[Secondary lethal catastrophic antiphospholipid syndrome in 24-years old female patient with overlap syndrome (systemic sclerosis and systemic lupus erythematosus)]. / Wtórny katastroficzny zespól antyfosfolipidowy zakonczony zgonem u 24-letniej pacjentki z zespolem nakladania twardziny ukladowej i tocznia rumieniowatego.

In our article we describe the case of 24 years old woman with overlap syndrome under form of systemic sclerosis and systemic lupus erythematosus complicated by secondary antiphospholipid syndrome (APS). The first manifestation of antiphospholipid syndrome was intrauterine fetal death. Afterwards pulmonary embolism occurred. After several weeks in result of catastrophic course of antiphospholipid syndrome coronary artery thrombosis and myocardial infarction occurred with following prominent left ventricle systolic failure and multi organ failure. The patient died about one month after discharge from the hospital.

[Matrix metalloproteinases and tissue inhibitors of metalloproteinases in the pathogenesis of rheumatoid arthritis]. / Rola metaloproteinaz i tkankowych inhibitorów metaloproteinaz w patogenezie reumatoidalnego zapalenia stawów.

Rheumatoid arthritis (RA) is a chronic inflammatory disorder of joints characterized by the accumulation of mononuclear cells and the proliferation of the synovium-lining layer. The role of lymphocytes, macrophages and fibroblasts infiltrating the synovium is not fully understood. These cells are supposed to be involved in the tissue destruction by several mechanisms, including the production of proinflammatory cytokines and matrix metalloproteinases. Matrix metalloproteinases (MMPs) are the enzymes that participate in the proteolytic degradation and remodelling of the extracellular matrix. Their action is controlled by tissue inhibitors of metalloproteinases (TIMPs). In this review we describe the role of metalloproteinases and their tissue inhibitors in the pathogenesis of rheumatoid arthritis.

[Impression cytology in patients with dry eye syndrome and various rheumatic diseases]. / Cytologia impresyjna w zespole suchego oka w przebiegu wybranych chorób reumatologicznych.

PURPOSE: The aim of this study was to evaluate the cytological changes of bulbar conjunctiva in patients with various rheumatic diseases and dry eye syndrome. MATERIAL AND METHODS: 60 patients with rheumatoid arthritis (RA), systemic scleroderma (SScl), primary Sjbgren syndrome (pSS), systemic lupus erythematosus (SLE) and dry eye syndrome were studied. The ocular examination consisted of Schirmer I, break- up time of tear film (BUT), fluorescein and lissamine green staining and impression cytology of bulbar conjunctiva. RESULTS AND CONCLUSIONS: The morphological alternations of bulbar conjunctiva seen in impression cytology specimens correlated with clinical signs of dry eye syndrome.

The influence of doxycycline on articular cartilage in experimental osteoarthrosis induced by iodoacetate.

The experiment was performed on 36 Wistar rats. On the first day of the experiment iodoacetate was administered to the left posterior knee joint of the 18 rats which composed Group I. The second group of 18 rats received additionally doxycycline (doxy) through the gastric tube in doses comparable with those of doxycycline used in humans. The experiment lasted 21 days. The animals were sacrificed after 7, 14 and 21 days in groups of 6 rats each. In sections stained with Safranin 0 semiquantitative histochemical intensity tests were performed on articular cartilage glycosaminoglycans (GAG) using a four-point scale (0-3). In the first group examined destructive lesions in the articular cartilage and weak reactivity on GAG were noted at all stages of the experiment. The intensity of GAG staining was higher in the second group after 14 and especially after 21 days, which may suggest a protective action of doxy on articular cartilage.

[Kidneys in rheumatoid arthritis]. / Nerki w reumatoidalnym zapaleniu stawów.

Kidney pathology is a common phenomenon which is revealed in patients with rheumatoid arthritis (RA). Its incidence is estimated at 50-60% of all patients. It is an important clinical problem because it directly affects the outcomes of RA. Changes in the kidneys may result directly from either the underlying illness or complications due to various, including iatrogenic causes. In the following paper we present actual views on the subject of the known up-to-date causes of renal impairment in the course of RA.

[Analysis of the acid glycoprotein heterogeneity in patients with arthritis]. / Analiza heterogennosci kwasnej glikoproteiny u chorych na zapalenie stawów.

The concentration measurement of the acute phase proteins in blood serum has been applied in differential diagnosis of inflammatory arthritis since a long time. However, it appeared that the qualitative changes such as the presence of different glycoforms of the acute phase protein that was a glycoprotein, enabled to differentiate acute inflammatory conditions including the chronic ones, and to determine the dynamics of inflammatory process. This phenomenon is defined as a main heterogeneity, whereas the determination of the proportions of particular glycoforms is known as glycosylation profile. The changes of this profile are well known in the course of acute inflammatory conditions such as: bacterial sepsis, skin burns complicated with bacterial infections or acute pancreatitis. Considerably less observations concern the chronic conditions as: rheumatoid arthritis, systemic lupus erythematosus and degenerative joint disease. The examination encompassed 25 patients with rheumatoid arthritis, 21 with systemic lupus erythematosus, 19 with reactive arthritis and 21 patients with degenerative joint disease whose diagnosis was established on the basis of international diagnostic criteria. In all these patient the changes of C-reactive protein (CRP), acid glycoprotein (AGP) as well as glycosylation profile of the AGP were evaluated. For this purpose the electrophoresis method of two affinity directions with concanavalin A was applied, whereas the concentration of particular acute phase protein was determined by Laurell's immunoelectrophoresis method. The variants of glycoprotein resulted from electrophoresis were calculated with aid of planimetric method, and the results were presented as a coefficient of glycosylation. The characteristic patterns of glycosylation profile in the course of systemic lupus erythematosus, rheumatoid arthritis and reactive arthritis may be useful in differential diagnosis of the above mentioned diseases.

[The effect of low dose methotrexate treatment on bone mineral density in patients with rheumatoid arthritis]. / Wplyw leczenia niskimi dawkami metotreksatu na gestosc mineralna kosci u chorych na reumatoidalne zapalenie stawów.

OBJECTIVE: To evaluate the bone mineral density (BMD) in patients with rheumatoid arthritis (RA) treated with MTX or SF. The study consisted of 56 premenopausal women diagnosed with rheumatoid arthritis (RA). Bone mineral density (BMD) of the lower lumbar spine was assessed before starting treatment, and again after 12 months of treatment. DEXA scanning was used to evaluate BMD. Corticosteroids or other substances known to affect bone metabolism were not administered. 45 women completed the study, of whom 23 were treated using SF and 22 MTX. The average dosage of MTX used was calculated to be 590 mg. A significant difference in the BMD of SF and MTX patients was not observed in the pretreatment phase, nor after 12 months of treatment. However, in all patients a significant reduction of BMD was observed, irrelevant of the choice of drug. The average loss of bone mass was 1.7% and 1.4% in the MTX and SF groups, respectively. MTX therapy administered in low doses as assessed after 12 months did not cause a rapid decrease of bone density in patients with RA.