Reactive Arthritis Information Booklet
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Reactive Arthritis This Sheet Has Been Written for People Affected by Reactive Arthritis
ARTHRIINFORMATIONTI SHEETS ARTHRIINFORMATIONTI SHEETS Reactive arthritis This sheet has been written for people affected by reactive arthritis. It provides general information to help you understand how you may be affected. This sheet also covers how reactive arthritis usually resolves over time. What is reactive arthritis? It is not known why some people who get these Reactive arthritis is a condition that causes infections develop reactive arthritis and some do not. inflammation, pain and swelling of the joints. It usually A certain gene called HLA-B27 is associated with develops after an infection, often in the bowel or genital reactive arthritis, especially inflammation of the spine. areas. The infection causes activity in the immune However this is a perfectly normal gene and there are system. The normal role of your body’s immune system many more people who have this gene and do not get is to fight off infections to keep you healthy. In some reactive arthritis. people this activity of the immune system causes joints to become inflamed, however the joints themselves How is it diagnosed? are not actually infected. About one in 10 people with Your doctor will diagnose reactive arthritis from your specific types of infections will get reactive arthritis. symptoms and a physical examination. Your doctor may also order blood tests for inflammation, such as the What are the symptoms? erythrocyte sedimentation rate (ESR) and C-reactive Reactive arthritis usually begins a few weeks after an protein (CRP) tests. Blood tests may also help to rule infection. Symptoms can affect many parts of the body out other types of arthritis. -
Confidential
CONFIDENTIAL CHILD’S MEDICAL INFORMATION The following is important information about my child’s medical condition and how the condition may affect their ability to fully participate in a regular school setting. The goal is to try to normalize every day school routines/activities while also meeting my child’s unique needs in the least disruptive manner. This document is not intended to replace any existing Individual Educational Plan (IEP) or the 504 Plan, but rather to serve as a supplement or addendum to enhance my child’s education. Medical information will be updated at the beginning of each new school year and throughout the school year as deemed necessary. “We may not look sick, but turn our bodies inside out and they will tell different stories.” Wade Sutherland CHILD’S NAME: ____________________________________________________________________________ ACADEMIC YEAR: _____________________GRADE: __________DOB: __________________AGE: _________ HOME ADDRESS: __________________________________________________________________________ PARENT/LEGAL GUARDIAN: ________________________________________________________________ PARENT/LEGAL GUARDIAN CONTACT NUMBER: ______________________________________________ SCHOOL: ________________________________________________________________________________ EMERGENCY CONTACT (2 PEOPLE) NAME: __________________________________________________________________________________ RELATIONSHIP: ____________________________ PHONE NUMBER: ________________________________ NAME: __________________________________________________________________________________ -
Arthritis and Coeliac Disease
Ann Rheum Dis: first published as 10.1136/ard.44.9.592 on 1 September 1985. Downloaded from Annals of the Rheumatic Diseases 1985, 44, 592-598 Arthritis and coeliac disease J T BOURNE,' P KUMAR,2 E C HUSKISSON,' R MAGEED 3 D J UNSWORTH,3 AND J A WOJTULEWSKI4 From the Departments of 'Rheumatology and 2Gastroenterology, St Bartholomew's Hospital, West Smithfield, London ECIA 7BE; the 3Bone and Joint Research Unit, London Hospital Medical College, London El; and 4St Mary's Hospital, Eastbourne SUMMARY We report six patients with coeliac disease in whom arthritis was prominent at diagnosis and who improved with dietary therapy. Joint pain preceded diagnosis by up to three years in five patients and 15 years in one patient. Joints most commonly involved were lumbar spine, hips, and knees (four cases). In three cases there were no bowel symptoms. All were seronegative. X-rays were abnormal in two cases. HLA-type Al, B8, DR3 was present in five and B27 in two patients. Circulating immune complexes showed no consistent pattern before or after treatment. Coeliac disease was diagnosed in all patients by jejunal biopsy, and joint symptoms in all responded to a gluten-free diet. Gluten challenge (for up to three weeks) failed to provoke arthritis in three patients tested. In a separate study of 160 treated coeliac patients attending regular follow up no arthritis attributable to coeliac disease and no ankylosing was in a group spondylitis identified, though control of 100 patients with Crohn's disease thecopyright. expected incidence of seronegative polyarthritis (23%) and ankylosing spondylitis (5%) was found (p<0.01). -
Anaphylaxis During the Perioperative Period
REVIEW ARTICLE Anaphylaxis During the Perioperative Period David L. Hepner, MD*, and Mariana C. Castells, MD, PhD† *Department of Anesthesiology, Perioperative and Pain Medicine, and †Allergy and Clinical Immunology Training Program, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts Anesthesiologists use a myriad of drugs during the provi- perioperative period. Symptoms may include all organ sion of an anesthetic. Many of these drugs have side ef- systems and present with bronchospasm and cardiovas- fects that are dose related, and some lead to severe cular collapse in the most severe cases. Management of immune-mediated adverse reactions. Anaphylaxis is the anaphylaxis includes discontinuation of the presumptive most severe immune-mediated reaction; it generally oc- drug (or latex) and anesthetic, aggressive pulmonary and curs on reexposure to a specific antigen and requires the cardiovascular support, and epinephrine. Although a se- release of proinflammatory mediators. Anaphylactoid re- rum tryptase confirms the diagnosis of an anaphylactic actions occur through a direct non-immunoglobulin reaction, the offending drug can be identified by skin- E-mediated release of mediators from mast cells or from prick, intradermal testing, or serologic testing. Prevention complement activation. Muscle relaxants and latex of recurrences is critical to avoid mortality and morbidity. account for most cases of anaphylaxis during the (Anesth Analg 2003;97:1381–95) he term “anaphylaxis” was coined by Nobel reactions in which immune-complex formation and dep- prize recipients Portier and Richet (1) in 1902, osition leads to tissue damage (3). Anaphylactoid reac- T when they described a dog that had tolerated a tions occur through a direct nonimmune-mediated re- previous injection of actinotoxin, a jellyfish toxin, but lease of mediators from mast cells and/or basophils or reacted with bronchial spasm, cardiorespiratory ar- result from direct complement activation, but they rest, and death to a smaller dose 14 days later. -
Conditions Related to Inflammatory Arthritis
Conditions Related to Inflammatory Arthritis There are many conditions related to inflammatory arthritis. Some exhibit symptoms similar to those of inflammatory arthritis, some are autoimmune disorders that result from inflammatory arthritis, and some occur in conjunction with inflammatory arthritis. Related conditions are listed for information purposes only. • Adhesive capsulitis – also known as “frozen shoulder,” the connective tissue surrounding the joint becomes stiff and inflamed causing extreme pain and greatly restricting movement. • Adult onset Still’s disease – a form of arthritis characterized by high spiking fevers and a salmon- colored rash. Still’s disease is more common in children. • Caplan’s syndrome – an inflammation and scarring of the lungs in people with rheumatoid arthritis who have exposure to coal dust, as in a mine. • Celiac disease – an autoimmune disorder of the small intestine that causes malabsorption of nutrients and can eventually cause osteopenia or osteoporosis. • Dermatomyositis – a connective tissue disease characterized by inflammation of the muscles and the skin. The condition is believed to be caused either by viral infection or an autoimmune reaction. • Diabetic finger sclerosis – a complication of diabetes, causing a hardening of the skin and connective tissue in the fingers, thus causing stiffness. • Duchenne muscular dystrophy – one of the most prevalent types of muscular dystrophy, characterized by rapid muscle degeneration. • Dupuytren’s contracture – an abnormal thickening of tissues in the palm and fingers that can cause the fingers to curl. • Eosinophilic fasciitis (Shulman’s syndrome) – a condition in which the muscle tissue underneath the skin becomes swollen and thick. People with eosinophilic fasciitis have a buildup of eosinophils—a type of white blood cell—in the affected tissue. -
Still Disease
University of Massachusetts Medical School eScholarship@UMMS Open Access Articles Open Access Publications by UMMS Authors 2019-02-17 Still Disease Juhi Bhargava Medstar Washington Hospital Center Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/oapubs Part of the Immune System Diseases Commons, Musculoskeletal Diseases Commons, Pathological Conditions, Signs and Symptoms Commons, Skin and Connective Tissue Diseases Commons, and the Viruses Commons Repository Citation Bhargava J, Panginikkod S. (2019). Still Disease. Open Access Articles. Retrieved from https://escholarship.umassmed.edu/oapubs/3764 Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Open Access Articles by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Still Disease Juhi Bhargava; Sreelakshmi Panginikkod. Author Information Last Update: February 17, 2019. Go to: Introduction Adult Onset Still's Disease (AOSD) is a rare systemic inflammatory disorder characterized by daily fever, inflammatory polyarthritis, and a transient salmon-pink maculopapular rash. AOSD is alternatively known as systemic onset juvenile idiopathic arthritis. Even though there is no specific diagnostic test, a serum ferritin level more than 1000ng/ml is common in AOSD. Go to: Etiology The etiology of AOSD is unknown. The hypothesis remains that AOSD is a reactive syndrome in which various infectious agents may act as triggers in a genetically predisposed host. Both genetic factors and a variety of viruses, bacteria like Yersinia enterocolitica and Mycoplasma pneumonia and other infectious factors have been suggested as important[1][2]. -
Reactive Arthritis
PATIENT FACT SHEET Reactive Arthritis Reactive arthritis is an inflammatory disease that Most often, these bacterial infections are in the genitals occurs in reaction to infections by certain bacteria. or bowels, including the sexually transmitted infection Arthritis may show up a month after the infection. Once Chlamydia trachomatis, and bowel infections like called Reiter’s syndrome, it is a “spondyloarthropathy.” Campylobacter, Salmonella, Shigella and Yersinia. Reactive arthritis often affects men between 20 and CONDITION 50. It’s usually short in duration, but can be chronic in some people. DESCRIPTION Reactive arthritis symptoms include pain and swelling discharge from the genitals, but a urine or genital swab in knees, ankles or heels; severe swelling of toes or test can show signs of this infection. Bowel infections fingers; and persistent lower back pain that tends to may cause diarrhea. be more severe at night or in the morning. It may cause Most people with these very common infections irritated, red eyes, burning during urination, or a rash on don’t get reactive arthritis. People who test positive for the palms or soles of the feet. the HLA-B27 gene may be at higher risk for severe or To diagnose reactive arthritis, a rheumatologist may chronic arthritis, but those who test negative may get SIGNS/ look for these symptoms as well as signs of the original reactive arthritis too. People with weakened immune SYMPTOMS infection. Chlamydia may cause watery or pus-like systems from HIV or AIDS may develop reactive arthritis. Effective treatments are available for reactive arthritis. Later-stage, or chronic reactive arthritis, may be It is treated according to how far the disease has treated with disease-modifying antirheumatic drugs progressed. -
Hypersensitivity Reactions (Types I, II, III, IV)
Hypersensitivity Reactions (Types I, II, III, IV) April 15, 2009 Inflammatory response - local, eliminates antigen without extensively damaging the host’s tissue. Hypersensitivity - immune & inflammatory responses that are harmful to the host (von Pirquet, 1906) - Type I Produce effector molecules Capable of ingesting foreign Particles Association with parasite infection Modified from Abbas, Lichtman & Pillai, Table 19-1 Type I hypersensitivity response IgE VH V L Cε1 CL Binds to mast cell Normal serum level = 0.0003 mg/ml Binds Fc region of IgE Link Intracellular signal trans. Initiation of degranulation Larche et al. Nat. Rev. Immunol 6:761-771, 2006 Abbas, Lichtman & Pillai,19-8 Factors in the development of allergic diseases • Geographical distribution • Environmental factors - climate, air pollution, socioeconomic status • Genetic risk factors • “Hygiene hypothesis” – Older siblings, day care – Exposure to certain foods, farm animals – Exposure to antibiotics during infancy • Cytokine milieu Adapted from Bach, JF. N Engl J Med 347:911, 2002. Upham & Holt. Curr Opin Allergy Clin Immunol 5:167, 2005 Also: Papadopoulos and Kalobatsou. Curr Op Allergy Clin Immunol 7:91-95, 2007 IgE-mediated diseases in humans • Systemic (anaphylactic shock) •Asthma – Classification by immunopathological phenotype can be used to determine management strategies • Hay fever (allergic rhinitis) • Allergic conjunctivitis • Skin reactions • Food allergies Diseases in Humans (I) • Systemic anaphylaxis - potentially fatal - due to food ingestion (eggs, shellfish, -
Juvenile Idiopathic Arthritis Associated Uveitis
children Review Juvenile Idiopathic Arthritis Associated Uveitis Emil Carlsson 1,*, Michael W. Beresford 1,2,3, Athimalaipet V. Ramanan 4, Andrew D. Dick 5,6,7 and Christian M. Hedrich 1,2,3,* 1 Department of Women’s and Children’s Health, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L14 5AB, UK; [email protected] 2 Department of Rheumatology, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool L14 5AB, UK 3 National Institute for Health Research Alder Hey Clinical Research Facility, Alder Hey Children’s NHS Foundation Trust Hospital, Liverpool L14 5AB, UK 4 Bristol Royal Hospital for Children & Translational Health Sciences, University of Bristol, Bristol BS2 8DZ, UK; [email protected] 5 Translational Health Sciences, University of Bristol, Bristol BS2 8DZ, UK; [email protected] 6 UCL Institute of Ophthalmology, London EC1V 9EL, UK 7 NIHR Biomedical Research Centre, Moorfields Eye Hospital, London EC1V 2PD, UK * Correspondence: [email protected] (E.C.); [email protected] (C.M.H.); Tel.: +44-151-228-4811 (ext. 2690) (E.C.); +44-151-252-5849 (C.M.H.) Abstract: Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. The development of associated uveitis represents a significant risk for serious complications, including permanent loss of vision. Initiation of early treatment is important for controlling JIA-uveitis, but the disease can appear asymptomatically, making frequent screening procedures necessary for patients at risk. As our understanding of pathogenic drivers is currently incomplete, it is difficult to assess which JIA patients are at risk of developing uveitis. -
Rheumatic Fever and Post-Streptococcal Reactive Arthritis Version of 2016
https://www.printo.it/pediatric-rheumatology/IE/intro Rheumatic Fever And Post-streptococcal Reactive Arthritis Version of 2016 4. POST-STREPTOCOCCAL REACTIVE ARTHRITIS 4.1 What is it? Cases of streptococcal-associated arthritis have been described both in children and young adults. It is usually called "reactive arthritis" or "post-streptococcal reactive arthritis" (PSRA). PSRA commonly affects children between 8 to 14 years of age and young adults between 21 to 27 years. It usually develops within 10 days after a throat infection. If differs from arthritis of acute rheumatic fever (ARF), which mainly involves large joints. In PSRA, large and small joints and the axial skeleton are involved. It usually lasts longer than ARF — about 2 months, sometimes longer. Low grade fever might be present, with abnormal laboratory tests indicating inflammation (C reactive protein and/or erythrocyte sedimentation rate). The inflammatory markers are lower than in ARF. The diagnosis of PSRA relies on arthritis with evidence of recent streptococcal infection, abnormal streptococcal antibody tests (ASO, DNAse B) and the absence of the signs and symptoms in a diagnosis of ARF according to "Jones criteria". PSRA is a different entity to ARF. PSRA patients will probably not develop carditis. Currently, the American Heart Association recommends prophylactic antibiotics for one year after symptoms onset. In addition, these patients should be carefully observed for clinical and echocardiographic evidence of carditis. If heart disease appears, the patient should be treated as in ARF; otherwise prophylaxis can be discontinued. Follow-up with a cardiologist is recommended. 1 / 2 2 / 2 Powered by TCPDF (www.tcpdf.org). -
Reactivation of Inflammatory Monoarthritis During Dupilumab Treatment Used for Prurigo Nodularis
Arch Rheumatol 2022;37(x):i-ii doi: 10.46497/ArchRheumatol.2022.8780 LETTER TO THE EDITOR Reactivation of inflammatory monoarthritis during dupilumab treatment used for prurigo nodularis Ecem Bostan1, Duygu Gülseren1, Zehra Özsoy2, Fatma Bilge Ergen3 1Department of Dermatology, Hacettepe University Faculty of Medicine, Ankara, Turkey 2Department of Internal Diseases, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Turkey 3Department of Radiology, Hacettepe University Faculty of Medicine, Ankara, Turkey Dupilumab is a humanized monoclonal dupilumab. Although her clinical manifestations antibody which specifically targets interleukin-4/ and pruritus improved, she developed mild right interleukin-13 receptor and is primarily indicated for knee swelling, warmness, and arthralgia after the the treatment of atopic dermatitis, although it has first maintenance dose following the loading dose. been shown to be efficacious in various disorders Upon questioning, we recognized that the patient including asthma, chronic rhinosinusitis, prurigo developed reactive arthritis in the right knee, nodularis.1 Herein, we report an extraordinary when she was 10 years old. Until now, she stayed case related to the exacerbation of inflammatory asymptomatic. She was consulted to rheumatology arthritis in a patient under dupilumab treatment department and effusion was detected by right for prurigo nodularis. knee ultrasonography and arthrocentesis was performed which revealed no bacterial growth. An 18-year-old woman with a history of allergic Elevated C-reactive protein and erythrocyte rhinitis and atopic dermatitis, presented for her sedimentation levels were noted. Rheumatological pruritic lesions. The pruritic nodules started from markers were all negative. Right knee magnetic the lumbar area nine years ago and subsequently resonance imaging showed moderate effusion spread to entire body. -
Joint Pain and Sjögren’S Syndrome
Joint Pain and Sjögren’s Syndrome Alan N. Baer, MD, FACP Alan N. Baer, MD, FACP Associate Professor of Medicine Division of Rheumatology Johns Hopkins University School of Medicine Director, Jerome Greene Sjogren's Syndrome Clinic 5200 Eastern Avenue Mason F. Lord Bldg. Center Tower Suite 4100, Room 413 Baltimore MD 21224 Phone (410) 550-1887 Fax (410) 550-6255 In 1930, Henrik Sjögren, a Swedish ophthalmologist, examined a woman with rheumatoid arthritis who had extreme dryness of her eyes and mouth and filamentary keratitis, an eye condition related to her lack of tears (1). He became fascinated by this unusual debilitating condition and subsequently evaluated 18 additional women with the same combination of findings. He described this new syndrome as “keratoconjunctivitis sicca” in his postdoctoral thesis. Thirteen of the 19 women had chronic inflammatory arthritis. We would now classify these 13 women as having secondary Sjögren’s syndrome (SS), occurring in the context of rheumatoid arthritis. However, joint pain constitutes one of the most common symptoms of the primary form of SS, defined as SS occurring in the absence of an underlying rheumatic disease. In a recent survey of SS patients belonging to the French Sjögren’s Syndrome Society (Association Française du Gougerot-Sjögren et des Syndromes Secs), 81% reported significant joint and muscle pain (2). In this article, the joint manifestations of primary SS will be reviewed. A few definitions are needed for the reader. Although the term “arthritis” was originally applied to conditions causing joint inflammation, it now includes disorders in which the joint has become damaged by degenerative, metabolic, or traumatic processes.