Antibodies against cardiolipin are formed in many different infectious diseases, and high levels are associated with susceptibility to thrombosis, especially in patients with systemic lupus erythematosus. In view of the postulated infectious etiology of Kawasaki disease an its association with thrombosis, we have studied the occurrence of anticardiolipin antibodies in this disease. Serial serum specimens from 36 patients were tested, using a solid-phase enzyme immunoassay. A change of at least 0.3 optical density units between two consecutive specimens for at least one immunoglobulin class was observed in 47% of cases. Peak levels occurred one to two weeks after the onset of symptoms. Four patients developed coronary artery aneurysms, and they all showed a clear anticardiolipin response. Anticardiolipin antibodies might be one factor contributing to coagulation abnormalities in patients with Kawasaki disease.

Autoantibodies↗

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Effect of interferon on plasma lipoproteins and on the activity of postheparin plasma lipases.

The effect of interferon administration on the concentration of plasma lipoproteins and on the activity of postheparin plasma lipoprotein lipase and hepatic lipase was studied in six healthy men. Daily injection of human leukocyte interferon for 1 week lowered the plasma level of total cholesterol, very low density lipoprotein + low density lipoprotein cholesterol, high density lipoprotein cholesterol, and apolipoprotein A-1 in all subjects. Simultaneously, the activity of postheparin plasma hepatic lipase and lipoprotein lipase decreased by 20% to 50%. These observations may be of importance in the interpretation of lipoprotein changes seen in acute and chronic infections and should be borne in mind when prolonged treatment with interferon is considered.

Adult↗

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Incidence of stroke in a Finnish prospective population study.

The incidence of stroke was investigated in a large Finnish prospective population study. The study population consisted of 11,984 men and 11,682 women aged 15 years and over drawn from four geographical regions of the country. In a mean follow-up time of six years, 174 men and 169 women suffered a fatal or non-fatal stroke. The age-adjusted mean annual incidence of stroke in men, 4.0/1000, was statistically significantly higher than the annual incidence in women, 3.3/1000. In twelve percent of the cases stroke was caused by subarachnoid hemorrhage and in ten percent by cerebral hemorrhage. In 30 percent of the cases, cerebral infarction was ascertained as the cause of the stroke; while in 49 percent of the cases, the type of stroke could not be specified with certainty. The incidence of stroke was significantly higher in non-attendants than in attendants at the initial survey. The incidence of cerebral infarction appeared to be higher in men from eastern Finland than in men from southwestern Finland.

Adolescent↗

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Prevalence of stroke in Finland.

The prevalence of stroke was investigated in a Finnish population study. The results were based on cross-sectional data from a follow-up examination of a prospective study conducted in 1973-1976. The study population drawn from four regions of the country comprised 11,103 men and 11,096 women aged 20 years and over. The age-adjusted prevalence of stroke was 10.3/1000 in men and 5.8/1000 in women. The prevalence was significantly higher in non-attendants at the examination than in attendants. In 15 per cent of the prevalence cases the stroke was caused by subarachnoid hemorrhage, in six per cent by cerebral hemorrhage and in the remainder by cerebral infarction or the type could not be specified. Over half (57 per cent) of the survivors of stroke had no or only slight disability; eight per cent were totally disabled. Some form of organic heart disease and hypertension was significantly more common in the prevalence cases than in the others.

Adult↗

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Characteristics and survival of patients with brain stem infarction.

A retrospective study of 141 patients whith ischemic brain stem infarction admitted to the Department of Neurology, University of Helsinki, during 1966 to 1973 was performed. The patients were contacted by mail in January and February, 1974; in case of death, the death certificates were procured. The follow-up period was from 4 to 99 months (median 46.5 months), during which a total of 39 patients had died. A life table analysis gave a 50% probability of a seven-year survival after the stroke. Survival was similar for men and women, and age appeared to have little influence on the prognosis with only a slightly higher case fatality in old age. Soft palate paralysis, disturbed sensorium, need of special treatment measures (feeding by gastric tube intravenous infusions, etc.) during the acute phase, abnormalities in the ECG (T-wave negativity, S-T segment depression), fasting blood glucose 100 mg/100 ml or higher, and an abnormal eeg (slowing down of alpha rythm alone or in association with paroxysmal and/or focal disturbances) were all associated with high case fatality. Preceding TIAs, blood pressure level, serum cholesterol and triglyceride values, and aortic arch angiogram findings, on the other hand, had no effect upon the prognosis. The effects of body build on prognosis remained obscure.

Adult↗

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Humoral immune response to mammalian allergens.

Solid-phase enzyme immunoassay and passive hemagglutination were used to study the occurrence of antibodies of various isotypes against feline and bovine epithelial extracts in RAST-positive patients, exposed subjects (cat fanciers and senior veterinary students) and healthy controls. A high proportion of the patients had positive results, whereas the findings in exposed subjects varied, depending on the antigen and test technique. These observations caution against making far-reaching conclusions on the basis of narrow studies.

Allergens↗

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C-reactive protein as measured by a sensitive enzyme-linked immunosorbent assay in patients with juvenile idiopathic arthritis.

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Adolescent↗

PubMedDate not supplied

Radiographic remission in seropositive rheumatoid arthritis. A 20-year follow-up study.

OBJECTIVE: Rheumatoid arthritis (RA) is in most instances a progressive disease. Very little information is available on halting of the radiographic damage, particularly in later phases of the disease. We studied radiographic remission of RA lasting to the end of follow-up, covering the period 1973-96. METHODS: Radiographs of hands and feet were taken at onset and at 1, 3, 8, 15 and 20 years from entry in 102 cases of recent onset (< 6 months) seropositive and erosive RA. A Larsen score of 0-100 was formed for 20 joints of hands and feet. If the score did not worsen by more than one point between one of the above time points and the end of the study, the patient was considered to be in remission. RESULTS: Remission was confirmed in 27 (26%) of the patients. In 3 cases the remission was from the 1-year check-up, in 5 from the 3-year check-up, in 6 from the 8-year check-up and in 13 cases from the 15-year check-up. Some of the remission cases had a mild disease from the outset, but there were cases in which the disease process had led to marked joint destruction before slowing down. CONCLUSION: This data may serve as a basis for comparison with subsequent cohort studies on new treatments-of-choice.

Adolescent↗

PubMedDate not supplied

Anti-filaggrin antibody in patients with juvenilc idiopathic arthritis.

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Adolescent↗

PubMedDate not supplied

A cluster of inflammatory rheumatic diseases in a moisture-damaged office.

OBJECTIVE: To describe a cluster of inflammatory rheumatic diseases in an office workplace that suggests the presence of an environmental trigger. METHODS: There had been an indoor air problem in the workplace since the early 1990s. Large areas of the outer walls of the building were found to be moisture-damaged and contaminated by microbial growth. Case histories of the personnel were studied, and their working areas were related to the areas with highest microbial contamination. The incidence of inflammatory rheumatic diseases was compared with the statistics of the same geographic area. RESULTS: Ten patients with inflammatory rheumatic diseases (3 rheumatoid arthritis, 4 ankylosing spondylitis, 2 Sjögren's syndrome, and one of psoriatic arthritis) entitled to specially reimbursed medication were diagnosed in 1987-2000 (seven cases in 1995-1998). The incidence density ratio computed for the period 1987-2000 was 6.8 (95% confidence interval 3.6-13.0) for all office personnel and 13.2 (6.0-29.0) for those working close to the wall sustaining the worst damage. CONCLUSION: The accumulation of chronic inflammatory rheumatic diseases in a single workplace suggests that some environmental exposure in this damp office had triggered the diseases.

Adult↗

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Increased type I collagen degradation correlates with disease activity in reactive arthritis.

OBJECTIVE: The assay for the cross-linked carboxyterminal telopeptide of type I collagen (ICTP) has been shown to reflect increased type I collagen degradation in patients with rheumatoid arthritis. To look for increased collagen degradation in other inflammatory rheumatic diseases, we studied plasma ICTP in patients with reactive arthritis (ReA). METHODS: ICTP was determined by radioimmunoassay from 69 ReA patients. ICTP data on 56 patients aged > or = 20 years were compared with normal ICTP values available for that age group. RESULTS: The median (range) plasma ICTP concentration of the patients > or = 20 years of age was 3.9 (2.1-9.6) micrograms/l, and in 13 (23%) of them the value was elevated if compared with the normal upper reference limit (mean + 2SD), 5.2 micrograms/l, given by the manufacturer. The mean (SD) duration of joint symptoms was 76 (61) days in patients with ReA. Modest albeit statistically significant correlations were noted between the plasma ICTP and the erythrocyte sedimentation rate, C-reactive protein and the Lansbury articular index (Spearman's r 0.39, 0.37 and 0.29, respectively). The median values for all of the above mentioned parametres were at least twice as high in the group of patients with elevated ICTP compared with those in patients with normal values (p < 0.05). No statistically significant correlation was detected between the plasma ICTP and the duration of joint symptoms. CONCLUSION: Increased type I collagen degradation can take place in ReA, and this process seems to correlate with the extent and activity of the joint disease.

Adult↗

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Occurrence of chronic inflammatory rheumatic diseases among parents of multiple offspring affected by juvenile idiopathic arthritis.

OBJECTIVE: The rarity of reports on extended multiplex families points out that the genetic component in juvenile idiopathic arthritis (JIA) might not be particularly strong. Our objective was to determine the frequency of chronic inflammatory rheumatic diseases among the parents who had two or more offspring affected by JIA. METHODS: During the last 17 years patients with JIA treated at the Rheumatism Foundation Hospital in Heinola and their parents have been systematically asked about the familial occurrence of rheumatic diseases. A total of 45 families with more than one sibling affected by JIA were found among about 2,300 JIA cases. In these "multicase families", 9 parents from 8 families also had a diagnosis of chronic inflammatory rheumatic disease. Their case histories were studied. RESULTS: Four of the parents had had JIA (one subsequently developed ankylosing spondylitis), and 4 had rheumatoid factor-negative chronic arthritis (one had also had chronic iritis since the age of 10, resembling that seen in JIA). Three of them had features of JIA and only one met the classification criteria for rheumatoid arthritis. One had ankylosing spondylitis. CONCLUSIONS: Since the expected number of JIA cases among the 90 parents was about 0.2, there was drastic increase in JIA frequency among the parents in families with multiple offspring also affected by JIA. These results suggest that JIA susceptibility genes may likely be clustered in these families.

Adolescent↗

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Severe childhood uveitis without overt arthritis.

OBJECTIVE: To look for forme fruste (incomplete) forms of juvenile idiopathic arthritis (JIA)-associated uveitis. METHODS: The study involved 6 patients (3 girls and 3 boys) without overt arthritis who had been sent for ophthalmologic and rheumatologic evaluation because of uveitis resembling that seen in JIA. RESULTS: Two patients evinced no evidence of arthritis, 3 had non-specific signs and symptoms such as pains or valgus ankle and one may have had an episode of arthritis. Five patients carried the HLA allele B27 and 4 were positive for antinuclear antibodies. The mean age at diagnosis of uveitis was 8.4 years (range 3.5-14.2 years) and the mean follow-up period was 6.2 years (range 3.8-7.3 years). All patients had obviously had their uveitis for a long period prior to the first contact with an ophthalmologist. In 3 patients uveitis was asymptomatic when diagnosed, 2 had mild conjunctival injection and one had exacerbation of the disease process. Subsequently the uveitis was asymptomatic and bilateral in all patients. Complications of uveitis were common: cataract was found in 4 patients, glaucoma in 1 patient, cystoid macular edema in 4, posterior synechiae in 5 and band keratopathy in 3. The final visual acuity was poor in one eye of 1 patient despite effective treatment of uveitis. Uveitis was still active in all patients at the close of follow-up. CONCLUSION: Asymptomatic uveitis, which is frequently positive for antinuclear antibodies, can occur in children who show no clear evidence of arthritis. Complications occur in consequence of a delay in the diagnosis of insidious uveitis.

Adolescent↗