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Annals of Thoracic and Cardiovascular... 2011This is the first report of adalimumab-associated pulmonary cryptococcosis. A 56-year-old female with rheumatoid arthritis without a history of pulmonary disease was...
This is the first report of adalimumab-associated pulmonary cryptococcosis. A 56-year-old female with rheumatoid arthritis without a history of pulmonary disease was simultaneously administered adalimumab (40 mg/2 wks), methotrexate (4 mg/wk), and isoniazid (200 mg/day). Five months later, chest radiography revealed a small spiculated pulmonary nodule, and the laboratory test results, including levels of tumor markers and plasma β-D-glucan, were within normal ranges. Since the lesion continued to grow, even after discontinuing adalimumab, it was surgically resected. Grocott staining of the tissue sample revealed black-brown fungi, identified as Cryptococcus neoformans in culture. The patient now remains well, without adalimumab therapy.
Topics: Adalimumab; Anti-Infective Agents; Antibodies, Monoclonal, Humanized; Antirheumatic Agents; Arthritis, Rheumatoid; Cryptococcosis; Cryptococcus neoformans; Drug Therapy, Combination; Female; Humans; Isoniazid; Lung Diseases; Methotrexate; Middle Aged; Thoracic Surgery, Video-Assisted; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 21881327
DOI: 10.5761/atcs.cr.10.01561 -
Reumatologia 2015We present a case of 45-year-old female patient with the diagnosis of seropositive rheumatoid arthritis, who was admitted to our rheumatology department with...
We present a case of 45-year-old female patient with the diagnosis of seropositive rheumatoid arthritis, who was admitted to our rheumatology department with exacerbation of the disease. The patient's disease activity score (DAS 28) was 6.9. Physical examination revealed changes in the lung auscultation as a rough breathing sound at the middle and lower lobe of the right lung. Chest X-ray revealed multiple nodular densities in both lungs. Lung biopsy was performed for the diagnosis and revealed necrotizing granulomas with central fibrinoid necrosis surrounded by epithelioid cells. Such a histopathological picture is typical for rheumatoid nodules. Finally the patient was treated with rituximab, with significant improvement.
PubMed: 27407259
DOI: 10.5114/reum.2015.55831 -
Iranian Journal of Otorhinolaryngology May 2020The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and vocally healthy controls.
INTRODUCTION
The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and vocally healthy controls.
MATERIALS AND METHODS
This case-control descriptive study was performed on 113 people, including 50 patients with rheumatoid arthritis and 63 controls. The participants were subjected to videolaryngostroboscopic examinations in order to evaluate fundamental frequency, different structural vocal lesions, patterns of glottal closure, subglottal changes, supraglottis appearance, and movement patterns of the arytenoid cartilage. The obtained results were compared between the two research groups. Data analysis was performed in the Statistical Package for the Social Sciences, version 24.0. A p-value less than 0.05 was considered statistically significant.
RESULTS
The results revealed a statistically significant difference between the two groups in terms of the complete pattern (P=0.00) and strained state of glottal closure (P=0.00), pattern of subglottal changes (χ=25.98, df=2; P<0.001), and movement patterns of the arytenoid (χ=21.16, df=1; P<0.001). Additionally, based on the obtained frequencies, the two groups showed significant differences regarding the normal state of the larynx (P=0.00), hypertrophy of vocal fold (P=0.007), epithelial change (P=0.007), and Reinke's edema (P=0.001). However, the videolaryngostroboscopic examination results revealed no significant difference between the two groups in terms of polyp (P=0.20), nodule (P=0.57), sulcus vocalis (P=0.08), cyst (P=0.45), and atrophy of vocal folds (P=0.45).
CONCLUSION
It seems that rheumatoid arthritis affects the patterns of arytenoids movement, some kinds of glottal closure patterns, and subglottal changes. As the results indicated, the occurrence of some laryngeal structural changes was higher in patients with rheumatoid arthritis than in individuals without this disorder.
PubMed: 32596173
DOI: 10.22038/ijorl.2020.43213.2418 -
Annals of the Rheumatic Diseases Jan 1994
Topics: Arthritis, Rheumatoid; Humans; Rheumatic Fever; Rheumatoid Nodule
PubMed: 8311566
DOI: 10.1136/ard.53.1.83 -
Cureus Mar 2023Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis. Intra-articular rheumatoid nodules are very rare and usually associated...
Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis. Intra-articular rheumatoid nodules are very rare and usually associated with clinical symptoms. Case reports of intra-articular rheumatoid nodules in the knee joint, wrist joint, ankle joint, and sacrococcygeal joint are reported. However, an intra-articular rheumatoid nodule in the elbow joint has not been reported in the literature. Herein, we report a unique and rare case of a symptomatic intra-articular rheumatoid nodule in the elbow joint of a 49-year-old female with a 15-year history of rheumatoid arthritis. The symptoms resolved after surgical excision of the nodule.
PubMed: 37123690
DOI: 10.7759/cureus.36747 -
The Israel Medical Association Journal... Mar 2024
Topics: Humans; Rheumatoid Nodule; Radiography; Radiology; Lung Neoplasms
PubMed: 38493335
DOI: No ID Found -
BMJ Case Reports May 2018A 22-year-old man presented with symmetric polyarthritis, pruritus and deviation of angle of mouth to the right side since the last 7 years. His symptoms were...
A 22-year-old man presented with symmetric polyarthritis, pruritus and deviation of angle of mouth to the right side since the last 7 years. His symptoms were persistent despite receiving ayurvedic medications and symptomatic therapy. Examination revealed dry skin, cutaneous nodules, xanthelasma, periarticular non-tender swellings, pitting oedema of hands and feet and lower motor neuron type right facial palsy. Haematological investigations revealed eosinophilia and skin biopsy had cutaneous eosinophilic infiltration. The constellation of above findings comprises the nodules, eosinophilia, rheumatism, dermatitis and swelling syndrome. It a rare syndrome with few reported cases in literature. The patient was started on oral corticosteroids which was subsequently tapered and methotrexate therapy. His polyarthritis and skin rashes resolved with therapy. He has been followed-up for 2 years and is presently asymptomatic for the last 1 year.
Topics: Adrenal Cortex Hormones; Dermatitis; Edema; Eosinophilia; Facial Paralysis; Finger Joint; Humans; Male; Methotrexate; Rheumatic Diseases; Rheumatoid Nodule; Syndrome; Treatment Outcome; Young Adult
PubMed: 29754136
DOI: 10.1136/bcr-2017-223506 -
Cureus Jan 2022A 63-year-old female patient, with a past history of rheumatoid arthritis, presented with insidious pain on the left foot second and third metatarsophalangeal joints,...
A 63-year-old female patient, with a past history of rheumatoid arthritis, presented with insidious pain on the left foot second and third metatarsophalangeal joints, associated with swelling and morning stiffness (mean time: four hours). Physical examination evidenced a tender and soft nodularity in the third intermetatarsal space, along with sharp pain, consistent with Morton's neuroma. Foot ultrasound suggested Morton's neuroma, but not excluding the possibility of rheumatoid arthritis involvement. Foot magnetic resonance imaging suggested the possibility of extensive synovitis of the third metatarsophalangeal joint, but not excluding the coexistence of Morton's neuroma because of the mass effect. Finally, the patient underwent an ultrasound-guided needle biopsy of the nodule, which confirmed metatarsophalangeal joint synovitis. The foot is a common location of rheumatoid arthritis manifestation, and metatarsophalangeal joint synovitis can mimic Morton's neuroma. After a definite diagnosis, the patient recovered lower limb functional impairment after introducing adalimumab and a rehabilitation program. This case highlights the importance of an accurate differential diagnosis, pharmacological rheumatoid arthritis control, and physical medicine and rehabilitation programs to optimal clinical and functional improvement.
PubMed: 35251822
DOI: 10.7759/cureus.21751 -
Journal of Current Ophthalmology 2022To evaluate the B-scan ultrasound findings in unilateral posterior scleritis.
PURPOSE
To evaluate the B-scan ultrasound findings in unilateral posterior scleritis.
METHODS
This was a retrospective observational case series at a tertiary uveitis clinic. The study population included patients who had been diagnosed with milder forms of unilateral posterior scleritis since 2010 and had B-scan ultrasonography of that eye. The healthy eye of each patient was considered the control eye for that patient.
RESULTS
The average age of patients was 50.2 ± 17.8 (range, 18-67). Posterior scleritis was idiopathic in 6 (66.7%) patients and associated with rheumatoid arthritis in two and HLA-B27 ankylosing spondylitis in one patient. The thickness of the thickest area in the diseased eye was 2.08 ± 0.49 (range, 1.35-3.2) and the control eye was 1.53 ± 0.38 (range, 1.03-2.3). The difference between the symptomatic and control eye was statistically significantly different ( = 0.02). 1.7 mm was the cut-off-point on the receiver operating characteristics curve with the highest combined sensitivity and specificity of 87.5% and 88.9%, respectively. Comparing the thickness of the thickest section of the symptomatic eye of one patient with the same section in the other eye of the same patient, there was a difference of 20% or more in sclero-choroidal complex.
CONCLUSIONS
In this study, the sclero-choroidal complex thickness higher than 1.7 mm has the highest combined sensitivity and specificity. Comparing the thickest section of the symptomatic eye of one patient with the same section in the other eye can be diagnostic.
PubMed: 35620365
DOI: 10.4103/joco.joco_267_21 -
Reumatologia Clinica 2013To determine whether an association exists between the presence of rheumatoid nodules and thickening of the intima-media and plaque of the carotid artery, which is... (Observational Study)
Observational Study
OBJECTIVE
To determine whether an association exists between the presence of rheumatoid nodules and thickening of the intima-media and plaque of the carotid artery, which is evidence of atherosclerosis.
MATERIALS AND METHODS
Observational, cross-sectional study of 124 patients with rheumatoid arthritis from a University Hospital clinic from 2005 to 2006. We divided the patients into 2 groups, 62 with rheumatoid nodules and 62 without rheumatoid nodules, matched for age and sex. Medical history, erythrocyte sedimentation rate, anti-cyclic citrullinated peptide, rheumatoid factor, and a high resolution doppler ultrasound of the carotid arteries were performed.
RESULTS
Women comprised 89.5% of the patients. The prevalence of a carotid plaque was 57% in our population. The presence of a plaque was associated with age, arterial hypertension and abdominal circumference. Average intima-media thickness (IMT) in patients with a plaque was 0.085 cm (± 0.02). There was no correlation between laboratory parameters and thickening of the intima-media of the carotid artery. Subcutaneous nodules were present in 33 (47%) of the 70 patients with a carotid plaque and in 29 (54%) of patients without a carotid plaque (p=.471).
CONCLUSIONS
We did not find an association between rheumatoid nodules and the presence of a carotid plaque and thickening of the intima-media of the carotid in patients with rheumatoid arthritis.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Carotid Artery Diseases; Carotid Intima-Media Thickness; Case-Control Studies; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Prevalence; Rheumatoid Nodule; Young Adult
PubMed: 23273674
DOI: 10.1016/j.reuma.2012.07.006