Serum baseline hyaluronate and disease activity in rheumatoid arthritis.

The baseline serum hyaluronate (HA) concentration from samples obtained five to seven hours after mobilization of the patient was quantified using a radiometric 125I-HA binding method in 58 patients with rheumatoid arthritis and compared with several clinical and laboratory parameters by means of stepwise multiple linear regression. In the age- and sex-adjusted model, the variables with independent predictive value for serum hyaluronate concentration were the erythrocyte sedimentation rate (ESR) and the joint score index measuring the extent of the synovial inflammation. The estimated synovial mass index and C-reactive protein values did not improve the fit of the model after ESR and joint score were entered, and were left out from the multiple regression equation. When ESR and joint score were studied in univariate regression analysis with serum hyaluronate, the coefficients were r = 0.492 and r = 0.397, and the P values were P less than 0.001 and P less than 0.005, respectively. It was concluded that the baseline hyaluronate level in serum is closely related to the synovitic activity of the rheumatoid inflammation and that measurement of serum hyaluronate is of value when the activity and extent of synovial inflammation is being assessed in patients with rheumatoid arthritis.

Oral parameters for the diagnosis of Sjögren's syndrome.

Agreement is probably world wide in the medical profession that patient history is the most relevant part of the patient examination, but at the same time the most demanding part because there is no substitute to lack of knowledge and experience. These form the basis for an often subconscious process of selecting the most important pieces of information to help in decision making. We describe a stepwise forward discriminant analysis with a jackknife-validation in analysis of questionnaires as to diagnosis of Sjögren's syndrome. The second topic of current interest, also due to the need of generally acceptable criteria for diagnosis and classification, is the place of labial salivary gland (LSG) biopsy in such sets of criteria. In the histopathological part of our work we describe findings of a postmortem LSG study from the coroner's office.

Effect of vitamin A treatment on immune reactivity and lipid peroxidation in patients with Sjögren's syndrome.

Patients with Sjögren's syndrome were treated with vitamin A (100,000 U) daily during a two-week period. The vitamin treatment significantly elevated their ADCC and NK activity. The lymphocyte blast transformation, however was not noticeably changed. After the treatment, the retinyl-ester and retinol level of the plasma significantly increased as did the plasma level of vitamin E. The level of TBA reactive substances (malondialdehyde) in the plasma increased, whilst the glutathione peroxidase and catalase activity of erythrocytes decreased. The activity of the plasma glutathione peroxidase increased, but not significantly.

Cyclosporin and sulfasalazine combination in the treatment of early rheumatoid arthritis.

The aim of the study was to assess the efficacy of a new formulation of cyclosporin-A (CyA) and sulfasalazine (SASP) combination treatment in preventing disability and reducing inflammatory disease activity in patients with early rheumatoid arthritis, as well as to assess the tolerability, safety, and suitability for long-term treatment. Forty five patients with early, active rheumatoid arthritis, (RA) were treated with CyA and SASP combination therapy for 12 months. The patients were evaluated by disease activity and radiologic measurements. The combined CyA and SASP therapy seems to be effective. Disease activity parameters improved within 3 months. The individual treatment response rate according to EULAR response criteria was 78% after a one year treatment period. Five patients were withdrawn due to gastrointestinal side effect and two patients because of lack of efficacy. CyA and SASP combination treatment seems to be effective in early severe RA, and with careful monitoring, side effects can be kept under control.