Sirs, We describe a series of 3 RA patients in whom anti-TNF-α therapy was associated with the development of pulmonary nodules, or with the increase – in terms of number and size – of previously-existing nodules. In all patients, the interruption of anti-TNFα therapy and the subsequent administration of rituximab (1000 mg followed by 1000 mg 2 weeks later) were associated with a reduction in t...

OBJECTIVES To determine changes in demographic variables and severity of rheumatoid arthritis (RA) that may have occurred during the 30 year period from 1960 to 1990 in Japan. METHODS Using records of patients diagnosed with RA from two hospitals, demographic and clinical features at initial visit were compared between two groups, one from 1960 to 1965 (group I) and the other from 1985 to 199...

Cardiac necrobiotic lesions resembling rheumatoid granulomas were discovered in 2 patients without evidence of arthritis. Evidence from the literature indicates that pulmonary and subcutaneous nodules may occur before arthritis or before the appearance of the rheumatoid factor, and that cardiac lesions may occur early in the course of rheumatoid disease. Even in the absence of obvious arthritis...

Clinical and laboratory measures of disease expression were compared within and between 33 families with two or more affected siblings with rheumatoid arthritis (RA). None of the variables studied--age and calendar year of disease onset, pattern of joint involvement, the presence of rheumatoid nodules, Sjögren's syndrome, a positive latex or antinuclear antibody (ANA) titre--showed a greater co...

Rheumatoid nodules are a rare manifestation of lung disease associated with rheumatoid arthritis (RA). Their emergence and evolution in the course of the disease is variable. The diagnosis of pulmonary rheumatoid nodules may be suggested if they have a typical appearance in an appropriate clinical context, but an accurate diagnosis cannot be made based only on imaging tests. It is recommended t...

We describe seven children with subcutaneous rheumatoid nodules who had no clinical evidence of rheumatoid arthritis. Only one girl was seropositive for antinuclear factors and had a slightly raised erythrocyte sedimentation rate. Clinical aspects, risks for developing rheumatoid arthritis, and treatment of this entity are discussed.

Although rare, rheumatoid pneumoconiosis, also known as Caplan's syndrome, can occur in workers exposed to silica, as well as in patients with silicosis, coal workers' pneumoconiosis or asbestosis. Prevalence is higher among patients with silicosis, despite the fact that it was originally described in coal workers with pneumoconiosis. The classical finding that defines this syndrome is that of ...

Koebner phenomenon indicates the newly appearance of isomorphic lesions at the sites of mechanically stimulated or injured skin. This phenomenon can be seen in various inflammatory, auto-immune, viral, fibrotic, and even tumoral disorders. Also, rheumatic diseases such as lupus erythematosus, dermatomyositis, and rheumatoid arthritis (RA) often present with cutaneous manifestations with isomorp...

Bursal spaces between the cervical interspinous processes were found at necropsy in 14 out of 27 "normal' adult necks, especially when the spines were close together. In this random series they were the seat of crystallopathic disease in 2 instances out of 14 cases. In spines from 9 cases of adult-onset rheumatoid arthritis, rheumatoid bursitis was seen in 2 and banal bursitis in 2. In juvenile...

Rheumatoid arthritis (RA) represents the most commonly diagnosed arthropathy that affect many tissue types and organs, characterized by a clinical, functional and therapeutic pathogenic complexity and it affects especially diarthroidal joints. Rheumatoid nodules (RNs) are one of the most frequent extra-articular manifestations of RA, and usually reflect an advanced stage of the disease and a po...