Rheumatology international
-
Review Case Reports
Primary central nervous system vasculitis mimicking brain tumour: case report and literature review.
Primary central nervous system vasculitis (PCNSV) is a rare inflammatory disease causing significant morbidity and mortality. We present a detailed history and clinical course of a patient with PCNSV along with a literature review. A 50-year-old Chinese female presented with a 6-month history of mild to moderate headache and sudden onset of visual loss. ⋯ Steroid and immunosuppressive therapy dramatically improved the patient's condition. Our report highlights the importance of considering PCNSV as a differential diagnosis in patients who are suspected with encephalitis, multiple sclerosis, cerebral haemorrhage, cerebral thrombus, leukoencephalopathy, or brain tumour, etc. while their clinical presentations are exceptionally so changeable. This case also gives emphasis to the value of a brain biopsy in consolidating the diagnosis, and the efficacy of steroid and immunosuppressive therapy in PCNSV.
-
The objectives of the study were identification, quality evaluation and summary of RCTs on complementary and alternative medicine as defined by the National Institute of Health with the exception of dietary and nutritional supplements. A computerized search of databases from 1990 (year of publication of the ACR criteria for fibromyalgia) to July 2007 was performed. The RCTs were assessed by a methodological quality score. ⋯ Mindfulness meditation showed mostly positive results in two trials and acupuncture mixed results in multiple trials with a tendency toward positive results. Tendencies for improvement were furthermore noted in single trials of the Mesendieck system, connective tissue massage and to some degree for osteopathy and magnet therapy. No positive evidence could be identified for Qi Gong, biofeedback, and body awareness therapy.
-
Comparative Study
Evaluation of an interferon gamma assay in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis.
The tuberculin skin test is not an ideal screening test for the patients with rheumatoid arthritis to identify cases of latent tuberculosis infection (LTBI) prior to the start of treatment with anti-TNFs, as it responds inadequately to late hypersensitivity, which is fundamental for producing a response to the inoculated antigen. Assays based on detection of the production of IFNγ in vitro by mononuclear peripheral cells stimulated by specific antigens are more specific than PPD in detecting LTBI. The aim of this study was to evaluate the performance of T-SPOT. ⋯ TB varied from 87 to 90% and the negative-predictive value (NPV) from 94.4 to 100%. It can be concluded that the T-SPOT. TB showed high specificity and NPV, proving the capability of identifying false-negative cases of PPD, raising the level of safety for the use of anti-TNFs.