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Osteoporosis, uveitis

Muhammad A Khan
This is the story of a remarkable Swiss patient-Heinz Baumberger, PhD-who was born in 1931 and has suffered from ankylosing spondylitis (AS) since 1943. He has survived many manifestations and co-morbid conditions associated with his disease and its treatment. These include severe episodes of acute anterior uveitis, osteoporosis with fragility fractures, and also post-traumatic spinal fractures on three different occasions. In addition, he has suffered from multiple basal cell carcinomas as a late complication of a 3-week course of spinal radiation in 1952 and another one in 1962...
June 2016: Clinical Rheumatology
Jackson Machado-Pinto, Michelle dos Santos Diniz, Nádia Couto Bavoso
Psoriasis is a chronic inflammatory disease associated with several comorbidities. A few decades ago, it was considered an exclusive skin disease but today it is considered a multisystem disease. It is believed that 73% of psoriasis patients have at least one comorbidity. Studies have demonstrated the association of psoriasis with inflammatory bowel disease, uveitis, psychiatric disorders, metabolic syndrome and its components and cardiovascular diseases. The systemic inflammatory state seems to be the common denominator for all these comorbidities...
January 2016: Anais Brasileiros de Dermatologia
Yiming Tian, Rui Wang, Lianyuan Liu, Chunming Ma, Qiang Lu, Fuzai Yin
BACKGROUND: Zoledronic acid-induced uveitis (ZAIU) is rare but severe, and has been recently considered part of an acute phase reaction. Only 15 cases have been reported since 2005. Here we describe a case with macular edema, which is the first reported case observed after long-term alendronate tolerance. CASE PRESENTATION: A 63-year-old Asian woman received her first intravenous zoledronic acid treatment for the management of postmenopausal osteoporosis as a more convenient substitute for oral alendronate...
2016: BMC Musculoskeletal Disorders
Debottam Bandyopadhyay, Sanjay Bandyopadhyay, Parasar Ghosh, Abhishek De, Anupam Bhattacharya, G K Dhali, Kshaunish Das
BACKGROUND: There is a paucity of reports on extraintestinal manifestations (EIMs) in patients with inflammatory bowel diseases (IBD) from Asia and India. METHODS: From May 2011 to October 2012, consecutive IBD patients underwent a detailed history and physical examination, also by trained rheumatologist, dermatologist, and ophthalmologist, about whether they experienced any EIM at the time of inclusion or in the past. The disease phenotype/severity and location was classified according to the Montréal classification...
September 2015: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
P C Robinson, P J Leo, J J Pointon, J Harris, K Cremin, L A Bradbury, S Stebbings, A A Harrison, D M Evans, E L Duncan, B P Wordsworth, M A Brown
Acute anterior uveitis (AAU) involves inflammation of the iris and ciliary body of the eye. It occurs both in isolation and as a complication of ankylosing spondylitis (AS). It is strongly associated with HLA-B*27, but previous studies have suggested that further genetic factors may confer additional risk. We sought to investigate this using the Illumina Exomechip microarray, to compare 1504 cases with AS and AAU, 1805 with AS but no AAU and 21 133 healthy controls. We also used a heterogeneity test to test the differences in effect size between AS with AAU and AS without AAU...
January 2016: Genes and Immunity
T C Mitulescu, C Popescu, A Naie, D Predeţeanu, V Popescu, C Alexandrescu, L M Voinea
BACKGROUND: Spondyloarthritis (SpA) is associated with an array of peripheral manifestations. Our study aims to evaluate extra-articular manifestations of SpA in a Romanian academic clinical setting and to observe their associations with different disease measures. METHODS: The study was designed to note the extra-articular manifestations of SpA patients in a cross-sectional and retrospective manner. Records included demographics, inflammation markers, SpA clinical characteristics, treatment regimes, associated osteoporosis and cardiovascular morbidity...
July 2015: Journal of Medicine and Life
Massimo Accorinti, Francesca Romana Pesci, Maria Pia Pirraglia, Roberta Priori, Paola Pivetti-Pezzi
OBJECTIVES: To report on the clinical course of ocular and extraocular involvement in a multidrug-resistant patient with Behçet's disease (BD). METHODS: A 22-year-old male with BD (bilateral panuveitis and retinal vasculitis, oral ulcers, erythema nodosum, arthralgia, epididymitis) was followed-up from 1999 to 2014. He was treated continuously with corticosteroids in combination with different immunosuppressive therapies (cyclosporine, azathioprine, methotrexate, interferon, infliximab, mycophenolate), which exerted numerous side-effects such as nephrotoxicity, nephrolithiasis, increase of liver enzymes, severe depression with suicidal ideation, severe leucopenia, pulmonary tuberculosis, pulmonary legionellosis, recurrent bronchopneumonia...
November 2015: Clinical and Experimental Rheumatology
Clovis Arcoverde Freitas-Neto, Willian Breno de Oliveira Fagundes, Manoel Ribeiro, Katia Delalíbera Pacheco, Luiz Guilherme Freitas, Marcos Pereira Ávila
Zoledronic acid is widely used in the treatment of osteoporosis and other bone diseases. However, patients may experience adverse effects involving the anterior segment of the eye following intravenous infusion. This paper reports a rare case of uveitis involving the vitreous cavity following the intravenous administration of zoledronic acid.
May 2015: Seminars in Ophthalmology
Meng Zhao, Hong Wang, Xuan Jiao, Wen-bin Wei
OBJECTIVE: To investigate the effect and safety of immunosuppressive treatment (IMT) combined with steroids in patients with Behçet's uveitis. METHODS: Case-series study. Eighty-five patients (167 eyes) were enrolled in this study from June 2010 to June 2011 at the Beijing Tongren Hospital. The patients were examined before the initiation of IMT and were followed up once every 3 months after the therapy. The corrected visual acuity, inflammation score, ocular complications and side effects of IMT and steroid use were recorded...
March 2013: [Zhonghua Yan Ke za Zhi] Chinese Journal of Ophthalmology
L Procházková, P Němec, M Souček
Spondyloarthritides (SpA) are a heterogeneous group of chronic inflammatory diseases with common clinical features and genetic basis. They primarily affect the axial skeleton, especially the sacroiliac joint, other localizations of the affection being peripheral joints and entheses -  typical of the group of spondyloarthritides. On the basis of the predominant affection of the axial or peripheral skeleton, they can be divided, according to the current classification criteria, into axial SpA and peripheral SpA...
May 2013: Vnitr̆ní Lékar̆ství
C Böni, H Kordic, K Chaloupka
BACKGROUND: Drug-induced cases of orbital inflammation and uveitis are rare.We present a bisphosphonate-induced case of unilateral orbital inflammation and bilateral anterior uveitis. PATIENTS AND METHODS: A 75-year-old female presents because of pain and swelling around her left eye with an onset 2 days after an intravenous zoledronic acid therapy for osteoporosis. Examination reveals reduced visual acuity of 0.2, proptosis of 4 mm, marked conjunctival chemosis and hyperemia, ophthalmoplegia and choroidal folds in the left eye and a bilateral anterior uveitis...
April 2013: Klinische Monatsblätter Für Augenheilkunde
Mario Albani-Campanario, Gerardo Buendía-Díaz, María de Lourdes Flores-Islas, Carlos Maquita-Nakano, Josefina Ochoa-Cervantes
There are several treatment options for postmenopausic patients suffering from ostopenia or osteoporosis; one of them being inhibition of bone resorption using bisphosphonates. The most common side effects of these drugs are of gastrointestinal nature. There are, of course, other side effects that could jeopardize the function and integrity of other organs or systems. A case of a 58-year-old patient presenting zoledronic-acid induced uveitis symptoms is reported. The importance of this paper lies in that this complication is rather exceptional, in particular if associated with the biphosphonate in question...
May 2012: Ginecología y Obstetricia de México
Dipika V Patel, Anne Horne, Meaghan House, Ian R Reid, Charles N J McGhee
PURPOSE: To investigate the incidence of significant adverse ocular side effects after intravenous zoledronate infusion for osteopenia. DESIGN: Data analysis of a large, prospective, randomized, double-blind, placebo-controlled clinical trial. PARTICIPANTS: Postmenopausal women (n = 2001) with osteopenia randomized to placebo or zoledronate infusion. INTERVENTION: Intravenous infusion of zoledronate 5 mg or placebo. MAIN OUTCOME MEASURES: Adverse ocular events...
April 2013: Ophthalmology
Roger G Pertwee
Human tissues express cannabinoid CB(1) and CB(2) receptors that can be activated by endogenously released 'endocannabinoids' or exogenously administered compounds in a manner that reduces the symptoms or opposes the underlying causes of several disorders in need of effective therapy. Three medicines that activate cannabinoid CB(1)/CB(2) receptors are now in the clinic: Cesamet (nabilone), Marinol (dronabinol; Δ(9)-tetrahydrocannabinol (Δ(9)-THC)) and Sativex (Δ(9)-THC with cannabidiol). These can be prescribed for the amelioration of chemotherapy-induced nausea and vomiting (Cesamet and Marinol), stimulation of appetite (Marinol) and symptomatic relief of cancer pain and/or management of neuropathic pain and spasticity in adults with multiple sclerosis (Sativex)...
December 5, 2012: Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
Peter L Lakatos, Laszlo Lakatos, Lajos S Kiss, Laurent Peyrin-Biroulet, Alain Schoepfer, Stephan Vavricka
Inflammatory bowel disease (IBD) is a systemic disease associated with a large number of extraintestinal manifestations (EIM). EIM are present in 15-20% of patients with ulcerative colitis and in 20-40% of patients with Crohn's disease. The management of EIM is best provided by a multidisciplinary team, which includes specialists in the affected organ systems with training in the treatment of IBD. Therapeutic strategy is often empirical. This is explained by the paucity of randomized-controlled studies for the specific treatment of EIM in IBD and by the fact that treatment models are based on extrapolation from patients with similar conditions but without IBD...
2012: Digestion
Michael Pazianas, Emma M Clark, Pia A Eiken, Kim Brixen, Bo Abrahamsen
Ocular inflammatory reactions have been described in patients on bisphosphonate treatment. We estimated the incidence rate of ocular inflammation at 3 and 12 months in patients treated for osteoporosis using a register-based cohort linked to prescription data (hospitals and private practice) and hospital data. From January 1, 1997 to December 31, 2007, a total of 88,202 patients beginning osteoporosis therapy were identified. Of those patients, 82,404 (93%) began oral bisphosphonates and 5798 (7%) nonbisphosphonates...
March 2013: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
James Rosenbaum, Vinod Chandran
The major comorbidities of ankylosing spondylitis include uveitis, bowel inflammation, psoriasis and heart disease. The pathogenic mechanism to account for the coexistence of comorbidities remains largely unknown. In some instances, the comorbidity has a major impact on the choice of therapy.
May 2012: American Journal of the Medical Sciences
Jared D Peterson, Edward H Bedrossian
Bisphosphonates are becoming more widespread as indications for them broaden. Several ocular side effects due to bisphosphonates have been described, among the most potentially serious of which is orbital inflammation. Thirteen case reports of this side effect exist in the literature, with an additional case reported here. The most common presenting signs are lid edema, conjunctival hyperemia, and chemosis, while common symptomatology includes pain, diplopia, and blurry vision. A concomitant anterior uveitis is present in 30% of cases, and some degree of bilaterality is also seen in 30% of cases...
April 2012: Orbit
Abdellah El Maghraoui
Ankylosing spondylitis (AS) is the most frequent and most severe subtype of spondyloarthritis and can be an outcome of any of the other spondyloarthritis subtypes. It primarily affects the axial joints, most notably the sacroiliac joints. Other sites of involvement include the spine, peripheral joints, and entheses (capsules, ligaments, and tendons). Inflammatory enthesopathy progressing to ossification and ankylosis is the pathologic basis for the disease. Extra-articular manifestations vary widely in terms of both frequency and severity...
December 2011: European Journal of Internal Medicine
A Khan, G Lascaratos, T Rane-Malcolm, R Sanders
Zolendronic acid is a nitrogenous biphosphonate commonly used as an intravenous infusion for the management of Paget's disease, osteoporosis, and hypercalcemia of malignancy. We report a rare and challenging complication of zolendronate infusion: unilateral acute anterior uveitis followed by persistently raised intraocular pressure despite being on four different classes of antiglaucoma medication. The challenge was that the patient required topical steroid to treat her uveitis in the background of known glaucoma with corresponding steroid response...
2011: Clinical Ophthalmology
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