Lymphocyte surface marker expression in rheumatic diseases: evidence for prior activation of lymphocytes in vivo

Article Abstract:

Rheumatoid arthritis (RA) is a disorder characterized by inflammation of the joints, swelling, stiffness, overgrowth of cartilage, and pain. The inflammation is associated with accumulation of certain blood cells, primarily T lymphocytes, a type of immune cell. It is thought that the persistent activation of T lymphocytes results in continual immunological activity leading to destructive changes in the joint. Markers of the substances that activate T lymphocytes include the major histocompatibility (MHC) class II antigens, interleukin 2 receptor (IL2r), transferrin receptor, and CD3 and CD4 antigens. The levels of MHC class II antigens on T lymphocytes from the blood and synovial, or joint, fluid were measured in patients with RA and two other types of inflammatory diseases, psoriatic arthritis and Reiter's syndrome. Increased levels of MHC class II antigens were more prevalent in synovial fluid T lymphocytes of RA patients than in the same type of cells from other patients. However, there were lower levels of other types of markers, such as transferrin receptor, and there was a lack of correlation between these markers and IL2r. Among synovial fluid T lymphocytes, there was a subpopulation of larger cells with MHC class II and other lymphocyte activator antigens. CD3 and CD4 antigens were decreased on synovial T lymphocytes of all patients, indicating that synovial fluid T lymphocytes had been previously exposed to an unknown antigen. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Measurement, Physiological aspects, HLA antigens, T cells, Histocompatibility antigens

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Unexplained hip pain: look beyond the obvious abnormality

Article Abstract:

Patients with sudden hip pain while taking corticosteroids should be evaluated for osteonecrosis. A 53-year-old man with rheumatoid arthritis and a two-year history of daily prednisolone therapy developed pain and restricted motion in his left hip. The iliopsoas bursa of the hip was enlarged, and the patient received symptomatic treatment with only short-term relief. Magnetic resonance imaging revealed osteonecrosis of the joint and collapse of the femoral head, a type of joint degeneration sometimes caused by long-term corticosteroid use.

Abnormalities, Causes of, Complications and side effects, Corticosteroids, Adrenocortical hormones, Avascular necrosis, Hip

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Pulse methylprednisolone therapy for arthritis causing muscle weakness

Article Abstract:

The authors discuss multiple autoimmune disorders, focusing on a patient who had late onset rheumatoid arthritis, but no other diagnosed problems. Their treatment, consisting of high doses of corticosteroids relieved the arthritic symptoms, but brought on extreme muscle weakness, revealing an underlying additional condition of myasthenia gravis.

Health aspects, Diagnosis, Drug therapy, Methylprednisolone, Myasthenia gravis

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