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https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#1
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28188140/angioimmunoblastic-t-cell-lymphoma-with-polyarthritis-resembling-rheumatoid-arthritis
#2
Ralph Yachoui, Nouman Farooq, Jonathan V Amos, Gene R Shaw
Angioimmunoblastic T-cell lymphoma (AITL) is a rare subtype of peripheral T-cell lymphoma (PTCL). AITL typically presents with lymphadenopathy, fever, rash, hepatosplenomegaly, and rarely polyarthritis. We report the case of a 50-year-old female who presented with lymphadenopathy, rash, and symmetric polyarthritis. She was later diagnosed with AITL and was treated with chemotherapy with resolution of arthritis. AITL should be suspected in paitents presenting with rheumatoid-like arthritis and diffuse lymphadenopathy...
December 2016: Clinical Medicine & Research
https://www.readbyqxmd.com/read/28182665/padi4-and-the-hla-drb1-shared-epitope-in-juvenile-idiopathic-arthritis
#3
Kaori Hisa, Masakatsu D Yanagimachi, Takuya Naruto, Takako Miyamae, Masako Kikuchi, Rhoki Hara, Tomoyuki Imagawa, Shumpei Yokota, Masaaki Mori
OBJECTIVE: Both genetic and environmental factors are associated with susceptibility to juvenile idiopathic arthritis (JIA). Many studies have reported that both a 'shared epitope' (SE) encoded by several HLA-DRB1 alleles and the peptidyl arginine deiminase type 4 (PADI4) gene polymorphisms are associated with susceptibility to rheumatoid arthritis (RA). However, it is uncertain whether JIA and RA share the latter genetic risk factor. Therefore, here we investigated relationships between HLA-SE and PADI4 polymorphisms with clinical subtypes of JIA...
2017: PloS One
https://www.readbyqxmd.com/read/28176230/inflammatory-markers-and-disease-activity-in-juvenile-idiopathic-arthritis
#4
Sumantra Sarkar, Md Mahboob Alam, Gargi Das, Supratim Datta
OBJECTIVE: To evaluate the post treatment changes in disease activity and inflammatory markers over time in longitudinal follow-up involving different subtypes of juvenile idiopathic arthritis (JIA) patients. METHODS: This prospective longitudinal study, carried out over a period of 2 y, included JIA patients, both old and new, with high disease activity. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), ferritin, CHAQ (Childhood Health Assessment Questionnaire) score and JADAS27 (Juvenile Arthritis Disease Activity score with 27 active joint counts) were estimated at the initial visit, 6 mo, 12 mo and 18 mo of follow-up...
February 8, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28152495/pancreatitis-panniculitis-and-polyarthritis-ppp-syndrome-caused-by-post-pancreatitis-pseudocyst-with-mesenteric-fistula-diagnosis-and-successful-surgical-treatment-case-report-and-review-of-literature
#5
Wulf Dieker, Johannes Derer, Thomas Henzler, Alexander Schneider, Felix Rückert, Torsten J Wilhelm, Bernd Krüger
INTRODUCTION: Pancreatitis, panniculitis and polyarthritis syndrome is a very rare extra-pancreatic complication of pancreatic diseases. PRESENTATION OF CASE: While in most cases this syndrome is caused by acute or chronic pancreatitis, we report a case of a 62-year-old man presenting with extensive intraosseous fat necrosis, polyarthritis and panniculitis caused by a post-pancreatitis pseudocyst with a fistula to the superior mesenteric vein and extremely high blood levels of lipase...
January 18, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28148840/therapy-with-ctla4-ig-and-an-antiviral-monoclonal-antibody-controls-chikungunya-virus-arthritis
#6
Jonathan J Miner, Lindsey E Cook, Jun P Hong, Amber M Smith, Justin M Richner, Raeann M Shimak, Alissa R Young, Kristen Monte, Subhajit Poddar, James E Crowe, Deborah J Lenschow, Michael S Diamond
In 2013, chikungunya virus (CHIKV) transmission was documented in the Western Hemisphere, and the virus has since spread throughout the Americas with more than 1.8 million people infected in more than 40 countries. CHIKV targets the joints, resulting in symmetric polyarthritis that clinically mimics rheumatoid arthritis and can endure for months to years. At present, no approved treatment is effective in preventing or controlling CHIKV infection or disease. We treated mice with eight different disease-modifying antirheumatic drugs and identified CLTA4-Ig (abatacept) and tofacitinib as candidate therapies based on their ability to decrease acute joint swelling...
February 1, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28148696/attitudes-and-approaches-for-withdrawing-drugs-for-children-with-clinically-inactive-nonsystemic-jia-a-survey-of-the-childhood-arthritis-and-rheumatology-research-alliance
#7
Daniel B Horton, Karen B Onel, Timothy Beukelman, Sarah Ringold
OBJECTIVE: To assess the attitudes and strategies of pediatric rheumatology clinicians toward withdrawing medications for children with clinically inactive juvenile idiopathic arthritis (JIA). METHODS: Members of the Childhood Arthritis and Rheumatology Research Alliance (CARRA) completed an anonymous electronic survey on decision making and approaches for withdrawing medications for inactive nonsystemic JIA. Data were analyzed using descriptive statistics. RESULTS: Of 388 clinicians in CARRA, 124 completed surveys (32%), predominantly attending pediatric rheumatologists...
February 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28139956/bacterial-microbiota-in-harbor-seals-phoca-vitulina-from-the-north-sea-of-schleswig-holstein-germany-around-the-time-of-morbillivirus-and-influenza-epidemics
#8
Ursula Siebert, Marion Rademaker, Sophie A Ulrich, Peter Wohlsein, Katrin Ronnenberg, Ellen Prenger-Berninghoff
We present microbiologic findings in harbor seal (phoca; Phoca vitulina ) carcasses collected from the North Sea of Schleswig-Holstein, Germany, 1996-2014, and interpret results in relation to potential variations caused by phocine distemper virus and influenza A virus mass mortalities. We conducted microbiologic investigations on 2,124 tissue samples from lung, liver, kidney, spleen, intestine, and mesenteric lymph nodes from 549 dead harbor seals of the German North Sea. A large variety of bacteria, including potentially pathogenic species such as Bordetella bronchiseptica , Brucella spp...
January 31, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28138049/clinical-manifestations-associated-with-peripheral-joint-involvement-in-patients-with-acute-chikungunya-virus-infection
#9
Mariangelí Arroyo-Ávila, Amanda Cabán, Enid J García-Rivera, Marisela Irizarry-Pérez, Hilda Torres, Héctor Gorbea, Luis M Vilá
Chikungunya virus (CHIKV) causes an acute febrile illness usually accompanied by severe polyarthralgia and polyarthritis. Previous studies have shown that older age, female gender, and some comorbid conditions are associated with chronic CHIKV arthritis. However, the factors associated with acute arthralgia and arthritis are not well known. Thus, we studied the clinical manifestations associated with acute peripheral joint involvement in a group of CHIKV patients from Puerto Rico. Patients with a history of fever for < 7 days evaluated at the emergency department of a university-based hospital were tested for several pathogens including CHIKV...
January 30, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28134037/destiny-rides-again-the-reappearance-of-silicone-gel-filled-breast-implant-toxicity
#10
A E Brawer
Background Twenty-five years ago attorneys representing ailing women in class action litigation against silicone breast implant manufacturers made the procedural error of defining silicone-induced toxicity in the courtroom before it was properly studied in the exam room. This aberrant methodology perverted the proper research process, rendered verification of any real disease elusive, and cemented the groundwork for a repeat public health crisis potentially affecting two million women in the USA who possess new silicone gel devices inserted over the past 10 years...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28099077/disease-complexity-in-a-declining-alaskan-muskox-ovibos-moschatus-population
#11
Josephine A Afema, Kimberlee B Beckmen, Stephen M Arthur, Kathy Burek Huntington, Jonna A K Mazet
The muskox ( Ovibos moschatus ) population inhabiting the eastern North Slope (ENS) of Alaska declined dramatically during 1999-2006, whereas populations in western Alaska (WA) were stable or increasing. To understand morbidity and mortality factors contributing to the decline, Alaska Department of Fish and Game conducted pathologic investigations of carcasses from 2005 until 2008. Additionally, archived sera from both ENS and WA muskoxen collected during 1984-1992, before the documented beginning of the ENS decline; sera collected during 2000, near the beginning of the decline; and contemporary sera (from live capture-release, adult females) collected during 2006, 2007, and 2008 were analyzed to determine whether prevalence of antibody to potential pathogens differed in the two areas or changed over time...
January 18, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28094068/-large-vessel-vasculitis-with-myelodysplastic-syndrome-a-rare-association
#12
J Galland, H Kawski, J-F Guichard, F Maurier
INTRODUCTION: The vasculitis can be the consequence of malignancy: most often hematologic rather than solid tumors. The association between large vessels vasculitis and myelodysplastic syndrome is rare. CASE REPORT: A 55-year-old man experienced asthenia, fever, polyarthritis and inflammatory syndrome. Haematological investigations found a type 2 refractory anemia with excess blasts (RAEB-2) with discovery of severe anemia (Hb: 7,8g/dl) and thrombopenia (platelets: 40,000/mm(3))...
January 13, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28089975/in-vitro-fertilization-in-37-women-with-systemic-lupus-erythematosus-or-antiphospholipid-syndrome-a-series-of-97-procedures
#13
Pauline Orquevaux, Agathe Masseau, Véronique Le Guern, Vanessa Gayet, Danièle Vauthier, Gaelle Guettrot-Imbert, Du Le Thi Huong, Bertrand Wechsler, Nathalie Morel, Patrice Cacoub, Jean-Loup Pennaforte, Jean-Charles Piette, Nathalie Costedoat-Chalumeau
OBJECTIVE: To compile and assess data about complication and success rates for in vitro fertilization (IVF) of women with systemic lupus erythematosus (SLE) and/or antiphospholipid syndrome (APS). To date, such data are sparse. METHODS: This retrospective study described women with SLE and/or APS who have had at least 1 IVF cycle. RESULTS: Thirty-seven women with SLE (n = 23, including 8 with antiphospholipid antibodies), SLE with APS (n = 4), or primary APS (n = 10) underwent 97 IVF procedures...
January 15, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28056958/about-the-complexity-of-adult-onset-still-s-disease%C3%A2-and-advances-still-required-for-its-management
#14
EDITORIAL
Philippe Guilpain, Alain Le Quellec
Adult onset Still's disease (AOSD) is a rare inflammatory disorder that remains poorly understood. Its pathophysiology is yet to be completely elucidated, but is known to consist mainly on a cytokine cascade, responsible for the systemic manifestations. AOSD diagnosis is usually difficult and delayed, with physicians having to rule out several other conditions, including cancer or infectious diseases. Prognosis is heterogeneous and difficult to establish, ranging from benign outcome to chronic destructive polyarthritis and/or life-threatening events...
January 6, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28030537/molecular-virologic-and-clinical-characteristics-of-a-chikungunya-fever-outbreak-in-la-romana-dominican-republic-2014
#15
Rose M Langsjoen, Rebecca J Rubinstein, Tiffany F Kautz, Albert J Auguste, Jesse H Erasmus, Liddy Kiaty-Figueroa, Renessa Gerhardt, David Lin, Kumar L Hari, Ravi Jain, Nicolas Ruiz, Antonio E Muruato, Jael Silfa, Franklin Bido, Matthew Dacso, Scott C Weaver
Since emerging in Saint Martin in 2013, chikungunya virus (CHIKV), an alphavirus transmitted by the Aedes aegypti mosquito, has infected approximately two million individuals in the Americas, with over 500,000 reported cases in the Dominican Republic (DR). CHIKV-infected patients typically present with a febrile syndrome including polyarthritis/polyarthralgia, and a macropapular rash, similar to those infected with dengue and Zika viruses, and malaria. Nevertheless, many Dominican cases are unconfirmed due to the unavailability and high cost of laboratory testing and the absence of specific treatment for CHIKV infection...
December 2016: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/27998952/fine-mapping-the-mhc-locus-in-juvenile-idiopathic-arthritis-jia-reveals-genetic-heterogeneity-corresponding-to-distinct-adult-inflammatory-arthritic-diseases
#16
A Hinks, J Bowes, J Cobb, H C Ainsworth, M C Marion, M E Comeau, M Sudman, B Han, M L Becker, J F Bohnsack, P I W de Bakker, J P Haas, M Hazen, D J Lovell, P A Nigrovic, E Nordal, M Punnaro, A M Rosenberg, M Rygg, S L Smith, C A Wise, V Videm, L R Wedderburn, A Yarwood, R S M Yeung, S Prahalad, C D Langefeld, S Raychaudhuri, S D Thompson, W Thomson
OBJECTIVES: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of diseases, comprising seven categories. Genetic data could potentially be used to help redefine JIA categories and improve the current classification system. The human leucocyte antigen (HLA) region is strongly associated with JIA. Fine-mapping of the region was performed to look for similarities and differences in HLA associations between the JIA categories and define correspondences with adult inflammatory arthritides...
December 20, 2016: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/27998301/acute-polyarthritis-in-a-young-patient-caused-by-meningococcal-and-parvovirus-b19-infections-a-case-report-and-review-of-the-literature
#17
Virginie Lavoipierre, Anna Dellyes, Camille Aubry, Christine Zandotti, Pierre Lafforgue, Philippe Parola, Jean-Christophe Lagier
BACKGROUND: Meningococcal infection is a multifaceted disease including acute polyarthritis. This presentation should be known by clinicians in order to prevent delay in treatment. We report what we believe to be the first case of an association of parvovirus B19 and meningococcal polyarthritis in a young adult. CASE PRESENTATION: A 19-year-old Caucasian woman presented to our hospital with fever, intense leg pain, and a transient rash. A physical examination showed asymmetric polyarthritis and no neurological abnormalities...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27984003/a-systematic-analysis-of-treatment-and-outcomes-of-nod2-associated-autoinflammatory-disease
#18
Qingping Yao, Bo Shen
OBJECTIVES: Yao syndrome, formerly named NOD2-associated autoinflammatory disease, is a periodic disease characterized by fever, dermatitis, polyarthritis/leg swelling, and gastrointestinal and sicca-like symptoms associated with specific NOD2 sequence variants. Our aim was to evaluate the treatment and outcomes of the disease. METHODS: A total of 52 adult patients with autoinflammatory disease phenotype were diagnosed with Yao syndrome and enrolled at the Cleveland Clinic between November 2009 and May 2015...
October 28, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27974097/in-early-inflammatory-polyarthritis-more-intensive-management-according-to-2010-acr-eular-criteria-leads-to-higher-rates-of-clinical-remission-comparison-of-two-cohorts-treated-according-to-different-treat-to-target-protocols
#19
Silvia Balduzzi, Carlo Alberto Scirè, Garifallia Sakellariou, Francesca Benaglio, Serena Bugatti, Carlomaurizio Montecucco, Roberto Caporali
OBJECTIVES: The aim of this study was to compare the 12-month probability of remission in early inflammatory arthritis with a milder treatment based on the 1987 criteria or a more intensive protocol based on the 2010 criteria. METHODS: Patients with rheumatoid arthritis (RA) or undifferentiated arthritis (UA) (2005-2012) were included. Before October 2010, patients fulfilling the 1987 criteria received methotrexate (MTX) and possibly low-dose prednisone, while UA hydroxychloroquine (HCQ) (1987-driven cohort)...
December 13, 2016: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/27959743/autologous-adipose-stem-cell-therapy-for-autonomic-nervous-system-dysfunction-in-two-young-patients
#20
Mohammed T Numan, Ankur Kamdar, Jane Young, Ian J Butler
Postural orthostatic tachycardia syndrome and neurocardiogenic syncope are clinical manifestations of autonomic nervous system dysfunction (dysautonomia) that can lead to impaired daily functions. We report two young patients presenting with dysautonomia and autoimmune disease who both received autologous adipose stem cells (ASCs) infusions. This report is the first description of ASCs therapy for patients with combined dysautonomia and autoimmune disease. Case 1: A 21-year-old female presented at 12 years of age with escalating severe dysautonomia with weight loss and gastrointestinal symptoms...
February 1, 2017: Stem Cells and Development
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