder. Two subsets of the disease have been identified: a polyarthritis involving small joints that resembles rheumatoid arthritis, but is usually milder, and a mono-oligoarthritis that shows an intermittent course and is frequently associated with the presence of cryo-globulins in serum. Few data about HCVrA treatment are reported in the literature.

Juvenile onset psoriatic arthritis in a patient with X-linked agammaglobulinemia (Bruton's disease).

We describe a 47-year-old male patient suffering from X-linked (or Bruton's) agammaglobulinemia with severe psoriatic arthritis (PsA), which started in childhood. PsA has been previously described in T-cell defective disorders, such as HIV infection, but our observation demonstrates that this rheumatic disease can also occur in subjects with B-lymphocyte cell functional impairment. Chronic inflammatory (bacterial?) involvement of the bowel could represent a pathogenetic connection between X-linked agammaglobulinemia and PsA.

Ureaplasma urealyticum as a possible cause of reflex sympathetic dystrophy syndrome.

We describe the cases of two patients with clinical and radiological findings of the reflex sympathetic dystrophy syndrome (RSDS) in whom the history of a previous genito-urinary inflammation and high levels of ESR lead us to suspect a hidden reactive arthritis. However, instrumental examinations showed a characteristic picture of RSDS without evident signs of arthritis. In both patients we decided a treatment with quinolones because of detection of an ureaplasma urealyticum genito-urinary infection.

Ocular and orbital blood flow in cigarette smokers.

Objective: To report the effect of cigarette smoking on the blood flow velocity of the ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery (PCA) in patients who smoke at least 20 cigarettes a day.

Methods: The color duplex scanner was used to measure the systolic and diastolic flow velocity of the OA, CRA, and PCA in 10 smokers and 11 nonsmokers.

Results: Both the systolic and diastolic flow velocity decreased in the OA, CRA, and PCA in smokers compared with nonsmokers.