A clinical evaluation of indomethacin employing a controlled, cross-over technique with an inert placebo was undertaken in 30 patients with ankylosing spondylitis. Patients were studied for the frequency and dose relationship of side effects and for the subjective response of morning stiffness, chronic spinal pain, acute exacerbations of pain and peripheral arthralgia. Objective evaluation assessed measured change in movements of the cervical and lumbar spines, in chest expansion and in the range of movement of involved peripheral joints.Evaluation of the results indicated that a significant number of patients experienced side effects in the form of headache and dizziness while receiving indomethacin in doses above 150 mg. per day. Many other side effects reported by the patients were not found to occur at a statistically significant level. The significance of pulmonary infections encountered in three patients was reviewed. Relief of chronic spinal pain and peripheral arthralgia occurred in 14 and 16 patients, respectively (p < 0.05). Relief of morning stiffness and acute exacerbations of pain, and increase in the range of movement of any of the segments of the spine or the involved peripheral joints were not significant (p > 0.05). Based on the results of this study, it is suggested that the role of indomethacin in the management of ankylosing spondylitis be re-evaluated and that the daily therapeutic dose of this drug which has been heretofore recommended be decreased.

Alkaline Phosphatase↗

PubMed1966

Ankylosing spondylitis: a late re-evaluation of 92 cases.

Ninety-two patients who satisfied the criteria proposed by Kellgren for the diagnosis of ankylosing spondylitis were re-evaluated by clinical, radiological and laboratory parameters after an average length of illness of 18.7 years. The following associated clinical lesions were studied: aortic insufficiency 8%, heart block 3%, iritis 11%, and other associated lesions. Long-term effects of x-ray therapy were evaluated by comparing irradiated and non-irradiated patients; no significant difference was noted in the clinical course of these two treatment groups. On serum protein electrophoresis no characteristic dysproteinemia was demonstrated; in no instance was there a marked hypergammaglobulinemia. Test results for rheumatoid factor, antinuclear factor and antithyroglobulin were all within the range expected for a normal population. In addition to bilateral sacroiliitis, several other characteristic radiological lesions, such as anterior spondylitis, were present in a high percentage of cases. It is suggested that the diagnostic criteria proposed by Kellgren, although useful, should be enlarged and refined.

Humans↗

PubMed1966

The plasma phenolsulfonphthalein index (PSPI) of renal function. II. Correlation with other parameters of renal function and indications for use.

The plasma phenolsulfonphthalein index (PSPI) was determined in 175 subjects and was compared with levels of blood urea nitrogen (BUN) and serum creatinine, 15-minute urinary excretion of PSP, and clearance of creatinine, PAH and inulin. Statistical analyses indicate that the PSPI measures the same function as the 15-minute urine test when PSP is administered in a dosage of 1 mg./kg. body weight; and that, although the index cannot be used as a precise substitute for PAH clearance, it is equally repeatable and no greater error is associated with its measurement. The PSPI has been found of most value when complete, accurately timed urine collections are unobtainable because of urological abnormality or inability of the patient to co-operate.

Adolescent↗

PubMed1965

Adrenocortical hyperfunction associated with bronchogenic carcinoma: report of five cases.

Five patients with bronchogenic carcinoma associated with adrenocortical hyperfunction are described. The clinical features, laboratory studies and autopsy findings are discussed and compared with previously reported cases. Four patients presented most of the typical features of this disorder as previously described, whereas the fifth was atypical in some respects. Typical features included: acute onset of adrenocortical hyperfunction in a middle-aged male, rapid downhill course, slight or absent physical signs of Cushing's syndrome, frequently impaired glucose tolerance, markedly elevated plasma and urinary 17-hydroxycorticosteroids not suppressed by exogenous steroids, absent diurnal variation of plasma corticoids, hypokalemic alkalosis with normal aldosterone excretion, and tumour histology of the oat cell variety. The adrenal glands of two patients were of normal or slightly increased weight, and mean 17-ketosteroid excretion values were normal in three; this contrasts with the marked increase in adrenal weight and 17-ketosteroid excretion in most reported cases.

17-Ketosteroids↗

PubMedDate not supplied

Studies of isolated synovial living cells of rheumatoid and nonrheumatoid synovial membranes.

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Adult↗

PubMedDate not supplied

Correlative studies of lymphocyte transformation and plasma protein levels in ankylosing spondylitis.

Lymphocyte transformation was studied in 24 patients with ankylosing spondylitis (AS), 21 with rheumatoid arthritis (RA) and 23 control subjects (CS). Enhanced transformation was found in response to phytohemagglutinin (PHA) (p less than 0.01) and human aggregated gamma globulin (p less than 0.025), but not to inulin, for AS patients. Correlation coefficients between the concentrations of each of 8 AS plasma proteins and PHA-induced lymphocyte transformation in autologous plasma showed significance only for C-reactive protein (CRP). However, co-culture experiments with PHA in autologous and allogeneic (AB) plasma, and in CRP-devoid AB serum showed no specific enhancing effect by AS plasma on lymphocyte responses. Although these studied demonstrate that AS is frequently characterized by enhanced in vitro transformation to T lymphocyte dependent mitogens, this response does not appear to be related to the known immunoregulatory properties of CRP.

Adolescent↗

PubMedDate not supplied

CRP: an immunoregulatory protein.

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Agglutinins↗

PubMedDate not supplied

Clinical features of systemic lupus erythematosus patients with antihistone antibodies.

The presenting features of 25 systemic lupus erythematosus (SLE) patients with antihistone antibodies were compared to 25 age and sex matched patients who had antibodies to Sm, ribonuclear protein, Sjögren's syndrome antigen B and native DNA. The SLE patients with antihistone antibodies had a significantly lower frequency of renal disease, central nervous system disease, alopecia, anemia and hypocomplementemia. Nine of 25 (36%) age and sex matched RA patients had antihistone antibodies but in lower titers than the SLE patients. There was no correlation of antihistone antibody titers with disease activity, corticosteroid therapy or rheumatoid factor titer. Histone-antihistone complexes did not bind complement components of either the classical or alternative pathway of complement.

Adolescent↗

PubMedDate not supplied

Pyogenic sacroiliitis. Diagnosis and significance.

Two patients are described with unilateral pyogenic sacroiliitis, 1 complicating intravenous heroin addiction and the other complicating a septic skin lesion. The need for diagnostic alertness in the early recognition of this uncommon condition is illustrated and the apparent lack of relationship of pyogenic sacroiliitis to idiopathic ankylosing spondylitis is discussed.

Adult↗