Læknablaðið - 15.10.1992, Síða 16

324
LÆKNABLAÐIÐ
Table I. Clinical features of ten patients with rheumatoid arthritis and one patient with ankylosing spondylitis
undergoing six weeks treatment with recombinant human erythropoietin.
Case no Disease Sex/Age duration (years) (years) Serology X-ray Extra articular symptoms Function class Ritchie index Antirheumatic medications
1 F/69 31 RF+ Y None i 12 Sulphasalazine, f, §
2 F/35 10 RF+ Y None n 16 Auranofin (Ridaura®)
3 F/76 29 RF+, ANA+ Y Amyloidosis. Renal insuff. iii 11 t, §
4 F/70 17 RF+, ANA+ Y Sec Sjögren’s syndrome n 20 Azathioprine, f, §
5 F/56 22 RF+, ANA+ Y Rh. nodules. Cut. vasculitis n 11 Natr. aurothiomalat, f, §
6 M/42 10 Neg Y None in 14 Natr. aurothiomalat, f, §
7 F/21 15 Neg Y None n 19
8 M/79 3 RF+ Y None n 3 t, §
9 F/77 28 RF+ Y Sec Sjögren's syndrome ii 13 Azathioprine, f, §
10 F/56 11 RF+ Y Rh. nodules n 14 Sulphasalazin, §
11 M/47* 18 Neg AS Amyloidosis. Renal Insuff. in -
* = Patient with ankylosing spondylitis.
RF+ = Positive rheumatoid factor; ANA+ = Positive antinuclear antibody (titer>1/25).
X-ray: Roentgenological erosions yes (Y) or no (N); ankylosing spondylitis (AS).
f Patients taking corticosteroids.
§ Patients receiving nonsteroidal anti-inflammatory drugs.
Table II. Laboratory features of ten patients with rheumatoid arthritis and of one patient with ankylosing spondylitis
before undergoing a six week treatment period with recombinant human erythropoietin.
Patients (n=11) Reference
mean SD (range) values
Hemoglobin (g/l) Female (n=8) 95 ±6.8 (81-103) 113-134
Male (n=3) 88 ±11 (75- 97) 134-166
Hematocrit (%) Female (n=8) 30 ±3.0 (24- 34) 35- 44
Male (n=3) 28 ±0.4 (27- 28) 40- 49
MCV (Mm3) 89 ±11 (72-109) 70- 98
MCH (pg) 29 ±5 (20- 37) 28- 35
MCHC (g/l) 315 ±19 (281-339) 320-360
Reticulocytes (%) 1.9 ±0.8 (0.2-3.4) 0.2- 2.0
White-blood cells (109/1) 7.7 ±2.7 (4.3-13.1) 4- 9
Platelets (109/1) 394 ±181 (227-841) 150-400
ESR (mm/h) 76 ±42 (23-145) 2- 15
Haptoglobin (g/l) 3.8 ±2.3 (1.9-10.0) 0.2- 1.4
Serum iron (yxmol/l) 6.3 ±3.8 (2.0-12.8) 11- 35
Serum transferrin (y+mol/l) 44.1 ±18 (29- 85) 45- 72
Serum ferritin (/zg/l) 334 ±445 (10-1353) 10-240
Serum erythropoietin 19.5 ±12 (6.1-43.0) 3.3- 13.5
MCV = mean corpuscular volume
MCH = mean corpuscular hemoglobin
MCHC= mean corpuscular hemoglobin concentration.
modifying antirheumatic drugs=DMARD), sjö
sjúklingar með lágskammta barksterum og níu
sjúklingar tóku reglubundið bólgueyðandi lyf
önnur en barkstera (NSAID) (tafla I). Tveir
sjúklingar höfðu bólgumýlildi (secundary
amyloidosis) með skertri nýmastarfsemi
(s-kreatínin 350 /xmol/1 og 280 /rmol/1
(normalgildi: 64-106 /imol/1)). Aðrar klínískar
upplýsingar em sýndar í töflu I.
Allir sjúklingamir höfðu virkan sjúkdónt með
hækkað sökk, C-reaktíft prótín (CRP) og þeir
voru einnig háir á Ritchie kvarða (tafla II).
Meðferðaráœtlun: Sjúklingamir
voru rannsakaðir við göngudeild
gigtlækningadeildar Akademíska sjúkrahússins
í Uppsölum, Svíþjóð. Einungis voru teknir til
rannsóknar sjúklingar með stöðuga virkni í
gigtarsjúkdómnum. Engin breyting var gerð á
gigtarlyfjameðferð meðan á rannsókn stóð.
Allir sjúklingar fengu 50 alþjóðlegar
einingar/kg undir húð fimm vikudaga af rh-
EPO (Recormon®, Boehringer Mannheim,
Mannheim, Þýskalandi) þ.e. 250 einingar/kg
á viku. Hámarks dagskammtur var 4000
alþjóðlegar einingar og sjúklingar sem