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H Kellner

Publications and source records attributed to H Kellner.

At least 37 records · Page 2Linked to original sources
PubMed2002

[Expert assessment of patients with seronegative spondyloarthropathies].

Besides rheumatoid arthritis, seronegative spondyloarthropathies are one of the most common inflammatory musculoskeletal diseases. The main clinical manifestations are spondylitis and sacroiliitis, but peripheral arthritis and involvement of other organ systems are known as well. The typical ankylosis of the spine is resulting in a marked loose of the functional capacity. During the course of disease, work disability is progressing and finally the patient may become permanent disabled. Patients with ankylosing spondylitis can be viewed by experts for several reasons. To guarantee an objective medical expert view, a detailed clinical examination and use of clinical indices are mandatory.

Arthritis, Psoriatic↗
PubMed2002

[Gastrointestinal side effects in the therapy of rheumatologic diseases].

Antirheumatic drugs may lead to a number of relevant gastrointestinal complications. Symptomatical treatments with glucocorticoids and non steroidal antirheumatic drugs (NSAD) are known to induce gastric or duodenal ulcers, above all under combination therapies. Side effects of DMARD's (methotrexate, leflunomide, hydroxy/chloroquine, sulfasalazine) include unspecifical gastrointestinal symptoms like nausea, vomiting and diarrhea as well as induction of ulcerative mucosal lesions (methotrexate) and occurrence of a hepatopathy. The latter may appear as an asymptomatical elevation of liver transaminases or cholestase parameters, but can also lead, in some cases of a monothera-py (hydroxy-/chloroqine, sulfasalazine) or combination therapy (methotrexate + leflunomide) to a fulminant hepatitis. TNF-alpha-inhibiting drugs (etanercept, infliximab) as a new generation of anti-inflammatory therapeutics don't have relevant gastrointestinal side effects according recently published data.

Administration, Oral↗
PubMed2001

Surface expression of CC- and CXC-chemokine receptors on leucocyte subsets in inflammatory joint diseases.

Chemokine receptors play a crucial role in the recruitment of leucocyte subsets into inflamed tissue. Using FACS analysis we have studied the surface expression of different CC- and CXC-chemokine receptors on synovial fluid (SF) and peripheral blood leucocytes from 20 patients with various forms of arthritis. In the SF the majority T cells stained positive for CCR5 (93%) and CCR2 (57%), compared to the peripheral blood (36% and 25%). In addition, most of the T cells expressed CXCR4 in both compartments, with a somewhat higher percentage in the SF (90%) versus peripheral blood (83%). To date little information is available on chemokine receptor expression on monocytes in arthritis. We report a marked increase of CCR5(+) monocytes in the SF (87%) compared to the peripheral blood (22%). In contrast, the frequency of CXCR1(+), CXCR2(+), CXCR4(+) and CCR1(+) monocytes was considerably lower in the SF than in the peripheral blood. Moreover, we report the expression CXCR4 on neutrophils in the SF. Approximately 60% of neutrophils stained positive for CXCR4 in the SF, while in the peripheral blood the number of CXCR4(+) neutrophils was low (24%). Surface expression of CXCR1 and CXCR2 was significantly reduced on SF neutrophils (53% and 68%) compared to the peripheral blood. Chemokine receptors are differentially expressed on leucocyte subsets in arthritis. The identification of their pattern of expression might help to identify suitable targets for therapeutic intervention.

Alleles↗
PubMed2000

[1: Clinical aspects, laboratory diagnosis and therapy. Low backache--when is sacroiliitis the cause?].

Despite the availability of modern imaging modalities, early diagnosis of sacroiliitis remains a challenge. The patient's history and the results of the clinical examination form the basis for establishing a working diagnosis, which then needs to be confirmed by laboratory tests and diagnostic imaging. Common causes of sacroiliitis are inflammatory diseases of the spine, in particular seronegative spondyloarthropathies; infectious sacroiliitis is much less common. Besides serological testing (HLA-B27), imaging techniques are essential for diagnosing early forms of sacroiliitis. The treatment of the condition initially involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). In patients with infectious sacroiliitis, antibiotics are the treatment of choice. Local application of steroids, or physiotherapy, can be helpful. The value of disease-modifying drugs (DMARDs) (sulfasalazine, methotrexate) has not been verified, and is questionable. New approaches such as anti-tumor necrosis factor alpha (anti-TNF alpha) need to be tested in controlled studies.

Arthritis↗
PubMed2000

[Roentgen, magnetic resonance with contrast medium, scintigraphy. Staged diagnosis of sacroiliitis].

Radiographic imaging techniques including conventional tomography and computed tomography play a major role in the diagnosis of sacroiliitis (SI). In acute or early stages, however, it may take years before the first morphologic changes become apparent, and the diagnosis of early stages of sacroiliitis still challenges the diagnostician. While scintiscanning is capable of depicting early changes to the joints, it has only low specificity, and interpretation is often difficult, especially in young patients or in cases with bilateral SI arthritis. Contrast-enhanced magnetic resonance imaging (MRI) holds out promise of offering a solution to this problem. With no radiation dose to the patient, MRI is capable of reliably depicting early, acute and chronic alterations to the sacroiliac joints.

Arthritis↗