[Levels of different metabolites of arachidonic acid in synovial fluid of patients with arthrosis or rheumatoid arthritis]. / Livelli di differenti metaboliti dell'acido arachidonico nel liquido sinoviale di pazienti con artrosi o con artrite reumatoide.

OBJECTIVE: Clinical and experimental evidence suggests that arachidonic acid metabolism through lipoxygenase and cyclooxygenase pathways may play an important role in the pathogenesis of both inflammatory and degenerative joint diseases. The aim of the present paper was to measure the levels of different arachidonate metabolites in arthrosis or rheumatoid joint effusions. MATERIALS AND METHODS: We studied synovial fluids from 22 patients with arthrosis and 8 patients with rheumatoid arthritis. The levels of TxB2, 6-keto-PGF1 alpha LTB4 and LTC4 were measured by radioimmunoassay. RESULTS: The levels of the different arachidonate metabolites were higher in patients with rheumatoid arthritis than in those with arthrosis and the differences were always statistically significant, except for TxB2 values. Furthermore, in patients with arthrosis the levels of such metabolites were not significantly correlated with one another, with the exception of LTB4 and LTC4 values, while in patients with rheumatoid arthritis these levels were directly and significantly correlated. CONCLUSIONS: In inflammatory joint disease levels of arachidonate metabolites are higher and more directly correlated with one another than in degenerative joint disease. Our data may explain the better efficacy of non-steroidal anti-inflammatory drugs in patients with arthrosis than in those with rheumatoid arthritis and the frequent necessity for steroidal treatment in this last condition.

Serum osteocalcin (bone Gla-protein) following corticosteroid therapy in postmenopausal women with rheumatoid arthritis. Comparison of the effect of prednisone and deflazacort.

In 28 postmenopausal women with rheumatoid arthritis, serum osteocalcin (OC) concentration decreased from 5.2 +/- 1.9 ng/ml to 3.0 +/- 1.6 ng/ml after 6 months therapy with corticosteroids (p less than 0.005). No differences, however, were found in a control group of 13 patients treated for 6 months with nonsteroidal anti-inflammatory drugs. In those patients with serial OC measurements, changes in serum OC were already evident within the first month of therapy. This suggests that a suppressed osteoblast function may be detectable early during corticosteroid therapy in rheumatoid arthritis. Fifteen patients treated with prednisone (5-25 mg once daily, mean 12.33 mg/day) showed a more marked decrease in serum OC than 13 patients treated with equivalent doses of deflazacort (p less than 0.005). Prednisone therapy at doses higher than 10 mg/day resulted in a severe suppression of OC values in most cases. The effect of deflazacort was, however, mild in the majority of patients treated with doses of up to 30 mg/day.

Improvement of hyperinsulinemic diabetes following removal of a meningioma in Werner's syndrome. A case report.

A significant improvement of hyperinsulinemic diabetes was observed in a patient with Werner's syndrome after the removal of a large parasagittal meningioma. To our knowledge this is the second case reported in the literature. The possible relationship between meningioma and diabetes in Werner's syndrome is discussed.