{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T12:34:48Z","timestamp":1773405288328,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2003,9,11]],"date-time":"2003-09-11T00:00:00Z","timestamp":1063238400000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2003,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In some patients with rheumatoid arthritis (RA), the disease improves following tonsillectomy. We describe a 28\u2010year\u2010old woman with treatment\u2010resistant RA and chronic tonsillitis. Initially, her arthritis had been well controlled with methotrexate and corticosteroids, but the RA activity became difficult to control in spite of addition of bucillamine to the treatment regimen and repeated arthrocentesis with infusion of corticosteroid into her swollen joints. Closer examination revealed that the period of exacerbation of her chronic tonsillitis paralleled that of the systemic arthritis, and administration of antibiotics brought transient relief of the systemic symptoms. Her arthritis was ameliorated after successful tonsillectomy and synovectomy, with marked reduction of the serum rheumatoid factor concentration. Analysis of infiltrating T cell clones in tonsil and synovium using T cell receptor V<jats:sub>\u03b2<\/jats:sub> repertoire and third complementarity\u2010determining region size distribution analysis followed by nucleotide sequencing revealed common clonal T cell expansion in both tissues. This finding suggests the possible involvement of chronic focal infection in refractory RA.<\/jats:p>","DOI":"10.1002\/art.11212","type":"journal-article","created":{"date-parts":[[2003,9,16]],"date-time":"2003-09-16T14:43:17Z","timestamp":1063723397000},"page":"2483-2488","source":"Crossref","is-referenced-by-count":20,"title":["Simultaneous, clonally identical T cell expansion in tonsil and synovium in a patient with rheumatoid arthritis and chronic tonsillitis"],"prefix":"10.1002","volume":"48","author":[{"given":"Mitsuhiro","family":"Kawano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanae","family":"Okada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Muramoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Morishita","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takayo","family":"Omura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susumu","family":"Kitajima","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Katano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Koni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Mabuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiro","family":"Yachie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2003,9,11]]},"reference":[{"key":"e_1_2_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200011303432202"},{"key":"e_1_2_4_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200110)44:10<2235::AID-ART385>3.0.CO;2-A"},{"key":"e_1_2_4_4_2","volume-title":"Harrison's principles of internal medicine","author":"Lipsky PE","year":"2001"},{"key":"e_1_2_4_5_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI117624"},{"key":"e_1_2_4_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.54.4.314"},{"key":"e_1_2_4_7_2","doi-asserted-by":"crossref","first-page":"852","DOI":"10.4049\/jimmunol.156.2.852","article-title":"Oligoclonality of V\u03b23 TCR chains in the CD8+ T cell population of rheumatoid arthritis patients","volume":"156","author":"Hingorani R","year":"1996","journal-title":"J Immunol"},{"key":"e_1_2_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.11.1189"},{"key":"e_1_2_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780310302"},{"key":"e_1_2_4_10_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2002-04-1136"},{"key":"e_1_2_4_11_2","first-page":"161","article-title":"Clinical analyses of focus tonsil and related diseases in Japan","volume":"523","author":"Kataura A","year":"1996","journal-title":"Acta Otolaryngol"},{"key":"e_1_2_4_12_2","first-page":"316","article-title":"Antecedent tonsillectomy and appendectomy in rheumatoid arthritis","volume":"6","author":"Gottlieb NL","year":"1979","journal-title":"J Rheumatol"},{"key":"e_1_2_4_13_2","first-page":"309","article-title":"Rheumatoid arthritis and antecedent tonsillectomy","volume":"10","author":"Wolfe F","year":"1983","journal-title":"J Rheumatol"},{"key":"e_1_2_4_14_2","first-page":"313","article-title":"Preceding tonsillectomy and appendicectomy in rheumatoid and degenerative arthritis","volume":"10","author":"Patel SB","year":"1983","journal-title":"J Rheumatol"},{"key":"e_1_2_4_15_2","doi-asserted-by":"publisher","DOI":"10.1159\/000110302"},{"key":"e_1_2_4_16_2","first-page":"1241","article-title":"Do appendectomy and tonsillectomy reduce the risk of rheumatoid arthritis?","volume":"24","author":"Koumantaki Y","year":"1997","journal-title":"J Rheumatol"},{"key":"e_1_2_4_17_2","first-page":"43","article-title":"Influence of antecedent lymphoid surgery on the odds of acquiring rheumatoid arthritis","volume":"12","author":"Fernandez\u2010Madrid F","year":"1985","journal-title":"J Rheumatol"},{"key":"e_1_2_4_18_2","first-page":"206","article-title":"Reactive arthritis induced by tonsillitis","volume":"523","author":"Kobayashi S","year":"1996","journal-title":"Acta Otolaryngol"}],"container-title":["Arthritis &amp; 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