Subject(s)
Rheumatic Fever/complications , Rheumatic Fever/diagnosis , Rheumatic Nodule/complications , Rheumatic Nodule/diagnosis , Acute Disease , Adolescent , Arthritis/complications , Dyspnea/complications , Echocardiography , Heart/diagnostic imaging , Humans , Male , Rheumatic Fever/drug therapy , Rheumatic Heart Disease/complications , Rheumatic Heart Disease/diagnosis , Rheumatic Heart Disease/drug therapy , Rheumatic Nodule/drug therapySubject(s)
Arthritis, Rheumatoid/complications , Conjunctiva/pathology , Conjunctival Diseases/etiology , Rheumatic Nodule/etiology , Adult , Arthritis, Rheumatoid/diagnosis , Biopsy , Conjunctival Diseases/diagnosis , Diagnosis, Differential , Humans , Male , Rheumatic Nodule/diagnosis , Slit Lamp MicroscopySubject(s)
Adrenal Cortex Hormones/therapeutic use , Central Nervous System Diseases/drug therapy , Hydrocephalus/drug therapy , Methotrexate/therapeutic use , Rheumatic Nodule/drug therapy , Sarcoidosis/drug therapy , Central Nervous System Diseases/diagnosis , Central Nervous System Diseases/epidemiology , Cognition Disorders/diagnosis , Cognition Disorders/drug therapy , Cognition Disorders/epidemiology , Comorbidity , Drug Therapy, Combination , Female , Humans , Hydrocephalus/diagnosis , Hydrocephalus/epidemiology , Magnetic Resonance Imaging , Middle Aged , Recurrence , Rheumatic Nodule/diagnosis , Rheumatic Nodule/epidemiology , Sarcoidosis/diagnosis , Sarcoidosis/epidemiology , Treatment OutcomeSubject(s)
Gout/diagnosis , Gout/epidemiology , Rheumatic Nodule/diagnosis , Rheumatic Nodule/epidemiology , Aged , Allopurinol/therapeutic use , Colchicine/therapeutic use , Comorbidity , Disease Progression , Gout/drug therapy , Gout Suppressants/therapeutic use , Hand Joints/pathology , Humans , Male , Osteoarthritis/complications , Osteoarthritis/epidemiologySubject(s)
Sarcoidosis/diagnosis , Sarcoidosis/drug therapy , Arthralgia/diagnosis , Arthralgia/etiology , Colchicine/therapeutic use , Cough/diagnosis , Cough/etiology , Diagnosis, Differential , Drug Therapy, Combination , Erythema Nodosum/diagnosis , Erythema Nodosum/etiology , Female , Fever/diagnosis , Fever/etiology , Follow-Up Studies , Humans , Middle Aged , Prednisone/therapeutic use , Rheumatic Nodule/diagnosis , Rheumatic Nodule/etiology , Risk Assessment , Treatment OutcomeABSTRACT
We present the case of a 63-year-old woman chronic smoker with a history of severe rheumatoid arthritis, who presented with dyspnea and cough. Her chest x-ray film and CT scan (as part of a PET/CT scan) showed multiple lung nodules and a left pleural effusion. A PET scan (as part of a PET/CT scan) revealed no uptake in the larger lung nodules and intense left pleural uptake. The findings favored rheumatoid lung disease with rheumatoid pleural involvement, but malignant involvement was not excluded. A CT-guided lung and pleural biopsy confirmed the diagnosis of rheumatoid lung disease. On the basis of these findings, the patient was put on immunomodulators and responded to treatment.
Subject(s)
Lung Diseases, Interstitial/diagnosis , Positron-Emission Tomography/methods , Rheumatic Nodule/diagnosis , Tomography, X-Ray Computed/methods , Female , Humans , Middle Aged , Subtraction TechniqueABSTRACT
The evaluation of patients with subcutaneous nodules remains a diagnostic challenge. The presence of nodules can be a clue to an underlying systemic disease; however, the varied presentations of nodules and numerous disease associations make the assessment of patients with nodules far from simple. With further investigation into the appearance, location, and symptoms associated with nodules, the clinical significance of these lesions can become clearer and aid in logical diagnostic evaluation. We have reviewed the causes of nodules with emphasis on those associated with rheumatic disease and provide guidelines for nodule evaluation to better characterize disease association and lead to directed diagnostic assessment.
Subject(s)
Rheumatic Nodule/diagnosis , Rheumatic Nodule/pathology , Skin/pathology , Diagnosis, Differential , Humans , Metabolic Diseases/diagnosis , Metabolic Diseases/pathology , Panniculitis/diagnosis , Panniculitis/pathology , Practice Guidelines as Topic , Rheumatic Diseases/diagnosis , Rheumatic Diseases/pathology , Skin Diseases, Infectious/diagnosis , Skin Diseases, Infectious/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathologySubject(s)
Bone Neoplasms/diagnosis , Facial Neoplasms/diagnosis , Neuroblastoma/diagnosis , Rheumatic Nodule/diagnosis , Bone Neoplasms/diagnostic imaging , Bone Neoplasms/secondary , Child, Preschool , Diagnosis, Differential , Facial Neoplasms/diagnostic imaging , Facial Neoplasms/pathology , Female , Humans , Neuroblastoma/diagnostic imaging , Neuroblastoma/secondary , Radiography , Skin/pathologyABSTRACT
No disponible
Subject(s)
Female , Middle Aged , Humans , Pain/complications , Rheumatic Nodule/complications , Rheumatic Nodule/diagnosis , Arthritis, Rheumatoid/complications , Arthritis, Rheumatoid/diagnosis , Fingers , Fingers/pathology , Hand Deformities/diagnosis , Hand Deformities/complications , Furosemide/administration & dosage , Arthritis/diagnosis , Arthritis/drug therapy , Hand , Atrial Fibrillation/complications , Atrial Fibrillation/diagnosis , Uric Acid/analysis , Uric Acid/blood , Creatinine/analysis , Creatinine/bloodSubject(s)
Humans , Female , Adult , Bioprosthesis , Endomyocardial Fibrosis/complications , Papillary Muscles/pathology , Rheumatic Nodule/complications , Endomyocardial Fibrosis/diagnosis , Endomyocardial Fibrosis/surgery , Mitral Valve Insufficiency/etiology , Mitral Valve Insufficiency/surgery , Rheumatic Nodule/diagnosis , Rheumatic Nodule/surgerySubject(s)
Rheumatic Nodule/diagnosis , Child , Diagnosis, Differential , Humans , Lupus Erythematosus, Systemic/diagnosis , MaleSubject(s)
Dermatitis/diagnosis , Edema/diagnosis , Eosinophilia/diagnosis , Hypersensitivity, Immediate/diagnosis , Rheumatic Diseases/diagnosis , Rheumatic Nodule/diagnosis , Adult , Cetirizine/therapeutic use , Cimetidine/therapeutic use , Dermatitis/drug therapy , Dermatitis/immunology , Diagnosis, Differential , Edema/drug therapy , Edema/immunology , Eosinophilia/drug therapy , Eosinophilia/immunology , Follow-Up Studies , Histamine H1 Antagonists/therapeutic use , Histamine H2 Antagonists/therapeutic use , Humans , Hypersensitivity, Immediate/drug therapy , Hypersensitivity, Immediate/immunology , Male , Rheumatic Diseases/drug therapy , Rheumatic Diseases/immunology , Rheumatic Nodule/drug therapy , Rheumatic Nodule/immunologyABSTRACT
NERDS is an eosinophilic disorder recently described by Butterfield and characterized by an association of nodules, eosinophilia, rheumatism, dermatitis and swelling. We describe an additional case, the third, of this new eosinophilic syndrome. The cardinal features included joint and cutaneous manifestations with prominent para-articular nodules and rheumatism, xerosis, recurrent urticarial eruption with angioedema associated with tissue and peripheral blood eosinophilia. A drug-induced (diclofenac) allergic rash and lymphadenopathy appeared during the course of the illness. Persistent leukocytosis with a maximum of 65% of eosinophils, mostly exhibiting the hypodense phenotype (activation index), was always present. During the acute phase of the disease, flow-cytometric analysis of blood and bone marrow revealed proliferation of activated CD4+/OKDR+ T helper cells and CD25+/OKDR+ eosinophils.
Subject(s)
Dermatitis/diagnosis , Edema/diagnosis , Eosinophilia/diagnosis , Rheumatic Diseases/diagnosis , Rheumatic Nodule/diagnosis , Acute Disease , CD4 Antigens/metabolism , Dermatitis/immunology , Edema/immunology , Eosinophilia/immunology , Eosinophils/immunology , Female , Flow Cytometry , HLA-DR Antigens/metabolism , Humans , Lymphocyte Activation , Middle Aged , Receptors, Interleukin-2/metabolism , Rheumatic Diseases/immunology , Rheumatic Nodule/immunology , Syndrome , T-Lymphocytes, Helper-Inducer/immunologyABSTRACT
Los nódulos subcutáneos están presentes en múltiples enfermedades sistémicas incluyendo lupus eritematoso sistémico, fiebre reumática, artritis reumatoidea y gota. Llamamos la atención sobre aquellos pacientes con tofos subcutáneos múltiples por depósito de urato monosódico sin historia de artritis gotosa. Presentamos un caso de un hombre con presencia de nódulos subcutáneos indoloros de seis años de evolución en carpos, metacarpofalángicas, interfalángicas proximales, codos y rodillas, sin antecedentes de artritis. Planteamos la existencia de un subgrupo clínico de pacientes con gota, cuyo curso es más benigno con respecto al compromiso articular y se proponen sus criterios clínicos
Subject(s)
Humans , Male , Adult , Gout/classification , Gout/complications , Gout/diagnosis , Gout/epidemiology , Rheumatic Nodule/classification , Rheumatic Nodule/complications , Rheumatic Nodule/diagnosisABSTRACT
Laryngeal involvement in systemic lupus erythematosus (SLE) can range from mild ulcerations, vocal cord paralysis, and edema to necrotizing vasculitis with airway obstruction. In this report, four cases showing the range of severity of this disease manifestation are presented, accompanied by a comprehensive review of the literature. The clinical course of 97 patients with laryngeal involvement with SLE are reviewed, of whom 28% had laryngeal edema and 11% had vocal cord paralysis. In the majority of cases, symptoms such as hoarseness, dyspnea, and vocal cord paralysis resolved with corticosteroid therapy. Other, less common causes of this entity included subglottic stenosis, rheumatoid nodules, inflammatory mass lesions, necrotizing vasculitis, and epiglottitis. The clinical presentation of laryngeal involvement in patients with SLE follows a highly variable course, ranging from an asymptomatic state to severe, life-threatening upper airway compromise. With its unpredictable course and multiple causations, this complication remains a diagnostic and therapeutic challenge to physicians involved in the care of patients with SLE.