Pneumonitis is one of the most serious adverse effects associated with low-dose weekly methotrexate (MTX) therapy. Immediate cessation of MTX, and the introduction of oxygen therapy and glucocorticoids usually results in a dramatic improvement in the pulmonary toxicity. We report here a case of MTX-induced pneumonitis in a patient with rheumatoid arthritis (RA). Severe hypoxemia and interstitial infiltration in both lung fields did not respond to the withdrawal of MTX and the administration of oxygen and steroid pulse therapy. When intravenous cyclophosphamide (CYC) pulse therapy was initiated, however, rapid physiologic and radiographic improvement was seen. Our case suggests that CYC treatment may have a beneficial effect on MTX-induced pneumonitis that is resistant to steroid therapy.

Aged↗

PubMedDate not supplied

A case of polymyositis with anti-OJ (isoleucyl-transfer RNA synthetase) antibodies.

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Aged↗

PubMedDate not supplied

Systemic lupus erythematosus associated with Down syndrome.

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Adult↗

PubMedDate not supplied

Clinical characteristics of Japanese patients with anti-PL-7 (anti-threonyl-tRNA synthetase) autoantibodies.

OBJECTIVE: The clinical and laboratory features of seven Japanese patients with anti-aminoacyl-tRNA synthetase (ARS) autoantibodies against PL-7 (anti-threonyl-tRNA synthetase) were analyzed and compared with previously published findings. METHODS: Serum samples from 1,135 Japanese patients with various autoimmune diseases were screened for anti-PL-7 antibodies using RNA and protein immunoprecipitation assays. The patients whose sera contained anti-PL-7 antibodies were assessed regarding clinical symptoms and clinical course. RESULTS: Sera from seven patients were found to have anti-PL-7 antibodies. These autoantibodies were associated with polymyositis/dermatomyositis (PM/DM) and/or interstitial lung disease (ILD). The clinical diagnoses of these seven patients were PM - systemic sclerosis (SSc) overlap (5 patients), DM (1 patient) and idiopathic pulmonary fibrosis (IPF) (1 patient). All patients had ILD with a chronic course and six also had arthritis (85%) and five sclerodactyly (71%). CONCLUSIONS: These results indicate that anti-PL-7 autoantibodies are closely associated with PM-SSc overlap as well as ILD, arthritis and sclerodactyly in our series of Japanese patients.

Adult↗

PubMedDate not supplied

Electromyographic analysis of canine distemper myoclonus.

Canine distemper myoclonus was electromyographically analysed to throw more light upon the condition without invasive surgical intervention. Although myoclonus seemed to occur synchronously in many muscles, the onset of myoclonus appeared to be slightly earlier in one or two particular muscles and, furthermore, myoclonus did not arise temporally in descending or ascending order along the neuroaxis. Myoclonus-like discharges were evoked by tendon-tapping and this feature disappeared after cessation of myoclonus. In successive myoclonic bursts, a significant positive correlation was noted between the silent period and the subsequent discharge period, independently of the level of consciousness, i.e., the longer the silent period, the longer the subsequent episode of myoclonus. This correlation was re-established very early after recovery from anesthesia with halothane, when electroencephalograms showed slow waves. These results strongly indicate that the lower motor neurons may be the primary site responsible for the genesis of canine distemper myoclonus.

Animals↗