pituitrin and Arthritis--Rheumatoid

Topics: Adrenocorticotropic Hormone; Adult; Arthritis, Rheumatoid; Humans; Hypothalamo-Hypophyseal System; Immunity; Inflammation; Interleukin-6; Middle Aged; Neoplasms; Pituitary-Adrenal System; Vasopressins

Topics: Adrenocorticotropic Hormone; Adult; Arthritis, Rheumatoid; Humans; Hypothalamo-Hypophyseal System; Immunity; Inflammation; Interleukin-6; Middle Aged; Neoplasms; Pituitary-Adrenal System; Vasopressins

Topics: Adult; Aged; Arthritis, Rheumatoid; Blood Sedimentation; Clinical Trials as Topic; Creatinine; Female; Gold; Gold Sodium Thiomalate; Humans; Joints; Kidney Function Tests; Male; Middle Aged; Movement; Rheumatoid Factor; Spectrophotometry, Atomic; Time Factors; Vasopressins

We describe a 74-year-old man with rheumatoid arthritis (RA) who developed syndrome of inappropriate secretion of antidiuretic hormone (SIADH) 1.5 months after commencement of mizoribin prescription when his arthritis was improved. He noticed nausea and headache and serum Na fell as low as 118 mEq/l. Normal urinary Na excretion without hypotension or hemoconcentration negated the possibility of dehydration resulting from urinary Na loss. Serum antidiuretic hormone (ADH) remained elevated at 0.59 pg/ml in spite of a significant reduction in serum osmolality to 254 mosm/kg. He had no organic disease likely to cause SIADH. Despite infusion of hypertonic saline, his serum Na was not restored to normal. Shortly after mizoribin withdrawal, his serum Na increased significantly from 128 to 139 mEq/l and plasma osmolality from 265 to 287 mosm/kg. ADH hypersecretion in relation to plasma osmolality was reversed by mizoribin withdrawal, suggesting that bredinin might adversely induce SIADH. Additional predisposing factors were the patient's age and difficulty in urination due to benign prostatic hypertrophy. In summary, we report herein the first case of SIADH believed to be an adverse effect of mizoribin, which may therefore needed to be added to the list of drugs which can induce SIADH.

Topics: Aged; Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Drinking; Humans; Inappropriate ADH Syndrome; Male; Neurophysins; Osmolar Concentration; Protein Precursors; Ribonucleosides; Sodium; Vasopressins

To estimate the level of natural autoantibodies (NAAb) to angiotensin-converting enzyme (ACE) and endogenic mediators affecting vascular tone (bradykinin--BK, angiotensin II--AII, vasopressin--VP) as well as the activity of serum ACE in patients with systemic diseases of the connective tissue.. Levels of NAAb were measured by enzyme immunoassay in sera from 30 patients with SLE, 19 patients with rheumatoid arthritis (RA) and 36 patients with scleroderma systematica (SS). Serum from donors served control. IgM NAAb to ACE were measured by a new technique. Serum ACE activity was determined by the initial velocity of hydrolysis reaction using spectrofluometry.. IgM NAAb were detected in the sera of both patients and donors. SS patients had the level of NAAb to ACE in diffuse form significantly higher than in limited (p < 0.05). In SLE and SS patients ACE activity was significantly lower (p < 0.05) than in healthy subjects and RA patients. Levels of NAAb to BK was significantly elevated (p < 0.01) in patients with SLE and RA vs donors while to AII in SS patients it was lowered (p < 0.001). Patients with diffuse SS had NAAb to BK higher than patients with SS limited form (p < 0.01). In SLE the lowest levels of NAAb to all the mediators studied were observed in patients with nephritis, for NAAb to VP the differences were significant (p < 0.05). In patients with urinary syndrome concentration of NAAb to BK was significantly higher (p < 0.01), differences between their levels in patients with nephritis and urinary syndrome were also significant (p < 0.05).. Further studies are needed for specification of physiological or pathological role of NAAb to endogenic mediators.

Topics: Angiotensin II; Arthritis, Rheumatoid; Autoantibodies; Blood Donors; Bradykinin; Humans; Immunoenzyme Techniques; Immunoglobulin M; Lupus Erythematosus, Systemic; Peptidyl-Dipeptidase A; Scleroderma, Systemic; Spectrometry, Fluorescence; Vasopressins

To measure blood pressure (BP), plasma endothelin-1 (ET-1), atrial natriuretic peptide (ANP), antidiuretic hormone (ADH) and aldosterone (ALDO) concentration, and plasma renin activity (PRA) in patients treated with a low-dose cyclosporin A (CyA).. An open study of patients with rheumatoid arthritis (RA) or palmoplantar pustulosis (PPP).. Out-patient clinics at the Central Hospital of Jyväskylä and Helsinki University Central Hospital.. CyA was given to 25 patients with RA and to 10 patients with PPP.. RA patients were given CyA at a dose of 2.5 +/- 0.13 mg kg-1 body weight (BW) to 3.47 +/- 0.79 mg kg-1 BW (mean values +/- SD) at the start of the study and after 6 months, respectively, and the CyA dose was 2.67 +/- 0.13 mg kg-1 BW decreasing to 2.07 +/- 0.96 mg kg-1 (P < 0.001) after 4 months in PPP subjects.. Systolic (sBP) and diastolic blood pressure (dBP) increased from 127.8 +/- 13.6/79.7 +/- 8.4 mmHg to 140.0 +/- 19.8/83.8 +/- 9.7 mmHg during the study (P < 0.03). Plasma ET-1, ANP, ALDO and ADH concentration and PRA did not change during 4 to 6 months of CyA treatment. The plasma ANP concentration was constantly higher in CyA-treated RA patients (112 +/- 87 ng 1-1 to 118 +/- 78 ng 1-1) than in PPP patients (37.3 +/- 26 ng 1-1 to 47.7 +/- 39.9 ng 1-1; P < 0.02). The serum creatinine concentration remained within the normal range, but increased from baseline (76.7 +/- 11.9 mumol 1-1), to 90 +/- 15.4 mumol 1-1 (p < 0.001). The serum magnesium concentration decreased significantly (P < 0.005) after 6 months of CyA treatment in RA patients. No correlation was found between serum creatinine and plasma ET-1 concentration.. Increased blood pressure during CyA treatment was independent of circulating ET-1 levels. A low dose of CyA did not induce increased ET-1 synthesis as judged from plasma samples. The high plasma ANP level observed in RA patients could be due to fluid retention caused by concomitant treatment with non-steroid anti-inflammatory drugs. Fluid retention and decreased magnesium levels could also be involved in the development of hypertension in CyA-treated subjects.

Topics: Adult; Aldosterone; Arthritis, Rheumatoid; Atrial Natriuretic Factor; Blood Pressure; Cyclosporine; Endothelins; Female; Humans; Hypertension; Male; Middle Aged; Psoriasis; Renin; Vasopressins

Topics: Administration, Oral; Adrenal Cortex Hormones; Adult; Aged; Arthritis, Rheumatoid; Circadian Rhythm; Cosyntropin; Female; Humans; Hydrocortisone; Hypoglycemia; Hypothalamo-Hypophyseal System; Insulin; Lysine; Male; Metyrapone; Middle Aged; Vasopressins

Four patients treated with depot tetracosactrin for 10 to 18 months maintained normal hypothalamic-pituitary-adrenal function assessed by the nyctohemeral variation of plasma corticosteroids and by the responses of plasma corticosteroids to insulin-induced hypoglycaemia, lysine-vasopressin, and depot tetracosactrin. The pituitary component of the response was analysed by measuring plasma immunoreactive ACTH levels. Three patients showed a nyctohemeral ACTH rhythm and normal ACTH responses to insulin-induced hypoglycaemia. Consistently undetectable morning plasma ACTH levels were found in the fourth patient, who also showed an unusually delayed rise in both ACTH and corticosteroid levels in response to insulin-induced hypoglycaemia, though the peak values attained were normal.The lack of suppression of hypothalamic-pituitary-adrenal function together with the good clinical response in these four patients suggests that treatment with depot tetracosactrin should be considered when long-term corticosteroid therapy is required.

Topics: Adolescent; Adrenal Cortex Hormones; Adrenal Glands; Adrenocorticotropic Hormone; Aged; Arthritis, Rheumatoid; Circadian Rhythm; Delayed-Action Preparations; Dermatitis Herpetiformis; Dermatitis, Exfoliative; Female; Humans; Hypothalamus; Insulin; Lupus Erythematosus, Systemic; Male; Middle Aged; Peptides; Pituitary Gland; Radioimmunoassay; Sjogren's Syndrome; Vasopressins

Topics: Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Aged; Arthritis, Rheumatoid; Blood Glucose; Female; Humans; Hydrocortisone; Insulin; Lysine; Male; Middle Aged; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Vasopressins

Topics: Arthritis, Rheumatoid; Female; Glucocorticoids; Humans; Hypoglycemia; Injections, Intramuscular; Injections, Intravenous; Insulin; Lysine; Male; Pituitary-Adrenal Function Tests; Vasopressins

Topics: Adrenocorticotropic Hormone; Adult; Aged; Arthritis, Rheumatoid; Asthma; Dexamethasone; Female; Humans; Hydrocortisone; Injections, Intramuscular; Injections, Intravenous; Male; Methods; Middle Aged; Pituitary-Adrenal Function Tests; Time Factors; Vasopressins

Topics: Adrenocorticotropic Hormone; Arthritis, Rheumatoid; Circadian Rhythm; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Insulin; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Stress, Physiological; Time Factors; Vasopressins

Topics: Arthritis, Rheumatoid; Humans; Hypoglycemia; Hypothalamo-Hypophyseal System; Insulin; Lysine; Middle Aged; Pituitary-Adrenal System; Steroids; Triamcinolone; Vasopressins

Topics: Arthritis, Rheumatoid; Extracellular Space; Felty Syndrome; Female; Hormones, Ectopic; Humans; Hyponatremia; Middle Aged; Sjogren's Syndrome; Sodium; Vasopressins; Water-Electrolyte Balance

Topics: 17-Hydroxycorticosteroids; Adrenal Glands; Adult; Arthritis, Rheumatoid; Blood Glucose; Female; Glucocorticoids; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; Insulin; Lysine; Metyrapone; Middle Aged; Pituitary-Adrenal Function Tests; Pituitary-Adrenal System; Vasopressins

Topics: 17-Hydroxycorticosteroids; Adolescent; Adrenocorticotropic Hormone; Adult; Aged; Arthritis, Rheumatoid; Asthma; Blood; Female; Humans; Hydrocortisone; Hypothalamo-Hypophyseal System; In Vitro Techniques; Injections, Intramuscular; Male; Metyrapone; Middle Aged; Pituitary Function Tests; Pituitary-Adrenal Function Tests; Urine; Vasopressins

Topics: Arginine Vasopressin; Arthritis; Arthritis, Rheumatoid; Phenylbutazone; Sciatica; Vasopressins

Topics: Arthritis; Arthritis, Rheumatoid; Humans; Vasopressins