Rheumatoid Arthritis: Reis P

Fonseca JE, Canhão H, Reis P, Jesus H, Silva JA, Branco J, Queiroz MV. · Unidade de Investigação em Reumatologia Instituto de Medicina Molecular Faculdade de Medicina da Universidade de Lisboa. · Acta Reumatol Port. · Pubmed #18159204 links to  free full text

Abstract: The authors present the update of a protocol for the clinical follow-up of Rheumatoid Arthritis Patients PMAR which aims to contribute to a standardized clinical observation of these patients particularly when they are being treated with biologic therapies.

Amor B, Reis P, Nahal R, Dougados M. · Rheumatology department, Hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. · Joint Bone Spine. · Pubmed #12713856 No free full text.

Abstract: OBJECTIVE: To individualize a new clinical entity of chronic arthritis and/or a factor indicating good prognosis of chronic arthritis. METHODS: We retrospectively studied 12 cases of monoarthritis or oligoarthritis that met none of the criteria sets for known diseases, even after more than 10 years of follow-up. RESULTS: Features in these 12 patients included recurrent effusions of inflammatory joint fluid consistently showing a predominance of lymphocytes and monocytes, long periods of remission separating the flares, absence of clinical or radiological joint lesions despite prolonged follow-up (10-40 years), an excellent response to joint aspiration and intraarticular glucocorticoid injection, unresponsiveness to second-line drugs, and young age at onset. Males and females were equally affected. Absolute lymphocyte/monocyte counts in joint fluid were similar in the 12 study patients and in 59 patients with rheumatoid arthritis, whereas absolute and differential neutrophil counts were significantly lower in the study patients. CONCLUSION: The above-described features and excellent functional outcome suggest that this clinical pattern may deserve to be viewed as a separate entity. We suggest the name "idiopathic lymphomonocytic arthritis" or, since a low-neutrophil count in joint fluid was also a conspicuous finding, "Flory syndrome", Flory being the name of the first patient in our series.

Fonseca JE, Reis P, Saraiva F, Crujo C, Baptista A, da Silva JA, Viana Queiroz M. · Unidade de Reumatologia e Doenças Osseas Metabólicas, Serviço de Medicina IV, Lisboa, Portugal. · Clin Rheumatol. · Pubmed #10524558 No free full text.

Abstract: Liver involvement in patients with systemic lupus erythematosus (SLE) is considered rare. Previous treatment with potentially hepatotoxic drugs or viral hepatitis have usually been implicated as the main causes of liver disease in SLE patients. On the other hand, even after careful exclusion of these aetiologies, the problem remains whether to classify the patient as having a primary liver disease with associated autoimmune clinical and laboratory features resembling SLE, such as autoimmune hepatitis, or as having liver disease as a manifestation of SLE. We report the case of an elderly woman who presented with acute hepatitis, who had been diagnosed with SLE 14 years ago and who also had Sjögren's syndrome and anti-phospholipid's syndrome for several years. The histology depicted chronic active hepatitis and, after drug-induced hepatitis and viral hepatitis were excluded, the serological and clinical features were shown to be typical of liver damage caused by SLE. The patient was treated with azathioprine 100 mg/d and prednisone 30 mg/d. The clinical symptoms resolved in 10 days and the laboratory values were normal at the end of the first month of therapy. Prednisone was progressively reduced, during a period of 4 months, to 10 mg/d but azathioprine was kept to the same dose. One year after the diagnoses the patient is still in remission. Although uncommon, hepatic involvement is well recognised in SLE. The interest of this case lies in the differential diagnosis and recognition of this condition, which deserves an aggressive treatment.