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Palindromic Rheumatism
The recording you
hear was not created by The IPRS.
The opinions expressed within are
not necessarily the same as those of the IPRS. The recording is played purely
for the interest of anyone browsing this website.
Palindromic Rheumatism
"PR" also known as
Hench-Rosenberg syndrome or Hench’s syndrome. PR may also be referred to as
"PRA" in the case of Palindromic Rheumatoid Arthritis and "PA" Palindromic
Arthritis.
"PR" gets it's name
from a Palindrome, usually associated with a word like Hannah spelt the same
forward and back i.e. comes and goes, but with Rheumatism it basically means comes and goes. Although in my
case having had it for many years the pain just doesn't go any more.
The "comes and goes" also applies to it
moving from one joint to another affected joint, sometimes in many joints at
once. It also applies to damage caused to joints unlike Rheumatoid Arthritis
after a "flare up" (inflammation of the joint and surrounding tissue) the joint
usually returns back to normal without any permanent joint damage.
There aren't any specific numbers on the
amount of people in the UK affected with PR. As some have gone onto develop "RA"
(Rheumatoid Arthritis) or another Autoimmune Disorder by the time a diagnosis is
made. I have made a conservative estimate that there are a 1000 diagnosed
suffers in the UK with many more at this time not diagnosed. The amount in
America is likely to be 5x more and of course many others in other countries.
Hench-Rosenberg
syndrome
Also known as:
Hench’s syndrome
Synonyms:
Palindromic rheumatism.
Associated persons:
Philip Showalter Hench
And
Edward Frank Rosenberg
Description:
The unusual features of this syndrome consists of the sudden and rapidly
developing afebrile attacks of arthritis or periarthritis, occasionally
paraarthritis, that continue for a few hours or a few days and then disappear
completely. There is pain, redness, swelling, and disability of one (usually) or
multiple joints. The interval between recurrent attacks is extremely variable.
There are no joint deformities or roentgenographic manifestations.
Hench and Rosenberg suggested the term «palidromic rheumatism», meaning
«repeated course». It was entered in the international rheuma nomenclature in
1957. Bibliography:
P. S. Hench, E. F. Rosenberg:
Palidromic rheumatism. A «new», often recurring disease of joints (arthritis,
periarthritis, para-arthritis) apparently producing no articular residues -
report of thirty-four cases; its relation to «angioneural arthrosis,» «allergic
rheumatism,» and rheumatoid arthritis.
Archives of Internal Medicine, Chicago, 1944, 73: 293-321.
Hench-Rosenberg Syndrome
WHAT IS PALINDROMIC
RHEUMATISM?
Palindromic Rheumatism, also known as Hench-Rosenberg syndrome or
Hench’s syndrome, was named for Nobel Prize winner Philip S. Hench and his
partner Edward Frank Rosenberg. Mr. Hench (1896-1965) received his doctorate in
medicine from the University of Pittsburgh in 1920. His association with the
Mayo Clinic began in 1923 when he became first an assistant, then, three years
later, Head of its Department of Rheumatic Diseases. At the Mayo Clinic he
specialized in arthritic disease. In the course of his work he observed the
favourable effects of jaundice on arthritic patients, causing a remission of
pain. Other bodily changes, for example pregnancy, produced the same effect.
These and other observations led him gradually to the conclusion that the
pain-alleviating substance was a steroid. In the period 1930-1938, Dr. E. C.
Kendall had isolated several steroids from the adrenal gland cortex. After
several years of collaboration with Dr. Kendall, it was decided to try the
effect of one of these substances, Compound E (later named cortisone), on
arthritic patients. In 1948-1949, cortisone was successfully tested on arthritic
patients. Hench also treated patients with ACTH, a hormone produced by the
pituitary gland which stimulates the adrenal gland.
Palindromic Rheumatism is a form of an autoimmune disorder. Although PR is
listed on the World Rare Disease Listing, it is only one of about five-hundred
types of autoimmune disorders. Approximately 50 million Americans, 20 percent of
the population or one in five people, suffer from autoimmune diseases. An
Autoimmune disorder is a condition caused by an immune response against the
body's own tissues. The immune system protects the body from potentially harmful
substances (antigens) such as micro organisms, toxins, cancer cells, and foreign
blood or tissues from another person or species. Antigens are destroyed by the
immune response, which includes production of antibodies (molecules that attach
to the antigen and make it more susceptible to destruction) and sensitized
lymphocytes (specialized white blood cells that recognize and destroy particular
antigens).
Immune system disorders occur when the immune response is inappropriate,
excessive, or lacking. Autoimmune disorders develop when the immune system
destroys normal body tissues. This is caused by a hypersensitivity reaction
similar to allergies, where the immune system reacts to a substance that it
normally would ignore. In allergies, the immune system reacts to an external
substance that would normally be harmless. With autoimmune disorders, the immune
system reacts to normal "self" body tissues.
Normally, the immune system is capable of differentiating "self" from "non-self"
tissue. Some immune system cells (lymphocytes) become sensitized against "self"
tissue cells, but these faulty lymphocytes are usually controlled (suppressed)
by other lymphocytes. Autoimmune disorders occur when the normal control process
is disrupted. They may also occur if normal body tissue is altered so that it is
no longer recognized as "self." The mechanisms that cause disrupted control or
tissue changes are not known. One theory holds that various micro organisms and
drugs may trigger some of these changes, particularly in people with a genetic
predisposition to an autoimmune disorder.
Palindromic Rheumatism derives its name from the term "palindrome" — a word that
is spelled the same forward as backward (examples include "kayak" and "mom") —
emphasizing how the illness begins and ends in a similar way. It is a rare type
of inflammatory arthritis that causes sudden inflammation in one or several
joints, lasts a few hours or up to a few days, and then goes away completely.
The problem usually involves 2 or 3 joints, which have onset over hours and last
days - weeks, before subsiding. However episodes of recurrence form a pattern,
with symptom free periods between attacks lasting for weeks to months. The large
joints are most commonly involved. The soft tissues are also involved with the
swelling of the periarticular tissues, especially heel pads and the finger pads.
Nodules may be found in the subcutaneous tissues.
Constitutionally, the patient may or may not have a fever, and swelling of the
joints.
Palindromic rheumatism is a disease of unknown cause. It has been suggested that
it is an abortive form of rheumatoid arthritis, since anti-cyclic citrullinated
peptide antibodies (anti-CCP) and antikeratin antibodies (AKA) are present in a
high proportion of patients, as is the case in rheumatoid arthritis. Unlike RA
and some other forms of arthritis, palindromic rheumatism affects men and women
equally. It typically affects people between the ages of 20 and 50. No single
test can confirm a diagnosis. A doctor may make a diagnosis based on medical
history and signs and symptoms. Palindromic rheumatism must be distinguished
from acute gouty arthritis and an atypical, acute onset of rheumatoid arthritis.
Without specific tests (such as analysis of joint fluid), it may be difficult to
distinguish palindromic rheumatism from other episodic joint problems. It is
important to note that a person may experience more than one autoimmune disorder
at the same time. Laboratory findings are usually normal. Blood tests may show
an elevation of the ESR and CRP, but are otherwise unremarkable. Rheumatoid
factor may be present especially in the group that is likely to develop
Rheumatoid arthritis.
This is a Podcast (recording) that
I recently found on the internet talking about PR. It is interesting to listen
to. It was recorded in 2005.
I clearly would like to thank M ike
Mc M ahon for creating this audio blog and for letting us use it.
This is NOT my voice, by the way.
Back to PR Main Page
Founded 2005.
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