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Results for “Rheumatoid Nodule”

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At least 19 recordsLinked to original sources
PubMed2004

Rheumatoid arthritis with diffuse pulmonary rheumatoid nodules.

Rheumatoid nodules in dermal or subcutaneous tissues, while indicative of rheumatoid arthritis, are very rare. It is even less common to identify these rheumatoid nodules by biopsy as well as in autopsy materials from lung tissue. These nodules may be single or multiple, which seldom cause respiratory symptoms. Here, a patient with diffuse pulmonary rheumatoid nodules and interstitial fibrosis throughout both lungs, is described. The patient, with articular symptoms and seropositivity, exhibited a rapid clinical course and died of respiratory failure 3 months after the appearance of dyspnea. Chest radiography indicated interstitial pneumonitis with bilateral diffuse peripheral shadows. At autopsy, numerous rheumatoid nodules and interstitial fibrosis had destroyed both lungs, such that no residual normal pulmonary tissue remained. It is believed that this was an extremely rare case exhibiting large numbers of rheumatoid nodules throughout the lungs. Findings with this patient indicate that, in patients with rheumatoid arthritis, clinical interstitial pneumonitis confirmed radiologically does not exclude the existence of rheumatoid lung nodules.

Arthritis, Rheumatoid↗
PubMed1996

The management of rheumatoid nodules.

Rheumatoid nodules are present in approximately 25% of patients with seropositive rheumatoid arthritis (RA) and are the most common extra-articular lesions of this disease. Current methods of treatment include a variety of antirheumatic agents, surgical excision, or observation. Treatment options for the rheumatoid nodule are limited, due in part to the highly variable nature of the nodule. This series describes 4 seropositive RA patients, all with extensive rheumatoid nodules. Three were successfully treated by surgical excision, and 1 was successfully treated with conservative management. Surgical treatment is effective. Indications include local pain, nerve compression, limited range of motion, erosion, and infection.

Aged↗
PubMed1986

Cardiac rheumatoid nodules.

Rheumatoid nodules in the heart are unusual specific manifestations of rheumatoid arthritis. This paper describes three cases in which these nodules were found at necropsy. The patients were women with long histories of rheumatoid arthritis, two of whom had significant but unexplained congestive cardiac failure. The rheumatoid nodules were present in the patients' myocardium and in one patient's pericardium. We suggest that in patients with rheumatoid arthritis with severe but unexplained cardiac failure, the possibility of rheumatoid nodules in the heart should be considered.

Aged↗
PubMed2003

Extradural spinal cord compression by rheumatoid nodule.

Rheumatoid disease is a systemic disorder affecting multiple organs. It is known to affect the nervous system in a variety of ways, but its presentation with spinal cord compression by a rheumatoid nodule is rare. We report two cases presenting with cord compression by a rheumatoid nodule who underwent surgical decompression with good recovery.

Aged↗
PubMedDate not supplied

Complement-fixing hidden rheumatoid factor in children with benign rheumatoid nodules.

Rheumatoid nodules have been described in many children without evidence of clinical disease. These have been referred to as benign rheumatoid nodules (BRN). Except for one report, no serological abnormalities have been demonstrated. Four children with BRN have been studied. By means of a hemolytic assay, high titers of hidden rheumatoid factor (RF) have been found in the blood, i.e., 19S IgM RF detected after acid separation of IgM-containing fraction from the serum. The median hidden RF titer of the children with BRN was 1:362 and in healthy and disease controls was 1:7. The difference was significant at P less than 0.001. The results indicate that patients with BRN have active complement-fixing 19S IgM RF in their serum. Thus the association of hidden RF with BRN raises the possibility that the deposition of immune complexes (19S IgM-7S IgG) leads to small vessel vasculitis and nodular formation.

Antigen-Antibody Complex↗
PubMed1988

Immunohistology of rheumatoid nodules and rheumatoid synovium.

The immunohistological features of rheumatoid nodules and rheumatoid synovium were examined using monoclonal and polyclonal antibodies raised against macrophages, HLA-DR, leucocyte common antigen, and immunoglobulin components. The palisading cells surrounding the necrotic centre of the rheumatoid nodule were shown to be HLA-DR positive leucocytes, mostly histiocytes. The inflammatory infiltrate associated with rheumatoid nodules showed many immunohistochemical similarities to that of rheumatoid synovium, including a preponderance of IgG positive plasma cells, and a similar number and microanatomical pattern of distribution of HLA-DR positive cells. The significance of these findings for the cellular immunopathology and aetiology of the rheumatoid lesion is discussed.

Antigens, Differentiation↗
PubMed1998

A comparative phenotypical analysis of rheumatoid nodules and rheumatoid synovium with special reference to adhesion molecules and activation markers.

OBJECTIVES: (1) To analyse the in situ expression of adhesion molecules in rheumatoid nodules. (2) To compare the endothelial expression of adhesion molecules in synovial tissue and subcutaneous nodules obtained from the same patients. (3) To compare the expression of adhesion molecules and activation markers on T cell lines from nodules and synovium. METHODS: (1) Immunohistochemical analysis by APAAP technique of E selectin, CD44, ICAM-1, PECAM-1, and VCAM-1 was performed on 10 rheumatoid nodules from seven patients with rheumatoid arthritis (RA); nodules and synovium were simultaneously analysed from three patients. (2) T cell lines were generated from RA nodules (n = 7) and synovium (n = 7) by interleukin 2 expansion, and subsequently characterised by flow cytometry for surface expression of alpha E beta 7, alpha 4 beta 7, CD44, L selectin, LFA-1a, PECAM-1, and CD30. RESULTS: (1) In rheumatoid nodules, the palisading layer strongly stains for ICAM-1 and PECAM-1, but less pronounced for CD44. VCAM-1 staining was usually negative. ICAM-1 is upregulated in the vessels surrounding the central zone of fibrinoid necrosis. The immunohistological picture in different nodules derived from the same patient was similar. (2) The endothelial expression of adhesion molecules is comparable in RA nodules and synovium on an individual level, except for E selectin, which is overexpressed in nodule endothelium. (3) T cell lines from nodules and synovium display similar adhesion molecule profiles. However, the expression of CD30, a T cell activation marker linked with Th2 subsets, is higher in nodules compared with synovium. CONCLUSION: These data support a recirculation hypothesis of T cells between articular and extra-articular manifestations in RA, although the activation state of the T cells in each of these localisations may differ.

Adult↗
PubMed1980

Histopathological analysis of sixteen subcutaneous rheumatoid nodules.

An immunopathological study was carried out on subcutaneous nodules (rheumatoid nodules) biopsied from 16 patients with rheumatoid arthritis. Sixteen rheumatoid nodules were histologically classified into three stages, the 1st stage (acute inflammatory stage, 3 cases), the 2nd stage (granulomatous stage, 10 cases), and the 3rd stage (scar-formed stage, 3 cases). In necrotic or granulation tissue of the nodules in the 3 stages, immunofluorescent analysis using FITC-labeled rabbit anti-human immunoglobulins, beta 1C, and fibrinogen serum gamma-globulins and FITC-labeled aggregated human IgG gave results that were strongly positive in the 1st stage, moderately positive in the 2nd stage, and only slightly positive or almost negative in the 3rd stage. Acute or chronic thrombotic endoarteritis was observed around rheumatoid nodules in 6 out of the 16 cases. Among them, 2 cases of the 1st stage showed acute thrombotic endoarteritis with marked infiltration of neutrophils in the wall, and 2 cases of the 2nd and the 3rd stages respectively showed chronic endoarteritis with organized thrombi.

Adult↗
PubMed2005

Smoking is a strong risk factor for rheumatoid nodules in early rheumatoid arthritis.

OBJECTIVE: To examine whether smoking is a risk factor for rheumatoid nodules in early rheumatoid arthritis, and if so to determine the quantitative effect of smoking. METHODS: From a cohort (n = 1589) in a structured programme for follow up of newly diagnosed cases of rheumatoid arthritis (symptoms of swollen joints < or =12 months), 112 individuals with rheumatoid nodules at inclusion were identified. Nodular patients were each compared with two age and sex matched controls without nodules from the same cohort. A detailed self administered tobacco use questionnaire was answered by 210 patients (63%). RESULTS: Seventy patients were current smokers, 71 former smokers, and 69 had never smoked. Current smoking and former smoking were more common in patients with rheumatoid nodules compared with controls (86% v 59%) in both sexes. Positive rheumatoid factor (RF) was found more often among cases with nodules than controls (78% v 64%). Using detailed information from the questionnaires with conditional logistic regression analyses, ever having smoked was associated with an increased risk of the presence of rheumatoid nodules (odds ratio (OR) = 7.3 (95% confidence interval, 2.3 to 23.6); p = 0.001). The risk of having nodules was not obviously dose dependent when smoking duration as well as smoking amount were examined. A stratified analysis showed that only RF positive smokers had an increased risk of rheumatoid nodules. Smoking was associated with rheumatoid nodules among both men (p = 0.006) and women (p = 0.001). Tobacco use other than smoking (n = 31) was not associated with an increased risk of nodules (OR = 0.8 (0.2 to 3.4); p = 0.813). CONCLUSIONS: There is a strong association between smoking and rheumatoid nodules in early seropositive rheumatoid arthritis.

Adult↗
PubMed2004

A giant rheumatoid nodule.

Subcutaneous rheumatoid nodules occur commonly in advanced cases of rheumatoid arthritis and are the most common extra-articular lesion of this disease. We present a case of a very unusual giant rheumatoid nodule that developed on the lateral side of a knee. The case was devoid of systemic symptoms of arthritis and the lesion was limited to a rheumatoid nodule. The nodule was successfully treated by surgical excision. However, other new nodules developed in her hand. Her clinical course has not been satisfactory.

Aged↗
PubMed1998

Pathogenic mechanisms in the rheumatoid nodule: comparison of proinflammatory cytokine production and cell adhesion molecule expression in rheumatoid nodules and synovial membranes from the same patient.

OBJECTIVE: To investigate the production of proinflammatory cytokines and expression of cell adhesion molecules in the rheumatoid nodule. METHODS: Cytokine content (tumor necrosis factor alpha [TNFalpha], interleukin-1beta [IL-1beta], and IL-1 receptor antagonist [IL-1Ra]), at the messenger RNA (mRNA) and protein levels, and cell adhesion molecule expression were studied in 16 rheumatoid nodules and 6 synovial membranes. RESULTS: Macrophages in the rheumatoid nodules contained TNFalpha, IL-1beta, and IL-1Ra mRNA and protein, particularly in perivascular cells of the stroma and in the palisading layer. All cell adhesion molecules studied were expressed in both the rheumatoid nodules and synovial membranes, with increased expression of E-selectin in the rheumatoid nodule compared with the synovial membrane, and with the absence of vascular cell adhesion molecule 1 expression on cells of the palisading layer in the rheumatoid nodule. CONCLUSION: The presence of similar proinflammatory cytokines and cell adhesion molecules in the rheumatoid nodule and synovial membrane suggests that similar pathogenic processes result in the chronic inflammation and tissue destruction in these lesions.

Adult↗
PubMed1998

[Occurrence of subcutaneous rheumatoid nodules in patients with rheumatoid arthritis in Croatia].

The subcutaneous rheumatoid nodules (RN) have been recognized by the American Rheumatism Association, both in 1958 and in 1987, as one of the diagnostic criteria (ARA criteria) among other rheumatoid arthritis (RA) symptoms. The aim of this research has been both to provide the incidence of occurrence of RN in patients with RA in Croatia and to determine its significance in making the RA diagnose. The test group comprised 233 patients (182 women and 51 men) with RA, their average age being 48.3 years in the range of 18 to 77. Both the anamnesis and the clinical examination have determined the occurrence of RN in 54 (23.2%) of 233 patients. The range of occurrences was more evident in men (31.4%) than in women (20.8%), though this difference was statistically irrelevant. The most common localization of benign rheumatoid nodules was the exterior side of elbow and PIP hand joints. The obtained results prove that the incidence of RN in our tested patients with RA can be compared with those of the earlier researches done in Croatia (18.1% Jajić, Vlak; 20-25% Jajić), as well as with those obtained in the western European countries (20% Doherty, George; 25% Ziff; 20-25% Miehle; 21% Wolf et al.).

Adolescent↗