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Biomedical subjects

J Dequeker

Publications and source records attributed to J Dequeker.

338 records · Page 19Linked to original sources
PubMedDate not supplied

Prognostic factors in juvenile chronic arthritis.

We evaluated 96 patients (50 males, 46 females) with juvenile chronic arthritis (JCA) for various prognostic factors in an adult rheumatology clinic. Although the onset of JCA occurred before the age of 15 in all cases, the majority had a juvenile or late onset of disease. The mean duration of disease was 14 years. Twenty-eight % had a monoarticular onset, 26% a pauciarticular, 28% a polyarticular and 14% a spondylarthropathic onset. HLA-B27 was positive in 52% of the cases, 35 males and 12 females, and HLA-DW4 was present in 10%; 11.5% were ANA positive and 4% were found rheumatoid factor positive (latex greater than 1/128). Patients were classified in functional classes, using a slight modification of Steinbrocker's criteria. Patients who underwent major orthopaedic surgery of the hip or knee were classified in functional class IV, although they actually showed better function. Twenty-seven % had a functional class I, 45% class II and 24% class III-IV at the latest evaluation. In the group with poor prognosis (functional class III and IV) there were significantly more cases with a persistently high erythrocyte sedimentation rate; polyarticular involvement at onset and at the time of their last evaluation; and a family history of rheumatic diseases. There were significantly more females in the poor prognosis group. The presence of HLA-B27 and an ANA positive test were not significantly different in the functional class groups. HLA-B27 did not predict the development of typical ankylosing spondylitis but was associated with pauciarticular peripheral arthritis with or without mild spondylitis.

Adolescent↗
PubMedDate not supplied

Relevance of urinary excretion of alcian blue-glycosaminoglycans complexes and hydroxyproline to disease activity in rheumatoid arthritis.

Urinary excretion of glycosaminoglycans (GAG) and hydroxyproline was studied in 42 adult patients with rheumatoid arthritis (RA). A significant increase of GAG and hydroxyproline was found in RA patients compared to normal controls. RA patients fulfilling the criteria of disease activity were found to have urinary excretion of GAG and hydroxyproline higher than of RA patients not fulfilling these criteria. No significant correlation however was observed between urinary GAG and hydroxyproline. GAG and hydroxyproline excretion might be the expression of cartilage destruction and bone involvement and both may be related to the activity of the rheumatoid process.

Adult↗
PubMedDate not supplied

HLA-B27, arthritis and Yersinia enterocolitica infection.

Over a 3 1/2-yr period 25 cases of Yersinia enterocolitica arthritis were observed. This is a frequency of about 1% of the new patients seen at our Rheumatology Clinic. The histocompatibility antigen HLA-B27 was found in 14 of the 25 patients with Yersinia arthritis (56%). There was no difference in duration of disease, joint symptoms or laboratory data between the HLA-B27 positive or negative group. Six cases had a disease course longer than 1 yr. Four of them had a disease onset before the age of 16 yr and all cases had knee joint involvement. Our findings are discussed in relation to reports from other centers.

Adolescent↗
PubMedDate not supplied

The effect of D-penicillamine on lung function parameters (diffusion capacity) in rheumatoid arthritis.

Sequential lung function tests were performed on 28 rheumatoid arthritis (RA) patients who were treated with D-penicillamine (total of 101 treatment years) and on 42 control RA patients who were not treated or who were treated with NSAIDs, chloroquine, gold salts, corticosteroids, salazopyrine or methotrexate. A decline in lung function parameters was found in both groups, although it was only significant for the carbon monoxide diffusing capacity corrected for lung volume (DLCO/VL). This decrease in DLCO/VL was less pronounced in the D-penicillamine group (mean -6.9%) than in the control group (mean -11.3%). This difference could not be attributed to smoking, which was more frequent in the control group. When reviewing only the patients with an initial DLCO/VL < 80% of the predicted value and having, with some exceptions, chest X-ray abnormalities, we even observed an amelioration in the mean DLCO/VL in the D-penicillamine group, in contrast with a deterioration in the control group (+5.1% versus -5.6%).

Adult↗
PubMedDate not supplied

Osteoporosis in rheumatoid arthritis.

OBJECTIVE: To answer and comment on a number of controversial issues in relation to osteoporosis and rheumatoid arthritis (RA), including: Is osteoporosis an extra-articular manifestation of rheumatoid arthritis? Does periarticular osteoporosis reflect disease activity in early arthritis? Is there a threshold for corticosteroid-induced osteoporosis? Can anti-resorbing drugs prevent rheumatoid arthritis progression? Are stress fractures rare in rheumatoid arthritis Is methotrexate toxic for bone? METHODS: Confrontation of current literature and our own experience in order to formulate a general opinion. RESULTS AND CONCLUSIONS: Because most studies agree that osteoporosis in postmenopausal women and in men with RA is more evident at the hip and radius than at the spine, and that the most important determinants of bone loss are disability, local disease activity and cumulative corticosteroid dose, osteoporosis is not a common systemic extra-articular manifestation of RA. In early arthritis, periarticular osteoporosis does indeed reflect disease activity because it is closely related to the acute phase reactants, but once periarticular osteoporosis is established it is no longer a marker of disease activity. The threshold does for corticosteroid-induced osteoporotic fractures is the cumulative rather than the actual dose. Statements based on quantitative computed tomography concerning the acute effects (and their reversal) of corticosteroids on bone have to be interpreted with care because of important body composition changes, in particular in bone marrow fat, during corticosteroid treatment. At present there is no evidence that anti-resorbing drugs can change the progress of RA erosions, probably because erosions are the result of non-osteoclast mediated mechanisms. Stress fractures in RA are underdiagnosed and are often confused with synovitis, and therefore it is likely that they are more frequent than commonly thought, in particular at the lower limbs. Methotrexate osteopathy is known in oncological practice. Whether low dose methotrexate is toxic for bone is not clear, but a number of clinical observations suggest that the occurrence of spontaneous fractures and lower extremity pain is more frequent in methotrexate treated patients than expected. Prospective studies are necessary to confirm these impressions.

Adrenal Cortex Hormones↗