Polyarthritis disease

Lipid abnormalities are associated with a wide spectrum of pathological conditions. In particular, recent advances have been made in understanding the role of lipoproteins in coronary heart disease (Davies and Woolf, 1993). However, included within the spectrum of diseases associated with perturbations of lipid metabolism are a number of musculoskeletal problems including inflammatory polyarthritis, tenosynovitis, osteoporosis and bone cysts. 

There is a long-standing hypothesis that the microvasculature plays a pathological role in forms of chronic inflammatory polyarthritis, particularly RA (Rothschild and Masi, 1982). One of the proposed mechanisms of vascular damage in connective tissue disease is the direct action of a cytotoxic serum factor inducing endothelial cell damage. Blake et al. (1985) have su ested that the vascular abnormalities associated with RA may be linked to oxidized lipoproteins because they are cytotoxic to endothelial cells. 

Suggested Alternatives for Differential Diagnosis Foot-and-mouth disease, vesicular stomatitis, peste des petits ruminants, photosensitisation, nasal botfly infestation, pneumonia, akabane infection, epizootic hemorrhagic disease of deer, contagious ecthyma, polyarthritis, footrot, foot abscesses, plant poisonings, and coenurosis. 

Indomethacin is used in rheumatoid arthritis, nonspecific infectious polyarthritis, gouty arthritis, osteoarthritis, ankylosing spondylitis, arthrosis, back pain, neuralgia, myalgia, and other diseases accompanied by inflammation. Synonyms for indomethacin are, among others, metindol, indacide, and rumacide. 

Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory joint disease. It is a progressive symmetrical, destructive and deforming polyarthritis affecting proxi-... 

The alphaviruses are a group of 26 icosahedral, positive-sense RNA viruses primarily transmitted by mosquitoes [64]. These 700-A-diameter viruses are some of the simplest of the membrane-enveloped viruses, and members of this group cause serious tropical diseases with characteristic symptoms such as myositis, fever, rash, encephalitis, and polyarthritis [65]. The structures of two different alphavirus-Fab complexes have been determined by cryo-TEM Ross River virus (RR) and Sindbis virus (SIN) [66]. The amino acid sequences of the RR and SIN virus structural and nonstructural proteins are 49 and 64% identical, respectively [67]. The viral RNA genome and 240 copies of the capsid protein form the nucleocapsid core [68-73], and the El and E2 glycoproteins form heterodimers that associate as 80 trimeric spikes on the viral surface. Native SIN and RR lack the E3 glycoprotein because it disassociates from the spike complex after its display on the plasma membrane surface [74, 75]. El has a putative fusion domain that may facilitate host membrane penetration [76, 77]. E2 contains most of the neutralizing epitopes and is also probably involved in host cell recognition [78-80]. 

Differential diagnosis Palmar erythema is also found in pregnancy, in hyperthyroidism, collagen diseases, endocarditis, long-standing feverish conditions, tuberculosis, diabetes mellitus, malignant tumours, chronic polyarthritis and in cases of malnutrition — as well as in healthy people. 

Men and women are affected with the same frequency at almost any age. Familial forms have been described. (63) There is an association with polyarthritis, coeliac disease (58), PSC, PBC (61), sarcoidosis, Budd-Chiari syndrome, and collagenoses or myeloproliferative diseases. A connection with thorotrast (59), immunosuppressives, cytostatics and contraceptives or androgens as... 

Adult Still s disease presents with seronegative polyarthritis, febrile attacks, lymphadenopathy, skin symptoms, hepatosplenomegaly, jaundice and involvement of the pleura and pericardium. The liver is enlarged in about 30% of patients transaminases may be slightly elevated. Periportal lymphocytic infiltrates and Kupffer cell proliferation can be demonstrated histologically. (68, 69)... 

Pillans PI, Tooke AF, Bateman ED, Ainslie GM. Acute polyarthritis associated with azathioprine for interstitial lung disease. Respir Med 1995 89(l) 63-4. 

In a large worldwide analysis of BCG adverse effects (1948-74) co-ordinated by the International Union Against Tuberculosis and Lung Disease (SED-12, 795) there were 272 cases of lesions of bones and joints, including synovial lesions. However, case reports of arthritis after BCG vaccination in healthy individuals are rare. Polyarthritis has been reported in a 33-year-old healthy woman 3 weeks after BCG vaccination (52). 

There was an unexpectedly high incidence of rheumatoid and lupus-like symptoms (27 of 137 patients), namely arthralgia, arthritis, myalgia, and Raynaud s phenomenon, in patients with myeloproliferative disorders taking interferon alfa alone or combined with interferon gamma (365). However, only a minority of affected patients fulfilled the diagnostic criteria for systemic lupus erythematosus. By contrast, systemic autoimmune diseases appeared to be genuine but very rare complications of interferon alfa in chronic hepatitis C, with only one case of lupus-like syndrome and two cases of polyarthritis in a survey of 677 patients (18). 

Metrifonate, which is given orally, is effective in Schistosoma hematobium infections in three doses of 7.5-10 mg/kg 14 days apart. When metrifonate was used in daily doses, as in the treatment of Onchocerca volvulus infections, it produced muscarinic effects, and in one case there was proximal weakness due to a nicotinic effect. The combination of polyarthritis, fever, and a raised sedimentation rate was described in 11 of 34 patients treated. Metrifonate inhibits blood cholinesterase activity for up to 48 hours, and common reactions that probably result from this effect comprise nausea, vomiting, abdominal pain, diarrhea, dizziness, weakness, headache, and muscle cramps. Because of its prolonged inhibition of brain cholinesterase and increased steady-state concentrations of acetylcholine in the cortex and the hippocampus, it is now also increasingly used in the treatment of Alzheimer s disease. 

Although rare, Wilson s disease may itself be associated with a polyarthritis resembhng rheumatoid arthritis and when it develops during the use of penicillamine it can be mistaken for an adverse reaction to the drug (331). Demineralization osteopathy has been reported in a study on the use of o-penicillamine in Wilson s disease (SED-8, 536). 

Narvaez J, Alegre-Sancho JJ, Juanola X, Roig-Escofet D. Arthropathy of Wilson s disease presenting as noninflammatory polyarthritis. J Rheumatol 1997 24(12) 2494. 

The saltmarsh mosquito pc. vigilax) is a major vector species of the Ross River virus (Epidemic Polyarthritis) in coastal Queensland, Australia. During summer months, widespread spraying of larvae populations is carried out by local authorities in coastal mangrove environments in an attempt to lower mosquito population levels and reduce the incidence of disease transmission. Given the... 

Psoriatic arthritis occurs in approximately 15% of patients with psoriasis. The cause is unknown. Skin lesions are minimal with a polyarthritis affecting particularly the small joints of the hand in an asymmetrical pattern. Usually the disease is mild but chronic. Sometimes the joint involvement is similar to that seen in rheumatoid arthritis, that is, symmetrical polyarthritis. Rarely, the disease is rapidly progressing with joint destruction. The serum is rheumatoid factor negative. 

Mr Lewis is 68 years old. He has a chronic rheumatoid disease called Wegener s granulomatosis. In this condition, there is polyarthritis and vasculitis of small and medium sized blood vessels throughout the body. Mr Lewis also has type 2 diabetes. 

A. Acute and chronic polyarthritis and other synovial diseases... 

In this chapter we will investigate the putative role for chemokines in RRV disease, and will focus particularly on the polyarthritis often associated with RRV infection. Here we will address the precise role and activity of chemokines in EPA. This chapter will also draw on studies from other infectious and noninfectious arthritic syndromes in an attempt to understand the possible chemokine basis of RRV pathogenesis and EPA. 

Fraser JRE. Epidemic polyarthritis and Ross River virus disease. Clin Rheum Dis 1986 12 369-388. 

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