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Journal of Feline Medicine and Surgery Oct 2022Cats with non-erosive immune-mediated polyarthritis (IMPA) were identified from seven referral hospitals between 2009 and 2020 for a multicentre retrospective case...
CASE SERIES SUMMARY
Cats with non-erosive immune-mediated polyarthritis (IMPA) were identified from seven referral hospitals between 2009 and 2020 for a multicentre retrospective case series. Data were obtained from hospital records and referring veterinarians were contacted for follow-up. Twenty cases were identified: 12 castrated males (60%), one entire male (5%) and seven spayed females (35%). Common clinical signs included lameness (n = 20/20) and pyrexia (n = 10/18). Three cats presented with and two cats developed ligament laxity during treatment. Thirteen cats (65%) were diagnosed with non-associative IMPA and seven (35%) with associative IMPA. Comorbidities identified included chronic enteropathy (n = x/7), feline immunodeficiency virus (n = x/7) feline herpesvirus (n = x/7), bronchopneumonia (n = x/7) and discospondylitis (n = x/7). Sampling of the tarsal joints most frequently identified an increased proportion of neutrophils, consistent with IMPA. Eighteen cats (90%) received immunosuppressants. Eleven cats were started on prednisolone; eight had a poor response resulting in the addition of a second agent, euthanasia or acceptance of the persisting signs. One cat received ciclosporin and required an alternative second agent owing to adverse effects. Five cats were started on prednisolone and ciclosporin; three had a poor response and required an alternative second agent. One cat received prednisolone and chlorambucil and had a good response. Two cats (10%) received meloxicam and had a good response, although the clinical signs recurred when medication was tapered. A good outcome was achieved in 14/20 cats (70%) with IMPA. In the cats with a poor outcome 4/6 were euthanased and 2/6 had chronic lameness.
RELEVANCE AND NOVEL INFORMATION
Prognosis for feline IMPA can be good. Multimodal immunosuppression was often required. IMPA should be considered in lame cats, with or without pyrexia, when there is no evidence of trauma or infection. The tarsal joints should be included in the multiple joints chosen for sampling. Ligament laxity can occur in non-erosive feline IMPA.
Topics: Animals; Arthritis; Cat Diseases; Cats; Chlorambucil; Cyclosporine; Female; Fever; Immunosuppressive Agents; Joint Diseases; Lameness, Animal; Male; Meloxicam; Organophosphorus Compounds; Prednisolone; Retrospective Studies
PubMed: 35762267
DOI: 10.1177/1098612X221107783 -
Annals of the Rheumatic Diseases Jan 1993The menstrual cycle is characterised by variations in the absolute and relative concentrations of the hormones of the hypothalamic pituitary ovarian axis, which in turn...
The menstrual cycle is characterised by variations in the absolute and relative concentrations of the hormones of the hypothalamic pituitary ovarian axis, which in turn affect cell function and cytokine and heat shock protein production. Menstruation involves the shedding of the secretory endometrium, which is part of the mucosal associated lymphoid tissue and hence is rich in immunologically competent cells such as CD8 T cells and macrophages. The case is reported here of a patient presenting with a recurrent but transient symmetrical inflammatory polyarthritis which only occurred at menstruation with no residual damage. The disease was suppressed by danazol. Endometrial degradation products are suggested as the trigger of this 'menstrual arthritis'.
Topics: Adult; Arthritis; Danazol; Female; Humans; Menstruation; Recurrence
PubMed: 8427519
DOI: 10.1136/ard.52.1.65 -
Reumatologia Clinica 2016Paraneoplastic syndromes can be presented in multiple ways, which include endocrinological, hematologic, rheumatologic and nephrologic manifestations. While most of the... (Review)
Review
Paraneoplastic syndromes can be presented in multiple ways, which include endocrinological, hematologic, rheumatologic and nephrologic manifestations. While most of the publications described solid tumors as responsible for these manifestations, hematologic neoplasms are important cause to consider as part of the differential diagnosis. We report the case of a 46 year-old man with seronegative symmetric polyarthritis of large and small joints associated with membranoproliferative glomerulonephritis with deposits of immune complexes and acute impairment of renal function, as part of a paraneoplastic syndrome secondary of a classical Hodgkin lymphoma with bone marrow invasion, which reversed completely with chemotherapy treatment.
Topics: Arthritis; Diagnosis, Differential; Glomerulonephritis, Membranoproliferative; Hodgkin Disease; Humans; Male; Middle Aged; Paraneoplastic Syndromes
PubMed: 26654571
DOI: 10.1016/j.reuma.2015.10.002 -
BMJ Case Reports Nov 2019
Topics: Aged; Arthritis; Contracture; Fasciitis; Hand; Humans; Male; Paraneoplastic Syndromes
PubMed: 31685539
DOI: 10.1136/bcr-2019-232954 -
Italian Journal of Pediatrics Sep 2013We report on pediatric patient with Nijmegen breakage syndrome (NBS), a rare DNA repair disorder characterized by microcephaly, immunodeficiency and predisposition to... (Review)
Review
We report on pediatric patient with Nijmegen breakage syndrome (NBS), a rare DNA repair disorder characterized by microcephaly, immunodeficiency and predisposition to malignant lymphomas, who developed juvenile idiopathic arthritis (JIA)-like polyarthritis. In patients with primary immunodeficiencies (PID), septic arthritis due to pyogenic bacteria or mycoplasmal arthritis are the most common osteoarticular manifestations. In certain PID, chronic, non-infectious arthritis resembling rheumatoid arthritis may occur. In our patient microbiologic cultures of synovial fluid including Mycoplasma spp. were negative. At first, because of suspected mycoplasmal arthritis we used macrolides and doxycycline combined with hydroxychloroquine but without therapeutic response. However, the use of rituximab led to remission of her polyarthritis lasting for 9 months. Autoimmune features were rarely reported in NBS. An occurrence of JIA-like, chronic polyarthritis in NBS, a DNA repair disorder characterized by decreased tolerance of immunosuppressive drugs such as methotrexate and a high natural risk for lymphomas, makes therapeutic approach even more complex.
Topics: Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Monoclonal, Murine-Derived; Antirheumatic Agents; Arthritis; Child; Chronic Disease; Drug Therapy, Combination; Female; Follow-Up Studies; Humans; Nijmegen Breakage Syndrome; Radiography; Rare Diseases; Risk Assessment; Rituximab; Severity of Illness Index; Treatment Outcome
PubMed: 24044622
DOI: 10.1186/1824-7288-39-59 -
Annals of the Rheumatic Diseases Jul 1987Angioimmunoblastic lymphadenopathy (AILD) is a lymphoproliferative disorder with well established clinical and histological features, one of the clinical manifestations...
Angioimmunoblastic lymphadenopathy (AILD) is a lymphoproliferative disorder with well established clinical and histological features, one of the clinical manifestations being a peripheral polyarthritis. A case of AILD with a symmetrical non-erosive peripheral polyarthritis is described, including the findings in the synovial fluid and histology of the synovium. There was a marked reduction in the number of peripheral blood T lymphocytes bearing the CDT8 phenotype in both the peripheral blood and synovial fluid. The arthritis was difficult to control, requiring large doses of corticosteroids, which produced significant side effects. Levamisole 150 mg, one day each week, was effective in controlling the arthritis and returning the numbers of CDT8 lymphocytes to normal. The aetiology of AILD is unknown, though a defect in T cell regulation, in particular T cell suppression, with a secondary B cell proliferation has been postulated. The demonstration of reduced numbers of lymphocytes bearing the CDT8 phenotype in this patient supports that theory.
Topics: Arthritis; Female; Humans; Immunoblastic Lymphadenopathy; Leukocyte Count; Levamisole; Lymphocytes; Middle Aged
PubMed: 3662644
DOI: 10.1136/ard.46.7.555 -
RMD Open Jan 2022To critically appraise study designs evaluating spondyloarthritis (SpA) phenotypes in patients with inflammatory bowel disease (IBD). A systematic literature review of... (Review)
Review
To critically appraise study designs evaluating spondyloarthritis (SpA) phenotypes in patients with inflammatory bowel disease (IBD). A systematic literature review of PubMed, Ovid, Scopus, Cinahl, Medline, Web of Science, and Cochrane databases was performed. Articles published from January 2000 - March 2020 were included if they evaluated the prevalence/incidence of musculoskeletal disease in cohorts of IBD patients. Most of the 69 included studies were clinic based (54/69, 78%), single center (47/69, 68%) and cross-sectional (60/69, 87%). The median prevalence of axial and peripheral SpA in IBD was 5% (range 1 - 46%) and 16% (range 1 - 43%), respectively. In 38 studies that evaluated axial disease in prospectively enrolled patients, inflammatory back pain was analyzed in 53%. SpA classification criteria were used in 68% and imaging was performed in 76%. In 35 studies that evaluated peripheral disease in prospectively enrolled patients, SpA classification criteria were used in 46%. A physical exam was performed in 74%, and it was performed by a rheumatologist in 54% of studies with a physical exam. Sub-phenotypes of peripheral SpA (mono- or oligo-arthritis, polyarthritis, enthesitis, dactylitis) were variably reported. Seventy-four percent of studies did not mention whether osteoarthritis and fibromyalgia had been assessed or excluded. The spectrum of SpA phenotypes in IBD patients remains incompletely characterized. Future studies should focus on standardizing the variables collected in IBD-SpA cohorts and defining musculoskeletal phenotypes in IBD-SpA in order to better characterize this disease entity and advance the field for clinical and research purposes.
Topics: Cross-Sectional Studies; Humans; Inflammatory Bowel Diseases; Rheumatologists; Spondylarthritis; Spondylitis, Ankylosing
PubMed: 35046098
DOI: 10.1136/rmdopen-2021-001777 -
Arthritis Research & Therapy Jul 2019To compare the long-term disease state, in terms of activity and damage, of children with juvenile idiopathic arthritis (JIA) who had their disease onset in methotrexate...
OBJECTIVE
To compare the long-term disease state, in terms of activity and damage, of children with juvenile idiopathic arthritis (JIA) who had their disease onset in methotrexate (MTX) or biologic eras.
METHODS
Patients were included in MTX or biologic era cohort depending on whether their disease presentation occurred before or after January 2000. All patients had disease duration ≥ 5 years and underwent a prospective cross-sectional assessment, which included measurement of disease activity and damage. Inactive disease (ID) and low disease activity (LDA) states were defined according to Wallace, JADAS10, and cJADAS10 criteria. Articular and extraarticular damage was assessed with the Juvenile Arthritis Damage Index (JADI).
RESULTS
MTX and biologic era cohorts included 239 and 269 patients, respectively. Patients were divided in the "functional phenotypes" of oligoarthritis and polyarthritis. At cross-sectional visit, patients in the biologic era cohort with either oligoarthritis or polyarthritis had consistently higher frequencies of ID and LDA by all criteria. The measurement of disease damage at cross-sectional visit revealed that the frequency of impairment of > 1 JADI-Articular items was higher in MTX than in biologic era cohort (17.6% versus 11% in oligoarthritis and 52.6% versus 21.8% in polyarthritis). Likewise, frequency of involvement of > 1 JADI-Extraarticular items was higher in the MTX than in the biologic era cohort (26.5% versus 16.2% in oligoarthritis and 31.4% versus 13.5% in polyarthritis).
CONCLUSION
Our study provides evidence of the remarkable outcome improvement obtained with the recent therapeutic advance in JIA.
Topics: Antirheumatic Agents; Arthritis, Juvenile; Biological Products; Cartilage, Articular; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Joints; Male; Methotrexate; Outcome Assessment, Health Care; Prospective Studies; Severity of Illness Index
PubMed: 31287015
DOI: 10.1186/s13075-019-1950-7 -
Annals of the Rheumatic Diseases Mar 1960
Topics: Arthritis; Humans; Rheumatic Diseases
PubMed: 14414718
DOI: 10.1136/ard.19.1.20 -
The Journal of the Royal College of... Dec 1979
Topics: Arbovirus Infections; Arthritis, Infectious; Disease Outbreaks; Fiji; Humans; Ross River virus
PubMed: 536985
DOI: No ID Found