Rheumatoid Arthritis: Li Gobbi F

Benucci M, Li Gobbi F, Saviola G, Manfredi M. · Rheumatology Unit, Nuovo Ospedale S. Giovanni di Dio, ASL 10 Florence via di Torregalli 3, Florence, Italy. · Rheumatol Int. · Pubmed #18493770 No free full text.

Abstract: Rheumatoid vasculitis (RV) is an uncommon but potentially catastrophic complication of rheumatoid arthritis (RA). There are few current extensive studies and no consensus regarding the clinical, laboratory, histologic features and management or prognosis of RV. We report a case of RV in a 74-year old woman with a long (14 years) history of RA, who developed vasculitis of distal arteries with gangrene of digits of upper and lower extremities. After the failure of various immunosuppressive drugs (cyclophosphamide, methotrexate), the patient was treated with anti-TNFalpha infliximab. Digital gangrene healed within four months from the start of anti-TNFalpha treatment.

Benucci M, Li Gobbi F, Fossi F, Manfredi M, Del Rosso A. · Section of Rheumatology, Nuovo Ospedale di S. Giovanni di Dio ASL 10, Via di Torregalli 3, 50143 Florence, Italy. · J Clin Rheumatol. · Pubmed #16357696 No free full text.

Abstract: We report a case of a 45-year-old man with an 8-month history of rheumatoid arthritis, who was treated with hydroxychloroquine 400 mg per day and 15 mg intramuscular methotrexate per week without reaching a good control of the disease. The patient was successfully treated with 3 mg/kg infliximab for 20 weeks. Before the last infusion, drug-induced lupus (DIL) was diagnosed based on the clinical features of fever > 37.5 degrees C, recurrence of active synovitis, myalgia, erythematosus rash, pericardial and pleural effusion, and of some laboratory findings (antinuclear antibodies 1:160 and anti double-strand DNA positive by DNA recombinant plasmid assay dsDNA). After infliximab discontinuation and the beginning of therapy with methylprednisolone, lupus symptoms resolved within 6 weeks. A new rheumatoid arthritis flare, occurring after 8 weeks, was controlled by methotrexate plus leflunomide. We also review the development of antinuclear and antidouble-strand DNA antibodies and drug-induced lupus in patients treated with anti-TNFalpha agents (infliximab, etanercept, and adalimumab).

Benucci M, Li Gobbi F, Fossi F, Cammelli E, Manfredi M. · Sezione di Reumatologia, Dipartimento Medicina Interna, Nuovo Ospedale S.Giovanni di Dio, ASL 10, Firenze. · Recenti Prog Med. · Pubmed #16229322 No free full text.

Abstract: The aim of the study was to evaluate the composition and functional integrity of the various components of immune response in patients with rheumatoid arthritis (RA). We evaluated in 14 patients with RA with stable methotrexate therapy 12.5 mg/weekly, the number of peripheral mononuclear (PMN) cells lymphocytes, monocytes and the circulating levels of TNFalpha, IL-6 and IL-10 before and during adalimumab therapy 40 mg every other week for 6 months. No difference in baseline versus 6 months values between two treated group for PMN cells. Data about cytokines show a reduction for TNFalpha, IL-6 circulating levels and an increase for IL-10 circulating levels. Our data reveal that adalimumab doesn't reduce lymphocyte population and subsets such as CD14 or CD56 cells that have an important role against infections.

Benucci M, Li Gobbi F, Del Gobbo A, Gambacorta G, Mannoni A. · Sezione Aggregata di Reumatologia, Nuovo Ospedale S. Giovanni di Dio, Florence, Italy. · Reumatismo. · Pubmed #12874643 links to  free full text

Abstract: OBJECTIVES: The presence of secondary amyloidosis is a complication of different rheumatic diseases. We investigated the presence of Serum Amyloid A (SAA), marker of secondary amyloidosis, in salivary glands of patients (pts) with Sjögren Syndrome (SS) and correlated it to biohumoral parameters. MATERIALS AND METHODS: 141 pts with sicca syndrome who fulfilled 3 items of the European Criteria for SS by Vitali et al underwent biopsies of labial salivary glands, that were scored according to Chisholm and Mason index and evaluated for the presence of SAA. All pts were evaluated for ANA, ENA, rheumatoid factor, gamma-globulins, IgA, IgG, IgM, C3, C4, beta 2-microglobulin, erythrosedimentation rate, C reactive protein. RESULTS: Forty out of 141 pts, showed sialoadenitis (SL) with focus score 3-4 (definite SS), and 101 pts showed SL with focus score 1-2. Fourteen out of 101 pts (13.8%) with score 1-2 and 12/40 pts (30%) with definite SS were positive for SAA, respectively. SS pts were further divided in group A (positive for SAA) and group B (negative for SAA). These groups were compared to detect if differences could exist in biohumoral parameters: group A showed higher levels of biohumoral parameters than group B, but the difference was significant only for beta 2-microglobulin: 2653+610 ng/ml versus 1848+440 ng/ml; p< 0.025. CONCLUSION: Secondary amyloidosis is a complication of SS. In pts with SAA in salivary glands were detected high levels of beta 2-microglobulin, that could be considered a factor predicting the development of amyloidosis in SS.

Li Gobbi F, Benucci M, Del Rosso A. · No affiliation provided · J Clin Rheumatol. · Pubmed #16357717 No free full text.

This publication has no abstract.

Benucci M, Bardazzi G, Magarò L, Li Gobbi F, Mannoni A, Serni U. · No affiliation provided · Clin Exp Rheumatol. · Pubmed #11491510 No free full text.

This publication has no abstract.