ABSTRACT
To evaluate glucocorticoids as an alternative to nonsteroidal antiinflammatory drugs in patients with crystal-induced arthritis, a study was conducted in 27 patients with acute attacks of gout or chondrocalcinosis. Patients with contraindications to nonsteroidal antiinflammatory drug therapy were given either a single intramuscular injection of 7 mg betamethasone (group B, n = 10) or, if they were receiving anticoagulant therapy, a single intravenous injection of 125 mg methylprednisolone (group C, n = 7). The remaining patients (group A, n = 10) were given diclofenac in a dosage of 150 mg per day for three days then 75 mg per day for three days. Efficacy was evaluated based on the self-evaluated subjective improvement (%) and on the severity of joint swelling on days 1, 3, and 6. Both parameters improved promptly in all three groups. C-reactive protein decreased between baseline and day 6. Few patients had relapses. Glucocorticoid therapy was well tolerated. Our data show that a single intramuscular or intravenous injection of a glucocorticoid is safe and effective in patients with crystal-induced arthritis and risk factors for intolerance to nonsteroidal antiinflammatory drugs.
Subject(s)
Anti-Inflammatory Agents/administration & dosage , Arthritis, Gouty/drug therapy , Chondrocalcinosis/drug therapy , Glucocorticoids/therapeutic use , Administration, Oral , Adult , Aged , Aged, 80 and over , Arthritis, Gouty/diagnosis , Betamethasone/administration & dosage , Blood Sedimentation , C-Reactive Protein/analysis , Chondrocalcinosis/diagnosis , Diclofenac/administration & dosage , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Injections, Intramuscular , Injections, Intravenous , Male , Methylprednisolone/administration & dosage , Middle Aged , Treatment OutcomeABSTRACT
We report the case of an 29-year-old male Turkish patient suffering from generalized Behçet's disease. After an evolution of twelve years, he suddenly presented a nephrotic syndrome, a terminal renal insufficiency and thrombosis of the renal veins as well as the inferior vena cava. A percutaneous renal biopsy showed amyloidosis of the AA type, characteristic of secondary amyloidosis. Attempts to install an arterio venous shunt of the arm and to set up a peritoneal dialysis catheter were complicated by septic thrombosis. The patient died of renal failure. The association of renal amyloidosis and Behçet's disease is rare. It is, as far as we know, the first case reported in Switzerland.
Subject(s)
Amyloidosis/complications , Behcet Syndrome/complications , Kidney Diseases/complications , Acute Kidney Injury/etiology , Adult , Amyloidosis/metabolism , Fatal Outcome , Humans , Male , Renal Veins , Serum Amyloid A Protein/metabolism , Thrombosis/etiologyABSTRACT
To evaluate urinary GLA excretion, a marker of vitamin K metabolism, the effect of an oral calcium load was studied in 8 volunteers under three conditions: (1) after 1.5 g elementary calcium (calcium carbonate), (2) after 1.5 g calcium (Ossopan, a preparation containing 1 mg osteocalcin per g) and (3) after 1.5 g calcium but with pretreatment of 10 mg vitamin K1 orally for 3 days. No differences in blood calcium, osteocalcin concentration of calciuria were observed. However, GLA excretion was significantly higher with Ossopan or after pretreatment with vitamin K1.
