Nihon rinsho. Japanese journal of clinical medicine
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Various pulmonary lesions can be found in patients with collagen vascular diseases. Not only the diseases but also treatment with various drugs relate to an occurrence of the pulmonary lesions such as infection, drug reaction, bronchiolitis and interstitial pneumonias. ⋯ Incidence of the interstitial pneumonias and diagnostic problems before biopsy using HRCT and BAL were evaluated. Comparison of interstitial pneumonias between idiopathic and associated with collagen vascular diseases is a problem to be solved.
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Fibromyalgia syndrome (FMS) is recognizable syndrome characterized by chronic, diffuse pain, an absence of inflammatory or structural muscloskeletal abnormalities, and a range of symptoms that include fatigue, and sleep and mood disturbances. Physical examination and laboratory testing are unrevealing, except for the presence of pain on palpation of characteristic soft-tissue sites, the tender points. Despite the recognition of FMS by the World Health Organization, it remains a controversial condition and its existence as a distinct entity remains uncertain. ⋯ Many patients with chronic fatigue syndrome(CFS) fulfill the criteria of FMS and represent one end of a spectrum of presentation. Evidence for triggering viral infection and the lower level of serum acylcarnitine, observed in CFS patients, is lacking in the majority of patients with FMS. These findings are suggestive to be distinctively another disorders between FMS and CFS.
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Recent evidence suggests that most of the rheumatic diseases are complex or multifactorial diseases with contributions from HLA and multiple non-HLA genes. Studies using candidate gene approach suggested that early components of the complement pathway, Fc receptor IIa, IIIa, mannose-binding lectin, IL-10 and TNFR2 might be potential non-HLA susceptibility genes to systemic lupus erythematosus, although substantial difference among populations are reported. ⋯ A recently completed genome-wide linkage analysis of rheumatoid arthritis revealed a number of possible candidate regions in addition to HLA. Identification of the susceptibility genes will be accelerated along with technological advances and the accomplishment of human genome project, and will deepen our understanding of rheumatic diseases.
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Many classifications of vasculitis syndrome have been proposed. The American College of Rheumatology (ACR) proposed criteria for classification of vasculitis in 1990. In 1994, the nomenclature of systemic vasculitides was proposed by Chapel Hill International Consensus Conference. ⋯ In Japan, Research committee of intractable vasculitis syndrome, Survey and Research on Specific Diseases, the Ministry of Health and Welfare of Japan proposed diagnostic criteria for vasculitis syndrome. The criteria for ANCA related vasculitis syndrome, temporal arteritis and antiphospholipid syndrome were proposed and a nation-wide survey has been undertaken in this committee (Chairman: Hiroshi Hashimoto). In this review, we describe a recent classification of vasculitides and recent topics on Takayasu arteritis, temporal arteritis, Wegener's granulomatosis and Churg-Strauss syndrome.