Clinical rheumatology
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Clinical rheumatology · Feb 2007
Diastolic function of the heart in mixed connective tissue disease.
The authors examined the right and left ventricle functions in patients with mixed connective tissue disease (MCTD) by Doppler echocardiography. Of 51 patients, 20 had temporary pulmonary arterial hypertension in their case history. According to our knowledge, this is the first study examining the use of Doppler echocardiography and tissue Doppler technique in MCTD patients. ⋯ In the case of patients with MCTD, signs of the disorder of the left ventricle diastolic function were observed. Our results suggest that the global impairment of the left ventricle function is the consequence of the disease itself and not the side effect of the treatment. In the case of MCTD patients complicated with PAH, the signs of the right ventricle function impairment proved to be permanent.
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Clinical rheumatology · Feb 2007
Comparative Study Clinical TrialComparison of the effect of alendronate on lumbar bone mineral density and bone turnover in men and postmenopausal women with osteoporosis.
The purpose of the present study was to compare the effect of alendronate treatment on lumbar bone mineral density (BMD) and bone turnover in men and postmenopausal women with osteoporosis. Sixty men with primary or secondary osteoporosis and 318 women with postmenopausal osteoporosis were treated with alendronate. The primary end points were lumbar BMD and urinary cross-linked N-terminal telopeptides of type I collagen (NTX) and serum alkaline phosphatase (ALP) levels. ⋯ Reduction in urinary NTX level and increase in lumbar BMD were smaller in men than in postmenopausal women. The incidence of vertebral and nonvertebral fractures was 10.6 and 8.5%, respectively, in men and 8.3 and 7.5%, respectively, in postmenopausal women, with no significant difference in these incidences between them. These results suggested that alendronate treatment effectively increased lumbar BMD from baseline in men with primary or secondary osteoporosis following reduction in bone turnover, although its efficacy did not appear to be greater than in postmenopausal women with osteoporosis.
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Clinical rheumatology · Feb 2007
Dietary calcium and bone mineral density in premenopausal women with systemic lupus erythematosus.
The primary objective of this study was to determine the relationship between dietary calcium intake and bone mineral density (BMD) in premenopausal women with systemic lupus erythematosus (SLE) on corticosteroids (CS). The secondary aim was to identify other risk factors for osteoporosis in these patients. A cross-sectional sample of patients attending the SLE Clinic at a teaching hospital was recruited. ⋯ Duration of SLE significantly correlated with cumulative CS dosage. In conclusion, 6.7% of these Asian premenopausal SLE women had osteoporosis and only 46.7% had normal BMD. Daily dietary calcium intake did not correlate with BMD.
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Clinical rheumatology · Feb 2007
Case ReportsPeripheral neuropathy in two patients with rheumatoid arthritis receiving infliximab treatment.
Antitumor necrosis alpha agents have been successfully used for the treatment of rheumatoid and seronegative arthritis, Crohn's disease, psoriasis, and severe cases of vasculitis. Several side effects have been observed in patients receiving these agents including hypersensitivity reactions, infections, drug-induced lupus, or demyelinating syndromes. The presence of peripheral neuropathy has been reported only in isolated cases. We describe two cases of peripheral neuropathy which occurred in patients with rheumatoid arthritis receiving infliximab treatment, one with multifocal motor neuropathy with conduction block and another with axonal sensory polyneuropathy, reversed upon discontinuation of infliximab and intravenous gammaglobulin treatment.