eLetters

131 e-Letters

published between 2005 and 2008

  • Melatonin suppression may not be a promising therapeutic option for the treatment of RA
    Robert Eli

    Dear Editor,

    The article, "Circadian Rhythms in RA" postulates a dynamic equilibrium between melatonin and cortisol as at least part of the etiology of rheumatoid arthritis. The authors note that the clinical symptoms of pain and stiffness seem to peak around 5:00 o'clock in the morning and that this coincides with the diurnal rhythms of melatonin and cortisol. Because melatonin enhances inflammatory cytokine and...

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  • Intrarticular Steroids have a place
    Sidha S Sambandan

    Dear Editor,

    Brandt has given an excellent comprehensive review on the non surgical management of Osteoarthritis. For the sake of completeness, it would be useful to include the place of long acting intrarticular steroids in OA.

  • Brucellosis as a cause of carpal tunnel syndrome
    Bonifacio Alvarez Lario

    Dear Editor,

    We read with great interest the recent paper by Pappas et al. [1] and we would like to add some considerations about brucellosis as a cause of carpal tunnel syndrome (CTS).

    Brucellosis has been an endemic disease in Castilla y León (Spain) until the 1990’s. In 1992 we reported a series of 44 cases of brucellosis with musculoskeletal manifestations diagnosed in the division of rheumatology of...

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  • Raised levels of IL-6 in SLE correlate with anemia
    Ines Colmegna

    Dear Editor,

    We read with interest the recent article by Ripley et al. describing a linear (negative coefficient) correlation between levels of IL-6 and hemoglobin in patients with systemic lupus erythematosus (SLE).[1] What needs mention is that the correlation is due to a recently described peptide, hepcidin.[2]

    Hepcidin is a small peptide with dual roles as an effector of the innate immune system an...

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  • Half of rheumatoid arthritis patients discontinue the disease-modifying anti-rheumatic drug therapy
    Riina Kallikorm

    Dear Editor,

    In a recent study, Heiberg et al. [1] reported that in 2001 37% of their rheumatoid arthritis (RA) patients were using nonsteroidal antirheumatic drugs (NSAIDs); 15%, coxibs; 43%, corticosteroids; 48%, disease-modifying anti-rheumatic drugs (DMARDs); and 3%, biologicals. In 2003 we performed a follow-up study on drug use and quality of life (QoL) in a cohort of RA patients who had been hospitalised in...

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  • Lymphomas and TNF alpha inhibitors
    Hasan Yazici

    Dear Editor,

    There are issues that deserve more thought and discussion as they relate to the Geborak et al. paper [1] on the tumour and lymphoma incidence associated with TNF alpha inhibitor use. The title says a) these drugs do not raise the overall incidence of tumours and b) they may be associated with an increased risk of lymphoma. Given that lymphomas are also counted under tumours, I cannot see how "a" and...

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  • ANA negative lupus as a risk factor for atherosclerosis?
    Christian J. Rhea

    Dear Editor,

    I was intrigued by the observations of Drs. Marasini, De Monti and Ghilardi on the risk factors for accelerated atherosclerosis in patients with systemic lupus erythematosus. Most interesting was the high percentage of ANA negative lupus patients they evaluated. Given the sensitivity of the Hep2 substrate, I would expect no more than one such patient in a total population of 48.

    The fact...

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  • Radiotherapy in painful skeletal disorders - Dose does really matter!
    Oliver Micke

    Dear Editor,

    We read with great interest the report of Graninger et al. about a small randomized study on local radiotherapy of painful joints in rheumatoid arthritis [1]: They treated series of six patients on one painful site with a total dose of 20 Gy in 10 daily fractions. A single inflamed joint on the contralateral side of the body was used as internal control and received sham irradiation. Swelling and t...

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  • Rheumatological presentations of paraneoplastic disease
    Holly Piper

    Dear Editor,

    We read with interest the case report by Denschlag et al. [1]. In addition, von Lilienfield-Toal et al. also recently described the presentation of adult onset Still’s disease associated with occult breast malignancy [2]. These case reports remind us that rheumatic symptoms may precede the diagnosis of an underlying neoplasm. We recently observed an atypical presentation of scleroderma associated wit...

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  • Experience versus Evidence
    Sidha S Sambandan

    Dear Editor,

    Over quarter of a century of experience with injecting steroids has led me to believe in the value of steroid injections for OA of small and large joints. I have used Depot-Medrone with lidocaine for the CMC Joint, especially in the elderly who have disabling CMC joint OA, leading to inability to lift a pot of Tea, an extremely important activity of daily living for the elderly at least in UK! Many...

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