Each of the following conditions has a 4 to 6 percent frequency of association with the Gugerot-Sjögren syndrome: systemic lupus erythematous, scleroderma, autoimmune liver disease (simple biliary cirrhosis and chronic active hepatitis), and Hashimoto's thyroiditis. Association with a nodular periarteritis and a polymyositis is very much more unusual and should be discussed on account of the existence of myositis and the vascularity peculiar to the Gougerot-Sjögren syndrome. Very many true or supposedly autoimmune diseases have been reported in association with the Gougerot-Sjögren syndrome: mixed connectivity, atrophying polychondritis, Reynolds' syndrome (scleroderma plus simple biliary cirrhosis), thrombotic thrombocytopenic purpura, thyrotoxicosis of simple hypothyroidism, and total or partial lipodystrophy. The lacrymal and salivary condition is almost constant during systemic lupus erythematosus, scleroderma, simple biliary cirrhosis and mixed connectivity. From the point of view of autoimmune pathology, the Gougerot-Sjögren syndrome might constitute either an autonomous condition when found in isolation or represent the exocrine glandular expression of a dysimmunitary disease with which it is associated.

Autoimmune Diseases↗

PubMedDate not supplied

Multidisciplinary day hospital treatment of rheumatoid arthritis patients. Evaluation after two years.

The availability of multidisciplinary care for rheumatoid arthritis is still limited. The Raoul Dufy Program offered by the Saint-Antoine Teaching Hospital in Paris provides one-on-one personalized care in a day hospital setting as an adjunct to conventional medical follow-up. Listening and providing information and education are major objectives of the nurse, rheumatologist and physical therapist participating in the program. The team also includes a social worker, a surgeon, a dietician, a podiatrist and a psychologist, who intervene as needed. Seventy patients attended the program between December 1993 and September 1995 and were asked to complete a baseline and a three-month questionnaire designed to evaluate the effects of the program in terms of new therapeutic interventions, patient knowledge and quality of life. The patient knowledge score increased significantly (P < 0.0001). Many therapeutic interventions were initiated after program attendance, especially in the fields of podiatry, psychology and physical therapy. However, the quality of life score failed to improve. These results and the substantial patient demand for appointments are encouraging. Further work is needed on the methodology of multidisciplinary care evaluation. Coping strategy evaluation tools may allow to identify some of the specific benefits provided by the multidisciplinary approach.

Adult↗

PubMedDate not supplied

Multiple stress fractures in a scleroderma patient on methotrexate therapy.

A patient on methotrexate therapy for scleroderma developed four stress fractures within a period of 13 months. She was not on steroid therapy and had no risk factors for osteoporosis. A review of the literature found 13 cases of stress fractures under methotrexate therapy. Whether methotrexate can induce bone changes remains controversial.

Female↗