Polyarticular disease

Author(s):  
Ade Adebajo ◽  
Lisa Dunkley

Polyarticular disease is a commonly encountered musculoskeletal problem which regularly confronts clinicians as a diagnostic dilemma. Polyarticular disease is a musculoskeletal presentation in which more than four joints are affected by the disease. The classical rheumatological condition which presents as polyarticular disease is rheumatoid arthritis, although even this condition can very occasionally present with a mono- or oligoarticular onset. Polyarticular disease includes a wide range of musculoskeletal conditions including such disorders as polyarticular gout, the seronegative spondyloarthropathies, rheumatic fever, and systemic lupus erythematosus. This chapter emphasizes how through a careful history, thorough clinical examination and appropriate investigations, a definitive diagnosis can be made in a patient presenting clinically with polyarticular disease. General management principles for patients with polyarticular disease are also provided.

Author(s):  
Ade Adebajo ◽  
Lisa Dunkley

Polyarticular disease is a commonly encountered musculoskeletal problem which regularly confronts clinicians as a diagnostic dilemma. Polyarticular disease is a musculoskeletal presentation in which more than four joints are affected by the disease. The classical rheumatological condition which presents as polyarticular disease is rheumatoid arthritis, although even this condition can very occasionally present with a mono- or oligoarticular onset. Polyarticular disease includes a wide range of musculoskeletal conditions including such disorders as polyarticular gout, the seronegative spondyloarthropathies, rheumatic fever, and systemic lupus erythematosus. This chapter emphasizes how through a careful history, thorough clinical examination and appropriate investigations, a definitive diagnosis can be made in a patient presenting clinically with polyarticular disease. General management principles for patients with polyarticular disease are also provided.


Author(s):  
Ade Adebajo ◽  
Lisa Dunkley

Polyarticular disease is a commonly encountered musculoskeletal problem which regularly confronts clinicians as a diagnostic dilemma. Polyarticular disease is a musculoskeletal presentation in which more than four joints are affected by the disease. The classical rheumatological condition which presents as polyarticular disease is rheumatoid arthritis, although even this condition can very occasionally present with a mono- or oligoarticular onset. Polyarticular disease includes a wide range of musculoskeletal conditions including such disorders as polyarticular gout, the seronegative spondyloarthropathies, rheumatic fever, and systemic lupus erythematosus. This chapter emphasizes how through a careful history, thorough clinical examination and appropriate investigations, a definitive diagnosis can be made in a patient presenting clinically with polyarticular disease. General management principles for patients with polyarticular disease are also provided.


2019 ◽  
Vol 72 (7) ◽  
pp. 1359-1363
Author(s):  
Marcin Zarzycki ◽  
Magdalena Flaga-Łuczkiewicz ◽  
Joanna Czuwara ◽  
Lidia Rudnicka

Systemic lupus erythematosus (SLE) is a chronic multiorgan autoimmune disease belonging to spectrum of interest of many medical specialties. Wide range of patients 14−75% with SLE suffers from neuropsychiatric disorders. The problematic diagnosis of neuropsychiatric SLE has generated many studies focusing on etiology of the disease with the presence of specific autoantibodies, abnormalities which can be detected by imaging examinations or correlation with catecholamine levels. The aim of this review paper is to discuss the frequency of neuropsychiatric disturbances in patients with SLE and their potential association with immunological abnormalities and specific disease markers. So far published literature regarding this topic indicates the usefulness of autoantibodies specificity. The use of the specific antibodies may be helpful in targeting diagnostics towards psychiatric disorders, especially depressive ones. Imaging scanning techniques such as computed tomography (CT) have limited value in psychiatric disorders diagnosis but can be useful in neurological symptoms and complains. Therapeutic use of systemic glucocorticosteroids due to anti-inflammatory properties with multidirectional action, may also significantly influence the course of neuropsychiatric diseases, especially in patients with SLE. Awareness of the morbidity of neuropsychiatric disorders and the possibilities of their diagnosis are important in the management of patients with systemic lupus erythematosus, which significantly affects the quality of life of patients, treatment efficacy and psyche.


2021 ◽  
Vol 7 (3) ◽  
pp. 28-34
Author(s):  
Yu. Minakova ◽  
M. Silenko ◽  
O. Ivanova

Damage to the nervous system (neurolupus) is one of the most common clinical manifestations of systemic lupus erythematosus (SLE) in childhood, and is also considered as an unfavorable prognostic criterion for the course of this disease. Neurolupus is characterized by a wide range of clinical manifestations in both children and adult patients, which is due in most cases to a common pathogenetic mechanism - the formation of systemic microvasculitis. The non-specificity and variability of neuropsychiatric symptoms, which may appear already at the onset of the disease, significantly complicate the early diagnosis of SLE and necessitate a close acquaintance of the pediatrician with neurolupus polymorphism in children.


Author(s):  
Ida Dzifa Dey ◽  
David Isenberg

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease with varied presentation and a disease course characterized by remission and flares. Over the last 50 years the prognosis of SLE has improved considerably. The introductions of corticosteroids and later of cytotoxic drugs, dialysis, and renal transplantation were the major contributors to this improvement. Nevertheless, the treatment and general management of lupus continues to present a challenge. While lupus may, for some patients, represent a relatively mild set of problems, many others require large doses of immunosuppressive drugs, which carry long-term concerns about side effects. New immunotherapeutic drugs, with actions more closely targeted to the immune cells and molecules involved in the pathogenesis of SLE, are being introduced and the future looks promising. The role of early atherosclerosis and cardiovascular disease as a cause of death in patients with SLE is increasingly recognized and will present further challenges in the future.


Author(s):  
Ida Dzifa Dey ◽  
David Isenberg

Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease with varied presentation and a disease course characterized by remission and flares. Over the last 50 years the prognosis of SLE has improved considerably. The introductions of corticosteroids and later of cytotoxic drugs, dialysis, and renal transplantation were the major contributors to this improvement. Nevertheless, the treatment and general management of lupus continues to present a challenge. While lupus may, for some patients, represent a relatively mild set of problems, many others require large doses of immunosuppressive drugs, which carry long-term concerns about side effects. New immunotherapeutic drugs, with actions more closely targeted to the immune cells and molecules involved in the pathogenesis of SLE, are being introduced and the future looks promising. The role of early atherosclerosis and cardiovascular disease as a cause of death in patients with SLE is increasingly recognized and will present further challenges in the future.


Cells ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 140 ◽  
Author(s):  
Yasuo Nagafuchi ◽  
Hirofumi Shoda ◽  
Keishi Fujio

Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide range of clinical symptoms. Enormous progress has been made in the immunological and genetic understanding of SLE. However, the biology of disease heterogeneity in SLE has remained largely unexplored. Human immune profiling studies, helped by recent technological advances especially in single-cell and “omics” analyses, are now shedding light on the cellular and molecular basis of clinical symptoms and disease flares in individual patients. Peripheral blood immunophenotyping analysis with flow cytometry or mass cytometry are identifying responsible cell subsets and markers characteristic of disease heterogeneity. Transcriptome analysis is discovering molecular networks responsible for disease activity, disease subtype and future relapse. In this review, we summarize recent advances in the immune profiling analysis of SLE patients and discuss how they will be used for future precision medicine.


2017 ◽  
Vol 2 (2-3) ◽  
pp. 36-39
Author(s):  
Bhupen Barman ◽  
Arvind Nongpiur ◽  
Vandana Raphael ◽  
Sameer Joshi ◽  
Taso Beyong ◽  
...  

Lupus ◽  
2016 ◽  
Vol 26 (2) ◽  
pp. 208-217
Author(s):  
M J Fritzler ◽  
E K L Chan

At the age of ninety years, Dr Eng Meng Tan has had a remarkable impact on the accumulated knowledge of autoimmune diseases, including seminal findings in systemic lupus erythematosus (SLE) and a wide range of other autoimmune diseases. Dating to the first description of the Sm (Smith) autoantibody in SLE, his focus has been the use of autoantibodies as probes to identify and elucidate novel cellular molecules and then translating these discoveries into biomarkers and immunoassays for a wide range of these diseases and, later, cancer. He led efforts to standardize autoantibody nomenclature and testing protocols. Through his mentorship a great number of trainees and collaborators have had remarkably successful careers, and by that virtue he has garnered a remarkable continuing legacy.


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