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Biomedical subjects

R S Rothwell

Publications and source records attributed to R S Rothwell.

9 recordsLinked to original sources
PubMed1981

Relationship between serum ferritin, anemia, and disease activity in acute and chronic rheumatoid arthritis.

The assessment of anemia in patients with rheumatoid arthritis may be difficult, especially when iron deficiency and the anemia of chronic disease coexist. The development of a radioimmunoassay for serum ferritin concentration has aided the detection of reduced body iron stores in uncomplicated iron deficiency, but its use is compromised in clinically active rheumatoid arthritis by the tendency of serum ferritin to behave as an acute phase reactant. In this latter role it correlated well with disease activity in the patients we studied. Followed serially, serum ferritin levels fell in patients whose disease activity improved after institution of appropriate therapy. In anemic patients with clinically inactive disease, supplemental iron was associated with a significant rise in hemoglobin when compared to untreated patients. Serum ferritin levels behaved independently of hemoglobin levels. Therefore even in clinically inactive rheumatoid arthritis, serum ferritin does not accurately reflect an iron deficiency.

Adult↗
PubMed1981

The absence of circulating immune complexes in patients with ankylosing spondylitis.

Sera from 50 patients with well-defined ankylosing spondylitis were examined for circulating immune complexes using both a Clq binding (fluid phase) assay and a Raji cell assay. No more than five of the patients assessed had circulating immune complexes by either one of these techniques and none were positive in both. This result is in contrast to the high prevalence in sera from unselected patients with rheumatoid arthritis and systemic lupus used as positive controls.

Adult↗
PubMed1981

Radionuclide bone scanning in females with chronic low back pain.

Sixty female patients with chronic low back pain have been studied clinically, radiographically, and by radionuclide bone scanning for evidence of sacroiliac disease. Twenty-four patients had quantitative sacroiliac scintigraphy (QSS) results suggesting sacroiliitis. In only one of these patients was the radiograph abnormal. Clinical and laboratory examinations failed to reveal any possible associated aetiological factors. Six-month follow-up of 18 patients showed that subjective improvement of pain is associated with a return to normal of QSS results, often secondary to anti-inflammatory medication. It is concluded that sacroiliac disease may be a common cause for chronic low back pain in women and that its presence may be missed if radiographs are relied upon to confirm the diagnosis. Its aetiology remains obscure.

Adolescent↗
PubMed1980

A controlled study of plasma exchange in the treatment of severe rheumatoid arthritis.

To learn whether the removal of immune complexes from the circulation by plasma exchange could effect an improvement in disease activity in rheumatoid arthritis (RA) patients, we performed a controlled study of 20 patients, we performed a controlled study of 20 patients with severe progressive disease which had not responded to previous therapy. Ten patients (Group 1) were hospitalized, continued on their regular anti-inflammatory medication, and given a graded course of physiotherapy. A further 10 patients (Group 2) received the same treatment as the first group with the addition of a concurrent course of plasmapheresis. Clinical measurement of disease activity after treatment revealed little difference between the two groups with a statistically significant improvement in four measures in Group 1 and in five in Group 2. Laboratory studies suggested that the intensity of plasma exchange was sufficient to remove circulating immune complexes in these patients. Our results confirm that hospitalization in itself is of benefit in the treatment of acute exacerbations of rheumatoid arthritis. The marginal improvement achieved by the addition of plasma exchange in the management of these patients (despite the removal of circulating immune complexes) makes its short-term use of questionable value in the treatment of severe rheumatoid arthritis.

Adult↗
PubMed1980

Angioimmunoblastic lymphadenopathy associated with polyarthritis.

A patient with angioimmunoblastic lymphadenopathy with dysproteinaemia is described. The patient had a severe clinical illness with a pronounced haemolytic anaemia, which followed well-established polyarthritis and gold therapy. It was accompanied by in-vitro evidence of suppressed cell-mediated immune responses and by development of serum antismooth muscle antibodies. These features are unusual and support theories that this disease has an immunological basis. Improvement occurred with prednisone and azathioprine therapy, suggesting that combined use of these agents is useful in some patients with AILD. The patient subsequently developed a lymphoma.

Anemia, Hemolytic↗
PubMedDate not supplied

Methotrexate levels, a guide to therapy?

Methotrexate (MTX) is being used with increasing frequency in the treatment of inflammatory arthritis. Seventy-one patients have been treated with MTX with only five ceasing treatment because of toxicity. From a study of the serum levels of this drug, we believe that 10 mg intramuscularly once per week should be an optimum method of treating arthritis. The measurement of a 24 hour serum level of MTX, which normally is less than 0.01 mumole/litre after 10 mg I.M., should aid in identifying those patients more at risk of developing toxicity.

Aged↗
PubMedDate not supplied

Splenic reticuloendothelial function in patients with active rheumatoid arthritis.

Splenic reticuloendothelial function was assessed in 20 patients with active rheumatoid arthritis by measuring the clearance of autologous heat-damaged labeled erythrocytes from the circulation. Eight patients (40%) had delayed clearance but in contrast to previous reports, we found no correlation between disease activity, levels of circulating immune complexes and splenic hypofunction. The absence of IgM rheumatoid factor was noted in 7 of 8 patients with delayed clearance times.

Adult↗