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PubMedDate not supplied

[Pseudorheumatoid nodules in childhood. A case report].

Subcutaneous nodules of the rheumatic type can occur in patients without other evidence of rheumatic disease. Nodules are characterized by subcutaneous location with predilection for pretibial regions and scalp, occasional large size, spontaneous regression and frequent recurrence. Sometimes lesion biopsy may be usefull for confirmation of the clinical diagnosis; etiology is unknown, therapy is unnecessary. One asymptomatic child with benign rheumatoid nodules is described by the Authors.

Age Factors↗
PubMed1995

NERDS syndrome: an additional case report.

NERDS is an eosinophilic disorder recently described by Butterfield and characterized by an association of nodules, eosinophilia, rheumatism, dermatitis and swelling. We describe an additional case, the third, of this new eosinophilic syndrome. The cardinal features included joint and cutaneous manifestations with prominent para-articular nodules and rheumatism, xerosis, recurrent urticarial eruption with angioedema associated with tissue and peripheral blood eosinophilia. A drug-induced (diclofenac) allergic rash and lymphadenopathy appeared during the course of the illness. Persistent leukocytosis with a maximum of 65% of eosinophils, mostly exhibiting the hypodense phenotype (activation index), was always present. During the acute phase of the disease, flow-cytometric analysis of blood and bone marrow revealed proliferation of activated CD4+/OKDR+ T helper cells and CD25+/OKDR+ eosinophils.

Acute Disease↗
PubMed1951

The occurrence of leucocyte-platelet thrombosis in rheumatic carditis.

Leucocyte-platelet thrombi, involving the smaller branches of the coronary blood vessels, have been found in the hearts of patients with active rheumatic fever and rheumatic carditis. A consistent correlation has been observed between the existence of these vascular lesions and the presence of typical Aschoff bodies. It is suggested that these cellular thrombi may play a role in the pathogenesis of rheumatic carditis.

Blood Platelets↗
PubMed1955

Rheumatic lesions in left atrial appendages; pathologic studies of material removed during mitral commissurotomy.

The left atrial appendage removed incidental to mitral valve commissurotomy was studied for rheumatic lesions in 128 cases. Endocardial Aschoff bodies, which are usually considered indicative of active rheumatic disease, were found in 35.9 per cent of the cases.Postoperative follow-up observations were available in only 53 patients. Of these, only eight had clinical evidence of postoperative rheumatic activity. In none of this group of eight cases had Aschoff bodies been observed in pathologic study of the surgically removed left atrial appendage.

Adult↗
PubMed1991

Rheumatoid nodules do not predict response to treatment with slow-acting anti-rheumatic drugs.

Rheumatoid nodules have been associated with a poor long-term prognosis. We investigated whether they predict a poor response to treatment with slow-acting anti-rheumatic drugs (SAARDs). Two hundred and twenty-eight patients with rheumatoid arthritis (RA) were treated for six months with a SAARD. Clinical and laboratory assessments of disease activity were made initially and after 6 months' treatment. Patients were divided into two groups according to the presence or absence of nodules at entry. Twenty-one % had nodules before treatment but their response was no different to patients without nodules (79%), both groups showing improvements in all variables. Males were more likely to develop nodules and had a relative risk of 1.7. High titres of rheumatoid factor correlated with nodules and no sero-negative patients had nodules. We conclude that nodules are not predictive of poor response to treatment with a SAARD, despite their presence being associated with a poor long-term prognosis. One possible implication is that SAARDs themselves, despite an early response, may not effect long-term outcome.

Anti-Inflammatory Agents↗
PubMed1952

Evidence that Aschoff bodies of rheumatic myocarditis develop from injured myofibers.

COMPARATIVE STUDIES ON THE HISTOPATHOGENESIS OF EXPERIMENTALLY INDUCED LESIONS OF MYOCARDIAL ASCHOFF BODY TYPE IN RABBITS AND OF MANY MYOCARDIAL ASCHOFF BODIES FROM SEVERAL ACTIVE RHEUMATIC FEVER PATIENTS HAVE REVEALED THE FOLLOWING: Almost invariably these experimental lesions and very frequently the myocardial Aschoff bodies studied in their early stages have been shown to originate in and evolve from lesions of heart muscle fibers. The mono-, multi-, and non-nuciested cell masses, most characteristic of myocardial disease of the rheumatic type, appear to be damaged muscle fibers their fragments, and syncytial cell masses of probable muscular origin that proliferate from beneath the sarcolemma and in the tracks of damaged muscle fibers in reaction to that damage. In addition to destructive changes in cardiac muscle fibers an attempt at myofiber regeneration may occur in some myocardial Aschoff bodies. The most distinguishing histologic feature of the myocardial Aschoff bodies in rheumatic heart disease are the peculiar lesions of muscle fibers. Therefore, it is proposed that they be designated as myofiber Aschoff bodies in order to indicate their origin more accurately. The results of these investigations contrast with the widely accepted theory that all myocardial Aschoff bodies originate as injured interstitial collagen, and that, as they evolve, they consist of damaged interstitial collagen intermingled with cells of non-myogenic derivation that proliferated in response to that collagen injury. These studies, furthermore, provide evidence that experimental homologues of rheumatic myocardial Aschoff bodies have been induced in a very few among many rabbits subjected to reposted focal infections with group A streptococci of different serological types. Hence, they support the concept that the myocardial Aschoff bodies of rheumatic fever are induced by repeated infections with group A streptococci of several different serological types; even though only a certain few among the many patients so infected develop these lesions.

Animals↗