Marked improvement of intractable arthritic pain in a woman with rheumatoid arthritis with sympathomimetic amine treatment despite previous failure with standard therapy and possible implications for last trimester unexplained fetal demise--case repo

摘要

PURPOSE: To determine if sympathomimetic amine treatment could alleviate severe arthritic pain and fatigue associated with rheumatoid arthritis which was refractory to other medical therapy in a patient with a history of unexplained last trimester fetal demise and unexplained cessation of fetal movement and acidosis. METHODS: A 32-year-old female was treated with 10 mg of dextroamphetamine sulfate daily after failing to gain relief with standard therapy for rheumatoid arthritis. RESULTS: After several weeks of therapy the patient noticed fewer flare ups of arthritic pain and a marked improvement in her fatigue. Six months on the sympathomimetic amines she noticed improvement in her ability to carry out everyday activities, less flare ups, and increased energy. CONCLUSIONS: Sympathomimetic amines as demonstrated in this case report can effectively relieve joint pain when conventional therapies for rheumatoid arthritis fail, at least if the water load test is abnormal. Perhaps this therapy could prove beneficial in inhibiting chorionic villitis which can cause fetal death.