Difference between revisions of "Rheumatoid arthritis"
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'''Rheumatoid arthritis''', commonly abbreviated '''RA''', is an autoimmune disorder. | '''Rheumatoid arthritis''', commonly abbreviated '''RA''', is an autoimmune disorder. | ||
== | =Skin= | ||
==Rheumatoid neutrophilic dermatitis== | |||
===General=== | ===General=== | ||
*May manifest as ''rheumatoid neutrophilic dermatitis'' - super rare.<ref name=pmid9197831>{{Cite journal | last1 = Mashek | first1 = HA. | last2 = Pham | first2 = CT. | last3 = Helm | first3 = TN. | last4 = Klaus | first4 = M. | title = Rheumatoid neutrophilic dermatitis. | journal = Arch Dermatol | volume = 133 | issue = 6 | pages = 757-60 | month = Jun | year = 1997 | doi = | PMID = 9197831 }}</ref> | *May manifest as ''rheumatoid neutrophilic dermatitis'' - super rare.<ref name=pmid9197831>{{Cite journal | last1 = Mashek | first1 = HA. | last2 = Pham | first2 = CT. | last3 = Helm | first3 = TN. | last4 = Klaus | first4 = M. | title = Rheumatoid neutrophilic dermatitis. | journal = Arch Dermatol | volume = 133 | issue = 6 | pages = 757-60 | month = Jun | year = 1997 | doi = | PMID = 9197831 }}</ref> | ||
| Line 10: | Line 11: | ||
*[[Neutrophil]]s. | *[[Neutrophil]]s. | ||
= | =Joints= | ||
{{Main|Joints}} | {{Main|Joints}} | ||
*[[AKA]] ''rheumatic | ==Rheumatic joint disease== | ||
*[[AKA]] ''joint with rheumatic disease''. | |||
===General=== | ===General=== | ||
Clinical: | Clinical: | ||
| Line 39: | Line 41: | ||
===General=== | ===General=== | ||
*Usually only in seropositive cases.<ref name=Ref_DCHH299>{{Ref DCHH|299}}</ref> | *Usually only in seropositive cases.<ref name=Ref_DCHH299>{{Ref DCHH|299}}</ref> | ||
*Typically close to a joint.{{fact}} | |||
===Microscopic=== | ===Microscopic=== | ||
| Line 63: | Line 66: | ||
**[http://commons.wikimedia.org/wiki/File:Rheumatoid_nodule_-_high_mag.jpg Rheumatoid nodule - high mag. (WC)]. | **[http://commons.wikimedia.org/wiki/File:Rheumatoid_nodule_-_high_mag.jpg Rheumatoid nodule - high mag. (WC)]. | ||
=Pleural disease= | |||
:''See [[Rheumatoid pleuritis]]''. | :''See [[Rheumatoid pleuritis]]''. | ||
=Lung disease= | |||
:''See [[Medical lung disease]]''. | :''See [[Medical lung disease]]''. | ||
RA may involve the [[lung]]. | RA may involve the [[lung]]. | ||
=Miscellaneous= | |||
==Amyloidosis== | ==Amyloidosis== | ||
:''See [[Amyloidosis]]''. | :''See [[Amyloidosis]]''. | ||
| Line 82: | Line 86: | ||
Felty syndrome is associated with ''[[T-cell large granular lymphocytic leukemia|large granular lymphocytic leukemia]]''.<ref name=Ref_PCPBoD8_328>{{Ref PCPBoD8|328}}</ref><ref name=pmid21546829>{{Cite journal | last1 = Liu | first1 = X. | last2 = Loughran | first2 = TP. | title = The spectrum of large granular lymphocyte leukemia and Felty's syndrome. | journal = Curr Opin Hematol | volume = 18 | issue = 4 | pages = 254-9 | month = Jul | year = 2011 | doi = 10.1097/MOH.0b013e32834760fb | PMID = 21546829 }}</ref> | Felty syndrome is associated with ''[[T-cell large granular lymphocytic leukemia|large granular lymphocytic leukemia]]''.<ref name=Ref_PCPBoD8_328>{{Ref PCPBoD8|328}}</ref><ref name=pmid21546829>{{Cite journal | last1 = Liu | first1 = X. | last2 = Loughran | first2 = TP. | title = The spectrum of large granular lymphocyte leukemia and Felty's syndrome. | journal = Curr Opin Hematol | volume = 18 | issue = 4 | pages = 254-9 | month = Jul | year = 2011 | doi = 10.1097/MOH.0b013e32834760fb | PMID = 21546829 }}</ref> | ||
=See also= | |||
*[[Arthritis]]. | *[[Arthritis]]. | ||
*[[Joints]]. | *[[Joints]]. | ||
*[[Basics]]. | *[[Basics]]. | ||
=References= | |||
{{Reflist|2}} | {{Reflist|2}} | ||
=External links= | |||
*[http://www.pathguy.com/lectures/joints.htm Joint disease (pathguy.com)]. | *[http://www.pathguy.com/lectures/joints.htm Joint disease (pathguy.com)]. | ||
[[Category:Weird stuff]] | [[Category:Weird stuff]] | ||
Revision as of 16:21, 29 October 2012
Rheumatoid arthritis, commonly abbreviated RA, is an autoimmune disorder.
Skin
Rheumatoid neutrophilic dermatitis
General
- May manifest as rheumatoid neutrophilic dermatitis - super rare.[1]
Microscopic
Features:
- Nodular and diffuse pattern.
- Neutrophils.
Joints
Main article: Joints
Rheumatic joint disease
- AKA joint with rheumatic disease.
General
Clinical:
- Tumour - swelling.
- Rubor - redness.
- Calor - heat.
- Dolor - pain.
Microscopic
Features:[2]
- Chronic inflammation, esp. lymphocytes.
- +/-Lymphoid follicles.
- Synovial hyperplasia - with papillary or polyoid architecture.
- Synoviocytes may show binucleation and mild atypia.
- +/-Fibrin.
- +/-Bone.
- +/-Cartilage.
Note:
- Changes are non-specific - DDx includes other rheumatic diseases (systemic lupus erythematosus, psoriatic arthritis).
Images:
Rheumatoid nodule
General
- Usually only in seropositive cases.[4]
- Typically close to a joint.[citation needed]
Microscopic
- Necrotic collagen bundles with fibrin surrounded by:
- Palisading granuloma.
- +/-Eosinophils.
Notes:
- Histomorphologically very similar to Granuloma annulare.
DDx:
- Granuloma annulare - has mucin in the core of the granuloma.[5]
- Necrobiosis lipoidica.
Images:
- www:
- WC:
Pleural disease
- See Rheumatoid pleuritis.
Lung disease
- See Medical lung disease.
RA may involve the lung.
Miscellaneous
Amyloidosis
- See Amyloidosis.
Amyloidosis may be due to RA.
Felty syndrome
RA may occur in Felty syndrome -- the triad:[8]
- Rheumatoid arthritis.
- Splenomegaly.
- Neutropenia.
Felty syndrome is associated with large granular lymphocytic leukemia.[8][9]
See also
References
- ↑ Mashek, HA.; Pham, CT.; Helm, TN.; Klaus, M. (Jun 1997). "Rheumatoid neutrophilic dermatitis.". Arch Dermatol 133 (6): 757-60. PMID 9197831.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 660. ISBN 978-0781765275.
- ↑ URL: http://library.med.utah.edu/WebPath/EXAM/IMGQUIZ/msfrm.html. Accessed on: 5 December 2010.
- ↑ 4.0 4.1 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 299. ISBN 978-0470519035.
- ↑ 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 52. ISBN 978-0443066542.
- ↑ 6.0 6.1 URL: http://granuloma.homestead.com/palisading.html. Accessed on: 1 November 2010.
- ↑ URL: http://www.pathguy.com/lectures/joints.htm. Accessed on: 1 November 2010.
- ↑ 8.0 8.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 328. ISBN 978-1416054542.
- ↑ Liu, X.; Loughran, TP. (Jul 2011). "The spectrum of large granular lymphocyte leukemia and Felty's syndrome.". Curr Opin Hematol 18 (4): 254-9. doi:10.1097/MOH.0b013e32834760fb. PMID 21546829.