The Experts below are selected from a list of 114 Experts worldwide ranked by ideXlab platform

M Cutolo - One of the best experts on this subject based on the ideXlab platform.

  • therapy of Rheumatic Polymyalgia the pathophysiologic management
    Reumatismo, 2011
    Co-Authors: M Cutolo, M Oliveri, M E Secchi, M A Cimmino
    Abstract:

    Polymyalgia Rheumatica (PMR) is an inflammatory syndrome affecting older people whose prevalence has increased in recent years. The suppression of the hypothalamic-pituitary-adrenal axis (HPA) and ageing may contribute to the pathogenesis of PMR. Chronic stress (i.e. interpersonal, chronic infections etc.) in elderly people may represent a risk factor for the development of PMR. In fact, elderly represent per se a condition of endocrine senescence including adrenal hypofunction, in addition chronic stress represents a further harmful stimulus to seriously compromise endogenous glucocorticoid production. Synovitis and vasculitis characterize the majority of the patients. Serum cytokine and steroidal hormone patterns suggest that patients with PMR have an intensive inflammatory reaction. As a matter of fact, glucocorticoids represent the most useful temporary “replacement” treatment during the active phase of PMR. The use of modified-release glucocorticoids that might induce higher levels during the night (circadian rhythms as in physiological conditions), will represent another important approach to optimize PMR treatment and reduce the side effects. Combination therapy between glucocorticoids and inhibitors of pro-inflammatory cytokines should be tested in large studies and early cases of PMR.

  • trattamento della polimialgia reumatica l approccio fisiopatologico therapy of Rheumatic Polymyalgia the pathophysiologic management
    2007
    Co-Authors: M Cutolo, Viale Benedetto Xv
    Abstract:

    SUMMARY Polymyalgia Rheumatica (PMR) is an inflammatory syndrome affecting older people whose prevalence has increased in recent years. The suppression of the hypothalamic-pituitary-adrenal axis (HPA) and ageing may contribute to the pathogenesis of PMR. Chronic stress (i.e. interpersonal, chronic infections etc.) in elderly people may represent a risk factor for the development of PMR. In fact, elderly represent per se a condition of endocrine senescence including adrenal hypofunction, in addition chronic stress represents a further harmful stimulus to seriously compromise endogenous glucocorticoid production. Synovitis and vasculitis characterize the majority of the patients. Serum cytokine and steroidal hormone patterns suggest that patients with PMR have an intensive inflammatory reaction. As a matter of fact, glucocorticoids represent the most useful temporary “replacement” treatment during the active phase of PMR. The use of modified-release glucocorticoids that might induce higher levels during the night (circadian rhythms as in physiological conditions), will represent another important approach to optimize PMR treatment and reduce the side effects. Combination therapy between glucocorticoids and inhibitors of pro-inflammatory cytokines should be tested in large studies and early cases of PMR.

J. S. López Arranz - One of the best experts on this subject based on the ideXlab platform.

  • Tongue necrosis as a complication of temporal arteritis
    Oral Surgery Oral Medicine Oral Pathology, 1994
    Co-Authors: S. Llorente Pendás, J.c. De Vicente Rodríguez, M. González García, L.m. Junquera Gutiérrez, J. S. López Arranz
    Abstract:

    Abstract Tongue necrosis is a rare complication in giant cell arteritis, an entity in which both temporal arteritis and Rheumatic Polymyalgia may be included as two different manifestations of the same pathologic process. The case of a 79-year-old patient who had tongue necrosis 3 hours after ingestion of 2 mg of ergotamine tartrate is presented. This complication was the basis for the diagnosis of temporal arteritis. We reviewed possible clinical manifestations of temporal arteritis and cases of tongue necrosis in the world literature. The possible existence of triggering factors that seemed to be present in 11 of the published cases was analyzed. In seven of these cases ingestion of ergotamine derivates had taken place.

Ballester Belda Je - One of the best experts on this subject based on the ideXlab platform.

  • Immunosuppressor treatment in temporal arteritis of long-term evolution
    Anales De Medicina Interna, 1992
    Co-Authors: Roig López De Los Mozos A, Calvo Catalá J, Hortelano Martínez E, Liñana Santafé Jj, González-cruz Cervellera Mi, Ballester Belda Je
    Abstract:

    : We report a case of Rheumatic Polymyalgia associated with temporal arteritis, in which clinical-biological symptoms and evolution with steroid or immunosuppressive therapy were analyzed. We confirm the lack of effectiveness of the treatment with AINES, the low response to steroids and the high response to immunosuppressive therapy.

J. Wollenhaupt - One of the best experts on this subject based on the ideXlab platform.

  • Gerontorheumatologie
    Zeitschrift für Rheumatologie, 2009
    Co-Authors: J. Wollenhaupt
    Abstract:

    Die Gerontorheumatologie befasst sich mit den Besonderheiten der Manifestationen, des Verlaufs und der Behandlung rheumatologischer Erkrankungen bei Patienten im höheren Lebensalter. Die Erstdiagnose einer entzündlich-rheumatischen Erkrankung nach dem 60. Lebensjahr wird erschwert durch die Häufigkeit unspezifischer allgemeiner Krankheitssymptome. Die wichtigsten gerontorheumatologischen Erkrankungen sind die rheumatoide Arthritis mit Erstmanifestation im höheren Lebensalter („late onset rheumatoide arthritis“, LORA), die Polymyalgia Rheumatica und die Riesenzellarteriitis. Wichtige Differenzialdiagnosen bei älteren Rheumapatienten sind das RS3PE-Syndrom, die polyartikuläre Chondrokalzinose und die paraneoplastischen rheumatischen Syndrome. Für die Therapie sind grundsätzlich alle spezifischen Basistherapeutika, Immunsuppressiva und Biologika einsetzbar. Allerdings sollte mit Rücksicht auf altersbedingte Einschränkungen der Organfunktionen und des Stoffwechsels besonders in der Anfangsphase die Dosierung vorsichtig gewählt werden und eine engmaschige Verträglichkeitsüberprüfung erfolgen. Gerontorheumatology deals with the particular features of onset, course and treatment of Rheumatic diseases in patients of advanced age. The initial diagnosis of inflammatory Rheumatic disease after the age of 60 is hindered by the frequency of non-specific general disease symptoms. The most important gerontorheumatological diseases include rheumatoid arthritis first occurring at advanced age (“late onset rheumatoid arthritis”, LORA), Rheumatic Polymyalgia and giant cell arteritis. Important differential diagnoses in older rheumatology patients are RS3PE syndrome, polyarticular chondrocalcinosis and paraneoplastic Rheumatic syndrome. In principle, all specific basic therapeutics, immunosuppressants and biologics can be used for the therapy of these diseases. However, careful dose selection is particularly necessary in the initial phase, taking age-specific limitations in organ function and metabolism into consideration; moreover, close-meshed tolerance tests should be carried out.

V N Larina - One of the best experts on this subject based on the ideXlab platform.

  • Rheumatic Polymyalgia case report
    Klinicheskaia meditsina, 2015
    Co-Authors: B Y Bart, E V Kudina, V N Larina
    Abstract:

    : This case report demonstrates the diagnostic potential of outpatient examination of patients with Rheumatic Polymyalgia and describes an algorithm for differential diagnostics. The report is also of interest as an example of long-term (10 year) remission that can be interpreted as a complete recovery.