The effect of mizoribine on rheumatoid arthritis / 대한내과학회지

BACKGROUND: This retrospective study was performed to investigate the clinical effects of mizoribine with using methotrexate (MTX) or mizoribine alone on those patients with rheumatoid arthritis (RA) who showed an ineffective response or intolerance to the MTX. METHODS: The patients were divided into two groups: (1) combination therapy of mizoribine with MTX and (2) mizoribine alone. All the patients took 100 mg mizoribine daily for at least 16 weeks. Before and after administration of mizoribine for 16 weeks, we assessed the clinical variables such as the visual analogue pain scale (VAS), the tender joint counts (TJC), and the swollen joint counts (SJC). At each time, the laboratory parameters including the ESR, CRP, complete blood count (CBC), liver enzymes and creatinine were also measured. Disease activity scores (by the DAS28) and the adverse effects were determined at baseline and after 16 weeks. RESULTS: Fifty patients were recruited in this study (mizoribine plus MTX group: n=35, mizoribine group: n=15). There were no significant differences in the initial laboratory values between the two treatment groups. After treatment for 16 weeks, the DAS28 was decreased significantly in the mizoribine plus MTX group (4.7+/-1.14 vs. 3.9+/-0.97, respectively, p<0.05). Yet the mizoribine alone group did not showed any significant change of the DAS28 (4.3+/-0.56 vs. 3.9+/-0.37, respectively, p=0.076). Mild gastrointestinal disturbance was the most common adverse effect. The incidence of adverse effects was similar in both treatment groups (20% vs. 27%, respectively). CONCLUSIONS: Mizoribine in combination with MTX was effective for RA patients who showed an ineffective response or intolerance to MTX. Furthermore, this treatment can be considered to be relatively safe.

The association of programmed cell death 1 (PDCD1) gene polymorphism with ankylosing spondylitis in a Korean population / 대한내과학회지

BACKGROUND: The programmed death 1 (PD-1) protein, the product of the PDCD1 gene, is a negative regulator of T cells, and a genetic association of PDCD1 in systemic lupus erythematosus and rheumatoid arthritis (RA) in Caucasians has been reported. However, there have been no studies on the association of this gene and ankylosing spondylitis (AS). The aim of this study was to investigate the association of PD-1 polymorphisms with ankylosing spondylitis in the Korean population METHODS: One single-nucleotide polymorphism PD-1.9 T/C were genotyped in 95 patients with AS and 130 healthy controls in a case-control association study. We analyzed this SNP by use of a PCR-RFLP assay using genomic DNA. RESULTS: The T allele of the PD-1.9 polymorphism was significantly more frequent in a Korean male population with AS than in Korean male controls (21.0% versus 6.9%; odds ratio[OR] 1.89; 95% confidence interval [95% CI] 1.483-2.408). CONCLUSIONS: We demonstrated the presence of the PD-1 polymorphism in Korean AS patients. This finding suggests a genetic association between the PD-1 polymorphism and AS susceptibility.

A case of henoch-Sch?nlein purpura complicated by hemorrhagic gastroenteritis and IgA nephropathy in a patient suffering with juvenile rheumatoid arthritis / 대한내과학회지

Henoch-Sch?nlein purpura (HSP) is a systemic vasculitis with IgA dominant immune complex deposits that affect the small vessels in the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal symptoms are common and the manifestations include abdominal pain, bleeding, bowel infarction, intussusceptions or even perforation. Polyarticular onset juvenile rheumatoid arthritis (JRA) is a rare form of arthritis that affects children and young adults. The relationship between HSP and JRA is uncertain. We report on a 24-year-old man with a history of polyarticular onset JRA and HSP that was complicated by hemorrhagic gastroenteritis. The gastroscopy and colonoscopic findings showed extensive hemorrhagic inflammatory changes of the gastric and intestinal mucosa. The patient had severe bloody diarrheal symptoms, abdominal pain and gross hematuria. The 24 hours urine chemistry profile showed the proteinuria was greater than 4.5 g/day, and immunofluorescent staining of the renal biopsy specimen showed diffuse granular mesangial deposits of IgA and C3. The abdominal manifestations and proteinuria were improved after methylprednisolone therapy.

Morton Neuroma in a Patient with Rheumatoid Arthritis / 대한류마티스학회지

No abstract available.

Ankylosing Spondylitis associated with Plasmacytoma: a Case Report / 대한류마티스학회지

Plasmacytomas are tumors composed of plasma cells of variable maturity, which are histologically identical to those seen in multiple myeloma. Ankylosing spondylitis is a chronic inflammatory disease, probably resulting from the interaction of a genetic predisposition involving HLA-B27 with an environmental event such as enteric bacterial infection. Multiple myeloma has been intermittently reported in patients with ankylosing spondylitis. It has been proposed that the protracted stimulation of immunocytes by inflammatory lesions on the mucosal surfaces of the gastrointestinal, respiratory tracts may be implicated in the pathogenesis of multiple myeloma in some patients. We observed a 23 year old male patient with a history of plasmacytoma who subsequently developed ankylosing spondylitis. He was diagnosed as plasmacytoma 4 years ago and took a radiation therapy. There was no previous report of ankylosing spondylitis following plasmacytoma. The relationship between two diseases is uncertain until now and further study should be needed.