RESUMEN
OBJECTIVES: The aim of this work was to evaluate in a randomised double-blind prospective study the effect of pamidronate on intracellular monocytic cytokine profiles (IL-1, IL-6, TNF-alpha) and bone density in rheumatoid arthritis patients. METHODS: Twenty rheumatoid arthritis patients were treated for one year with methotrexate and a low dose of prednisolone. Double blind randomisation was performed for either i.v. pamidronate (at 3-month intervals) or placebo. The effect of pamidronate was evaluated on intracellular cytokine profiles (IL-1, IL-6, TNF-alpha), disease activity and bone mass measurements. The human monocytic cell line THP-1 was used to evaluate in vitro apoptosis by pamidronate. RESULTS: Spontaneous production of interleukin-1 beta by patient blood monocytes was lower in the pamidronate group and was associated with an increase in bone density of the spine after 12 months of therapy. In vitro a dose-related increase in pamidronate induced apoptosis was found in THP-1 cells. CONCLUSIONS: This prospective double-blind randomised study demonstrated that pamidronate therapy resulted in an increase of bone density despite treatment with steroids. This rise is associated with a suppression of interleukin-1 beta production in monocytes of patients treated with pamidronate. Our in vitro experiments suggest that this anti-inflammatory effect could be due to an increase in the apoptosis of monocytic cells.
Asunto(s)
Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Apoptosis/efectos de los fármacos , Artritis Reumatoide/tratamiento farmacológico , Densidad Ósea/efectos de los fármacos , Citocinas/efectos de los fármacos , Inmunosupresores/farmacología , Monocitos/efectos de los fármacos , Adulto , Anciano , Sedimentación Sanguínea/efectos de los fármacos , Proteína C-Reactiva/efectos de los fármacos , Difosfonatos/farmacología , Difosfonatos/uso terapéutico , Método Doble Ciego , Interacciones Farmacológicas , Femenino , Humanos , Inyecciones Intravenosas , Masculino , Metotrexato/farmacología , Persona de Mediana Edad , Pamidronato , Prednisolona/farmacología , Prednisolona/uso terapéutico , Estudios Prospectivos , Distribución AleatoriaRESUMEN
This case report describes a patient with Behçet's syndrome with sustained anticardiolipin antibodies presenting a vena cava inferior thrombosis in a period of anabolic steroid use. The vascular manifestations and occurrence of antiphospholipid antibodies in Behçet's syndrome are reviewed. The possible thrombogenicity of anabolic steroids is reemphasized.
Asunto(s)
Anabolizantes/efectos adversos , Anticuerpos Anticardiolipina/sangre , Síndrome de Behçet/complicaciones , Infarto Cerebral/complicaciones , Estanozolol/efectos adversos , Trombosis/inducido químicamente , Vena Cava Inferior , Anabolizantes/administración & dosificación , Anabolizantes/uso terapéutico , Anticuerpos Anticardiolipina/análisis , Síndrome de Behçet/tratamiento farmacológico , Síndrome de Behçet/inmunología , Infarto Cerebral/diagnóstico por imagen , Infarto Cerebral/inmunología , Ensayo de Inmunoadsorción Enzimática , Humanos , Inyecciones Intramusculares , Masculino , Estanozolol/administración & dosificación , Estanozolol/uso terapéutico , Trombosis/diagnóstico por imagen , Trombosis/inmunología , Ultrasonografía DopplerRESUMEN
The authors report an unusual case of jejunal mesenchymal hamartoma which presented as a bleeding pedunculated polyp in a 67-year-old woman. The lesion was detected by enteroclysis and resected after localization by intraoperative endoscopy.