[Chlorbutin, azathioprine, D-penicillamine, and levamisole (Decaris) in the treatment of rheumatoid arthritis patients. I. Comparative analysis of side effects].
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Biomedical subjects
Publications and source records attributed to A A Krel'.
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Morphological signs of rheumatoid synovitis have been analysed on the basis of 130 puncture biopsies taken from 46 patients prior to the beginning and during parenteral therapy with auric preparations (crysanolom and myocrysin) and peroral administration of an auric preparation rhidaura and small doses of D-penicillamine. The most marked morphological effect was reached in 1.5 years. With a favourable clinical effect all the preparations exhibited capacity for suppressing the following basic signs of rheumatoid synovitis: proliferative changes in the layer of synoviocytes, reaction of blast cells.
During a prospective observation lasting 6 years 68 patients with rheumatic arthritis (RA) were repeatedly examined (up to 8 times) roentgenologically with parallel puncture biopsy of the synovial fluid of the knee joint made with an atraumatic needle, and numerical evaluation of markedness of 25 morphological signs of synovitis. A comparative analysis of the markedness of morphological signs of synovitis in relation to the degree and dynamics of destructive changes in the knee joint was made on the basis of the findings of 254 puncture biopsies and the same amount of roentgenograms. There is a close relationship between the activity of synovitis and the progress of destructive arthritis except for the morphological signs characterizing the reaction of hypersensitivity of an immediate type that may serve the purpose of prognostication of further articular destruction and of the choice of an early adequate therapy.
In the period of 5 years the authors observed 213 patients with RA. Of this number 80 patients got Au parenteral preparations and 61--D-penicillamin in the average daily dose of 450 mg. The efficacy of the drugs was assessed by its effect of the indices of the activity (quantitative assessment of clinical manifestations of vascular syndrome) which had been determined by the time of treatment and on the 3, 6, 12, and 18th month of subsequent therapy.
Results of a light optics morphological study of kidney biopsy material in 20 patients with rheumatoid glomerulonephritis supplemented by the data of immunofluorescent and electron microscopic diagnosis have been presented. All-round morphological investigation of biopsy material is the only proof for the presence of a renal lesion in 1/4 of the patients.
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