Heel Pain in Behcet's Disease / 대한류마티스학회지

OBJECTIVES: To evaluate the clinical significance of heel pain, a frequently associated enthesopathy in Behcet's disease and to evaluate the association with seronegative spondyloarthropathy. METHODS: 15 Behcet's disease patients diagnosed by International Study Group for Behcet's disease criteria with arthritis were studied prospectively in the period of 1994. 3. 1-1995. 3. 31. Modified New York criteria was adopted for the diagnosis of ankylosing spondylitis. The patients were grouped into two by the presence of heel pain which was documented as tenderness on heel. RESULTS: There were 6 patients in the heel pain group and 9 patients in the non-heel pain group. Clinical characteristics were not significantly different between the two groups. Ankylosing sponaylitis was not associated in either group. ESR was higher with the value of 41.2mm/hr in heel pain group than 25.7mm/hr in non-heel pain group but it was not significant. In heel pam group, one patient showed HLA-B27 positivity, one patient showed erosive bone cha. nge, and one patient showed sacroiliitis but non-heel pain group showed no HLA positivity or bony changes. CONCLUSIONS: We find that subset of Behcet's disease patients with heel pain showed tendency to have higher inflammatory activity, erosive bone change, sacroilitis and HLA B-27 association, thus should be classified as seronegative spondyloarthropathy but seems to be different category from ankylosing spondylitis. These observations should be conducted in a large number of patients to establish the clinical value.

Immunoglobulin Gene Repertoire In Rheumatoid Synovium As A Model For Autoimmune Disease / 대한류마티스학회지

OBJECTIVE: To gain insights into structural characteristics of immunoglobulin kappa chain repertoire expressed in the inflammed synovium of rheumatoid arthritis (RA), we analyzed V kappa transcirpts expressed in the synovium of a patient with longstanding RA and compared to those expressed in the PBLs of RA and normal controls. METHODS: RT-PCR was done to amplify kappa chain transcripts from RA synovial lymphocytes and the cDNA sequences were compared to those from PBL of RA patient or normal control. RESULTS: Kappa chain repertoire from RA patient's synovial lymphocytes or PBL revealed increased somatic mutation and unusually long complementarity determining region (CDR) 3 compared to normal control. CONCLUSIONS: These changes in kappa chain repertoire in RA patient are suggesting that the antibody repertoire expressed in the synovium or PBL is unique and may be related with systemic dysregulation of B cell development