Clinical Case Database / Category: Patient Management
Positive effects of low-dose immunotherapy in a rheumatoid arthritis patient
Foundation Years Journal, volume 7, issue 8, p.22 (123Doc Education, London, August 2013)
Rheumatoid arthritis is an autoimmune systemic disease of unknown aetiology involving chronic polyarthritis and affects 2% of the economically active population. This paper discusses the case of a 39-year-old woman who presented with particular flaring-up of her arthritis at ovulation and in the second half of her menstrual cycle when oestrogen levels are high. At these times she became very fatigued, trembled internally, became easily confused and overtired, and had an acute reaction with uncontrollable muscle twitch and spasm. She also felt very nauseated and her limbs became weak. The patient was managed by low-dose immunotherapy (LDI) desensitising her for oestrogen, aerobic and anaerobic bacteria. The patient also switched over to a progesterone-only pill in an attempt to override her hormonal cycle and suppress ovulation. Desensitisation with LDI and self-vaccination treatment brought back the patientâ€™s energy, calmed her stomach and improved her arthritis.
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1. Abraham SimÃ³n J. [Biological therapy in rheumatoid arthritis]. Rev Invest Clin. 2001;53:452-9.
2. CalderÃ³n MA, Cox L, Casale TB, Moingeon P, Demoly P. Multiple-allergen and single-allergen strategies in polysensitized patients: looking at the published evidence. J Allergy Clin Immunol. 2012;129:929-34.
3. Hong DI, Bankova L, Cahill KN, Kyin T, Castells MC. Allergy to monoclonal antibodies: cutting-edge desensitization methods for cutting-edge therapies. Expert Rev Clin Immunol. 2012;8:43-52.
4. Itsekson AM, Seidman DS, Zolti M, Alesker M, Carp HJ. Steroid hormone hypersensitivity: clinical presentation and management. Fertil Steril. 2011;95:2571-3.
5. Cox L, Larenas-Linnemann D, Lockey RF, Passalacqua G. Speaking the same language: The World Organization Subcutaneous Immunotherapy Systemic Reaction Grading System. J Allergy Clin Immunol. 2010;125:569-74.
6. Spoerl D, Scherer K, Tyndall A. Aspects of allergy in rheumatology. Clin Exp Rheumatol. 2011;29:560-6.
7. LarchÃ© M, Wraith DC. Peptide-based therapeutic vaccines for allergic and autoimmune diseases. Nat Med. 2005;11(4 Suppl):S69-76.
8. Pipet A, Botturi K, Pinot D, Vervloet D, Magnan A. Allergen-specific immunotherapy in allergic rhinitis and asthma: mechanisms and proof of efficacy. Respir Med. 2009;103:800-12.
9. Chen J, Zhou N, Huang Z. [The changes of serumal eosinophil cationic protein of patients with allergic rhinitis with specific immunotherapy.] Lin Chung Er Bi Yan Hou Tou Jing Wai Ke ZaZhi. 2011;25:347-8.
10 . Yacoub M-R, Incorvaia C, Caminati M, Colombo G. Immune mechanisms of allergen-specific immunotherapy. Open Allergy Journal. 2012;5:47-52.
11 . Norman PS. Immunotherapy: 1999-2004. J Allergy Clin Immunol. 2004;113:1013-23.
12. Justicia JL, BarÃ³ E, Cardona V, Guardia P, Ojeda P, OlaguÃbel JM, et al. Development of a questionnaire to assess patient satisfaction with allergenspecific immunotherapy in adults: item generation, item reduction, and preliminary validation. Patient Prefer Adherence. 2011;5:239-50.
13. Oâ€™Boyle G, Fox CR, Walden HR, Willet JD, Mavin ER, Hine DW, et al. Chemokine receptor CXCR3 agonist prevents human T-cell migration in a humanized model of arthritic inflammation. Proc Natl Acad Sci U S A. 2012;109:4598-603.
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The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
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