RT Journal Article
SR Electronic
T1 Co-existent sickle cell disease and juvenile rheumatoid arthritis. Two cases with delayed diagnosis and severe destructive arthropathy.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2125
OP 2128
VO 28
IS 9
A1 Nistala, K
A1 Murray, K J
YR 2001
UL http://www.jrheum.org/content/28/9/2125.abstract
AB We describe 2 pediatric patients with sickle cell disease (SCD) who developed seropositive juvenile rheumatoid arthritis (JRA). Both patients have severe joint damage, the compound effect of both disease processes. The bone and cartilage destruction, which poses serious therapeutic challenges, highlights the difficulty of making a diagnosis of chronic inflammatory disease in the setting of SCD. There may be a correlation between increased levels of tumor necrosis factor-alpha in the synovial tissue of joints damaged by arthritis and local sickling. The resultant ischemia and corresponding inflammatory infiltrates could in turn worsen existing synovial proliferation and cartilage destruction as well as trigger further sickling.