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N C Acritidis

Publications and source records attributed to N C Acritidis.

9 recordsLinked to original sources
PubMed2005

A single pulmonary rheumatoid nodule masquerading as malignancy.

We present a 54-year-old man, a heavy smoker, with clinical and laboratory evidence of familial hypercholesterolemia and an asymptomatic solitary pulmonary nodule (SPN) increasing in size on follow-up chest X-ray. Laboratory work-up revealed high titers of rheumatoid factor and the presence of acute phase reactants. Because of the patient's age and history of smoking, open lung biopsy was performed to rule out malignancy. The biopsy showed histological features compatible with a rheumatoid nodule. Identical features were noted in the histological examination of the subcutaneous nodule. Usually, rheumatoid nodules occur in patients with active, long-standing rheumatoid arthritis (RA) with other extra-articular manifestations. The presence of a single pulmonary rheumatoid nodule as the first manifestation of RA is extremely rare. Histologic proof is often required since pulmonary carcinoma can present an identical clinical and radiological pattern. The diagnostic work-up and the differential diagnosis of an SPN, particularly in a heavy smoker, is a common clinical request and remains a diagnostic challenge.

Decision Trees↗
PubMed1991

Sjögren's syndrome in patients with the CREST variant of progressive systemic scleroderma.

Twenty-three patients with the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) variant of progressive systemic sclerosis, were clinically, histopathologically and serologically examined for the presence of Sjögren's syndrome (SS). Fourteen were found to be positive. No significant difference could be demonstrated between them and the remaining 9. Characteristics of patients with CREST were compared with those of 29 randomly chosen patients with primary SS. Parotid gland enlargement was more frequently present (p less than 0.01) in the latter than in the former. Virtually no patients with CREST with SS had antibodies to Ro(SSA)/La(SSB).

Autoantibodies↗
PubMed1988

Pulmonary function of nonsmoking patients with giant cell arteritis and/or polymyalgia rheumatica; a controlled study.

The pulmonary function of 26 nonsmoking patients with giant cell arteritis (GCA) and/or polymyalgia rheumatica (PMR) was evaluated and the results were compared with those of 28 age and sex matched nonsmoking controls. Normal function was observed in 30.8% of the patients and 50% of the controls (p = non significant). Isolated small airways disease (SAD) was detected in a high percentage of the patients (46.2%), but not significantly different from that of the controls (50%). Its clinical significance remains to be answered. Obstructive, restrictive and diffuse interstitial lung disease (DILD) was seen in one, three and two patients respectively, but was absent in the control population. All the patients had a normal chest radiograph and were asymptomatic, except for three. Two of them had normal respiratory function and one DILD. It is speculated that DILD and restrictive disease, seen only in patients with biopsy proven GCA, may be related to the underlying process.

Aged↗
PubMed1988

Pulmonary function of nonsmoking patients with systemic lupus erythematosus.

The pulmonary function of 70 nonsmoking patients with systemic lupus erythematosus (SLE) was evaluated, and the results were compared with those of 70 age- and sex-matched, nonsmoking healthy individuals. Isolated reduction of carbon monoxide diffusing lung capacity (DCO), usually subclinical, was the most commonly detected functional abnormality in the SLE population, whereas it was absent in the comparison group. Isolated small airways disease (SAD) was observed in a relatively high percentage of patients, but not significantly different from that in the healthy people. Restrictive and obstructive patterns were very unusual in the SLE people and absent in the members of the comparison group. Finally, normal lung function was seen in the majority of the latter, but only in one third of the lupus patients. Subclinical respiratory dysfunction, most commonly expressed as diminished DCO, is a common feature of SLE.

Adult↗
PubMed1987

Secondary Sjögren's syndrome in rheumatoid arthritis.

One hundred and forty-three sequential, unselected patients with rheumatoid arthritis (RA) were prospectively evaluated for evidence of secondary Sjögren's syndrome (sSS). All of them had a labial salivary gland (LSG) biopsy, since a greater than or equal to 2+ score (Tarpley's classification) was considered mandatory for the diagnosis of sSS. One hundred eleven were completely investigated. The diagnosis of sSS was established when a patient with a positive LSG biopsy (greater than or equal to 2+ score) had keratoconjunctivitis sicca (KCS) (positive rose bengal test and/or the combination of subjective xerophthalmia and positive Schirmer's I) and/or xerostomia (subjective xerostomia and decreased parotid flow rate = [PFR]). Forty-four patients had an LSG biopsy score of greater than or equal to 2+, 28 a 1+ score and 39 a negative biopsy. Thirty-four of the 44 patients with positive biopsy had sSS, suggesting a 31% prevalence of sSS in RA. The 1+ score group represents a nonspecific category, resembling the negative biopsy group. Rose bengal test was very sensitive for sSS, whereas Schirmer's I and PFR were not. Parotid gland enlargement was unusual, and extraglandular manifestations, with the exception of diffuse interstitial lung disease, were relatively uncommon in all biopsy groups. No patient complained of xerophthalmia or xerostomia on his/her own. Anti-Ro (SSA) antibodies, detected in 23.5% of the patients with sSS, correlated well with positive LSG biopsy. Our study suggests that sSS in RA is common, benign and subclinical, requiring a positive lip biopsy and specific tests for its diagnosis.

Adult↗
PubMedDate not supplied

CT evaluation of mediastinal lymph nodes in primary Sjögren syndrome.

Computed tomography was used to evaluate mediastinal lymph nodes of 25 patients with primary Sjögren syndrome (pSS) and in 38 control subjects. Abnormally enlarged nodes, according to accepted CT criteria, were detected in four pSS patients and in 10 control subjects (differences not significant). The presence of enlarged mediastinal nodes did not correlate with peripheral lymphadenopathy, splenomegaly, parotid enlargement, or cryoglobulinemia in the pSS group. One pSS patient with pseudolymphoma and another with non-Hodgkin lymphoma did not have enlarged mediastinal lymph nodes. Our results suggest that the detection by CT of slightly enlarged mediastinal nodes, invisible in plain radiography, in pSS patients is of uncertain clinical significance.

Adult↗
PubMedDate not supplied

High C-reactive protein response in lupus polyarthritis.

Five out of 6 patients with systemic lupus erythematosus (SLE) and chronic polyarthritis were found to have significantly raised (greater than 20 mg/l.) C-reactive protein (CRP) levels. In contrast, slight elevations in CRP levels were present in only 5 of 16 SLE patients without chronic polyarthritis. Thus, an elevated CRP level might be a distinctive feature of SLE patients with chronic polyarthritis.

Adolescent↗
PubMedDate not supplied

Serum C-reactive protein in primary Sjögren's syndrome.

Only 11 out of 50 patients with primary Sjögren's syndrome were found to have minimal or moderate increases of C-reactive protein (CRP) levels. Patients with elevated CRP levels did not differ clinically from those with normal CRP levels. Thus, primary Sjögren's syndrome is one of the inflammatory disorders characterized by a relatively low CRP response.

Adult↗