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Biomedical subjects

J T Gran

Publications and source records attributed to J T Gran.

At least 55 records · Page 3Linked to original sources
PubMed1997

[Subacute cutaneous lupus erythematosus].

Subacute cutaneous lupus erythematosus (SCLE) is recognized as a variant of Systemic lupus erythematosus (SLE) and affects mainly middle-aged Caucasian women. The clinical picture is characterized by typical skin lesions, joint or muscle pain and occasionally arthritis. Serious systemic manifestations such as affection of the central nervous system and kidneys are rarely observed. Most SCLE patients are strongly photosensitive, which is associated with the presence of anti-SSA and/or anti-SSB antibodies. The disease can mimic both Sjögren's syndrome and SLE. The course is characterized by exacerbations and remissions. SCLE sometimes occurs concomitantly with other diseases of both a rheumatological or non-rheumatological nature, and it has also been discussed whether SCLE might be an example of a paraneoplastic syndrome. Treatment with hydroxychloroquine is usually effective. Five patients with SCLE are described.

Adult↗
PubMed1997

[Vasculitis and malignant diseases].

Approximately 1 - 7% of all patients with cutaneous vasculitis have an associated malignant disease. In such cases, vasculitis most often accompanies myelo- and lymphoproliferative diseases. Histologically, leukocytoclastic or panarteritis nodosa-like vasculitis are the most frequently observed types, and in most instances manifest clinically as palpable purpura. Malignancy should be suspected if the clinical picture does not fit into any well defined category of connective tissue disease, and when drugs and infection are excluded as causes of the vasculitis. The author discusses possible mechanisms of paramalignant vasculitis.

Humans↗
PubMed1997

[Remittent seronegative symmetrical synovitis with pitting edema].

The symptoms and signs of remitting, seronegative symmetrical synovitis with pitting oedema (RS3PE-syndrome) are reviewed. Three patients with the disease are described, of whom one also developed multiple myeloma. All patients presented with diffuse swelling of the hands, consisting of both arthritis and oedema. Radiological examination did not disclose erosive changes, and all patients recovered. The article includes recommendations for clinical and laboratory investigations and therapy. The condition usually has a favourable outcome.

Aged↗
PubMed1997

A population study of the incidence of fibromyalgia among women aged 26-55 yr.

In a population survey, we assessed the incidence of fibromyalgia (FM) among females. A screening questionnaire about pain was distributed twice (in 1990 and 1995) to 2498 females aged 20-49 yr, living in South Norway. A positive answer classified the responder as positive, merely negative answers as negative. One hundred females converting from negative to positive responders and 100 females remaining negative responders (controls) underwent a structural interview and examination for tender points (TP). Of the 870 negative responders in 1990, 717 answered the questionnaire in 1995. Of these, 523 were still negative responders, while 194 were positive converters. Twelve of the converters developed FM and none of the controls. The calculated annual incidence of FM in females was 583/100,000. This rather high incidence is most likely explained by the design of the study, also detecting cases usually not seen in hospital settings.

Adult↗
PubMed1997

The outcome of ankylosing spondylitis: a study of 100 patients.

The outcome was studied in 100 patients with adult-onset primary ankylosing spondylitis (AS). After a mean disease duration of 16 yr, 51.5% of the patients were employed in full-time work. Cessation of work occurred at a mean disease duration of 15.6 yr, and was significantly associated with female sex, low levels of education, acute anterior uveitis, 'bamboo spine' and the co-existence of non-rheumatic diseases. Functional outcome was studied by analysing activities of daily living, and revealed similar findings in males and females. Most of the loss of function occurred during the first 10 yr of disease, and correlated significantly with the occurrence of peripheral arthritis, spinal X-ray changes of AS and development of 'bamboo spine'. After > 20 yr of disease, > 80% of the patients still complained of daily pain and stiffness, and > 60% reported daily use of drugs.

Activities of Daily Living↗
PubMed1997

The incidence of polymyalgia rheumatica and temporal arteritis in the county of Aust Agder, south Norway: a prospective study 1987-94.

OBJECTIVE: To determine the incidence of giant cell arteritis (GCA) including polymyalgia rheumatica (PMR) and temporal arteritis (TA) in a region of South Norway. METHODS: All physicians in the county were asked to refer all patients suspected of having PMR or TA to the Department of Rheumatology. Patients meeting diagnostic criteria and with disease onset during 1987-94 were included in a prospective study. In addition, all cases admitted to hospital departments other than rheumatology were evaluated retrospectively. RESULTS: In total, 322 patients with PMR or TA were found. The annual incidence of GCA per 100,000 population aged 50 years or more was 141.7, 177.6 in women and 99.5 in men. Pure PMR was found in 256 cases, while 66 patients had biopsy verified TA. The annual incidence of pure PMR per 100,000 residents aged 50 years or more was 112.6, 137.7 in women and 83.2 in men. The annual incidence of TA in persons 50 years and older was 29.0 per 100,000, 39.9 in women and 16.3 in men. CONCLUSION: The high incidence of GCA we found was due to excess of cases with pure PMR. The high number of cases with PMR was most likely due to the design of the study, allowing inclusion of patients usually not detected by retrospective hospital based studies.

Aged↗
PubMed1996

Hereditary angio-oedema: new clinical observations and autoimmune screening, complement and kallikrein-kinin analyses.

OBJECTIVES: To study clinical and laboratory manifestations of hereditary angio-oedema (HAE). SUBJECTS: Thirty-three affected members of a kindred of 63. RESULTS: Oedematous attacks in the skin, mucous membranes and gastrointestinal tract with fluid displacement were elicited by mental and physical stress, minor traumas, dental and surgical procedures, eruption of teeth, tonsillitis, pregnancies, and use of oestrogen-containing pills including menopausal substitution. Every adult woman with symptomatic HAE (n = 11) showed symptoms of urinary tract infections in conjunction with the attacks (P = 0.010), and also experienced more spontaneous abortions or premature labours (P = 0.037) than healthy relatives. Patients with HAE of both sexes more frequently reported heartburn or peptic ulcers (P = 0.002). Rheumatic complaints were reported by 53% of HAE patients and 12% of their unaffected relatives (P = 0.013), but biochemical screening for 18 autoantibodies and quantitation of immunoglobulins did not reveal statistically significant differences between the two groups. C3, prekallikrein, total kininogen, high molecular weight kininogen (HK), alpha-2-macroglobulin and factor XII were not significantly different in HAE patients. In contrast, levels of C1-INH and C4 were depressed and cleaved HK increased in patients compared to unaffected relatives. CONCLUSIONS: HAE manifests in a variety of ways, and may influence risk of spontaneous abortions and premature labour.

Adolescent↗
PubMed1996

A prospective study of 287 patients with polymyalgia rheumatica and temporal arteritis: clinical and laboratory manifestations at onset of disease and at the time of diagnosis.

A prospective study of 287 patients with giant cell arteritis (GCA), including polymyalgia rheumatica (PMR) and temporal arteritis (TA), was conducted during 1987-1994. All patients were evaluated prior to the start of drug treatment. During the same period, 31 patients with GCA, of whom 12 cases had TA, were admitted to other departments in the hospital. At onset of disease, all patients were > or = 50 yr of age. Peripheral arthritis was found in 24.4% of patients with PMR, while none of the patients with TA exhibited such manifestations. Clinical features at onset of disease differed from those appearing at presentation to the hospital. Thus, the gradual development of a full-blown clinical picture may be responsible for the delay in diagnosis of GCA. The majority of cases (80%) presented with "pure' PMR without clinical signs or symptoms of concomitant TA. In a random sample of 68 patients with "pure' PMR, histological examinations of biopsy specimens of the temporal artery revealed inflammatory changes in three patients only (4.4%). Consequently, arterial biopsy in patients with clinical features of PMR only, appears to be unnecessary. Among patients with TA referred to the department of internal medicine, general malaise, loss of weight and sustained fever were prominent manifestations. Such features may thus necessitate a diagnostic arterial biopsy even in the absence of clinical arteritis or myalgia. Both ESR and CRP were within normal levels in 1.2% of the cases. Further clinical and laboratory examinations performed at diagnosis of GCA disclosed only one case of malignancy. Routine chest X-rays did not reveal unexpected pathological findings. Permanent and complete blindness due to arteritis was observed in one patient only. No association between GCA and thyroid dysfunction was detected.

Aged↗
PubMed1996

Acute sarcoid arthritis: a favourable outcome? A retrospective survey of 49 patients with review of the literature.

Forty-nine patients, 30 males and 19 females with acute sarcoid arthritis admitted to three different hospitals in Norway were studied retrospectively. All patients had peripheral arthritis and hilar adenopathy, and 87.8% also presented with erythema nodosum (EN). Mean duration of arthritis was 3.7 months (0.5-12 months), but in 26% of the cases, duration of the inflammatory joint disease exceeded three months. Radiological bony erosions were not seen. Two patients had recurrence of acute sarcoid arthritis, 14 months and 10 years after the initial episode, respectively. Two other patients developed chronic myalgia and fibromyalgia. Four patients, one female and three males, developed chronic pulmonal sarcoidosis. Of these, two patients had simultaneous onset of acute sarcoid arthritis and parenchymal disease while two patients developed chronic lung disease three months after onset of acute sarcoid arthritis. We thus tentatively suggest that although acute sarcoid arthritis is usually a self-limiting joint disease, recurrences may occasionally occur and some cases develop chronic sarcoidosis of the lungs.

Acute Disease↗
PubMed1995

The variable clinical picture of arthritis induced by human parvovirus B19. Report of seven adult cases and review of the literature.

Seven patients with arthritis due to infection with human parvovirus B19 are reported, and the literature association reviewed. B19 virus arthritis most frequently affects young to middle aged women and occurs predominantly during the first six months of the year. The majority of cases have oligoarthritis or polyarthritis, and the joints most often involved are the proximal interphalangeal joints and knees. Of the seven patients reported, one case developed systemic lupus erythematosus, one case evolved into erosive, seropositive rheumatoid arthritis while one case was subsequently diagnosed as undifferentiated connective tissue disease.

Adult↗
PubMed1994

Small cell pleomorphic T-cell lymphoma presenting with cutaneous vasculitis.

The association between cutaneous vasculitis and lymphoproliferative disease has been increasingly recognized. We report a female patient who presented with cutaneous vasculitis which was due to a small cell pleomorphic T-cell lymphoma. In spite of aggressive therapy, she died two years after onset of disease. The clinical picture of vasculitis associated with lympho-proliferative disease is addressed with particular emphasis on symptoms and signs suggesting malignancy rather than vasculitis appearing in concert with well-defined connective tissue disorders.

Adrenal Cortex Hormones↗
PubMed1993

[Etiological aspects of fibromyalgia].

The etiopathogenesis of primary fibromyalgia still remains an enigma to modern medicine. Several hypotheses have been suggested during the last years, and these are reviewed.

Fibromyalgia↗
PubMed1993

[Pustular arthro-osteitis. An affection of the musculoskeletal system in pustulosis palmoplantaris].

Musculoskeletal involvement is seen in approximately 15% of patients with pustulosis palmoplantaris. Usually the upper anterior parts of the trunk are affected, but, not infrequently, the peripheral joints are involved. The author reports the case of a female patient with pustulosis palmoplantaris and arthritis of a wrist and a knee. The patient was followed for more than seven years, and the course of pustulotic arthroosteitis was characterized by frequent exacerbations of unilateral gonarthritis. The arthritis of the wrist did not respond to treatment with non steroidal anti-inflammatory drugs or to intraarticular injections of corticosteroids. She responded well, however, to surgical synovectomy.

Aged↗
PubMed1993

[Sternocostoclavicular hyperostosis].

The syndrome of synovitis, acne, pustulosis, hyperostosis and osteomyelitis (SAPHO syndrome) includes disorders with common clinical and radiological manifestations. One of these, sternocostoclavicular hyperostosis, is characterized by inflammation and ossification of ligaments, bones and joints in the upper anterior parts of the trunk. The author reports the case of a 20 year-old female who developed unilateral sternocostoclavicular hyperostosis and complete ankylosis of the second, third and fourth lumbar vertebrae. Prior to onset of musculoskeletal complaints, she experienced a brief episode of dermatitis of the scalp, accompanied by transient alopecia. The condition was controlled by administration of ketoprofen and naproxen.

Adult↗
PubMed1993

[Bacterial arthritis].

During the years 1980-89, 13 patients were hospitalized because of bacterial arthritis of the peripheral joints. There were five juvenile patients (under 15 years of age). The remaining eight patients were adults, of whom seven were older than 50 years. The mean delay in establishing the diagnosis was four days (0-10 days). Monarthritis was found in 12 patients, and in one patient two joints were involved. The most commonly affected joints were the shoulder (four cases), knee (four cases), ankle (three cases), hip (two cases) and toe (one case). A predisposing condition was found in five patients, and three cases suffered from reduced mobility of the joint at follow-up. Staphylococcus aureus was the most common etiologic agent.

Adolescent↗
PubMed1993

The occurrence of fibromyalgia-like syndromes in a general female population.

In an epidemiological survey of females aged 20-49 years in Arendal, Norway, 217 persons with musculoskeletal pain were examined for the presence of fibromyalgia as defined by the ACR criteria of 1990. Forty females with fibromyalgia were found whereas 129 females had chronic musculoskeletal pain of more than three months duration but failed to meet the criteria. Two females suffered from nonrheumatic disorders which could explain their musculoskeletal pain. Forty-six females had pain of less than three months duration. Somewhat surprising, the presence of tender points and symptoms regarded as typical of fibromyalgia were rather frequently observed among the females who failed to satisfy the ACR 1990 criteria. No other diseases were found which could explain their complaints or clinical findings. The presence of fibromyalgia-like syndromes is suggested, and the classification and nature of such syndromes are discussed.

Adult↗