Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Sustained remission of rheumatoid arthritis with a specific serotonin reuptake inhibitor antidepressant: a case report and review of the literature. | Krishnadas et al. Journal of Medical Case Reports 2011 5 112 http content 5 1 112 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Sustained remission of rheumatoid arthritis with a specific serotonin reuptake inhibitor antidepressant a case report and review of the literature Rajeev Krishnadas1 Ranjit Krishnadas2 and Jonathan Cavanagh1 Abstract Introduction The mainstay of pharmacologic therapy for rheumatoid arthritis includes the use of diseasemodifying agents like sulfasalazine and methothrexate and more recently anti-tumor necrosis factor-a agents. Depression remains a major co-morbidity in patients with rheumatoid arthritis and is thought to contribute to disability and mortality in these patients. Evidence now suggests that a biologic link exists between substrates responsible for inflammatory conditions and mood disorders. Most of this evidence comes from preclinical studies. Nevertheless more research into this area is helping us to understand the possible mechanisms through which these conditions interact with each other. Case presentation We describe a 60-year-old Indian man with rheumatoid arthritis diagnosed 15 years ago who had minimal response to multiple therapies with disease-modifying agents and whose arthritis symptoms surprisingly remitted when he was started on a specific serotonin reuptake inhibitor antidepressant three years ago for co-morbid major depression. This remission has been maintained with this medication and the patient is currently not taking any antirheumatoid medications. Conclusion Possible mechanisms linking substrates of mood disorders and inflammation are reviewed in this case report particularly the serotonergic system. Evidence seems to suggest a significant interaction between the serotonergic systems and inflammation. This interaction seems to be bidirectional. An understanding of this relation is most important to gain insight not only into pathophysiological mechanisms underlying this
