Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
1.
Immunol Med ; 42(1): 29-38, 2019 Mar.
Article in English | MEDLINE | ID: mdl-31067155

ABSTRACT

The aim of this study was to assess abatacept in rheumatoid arthritis (RA) patient. Patients (20 men, 89 women, aged 61.9 ± 10.4 y) who responded inadequately to conventional synthetic disease-modifying anti-rheumatic drug were treated with abatacept for 24-months. Disease activity score in 28 joints (DAS28-CRP) was evaluated. Of 109 patients, 82 (75.2%) were on methotrexate (MTX; mean dosage 9.0 ± 2.7 mg/week); 48 (44.0%) were naive to biologics and 61 (56.0%) had failed biologics. The 1- and 2-year retention rates were 77% and 53%, respectively. At 24-months, the DAS28-CRP remission rates were 54.5% in the biologic-naïve patients, and 28.2% in the biologic-failure patients (p < .01), while the structural remission rates were 83.9% and 73.1%, respectively (p = .461). Abatacept was equally effective in RA patients who were and were not on concomitant MTX. Biologic-naïve was associated with better clinical outcome. Abatacept was effective in patients who showed decreasing anti-CCP antibody titers or serum MMP-3 levels during treatment. Infection was the most frequent adverse effect of abatacept therapy. In conclusion, abatacept is more effective in biologic-naïve than in biologic-failure RA patients with or without concomitant use of MTX. Abatacept is more effective in RA patients with than without decreasing serum MMP-3 or anti-CCP antibody titers during treatment.


Subject(s)
Abatacept/administration & dosage , Antirheumatic Agents/administration & dosage , Arthritis, Rheumatoid/drug therapy , Immunosuppressive Agents/administration & dosage , Adult , Aged , Aged, 80 and over , Anti-Citrullinated Protein Antibodies/blood , Arthritis, Rheumatoid/diagnosis , Asian People , Biomarkers/blood , Dose-Response Relationship, Drug , Female , Humans , Male , Matrix Metalloproteinase 3 , Methotrexate/administration & dosage , Middle Aged , Remission Induction , Treatment Outcome
2.
Mod Rheumatol ; 19(6): 675-80, 2009.
Article in English | MEDLINE | ID: mdl-19609486

ABSTRACT

A 25-year-old Japanese man was suffering from high fever, sore throat, arthralgia, and macular salmon-pink eruption. The superficial lymph node was not palpable, and computed tomographic scans from the neck to pelvis demonstrated hepatosplenomegaly without apparent lymphadenopathy. Therefore, the possibility of malignant lymphoma was considered to be extremely low. Serology for Epstein Barr virus (EBV) and cytomegalovirus showed a postinfectious state, and blood culture was negative. Serum rheumatoid factor and antinuclear antibody were negative. Leukocytopenia (2.4 x 10(3)/mul) was observed, and thus a diagnosis of adult-onset Still's disease (AOSD) with hemophagocytic syndrome (HPS) was made. Fifty-five milligrams of prednisolone daily improved his symptoms and leukocytopenia promptly, but high fever with severe and progressive thrombocytopenia occurred 12 days later. Bone marrow aspiration revealed the presence of lymphoma cells and hemophagocytosis, and the CD45 gating analysis showed expanding population of CD2(+), CD3(-), and CD56(+) cells. Further, mucosal ulceration in the nasal cavity was detected. Therefore, a diagnosis of extranodal natural killer (NK)/T-cell lymphoma, nasal type, concomitant with HPS was made, and treatment with dexamethasone, etoposide, ifosfamide, carboplatin (DeVIC) regimen ameliorated his symptoms and platelet transfusion dependency. Later, a high titer of serum EBV-DNA was detected, which supported the diagnosis. Diagnosing AOSD, extranodal presentation of malignant lymphoma such as extranodal NK/T-cell lymphoma, nasal type, should be carefully considered.


Subject(s)
Herpesvirus 4, Human/isolation & purification , Lymphoma, Extranodal NK-T-Cell/diagnosis , Still's Disease, Adult-Onset/diagnosis , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor , Carboplatin/therapeutic use , Dexamethasone/therapeutic use , Diagnosis, Differential , Disease Progression , Etoposide/therapeutic use , Humans , Ifosfamide/therapeutic use , Lymph Nodes/diagnostic imaging , Lymph Nodes/pathology , Lymphatic Diseases/diagnosis , Lymphoma, Extranodal NK-T-Cell/complications , Lymphoma, Extranodal NK-T-Cell/drug therapy , Male , Radiography , Splenomegaly/drug therapy , Splenomegaly/etiology , Treatment Outcome
3.
Auris Nasus Larynx ; 32(1): 71-6, 2005 Mar.
Article in English | MEDLINE | ID: mdl-15882830

ABSTRACT

Relapsing polychondritis is a rare disease of unknown etiology causing systematic inflammation of the whole cartilaginous tissues. We report a patient with relapsing polychondritis preceded by inner ear involvement. A 68-year-old female visited our hospital for a chief complaint of sudden bilateral hearing loss. On pure-tone audiometry, sensorineural hearing loss, 47dB on the right and 51dB on the left, was observed. Later, bilateral auricular chondritis and uveitis developed. On biopsy of the auricular cartilage, perichondritis was observed. The patient was diagnosed with relapsing polychondritis in the early stage, 2 weeks after the onset. Oral predonine administration was initiated, and the auricular inflammation was improved within 10 days. The hearing loss disorder was gradually improved. The steroid dose was reduced, and no decrease in hearing has been observed so far.


Subject(s)
Ear, Inner/pathology , Polychondritis, Relapsing/complications , Polychondritis, Relapsing/pathology , Uveitis/complications , Aged , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Audiometry, Pure-Tone/methods , Biopsy , Female , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Humans , Polychondritis, Relapsing/drug therapy , Prednisolone/therapeutic use , Severity of Illness Index , Uveitis/drug therapy , Uveitis/pathology , Vitamin B 12/analogs & derivatives , Vitamin B 12/therapeutic use
4.
Rheumatol Int ; 25(3): 230-3, 2005 Apr.
Article in English | MEDLINE | ID: mdl-15660236

ABSTRACT

In this report, we present a rare case of a 52-year-old man with a unique form of hypertrophic pachymeningitis involving the anterior part of the falx and who was positive for rheumatoid factor. The clinical symptom was only headache, without any cranial nerve palsies or ataxia. Diagnosis was made by gallium scintigraphy and magnet resonance imaging but was not confirmed by dural biopsy. Treatment with corticosteroid alone was extremely effective for him, while in most cases hypertrophic pachymeningitis recurs or progresses despite the treatment.


Subject(s)
Arthritis, Rheumatoid/diagnosis , Cranial Sinuses/pathology , Dura Mater/pathology , Meningitis/diagnostic imaging , Rheumatoid Factor/blood , Arthritis, Rheumatoid/complications , Biomarkers/blood , C-Reactive Protein/analysis , Follow-Up Studies , Gallium , Humans , Hypertrophy/complications , Hypertrophy/diagnostic imaging , Hypertrophy/drug therapy , Magnetic Resonance Imaging/methods , Male , Meningitis/complications , Meningitis/drug therapy , Middle Aged , Prednisolone/therapeutic use , Radionuclide Imaging , Risk Assessment , Severity of Illness Index , Treatment Outcome
SELECTION OF CITATIONS
SEARCH DETAIL
...