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rheumatoid arthritis spontaneous remission

Adam J Pelzek, Caroline Grönwall, Pamela Rosenthal, Jeffrey D Greenberg, Mandy McGeachy, Larry Moreland, William F C Rigby, Gregg J Silverman
OBJECTIVE: In RA, autoreactive B cells are pathogenic drivers and sources of anti-citrullinated protein antibodies (ACPA) that serve as a diagnostic biomarker and predictor of worse long-term prognosis. Yet the immunobiologic significance of persistent ACPA production at a cellular level is poorly understood. METHODS: In a cross-sectional study of RA patients, we investigated for the presence of continued defects in immune homeostasis as a function of disease activity...
January 24, 2017: Arthritis & Rheumatology
Alexandr Sidorov, Liubov Beduleva, Igor Menshikov, Alexey Terentiev, Elena Stolyarova, Nadezhda Abisheva
We recently identified rheumatoid factor, the production of which neither predicts nor exacerbates experimental autoimmune disease, but the opposite, namely it is associated with autoimmune disease resistance and remission. We have named it regulatory rheumatoid factor (regRF). The aim of this study was to determine whether rat Fc fragments and human Fc fragments are an antigen for regRF, and to determine the conditions for obtaining them. The presence of an antigenic determinant for regRF on IgG fragments was inferred from the fragments' ability to inhibit the agglutination caused by regRF and to induce regRF production in vivo...
February 2017: International Journal of Biological Macromolecules
Mariana Lagrutta, Gelsomina Alle, Roberto Leandro Parodi, Alcides Alejandro Greca
Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease occasionally associated with severe extra-articular manifestations, mostly in cases of longstanding highly active disease. We report the case of a 56 year-old woman diagnosed with active RA at the age of 40. After 5 years of high activity, her arthritis subsides spontaneously during pregnancy despite the lack of treatment with disease-modifying anti-rheumatic drugs. She remains without articular symptoms for 7 years, and then she develops a Felty's syndrome requiring steroid treatment and splenectomy...
July 2016: Reumatología Clinica
Hideki Yasui, Yutaro Nakamura, Hirotsugu Hasegawa, Tomoyuki Fujisawa, Noriyuki Enomoto, Naoki Inui, Junya Fukuoka, Takafumi Suda
A 72-year-old man who had suffered from rheumatoid arthritis (RA) and Sjögren's syndrome (Sjs) since he was 66 years of age had been treated with methotrexate (MTX) for six years. He presented with a cough, sputum and dyspnea on exertion, and computed tomography findings showed multiple ground-glass opacities in both of his lungs. A biopsy of the lungs revealed low-grade mucosa-associated lymphoid tissue (MALT) type B-cell non-Hodgkin's lymphoma. Spontaneous complete remission of the lymphoma was achieved six months after withdrawing immune suppression with MTX...
2015: Respiratory Medicine Case Reports
Sarah E Herlihy, Monica L Brown, Darrell Pilling, Brad R Weeks, Linda K Myers, Richard H Gomer
OBJECTIVE: To determine whether an intraarticular injection of the neutrophil chemorepellent dipeptidyl peptidase IV (DPPIV; CD26) can attenuate inflammation and decrease the severity of arthritis in a murine model. METHODS: DBA/1 mice were immunized with type II collagen/Freund's complete adjuvant to produce collagen-induced arthritis (CIA). On day 25 postimmunization, recombinant human DPPIV (rhDPPIV) or phosphate buffered saline was injected intraarticularly, and arthritis severity scores were recorded 3 times per week...
October 2015: Arthritis & Rheumatology
Jonas Kure Buer
The article outlines a history of the concept of "disease-modifying antirheumatic drugs" or DMARDs--from the emergence in the 1970s of the idea of drugs with decisive long-term effects on bone erosion in rheumatoid arthritis (RA), through the consolidation and popularisation in the term DMARD in 1980s and 1990s. It then examines the usage of the terms "remission-inducing drugs" (RIDs) and "slow-acting anti-rheumatic drugs" (SAARDs), which for some years offered competition to the term DMARDs, thus underscoring the contingency of the establishment of DMARD as a word...
August 2015: Inflammopharmacology
Yu Funakubo Asanuma
Rheumatoid arthritis (RA) affects mainly women during their childbearing years. As aging of childbirth advances in Japan, women who plan pregnancy would increase after they developed RA. Recent findings showed that high disease activity of RA might impair fertility. Planning pregnancy is preferable after female patients achive and maintain low disease activity or remission of RA. Women on methotrexate, which is the anchor drug for RA, need to discontinue the medication with a high risk of causing birth defects during conception and pregnancy...
2015: Nihon Rinshō Men'eki Gakkai Kaishi, Japanese Journal of Clinical Immunology
Christopher Banse, Ygal Benhamou, Thierry Lequerré, Véronique Le Cam-Duchez, Hervé Lévesque, Olivier Vittecoq
A 47-year-old woman with rheumatoid arthritis (RA) treated successively with infliximab, abatacept, and etanercept spontaneously developed subcutaneous bruises and a noncompressive hematoma 11 months after starting etanercept therapy (50mg/week). Her prothrombin time was normal but her activated partial thromboplastin time was increased to 2.48 (normal range, 0.85-1.17). She had a circulating anticoagulant (Rosner index, 45; normal,<13) due to an anti-factor VIII antibody in a titer of 45 Bethesda units...
May 2015: Joint, Bone, Spine: Revue du Rhumatisme
Carolyn Riester O'Connor
OBJECTIVES: To provide a comprehensive review regarding the clinical presentation of acquired factor VIII (FVIII) inhibitors, also known as "acquired hemophilia," in patients with rheumatic diseases. METHODS: A systematic MEDLINE search was conducted to identify English-language articles published from 1993 through January 10, 2012, providing details regarding the clinical presentation, laboratory evaluation, and management of a patient(s) with newly or previously diagnosed autoimmune disease coexistent with an acquired FVIII inhibitor...
June 2015: Seminars in Arthritis and Rheumatism
Abraham Tsur, Grant C Hughes, Yehuda Shoenfeld, Howard Carp
In recent years, there has been a growing interest in the role of immune, alloimmune and autoimmune processes in the pathogenesis of spontaneous preterm birth and recurrent pregnancy loss. The association between an inflammatory response and preterm labor has been established. Indeed, many women suffering from preterm labor have elevated inflammatory markers such as tumor necrosis factor alpha, interleukin 6 and matrix metaloproeinase 8. The role of immune processes in the pathogenesis of recurrent pregnancy loss has also been widely researched...
February 2015: Immunologic Research
Yuki Tsukazaki, Tsutomu Shinohara, Kumiko Tanaka, Keishi Naruse, Yoshihito Iwahara, Shuji Inoue
Lymphoproliferative disorders (LPDs) occur more frequently in rheumatoid arthritis (RA) patients treated with immunosuppressive agents than in the non-RA population. However, the various forms of disease progression have not yet been elucidated in detail. We encountered a case of Epstein-Barr virus (EBV)-positive atypical polymorphous LPD in the cervical and intraabdominal lymph nodes with hepatosplenomegaly in an 88-year-old female with RA who had taken infliximab and methotrexate (MTX) for six years. Although spontaneous remission occurred following the withdrawal of infliximab and MTX, reversible LPD evolved into hepatosplenic Hodgkin lymphoma without lymphadenopathy presenting as a cholestatic febrile illness...
November 17, 2014: Modern Rheumatology
K G Goh, S G Ong
Patients with autoimmune connective tissue disease may manifest as overlap syndrome with features of systemic lupus erythematosus (SLE), systemic sclerosis, rheumatoid arthritis and myositis. Those presenting with active SLE can present with immune thrombocytopenia (IT) and may be complicated with subdural hematoma which, though rare, is potentially life-threatening. We report here a patient with overlap syndrome who had recurrent spontaneous subdural hematoma due to severe thrombocytopenia which did not respond to corticosteroids and azathioprine...
January 2015: Lupus
Yael A de Man, Radboud J E M Dolhain, Johanna M W Hazes
PURPOSE OF REVIEW: Disease activity of rheumatoid arthritis (RA) can ameliorate spontaneously during pregnancy; however, adequate measurement of disease activity during pregnancy is a challenge, as is quantifying disease improvement during pregnancy and disease flare postpartum. Adverse pregnancy outcomes may be related to high disease activity during pregnancy, the full extent of which remains to be fully defined. RECENT FINDINGS: Disease activity might best be measured during pregnancy with DAS28-CRP without visual analogue scale (VAS) general health...
May 2014: Current Opinion in Rheumatology
Amir Sternheim, Ofir Chechik, Yehuda Freedman, Ely L Steinberg
BACKGROUND: The sternoclavicular joint (SCJ) is a true diarthrodial synovial joint and therefore vulnerable to the same disease processes as in other synovial joints. We identified a group of patients with monarticular arthritis of the SCJ that had a benign process and a self-limited disease course. METHODS: This retrospective study included 25 female patients who presented with pain or swelling of the SCJ between January 2000 and December 2010. Their mean age was 59 years, and the average follow-up was 44 months...
April 2014: Journal of Shoulder and Elbow Surgery
Aparna Naidu, Harvey P Kessler, Miro A Pavelka
Immunosuppressive therapy for patients diagnosed with rheumatoid arthritis has long been implicated in the development of various neoplastic processes, including leukemia and lymphoma. Methotrexate is a commonly administered antimetabolic medication thought to improve the symptoms of rheumatoid arthritis through its anti-inflammatory effects. Longterm methotrexate therapy and concurrent rheumatoid arthritis have both been independently suggested as risk factors for developing lymphoma. The mechanism has been theorized to be severe immunosuppression and an increased frequency of latent infection with pro-oncogenic viruses, such as the Epstein-Barr virus (EBV)...
April 2014: Journal of Oral and Maxillofacial Surgery
Sushrut Jangi, Leo Otterbein, Simon Robson
Nearly a century ago, jaundiced patients were observed to have surprising and spontaneous remissions from incurable immunologic diseases including rheumatoid arthritis, allergy, and asthma. The mystery of why this phenomenon occurred remains unresolved to this day. Bilirubin has traditionally been considered an excretory product resulting from heme metabolism with little benefit to human physiology. In the past few decades, however, the salutary role of this byproduct as a potent antioxidant has been repeatedly noted...
December 2013: International Journal of Biochemistry & Cell Biology
Arkadiusz Drobiecki, Marcin Pasiarski, Iwona Hus, Bożena Sokołowska, Marzena Wątek
Acquired hemophilia is a severe bleeding diathesis caused by autoantibodies against a coagulation factor VIII (FVIII inhibitor). Massive bleeding diathesis, often life threatening are observed in almost 90% of patients. In 50-60% of cases, inhibitor emerges spontaneously. However, there are some conditions like pregnancy, puerperium, autoimmune disorders or cancers that seem to induce acquired hemophilia. We report a case of a 49-year-old woman suffering from rheumatoid arthritis (RA) for several years, who was diagnosed with acquired hemophilia in September 2011...
December 2013: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Jill van Aken, Lotte Heimans, Henrike Gillet-van Dongen, Karen Visser, H Karel Ronday, Irene Speyer, André J Peeters, Tom W J Huizinga, Cornelia F Allaart
OBJECTIVE: To assess long-term disease outcome of undifferentiated arthritis (UA) after initial treatment with methotrexate (MTX) or placebo. METHODS: 110 patients with UA were randomised to receive MTX (n=55) or placebo (n=55) for 1 year. After 5 years the outcomes for diagnosis (rheumatoid arthritis, 1987 criteria (RA (1987)), UA or UA in remission) and radiographic progression were compared between treatment arms and anti-citrullinated protein antibody (ACPA)-positive and -negative patients...
February 2014: Annals of the Rheumatic Diseases
Garifallia Sakellariou, Carlo Alberto Scirè, Suzanne M M Verstappen, Carlomaurizio Montecucco, Roberto Caporali
OBJECTIVES: To test the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) and disease activity score in 44 and 28 joints (DAS, DAS28) definitions of remission in early rheumatoid arthritis (RA), against disability and ultrasound-detectable synovitis. METHODS: In an observational study of early RA patients, remission rates were determined and compared in 166 patients. The remission definitions included the simplified disease activity index (SDAI≤3...
February 2013: Annals of the Rheumatic Diseases
Mohamed Abdgawad, Åsa Pettersson, Lena Gunnarsson, Anders A Bengtsson, Pierre Geborek, Lars Nilsson, Mårten Segelmark, Thomas Hellmark
BACKGROUND: ANCA-Associated Systemic Vasculitis (AASV) is characterized by leukocytoclasis, accumulation of unscavenged apoptotic and necrotic neutrophils in perivascular tissues. Dysregulation of neutrophil cell death may contribute directly to the pathogenesis of AASV. METHODS: Neutrophils from Healthy Blood Donors (HBD), patients with AASV most in complete remission, Polycythemia Vera (PV), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA) and renal transplant recipients (TP) were incubated in vitro, and the rate of spontaneous apoptosis was measured by FACS...
2012: PloS One
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