rheumatoid

• adj.

• リウマチ様の、リウマチの、リウマトイド

関

rheumatic、rheumatism

　

WordNet

1. a person suffering with rheumatism
2. any painful disorder of the joints or muscles or connective tissues

PrepTutorEJDIC

1. リューマチ[性]の
2. リューマチの / リューマチにかがった / リューマチ患者
3. リューマチ

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/07/08 23:06:10」(JST)

wiki en

[Wiki en表示]

Rheumatism
Classification and external resources
ICD-10	M79.0
ICD-9	729.0
MeSH	D012216

Rheumatism or rheumatic disorder is a non-specific term for medical problems affecting the joints and connective tissue. The study of, and therapeutic interventions in, such disorders is called rheumatology.

Terminology

The term "rheumatism" is still used in colloquial speech and historical contexts, but is no longer frequently used in medical or technical literature; there is no longer any recognized disorder simply called "rheumatism." The traditional term covers such a range of different problems that to ascribe symptoms to "rheumatism" is not to say very much. Nevertheless, sources dealing with rheumatism tend to focus on arthritis. However, "non-articular rheumatism," also known as "regional pain syndrome" or "soft tissue rheumatism," can cause significant discomfort and difficulty. Furthermore, arthritis and rheumatism between them cover at least 200 different conditions.

The term "Rheumatic Diseases" is used in MeSH to refer to connective tissue disorders.

Palindromic rheumatism has been theorized to be a form of rheumatoid arthritis.

Types

The major rheumatic disorders currently recognized include

• Ankylosing spondylitis
• Back pain
• Bursitis/Tendinitis, Shoulder pain, wrist, biceps, leg, knee (patellar), ankle, hip, and Achilles
• Capsulitis
• Neck pain
• Osteoarthritis

Although these disorders probably have little in common in terms of their epidemiology, they do share two characteristics: they cause chronic (though often intermittent) pain, and they are difficult to treat. They are also, collectively, very common.

Other rheumatic diseases which are caused by autoimmunity include:

• systemic lupus erythematosus
• rheumatoid arthritis
• juvenile arthritis
• Sjögren syndrome
• scleroderma
• Polymyositis
• Dermatomyositis
• Behçet's disease
• Reiter's syndrome
• Psoriatic arthritis

Treatment

A vast number of traditional herbal remedies were recommended for "rheumatism". Modern medicine, both conventional and alternative, recognises that the different rheumatic disorders have different causes (and several of them have multiple causes) and require different kinds of treatment.

Nevertheless, initial therapy of the major rheumatological diseases is with analgesics, such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs), members of which are ibuprofen and naproxen. Often, stronger analgesics are required.

The ancient Greeks recorded that bee venom had some beneficial effects on some types of rheumatism.

Cod liver oil has also been used as a remedy.

"Rheumatism" and weather

There has long been said to be a link between "rheumatic" pain and the weather. There appears to be no firm evidence in favour or against; a 1995 questionnaire given to 557 people by A. Naser and others at the Brigham and Women's Hospital's Pain Management Center concludes that "changes in barometric pressure are the main link between weather and pain. Low pressure is generally associated with cold, wet weather and an increase in pain. Clear, dry conditions signal high pressure and a decrease in pain."

References

Further reading

• The Rheumatology Handbook (WSPC 2012) ISBN 978-1-84816-320-1

External links

• American College of Rheumatology
• EULAR - The European League Against Rheumatism
• BBC "Your Health" website on Arthritis and Rheumatism

UpToDate Contents

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• 1. 関節リウマチの診断および鑑別診断 diagnosis and differential diagnosis of rheumatoid arthritis?detectedLanguage=en&source=search_result&translation=rheumatoid&search=rheumatoid&selectedTitle=1%7E150&provider=medicamap
• 2. 関節リウマチの臨床的特徴 clinical features of rheumatoid arthritis?detectedLanguage=en&source=search_result&translation=rheumatoid&search=rheumatoid&selectedTitle=2%7E150&provider=medicamap
• 3. 成人における中等度～重度の活動性関節リウマチの初期治療 initial treatment of moderately to severely active rheumatoid arthritis in adults?detectedLanguage=en&source=search_result&translation=rheumatoid&search=rheumatoid&selectedTitle=3%7E150&provider=medicamap
• 4. 成人における関節リウマチのマネージメントの一般的原則 general principles of management of rheumatoid arthritis in adults?detectedLanguage=en&source=search_result&translation=rheumatoid&search=rheumatoid&selectedTitle=4%7E150&provider=medicamap
• 5. 関節リウマチ関連肺疾患の概要 overview of lung disease associated with rheumatoid arthritis?detectedLanguage=en&source=search_result&translation=rheumatoid&search=rheumatoid&selectedTitle=5%7E150&provider=medicamap

English Journal

• Functional role of the KCa3.1 potassium channel in synovial fibroblasts from rheumatoid arthritis patients.

• Friebel K1, Schönherr R, Kinne RW, Kunisch E.
• Journal of cellular physiology.J Cell Physiol.2015 Jul;230(7):1677-88. doi: 10.1002/jcp.24924.
• Rheumatoid arthritis synovial fibroblasts (RA-SFs) show an aggressive phenotype and support joint inflammation and tissue destruction. New druggable targets in RA-SFs would therefore be of high therapeutic interest. The present study shows that the intermediate-conductance, calcium-activated potassi
• PMID 25545021

• Association of quality of life with laboratory measurements and lifestyle factors in community dwelling older people in Taiwan.

• Wu TY1, Chie WC, Liu JP, Liaw CK, Netuveli G, Blane D.
• Aging & mental health.Aging Ment Health.2015 Jun;19(6):548-59. doi: 10.1080/13607863.2014.962000. Epub 2014 Sep 30.
• OBJECTIVES: Little is known about the influence of routine laboratory measurements and lifestyle factors on generic quality of life (QOL) at older ages. We aimed to study the relationship between generic QOL and laboratory measurements and lifestyle factors in community dwelling older Chinese people
• PMID 25266062

• Immuno-proteomics: Development of a novel reagent for separating antibodies from their target proteins.

• Ganesan V1, Schmidt B1, Avula R1, Cooke D1, Maggiacomo T1, Tellin L1, Ascherman DP2, Bruchez MP1, Minden J3.
• Biochimica et biophysica acta.Biochim Biophys Acta.2015 Jun;1854(6):592-600. doi: 10.1016/j.bbapap.2014.10.011. Epub 2014 Oct 22.
• Immunoprecipitation (IP) is a widely used technique for identifying the binding partners of the target proteins of specific antibodies. Putative binding targets and their partners are usually in much lower amounts than the antibodies used to capture these target proteins. Thus antigen identification
• PMID 25466873

Japanese Journal

• 進化する超音波の実像に迫る リウマチ診療における関節エコー検査の有用性と展望 (超音波はここまで見えるようになっている)

• 谷村 一秀,成田 明宏
• 月刊新医療 41(5), 122-126, 2014-05
• NAID 40020042281

• インフリキシマブが有効であった関節リウマチによる壊死性強膜炎の1例 (第47回 日本眼炎症学会)

• 小溝 崇史,寺田 裕紀子,子島 良平
• あたらしい眼科 31(4), 595-598, 2014-04
• NAID 40020072503

• エアウェイスコープ乳児用イントロックを用いて分離肺換気用二腔チューブを気管挿管した慢性関節リウマチの1症例

• 尾野 直美,駒澤 伸泰,中野 祥子
• 麻酔 63(4), 406-408, 2014-04
• NAID 40020059342

Related Links

• rheumatoidの意味 - 英和辞書 - goo辞書

rheumatoidとは。意味や和訳。[形]（またrhegrave;u・ma・toi・dal）リューマチ（性）のrheumatoid arthritisリューマチ性関節炎. [名]リューマチ性関節炎患者. - goo辞書は国語、英和、和英、中国語、百科事典等からまとめて探せる辞書 ...

• Rheumatoid arthritisとは - goo Wikipedia (ウィキペディア)

Rheumatoid arthritis (RA) is an autoimmune disease that results in a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks flexible (synovial) joints. It can be a disabling and painful

Related Pictures

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★リンクテーブル★

リンク元	「100Cases 14」「rheumatic」「rheumatism」「リウマチ様」「リウマトイド」
拡張検索	「seropositive rheumatoid arthritis」「rheumatoid factor test」

「100Cases 14」

　　[★]

☆case14　複視

■glossary

diplopia n. 複視

筋力低下、筋無力、筋脱力 muscle weakness, muscular weakness

sunken

vt. sinkのpp.

adj.

沈没した、沈んだ、水中の

沈下した、一段低いところにある

落ち込んだ、くぼんだ

3,4-ジアミノピリジン 3,4-diaminopyridine 3,4-DAP K+チャネル阻害薬;ランバート・イートン筋無力症治療

■症例

43-year-old woman

cheif complaint: diplopia

present history: diplopia and holding her head up ; more marked in the evenings, for the last 3 months. difficulty of chewing. voice has become quieter. weight loss (3kg / 6months). non-smoker. drinks about 15 units/week. no regular medication.

past history: no significant previous medical illnesses.

family history: lives with her husband and three children.

・診察 examination

looks well.

organ systems: normal; cardiovascular, respiratory, and abdominal systems.

muscle power; grossly normal. decrease after testing a movement repetitively.

motor function: normal; tone, coordination, reflexes and sensation.

bilateral ptosis. exacerbated by prolonged upward gaze

eye: normal; pupillary reflexes, eye movements, and funduscopy

■答え

diagnosis: myathenia gravis

differential diagnoses:

CASES

上位and/or下位運動ニューロン motor neurone disease　運動ニューロン疾患：線維束性攣縮。進行例では筋力低下

筋 muscular dystrophy　筋ジストロフィー：ある種の筋肉が選択的に筋力低下する。家族歴がある。

筋 dystrophia myotonica　強直性筋ジストロフィー：咬筋、側頭筋、胸鎖乳突筋の筋萎縮、四肢遠位端の筋萎縮。顔貌が特徴的(前頭部脱毛、無表情、窪んだ頬)。家族歴ある。筋電図が診断に有用(急降下爆撃音)。

筋 polymyositis　多発筋炎：普通は皮疹と関節痛が出現。CKが上昇。筋生検が診断に有用

筋 myopathy　ミオパチー：甲状腺中毒性ミオパチー、甲状腺機能低下症によるミオパチー、クッシング症候群によるミオパチー、アルコール性のミオパチー

神経筋接合部？ non-metastatic associations of malignancy (paraneoplastic syndrome(傍腫瘍性症候群 = 腫瘍随伴症候群)のこと)：胸腺腫の症例の10%に重症筋無力症がみられる。ランバート・イートン筋無力症症候群は小細胞癌と関連がある。

HIM.2674

• 神経筋接合部 congenital myasthenia syndrome　先天性筋無力症症候群
• 神経筋接合部 drug-induced myasthenia　薬剤性筋無力症

Treatment with penicillamine (used for scleroderma or rheumatoid arthritis) may result in true autoimmune MG, but the weakness is usually mild, and recovery occurs within weeks or months after discontinuing its use.

　重症筋無力症の誘発：ペニシラミン(強皮症や関節リウマチの治療に用いられる)。

　　mildだし、薬剤の中断で改善する。

Aminoglycoside antibiotics or procainamide can cause exacerbation of weakness in myasthenic patients; very large doses can cause neuromuscular weakness in normal individuals.

　重症筋無力症の悪化：アミドグリコシド系抗菌薬、プロカインアミド

　　MGの患者の筋脱力が悪化する。

• 神経筋接合部 Lambert-Eaton myasthenic syndrome　ランバート・イートン筋無力症症候群：全身の筋肉が冒されるが、特に下肢の近位筋が冒される。MGと同じように～70%の患者で脳神経所見(眼瞼下垂、複視など)が認められる。MGと違うのは(1)反射が消失・減弱すること、(2)自律神経系の変化(口渇、勃起不全)を生じる、(3)神経刺激検査で漸増(waxing)が見られることである。病因は神経筋接合部のP/Q type calcium channelsに対する抗体の出現であり、85%の患者で見いだされる。治療はMGのように血漿交換や免疫抑制薬が使われる。3,4-DAPやpyridostigmineは症状に対する治療のために用いる。前者は運動神経の終末部でカルシウムチャネルをブロックし活動電位を延長させる。後者はアセチルコリンエステラーゼを阻害してシナプスにおける神経伝達物質の濃度を上げる。
• 精神疾患 neurasthenia　神経衰弱症：歴史的な用語。器質的な障害を伴わない筋無力症のような脱力を伴う症候群。患者は筋脱力や疲労を訴えてやってくる。筋肉の検査では器質的変化は認めないが"jerky release"あるいは"give-away weakness"が認められる。患者の主訴は反復動作による筋力低下よりむしろ疲労や感情鈍麻である。
• 内分泌疾患 hyperthyroidism　甲状腺機能亢進症：MGが疑われる患者にはthyroid function testをルーチンにやる。甲状腺機能異常は筋無力症の筋力低下を大きくすることがある。
• 神経筋接合部 botulism　ボツリヌス症：ボツリヌス毒素はシナプス前膜からの神経伝達物質の開口分泌を妨げる。症状はbulbar weakness (複視、構音障害、嚥下困難)。感覚障害はない。深部腱反射は初期には保たれている。進行すれば反射は見られなくなる。筋脱力は全身性。呼吸困難に陥ることがある。精神状態は正常。自律神経症状(麻痺性イレウス、便秘、urinary retention、瞳孔の散大、瞳孔の反応性低下、口渇)。確定診断は血清中の毒素の検出だけど、見つかることはまれ。神経伝導検査(nerve conduction studies)：compound muscle action potentials (CMAPs)の低下。高頻度の刺激で振幅が増加。治療：intubation for airway protection、呼吸補助、aggressive inpatient supportive care(e.g., nutrition, DVT prophylaxis)。馬の抗毒素を検査結果が帰ってくる前に投与する(？)。
• 上位運動ニューロン intracranial mass lesions　頭蓋内占拠病変：複視はintracranial mass lesionが外眼筋の神経を圧迫することにより生じる。
• 筋 progressive external ophthalmoplegia　進行性外眼筋麻痺：外眼筋の筋脱力を伴う。四肢の近位筋の筋力低下やそのほかの全身症状を伴うことがある。ミトコンドリアの異常を有する。

■参考文献

HIM = Harrison's Principles of Internal Medicine 17th Edition

CASES = 100 Cases in Clinical Medicine Second edition

IMD = 内科診断学第2版

「rheumatic」

　　[★]

• adj.

• リウマチ性の、リウマチの

関

rheumatica、rheumatism、rheumatoid

　 　

「rheumatism」

　　[★]

リウマチ

関

enthesopathy、rheumatic、rheumatic disease、rheumatoid

　 　

「リウマチ様」

　　[★]

英

rheumatoid

関

リウマチ、リウマトイド

「リウマトイド」

　　[★]

英

rheumatoid

関

リウマチ、リウマチ様

「seropositive rheumatoid arthritis」

　　[★]

血清反応陽性関節リウマチ

「rheumatoid factor test」

　　[★] リウマトイド因子検査法