ABSTRACT
Twenty-six patients with various inflammatory diseases of the knee were treated with a 400 mg dose of pirprofen orally twice a day for 2 days. On the third day, samples of blood and synovial fluid were taken 3 h and 10 h approximately after a fifth 400 mg dose of the drug. Pirprofen concentrations, as determined by gas-liquid chromatography, were higher in plasma than in synovial fluid during the 2-5 h period post-dosing. They decreased with an elimination half-life of 6 h in plasma as against 41 hours in synovial fluid. This study demonstrates that pirprofen diffuses into the synovial fluid where it remains significantly longer than in plasma.
Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/metabolism , Phenylpropionates/metabolism , Synovial Fluid/metabolism , Adolescent , Adult , Aged , Anti-Inflammatory Agents, Non-Steroidal/blood , Female , Humans , Knee Joint , Male , Middle Aged , Phenylpropionates/bloodABSTRACT
Anti-perinuclear antibodies (APN) were studied in 547 subjects, 123 of whom suffered from rheumatoid polyarthritis (RP). They were detected 88 times in the latter group (72 percent). 26 percent of RP were without serological abnormalities when only rheumatoid factors were considered (latex, Waaler-Rose, Waaler-Rose LOR, rheumatoid factors by indirect immunofluorescence). The rate dropped to 10 percent when APN were included. This test is therefore sensitive. It is also specific as APN exists in only 11 percent of non-rheumatoid rheumatological diseases not including psoriasis (42 percent) and in 16 percent of other auto-immune diseases. In addition, there is a correlation (p less than 0.01) between APN level and the evolution of the rheumatoid illness. APN appears early in an illness and is thus of diagnostic and prognostic interest in RP.
Subject(s)
Antibodies, Antinuclear/analysis , Arthritis, Rheumatoid/immunology , Adolescent , Adult , Aged , Arthritis, Rheumatoid/diagnosis , Autoimmune Diseases/immunology , Female , Fluorescent Antibody Technique , Humans , Male , Middle Aged , Prognosis , Rheumatoid Factor/analysisABSTRACT
Still disease was first described in adults ten years ago. Muscular involvement was already mentioned in the first reports. However, it's incidence is underestimated as it is often mistaken for arthralgia. Diagnosis of muscular involvement is suggested by clinical features and established by biological, electromyographical, and histological investigations. We describe five new cases of adult-onset Still disease with muscular involvement. All five cases followed the usual favorable course.
Subject(s)
Arthritis, Juvenile/complications , Muscular Diseases/etiology , Adolescent , Adult , Female , Humans , Male , Muscular Diseases/enzymology , Muscular Diseases/physiopathologyABSTRACT
In 1971, less than one-hundred years after Still's publication (1897) concerning children, Bywaters described the adult-onset form of Still disease. Over one-hundred cases of this disorder have been recorded since. In adults, Still disease affects mainly women, and the average age at onset is twenty-seven. The well-known features demonstrated by clinical examination and complementary investigations are recalled. They include fever, arthritis, rash, lymphadenopathy, enlarged spleen, and serositis. Attention is drawn to hepatic and muscular involvement as well as to articular prognosis. Additional information is provided on questions which remain open to debate, particularly concerning management and therapeutic results.
Subject(s)
Arthritis, Juvenile/diagnosis , Wissler's Syndrome/diagnosis , Adolescent , Adult , Arthritis, Juvenile/physiopathology , Arthritis, Juvenile/therapy , Female , Humans , Male , Middle Aged , Prognosis , Wissler's Syndrome/physiopathology , Wissler's Syndrome/therapyABSTRACT
In a 44 years old woman, a flare up of polyarthritis becoming positive for sero-reaction at the time of hospitalization, is referred to an earlier unknown SLE. The bilateral optic neuritis which began 15 years earlier, while she was pregnant, simultaneously with a bilateral carpal tunnel syndrome is retrospectively related to the SLE. Such an optic neuritis is rare, its clinical features are specified among the neuro-ophthalmological complications in SLE. Very often optic neuritis is associated with myelopathy. Hypercytosis with moderate elevation of albumin C.S.F., a high level of cyclic GMP, and a low concentration of IgG in C.S.F., are found in central neurological complications in SLE. Other biological alterations are described but both their signification and their interest, as well for diagnostic as for therapeutic supervision, are unknown. Neuropathological findings show either vasculitis or demyelinizing lesions. This case shows the therapeutic problems of such medical situations.
