An Effective Case of Keishikajutsubuto and Maobushisaishinto for Arthritis / 日本東洋医学雑誌

We report the case of a 60-years-old man who complained fever and left knee pain. Fever and arthralgia appear once a month, and these symptoms disappear spontaneously in 3 days. The patient came to our hospital to receive Kampo treatment, because the patient experienced improving these symptoms by Kampo medicine about 20 years ago. I judged the arthralgia as kanshippi, because the arthralgia improved when the patient warmed the joint. We prescribed keishikajutsubuto 7.5 g/day. Arthralgia improved after administration of keishikajutsubuto, but the attack appeared every month. We prescribed maobushisaishinto 5 g/day in addition to keishikajutsubuto 5 g/day for further improvement of arthralgia. The frequency of fever and arthralgia attack was dramatically decreased after we prescribed keishikajutsubuto 5 g/day and maobushisaishinto 5 g/day. We considered the possibility of palindromic rheumatism based on clinical symptoms, X-ray in other clinic and blood test results in our hospital. We report an effective case of keishikajutsubuto and maobushisaishinto on arthritis attacks with fever that resolved spontaneously in a short time.

Anti-CCP antibodies predict progression of palindromic rheumatism to rheumatoid arthritis / 대한내과학회지

BACKGROUND/AIMS: Palindromic rheumatism (PR) is an episodic arthropathy that may precede typical rheumatoid arthritis (RA). The objective of this study was to determine whether anti-cyclic citrullinated peptide (anti-CCP) antibodies in patients with PR contribute to the progression to RA. METHODS: The study group included 115 patients who were initially diagnosed with PR. Baseline serum samples were stored and analyzed for the presence of anti-CCP antibodies, APF, and RF or for anti-CCP antibodies and HLA-DR4. A multiple logistic regression analysis was used to identify predictive factors for progression to RA. RESULTS: The anti-CCP antibodies APF and RF were found in 33.3%, 28.9%, and 35.7% of the 115 patients with PR, and 36 (31.3%) of these patients eventually progressed to RA. Comparing the risk factors for patients who progressed to RA (31.3%) and those who did not (68.7%), only the presence of anti-CCP antibodies was found to affect progression to RA (95% CI for OR, 0.0001-0.114; p<0.001). HLA-DR4-positivity was noted in 40% of the patients with PR, although it did not affect progression to RA and was not significantly associated with the presence of anti-CCP antibodies. CONCLUSIONS: Anti-CCP antibodies are found more frequently in patients with PR who eventually progress to RA. Therefore, anti-CCP antibody testing of patients with PR may facilitate prediction of progression to RA.

Clinical analysis and follow-up years of 63 palindromic rheumatism patients / 中华风湿病学杂志

Objective This research is proposed to improve the recognition of the clinical features, therapy and prognosis of palindromic rheumatism.Methods We analyzed the clinical data of 63 palindromic rheumatism patients.Their response to therapy was observed,and they were followed up for 1.5 to 3 years. Results The average onset age of the patients was(40?11)years and the average disease duration was(8?7) years.They were characterized by recurrent attacks of sudden-onset acute arthritis and(or)periarticular tis- sue inflammation,in which most joints were involved.In 46 percent of the patients,the attacks were incited by some events.In 67 percent of them,the attacks recurred more and more frequently.Nonsteroidal anti-in- flammatory drugs and disease modifying anti-rheumatic drugs(DMARDs)was effeeive in variant extents,to palindromic rheumatism patients.Five percent of patients achieved complete remission.Nine percent of them had relapses for a long time.And 5% of them evolved to RA.Conclusion Palindromic rheumatism is a syn- drome characterized by recurrent attacks of sudden-onset acute arthritis and(or)periarticular tissue inflam- mation.The therapy of DMARDs,especially penicillamine and chloroquine diphosphate,is effective on the syndrome.The outcomes of palindromic rheumatism is diverse.

Clinical Presentation of Palindromic Rheumatism / 대한류마티스학회지

OBJECTIVE: Palindromic rheumatism refers to the intermittent, relatively brief episodes of arthritis and/or inflammation of the soft tissue around the joint. The purpose of this study is to evaluate the clinical features, laboratory findings and prognosis of patients with palindromic rheumatism. METHODS: Study group was forty-nine consecutive patients that enrolled as palindromic rheumatism at Gwangmyung Sungae General Hospital between January 1996 and December 2000 by retrospective chart review. Follow up durations of all cases were more than 2 years and mean follow up duration was 59+/-21.8 months. RESULTS: There were 14 males and 35 females and sex ratio was 1:2.5. The mean age was 43.9+/-5.8 years. The attacks usually lasted less than 2 days and the most common attack pattern was monoarticular. In all cases, the most common affected site was proximal interphalangeal joints followed by wrist joint. But in males, the most common affected joint was knee. Rheumatoid factor was positive in 34.7%. Two patients were progressed to suspected rheumatoid arthritis and three patients were progressed to rheumatoid arthritis definitely. CONCLUSION: This study showed similar results with other previously reported studies, but showed more knee joint involvement in males and less progression to rheumatoid arthritis than other studies. But compared with previous Korean studies, patient's age was older in this study and progression to rheumatoid arthritis was similar in both studies. The number of patients in this study was limited, large-scale epidemiologic study will be necessary for further investigation.

Three Cases of Palindromic Rheumatism Effectively Treated with Kampo Medicine. Consideration of Kampo Treatment in Palindromic Rheumatism / 日本東洋医学雑誌

We examined three cases where Kampo medicine had effects on palindromic rheumatism. All the patients are men with arthralgia accompanied by redness, fever, and swelling. All cases are RF negative. Cases 2 and 3 are brothers. Case 1: A 58-year-old patient with recurrent arthralgia on shoulders, hands, and legs for 30 years. Eppi-ka-jutsu-to was administrated for arthralgia. When discomfort of the hypochondrium (Kyokyokuman) was noted, the administration of Sho-Saiko-to reduced the symptom.<br>Case 2: A 40-year-old patient with recurrent arthralgia on shoulders, hands and legs for nine years. Eppi-ka-jutsu-to was administrated for arthralgia. When discomfort of the hypochondrium (Kyokyokuman) and contraction of the abdominal muscles (Fukuhikokyu) was noted, the administration of Eppi-ka-jutsu-to-go-Shigyaku-san-ryo was replaced, which reduced the symptoms.<br>Case 3: A 46-year-old patient with recurrent arthralgia on knees and fingers, and pain in hip joints. Eppi-ka-jutsu-to was administrated for arthralgia. When discomfort of the hypochondrium (Kyokyokuman) and contraction of the abdominal muscles (Fukuhikokyu) were noted, the administration of Shigyaku-san reduced the symptoms.<br>All cases were typical palindromic rheumatism, and Eppi-ka-jutsu-to was effective to a certain degree. Kampo diagnosis of Saiko (Saiko-sho) was made and additional Saiko-drugs (Saiko-zai) reduced the frequency, the degree, and the length of the period of symptoms.