Clinical features of rheumatoid arthritis

2020 ◽  
pp. 109-120
Author(s):  
Annette van der Helm-van Mil
Keyword(s):  
Rheumatoid Arthritis ◽  
Pattern Recognition ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Early Recognition ◽  
Classification Criteria ◽  
Differential Diagnoses ◽  
Disease Stage ◽  
Over Time

The diagnosis of rheumatoid arthritis (RA) is based on a combination of symptoms, signs, and investigation results. As such, it is mainly based on pattern recognition. Classification criteria are not developed to make accurate diagnoses in individual patients, but for the primary purpose of defining homogeneous disease groups for scientific studies. The RA classification criteria have changed over time. This chapter discusses the process of diagnosing RA, the range of clinical characteristics that contribute to this process, its relationship with evolving classification criteria for the condition, and important differential diagnoses. Current recommendations encourage early recognition of arthritis and RA. Since clinical presentation may differ with disease stage, this chapter will also review how the RA phenotype changes as prearthritis progresses to early undifferentiated arthritis and established RA.

scholarly journals Practice Current: When do you suspect autoimmune encephalitis and what is the role of antibody testing?

2018 ◽  
Vol 8 (1) ◽  
pp. 67-73 ◽  
Author(s):  
Aravind Ganesh ◽  
Sarah F. Wesley
Keyword(s):  
Lumbar Puncture ◽  
Sensitivity And Specificity ◽  
Clinical Characteristics ◽  
Online Survey ◽  
Clinical Presentation ◽  
Autoimmune Encephalitis ◽  
Differential Diagnoses ◽  
Antibody Testing ◽  
Case Based

Diagnosing autoimmune encephalitis (AE) is complicated by several factors, including issues with availability, sensitivity, and specificity of antibody testing, particularly with variability in assay techniques and new antibodies being rapidly identified; nonspecific findings on MRI, EEG, and lumbar puncture; and competing differential diagnoses. Through case-based discussions with 3 experts from 3 continents, this article discusses the challenges of AE diagnosis, important clinical characteristics of AE, preferences for methods of autoantibody testing and interpretation, and treatment-related questions. In particular, we explore the following question: If a patient's clinical presentation seems consistent with AE but antibody testing is negative, can one still diagnose the patient with AE? Furthermore, what factors does one consider when making this determination, and should treatment proceed independent of antibody testing in suspected cases? The same case-based questions were posed to the rest of our readership in an online survey, the results of which are also presented.

scholarly journals Unusual Maculopapular Rash on the Scalp of a Patient with Mediterranean Spotted Fever

2018 ◽  
Vol 28 (3) ◽  
pp. 291-293
Author(s):  
Ivan Baltadzhiev ◽  
Nedialka Popivanova
Keyword(s):  
Breast Cancer ◽  
Clinical Features ◽  
Rare Case ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Spotted Fever ◽  
Good Condition ◽  
Maculopapular Rash ◽  
Mediterranean Spotted Fever ◽  
Immunofluorescent Assay

Objective: To report a rare case of maculopapular rash on the scalp in a patient with Mediterranean spotted fever (MSF). Clinical Presentation and Intervention: A 58-year-old woman with breast cancer and chemotherapy-induced alopecia contracted MSF. Her clinical features were typical, except for a maculopapular rash covering the scalp. The diagnosis of MSF was confirmed by immunofluorescent assay. The disease had a favorable course and the patient was discharged in good condition. Conclusion: The rash on the scalp described in this report enriches our knowledge on the clinical characteristics of MSF.

Repetition of Parasiticide: An Epidemiological and Clinical Study

1988 ◽  
Vol 153 (6) ◽  
pp. 792-800 ◽  
Author(s):  
Norman Kreitman ◽  
Patricia Casey
Keyword(s):  
Risk Factors ◽  
Clinical Study ◽  
Social Class ◽  
Epidemiological Study ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Treatment Centre ◽  
The Stability ◽  
Over Time ◽  
Repetitive Pattern

The dramatic clinical presentation of parasuicide tends to deflect attention from the repetitive pattern of this behaviour in many patients. In an epidemiological study of annual cohorts of parasuicides for 1972, 1977, and 1982 admitted to the Regional Poisoning Treatment Centre, Edinburgh, it was found that for certain subgroups of the population ‘repeaters' were actually commoner than ‘first-ever’ patients, and a number of risk factors were identified, of which social class was particularly important. The clinical characteristics of patients distinguished by their frequency of repetition were also described, with special attention to the stability of these differentiating features over time. It is suggested that the habitual repeater requires closer study, and that the factors which lead to initiation into a parasuicidal ‘career’ are not necessarily those which conduce to repetition.

scholarly journals FRI0065 CLINICAL FEATURES OF METHOTREXATE ASSOCIATED LYMPHOPROLIFERATIVE DISORDER IN RHEUMATOID ARTHRITIS PATIENTS AND INFLUENCE OF CD8 POSITIVE LYMPHOCYTE INFILTRATION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 609.2-609
Author(s):  
T. Kameda ◽  
S. Nakashima ◽  
M. Inoo ◽  
I. Onishi ◽  
N. Kurata ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Clinical Symptom ◽  
Clinical Features ◽  
Laboratory Data ◽  
Histological Finding ◽  
B Cell Lymphoma ◽  
Classification Criteria ◽  
Lymphocyte Infiltration ◽  
American College Of Rheumatology ◽  
Significant Difference

Background:Lymphoproliferative disorders (LPD) that develop in rheumatoid arthritis (RA) patients treated with MTX (MTX-LPD) is one of the important complications for RA patients. We have previously epidemiologically demonstrated an association between MTX and the development of LPD in RA patients1). MTX-LPD has varied pathologies including various clinical symptom and histological finding. Therefore, we need more information about MTX-LPD. In addition, it is one of the characteristics for MTX-LPD that spontaneous regression (SR) after MTX discontinuation. However, the mechanism of SR is not clarified.Objectives:We collect the information such as clinical symptom and histological finding of MTX-LPD with RA patients, and clarify the clinical features of MTX-LPD. In addition, we investigated the difference between SR cases and cases that treated with chemotherapy after MTX discontinuation (CTx cases).Methods:We enrolled 90 MTX-LPD patients from Kagawa Prefecture, Japan between June 2005 and December 2019. Patients were diagnosed according to American College of Rheumatology (ACR) 1987 classification criteria or ACR/European League Against Rheumatism (EULAR) 2010 classification criteria, and treated with disease modifying antirheumatic drugs (DMARDs) including MTX. We collected as follow information; age, gender, duration of RA, laboratory data (lymphocyte counts and sIL-2R) and treatment of MTX-LPD. In addition, we divided 16 MTX-LPD cases diagnosed histological into two groups (SR:CTx group; n=10:6), and analyzed the histological findings (CD4, CD8, CD163 and CD47) using the staining in immunohistochemistry (IHC) between the two groups. Each positive cell analyzed using virtual viewer soft ImageScope.Results:Characteristics of 90 MTX-LPD patients are as follow; mean age 66.5±11.2 years,63 female, duration of RA 18.5±19.4 years. 65 patients (72.2%) were spontaneously improved by discontinuing MTX. 58 patients (64.4%) were proven MTX-LPD histologically. In these patients, diffuse large B-cell lymphoma (DLBCL) was the most frequent histological type of MTX-LPD (56.9%). Infiltration of CD8 positive lymphocyte in the lesion was significant less in the SR cases than in the CTx cases (Figure 1). However, CD4, CD163 and CD47 positive cells had no significant difference between two groups.Figure 1.CD8 positive lymphocytes in the specimen of lesion using the staining in immunohistochemistry (IHC) between SR and CTxgroup.Conclusion:We revealed clinical features of MTX-LPD with RA patients. In addition, CD8 positive lymphocytes are involved in tumor immunity. In this study, we suggested that the extent of CD8 positive lymphocyte infiltration may predict SR of MTX-LPD. Further study is necessary on revealing the mechanism of SR in MTX-LPD.References:[1]Kameda T. et al. Arthritis Care Res (Hoboken). 2014 Sep;66(9):1302-9.Disclosure of Interests:None declared

Tumours of the Hand: a Review On Histology of Bone Malignancies

2010 ◽  
Vol 35 (5) ◽  
pp. 354-361 ◽  
Author(s):  
D. Baumhoer ◽  
G. Jundt
Keyword(s):  
Frequency Distribution ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Correct Diagnosis ◽  
Close Correlation ◽  
Differential Diagnoses ◽  
Bone Tumours ◽  
Malignant Bone Tumours ◽  
Almost All

Malignant bone tumours of the hands are uncommon. Although almost all lesions that occur in other parts of the skeleton can also affect the hands, their frequency, distribution and clinical characteristics differ. This review focusses on the histology of these tumours and gives an overview of the main differential diagnoses. Close correlation to radiologic and clinical features usually leads to the correct diagnosis.

scholarly journals Tuberculosis: through the artist’s eye

2021 ◽  
Vol 9 (7) ◽  
pp. 2181
Author(s):  
Cynthia A. Sukumar
Keyword(s):  
History Of Medicine ◽  
Clinical Features ◽  
Clinical Presentation ◽  
Pathological Features ◽  
History Of ◽  
Insight Into ◽  
Over Time

The history of medicine and art have intersected at several instances over time. Centuries ago, even when many diseases were obscure, art has shed some light over early clinical features and signs of many diseases. This article describes Leonardo Da Vinci’s famous sketch, “The Five Grotesque Heads” and highlights the hints of reference to the age-old infection of tuberculosis. Da vinci’s eye for detail has been known to capture several startling anatomical and pathological features of diseases, which were largely unknown at his time. However, these subtle references give us insight into the clinical presentation of the timeless disease of tuberculosis through the ages.

Hydrocephalus in Spinal Muscular Atrophy: A Case Report and Review of the Literature

2020 ◽  
Author(s):  
Jeetendra P. Sah ◽  
Aaron W. Abrams ◽  
Geetha Chari ◽  
Craig Linden ◽  
Yaacov Anziska
Keyword(s):  
Spinal Muscular Atrophy ◽  
Clinical Characteristics ◽  
Clinical Presentation ◽  
Muscular Atrophy ◽  
Communicating Hydrocephalus ◽  
Type I ◽  
Review Of The Literature ◽  
Radiographic Findings ◽  
Comprehensive Review ◽  
The Relationship

AbstractIn this article, we reported a case of spinal muscular atrophy (SMA) type I noted to have tetraventricular hydrocephalus with Blake's pouch cyst at 8 months of age following intrathecal nusinersen therapy. The association of hydrocephalus with SMA is rarely reported in the literature. Development of hydrocephalus after intrathecal nusinersen therapy is also reported in some cases, but a cause–effect relationship is not yet established. The aim of this study was to describe the clinical characteristics of a patient with SMA type I and hydrocephalus, to review similar cases reported in the literature, and to explore the relationship between nusinersen therapy and development of hydrocephalus. The clinical presentation and radiographic findings of the patient are described and a comprehensive review of the literature was conducted. The adverse effect of communicating hydrocephalus related to nusinersen therapy is being reported and the authors suggest carefully monitoring for features of hydrocephalus developing during the course of nusinersen therapy.

Ketamine Treatment in Depression: A Systematic Review of Clinical Characteristics Predicting Symptom Improvement

2020 ◽  
Vol 20 (15) ◽  
pp. 1398-1414 ◽  
Author(s):  
Darby J.E. Lowe ◽  
Daniel J. Müller ◽  
Tony P. George
Keyword(s):  
Clinical Features ◽  
Clinical Characteristics ◽  
Bipolar Depression ◽  
Antidepressant Effect ◽  
Future Research ◽  
Symptom Improvement ◽  
Randomized Controlled ◽  
Treatment Of Depression ◽  
Future Direction

Ketamine has been shown to be efficacious for the treatment of depression, specifically among individuals who do not respond to first-line treatments. There is still, however, a lack of clarity surrounding the clinical features and response periods across samples that respond to ketamine. This paper systematically reviews published randomized controlled trials that investigate ketamine as an antidepressant intervention in both unipolar and bipolar depression to determine the specific clinical features of the samples across different efficacy periods. Moreover, similarities and differences in clinical characteristics associated with acute versus longer-term drug response are discussed. Similarities across all samples suggest that the population that responds to ketamine’s antidepressant effect has experienced chronic, long-term depression, approaching ketamine treatment as a “last resort”. Moreover, differences between these groups suggest future research to investigate the potential of stronger efficacy towards depression in the context of bipolar disorder compared to major depression, and in participants who undergo antidepressant washout before ketamine administration. From these findings, suggestions for the future direction of ketamine research for depression are formed.

Sign in / Sign up

Export Citation Format

Share Document