Adult onset Still's disease and related renal amyloidosis

Article Abstract:

Adult onset Still's disease is an inflammatory disease that is associated with fever, rash and arthritis. The development of kidney disease (renal amyloidosis) in patients with Still's disease is rare and only five such cases have been reported in the medical literature. During renal amyloidosis proteins accumulate within the walls of the capillaries in the kidney. This reduces the ability of the kidney to function and in some cases results in hypertension and kidney failure. This article describes the case report of a 57-year-old woman who developed Still's disease and over the subsequent four years developed renal amyloidosis. The woman was in good health until she suddenly developed a rash and severe joint pain (arthralgia). At the time of admission to the hospital her blood pressure was normal and she had no signs of spleen or liver enlargement. Urinalysis revealed an excess of protein and the presence of red blood cells. A kidney sample (biopsy) was taken for examination and was found to be normal. Treatment with prednisolone was begun and the patient began to show sings of improvement. Fifteen months later colchicine treatment was started and was continued along with prednisolone. During the subsequent two years the patient showed some signs of improvement but continued to have an occasional relapse. Four years after the first kidney biopsy was performed, the patient had a severe relapse and another biopsy was done. This time the kidney sample showed the characteristic features of amyloidosis. In the previously reported cases of amyloidosis in patients with Still's disease the amyloidosis did not appear until 7 to 35 years after the onset of the disease. The case report described in this article shows that amyloidosis can occur during earlier stages of Still's disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Physiological aspects, Kidneys, Amyloidosis, Kidney

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Osteoporosis and arthritis

Article Abstract:

Osteoporosis is an age-related disorder characterized by decreased bone mass and increased risk of fracture, and may result from unknown causes, diseases of the endocrine system, joint disease, or excessive and long-term use of drugs that interfere with bone metabolism, such as corticosteroids. A deficiency in the female hormone estrogen increases the risk of developing osteoporosis. Persons at increased risk of developing osteoporosis tend to be small, thin, fair, pale-skinned women most commonly of European extraction, spinsters, or mothers with one or two children, persons with a history of hip and spine fracture, and heavy smokers with these other clinical characteristics. Various methods to identify high-risk persons are described. In long-term arthritis (inflammatory joint disease) bone loss within the joint results from the decreased movement of the joint, and from the disease process, where substances that resorb the bone are released. Non-steroidal anti-inflammatory drugs that are used to treat RA also prevent the production of prostaglandins, which are fatty acid compounds involved in bone resorption. These antirheumatic drugs and other agents that prevent bone resorption, such as estrogen, androgens, anabolic steroids, calcitonin, fluoride, and diphosphonates may be useful in reducing bone loss in long-term arthritis. Further investigation is needed to develop therapy for osteoporosis, methods of identifying high-risk groups, and techniques for measuring bone mass and bone metabolism over time. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Osteoporosis

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Characterisation of uveitis in patients with psoriatic arthritis

Article Abstract:

Patients diagnosed with uveitis should be asked if they have psoriasis or inflammatory bowel disease. Uveitis is an inflammation inside the eye. Patients with psoriasis and arthritis are likely to have uveitis with characteristics that are different than in patients with other rheumatic diseases.

Causes of, Uveitis

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