[Pregnancy in patients with rheumatoid arthritis and inflammatory spondylarthropathies]

The activity of a rheumatic disease can be influenced by pregnancy and puerperium. Prospective studies have shown an improvement in joint involvement in rheumatoid arthritis in two thirds to three quarters of pregnancies. After birth, an exacerbation is common. In spondylarthropathies there is no relevant change in disease activity. The fetal outcome is not impaired in patients with rheumatoid arthritis and inflammatory spondylarthropathies. Every pregnancy in women with a rheumatic disease should be considered as high-risk, and such pregnancies require close collaboration between rheumatologists and obstetricians

Cloning of collagenase-3 from the synovial membrane and its expression in rheumatoid arthritis and osteoarthritis

OBJECTIVE: To analyze synovial membrane of patients with rheumatoid arthritis (RA) for the expression of unknown matrix metalloproteinases (MMP). METHODS: Degenerate oligonucleotides corresponding to highly conserved regions of the MMP gene family and the rapid amplification of cDNA ends (RACE) method have been used to search for new members of this gene family. MMP gene expression has been characterized by Northern blot analysis. RESULTS: We cloned a MMP cDNA from the synovial membrane that is completely identical to the recently published collagenase 3 cDNA derived from a human breast cancer cDNA library (Freije, et al: J Biol Chem 1994;269:16766-73). Collagenase 3 is expressed in parallel with interstitial collagenase and stromelysin 1 in RA and osteoarthritis (OA). Collagenase 3 gene expression was not detected in several normal human tissues. CONCLUSION: The expression of collagenase 3 in the synovial membrane in RA and OA suggests its involvement in articular tissue degradation

Colour duplex sonography of finger arteries in vasculitis and in systemic sclerosis

CASE REPORTS: Three patients—two with Wegener's granulomatosis and one with an overlap syndrome of rheumatoid vasculitis, systemic lupus erythematosus, and antiphospholipid syndrome—are described. All patients experienced a sudden onset of Raynaud's phenomenon or acrocyanosis when they had a flare of their disease. DISCUSSION: Ultrasonography (US) showed dark (hypoechoic) arteries without colour signals, resembling the US pattern of embolism. In contrast, US in patients with systemic sclerosis is entirely different, delineating a smaller artery lumen, reduced pulsation, and thickened, slightly hyperechoic artery walls