Noninfectious Inflammatory Disorders Research Articles

Clinical Significance of Extreme Elevation of the Erythrocyte Sedimentation Rate

Charts of 1006 consecutive outpatients were reviewed to ascertain the cause of extreme elevation of the erythrocyte sedimentation rate (ESR) (greater than or equal to 100 mm/h) and the sensitivity of marked ESR elevation in patients with disorders commonly reported to cause ESR elevation. Prevalence of ESRs of 100 mm/h or more was 4.2%. Infection was the most common cause (33%), with malignant neoplasms and renal disease each responsible for 17% and inflammatory disorders for 14%. Only 1% of all other patients had ESRs of 100 mm/h or more. An ESR of 100 mm/h or more had low sensitivity: 36% among patients with infection, 25% among those with malignant neoplasms, and 21% among patients with noninfectious inflammatory disorders. Specificity was high, both for individual disease categories (96% for malignant neoplasms and 97% for infection) and as a "sickness" index (greater than 99%). The positive predictive value for an identifiable cause of marked ESR elevation was 90%.

Extraarticular steroid injection for hand and wrist disorders.

Extraarticular injection of steroid often relieves symptoms in noninfectious inflammatory disorders of the hand and wrist that have not responded to other forms of treatment. The technique is simple and does not require specialized equipment. Complications, including infection, are practically nonexistent.

Fluorometholone. Anti-inflammatory and intraocular pressure effects.

Fluorometholone 0.1% ophthalmic suspension applied topically was found to be an effective treatment in 308 patients with mild to severe noninfectious inflammatory disorders of the eye. The effect of fluorometholone on intraocular pressure was examined in steroid reactors who had accurately documented histories of pressure responses to prednisolone, dexamethasone, or betamethasone. The drug was also tested in a relatively large random patient population, including many with glaucoma, whose intraocular pressures were observed. The results of these studies indicate that fluorometholone shows a substantially reduced tendency to increase intraocular pressure as compared to several other steroids used topically.