HLA types in patients with rheumatoid arthritis developing leucopenia after both gold and sulphasalazine treatment

Article Abstract:

Rheumatoid arthritis (RA) is a joint disease characterized by inflammation of the joints, stiffness, swelling, enlargement of the cartilage, and pain. Certain drugs used to treat RA, including gold and D-penicillamine, cause toxic effects in the blood cells of some patients. It is thought that these sensitive patients have a genetic predisposition to develop adverse effects from these anti-rheumatic agents. Specifically, certain types of histocompatibility antigens (HLA) may be associated with toxic reactions to anti-rheumatic drugs. Histocompatibility antigens, which are present on all cells with a nucleus, can activate immune responses, and are controlled by a specialized set of genes called the major histocompatibility gene complex (MHC). The HLA-DR3 type has been associated with the development of toxic reactions to gold or D-penicillamine in RA patients. In a previous study, the drug sulphasalazine was given to 100 patients with RA. This produced neutropenia (a reduction in neutrophils, a type of white blood cell) in three patients who had similar reactions to gold. The HLA of these three patients were analyzed in the current study. Two patients who developed mild leukopenia (a reduction in white blood cells) had HLA-DR2; one patient with agranulocytosis (a disease associated with a reduction in white blood cells) had HLA-DR4. These findings are consistent with other studies that indicate there exists a genetic predisposition in certain individuals to develop toxic effects in blood cells as a reaction to certain anti-rheumatic agents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Genetic aspects, HLA antigens, Leukocytes, White blood cells, Histocompatibility antigens, Leucopenia, Leukopenia

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Microalbuminuria in patients with rheumatoid arthritis

Article Abstract:

New tests that can detect microalbuminuria may help prevent subsequent kidney dysfunction in patients with rheumatoid arthritis (RA). Microalbuminuria is small amounts of albumin in the urine that is associated with early kidney damage but is often undetectable. Researchers took urine samples from 65 RA patients and 51 people without RA and used a sensitive technique called immunoturbidimetry to measure urinary albumin. Twenty-eight percent of the RA patients had microalbuminuria, compared to only eight percent of the control group. Microalbuminuria in RA patients was not detectable using traditional urine tests. Patients treated with penicillamine and gold were more likely to have microalbuminuria. Immunological methods to measure urinary albumin should be used to screen RA patients so that early kidney dysfunction can be detected.

Diagnosis, Physiological aspects, Urine, Urinalysis, Albuminuria

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Placement of intra-articular injections verified by mini air-arthrography

Article Abstract:

The author describes the treatment of patients with osteoarthritis of the knee, who are given injections in the space between joints. The thrust of the article explains the technique of assuring that those injections are properly placed by using an injection of air to verify the location. When placement is correct, the radiograph will show it with a sharply defined shadow.

Care and treatment, Statistical Data Included, Evaluation, Osteoarthritis, Knee, Injections

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