[Importance of subchondral bone and synovial membrane on the pathogenesis and treatment of osteoarthritis]. / Importância do osso subcondral e da membrana sinovial na patogenia e no tratamento da osteoartrose.

Osteoarthritis (OA) is one of the most prevalent diseases of the musculoskeletal system, and it is caused by an unbalance in chondrocyte homeostasis. Although the chondrocyte is considered the key element in the maintenance of cartilage homeostasis, other structures like subchondral bone and synovial membrane are also involved in the development and progression of OA. In fact, OA is considered an example of a global failure of joint structures. In this paper, we will review the role of subchondral bone and synovium in the pathogenesis of OA, as well as their possible therapeutic implications.

[Polyarthritis associated with myelodysplastic syndromes]. / Poliartritis asociadas a síndromes mielodisplásicos.

Recently, different rheumatic manifestations have been reported in association with myelodysplastic syndromes (MDS). The objective of the present report was to know the prevalence and characteristics of joint inflammatory manifestations associated with MDS in our environment. Three cases were found in the review of 55 patients with MDS diagnosed in our institution in the last three years. The three patients had chronic non-erosive polyarthritis, with a poor response to non-steroidal anti-inflammatory drugs and required intermediate doses of glucocorticoids for its control. The arthritis was present in two patients at blood disease diagnosis. The prevalence of arthritis associated with MDS in our series was 5.4% (95% CI: 1.1% to 15.1%). Articular symptoms may be present before the hematological diagnosis; therefore, MDS must be considered in the differential diagnosis of late onset polyarthritis, particularly when associated with cytopenia. Glucocorticoid therapy at intermediate doses is usually required to control the articular symptoms.

Nodular regenerative hyperplasia of the liver and primary Sjögren's syndrome.

Nodular regenerative hyperplasia (NRH) of the liver is a rare entity associated with autoimmune diseases, hematologic disorders and therapy with immunosuppressive agents. We describe a patient with primary Sjögren's syndrome and NRH of the liver, the first report of this association. The pathogenesis of NRH is not clear, but the presence of some type of circulatory disorder is suspected.

Antithymocyte globulin in the treatment of gold induced severe aplastic anemia.

Severe aplastic anemia is the most serious complication of chrysotherapy. No treatment for this condition has been demonstrated effective. We report 3 patients with gold induced severe aplastic anemia treated with antithymocyte globulin. Complete marrow recovery was obtained in 1 case and a partial but satisfactory response in the other. All the patients remain alive without requiring blood transfusion after followup of longer than 16 months.