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Annals of the Rheumatic Diseases May 1988The immunohistological features of rheumatoid nodules and rheumatoid synovium were examined using monoclonal and polyclonal antibodies raised against macrophages,...
The immunohistological features of rheumatoid nodules and rheumatoid synovium were examined using monoclonal and polyclonal antibodies raised against macrophages, HLA-DR, leucocyte common antigen, and immunoglobulin components. The palisading cells surrounding the necrotic centre of the rheumatoid nodule were shown to be HLA-DR positive leucocytes, mostly histiocytes. The inflammatory infiltrate associated with rheumatoid nodules showed many immunohistochemical similarities to that of rheumatoid synovium, including a preponderance of IgG positive plasma cells, and a similar number and microanatomical pattern of distribution of HLA-DR positive cells. The significance of these findings for the cellular immunopathology and aetiology of the rheumatoid lesion is discussed.
Topics: Antigens, Differentiation; Arthritis, Rheumatoid; HLA-DR Antigens; Histocompatibility Antigens; Humans; Immunoenzyme Techniques; Leukocyte Common Antigens; Leukocytes; Rheumatoid Nodule; Synovial Membrane
PubMed: 2968782
DOI: 10.1136/ard.47.5.398 -
Indian Journal of Dermatology 2017Cutaneous manifestations are fairly common in rheumatoid arthritis (RA) and they can help in early diagnosis, prompt treatment, and hence reduced morbidity from the...
BACKGROUND
Cutaneous manifestations are fairly common in rheumatoid arthritis (RA) and they can help in early diagnosis, prompt treatment, and hence reduced morbidity from the disease.
AIMS
The objective of the present study was to find out the different patterns of dermatoses in a group of patients with RA from Eastern India.
METHODOLOGY
Consecutive patients fulfilling the American Rheumatism Association 1987 revised criteria for the classification of RA and who had different dermatoses were included in this cross-sectional study done over a period of 8 years in a tertiary care hospital in Eastern India. Thorough clinical examination and appropriate laboratory investigations were performed as needed. Data were recorded in a predesigned schedule, and appropriate statistical analysis was done.
RESULTS
We studied 111 evaluable patients with an age range of 19-71 years and a female to male ratio of 7:1. The mean disease duration of RA was 6.5 years. Cutaneous infections as a group was the most common mucocutaneous manifestation (34.2%) followed by xerosis including ichthyotic skin changes (27%), pigmented purpuric dermatoses (14.4%), leg ulcer (9.9%), periungual telangiectasia (9.9%), rheumatoid nodules (RNs) (8.1%), purpura and ecchymoses (7.2%), small vessel vasculitis in (7.2%), corn and callosities (6.3%), palmar erythema (4.5%), and neutrophilic dermatosis (4.5%). Raynaud's phenomenon was found in 3.6% patients and panniculitis in (3.6%) patients. Rheumatoid factor (RF) and anti-cyclic citrullinated peptides antibody were positive in 74.8% and 88.3% patients, respectively. No statistically significant difference of incidence of leg ulcer, small vessel vasculitis, RN, or Raynaud's phenomenon could be noted between RF positive and negative groups.
LIMITATIONS
Being an institution-based study, the study findings may not reflect the true situation in the community which remained a limitation of this study.
CONCLUSION
While some of the features of this study were analogous to Western data, other features showed discordance which may be due to ethnic variations among the patients with RA.
PubMed: 28794554
DOI: 10.4103/ijd.IJD_260_17 -
Annals of the Rheumatic Diseases Aug 1997Cigarette smoking may influence rheumatoid arthritis (RA) disease incidence and may have direct biological effects on the lungs and systemically. This study sought to...
OBJECTIVES
Cigarette smoking may influence rheumatoid arthritis (RA) disease incidence and may have direct biological effects on the lungs and systemically. This study sought to determine if cigarette smoking is associated with RA disease severity.
METHODS
Clinical evaluations of patients seen in the University of Iowa rheumatology and orthopaedic ambulatory clinics were conducted. A letter of interest was mailed to 1701 patients who were first assigned an ICD-9-CM diagnostic code for RA in one of these clinics. A total of 857 patients expressed interest and were offered a clinical examination and 395 were evaluated over an 18 month period. Of these, 336 satisfied examiner criteria for prevalent RA and were included in the analysis. The disease characteristics and arthritis care utilisation of these patients seemed representative of prevalent cases in the general community. RA disease severity was assessed by radiographic bone erosions (graded as either present/ absent and using the Larsen system), rheumatoid factor seropositivity, and presence of subcutaneous rheumatoid nodules.
RESULTS
Pack years of cigarette smoking was significantly associated with rheumatoid factor seropositivity (p = 0.0001), radiographic erosions (p = 0.024), and nodules (p = 0.051). After adjustment for potential confounders, smokers with > or = 25 pack years were 3.1 times more likely to be rheumatoid factor positive (95% CI 1.7, 5.6) and 2.4 times more likely to show radiographic erosions (95% CI 1.2, 4.5) than never smokers. Less severe radiographic disease seemed to be more strongly associated with cigarette smoking than more severe disease.
CONCLUSION
Cigarette smoking may adversely influence the severity of RA in a potentially dose dependent fashion.
Topics: Aged; Arthritis, Rheumatoid; Arthrography; Chronic Disease; Cohort Studies; Female; Humans; Male; Middle Aged; Multivariate Analysis; Rheumatoid Factor; Rheumatoid Nodule; Smoking; Statistics, Nonparametric
PubMed: 9306868
DOI: 10.1136/ard.56.8.463 -
Respirology Case Reports Jan 2021We report a case of Sjögren's syndrome with nodular pulmonary amyloidosis. Amyloidosis is a heterogeneous group of diseases caused by aggregation of autologous protein...
We report a case of Sjögren's syndrome with nodular pulmonary amyloidosis. Amyloidosis is a heterogeneous group of diseases caused by aggregation of autologous protein and its extracellular deposition as fibrils. Most cases of nodular pulmonary amyloidosis are the result of an underlying disorder such as mucosa-associated lymphoid tissue lymphoma, rheumatoid arthritis, or multiple myeloma. Nodular pulmonary amyloidosis with Sjögren's syndrome is very rare. The clinical outcome of patients with nodular pulmonary amyloidosis is good if the underlying disease can be controlled.
PubMed: 33343903
DOI: 10.1002/rcr2.699 -
Journal of Orthopaedics and... Sep 2013Among 101 feet that presented with symptoms and signs similar to Morton's neuroma, intermetatarsal rheumatoid nodules were found in five feet (three patients). Two...
Among 101 feet that presented with symptoms and signs similar to Morton's neuroma, intermetatarsal rheumatoid nodules were found in five feet (three patients). Two patients had bilateral involvement. Histology of the excised tissue showed the presence of a rheumatoid nodule and Morton's neuroma in four feet and a rheumatoid nodule with unremarkable nerve bundles in one. A rheumatoid nodule can coexist with Morton's neuroma, as seen in our patients, and the presentation is often similar to that of a Morton's neuroma. Our patients were rendered asymptomatic with surgical treatment and went on to have appropriate management of rheumatoid arthritis. Rheumatoid nodule should be considered in the differential diagnosis of Morton's neuroma in not only rheumatoid arthritis patients but also asymptomatic patients who have never been tested for rheumatoid antibodies.
Topics: Acute Pain; Adult; Biopsy; Diagnosis, Differential; Female; Humans; Neuroma; Peripheral Nervous System Neoplasms; Rheumatoid Nodule
PubMed: 23135058
DOI: 10.1007/s10195-012-0215-x -
Annals of the Rheumatic Diseases Nov 1999
Review
Topics: Finger Joint; Hand Deformities, Acquired; Humans; Osteoarthritis; Rheumatoid Nodule
PubMed: 10531070
DOI: 10.1136/ard.58.11.675 -
Respiratory Medicine Case Reports 2021Lymphomatoid granulomatosis (LYG) is a rare Epstein-Barr virus-associated B-cell lymphoproliferative disorder and was incorporated into the WHO classification of Tumours...
Lymphomatoid granulomatosis (LYG) is a rare Epstein-Barr virus-associated B-cell lymphoproliferative disorder and was incorporated into the WHO classification of Tumours of the Lung, Pleura, Thymus and Heart in 2015. LYG is known to be associated with the host's immune function, and can be caused by some immunosuppressive agents, including methotrexate. A woman in her sixties with an 18-year history of methotrexate treatment for rheumatoid arthritis visited our hospital after detection of an abnormal chest shadow on her radiograph. She had been having anemia and a slight fever. Computed tomography (CT) revealed a 2.9-cm sized nodule in her left lung and hilar adenopathy, which suggested a primary lung carcinoma or an inflammatory lesion. We performed a left upper lobectomy with lymph node dissection for the purpose of diagnosis and treatment. Pathologic findings revealed that the tumor was a grade 3 LYG based on the number of EBV-positive B cells. The patient was treated with two chemotherapy regimens including R-CHOP at another hospital, and survived for four years after resection without recurrence in the lung. It is rare to find a case resected LYG, and the clinical or pathological findings of our case are expected to be extremely helpful in studying this disease and improving the understanding of this disease.
PubMed: 33437613
DOI: 10.1016/j.rmcr.2020.101327 -
Case Reports in Surgery 2020Here, we present a case report of a woman who presented with a large sacral rheumatoid nodule. This patient failed conservative treatment and presented in search of a...
Here, we present a case report of a woman who presented with a large sacral rheumatoid nodule. This patient failed conservative treatment and presented in search of a surgical solution. We successfully removed her rheumatoid nodule using a surgical approach typically reserved for traumatic coccydynia. We show how coccygectomy, although a rare surgical procedure, was effective in treatment of a large rheumatoid nodule.
PubMed: 32455045
DOI: 10.1155/2020/2757625 -
British Medical Journal Apr 1965
Topics: Humans; Rheumatoid Nodule
PubMed: 14257393
DOI: 10.1136/bmj.1.5439.877 -
Annals of the Rheumatic Diseases Sep 1993To report benign rheumatoid nodules in a woman with chronic lymphocytic leukaemia and borderline lepromatous leprosy and to summarise the features of the patients with... (Review)
Review
OBJECTIVES
To report benign rheumatoid nodules in a woman with chronic lymphocytic leukaemia and borderline lepromatous leprosy and to summarise the features of the patients with adult onset benign rheumatoid nodules.
METHODS
A 66 year old woman with chronic lymphocytic leukaemia and borderline lepromatous leprosy who presented with subcutaneous elbow nodules, which were at first suspected to represent either progression of her haematological disease or leprosy, is described. The clinical characteristics of our patient and previous reports of another 24 subjects with adult onset benign rheumatoid nodules are reviewed.
RESULTS
Biopsy of the patient's subcutaneous lesion disclosed the histopathology of a rheumatoid nodule; serological and clinical evaluations for rheumatoid arthritis and other rheumatoid nodule associated systemic diseases were negative. Adult onset benign rheumatoid nodules are clinically and histologically identical to those found in patients with rheumatoid arthritis. They often appeared in women during their 20s, frequently resolved spontaneously or were adequately treated by excision, and recurred in about one third of patients. The lesions were located in the ocular adnexa in 60% of patients. The most common lesional sites in patients with non-ocular benign rheumatoid nodules were the elbows, feet, and knees. None of these patients subsequently developed rheumatoid arthritis or other rheumatoid nodule associated diseases during follow up periods of as long as 20 years.
CONCLUSION
The appearance of subcutaneous nodules is often the harbinger of an associated systemic disorder. Although benign rheumatoid nodules occur infrequently in adults, they should be considered in the differential diagnosis of new nodular lesions.
Topics: Adult; Connective Tissue; Elbow; Female; Follow-Up Studies; Humans; Leprosy, Lepromatous; Leukemia, Lymphocytic, Chronic, B-Cell; Male; Middle Aged; Rheumatoid Nodule
PubMed: 8239765
DOI: 10.1136/ard.52.9.685