Ive had Palandromic RA for over 2 years now. I'm interested in others telling me their stories. When were you diagnosed? What test were positive? Did you progress to full blown RA? Did your symptoms disappear? How often do you have attacks and where do they occur? Are they unilateral or bilateral? Are you on any RA medications?
Me....I was diagnosed 2 years ago. It started with attacks that were unilateral every 3 weeks or so. Knee, hip, hand, shoulder. Now I'm down to an attack (and it's usually my hand and mostly left) every few months. Always lasts 3 days. I was on Mobic but now just take Motrin as needed for the inflammation. My RF was over 650 two years ago and my anti ccp was greater than 250 two years ago. My x rays were negative for any erosion.
Hi Goldie,
| 1. | any of several academic degrees of the highest rank, as the Ph.D. or Ed.D., awarded by universities and some colleges for completing advanced work in graduate school or a professional school. |
| 2. | an honorary degree conferring the title of doctor upon the recipient, as with the LL.D. degree. |
| 3. | a degree awarded to a graduate of a school of medicine, dentistry, or veterinary science. |
—
[Middle English, ignorant person, from Old French idiote, from Latin idiōta, from Greek idiōtēs, private person, layman, from idios, own, private; see s(w)e- in Indo-European roots.]
That would certainly make any Joe M or Maz_Aust parent proud. Stand up again Maz-Aust, give Joe M another round of applause.
Palindromic rheumatism is a rare type of inflammatory arthritis. Symptoms are often mistaken for rheumatoid arthritis symptoms. There are distinguishing features between palindromic rheumatism and rheumatoid arthritis and it is important to recognize the difference.
Rare is a word commonly associated with palindromic rheumatism. To put it in perspective, there are 2.1 million people with rheumatoid arthritis in the United States. Reportedly, between 105,000 and 262,500 people in the United States have palindromic rheumatism.
Men and women are equally affected by palindromic rheumatism, another difference from rheumatoid arthritis which is more common among women. Palindromic rheumatism affects people from 20 years old to 70 years old.
During attacks associated with palindromic rheumatism, nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed. Oral steroids or local steroid injections may also be included in the treatment plan. Disease-modifying anti-rheumatic drugs (DMARDs) and colchicine are sometimes prescribed to prevent future attacks of palindromic rheumatism.
The use of anti-malarial drugs (e.g. Plaquenil) in patients with palindromic rheumatism has been associated with decreased risk of developing rheumatoid arthritis or other connective tissue diseases, according to a study published in the January 2000 issue of the Journal of Rheumatology.
Sources:
1. Lam M.D., Gordon. "Rheum Rounds: Palindromic Rheumatism." Johns Hopkins Arthritis Center. December 1, 2005. 9 Feb 2007 <http://www.hopkins-arthritis.org/rheumrounds/palindromic_rheumround1.html>
2. Gonzalez-Lopez, Laura. "Decreased Progression to Rheumatoid Arthritis or Other Connective Tissue Diseases in Patients with Palindromic Rheumatism Treated with Antimalarials." Journal of Rheumatology 27January 2000 41-6. <http://jrheum.com/abstracts/abstracts00/41.html>
Two of these doctors – Dr. Jarisch and Dr. Herxheimer – discussed these reactions in papers they published,
[Jarisch A. Therepeutische Versuche bei Syphilis. Wien Med Wochenschr (1895) 45: 721–42. ; Herxheimer K, Krause D. Ueber eine bei Syphilitischen vorkommende Quecksilberreaktion. Deutsch Med Wochenschr (1902) 28: 895–7. ]leading to the phenomenon being called the “Jarisch-Herxheimer reaction” (sometimes shortened to the “Herxheimer Reaction” or, worse yet, “herx”). Readers familiar with German will note that the article by Dr. Herxheimer is discussing a reaction seen after treating syphilis with mercury. This might account for number of “alternative” practitioners who claim to see a “Herxheimer reaction” while chelating for mercury, but I doubt that many of them have actually read the paper.
The Jarisch-Herxheimer reaction is also seen during treatment of Borrelia infections (Lyme disease and tick-borne relapsing fever), Coxiella infections (Q-fever), typhoid fever (Salmonella enterica serovar Typhi) and trichinellosis (a parasitic worm). It is caused by the rapid release of endotoxins from the bacteria (or parasitic worms) when they die from the antibiotic.
[Note: this reaction is due to inflammatory cytokines secreted in reaction to the sudden release of endotoxins, so "boosting" the immune system would only make the reaction worse.]
Anyway, it’s important to note that the Jarisch-Herxheimer reaction has not been noted during treatment of fungal infections (which would include “yeast”), despite the myriad references to “Herxheimer reaction” or “herxing” (shudder!) during “alternative” treatments of “yeast”.
Also, the symptoms of the Jarisch-Herxheimer reaction are similar to a bad “cold” or influenza-like illness (apart from the worsening of syphilitic skin lesions). It does not include the many fanciful symptoms that are often attributed to it by enthusiastic but poorly-educated “alternative” practitioners (and their fans).
Of course, a simple way around the limitations of the Jarisch-Herxheimer reaction is to simply avoid the term. Many “alternative” practitioners simply attribute any untoward symptoms (or lack of improvement) to “the toxins coming out”. Thus, a worsening in their behaviors after starting an “alternative” therapy, it’s “the toxins coming out”. If they develop a rash, lose their appetite, turn sickly yellow, suffer vomiting and diarrhea or collapse into a stupor….it’s “the toxins coming out”.
It’s a great system – if the patient gets better, it’s a sign that the “therapy” is working; if the patient doesn’t get better (or even gets worse), it’s a sign that the therapy is working.
Heads I win; tails you lose.
LAURA GONZALEZ-LOPEZ, JORGE I. GAMEZ-NAVA,
ABSTRACT.
Objective. To determine whether the use of antimalarials is associated with a reduction in the risk of developing rheumatoid arthritis (RA) or other connective tissue diseases in patients with palindromic rheumatism.
Methods. We conducted a retrospective cohort study based on a review of medical records to evaluate the outcome of patients with palindromic rheumatism referred to an academic center from 1986 to 1996; 113 patients complied with the selection criteria, including diagnostic criteria for palindromic rheumatism and onset of disease since 1980. After adjusting for potential confounders, Kaplan-Meier methods and Cox regression models were used to estimate the risk of developing RA or other connective tissue disease in patients who had received antimalarials compared to those who had not.
Results. Age of disease onset was 40 � 12 yrs, and mean disease duration 4.8 � 4 yrs; two-thirds of the patients were female. Sixty-two (55%) patients received antimalarials, for a mean duration of therapy of 28 mo. Thirty-three (29%) patients developed RA, 3 developed systemic lupus, and 4 developed other connective tissue diseases. Twenty (32%) patients in the antimalarial group developed a secondary disease, compared to 20 (39%) who did not receive therapy. Statistically significant differences were observed comparing time to event in both groups. The estimated median time to development of a chronic disease was 162 months in treated and 56 months in untreated patients. After adjusting for other variables in the Cox regression models, significant risk reduction in the development of a secondary disease was observed for antimalarial use (hazard ratio = 0.24; 95% CI 0.09�0.61). For RA, the risk reduction was 0.19 (95% CI 0.07�0.57). We conducted a sensitivity analysis around our censoring estimates. The risk reduction remained statistically significant, with 0.36 for RA and 0.41 for RA or other connective tissue disease.
Conclusion. Use of antimalarials in patients with palindromic rheumatism is associated with a reduction in the risk of developing subsequent RA or other connective tissue disease. (J Rheumatol 2000;27:41�6)
Key Indexing Terms:
ANTIMALARIALS