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H A Ménard

Publications and source records attributed to H A Ménard.

At least 37 records · Page 2Linked to original sources
PubMed1994

The Sa system: a novel antigen-antibody system specific for rheumatoid arthritis.

OBJECTIVE: To describe a novel autoimmune system (Sa/anti-Sa) specific for rheumatoid arthritis (RA). METHODS: Antibodies were detected in immunoblots using human spleen and placenta extracts as antigens. Sera from 482 patients with various rheumatic diseases as well as from healthy controls were evaluated to define the disease associations of anti-Sa antibodies. RESULTS: Sera from 88 of 206 (42.7%) unselected patients with RA recognized specific protein bands (the Sa antigen) in immunoblots of spleen or placenta extracts, including 9 of 31 (29%) patients seen in the first few months after disease onset. Anti-Sa antibodies were found both in rheumatoid factor (RF) negative (17/63 or 27%) and in RF positive patients with RA (71/143 or 50%). They were nevertheless absent in RF positive patients with other connective tissue diseases (0/39). Antibodies to Sa were essentially found in sera from patients with RA (specificity 98.9%) being found only in 3 patients whose arthritides did not fulfill the ACR criteria. The positive predictive value of anti-Sa antibodies for RA was 96.7%, while its negative predictive value was 69.8%. Anti-Sa antibodies were predominantly of the IgG isotype, with titers varying from 1/50 to > 1/1000. The Sa antigen was characterized as a poorly soluble protein that is present in normal human tissues and that is distinct from all previously described RA associated autoimmune systems. CONCLUSION: Anti-Sa antibodies are a novel serological marker highly specific for RA. Since anti-Sa antibodies occur independently of RF, they can be used as an additional diagnostic tool. The molecular nature of the Sa antigen as well as its potential pathogenic role in a significant proportion of patients with chronic articular inflammation of the rheumatoid variety merit further definition.

Antibody Specificity↗
PubMed1994

Chronic modulation of the autoimmune response following parvovirus B19 infection.

We describe 2 patients with prolonged autoimmune alterations following parvovirus B19 infection. B19 induced aplastic crises were the revealing manifestations of asymptomatic hemolytic conditions in the 2 patients: a Coombs' positive hemolytic anemia induced by D-penicillamine in the first and congenital spherocytosis in the second. Both patients had transient clinical and serological manifestations highly suggestive of systemic lupus erythematosus. In addition, prolonged clinical and serological remission of rheumatoid arthritis was observed in the first patient, while arthralgias, FANA, and anti-Ro antibodies persisted in the second, previously healthy patient. Our data suggest that parvovirus B19 infection may lead to chronic modulation of the autoimmune response in predisposed individuals.

Adult↗
PubMed1993

Heterogeneity of ANCA sera showing atypical, peripheral and classical cytoplasmic immunofluorescence patterns.

Atypical (A) ANCA immunofluorescence (IF) patterns have been described in several disease groups. We have previously reported a distinct cytoplasmic A-ANCA in 7-10% of patients with SLE and/or RA. Here, we show that these rheumatic disease associated A-ANCAs are best identified using U937 cells as substrate and that they do not target either a serine proteinase or a peroxidase. Furthermore, these sera immunoprecipitate a 40 kDa or a 42 kDa band using in vivo 35S-amino acid labelled HL60 or U937 cell extracts, respectively. Although these bands are the only one seen with pure A-ANCA sera, they can also be found in addition to the expected bands of PR3 or MPO in up to 30% of bona fide C- or P-ANCA sera. These data confirm and extend our previous observations. They also suggest that target heterogeneity of ANCA antibodies is frequent. Care should thus be taken in interpreting in a cause and effect relationship, an IF pattern or a biological effect produced by a serum with ill documented monospecificity. The exact nature and significance of this (these) new antigen(s) have yet to be clarified.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1993

Rheumatoid arthritis: anti-Ro antibodies define a non-HLA-DR4 associated clinicoserological cluster.

OBJECTIVE: To determine the clinical significance of anti-Ro antibodies in patients with rheumatoid arthritis (RA). METHODS: Cross sectional study of 278 consecutive patients with RA at a single academic rheumatology center. Clinical data were collected without knowledge of the anti-Ro status. Anti-Ro antibodies were detected in coded sera using immunoprecipitation of HeLa cell extracts. RESULTS: Ten (3.6%) of the 278 patient sera were found anti-Ro positive. Age, sex, duration of disease, prevalence of rheumatoid factor (RF), and severity of joint involvement were similar in anti-Ro positive and negative patients. Anti-Ro positive patients had significantly more symptomatic Sjögren's syndrome (SS), leukopenia, hypocomplementemia, vasculitic purpura, and photosensitivity (odds ratio [OR] varying from 7.3 to 26.8). Although SS was frequent in anti-Ro positive patients with RA, secondary SS was not independently linked to any of the associated extraarticular manifestations. Histocompatibility studies revealed the absence of HLA-DR4 in the 8 anti-Ro positive patients available for typing and the presence of DR2 and/or DR3 in 6 of them. CONCLUSIONS: Immunoprecipitating anti-Ro antibodies in serum delineate a clinical, non-HLA-DR4 associated cluster of patients with RA almost as numerous as systemic lupus erythematosus or primary SS. Production of these antibodies seems to precede clinical manifestations and may thus have prognostic implications.

Adult↗
PubMed1992

Efficacy and tolerability of enteric-coated naproxen in the treatment of osteoarthritis and rheumatoid arthritis: a double-blind comparison with standard naproxen followed by an open-label trial.

One hundred and twenty-three patients with osteoarthritis (n = 50) or rheumatoid arthritis (n = 73) were enrolled in a 6-week, double-blind, randomized, controlled, parallel trial comparing enteric-coated naproxen with standard naproxen. Ninety-eight patients subsequently entered a 20-week, open-label trial of enteric-coated naproxen. The study demonstrated that naproxen in both its standard formulation and its new enteric-coated formulation is a highly effective form of therapy for osteoarthritis and rheumatoid arthritis. The tolerability profiles of the two formulations were similar in terms of the types of complaints reported. It is concluded that enteric-coated naproxen is an efficacious and well-tolerated formulation for the treatment of osteoarthritis and rheumatoid arthritis.

Adult↗
PubMed1992

Open-label tolerability study of enteric-coated naproxen in the treatment of osteoarthritis and rheumatoid arthritis.

Two hundred and ninety-six patients were enrolled in a 6-month, open-label tolerability study of enteric-coated naproxen in patients with rheumatoid arthritis (n = 174) and osteoarthritis (n = 122). Thirty percent of the patients were greater than 65 years of age. Under standard clinical prescribing conditions, enteric-coated naproxen 500 mg twice daily and 375 mg twice daily demonstrated an acceptable tolerability profile that was not different from what one would expect with standard naproxen.

Adult↗
PubMed1991

Sera from patients with autoimmune disease recognize conformational determinants on the 60-kd Ro/SS-A protein.

Anti-Ro antibodies are found in a large proportion of patients with systemic lupus erythematosus and primary Sjögren's syndrome. These antibodies also characterize neonatal lupus, subacute cutaneous lupus erythematosus, and vasculitis associated with Sjögren's syndrome and rheumatoid arthritis. Anti-Ro-positive sera may contain either or both of 2 sets of antibodies, recognizing either a 60-kd or a 52-kd polypeptide component of the Ro particle. We found in this study that the immune response to the 60-kd Ro antigen is heterogeneous. Some sera specifically recognize the native Ro antigen but fail to bind the corresponding denatured polypeptides. In addition, after immunodepletion using the denatured 60-kd Ro polypeptide, all anti-Ro-positive sera tested still contained high titers of antibodies recognizing conformational determinants on the Ro antigen. The frequent immunodominance of anti-Ro antibodies targeted to conformational determinants suggests that native autoantigens may directly drive the autoimmune response.

Antibodies, Antinuclear↗
PubMed1988

Stiffness of the rib cage in a subset of rheumatoid patients.

In a previous investigation of lung function in patients with rheumatoid arthritis (RA), we observed that some patients had significant dysfunction of their chest wall mechanics without pleural disease that could contribute to their respiratory symptoms. To investigate further the chest wall functions of patients with RA, we selected 10 female lifetime nonsmoking patients with RA and compared them to 10 paid normal volunteers in detailed functional evaluations of lung and chest wall. Patients with significant airflow limitation were excluded from this study. We found a significant 7% reduction in total lung capacity in the RA patients without significant change in lung compliance. However, we found a significant reduction in rib cage compliance in patients with RA (0.044 +/- 0.006 L/cmH2O vs. 0.064 +/- 0.012 in controls), which was associated with a significant 38% reduction in expansion of the rib cage volume during various breathing maneuvers. These changes occurred in the absence of lung or pleural disease. This study documents that patients with RA have limited expansion of rib cage relative to abdomen, thus rib cage restriction and stiffness, which may contribute to reduced lung volume. The shift of thoracoabdominal breathing configuration observed in patients with RA will likely reduce the effectiveness of breathing muscles and thus could contribute to the dyspnea sensation experienced by patients with RA.

Arthritis, Rheumatoid↗
PubMed1988

Clinical significance of anti-Ro(SSA) antibody in rheumatoid arthritis.

A group of 12 patients with rheumatoid arthritis (RA) with anti-Ro antibody were compared to an age and sex matched group with RA. Both had similar articular manifestations but the anti-Ro positive patients had more severe extraarticular as well as serological abnormalities. Vasculitis, liver abnormalities, neutropenia and circulating immune complexes were prominent while sicca features were not. Treatment with remission inducing drugs failed frequently without increased toxicity. Two patients with classical RA with anti-Ro developed subacute cutaneous lupus erythematosus and anti-dsDNA. Our observations suggest that the presence of anti-Ro in RA sera may be a marker for a small but significant subset of rheumatoid disease.

Anti-Inflammatory Agents↗
PubMed1988

Destructive spondyloarthropathy in short term chronic ambulatory peritoneal dialysis and hemodialysis.

Of the many rheumatic manifestations of kidney failure treated by longterm dialysis, a destructive spondyloarthropathy has recently been recognized. We performed a survey of our small, relatively short term (3-year average) dialysis population of 45 patients to establish a prevalence figure and establish a data base to assess risk factors. Destructive spondyloarthropathy was seen in 4 of 34 patients receiving hemodialysis and in 2 patients receiving chronic ambulatory peritoneal dialysis (CAPD). Age of the patient (p less than 0.09) and duration of dialysis (p less than 0.05) seem to be associated risk factors. Although it may be coincidental, radiological and biochemical hyperparathyroidism can be clearly dissociated from destructive spondyloarthropathy. The very peculiar quasiconstant, asymptomatic and early cervical localization of destructive spondyloarthropathy suggests a local mechanical factor accentuated by crystal and/or amyloid deposition disease which may become overwhelming as survival is prolonged.

Adult↗
PubMed1987

Airways disease in rheumatoid arthritis patients. One element of a general exocrine dysfunction.

Airflow limitation is a frequent finding in patients with rheumatic diseases. We have previously suggested that it is associated with autoimmune exocrinopathy in Sjögren's syndrome. To compare clinical features of patients with and without airways dysfunction and to further test the hypothesis of a link between airways disease and exocrinopathy, we prospectively studied 2 groups of 15 lifetime nonsmoker female patients with seropositive rheumatoid arthritis (RA). The 2 groups were similar in their clinical and immunologic features, but differed in terms of airways function. Salivary, lacrimal, and sweat gland dysfunction were significantly more prevalent or severe in the group with airways disease. Antinuclear antibodies were also more prominent in the patients with airways disease, but antibodies against RNP, SS-A, SS-B, and double-stranded DNA were not present in these patients. HLA-DR4 was found in 80% of the RA patients with airways disease and in 57% of those without airways disease. HLA-B8 and DR3 were equivalently distributed in both groups. This prospective study further documents the existence of small airways disease in RA and supports the view that autoimmune exocrinopathy predisposes to its expression.

Adult↗
PubMed1987

Primary septic arthritis in heroin users: early diagnosis by radioisotopic imaging and geographic variations in the causative agents.

We reviewed 37 cases of septic arthritis in heroin users. Our data confirm the predominance of the fibrocartilaginous joint infections in this group (sacroiliac joint 39%, chondrosternocostal unions 37%). In Spain, Staphylococcus aureus is the most commonly isolated organism (73%). This emphasizes the geographic variations in the causative germs since, in contrast to other reports, we have not identified any gram negative bacillary arthritis in our population of heroin users. Our data show that the 67gallium citrate scintigraphy is positive earlier than the 99mTc-MDP bone scan in the poorly vascularized joints (p less than 0.0005). The early localization of the infectious focus by 67gallium citrate scintigraphy followed by a prompt bacteriologic diagnosis (blood, synovial fluid or tissue cultures) allowed good therapeutic results.

Adolescent↗
PubMed1986

Eosinophilic synovitis: clinical observations on a newly recognized subset of patients with dermatographism.

Eosinophilia of synovial fluid is uncommon. Using the identification of Charcot-Leyden crystals to alert for the presence of eosinophils, we have increased by a factor of 5 the detection rate of synovial fluid eosinophilia. We describe here our clinical and laboratory findings in 7 patients with this feature. We believe they constitute a defined syndrome. Typically, the patients were young (ages 18-51) and had a personal and family history of allergy. They developed an acute, painless monarthritis after a minor trauma, and had no concurrent allergic symptoms. Each episode resolved in 1-2 weeks without therapy, and 3 patients had recurrences. All had pronounced dermatographism. The synovial fluid was mildly inflammatory: 10,850 +/- 3,665 white blood cells/mm3, with 41 +/- 5% eosinophils (mean +/- SEM). The cellularity and chemistry of the peripheral blood was unremarkable, except for a mild elevation of IgE levels (370 +/- 104 IU/ml). The exact pathophysiologic mechanism underlying this benign entity is not clear, but we suspect a nonimmunologic triggering event is operant, i.e., synovial trauma which mimics the cutaneous dermatographism.

Adult↗
PubMed1986

Immunological cross-reactivity of adenovirus structural proteins.

The interserotypic cross-reactivity of adenovirus-specific antisera was examined on Western blots of virion proteins. The pattern of cross-reactivity was very complex. Virion polypeptides III, VI and the core VII were the major reactants. Generally, the degree of reactivity correlated with type and subgroup specificity.

Adenoviridae↗
PubMed1985

Comparative esophageal and anorectal motility in scleroderma.

Esophageal and anorectal pressures were recorded in 26 patients (4 men and 22 women) with scleroderma. Eleven patients suffered from a localized form of the disease and 15 from progressive systemic sclerosis. The latter only had marked functional abnormalities in esophageal and anorectal motility. Mean resting pressure at the lower esophageal sphincter of patients with progressive system sclerosis and controls was, respectively, 6 +/- 2 and 25 +/- 1 mmHg (p less than 0.001); mean closing pressure was 5 +/- 5 and 48 +/- 3 mmHg (p less than 0.001); coordination of opening the lower esophageal sphincter with the oncoming contraction in the distal esophagus was 0% and 68% +/- 5% (p less than 0.001); and relaxation (fall of the lower esophageal sphincter pressure to resting levels in the stomach) was 18% +/- 12% and 98% +/- 1% (p less than 0.001). The rectoanal inhibitory reflex was of lesser amplitude than normal in 74% of patients with progressive system sclerosis and was absent in 13%. Quantitative analysis demonstrated a significant reduction in response to rectal distention with 20 or more ml of air (p less than 0.001). There was a correlation between the amplitude of the lower esophageal sphincter relaxation and the amplitude of the rectoanal inhibitory reflex in response to rectal distention with 30-50 ml of air (p less than 0.05 to p less than 0.025). Our data show that in systemic sclerosis, anorectal motility is as frequently abnormal as esophageal motility.

Adult↗