Case definition of psoriatic arthritis

[No abstract available

Correlations between peripheral and axial radiological changes in patients with psoriatic polyarthritis

Peripheral radiological changes were investigated with respect to occurrence rates, severity and correlations with axial radiological change severity in a retrospective study in 140 patients with psoriatic polyarthritis. Study parameters were the number of erosions in joints of the hands and feet, severity of wrist lesions, sacroiliitis stage, number of syndesmophytes, number of pelvic and calcaneal enthesopathies and Larsen's damage score. Fifty patients had both peripheral changes and axial changes (bilateral stage 2 sacroiliitis or unilateral stage 3 or more sacroiliitis and/or syndesmophytes). Disease duration was correlated with radiological changes and the disease score. When patients were divided into quartiles based on polyarthritis duration, mean disease score was found to be significantly higher in the second than in the first quartile (p < 0.005) and in the fourth than in the third quartile (p < 0.0005), whereas the difference between the second and third quartiles was not significant. Peripheral changes progressed during the first five years of the disease. In contrast, the sacroiliitis score increased only in those patients with the longest disease durations. Correlations between severity of peripheral changes, sacroiliitis stage and disease score were found in all patients. In patients with axial lesions, peripheral involvement was more common and more severe and disease scores were significantly higher (p < 0.00001). Our findings suggest that both peripheral and axial changes contribute to the severity of psoriatic polyarthritis and that the subgroup of patients with axial changes is characterized by more frequent and more severe peripheral lesions

A CASE OF RELAPSING POLYCHONDRITIS - PATHOGENETIC CONSIDERATIONS

[No abstract available

Immunohistologic markers of immune activation and changes of glycosylation of serum proteins in primary Sjogren's syndrome

Objective To assess the possible correlations between the immune activation of certain surface antigens at the lip salivary gland (LSG) level, and changes in glycosylation of serum proteins in primary Sjogren's syndrome (SS). Methods LSG biopsy samples were obtained from 22 SS patients (mean age 56.3 years; mean disease duration 70.8 months) and prepared for immunohistochemical analysis using murine monoclonal antibodies for interleukin-2 receptor (IL-2R) (CD25) and for the class II major histocompatibility antigen HLA-DR. The glycosylation of serum proteins was evaluated in all patients by an enzyme-linked lectin assay (ELLA) using concanavalin A (Con A). Results In LSG specimens the presence of IL-2R was observed at the infiltrating level, mainly periductally, in 13 (59%) cases and on the epithelial cells of 14 (64%) patients. In 13 out of 22 SS patients (59%) a marked positivity both of the infiltrates and of the epithelium was found for anti-HLA-DR monoclonal antibody. The degree of expression of different antigens on LSG samples was correlated with their histologic class according to Tarpley evaluation. The positivity for IL-2R and HLA-DR molecules on glandular tissues was correlated. A significant increase in the total Con A reactivity of serum proteins was found in those patients expressing IL-2R and HLA-DR antigens on LSG specimens. Conclusions The co-expression of IL-2R and HLA-DR antigens on both the epithelium and infiltrates of LSG is consistent with a participation of these cells in the immune process of SS. Moreover changes in the glycosylation of serum proteins seem to be related to the presence of these immunoactivation markers of the disease at the LSG level, suggesting that the control of protein glycosylation could be mediated by the same mechanisms involved in the tissue damage of SS

Ultrasound measurements at the proximal phalanges in male patients with psoriatic arthritis

Bone ultrasound parameters at the proximal phalanges of the hands were measured in 55 male patients with psoriatic arthritis (PA) (39 with peripheral radiologic involvement and 16 with axial involvement), comparing the findings with those in 16 rheumatoid arthritis (PA) patients, 20 ankylosing spondylitis (AS) patients and 55 age- and sex-matched normal controls. Mean values of amplitude-dependent speed of sound (Ad-SoS) and ultrasound bone profile score (UBPS) were significantly lower in RA (p <0.001 andp <1 x 10(-5)) and PA (p <0.03 and p <1 x 10(-6)) patients than in controls, while there was no statistically significant difference between AS patients and healthy subjects. Ultrasound parameters showed a significant negative correlation with age in all groups. in each patient group ultrasound values were unrelated either to disease duration or to inflammatory indices such as erythrocyte sedimentation rate and C-reactive protein. Moreover no significant differences were observed between ultra-sound parameters of the dominant and the nondominant hand. PA patients with and without axial radiologic changes did not show any differences in ultrasound parameters. However, PA subjects with peripheral involvement only had significantly higher Ad-SoS (p <0,04) and UBPS (p <0.04) values than RA patients. PA patients with axial lesions had significantly lower (p <0.04 and p <0.01) ultrasound values than AS patients. These findings suggest that PA uItrasound techniques performed at the peripheral revel are of value to speculate on bone involvement, although we think that ultrasound measurements cannot yet be recommended for monitoring bone involvement in these patients

Soluble interleukin-2 receptor in Sjogren's syndrome: Relation to main serum immunological and immunohistochemical parameters

Our aim was to study sIL-2R relationship with main serum immunological and LSG immunohistochemical parameters, including surface antigen expression of immune activation, in 27 patients with primary SS. Serum sIL-2R levels were significantly higher in SS (p 1 (86% vs 40%; p < 0.047), and CD25 expression on lymphocytes (100% vs 40%; p < 0.008). The frequency (p < 0.025) of CD25 expression on lymphocytes was higher in group A than in group B. The frequency of CD25 expression on the infiltrates correlated not only with sIL-2R levels (p < 0.047), but also with anti-SSB/La antibody values (p < 0.044), with Tarpley histological classes (p < 0.009) and with frequency of HLA-DR expression on lymphocytes (p < 0.004) and on epithelial cells (p < 0.002). The frequency of epithelial CD25 expression also correlate with that of epithelial HLA-DR (p < 0.004). Our report suggests that sIL-2R is linked to glandular involvement in primary SS

Comparison of the health assessment questionnaire and arthritis impact measurement scale in patients with psoriatic arthritis

Objective. To determine which of two instruments, the Health Assessment Questionnaire (HAQ) and the Arthritis Impact Measurement Scales (AIMS), was more closely correlated with the main parameters reflecting activity and severity of psoriatic arthritis. Methods. Both instruments were administered to 72 consecutive patients with psoriatic arthritis. Results. Global HAQ and AIMS scores,were closely correlated with each other (r(s) =0.747; P<0.00001). AIMS physical function scales namely physical activity, dexterity, social activity and activities of daily living - were moderately or closely correlated with the main clinical disease activity parameters, most notably morning stiffness of axial joints (r(s)= 0.271-0.551). Scales measuring psychological status yielded weaker correlations with disease activity parameters (r(s)= 0.241-0.277) and were also correlated with the visual analog scale score for skin lesion severity. Morning stiffness of peripheral joints was correlated only with two AIMS scales, namely pain (r(s)= 0.532) and activities of daily living (r(s)= 0.303). Severity of radiological damage of peripheral and axial joints was most closely correlated with the scales of physical function, most notably physical activity. The global and scale HAQ scores showed moderate to close correlations with the main clinical disease activity parameters, most notably morning stiffness of axial joints. The global HAQ score was also correlated with radiological carpal involvement and with the radiological severity of peripheral joint involvement, whereas only the arising and hygiene scales were (moderately) correlated with the radiological severity of spinal involvement. Conclusion. Although both the HAQ and the AIMS were useful in assessing health status in psoriatic arthritis patients, only the AIMS captured some of the effects of the skin lesions. Our data also suggest that the AIMS may be more effective than the HAQ for evaluating the effect of radiological lesions produced by psoriatic arthritis

ONE-YEAR TREATMENT WITH LOW-DOSE METHOTREXATE IN RHEUMATOID-ARTHRITIS - EFFECT ON CLASS-SPECIFIC RHEUMATOID FACTORS

We evaluated the effect of a one-year treatment of low dose methotrexate (MTX) on class specific rheumatoid factors in 27 patients with rheumatoid arthritis (RA). Enzyme-linked immunosorbent assay (ELISA) showed after 6 and 12 months a significant reduction of IgM-RF, IgA-RF and IgG-RF levels from the baseline values. During MTX treatment, changes of each RF isotype were not correlated with any other isotype and its corresponding immunoglobulin changes. Moreover, immunological changes were not related to the improvement of clinical parameters. Our results showed that low dose MTX can specifically affect levels of RF isotypes, which are involved in the immune pathogenesis of RA

SACROILIAC JOINT INVOLVEMENT IN PRIMARY HYPERPARATHYROIDISM - PATHOGENETIC CONSIDERATIONS

The present report describes the first case of primary hyperparathyroidism with monolateral sacroiliac ankylosis assessed by coronal CT scans. The coexistence of ankylosis with erosive changes, without features of spondyloarthritis or degenerative changes, could be related to hyperparathyroidism