Rheumatology international
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Fibromyalgia (FM), pre-dominantly found in women, may accompany other pre-existing rheumatic diseases. The association between FM and ankylosing spondylitis (AS) is uncertain. We evaluated FM in women with AS. ⋯ Of all tested parameters, the ones with significant differences between the groups were time between symptom onset and AS diagnosis (longer for women), FM incidence and the number of tender points and enthesitis sites (higher for women), BASDAI (higher in women and correlated with FM and the number of tender points but not with ESR), and BASFI and BASDAI scores (increased in FM patients). FM was present in 50% of women with AS and associated with higher disease activity indices (BASDAI and BASFI) and not related to severity of physical findings or ESR. The reliability of well-accepted assessment tools of AS, such as BASDAI and BASFI, in evaluating AS activity in women may be called into question due to a confounding effect of FM.
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Review Case Reports
Beneficial effect of treatment with cyclosporin A in a case of refractory antisynthetase syndrome.
We report a case of idiopathic inflammatory myopathy accompanied with the presence of anti-Jo1 antibodies and complicated by diffuse parenchymal lung disease (antisynthetase syndrome). Efficacy of different therapeutic agents, including corticosteroids, cyclophosphamide and cyclosporin A, is described. ⋯ An interesting association of the disease onset with toxoplasmosis infection is discussed and difficulties regarding diagnosis of cardiac involvement are addressed. We also review other case reports of this rare disorder of poor prognosis.
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A 40-year-old woman with known systemic sclerosis presented with dyspnea. She had been treated for pneumonia, 2 months prior to the present admission and at this time presented with sudden dyspnea and was found to have a spontaneous pneumomediastinum and subcutaneous emphysema. Pneumomediastinum is an extremely rare complication in patients with systemic sclerosis.
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Comparative Study Clinical Trial
Preliminary evaluation in rheumatoid arthritis activity in patients treated with TNF-alpha blocker plus methotrexate versus methotrexate or leflunomide alone.
Methotrexate (MTX) is a first-line disease-modifying antirheumatic drugs (DMARD) in rheumatoid arthritis (RA). Leflunomide (LEF) and the biologic agents entered the arsenal of DMARDs in 1998. Therapeutic properties of new drugs are still under survey. ⋯ The study revealed equal effectiveness of MTX and LEF in reducing disease activity in rheumatoid arthritis. The efficacy of a TNF-alpha blocker combined with MTX was higher than that of each conventional DMARDs, especially with regard to ACR 70 criteria (considerable improvement after treatment). LEF was equally effective as MTX in patients unable to continue MTX treatment due to the drug's ineffectiveness.
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The purpose of this study was to determine the association of fibromyalgia (FM) with temporomandibular disorder (TMD) and masticatory myofascial pain (MMP). Thirty-one consecutive women diagnosed as having FM according to American College of Rheumatology criteria and 21 consecutive women diagnosed as having TMD were included in this prospective study. All patients were examined by a dentist and a physiatrist to identify the coexistence of FM and TMD. ⋯ In the TMD group, the prevalence of FM was 52%, which was significantly higher in those with TMD of arthrogenous origin with MMP. Our results indicate that coexistence of FM and TMD with MMP is high. Pain and tenderness in the masticatory muscles appear to be an important element in FM, so in some patients it may be the leading complaint.