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Adverse events in rheumatoid arthritis patient with etanercept therapy: The appearance of osteomalacia
No full textRheumatoid arthritis (RA) is a systemic autoimmune disease of unknown origin that predominantly involves synovial tissue. RA affects 0.5-1% of the global population, with females affected more frequently than males. Patients receiving standard care for RA have significantly better status in 2000 than in 1985, associated with aggressive treatment strategies, prior to the introduction of biologic agents. Disease-modifying antirheumatic drugs (DMARDs) decrease clinical signs and symptoms in RA. Methotrexate, leflunomide and biological agents are analyzed. Glucocorticoids have long been recognized to have beneficial effects in RA. Rickets and osteomalacia are metabolic bone diseases due to a mineralization defect as principal pathophysiology. The Autors present a case report on a female patient with RA in treatment con etanercept and with osteomalacia (secondary?)
Complication after vertebroplasty in patient with senile osteoporosis: Strategical therapy to revise?
No full textCompression fractures are common in patients with osteoporosis and they are crippling. By 1892, Julius Wolff et al. realized that mechanical loads can affect bone architecture in living beings, but the mechanisms responsible for this effect were unknown, and it had no known clinical applications. In 2003 we know how this effect occurs and some of its applications. Vertebroplasty and kyphoplasty are relatively new techniques used to treat painful vertebral compression fractures. Percutaneous vertebroplasty is a therapeutic, interventional radiologic procedure. The technique consists of the percutaneous puncture of the affected vertebral body, followed by injection of bone cement into a vertebral body for the relief of pain, and the strengthening of the bone. This procedure also carries a risk of complications, and the fracture risk of vertebrae adjacent to cement vertebrae may be increased. The authors describe a case of vertebrae's fractures adjacent to cement vertebrae that are occured in a patient with senile osteoporosis
RANKL/RANK, OPG and OPT in a group of patients affected by chronic arthritis. Preliminary report
No full textRecently, receptor activator of nuclear factor-kB ligand (RANKL), its receptor RANK, and the decoy receptor osteoprotegerin (OPG), have been identified as paracrine mediator of bone functions. The balance of RANKL/RANK and OPG is critical for osteoclastogenesis modulation and physiological bone remodeling. Osteopontin (OPN) is an extracellular glycosylate bone phosphoprotein and acts both as chemokine and cytochine. It is produced by osteoclast, macrophages, T cells, hematopoietic cells and vascular smooth muscle cells. It is present particularly at high concentration in the lamina limitans and cement line, suggesting its role in the initiation and termination of the bone turnover. Chronic arthritis are a group of rheumatic patologies characterized by periodical continuous or desultory use of corticosteroides. The main aims of this study are to valuate OPG, RANKL and OPN serum concentrations in patients affected by chronic arthritis and to compare the above results with those ones obtained by young healthy population. OPG, RANKL and OPN serum concentration has been measured by ELISA method both in 40 patients affected by chronic arthritis then in young healthy population of 81 subjects. The differences between the two considered groups have been analyzed using unpaired T-Student. The difference between the two groups is significant for considered variables: OPG: t=-6,54, p<0,001; RANKL: t=-2,71, p=0,008; OPN: t=2,55, p=0,01. These results suggest that RANKL/RANK system, OPG and OPN have important role in patients with chronic arthritis
Osteoporosis in adult with Marfan syndrome: casuality or causality?
No full textMarfan syndrome (MFS) is an inherited connective tissue disorder transmitted as an autosomal dominant trait. Recent studies indicate that decreased bone mineral density (BMD) occurs in the spine, femoral necks and greater trochanters of some adults and children with MFS. Since there is uncertainty regarding the BMD status of patients with MFS, the authors present a case report on a female patient with MFS and alteration of phosphocalcic metabolism
Etanercept in the treatment of rheumatoid arhritis. A case report
No full textAuthors present a case of a patient affected by rheumatoid arthritis, non responder to the different DMARDs treatment; besides some of these treatments have even provoked relevant side effects. It has been attempted the use of biological therapy, using etanercept. After some months of this treatment with a high performance of the therapy and great subsidence of the disease, the appearance of a severe infection has compelled the interruption of the therapy, causing very slow recovery. Authors underline the relevant importance of a careful and constant observation of the patients under biological therapy, since it could be always possible the appearance of serious infections
Hereditary thrombophilia and systemic sclerosis. An unusual case report
No full textAuthors describe a case of systemic sclerosis with deep venous thrombosis. Great attention must be taken for this case because it represents the condition of hereditary thrombophilia. No similar case was reported in literature; therefore, further studies must go ahead understand the possible relation between the two pathologies
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