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Biomedical subjects

J Sany

Publications and source records attributed to J Sany.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

[HL-A and psoriatic rheumatism].

The HL-A groups, including the characteristics of 25 antigens, were measured in 61 patients suffering from psoriatic rheumatism, among them 9 with central forms (pelvispondylitis) and 52 with peripheral forms (polyarthritis with or without sacroileitis). Analysis of the results and comparison of them with those of other workers led to the following conclusions: 1) Central psoriatic rheumatism is associated mainly with W27 and Da31, less closely with HL-A13, and slightly or not at all with W17. 2) Peripheral psoriatic rheumatism has the same relationship with the HL-A system as has psoriasis without anthropathy. It is associated mainly with W17, less closely with Da31 and HL-A13, and slightly or not at all with W27. 3) By their relationship to the HL-A system, the two varieties of psoriatic rheumatism may be clearly distinguished from one another and from other inflammatory rheumatisms. The HL-A groupings are of considerable value in the differential diagnosis between central psoriatic rheumatism, peripheral psoriatic rheumatism, ankylosing spondylarthritis, the Fiessinger-Leroy-Reiter syndrome and rheumatoid arthritis.

Adolescent↗
PubMedDate not supplied

Rheumatoid arthritis associated with high levels of immunoglobulin a: clinical and biological characteristics.

We measured the serum immunoglobulins in 191 patients with rheumatoid arthritis (RA) over an 8-month period, looking for a relationship between high IgA levels, disease activity, and clinical and biological features. Twenty-nine patients with a polyclonal hyperimmunoglobulin A (IgA) (15.2%) above 5 g/l constituted group A. A control group of 29 randomized RA patients with normal IgA levels was studied over the same period (group B). The mean serum IgA concentration was significantly elevated in group A: 6.6 +/- 1.8 g/l versus 2.8 +/- 0.9 g/l in group B (p < 0.01). In group A, microscopic haematuria occurred in 20.7% of the cases, as against 3.4% from group B (p < 0.05). Furthermore, the incidence of unilateral sacroiliitis and of arthritis of the distal interphalangeal joints was significantly increased in group A (41.4% and 34.5%, respectively) against 6.9% and 3.4% in group B (p < 0.01) and this correlated with a high IgA serum level (p < 0.01). On the other hand, neither disease activity nor the biological parameters of inflammation were influenced by the level of IgA. Patients with RA associated with high levels of IgA are characterized by a significant increase in the incidence of distal interphalangeal arthritis, unilateral sacroiliitis and microscopic haematuria. These clinical and biological features could define a distinct subgroup of patients with RA.

Adult↗
PubMedDate not supplied

The efficiency of switching from infliximab to etanercept and vice-versa in patients with rheumatoid arthritis.

OBJECTIVE: To determine whether it may be successful to try another TNF-alpha antagonist (infliximab or etanercept) when one has failed due to non response or the development of side effects. METHODS: In a cohort of 282 patients with rheumatoid arthritis treated with infliximab or etanercept, we observed 38 patients who had received both agents. RESULTS: Twenty-four patients received infliximab first and 14 received etanercept first. Discontinuation was due to a lack of efficiency for 29 patients and to the occurence of an adverse effect for 9 patients. For 25 out of the 38 patients, the switch was a success according to the global physician's assessment 3 months after switching. This result was correlated to a significant decrease of DAS 28 measurements and CRP values (p < 0.05). The response after switching was recorded as a success for 18 out of the 24 patients who were treated with infliximab first, and for 12 out of the 14 patients who were treated with etanercept first. There was no statistical difference concerning the response after the switch between the two groups. Among the 29 patients who discontinued the first anti TNF-alpha treatment due to lack of efficiency, only 6 did not respond to the second anti TNF-alpha treatment. Only one out of the 9 patients who stopped a first anti TNF-alpha treatment after developing a side effect underwent an adverse event with the second anti TNF-alpha treatment. CONCLUSION: Our study suggests that switching between TNF-alpha antagonists seems to be relevant, regardless of which one was used first. It is legitimate to try to switch TNF-alpha blockers before contemplating other therapeutic strategies.

Adult↗
PubMedDate not supplied

Visceral leishmaniasis infection in a rheumatoid arthritis patient treated with infliximab.

Anti-TNFalpha strategies can result in significant clinical benefits in rheumatoid arthritis (RA), but with an increased rate of opportunistic infections. Visceral leishmaniasis (VL) is a severe disease that can develop in immunocompromised hosts, principally in HIV patients. VL in RA patients treated with TNFalpha antagonists is an extremely rare event, and only one case has been described. Here we report a case of VL, occurring after 9 infusions of infliximab in association with azathioprine, in a patient who developed blood cytopenia, fluctuant fever, and splenomegaly.

Antibodies, Monoclonal↗
PubMedDate not supplied

The B cell repertoire in rheumatoid arthritis. II. Analysis of rheumatoid factors bearing the IdRQ cross-reactive idiotype.

With the view of studying whether rheumatoid factors (RFs) produced in rheumatoid arthritis (RA) were different from those synthesized in physiological situations, we analyzed the usage of a cross-reactive idiotype (IdRQ) previously reported to be specific for RA RFs. Using EBV immortalization of circulating B cells, we prepared monoclonal RFs from patients with RA and matched controls. In both groups between 1/2 and 2/3 of the monoclonal RFs bore IdRQ. Using limiting dilution analysis, we studied the frequencies of the EBV-activated B cells able to synthesize immunoglobulins bearing IdRQ. In patients and in controls, on average, 1/3 of the RF-secreting cells used IdRQ and around 2/3 of the synthesized IgM bearing IdRQ were devoid of RF activity. These results show that precursor cells containing the germline gene encoding IdRQ are present in similar quantities in RA patients and healthy individuals, and that the IdRQ cross-reactive idiotype, although interesting for the study of the B cell repertoire, is probably not useful as a marker for susceptibility to RA.

Antibodies, Monoclonal↗