bluuebunny/crossref_metadata_2025 huggingface dataset:
Homozygous C2 deficiency with fulminant lupus erythematosus. severe nephritis via the alternative complement pathway
Authors: Gewurz Anita , Lint Thomas F. , Roberts Jimmy L. , Zeitz Howard , Gewurz Henry
Published: February 2007

Absence of C2 was identified in an 18‐year‐old white male with progressive and rapidly fatal lupus nephritis. Genetic studies of the patient and 8 family members linked this deficiency with the HLA haplotype A10/B18, for which the patient was homozygous. High titers (1:1600) of anti‐RNP antibodies, as well as antibodies to double‐stranded DNA, were present. Serum levels of properdin factor B were persistently decreased, whereas levels of C1q and C3 intermittently were low. Biopsies of skin and kidney showed typical SLE histopathology with deposition of immunoglobulins and early‐ and late‐acting C components; properdin was deposited in the kidney. Despite the inability of the patient's serum to mediate lysis through the classic C pathway, C‐dependent lysis through the alternative pathway was readily achieved using either unsensitized rabbit cells in gels or mixtures of guinea pig cells and zymosan as the indicator system. These studies thus reveal a new association of fatal lupus nephritis with homozygous C2 deficiency and show the usefulness of two new assays for measuring the hemolytic capacity of the alternative C pathway in human serum. The decreased levels of properdin factor B in serum, deposition of properdin and C3 in renal tissue, and capacity of C2‐deficient serum to mediate hemolytic C activity through the properdin pathway in vitro implicate the alternative C pathway in the severe tissue damage observed.
Effect of systemic lupus erythematosus antibodies against DNA on rna synthesis
Authors: Makarova Olga V.
Published: February 2007

The majority of tested systemic lupus erythematosus (SLE) sera inhibited RNA synthesis in vitro on the stage of RNA chain elongation. Two sera were also active in inhibiting the binding of the enzyme to the template. No correlation has been found between the sera activity in filter radioimmunoassay, their specificity to double‐ or single‐stranded DNA, and the degree of RNA synthesis inhibition.
Oral mucosal ulceration in systemic lupus erythematosus
Authors: Urman Jeffrey D. , Lowenstein Mitchell B. , Abeles Micha , Weinstein Arthur
Published: February 2007

In 182 patients with systemic lupus erythematosus (SLE), oral mucosal ulceration occurred in 47 patients (26%), was usually painless (82%), and most often involved the hard palate (89%). Oral ulceration was associated with an increase in overall clinical activity, although this was not accompanied by significant changes in the levels or titers of C3, anti‐DNA antibodies, and antinuclear antibodies. Necrotizing vasculitis was not observed. Microscopic changes were similar to the skin lesions of SLE and immunoglobulin and complement were found in both the basement membrane and blood vessel walls.
Muscle disease in progressive systemic sclerosis. diagnostic and therapeutic considerations
Authors: Clements Philip J. , Furst Daniel E. , Campion David S. , Bohan Anthony , Harris Robert , Levy Joshua , Paulus Harold E.
Published: February 2007

Upon careful examination, 23 of 24 patients with progressive systemic sclerosis (PSS) were found to have abnormalities of muscle. Nineteen patients presented a homogeneous pattern of muscle abnormalities, which untreated was associated with a stable course (“simple myopathy”). Three patients demonstrated inflammatory muscle disease indistinguishable from polymyositis while a fourth patient developed marked weakness associated with a generalized neuropathic process. Muscle enzymes, electromyogram, and muscle biopsy permitted distinction among the different muscle disorders, a distinction that could have prognostic and therapeutic importance.
Hand structure and function in an industrial setting.
Authors: Hadler Nortin M. , Gillings Dennis B. , Imbus Harold R. , Levitin Peter M. , Makuc Diane , Utsinger Peter D. , Yount William J. , Slusser Derwood , Moskovitz Nancy
Published: February 2007

The influence of patterns of usage on the structure and function of the hands was formally tested. Three groups of female textile workers, each employed in a distinct and defined, atraumatic, repetitive, stereotyped manual task for at least 20 years, were identified in a single rural mill. Replicate data were obtained for the following measures of structure and function: range of motion, a score for the degree of radiographic degenerative changes at each hand joint, malalignment at digital joints determined radiographically, and a quantitative measure of osteophyte formation. Significant and consistent differences in the right hand when compared to the left were detected. Furthermore, highly significant task‐related differences were demonstrated. These task‐related differences in the structure and function of the hands were consistent with the pattern of usage. Therefore these three patterns of usage influence hand structure and function in the population studied.
Thrombocytosis and platelet aggregates in the circulation of adjuvant arthritic rats
Authors: Görög Peter , Kovács Iren B.
Published: February 2007

A marked increase in platelet count was observed in adjuvant‐induced polyarthritic rats. Elevation of platelet count was still significant 3 months after onset of disease. Increased number and larger size of platelets reflect an increase in the rate of platelet production. By means of the platelet‐count ratio technique, circulating platelet aggregates were demonstrated in rats with severe arthritis. Aspirin treatment prevented thrombocytosis and formation of platelet aggregates.
Lymphopenia In Systemic Lupus Erythematosus
Authors: Rivero Santiago J. , Díaz‐Jouanen Efraín , Alarcón‐Segovia Donato
Published: February 2007

One hundred fifty‐eight patients with active, untreated systemic lupus erythematosus (SLE) were studied from the time of diagnosis. Lymphopenia was present in 75%, and another 18% of these patients developed lymphopenia subsequent to disease reactivation. Lymphopenia of less than 1500 cells/m̈l occurred more frequently than any of the preliminary criteria for the classification of SLE, and it was the most prevalent initial laboratory abnormality. Lymphocyte counts were significantly lower in lupus than in the other connective tissue diseases except mixed connective tissue disease and polymyositis.
Immunoglobulin in Tophi and on the Surface of Monosodium Urate Crystals
Authors: Hasselbacher Peter , Schumacher H. Ralph
Published: February 2007

By means of immunohistologic techniques IgG, IgM, and to a lesser degree, IgA were found in the inter‐crystalline matrix of gouty tophi. Smaller amounts of IgG and IgM were inconstantly found in association with tissue deposits of calcium pyrophosphate. When a technique of immune agglutination was used, the affinity of all three major classes of immunoglobulin to the surface of monosodium urate (MSU) crystals was demonstrated. Immunoglobulin and fibrin were found on MSU aspirated from large tophi.
Non–Giant Cell Temporal Arteritis. Three Cases And a Review Of The Literature
Authors: Morgan G. James , Harris Edward D.
Published: February 2007

We report two cases of polyarteritis and one of hypersensitivity angiitis diagnosed by temporal artery biopsy. Autopsies showed no evidence of giant cell arteritis. A review of the English literature provides seven further autopsy cases of necrotizing vasculitis diagnosed by temporal artery biopsy. The term temporal arteritis includes many types of vasculitis, giant cell arteritis being one of them.
Prevalence of Rheumatic Diseases as Causes of Disability and Complaints by Ambulatory Patients
Authors: Reynolds Michael D.
Published: February 2007

Data from the National Health Survey reveal that musculoskeletal diseases are the most prevalent cause of chronic disability among the civilian, noninstitutionalized population. Because of the frequency of musculoskeletal injuries, rheumatic disorders are the second most common cause of acute disability. Problems referable to the musculoskeletal system constitute the second most frequent class of complaints presented by patients to office‐based physicians. Only respiratory and circulatory diagnoses are recorded more often by such physicians.
Effect of the anti‐estrogen, nafoxidine, on nzb/w autoimmune disease
Authors: Duvic Madeleine , Steinberg Alfred D. , Klassen Lynell W.
Published: February 2007

Treatment of female NZB/W F1 mice with Nafoxidine, an anti‐estrogen, led to delayed manifestation of autoimmune features. Such treated mice had reduced anti‐DNA antibodies, reduced proteinuria, and improved survival. These results support the hypothesis that sex hormones play an important role in the expression of autoimmunity and suggest that estrogens may accelerate autoimmunity in NZB/W F1 mice.
Pathologic features of a familial arthropathy associated with congenital flexion contractures of fingers
Authors: Athreya Balu H. , Ralph Schumacher H.
Published: February 2007

Three siblings with a recently recognized form of familial arthropathy were studied clinically and by light and electron microscopy of the synovium. On light microscopy, the synovium from all 3 children showed synovial hyperplasia, necrotic villi, deposition of eosinophilic and PAS‐positive material, and large numbers of multinucleated giant cells. Electron microscopy of the synovium in one patient revealed giant cells with profuse rough and smooth endoplasmic reticulum. Some phagocytic cells contained degenerated collagen in vacuoles or invaginations. There was granular and fibrinlike material on the synovial surface, but no amyloid. This symmetrical arthropathy now reported in three families appears to have characteristic histological appearance of synovium that allows its identification as distinct from other known joint diseases.
Light chain heterogeneity of 19s and 7s anti‐γ‐globulins in rheumatoid arthritis and subacute bacterial endocarditis
Authors: Carson Dennis A. , Lawrance Simon
Published: February 2007

Both 19S and 7S anti‐γ‐globulins in rheumatoid arthritis sera are enriched in kappa light chain bearing antibody molecules when compared to total 19S and 7S globulins from the same individuals. In patients with subacute bacterial endocarditis 19S anti‐γ‐globulins are also, to a degree, enriched in kappa light chains, whereas the 7S anti‐γ‐globulins have kappa to lambda light chain ratios indistinguishable from total 7S globulin.
Comparison of gold levels and distribution in guinea pig serum
Authors: Kamel H. , Brown D. H. , Ottaway J. M. , Smith W. E. , Cottney J. , Lewis A. J.
Published: February 2007

Serum levels after oral administration of 30 mg/kg of sodium aurothiomalate (Myocrisin), triethylphosphine gold chloride, or triphenylphosphine gold chloride to guinea pigs indicated that all were orally absorbed. However, the serum gold level of triethylphosphine gold chloride was three to four times that of Myocrisin or triphenylphosphine gold chloride and was comparable with the serum level produced when the same dose of Myocrisin was injected intramuscularly. A comparative time‐course study between intramuscular administration of Myocrisin and oral administration of triethylphosphine gold chloride indicated that during the first 24 hours after intramuscular injection of Myocrisin, a large fraction of the gold was not protein‐bound, whereas all detectable gold in serum after oral administration of triethylphosphine gold chloride was protein‐bound. Gold levels in the separated protein fractions indicate that the γ‐globulin level after oral administration of triethylphosphine gold chloride is approximately three times higher after 24 hours than with intramuscular Myocrisin.
Age, sex, and race effects on mortality from systemic lupus erythematosus in the united states
Authors: Kaslow Richard A. , Masi Alfonse T.
Published: February 2007

Nationwide rates of death from systemic lupus erythematosus (SLE) were estimated from National Center for Health Statistics mortality data for 1968 to 1972 according to age, sex, and race. The overall rates for females, 6.3 per million person‐years (whites 5.2, blacks 14.8), were about four times that for males, 1.6 per million person‐years (whites 1.5, blacks 2.2). The overall rate for blacks, 8.8, was 2.6 times that for whites, 3.4. An earlier rise in age‐specific mortality rates for females than males produced higher age‐specific female‐to‐male sex ratios in the early adult years than in later years. Mortality generally increased with age in whites whereas the phenomenon of an accentuation and decline during the early and middle adult ages was seen in blacks, particularly females. Analysis of age‐, sex‐, race‐specific rates using one measure of synergistic interaction, S, revealed substantial synergy between the effects of sex and race on mortality during the childbearing ages (S = 3.2, 95% confidence interval = 2.3–4.4).
Autoimmune neutropenia in systemic lupus erythematosus
Authors: Starkebaum Gordon , Price Thomas H. , Lee Minako Y. , Arend William P.
Published: February 2007

The mechanism of granulocyte depletion in a patient with systemic lupus erythematosus and neutropenia was investigated. Neutrophil kinetic studies showed a shortened intravascular survival (t1/2 of 1.6 hours) in the face of an increased marrow neutrophil pool. IgG bound to the patient's neutrophils, measured by the Fab anti‐F(ab)2 assay, was nearly three times normal. The IgG neutrophil‐binding activity of the patient's serum was elevated in serial samples obtained over two years. In addition, his serum was able to opsonize normal neutrophils for ingestion by other neutrophils as detected by 14C‐1‐glucose oxidation. Enhanced IgG PMN‐binding activity was observed with sucrose density gradient fractions of the patient's serum containing either large complexes (19S or greater in size), intermediate complexes (between 7S and 19S), or monomeric IgG. Only the monomeric IgG fraction from the patient's serum, however, opsonized normal neutrophils for ingestion by other neutrophils. These results support the hypothesis that anti‐cell antibodies were responsible for the neutropenia in this patient by opsonizing neutrophils for ingestion by other phagocytic cells.
A subgroup of ankylosing spondylitis associated with hla‐b7 in american blacks
Authors: A. Khan Muhammad , Kushner Irving , E. Braun William
Published: February 2007

In a study of 34 American black patients with primary ankylosing spondylitis, 18 were found to be HLA‐B27‐negative. Of these, 10 possessed HLA‐B7 (55.6%) compared to 23.7% of 59 B27‐negative black controls (P < 0.025, relative risk = 4). On comparing these 10 B7‐positive patients (group I) with 16 B27‐positive black patients (group II), a difference in mean age at onset of disease was found: 33.6 years in group I and 22.2 years in group II (P < 0.005). In addition, a family history of ankylosing spondylitis was absent in group I patients but present in 6 patients in group II (P = 0.034). These findings indicate an association between HLA‐B7 and ankylosing spondylitis in American blacks and suggest that these patients who lack B27 but possess B7 represent a subgroup of patients with this disease.
The infectious etiology of rheumatoid arthritis.
Authors: Bennett J. Claude
Published: February 2007

Several possible mechanisms of chronic inflammatory arthritis that might be initiated by infectious agents are discussed. Some recent information on mycoplasma infections, long‐term virus infections, and shed bacterial components provides the bases for new experimental approaches. Currently, evidence of involvement of mycoplasma or viral agents in rheumatoid arthritis is tenuous. Chronic peptidoglycan–immune‐complex formation is a consideration that has been discussed, but only recently pursued in depth. It may well be that experimental studies on the infectious etiology of rheumatoid arthritis will be revitalized through an appreciation of the bacterial antigen load in the gastrointestinal tract. The experimental vehicles for testing this possibility are available and should be directly applicable at the clinical level.
Ocular chrysiasis correlated with gold concentrations in the crystalline lens during chrysotherapy
Authors: Gottlieb Norman L. , Major James C.
Published: February 2007

The eyes of 11 patients with rheumatoid arthritis (RA) who received extended chrysotherapy (mean cumulative dose greater than 7 grams during a mean 6‐year period) were examined biomicroscopically. Minute reddish‐purple particles were seen in the cornea (corneal chrysiasis) in 5 and in the lens (lens chrysiasis) in 4 patients. Particulate deposits were absent in 11 other RA patients who had not received gold treatment. Seven crystalline lenses from 5 gold‐treated patients were removed surgically because of incidental cataract formation and analyzed for gold content using neutron activation analysis. Although the mean lens gold concentration was higher in these patients than in non–gold‐treated controls without RA (0.0073 m̈g/grams versus 0.001 m̈g/grams), the absolute gold level was markedly lower than that found in 25 diverse tissues analyzed previously. This finding is compatible with the absence of clinical gold‐related lens disease or visual impairment.
Marrow aplasia induced by colchicine. a case report
Authors: Liu Yong K. , Hymowitz Richard , Carroll Michael G.
Published: February 2007

A 70 year old male developed marrow aplasia and pancytopenia after receiving 10 mg of colchicine intravenously over a period of 5 days for acute gouty arthritis. Despite a fatal outcome, evidence of recovery of hematopoiesis was observed in the bone marrow 3 days after the last dose of the drug. The pathogenetic mechanism by which colchicine induced marrow aplasia in this patient remains unclear.
Collagenase production by cultures containing multinucleated cells derived from synovial fibroblasts
Authors: Brinckerhoff Constance E. , Harris Edward D.
Published: February 2007

Multinucleate cells are found frequently in rheumatoid synovium. In this study, polyethylene glycol was used to fuse rabbit synovial fibroblasts. Approximately 40% of the cells developed more than one nucleus in a 24 hour period, during which time cell membranes had increased permeability. In cultures containing multinucleate cells, 3H‐thymidine incorporation was depressed for 24 hours although 3H‐leucine incorporation into TCA precipitable material was unaffected; autoradiography showed that depression of 3H‐thymidine continued for at least 4 days. Collagenase production by cultures containing fused cells was increased more than 10‐fold over control cultures during a 28 day period.
Temporal arteriography. analysis of 21 cases and a review of the literature
Authors: Layfer Lawrence F. , Banner Barbara F. , Huckman Michael S. , Grainer Lorne S. , Golden Harvey E.
Published: February 2007

To define the role of temporal arteriography in the diagnosis of giant‐cell arteritis, the results of temporal arteriography in 21 patients who had temporal artery biopsies were reviewed. Abnormal angiography was found in all patients with biopsy‐proven giant‐cell arteritis, in some patients with polymyalgia rheumatica and normal biopsy, and in some patients with neither polymyalgia rheumatica nor giant‐cell arteritis. No pattern of angiographic abnormality typical for giant‐cell arteritis could be found. Results suggest temporal arteriography is a sensitive but nonspecific procedure in the diagnosis of giant‐cell arteritis and must be coupled with biopsy of angiographic abnormalities for confirmation of diagnosis.
Chrysotherapy. suppression of immunoglobulin synthesis
Authors: Lorber Arthur , Simon Timothy , Leeb John , Peter Alan , Wilcox Stuart
Published: February 2007

Forty‐four subjects with classic or definite rheumatoid arthritis who were on individualized chrysotherapy were observed for changes in serum protein electrophoresis, immunoglobulins, and circulating lymphocyte counts. By paired variate analysis, significant declines from pretreatment values were recorded for the following—electrophoretic protein fractions: gamma, alpha‐1, alpha‐2, (P < 0.05); immunoglobulins: IgM—53% (P < 0.001), IgG—37% (P < 0.01), IgA—34% (P < 0.001). Rheumatoid factor decreased in 29 of 39 subjects, 15 becoming seronegative (P < 0.001); circulating lymphocytes decreased by 27% (P < 0.001). The maximal suppressive effect on IgG and IgM was not achieved until the third and fourth years of therapy by sustained weekly administration of gold sodium thiomalate (one year cumulative dosage, mean 2106 mg, range 1065–2,885; ≥ 4 year cumulative dosage, mean 8747 mg, range 5,385–15, 160 mg). An immunosuppressive effect is suggested by these results.
Herpes zoster in patients with systemic lupus erythematosus
Authors: Moutsopoulos Haralampos M. , Gallagher John D. , Decker John L. , Steinberg Alfred D.
Published: February 2007

In the context of prospective trials of immunosuppressive drugs in systemic lupus erythematosus (SLE) nephritis, 83 patients were studied with regard to development of herpes zoster.

Herpes zoster was found to occur with high frequency (21%) in patients with SLE nephritis treated with immunosuppressive agents. The course of herpes zoster was benign: no deaths occurred and only 2 of the 18 patients developed generalized disease, which resolved without sequelae. Specific antiviral therapy was not necessary and there appears to be no need to decrease immunosuppressive medications. Zoster occurred when the SLE was relatively inactive and did not exacerbate the SLE. No statistical difference in the incidence of zoster was found among the patient groups treated with different immunosuppressive regimens.
Relative reactivities of rheumatoid factors in serum and cells. evidence for a selective deficiency in serum rheumatoid factor
Authors: Robbins Dick L. , Moore Terry L. , Carson Dennis A. , Vaughan John H.
Published: February 2007

Investigations of rheumatoid factors by a hemolytic plaque forming cell assay of blood lymphocytes with sensitized sheep cells have suggested that the rheumatoid factors released from the cells have higher affinities for human IgG than do the rheumatoid factors measured in the patient's serum. This study reaffirms this observation and provides evidence that the reported differences are not artifacts of technique. The findings imply that rheumatoid factors of higher affinity for IgG than those of the serum are being released into the tissue fluids by lymphocytes and locally precipitated. Such rheumatoid factors may never reach the peripheral blood serum in detectable quantity or may do so only infrequently.
Hemochromatotic arthropathy mimicking rheumatoid arthritis. a case with subcutaneous nodules, tenosynovitis, and bursitis
Authors: Bensen William G. , Laskin Carl A. , Little Hugh A. , Fam Adel G.
Published: February 2007

A 63‐year‐old man developed symmetrical polyarthritis, subcutaneous nodules at the elbows, olecranon bursitis, and recurrent tenosynovitis. He was later discovered to have idiopathic hemochromatosis. Staining of the subcutaneous nodule revealed iron deposits. These manifestations which are common to rheumatoid arthritis may be seen in hemochromatotic arthropathy.
Immunologic sex differences and the female predominance in systemic lupus erythematosus
Authors: Inman Robert D.
Published: February 2007

The female predominance in many rheumatic disorders, most notably systemic lupus erythematosus, suggests that immunologic sex differences may modify susceptibility to disease. Clinical and experimental data indicate heightened humoral immunity and depressed cellular immunity in females compared with males. These differences appear to be mediated by sex hormones.
Reactivities of systemic lupus erythematosus sera with cellular and virus antigen preparations
Authors: Pincus Theodore , Steinberg Alfred D. , Blacklow Neil R. , Decker John L.
Published: February 2007

Sera of patients with systemic lupus erythematosus (SLE) showed significantly higher complement fixation reactivities with 8 of 10 virus antigen preparations compared to sera of normal subjects, including virus workers, confirming earlier observations. However, one‐third of SLE sera were also reactive with cellular antigens, prepared in a manner identical to viral antigens, but from cells not infected with virus. By contrast, only one of 49 normal sera showed reactivity with one of nine cellular antigens, at a minimal titer. Apparently heightened reactivities of SLE sera with virus antigens could be explained in many instances on the basis of reactions with cellular antigens. Serum reactivities with nonviral tissue antigens in SLE must be considered in interpretation of immunologic studies related to viruses and SLE.
Involvement of prostaglandins from rheumatoid synovium in inhibition of articular cartilage metabolism
Authors: Lippiello L. , Yamamoto K. , Robinson D. , Mankin H. J.
Published: February 2007

Short term incubations of articular cartilage in media from cultures of rheumatoid synovial tissue result in marked inhibition of 3H‐glycine and Na235SO4 incorporation into trichloroacetic acid (TCA) insoluble macro‐molecules by the cartilage segments with little effect on degradation of prelabeled cartilage matrix. This inhibition is time dependent and not observed in cartilage segments incubated in media derived from rheumatoid synovia cultured in the presence of indomethacin (a specific inhibitor of prostaglandin synthesis). In addition, no indomethacin‐sensitive cartilage inhibitory activity was detectable in media from cultures of normal synovia. The ether solubility of the majority of the inhibitory activity and the indomethacin sensitivity suggest that the inhibitor(s) are prostaglandins.

The significance of prostaglandin‐induced cartilage inhibitory activity derived from rheumatoid synovial tissue remains speculative. However, these data suggest that prostaglandins may play a substantial role in the development of cartilaginous lesions in inflammatory arthritis in which elevated prostaglandin levels are commonly found in the synovial fluid.
Fate of antigen after intravenous and intraarticular injection into rabbits
Authors: Mitnick Hal , Hoffstein Sylvia , Weissmann Gerald
Published: February 2007

To determine the manner in which small protein antigens enter the synovium and are localized, horseradish peroxidase (molecular weight 40,000) was injected by intravenous and intraarticular routes. Passage of antigen from capillary lumen to joint space and vice versa occurred primarily across fenestrated vessels. Antigen localized to collagen fibers and lining cells. At low concentrations of antigen, antigen was taken up predominantly by marcrophages, whereas at higher concentrations both macrophages and fibroblast‐like lining cells accumulated antigen.
Echovirus‐associated polyarthritis. report of a case with synovial fluid and synovial histologic characterization
Authors: Wolfe Blotzer J. , Myers Allen R.
Published: February 2007

A patient with fever, myalgias, and acute polyarthritis in whom echovirus 9 was isolated from throat and rectal swab specimens is described. All symptoms resolved spontaneously over a one week period except for the arthritis which required three months for complete recovery. A mildly inflammatory synovial fluid and histologic picture were observed. Attempts to isolate the virus from synovial fluid and synovium during acute illness were unsuccessful.
Significance of serum c‐reactive protein elevation in patients with systemic lupus erythematosus
Authors: Zein Nazih , Ganuza Carlos , Kushner Irving
Published: February 2007

Serum C‐reactive protein (CRP) concentration was determined by a radial immunodiffusion method in serum samples collected over a mean period of 19 months from a group of 17 patients with systemic lupus erythematosus (SLE). Thirty‐two episodes of CRP elevation were detected. Twenty of these were associated with active SLE, and 9 with proven or possible infection or bone fracture. In 3 cases no explanation for CRP elevation was readily apparent. There were 8 instances of onset or exacerbation of lupus activity without accompanying CRP elevation. These data indicate that CRP elevation in the course of SLE is frequently associated with activation of lupus, and that detection of such elevation does not differentiate between lupus activity and infection.
Radiologic analysis of arthritis in rats after systemic injection of streptococcal cell walls
Authors: Clark Richard L. , Cuttino John T. , Anderle Sonia K. , Cromartie William J. , Schwab John H.
Published: February 2007

The intraperitoneal injection of an aqueous suspension of cell wall fragments from group A streptococci induces a chronic intermittent arthritis in rats that is associated with the persistence of cell wall material in joint tissues. The radiographic techniques utilized to study this experimental model are described and the radiologic findings encountered during the natural history of the disease are presented. The progressive erosive synovitis of this model is similar to that seen in rheumatoid arthritis.
SErum Amyloid a Protein in Amyloidosis, Rheumatic, and Neoplastic Diseases
Authors: Benson Merrill D. , Cohen Alan S.
Published: February 2007

Serum levels of amyloid protein A (SAA) have been shown to be elevated in different types of amyloidosis and in rheumatic diseases by radioimmunoassay using 125 iodine labeled AA and anti‐AA. SAA levels were elevated in both primary and secondary amyloidosis, but there were highly significant differences between these levels. In heredofamilial amyloid, SAA levels were within normal limits. While the mean SAA level was elevated in persons over 70 years, the fact that some persons in this age group had normal levels suggested that marked elevation after age 70 may be due to occult inflammatory or neoplastic disease. High SAA levels in patients with rheumatoid arthritis correlated, in most cases, with physician evaluation of disease activity and Westergren ESR. SAA levels in patients with systemic lupus erythematosus were lower than those in patients with rheumatoid arthritis, and most patients with degenerative joint disease had normal levels. Very high levels of SAA were found in patients with neoplastic diseases. Patients with carcinoma of the lung and bowel had much higher levels than patients with carcinoma of the breast. Determination of SAA levels may be of value in evaluating different forms of systemic amyloidosis, assessing the activity of rheumatic disease, and screening for occult inflammatory or neoplastic disease.
Articular manifestations of mixed connective tissue disease
Authors: Ramos‐Niembro Francisco , Alarcóan‐Segovia Donato , Hernández‐Ortíz Jorge
Published: February 2007

All but one of 28 patients with mixed connective tissue disease (MCTD) who were studied prospectively had arthralgia, and 15 of them had noticed joint swelling. Arthralgia was the first symptom in 14 patients and one of the first two symptoms in 24. Arthralgia was pauciarticular in 4 and polyarticular in 23. Presence of morning stiffness in 15 patients, symmetrical joint swelling in 16, joint deformity in 6, marginal erosions in roentgenograms of the hands of 12, rheumatoid factor in 25, and subcutaneous nodules in 5 caused 24 of the 28 patients with MCTD to fulfill criteria for definite or classic rheumatoid arthritis. All patients, however, also had prominent signs or symptoms of scleroderma, systemic lupus erythematosus, or polymyositis.
Ribavirin treatment in murine autoimmune disease
Authors: Klassen Lynell W. , Williams Gary W. , Reinertsen James L. , Gerber N. Lynn , Steinberg Alfred D.
Published: February 2007

NZB/W F, female mice were treated from 20 weeks of age with ribavirin (a broad spectrum antiviral drug), cyclophosphamide, or saline. Treatment with ribavirin (250 mg/kg twice weekly) prolonged survival from 9.8 to 18.5 months, reduced anti‐DNA antibodies, and prevented proteinuria. Ability of ribavirin to prolong survival was dose related when given on a twice weekly schedule. However, daily ribavirin (25 mg/kg/day) was as effective as higher intermittent doses. Optimal ribavirin therapy was equal to cyclophosphamide treatment with regard to prolongation of survival. Ribavirin treatment did not significantly alter the body weight, hematocrit, WBC count, serum immunoglobulins, or Coombs reactivity. No alterations in either cellular or humoral immune responses were noted in NZB/W F, or BALB/c mice treated for prolonged periods with ribavirin. The impressive therapeutic response to a broad spectrum antiviral agent seen in mice already manifesting immune complex nephritis provides a new therapeutic approach to the treatment of autoimmunity.
Cartilage proteoglycan alterations in an experimentally induced model of rabbit osteoarthritis
Authors: Moskowitz Roland W. , Howell David S. , Goldberg Victor M. , Muniz Ofelia , Pita Julio C.
Published: February 2007

Size distribution of cartilage proteoglycans (PG) extracted from control and osteoarthritic rabbit knees after partial meniscectomy was analyzed. In normal control knees, about 30% of PG molecules were in aggregate form and average sedimentation constant was 60S. No aggregates were found in osteoarthritic cartilage, whether ulcer, rim about ulcer, or distant normal‐appearing cartilage was examined. Weight average sedimentation constants for PG subunits were similar to controls, 15S. Up to 70% of guanidinium‐extractable PG could be extracted from osteoarthritic cartilage by using 0.5M guanidine HCI (GuHCI); sedimentation characteristics of extracted PG were similar to those using 4.0M GuHCI. Absence of aggregates is consistent with a disorder of link protein, hyaluronic acid, or PG subunit hyaluronic acid binding sites. Absence of subunit degradation was an unexpected finding. The demonstrated ability of 0.5M GuHCI to extract large amounts of PG from osteoarthritic cartilage will allow study of cartilage proteoglycans in their native nondissociated state.
Joint effusions after kidney transplantation
Authors: Macfarlane John D. , Filo Ronald S. , Brandt Kenneth D.
Published: February 2007

Thirty‐seven consecutive renal transplant recipients were studied prospectively for joint disease. Six developed arthralgias while corticosteroid doses were being lowered. Eleven patients (30%) developed knee effusions at a mean interval of 10 days following transplantation. Synovial fluids were colorless or very pale yellow, with few leukocytes (mean, 28/mm3). These benign transudative effusions did not correlate with immunologic abnormalities, transplant rejection, crystal deposition, or avascular necrosis and may have been due to high dose oral corticosteroid therapy.
Synovitis in secondary syphilis
Authors: Reginato Antonio J. , Schumacher H. Ralph , Jimenez Sergio , Maurer Kenneth
Published: February 2007

Polyarthritis and tenosynovitis were seen as the presenting complaints in 7 patients with secondary syphilis. Synovial needle biopsy was obtained in 3 cases and showed mild synovitis with infiltration by lymphocytes, plasma cells, and polymorphonuclear leukocytes; vascular congestion; and slightly increased synovial lining cells. In addition, electron microscopy in these synovial membranes showed many necrotic polymorphonuclear leukocytes, much interstitial debris and fibrin, and in 2 patients, bodies suggestive of Treponema pallidum in the interstitium and in vessel lumens.
Increased toxoplasma antibodies in idiopathic inflammatory muscle disease
Authors: Phillips Paul E. , Kassan Stuart S. , Kagen Lawrence J.
Published: February 2007

Antibodies to Toxoplasrna gondii were measured in sera from 69 patients with polymyositis, dermatomyositis, and myositis associated with other connective tissue diseases and compared to 69 age‐, race‐, and sex matched controls with unrelated diseases. Complement fixation toxoplasma antibodies were significantly more frequent in polymyositis and correlated with high IgM levels. Other distinguishing clinical or laboratory fea tures of these patients were not found. The high tox oplasma antibodies were not associated with generally hyperactive humoral immunity. The serologic data sug gested that inflammatory muscle disease was associated with recent active toxoplasma infection in certain patients. The pathogenetic role of the microorganism remains uncertain.
Anti‐dsdna and complement profiles as prognostic guides in systemic lupus erythematosus
Authors: Swaak A. J. G. , Aarden L. A. , Statius Eps L. W. Van , Feltkamp T. E. W.
Published: February 2007

Antibodies to dsDNA, tested with circular DNA in the Farr assay, are specific for systemic lupus erythematosus. A longitudinal study showed a clear relation between the clinical state, the anti‐dsDNA titer (expressed in units), and the C1q and C3 levels: when anti‐dsDNA levels remained high, no exacerbations were observed. A sharp drop in anti‐dsDNA, usually preceded by a rise, was related to a serious exacerbation. Only during the exacerbation when both C1q and C3 were very low was renal involvement seen.
Immunoelectrophoretic assay for synovial fluid C3 with correction for synovial fluid globulin
Authors: Hasselbacher Peter
Published: February 2007

Synovial fluid C3 was measured by electroimmunoassay. When C3 was expressed as mg/ml, the amounts found in Reiter's disease, psoriatic arthritis, gout, and systemic lupus erythematosus were significantly different from degenerative arthritis. When C3 was corrected for total protein, the levels for rheumatoid arthritis, Reiter's disease, psoriatic arthritis, and systemic lupus were significantly different from degenerative arthritis. When C3 was corrected for synovial fluid globulin, only rheumatoid arthritis and systemic lupus were significantly different from degenerative arthritis. Correction of C3 for globulin increases the difference between rheumatoid arthritis and degenerative arthritis. A proportion of gouty fluids with a relative decrease in C3 is demonstrated. It is argued that correction of C3 for globulin is more meaningful than correction for total protein. While many nonrheumatoid inflammatory effusions demonstrate split products of C3, the majority of fluids from patients with systemic lupus have none.
Apparent acute renal failure associated with therapeutic aspirin and ibuprofen administration
Authors: Kimberly Robert P. , Sherman Raymond L. , Mouradian Janet , Lockshin Michael D.
Published: February 2007

Aspirin and ibuprofen may cause a decrease in renal function which, although statistically significant, is usually small. We report a patient with active systemic lupus erythematosus and apparent acute renal failure associated with the administration of these drugs. Renal biopsy revealed no light microscopic evidence of drug nephrotoxicity although patchy nonspecific ultrastructural changes in the tubular epithelium were seen. The renal failure reversed rapidly when the drugs were withdrawn.
Rheumatology
Authors: Samuelson Cecil O. , Cockayne Thomas W. , Williams H. James
Published: February 2007

The majority of patients with rheumatologic problems are seen and followed by nonrheumatologists. Of concern is the perception that a significant number of United States medical schools do not have adequate teaching programs in the rheumatic diseases. Two thousand two hundred and seventy practicing physicians, trainees, and medical students were surveyed in the Intermountain West to determine what they think undergraduate medical students should learn about rheumatology. Most respondents felt that common diseases and problems should be emphasized and that basic skills in history taking and physical examination are more important than disease related information.
Acute monocytic arthritis
Authors: Brawer Arthur E. , Cathcart Edgar S. , Steere Allen C.
Published: February 2007

Five patients with the triad of fever, skin rash, and acute polyarthritis were studied with regard to synovial fluid analysis. All cases revealed inflammatory effusions with a predominant monocytosis. Skin biopsies from two cases and synovial membrane biopsy from one case revealed a nonnecrotizing vasculitis. Although the etiology of this syndrome was not ascertained, it bears striking similarities to certain viral arthritides. It also deserves consideration as a form of acute hypersensitivity angiitis.
Immune Complexes in Rheumatoid Arthritis Sera and Synovial Fluids
Authors: Halla James T. , Volanakis John E. , Schrohenloher Ralph E.
Published: February 2007

Sera and synovial fluids from 88 patients with rheumatoid arthritis were examined for circulating immune complexes by three assays: monoclonal rheumatoid factor radioimmunoassay, Clq binding assay, and Raji cell radioassay. Paired samples were available for 82 patients. Immune complexes were detected with high frequency in the synovial fluid by each assay (75% by the monoclonal rheumatoid factor radioimmunoassay, 95% by the Clq binding assay, and 61% by the Raji cell radioassay). In rheumatoid arthritis sera, immune complexes were detected with high frequency by the Clq binding assay (85%) and the monoclonal rheumatoid factor radioimmunoassay (70%) but infrequently by the Raji cell radioassay (26%). The presence of immune complexes in serum was most frequently accompanied by the presence of complexes in fluid, regardless of the method of detection; moreover, the levels of immune complexes in synovial fluid were generally higher than in paired serum. Further, the levels of immune complexes as measured by the Clq binding assay correlated with certain parameters of clinical activity, while the monoclonal rheumatoid factor radioimmunoassay and Raji cell radioassay correlated with extraarticular features (excluding nodules) of rheumatoid arthritis.
Long Term Chrysotherapy
Authors: Kean W. F. , Anastassiades T. P.
Published: February 2007

The frequency and incidence of certain forms of toxicity in patients receiving long term chrysotherapy for rheumatoid arthritis have been reliably calculated for defined, sequential time periods. Ninety‐four patients who received 100 courses of gold therapy for a total treatment period of 134.4 patient‐years were followed at one gold therapy clinic. For the period of 0–3 months, the incidences of rash, mouth ulcer, and proteinuria were 9.8, 4.0, and 1.8 episodes per 10,000 patients/month, respectively. However, the incidence of these forms of toxicity decreased progressively in subsequent time periods of continued chrysotherapy. No similar decrease was noted in the incidence of thrombocytopenia, but it would appear that the methodology used in monitoring significantly affects the incidence of clinically important thrombocytopenia. No predictive correlates could be determined for patients who had gone into sustained remission. However, the data strongly suggest that patients who improve within 6 months may continue chrysotherapy for at least up to 3 years with an increasing margin of safety for mucocutaneous and renal toxicity.
Development and Reversal of a Proteoglycan Aggregation Defect In Normal Canine Knee Cartilage After Immobilization
Authors: Palmoski Marshall , Perricone Elaine , Brandt Kenneth D.
Published: February 2007

Healthy adult dogs were studied for a defect in proteoglycan aggregation by immobilizing one limb for varying periods of time. Immobilization for 6 days resulted in a 41% reduction in proteoglycan synthesis by articular cartilage from the restrained knee compared with the contralateral control knee. After 3 weeks of immobilization, proteoglycan aggregation was no longer demonstrable in cartilage from the constrained limb. The aggregation defect was rapidly reversible and aggregates were again normal size 2 weeks after removal of a cast that had been worn for 6 weeks.
Cardiopulmonary Manifestations of Progressive Systemic Sclerosis
Authors: Pisko Edward , Gallup Kenneth , Turner Robert , Parker Michael , Nomeir Abdel‐Moshem , Box Jane , Davis John , Box Pat , Rothberger Henry
Published: February 2007

Sixteen patients with progressive systemic sclerosis were evaluated for cardiopulmonary manifestations of their disease and for serologic immune abnormalities. Twenty‐five percent of patients had abnormal echocardiograms, and 81% had a significant reduction in pulmonary function by spirometry. Circulating immune complexes (IC) were detected in 44% of patients by using a fluorescent Raji cell assay, and these patients were more likely to have an abnormal echocardiogram (P < 0.02). Seventy‐five percent of the patients had fluorescent antinuclear antibodies (FANA) and these patients were more likely to have pulmonary disease (p < 0.01).
C3 Activation by Monosodium Urate Monohydrate and Other Crystalline Material
Authors: Hasselbacher Peter
Published: February 2007

Monosodium urate monohydrate (MSUM) is a potent activator of the complement system as measured by electrophoretic conversion of β,C to β, A. Activation of C3 in human serum by MSUM is both time‐ and dose‐dependent. The sensitivity of the assay allows detection of C3 activation by as little as 0.2 mg/ml of MSUM. It was observed that C3 activation is calcium dependent and eliminated by both EDTA and EGTA, a finding that demonstrated the major role of the classic pathway of complement activation. Excess calcium or magnesium alone inhibited C3 activation by MSUM in accord with the inhibitory effect of these cations on sensitized sheep cell hemolysis by complement. Heating of MSUM at 200°C for 2 hours removes the water of crystallization such that heated crystals may no longer be considered MSUM. Such treatment has a variable effect on C3 activation. Of the crystals and other material studied, only zymosan was more potent than MSUM in activating C3. Calcium pyrophosphate dihydrate and hydroxyapatite activated significant amounts of C3. Asbestos, glass wool, or a variety of microcrystalline steroids activated little or no C3.
Plasmapheresis and lymphoplasmapheresis in the management of rheumatoid arthritis
Authors: Wallace Daniel J. , Goldfinger Dennis , Gatti Richard , Lowe Cheryl , Fan Peng , Bluestone Rodney , Klinenberg James R.
Published: February 2007

We have demonstrated the efficacy of therapeutic pheresis in a number of rheumatic diseases, especially rheumatoid arthritis (RA). Ten of 12 patients with RA went into remissions averaging 4 months. These patients were pheresed 20 times over 11 weeks in a tapering fashion on a Haemonetics Model 30 Blood Processor. Clinical remissions were sustained even though serologies, immunoglobulins, immune functions, sedimentation rates, and circulating immune complexes returned to their pre‐pheresis baseline by pheresis number 20. All these patients were taking gold or D‐penicillamine concurrently, but neither of the 2 patients who failed to respond was on these agents. Plasmapheresis was just as effective as lymphoplasmapheresis. It is theorized that removal of a plasma factor that modulates lymphocyte or neutrophil function produces remissions in RA and that long‐acting drugs (e.g., gold or penicillamine) are able to prevent its continued production and produce a sustained remission.
Cellular immunity in polymyalgia rheumatica and giant cell arteritis
Authors: Papaioannou Christos C. , Hunder Gene G. , Mcduffie Frederic C.
Published: February 2007

Peripheral blood lymphocyte functions were evaluated in 20 patients with active polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA) by determining the percent of E‐rosette‐forming cells and by measuring the uptake of tritiated thymidine by peripheral blood lymphocytes after exposure to common infectious antigens and to homogenates of homologous and heterologous artery, muscle, and elastin. Although lymphocytes from patients with PMR and/or GCA were stimulated slightly by artery and muscle homogenates, no differences in lymphocyte responses were found when the results were compared with 22 normal controls and 16 patients with rheumatoid arthritis. The hypothesis that GCA results from a cellular immune reaction to normal or diseased arterial wall antigens is not supported by these studies.