Ortopaedkirurgisk afdeling M, H:S Bispebjerg Hospital.
A case is described of a 33-year old woman with systemic lupus erythematosus (SLE) in longterm treatment with corticosteroids who experienced spontaneous rupture of the left patellar tendon. A comparative study of 28 previously reported cases of SLE patients with spontaneous tendon rupture in weight bearing joints is performed. It is suggested that renal disease may be an etiological factor for spontaneous tendon rupture in patients with systemic lupus erythematosus.
PMID: 11014141 [PubMed - indexed for MEDLINE]
Evangelische Stiftung Volmarstein Klinik II: Rheumaorthopädie- Endoprothetik, Sektion Handchirurgie, Lothar-Gau-Str. 11, 58300 Wetter-Volmarstein, Germany.
INTRODUCTION: Biological modifiers (BM) are very effective in a high percentage of patients with rheumatoid arthritis being resistant to disease modifying antirheumatic drugs (DMARD). In the beginning, the therapy with the BMs was thought to be of low risk. However, due to the increase of application, a few lethal septical complications have been reported. CASE REPORT: A 38 year old male with rheumatoid arthritis and insulin deficiency diabetes mellitus achieved remission under the therapy with Anakinra within three days. Due to a spontaneous disrupture of the finger extensor tendons operative revision was performed. A phlegmon from the dorsum of the hand to the cubita was found five months after resection of a septical cubital bursa. CONCLUSION: The very effective suppression of the immune system by the BMs should not lead to noncritical therapy in patients with history of infections of bone, joints and soft tissue, because inactive organism may start growing and lead to undetected lethal sepsis.
PMID: 14685719 [PubMed - indexed for MEDLINE