Etiopathogenetic aspects of psoriatic arthritis with special reference to immunologic factors

On 21 patients with psoriasis and 22 with psoriatric arthritis examinations for the recognition of the immune regulation were performed and the results were compared with those of healthy control persons and patients with rheumatoid arthritis. The psoriatric arthritis shows humoral as well as cellular disturbances of immune regulations which in the group comparison with the psoriasis and the rheumatoid arthritis partly have communities, but partly also have differences. With regard to size and distinction of the disturbances the patients with rheumatoid arthritis have the highest degree of severity. With the help of the techniques used by us systemic cellular disturbances of the immune regulations could not be proved in the psoriasis. The psoriatic arthritis to a certain extent occupies a medium position. But a clear coordination of these disturbances into the pathogenetic process is not yet possible.     

Followup study on patients with Reiter's disease and reactive arthritis, with special reference to HLA-B27

An analysis of 160 patients with Reiter's disease, 144 with yersinia arthritis, and 9 with salmonella arthritis was performed, Complete or incomplete Reiter's syndrome was observed in one-third of the patients with yersinia arthritis and in most of those with salmonella arthritis. During the followup period, chronic back pain and joint symptoms were frequent in all the patient groups. Patients who were HLA-B27 positive had a more severe acute disease (more frequent back pain, urologic symptoms, mucocutaneous manifestations, and a longer duration of the disease) and more frequent chronic back pain and sacroiliitis.     

Double-blind, placebo-controlled study of three-month treatment with lymecycline in reactive arthritis, with special reference to Chlamydia arthritis.

We conducted a double-blind, placebo-controlled, randomized study of 3-month treatment with lymecycline, a form of tetracycline, in reactive arthritis (ReA). Lymecycline therapy significantly decreased the duration of the illness in patients with Chlamydia trachomatis-triggered ReA, but not in other ReA patients. In 2 ReA patients, C trachomatis was found in the throat, an uncommon locale for this organism. Our results suggest that it is important to verify the triggering microbe and that it is beneficial to treat Chlamydia arthritis patients with a prolonged course of tetracycline.     

Lymphocyte stimulation in Reiter's syndrome. A comparative study between patients and normal controls with special reference to HLA-B27

The lymphocyte-stimulating capacity of bacterial antigens from Yersinia enterocolitica and Chlamydia trachomatis was studied in 14 patients with Reiter's syndrome and compared with 16 healthy controls. The influence of HLA-B27 was evaluated. There was an increased reactivity in patients compared with controls. The most pronounced reactivity was seen in HLA-B27-positive patients. These findings support the hypothesis that there is an impaired T-cell function in HLA-B27-associated diseases.     

Organ-specific autoantibodies in non-organ-specific autoimmune diseases with special reference to rheumatoid arthritis

Summary Sera from 367 patients with rheumatoid arthritis (RA) and from 102 patients with other non-organspecific (NOS) autoimmune diseases were examined for the presence of organ-specific (OS) autoantibodies. The incidence of these OS autoantibodies was not increased in patients with NOS autoimmune diseases with the exception of thyroglobulin antibodies, which were significantly more frequent in RA (P<0.001) and in Sjögren's syndrome (P<0.05) patients than in normal controls. Investigation of 169 patients with OS autoimmune diseases did not reveal an increased prevalence of NOS autoantibodies. In RA patients, OS autoantibodies correlated with NOS autoantibodies (P<0.04) and with HLA-DR3 antigen (P<0.01).     

Followup study on patients with reiter's disease and reactive arthritis,with special reference to HLA—B27

An analysis of 160 patients with Reiter's disease, 144 with yersinia arthritis, and 9 with salmonella arthritis was performed. Complete or incomplete Reiter's syndrome was observed in one-third of the patients with yersinia arthritis and in most of those with salmonella arthritis. During the followup period, chronic back pain and joint symptoms were frequent in all the patient groups. Patients who were HLA—B27 positive had a more severe acute disease (more frequent back pain, urologic symptoms, mucocutaneous manifestations, and a longer duration of the disease) and more frequent chronic back pain and sacroiliitis.     

A non-infective cause of recurrent purulent arthritis

We describe a case of recurrent attacks of acute sterile pyogenic arthritis in a 66-year old man. Seven years after the first presentation the diagnosis of acute disseminated fatty necrosis (DFN) was made.     

A clinicopathological study of inflammatory pseudotumors of the liver with special reference to vessels

BACKGROUND/AIMS: Inflammatory pseudotumor of the liver is rare, and patients with inflammatory pseudotumor frequently undergo unnecessary surgical resection as a result of misdiagnosis of malignancy. In this study, we therefore investigated inflammatory pseudotumor clinicopathologically to clarify its characteristics. METHODOLOGY: Twenty patients including 3 with inflammatory pseudotumor and 17 with various malignant liver tumors were studied. We further investigated tumor vessels by means of immunohistochemistry using monoclonal antibodies against CD34, factor VIII-related antigen and alpha-smooth muscle actin. RESULTS: Although serum levels of alkaline phosphatase were significantly higher in inflammatory pseudotumor patients than in other patients, the laboratory data alone could not precisely distinguish inflammatory pseudotumor from other hepatic tumors. On imaging studies such as ultrasonography and computed tomography, significant changes in tumor size, especially size reduction, during relatively short follow-up periods were often observed in inflammatory pseudotumor but not in other liver tumors. An enhancement of the peripheral regions of inflammatory pseudotumor was frequently observed in the early phase of contrast-medium dynamic computed tomography. This might be due to abnormal vessels located in the peripheral regions of inflammatory pseudotumor which might result from obliteration of some pre-existing vessels in portal tracts within inflammatory pseudotumor. Immunohistochemical analysis further revealed that abnormal vessels in the peripheral regions of inflammatory pseudotumor were positively stained with CD34, factor VIII-related antigen and alpha-smooth muscle actin as were tumor sinusoids within hepatocellular carcinoma and tumor capillaries in other malignant liver tumors. CONCLUSIONS: Although inflammatory pseudotumor seems to have some features in imaging studies, a biopsy is needed for a correct diagnosis of inflammatory pseudotumor.