, Cheol Keun Park, Hae Ryong Yun, Daehoon Kim, Soo-Kon Lee, Sang-Won Lee As a new humanized monoclonal antibody against the interleukin-6 receptor, tocilizumab is currently used for the treatment of rheumatoid arthritis (RA) patients. Tocilizumab was reported to provoke drug-related liver toxicity, although there have been no reports on significant liver toxicity from tocilizumab in Korean patients with RA to date. Here, we describe the first case of tocilizumab-related liver toxicity in a patient with complicated RA, accompanied with macrophage activation syndrome, who had received tacrolimus and prednisolone and in whom both conventional disease modifying anti-rheumatic drugs, including methotrexate, leflunomide and sulfasalazine or tumor necrotizing factor-α blockades, were contraindicated due to drug eruption and a history of lung cancer.
Citations
In ostroarthritis and rheumatoid arthritis, β-glucuronidase activity was measured in body fluid to diagnose this special disease entities.
The β-glucuronidase activity was studied in the urine, serum and joint fluid. The level of this specimens were estimated by statistical sections.
1) The β-glucuronidase activity in urine, serum and joint fluid of osteoarthritis patients were 0.09U/l urine, 0.14U/l serum, 0.06U/l joint fluid. The highest level of activity was in the serum.
2) The β-glucuronidase activity on rheumatoid arthritis was 0.19U/l urine, 0.17U/l serum, 0.07U/l joint fluid. The highest increased level of activity was in the urine.
3) In the joint fluid and serum, there is the no mean of stistical analysis. But in the urine, there is marked meaning of statistical analysis(Male : p=0.0041, Female : p=0.0001).
β-glucuronidase activity was influenced by osteoarthritis and rheumatoid arthritis. Especially in the urine, β-glucuronidase activity was outstanding statistical meaning. According to disease entities, The level of activity was different from each specimen.
, JiSoo Lee, Eun-Suk Kang To evaluate the clinical significances of antibodies to cyclic citrullinated peptides (anti-CCP) and IgM Rheumatoid Factor(RF) in patients with established rheumatoid arthritis.
The subjects included 86 established RA patients according to the revised ACR criteria and 46 non-RA patients presenting joint manifestations and 61 healthy individuals as control. Anti-CCP and IgM RF were measured by ELISA and nephelometric method, respectively.
The sensitivity and specificity of anti-CCP were 64% and 98% and of IgM RF were 69% and 76%, respectively. Eleven (4 I %) out of 27 sero-negative RA patients had elevated anti-CCP. Combination of anti-CCP with IgM RF increased diagnostic sensitivity and specificity of RA to 81% and 99%, respectively.
Simultaneous measurement of IgM RF and anti-CCP for the initial evaluation of arthritis would increase the diagnostic efficacy of RA.
, Jisoo Lee To examine the management status of patients with rheumatoid arthritis (RA) taking glucocorticoids treated at a tertiary hospital rheumatology Practice.
A retrospective chart review was performed on 114 RA patients who were noted to be taking glucocorticoids during the period of 2000.7 to 2003.7, and who had been followed up for at least one year period. Use of bone densitometry and use of prescription medication for osteoporosis management were assessed.
Thirty one % of patients underwent bone densitometry, and 34% of patients received prescription medication for osteoporosis management. Sixty-six percent of patents who underwent bone densitometry showed osteoporosis with T score of less than 2.5, Osteoporosis medication was prescribed most often in the prednisolone exposure group of at least 7.5mg/d for at least 6 months. Factors associated with not receiving management for osteoporosis included male sex, young age, and premenopausal woman.
The use of bone densitometry and prescription medication for osteoporosis were suboptimal. Interventions to improve detection and prevention of glucocorticoid induced osteoporosis are necessary.
, Wha Soon Cjung Systemic lupus erythematosus(SLE) and rheumatoid arthritis(RA) are the widely recognized rheumatic diseases of unknown etiology in which extensive immune dysfunction has been reported. Cytokines are considered to be the most important secretions of the immune system that participate in a variety of cellular, inflammatory and pathogenic processes in human disease. Since imbalance of the cytokine network in autoimmune disease may be detrimental for the severity or clinical manifestation of the disease, I determined serum level of IL-6 in patients with SLE, RA, and normal controls.
The results were as follows:
1) The serum levels of IL-6 in patients with SLE(p=0.0032) and RA(p=0.0001) were significantly higher than those of normal controls.
2) The serum levels of ESR, CRP, and complements did not correlated with serum IL-6 levels. Only the levels of anti-dsDNA in patients with SLE showed correlation with that of serum IL-6. And the serial follow-up of serum IL-6 levels in 6 systemic lupus erythematosus patients show no significant correlation.
3) There were no significant correlation between serum IL-6 of RA patients and disease activity markers such as CRP and rheumatoid factors.
This results indicate that serum IL-6 levels of SLE and RA patients were significantly higher than that of normal controls, and needs further study to be used as a marker for disease activity.
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