scholarly journals Cytomegalovirus Enteritis Induced by Baricitinib and Tacrolimus: Association or Coincidence?

2022 ◽  
pp. jrheum.211167
Author(s):  
Gang Wang ◽  
Ning Zhuo ◽  
Jingyang Li

We read the recent article by Sugawara et al with great interest.1 The authors described a 65-year-old patient with rheumatoid arthritis who had been treated with methotrexate for 14 years without any adverse effects, yet within the last 6 months had developed fever and abdominal pain when treated with 2 mg/day of tacrolimus and 4 mg of baricitinib.

2020 ◽  
Vol 16 (8) ◽  
pp. 1134-1146
Author(s):  
Priyanka Kriplani ◽  
Kumar Guarve ◽  
Uttam S. Baghel

Objective: Helenalin is a natural anti-inflammatory agent that is proving its efficacy to treat various medical conditions. Though many plants are proving their effectiveness but their mechanisms are still not well understood. The objective of the review is to summarize various mechanisms of helenalin to treat inflammatory disorders and cancers, adverse effects, and avenues of further research. Methods: Structured research was carried out including Pub med, Science direct Medline, Research Gate and Google Scholar to find all articles published on helenalin. Various keywords used were “helenalin”, “Arnica”, “cancer”, “anti-inflammatory”, “cardiovascular”, “IBD”, “pharmacokinetics” etc. The aim of the review was to find out the problem prevailing in the data published to date which will help the researchers to investigate the molecule clinically. Results: Seventy articles are included in the review. Helenalin is found to cure chronic conditions like rheumatoid arthritis, ulcers and malignancies like stomach, colon, breast, larynx, lung and skin cancers via multiple mechanisms. These diseases do not proceed via a unilateral pathway. So, it can be a useful molecule to treat numerous diseases. Conclusion: This review article will help us to systemically analyze the wealth of information concerning the medicinal properties of helenalin and to recognize the gaps which have vetoed its pervasive application in the medical community.


1985 ◽  
Vol 19 (5) ◽  
pp. 349-358 ◽  
Author(s):  
Peter W. Letendre ◽  
Douglas J. DeJong ◽  
Donald R. Miller

The use of methotrexate in rheumatoid arthritis is reviewed. Methotrexate, a folic acid antagonist, is sometimes employed in an attempt to symptomatically control patients whose disease does not respond adequately to conventional therapies. Systemic administration of 7.5–15 mg/wk in a “pulse” fashion appears to be effective without precipitating severe adverse effects. However, concern over potentially serious side effects and a lack of well-controlled clinical trials have limited its use to severe, refractory disease. Further studies are needed before its role in rheumatoid arthritis can justifiably be expanded.


2021 ◽  
Vol 14 (6) ◽  
pp. e244130
Author(s):  
Anasua Deb ◽  
Thanita Thongtan ◽  
Michael Phy ◽  
Vanessa Costilla

2021 ◽  
Vol 14 ◽  
pp. 117954762110177
Author(s):  
Rebecca DeBoer ◽  
Sahani Jayatilaka ◽  
Anthony Donato

Whipple’s disease (WD) is an uncommon cause of seronegative arthritis. WD is known for its gastrointestinal symptoms of diarrhea, weight loss, and abdominal pain. However, arthritis may precede gastrointestinal symptoms by 6 to 7 years. We describe a case of an 85-year-old Caucasian male with multiple joint complaints, not responsive to traditional treatments for conditions such as rheumatoid arthritis and osteoarthritis. We suggest that WD be considered for seronegative arthritis especially affecting large joints.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 559.2-560
Author(s):  
V. Rivera Teran ◽  
S. Sicsik ◽  
D. Vega-Morales ◽  
F. Irazoque-Palazuelos ◽  
D. Miranda ◽  
...  

Background:Rheumatoid arthritis (RA) is the most common autoimmune disease. Older patients treated with biologic DMARDs (bDMARDs) are at a significantly greater risk of adverse effects (AEs) [1]. However, the rate of drug discontinuation because of adverse effects caused by bDMARDs has not differed in elderly compared to younger patients in different registries.Objectives:Determine if drug discontinuation of bDMARDs differs by age in patients with rheumatoid arthritis in the Mexican Adverse Events Registry (BIOBADAMEX).Methods:BIOBADAMEX is a Mexican ongoing cohort of patients using bDMARDs since 2016. In this analysis we included all patients with diagnosis of RA with at least two assessments. Survival on bDMARDs was estimated using Kaplan-Meier analysis. Predictors of discontinuation, including age older than median age in the sample were investigated by Cox regression analyses.Results:Among 743 patients in the registry, 497 had RA diagnosis, from which, 214 had at least two assessments. At baseline, patients had a median (IQR) age of 53.4 (45-61) years old, median disease duration of 10.7 (6-17) months and median DAS28 of 4.7 (3-6). Conventional DMARDS were used by 185 (87%) patients and 94 (44%) patients used corticosteroids. Comorbidities were present in 194 (91%). The most common bDMARDs received at baseline were abatacept 59 (27%), tocilizumab 45(21%), adalimumab 31 (15%) and certolizumab 30 (14%). At the time of analysis, the median bDMARDs treatment duration was 21.0(13-34) months, 128 (59%) had discontinued treatment, 66 for inefficacy, 32 for adverse events and 30 for others. Fig 1 shows discontinuation rate curves in patients younger and older than median age. Cox proportional-hazards demonstrated no significant differences regarding age older than median age (HR 1.1, 95% CI 0.8-1.4, p=0.7), female sex (HR 1.2, 95% CI 0.7-1.9, p=0.44), use of corticosteroids (HR 1.2, 95% CI 0.9-1.6, p=0.20), comorbidities (HR 0.9, 95% 0.6-1.5, p=0.78), DAS28 (HR 0.9, 95% 0.9-1.1, p=0.93) or other factors.Figure 1.Discontinuation rate curves in patients younger and older than median age (< 53.4 and >=53.4 years old)Conclusion:This analysis did not show a role of age on discontinuation of bDMARDs in Mexican RA patients. Further longitudinal analyses will be performed including more patients to assess retention rate of bDMARDs and identify predictive variables of discontinuation in Mexican population.References:[1]Akter R, et al. Can Geriatr J. 2020 May 1;23(2):184-189.[2]Ikari Y, et al. Medicine (Baltimore). 2020 Dec 24;99(52):e23861.Disclosure of Interests:None declared


PEDIATRICS ◽  
1967 ◽  
Vol 40 (6) ◽  
pp. 1024-1026
Author(s):  
Donald G. Marshall

MUCH has been written in recent years about the importance of psychogenic disturbances as causes of abdominal pain in childhood. Yet, by no means all recurrent abdominal pain is so caused. A recent article in Pediatrics on nonorganic abdominal pain therefore promised this subsequent paper on pain of organic origin. I would like to caution the reader that his "surgeon's viewpoint" tends to exclude consideration of organic abdominal pain not surgically treated. Perhaps a third paper is indicated. Abdominal pain of whatever origin requires a planned approach to diagnosis. While it is only too easy for the clinician to submit a patient to innumerable investigations of varying degrees of unlikelihood of revealing disorders of differing degrees of rarity, a detailed history and searching interview with the parents, together with a complete physical examination, will go very far to reduce the number of cases submitted to any but quite simple tests. The diagnosis of psychogenic pain, no less than that of organic pain, must rest on positive findings. To make a diagnosis of psychogenic pain, there must be something more than the absence of demonstrable organic disease. There must be significant psychopathology. If there is evidence of neither this nor organic disease, one must resolve to be irresolute and decide to be undecided. One must not make a diagnosis of psychic disease simply because one can find no organic cause. One must also remember that psychic disturbance does not confer immunity from organic disease. A neurotic, psychotic, or brain-damaged child can have appendicitis.


1988 ◽  
Vol 10 (6) ◽  
pp. 183-190
Author(s):  
Robert M. Rennebohm

The pediatrician frequently encounters children and adolescents with musculoskeletal complaints that raise the possibility of rheumatic disease. The purposes of this article are: to review an approach to the evaluation of "joint" symptoms and to review the pharmacology, use, and adverse effects of nonsteroidal anti-inflammatory drugs. RHEUMATOLOGIC HISTORY Systematic collection of the historical details is fundamental in the evaluation of "joint" complaints (Table 1). Age and Sex The child's age and sex provide initial clues. For example, suspicion that a young girl (less than 5 years of age) with knee swelling might have monoarticular juvenile rheumatoid arthritis is heightened simply because of her age and sex. (At onset of their disease, almost 20% of all patients with juvenile rheumatoid arthritis are young girls with pauciarthritis, most commonly involving the knee.) Suspicion that an older boy (10 years of age or older) with axioskeletal complaints might have an enthesopathy syndrome is increased, in part, because of his age and sex. of the age and sex predilections of various rheumatic conditions is, therefore, helpful. Chief Complaint The chief complaint is often directive. For example, the complaint "his knees hurt every night" or "his legs hurt at night" is not characteristic of children who have juvenile rheumatoid arthritis or other well-defined inflammatory arthritides.


2020 ◽  
Vol 0 ◽  
pp. 1-7
Author(s):  
C. B. Sindhu ◽  
Sandhya George ◽  
Anita Sankar ◽  
Valsa Stephen

Hydroxychloroquine (HCQ) and its related drug, chloroquine, have been under use for malaria for the past 75 years. Its use for malaria, rheumatoid arthritis and systemic lupus erythematosus are Food and Drug Administration (FDA) approved. These drugs have immunomodulatory and antiviral actions. More and more indications for this drug are being explored. These drugs are still under study as possible treatments for coronavirus disease 2019 but at present FDA has revoked its emergency use authorization for these two drugs. However, in many other indications, HCQ is a valuable drug but monitoring for adverse effects is mandatory.


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