W. Esselinckx - Academia.edu (original) (raw)
Papers by W. Esselinckx
Advances in Experimental Medicine and Biology
The cross-sectional study of patients with RA receiving LDGC, compared with those on NSAID alone ... more The cross-sectional study of patients with RA receiving LDGC, compared with those on NSAID alone (or patients with AS) showed that LDGC significantly affects bone mass at midshaft and even more so at the distal radius. The loss of bone seems to be brisk but continuous on the long run, at least at the distal scanning site, and thus increases the C/T ratio, especially in aged men. The loss of bone mass in the LDGC group correlates with the duration of the disease as well as with carpal destruction (especially at mid shaft radius), with both parameters being correlated with one another. At equal carpal destruction, LDGC still affects bone mass. Whether receiving NSAID alone or LDGC in addition, patients with RA, as compared with controls, are more liable to lose bone when they grow older. In a longitudinal study, premenopausal women were unaffected by the administration of LDGC at both scanning sites. In contrast, postmenopausal women receiving LDGC lost at least twice as much bone as did normal women after the menopause. Men of all ages on LDGC lost bone at a rate equal to that of normal women after the menopause. Men with RA or with AS on NSAID alone did not significantly lose bone. It is concluded that LDGC may be given to premenopausal women without harm to their bone mass. After the menopause, hormonal replacement therapy, if not contra-indicated, should be given in association with LDGC. Men fortunately have a higher peak bone mass and therefore can afford to lose bone during a decade before they attain the same situation as women at the time of their menopause. If treatment is then continued for another two decades, their bone mass might behave as does that of postmenopausal women if bone loss is continuous over such long periods of time. This latter assumption has yet to be verified.
Revue du rhumatisme et des maladies ostéo-articulaires
Four new cases of ankylosing spondylitis complicated by a cauda equina syndrome are reported. Sim... more Four new cases of ankylosing spondylitis complicated by a cauda equina syndrome are reported. Similarly to the previous descriptions, the patients present with long-standing and severe spondylitis at the time when neurological symptoms, mainly radicular pain, develop. Computed tomography of the lumbar spine demonstrates in all cases typical laminar erosions and posterior arachnoid diverticula. Up to now, magnetic resonance imaging has rarely been performed in this particular pathology, though it is helpful in determining the anatomical relations and the nature of the lesions. Based on the previous publications, our study aims at describing the clinical and pathogenic aspects of the disease and defining the most useful diagnostic investigations and treatment choices. Therapeutic possibilities are often limited because of a late diagnosis. Better knowledge of this rare complication could lead to earlier recognition and more efficient therapy.
Annals of the rheumatic diseases, 1979
There has been little basis on which to standardise a diagnosis of polymyalgia rheumatica (PMR), ... more There has been little basis on which to standardise a diagnosis of polymyalgia rheumatica (PMR), and so 11 rheumatology units in the south and west of Great Britain have collaborated in a study to evaluate possible criteria. Symptoms and laboratory findings claimed to be of diagnostic value in PMR were included in an analysis of the features of 236 patients considered to have unequivocal PMR and 70 patients thought to have possible PMR. The results were compared with similar information from 253 patients with conditions that mimic PMR and from 201 consecutive new presentations to outpatients. The 7 most valuable criteria for differentiation were bilateral shoulder pain or stiffness, onset of illness of less than 2 weeks' duration, initial ESR greater than 40 mm/h, duration of morning stiffness exceeding 1 hour, age 65 years or more, depression and/or weight loss, and bilateral tenderness in the upper arms. We suggest that a patient might be regarded as having probable PMR if any...
Annals of The Rheumatic Diseases - ANN RHEUM DIS, 1977
Comparison of clinically assessed activity of disease with 112 paired readings of the erythrocyte... more Comparison of clinically assessed activity of disease with 112 paired readings of the erythrocyte sedimentation rate (ESR) and the plasma viscosity (PV) in 23 patients with polymyalgia rheumatica (PMR) showed the following. (1) A correlation between ESR and PV in both sexes, reaching the significance obtained in a comparison group of patients with rheumatoid arthritis (RA) (109 paired readings), with no significant difference between the PMR and RA groups on analysis of variance of the regression slopes. (2) A degree of scatter of readings around the regression lines so that they could not be used for prediction of ESR from the PV or vice versa. (3) ϰ2 analysis of normal and abnormal values of ESR and PV which showed a highly significant correlation. However 10 readings were abnormally high for ESR in the presence of a normal PV. 5 of these 10 observations were associated with clinical features of disease activity. 20 readings were abnormally high for PV in spite of a normal ESR wit...
Journal of Bone and Mineral Research, 2001
The aim of this study was to compare the action of two regimens of intravenous (iv) pamidronate i... more The aim of this study was to compare the action of two regimens of intravenous (iv) pamidronate in the primary prevention of glucocorticoid-induced osteoporosis (GC-OP). The primary purpose of the study was to determine whether any differences in bone mineral density (BMD) appeared after 1 year. A secondary endpoint aimed at assessing the remodeling parameters in order to better understand the mechanisms of action of the various regimens. Thirty-two patients, who required first-time, long-term glucocorticoid therapy at a daily dose of at least 10 mg of prednisolone, were studied. Simultaneously with the initiation of their glucocorticoid treatment, patients also were randomly allocated to receive a single iv infusion of 90 mg of pamidronate at the start (group A); a first infusion of 90 mg of pamidronate followed, subsequently, by an iv infusion of 30 mg pamidronate every 3 months (group B); and a daily 800-mg elemental calcium supplement given as calcium carbonate (group C), which also was taken by patients in groups A and B. Patients were matched for starting glucocorticoid doses, sex, menopausal status, and hormonal replacement therapy. Lumbar spine and hip (total and subregions) BMDs were measured at the outset and repeated at 6-month intervals by dual-energy X-ray absorptiometry (DXA; Hologic QDR-2000). Bone turnover was assessed by measurement of total and bone-specific serum alkaline phosphatase activity (B-ALP), serum osteocalcin (OC), and serum C-telopeptide cross-links of type I collagen (CTX). After 1 year, the mean BMD changes for groups A, B, and C were, respectively, 1.7, 2.3, and -4.6% at the lumbar spine; 1.2, 1.2, and -3.1% at the femoral neck; 1.0, 2.6, and -2.2% for the total hip region. No difference was observed between pamidronate regimens but a highly significant difference was observed between both pamidronate regimens and the control group at the lumbar spine (p < 0.001), at the femoral neck (p < 0.01), and for the total hip (p < 0.05). A significant decrease of serum C-telopeptide was observed, after 3 months, in groups A and B (p = 0.029), but a sustained decrease of bone resorption over time was observed only in group B. As far as BMD evolution over 1 year was concerned, iv pamidronate, given either as a single infusion or once every 3 months, effectively achieved primary prevention of GC-OP.
European Journal of Endocrinology, 1977
ABSTRACT
Clinical Rheumatology, 2001
The authors report three cases of thoracic radiculoneuropathy disclosing neuroborreliosis. All th... more The authors report three cases of thoracic radiculoneuropathy disclosing neuroborreliosis. All three patients had low back and abdominal pain and two had marked abdominal wall paresis. EMG confirmed a motor involvement of the lower thoracic roots and CSF analysis revealed a lymphocytic meningitis in all three cases. Antibodies against Borrelia burgdorferi were present in both the serum and the CSF. A favourable outcome was obtained in all three patients with appropriate antibiotherapy. The differential diagnosis of this misleading presentation is discussed.
Clinical Rheumatology, 1999
We report a case of multifocal-monosystemic Langherhans cell histiocytosis (LCH), formerly usuall... more We report a case of multifocal-monosystemic Langherhans cell histiocytosis (LCH), formerly usually referred to as eosinophilic granuloma (EG) of bone. The condition developed in a 36-year-old man. A notable infrequent thoracic spine location and two successive distinct costal lesions were observed. Both the first costal site and the vertebral location healed spontaneously; the second costal lesion underwent biopsy resection. The patient's disease course with an 8-year follow-up is discussed with reference to various treatment options, emphasising in selected cases a watchful conservative approach, in view of the widely documented potential for spontaneous healing.
Calcified Tissue International, 1997
The aim of this study was to assess whether early intermittent I.V. administration of disodium pa... more The aim of this study was to assess whether early intermittent I.V. administration of disodium pamidronate can effectively achieve primary prevention of glucocorticoid-induced osteoporosis (GIOP). A total of 27 in-or outpatients who required first-time, long-term corticosteroid therapy at a daily dose of at least 10 mg prednisolone were studied. Patients were randomly selected to receive either pamidronate and calcium or calcium alone. Patients allocated to pamidronate treatment (pamidronate group) received a first intravenous infusion of 90 mg pamidronate simultaneously with the initiation of their steroid treatment. Subsequently, they received 30 mg pamidronate, intravenously, every 3 months, for as long as steroid therapy was continued. As with the control patients (calcium group), they were put on a daily 800-mg elemental calcium supplement given as calcium carbonate. Lumbar spine and hip (total and subregions) bone mineral densities (BMDs) were measured at the start and every 3-months by dual-energy X-ray absorptiometry (Hologic QDR-2000). Over 1 year, the pamidronate group showed a significant BMD increase in the lumbar spine (3.6%), and at all sites of the hip (2.2% at the femoral neck). In the calcium group, a significant BMD reduction was registered at the lumbar spine (−5.3%) and at the femoral neck (−5.3%). Differences between the groups were significant at all sites measured. Intermittent intravenous pamidronate effectively achieves primary prevention of GIOP, as assessed by BMD measurements over 1 year.
Rheumatology, 1998
... may present aspecific changes with thicken-ing and chronic inflammation [24, 8]. These findi... more ... may present aspecific changes with thicken-ing and chronic inflammation [24, 8]. These findings are quite distinct from synovial fat necrosis associated with ischaemic pancreatic disease [12], from collections of lipid-laden macrophages sometimes ... Ryan WE, Sadeghian MR. ...
Advances in Experimental Medicine and Biology
The cross-sectional study of patients with RA receiving LDGC, compared with those on NSAID alone ... more The cross-sectional study of patients with RA receiving LDGC, compared with those on NSAID alone (or patients with AS) showed that LDGC significantly affects bone mass at midshaft and even more so at the distal radius. The loss of bone seems to be brisk but continuous on the long run, at least at the distal scanning site, and thus increases the C/T ratio, especially in aged men. The loss of bone mass in the LDGC group correlates with the duration of the disease as well as with carpal destruction (especially at mid shaft radius), with both parameters being correlated with one another. At equal carpal destruction, LDGC still affects bone mass. Whether receiving NSAID alone or LDGC in addition, patients with RA, as compared with controls, are more liable to lose bone when they grow older. In a longitudinal study, premenopausal women were unaffected by the administration of LDGC at both scanning sites. In contrast, postmenopausal women receiving LDGC lost at least twice as much bone as did normal women after the menopause. Men of all ages on LDGC lost bone at a rate equal to that of normal women after the menopause. Men with RA or with AS on NSAID alone did not significantly lose bone. It is concluded that LDGC may be given to premenopausal women without harm to their bone mass. After the menopause, hormonal replacement therapy, if not contra-indicated, should be given in association with LDGC. Men fortunately have a higher peak bone mass and therefore can afford to lose bone during a decade before they attain the same situation as women at the time of their menopause. If treatment is then continued for another two decades, their bone mass might behave as does that of postmenopausal women if bone loss is continuous over such long periods of time. This latter assumption has yet to be verified.
Revue du rhumatisme et des maladies ostéo-articulaires
Four new cases of ankylosing spondylitis complicated by a cauda equina syndrome are reported. Sim... more Four new cases of ankylosing spondylitis complicated by a cauda equina syndrome are reported. Similarly to the previous descriptions, the patients present with long-standing and severe spondylitis at the time when neurological symptoms, mainly radicular pain, develop. Computed tomography of the lumbar spine demonstrates in all cases typical laminar erosions and posterior arachnoid diverticula. Up to now, magnetic resonance imaging has rarely been performed in this particular pathology, though it is helpful in determining the anatomical relations and the nature of the lesions. Based on the previous publications, our study aims at describing the clinical and pathogenic aspects of the disease and defining the most useful diagnostic investigations and treatment choices. Therapeutic possibilities are often limited because of a late diagnosis. Better knowledge of this rare complication could lead to earlier recognition and more efficient therapy.
Annals of the rheumatic diseases, 1979
There has been little basis on which to standardise a diagnosis of polymyalgia rheumatica (PMR), ... more There has been little basis on which to standardise a diagnosis of polymyalgia rheumatica (PMR), and so 11 rheumatology units in the south and west of Great Britain have collaborated in a study to evaluate possible criteria. Symptoms and laboratory findings claimed to be of diagnostic value in PMR were included in an analysis of the features of 236 patients considered to have unequivocal PMR and 70 patients thought to have possible PMR. The results were compared with similar information from 253 patients with conditions that mimic PMR and from 201 consecutive new presentations to outpatients. The 7 most valuable criteria for differentiation were bilateral shoulder pain or stiffness, onset of illness of less than 2 weeks' duration, initial ESR greater than 40 mm/h, duration of morning stiffness exceeding 1 hour, age 65 years or more, depression and/or weight loss, and bilateral tenderness in the upper arms. We suggest that a patient might be regarded as having probable PMR if any...
Annals of The Rheumatic Diseases - ANN RHEUM DIS, 1977
Comparison of clinically assessed activity of disease with 112 paired readings of the erythrocyte... more Comparison of clinically assessed activity of disease with 112 paired readings of the erythrocyte sedimentation rate (ESR) and the plasma viscosity (PV) in 23 patients with polymyalgia rheumatica (PMR) showed the following. (1) A correlation between ESR and PV in both sexes, reaching the significance obtained in a comparison group of patients with rheumatoid arthritis (RA) (109 paired readings), with no significant difference between the PMR and RA groups on analysis of variance of the regression slopes. (2) A degree of scatter of readings around the regression lines so that they could not be used for prediction of ESR from the PV or vice versa. (3) ϰ2 analysis of normal and abnormal values of ESR and PV which showed a highly significant correlation. However 10 readings were abnormally high for ESR in the presence of a normal PV. 5 of these 10 observations were associated with clinical features of disease activity. 20 readings were abnormally high for PV in spite of a normal ESR wit...
Journal of Bone and Mineral Research, 2001
The aim of this study was to compare the action of two regimens of intravenous (iv) pamidronate i... more The aim of this study was to compare the action of two regimens of intravenous (iv) pamidronate in the primary prevention of glucocorticoid-induced osteoporosis (GC-OP). The primary purpose of the study was to determine whether any differences in bone mineral density (BMD) appeared after 1 year. A secondary endpoint aimed at assessing the remodeling parameters in order to better understand the mechanisms of action of the various regimens. Thirty-two patients, who required first-time, long-term glucocorticoid therapy at a daily dose of at least 10 mg of prednisolone, were studied. Simultaneously with the initiation of their glucocorticoid treatment, patients also were randomly allocated to receive a single iv infusion of 90 mg of pamidronate at the start (group A); a first infusion of 90 mg of pamidronate followed, subsequently, by an iv infusion of 30 mg pamidronate every 3 months (group B); and a daily 800-mg elemental calcium supplement given as calcium carbonate (group C), which also was taken by patients in groups A and B. Patients were matched for starting glucocorticoid doses, sex, menopausal status, and hormonal replacement therapy. Lumbar spine and hip (total and subregions) BMDs were measured at the outset and repeated at 6-month intervals by dual-energy X-ray absorptiometry (DXA; Hologic QDR-2000). Bone turnover was assessed by measurement of total and bone-specific serum alkaline phosphatase activity (B-ALP), serum osteocalcin (OC), and serum C-telopeptide cross-links of type I collagen (CTX). After 1 year, the mean BMD changes for groups A, B, and C were, respectively, 1.7, 2.3, and -4.6% at the lumbar spine; 1.2, 1.2, and -3.1% at the femoral neck; 1.0, 2.6, and -2.2% for the total hip region. No difference was observed between pamidronate regimens but a highly significant difference was observed between both pamidronate regimens and the control group at the lumbar spine (p < 0.001), at the femoral neck (p < 0.01), and for the total hip (p < 0.05). A significant decrease of serum C-telopeptide was observed, after 3 months, in groups A and B (p = 0.029), but a sustained decrease of bone resorption over time was observed only in group B. As far as BMD evolution over 1 year was concerned, iv pamidronate, given either as a single infusion or once every 3 months, effectively achieved primary prevention of GC-OP.
European Journal of Endocrinology, 1977
ABSTRACT
Clinical Rheumatology, 2001
The authors report three cases of thoracic radiculoneuropathy disclosing neuroborreliosis. All th... more The authors report three cases of thoracic radiculoneuropathy disclosing neuroborreliosis. All three patients had low back and abdominal pain and two had marked abdominal wall paresis. EMG confirmed a motor involvement of the lower thoracic roots and CSF analysis revealed a lymphocytic meningitis in all three cases. Antibodies against Borrelia burgdorferi were present in both the serum and the CSF. A favourable outcome was obtained in all three patients with appropriate antibiotherapy. The differential diagnosis of this misleading presentation is discussed.
Clinical Rheumatology, 1999
We report a case of multifocal-monosystemic Langherhans cell histiocytosis (LCH), formerly usuall... more We report a case of multifocal-monosystemic Langherhans cell histiocytosis (LCH), formerly usually referred to as eosinophilic granuloma (EG) of bone. The condition developed in a 36-year-old man. A notable infrequent thoracic spine location and two successive distinct costal lesions were observed. Both the first costal site and the vertebral location healed spontaneously; the second costal lesion underwent biopsy resection. The patient's disease course with an 8-year follow-up is discussed with reference to various treatment options, emphasising in selected cases a watchful conservative approach, in view of the widely documented potential for spontaneous healing.
Calcified Tissue International, 1997
The aim of this study was to assess whether early intermittent I.V. administration of disodium pa... more The aim of this study was to assess whether early intermittent I.V. administration of disodium pamidronate can effectively achieve primary prevention of glucocorticoid-induced osteoporosis (GIOP). A total of 27 in-or outpatients who required first-time, long-term corticosteroid therapy at a daily dose of at least 10 mg prednisolone were studied. Patients were randomly selected to receive either pamidronate and calcium or calcium alone. Patients allocated to pamidronate treatment (pamidronate group) received a first intravenous infusion of 90 mg pamidronate simultaneously with the initiation of their steroid treatment. Subsequently, they received 30 mg pamidronate, intravenously, every 3 months, for as long as steroid therapy was continued. As with the control patients (calcium group), they were put on a daily 800-mg elemental calcium supplement given as calcium carbonate. Lumbar spine and hip (total and subregions) bone mineral densities (BMDs) were measured at the start and every 3-months by dual-energy X-ray absorptiometry (Hologic QDR-2000). Over 1 year, the pamidronate group showed a significant BMD increase in the lumbar spine (3.6%), and at all sites of the hip (2.2% at the femoral neck). In the calcium group, a significant BMD reduction was registered at the lumbar spine (−5.3%) and at the femoral neck (−5.3%). Differences between the groups were significant at all sites measured. Intermittent intravenous pamidronate effectively achieves primary prevention of GIOP, as assessed by BMD measurements over 1 year.
Rheumatology, 1998
... may present aspecific changes with thicken-ing and chronic inflammation [24, 8]. These findi... more ... may present aspecific changes with thicken-ing and chronic inflammation [24, 8]. These findings are quite distinct from synovial fat necrosis associated with ischaemic pancreatic disease [12], from collections of lipid-laden macrophages sometimes ... Ryan WE, Sadeghian MR. ...