Clinical and experimental rheumatology最新文献

{"title":"The diagnostic utility of intima-media thickness measurement compared with the halo sign in temporal artery ultrasonography: a single-centre retrospective study.","authors":"Kazuma Yoshida, Ryuichi M Sada, Akiharu Yoshioka, Hiroyuki Akebo, Hirofumi Miyake, Kazuhiro Hatta","doi":"10.55563/clinexprheumatol/nazkih","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/nazkih","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to examine the diagnostic utility of temporal artery ultrasonography (TAUS) based on measurement of intima-media thickness (IMT) compared with the halo sign in diagnosing cranial giant cell arteritis (GCA).</p><p><strong>Methods: </strong>We retrospectively analysed consecutive patients with clinically suspected GCA who had undergone TAUS between January 2011 and December 2021 in Tenri hospital, Japan. A cut-off value of 0.5 mm was used for the IMT of the temporal arteries. We examined the diagnostic value of TAUS based on each of the halo sign and increased IMT in diagnosing cranial GCA.</p><p><strong>Results: </strong>In total, 203 patients were included. Temporal artery biopsy (TAB) was performed in 59 patients, with 32 being biopsy-positive. Fifty-three patients were diagnosed with cranial GCA. The sensitivity and specificity of TAUS based on the increased IMT and halo sign were as follows: sensitivity, 62.3% and 32.1%; specificity, 90.0% and 100% compared with the clinical diagnosis; and sensitivity, 81.2% and 46.9%; specificity, 76.9% and 96.2% compared with the TAB. When the relationship between the IMT and halo sign was evaluated, patients with cranial GCA who presented with the halo sign had the highest IMT compared with those without the halo sign or those without cranial GCA.</p><p><strong>Conclusions: </strong>A TAUS diagnosis relying only on the halo sign is specific but can underestimate cranial GCA. Therefore, evaluation of the IMT in addition to the halo sign can improve the diagnostic accuracy of TAUS when diagnosing cranial GCA.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to prescribe rituximab wisely for antineutrophil cytoplasmic antibody-associated vasculitides.","authors":"Loïc Guillevin","doi":"10.55563/clinexprheumatol/b1ec25","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/b1ec25","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive and diagnostic biomarkers for cytomegalovirus infection in patients with rheumatic musculoskeletal diseases treated by high-dose glucocorticoid therapy: multicentre, prospective cohort study.","authors":"Hirohiko Sueki, Kazuteru Noguchi, Bunki Natsumoto, Keishi Fujio, Yutaro Hayashi, Yuko Kaneko, Takahisa Gono, Kuninobu Wakabayashi, Haruka Ito, Takahiko Yoshimoto, Akatsuki Kokaze, Takemi Otsuki, Yurika Shimizu, Tatsuo Ito, Koh Okamoto, Shu Okugawa, Kyoji Moriya, Kiyoshi Matsui","doi":"10.55563/clinexprheumatol/th30zv","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/th30zv","url":null,"abstract":"<p><strong>Objectives: </strong>The incidence of cytomegalovirus (CMV) infection or disease in patients with rheumatic musculoskeletal diseases is reported to be 2%. Over half received pulsed methylprednisolone, and some experienced a fatal outcome. In this study, we aimed to explore predictive and diagnostic biomarkers for CMV infection or disease in such patients and compare them with biomarkers reported for immune reconstitution inflammatory syndrome (IRIS) in people with HIV.</p><p><strong>Methods: </strong>In this multicentre prospective cohort study, we collected blood and saliva samples from 38 patients with rheumatic musculoskeletal disease before initiating high-dose glucocorticoid therapy, at the start of glucocorticoid tapering, at the onset of CMV infection, and 4 weeks later. Peripheral blood cell counts, flow cytometry for CD4, CD8, and Tregs, ELISA for cytokine/chemokine panels, and measurements of herpesvirus-derived DNA in saliva were performed.</p><p><strong>Results: </strong>Lower white blood cells, CD4+ cells, IL-6, and interferon-γ levels and higher interferon-inducible protein (IP)-10 and granulysin levels at baseline could be predictive biomarkers for CMV infection. Furthermore, lower platelet counts and higher IL-10, IP-10, granulysin, TNF-a, IL-1ra, and IL-15 levels at the onset of CMV infection were found as diagnostic biomarkers for CMV infection. EBV, human herpes virus (HHV)-6, and HHV-7 DNA levels in the saliva were significantly increased after high-dose glucocorticoids, regardless of CMV infection.</p><p><strong>Conclusions: </strong>We identified predictive and diagnostic biomarkers for CMV infection after high-dose glucocorticoid therapy for rheumatic musculoskeletal diseases. While similarities with IRIS biomarkers in patients living with HIV were observed, complete agreement could not be confirmed.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe lung damage in anti-RNPC-3 antibody-positive patients: expanding the spectrum beyond systemic sclerosis.","authors":"Yasuhiko Yamano, Yoshinao Muro, Haruka Koizumi, Masashi Akiyama, Tomoki Kimura, Yasuhiro Kondoh","doi":"10.55563/clinexprheumatol/5o45p1","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/5o45p1","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic lupus erythematosus-related macrophage activation syndrome inducing severe cytopenia successfully treated with anifrolumab: a case report.","authors":"Emanuele Chiara, Michela Gasparotto, Danilo Malandrino, Edoardo Biancalana, Maria Letizia Uban, Elena Silvestri, Giacomo Emmi","doi":"10.55563/clinexprheumatol/uumehz","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/uumehz","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes in cancer patients with immune checkpoint inhibitor-induced arthritis treated with methotrexate: a retrospective longitudinal monocentric pilot study.","authors":"Elvis Hysa, Andrea Casabella, Nicola Iandolino, Emanuele Gotelli, Carlo Genova, Enrica Teresa Tanda, Carmen Pizzorni, Vanessa Smith, Alberto Sulli, Maurizio Cutolo, Sabrina Paolino","doi":"10.55563/clinexprheumatol/e49am5","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/e49am5","url":null,"abstract":"<p><strong>Objectives: </strong>Immune-mediated adverse events (irAEs) from immune checkpoint inhibitors (ICIs) often require high-dose glucocorticoids (GCs), which can promote cancer progression and counteract ICI benefits. This study evaluated the articular and oncologic clinical outcomes of ICI-induced arthritis treated with methotrexate (MTX) as a GC-sparing agent.</p><p><strong>Methods: </strong>Adult patients with ICI-induced arthritis in 2023 were included. Arthritis was assessed using the disease activity score on 28 joints by C-reactive protein (DAS28-CRP), with follow-ups every 3 months. All patients received subcutaneous MTX, and oncologic outcomes were evaluated using RECIST 1.1 criteria after one year.</p><p><strong>Results: </strong>Fourteen patients (median age 74.5 years) with melanoma (64.3%), colorectal cancer (14.3%), lung cancer (14.3%), or Hodgkin's lymphoma (7.1%) were treated with PD1 antagonists (92.9%) or combined with CTLA4 blockers (7.1%). Arthritis presentations included oligo-arthritis (36%), mono-arthritis (29%), polyarthritis (21%), and polymyalgia rheumatica-like syndrome (14.3%), with a mean onset of 4.7±3.7 months post-ICI. MTX was started for all at a mean dose of 9.5±1.5 mg weekly, beginning at the first rheumatology visit in 78.5% of patients. Over a mean follow-up of 12.8±4.6 months, DAS28-CRP scores improved significantly, and prednisone dosage was in all reduced (3.6 mg at V4 vs. 8.4 mg at V0, p=0.003). No major MTX-related toxicities were noted. Cancer responses at follow-up were complete (50%), partial (21.4%), stable disease (7.1%), and progression (21.5%).</p><p><strong>Conclusions: </strong>The use of MTX in ICI-induced arthritis showed promising results in reducing GC dosages and managing the inflammatory articular activity, with no major toxicities observed over one year. These findings suggest that MTX may be a viable GC-sparing option in this context, but larger, controlled studies are needed to confirm these observations and better understand the impact on both articular and oncologic outcomes.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PET-CT in the diagnosis and management of polymyalgia rheumatica: pros and cons.","authors":"Miguel Ángel González-Gay, Elena Heras-Recuero, Teresa Blázquez-Sánchez, Arantxa Torres-Roselló, Santos Castañeda","doi":"10.55563/clinexprheumatol/epk2z0","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/epk2z0","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the link: anti-TIF1γ dermatomyositis associated with plexiform neurofibroma.","authors":"Joshua A Peñafiel-Sam, Iban Aldecoa, José Milisenda, José A Gómez-Puerta","doi":"10.55563/clinexprheumatol/mmvy2o","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/mmvy2o","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distinct features of trisomy 8-associated autoinflammatory disease from Behçet's disease: case series and systematic review.","authors":"Kento Ichikawa, Soichiro Adachi, Kaoru Takase-Minegishi, Yuta Nakayama, Yuma Nagasawa, Yuki Iizuka, Ayaka Maeda, Lisa Hirahara, Yutaro Soejima, Takuma Ohashi, Hiroyoshi Kunimoto, Nobuyuki Horita, Ryusuke Yoshimi, Yohei Kirino, Hideaki Nakajima","doi":"10.55563/clinexprheumatol/8j7rbr","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/8j7rbr","url":null,"abstract":"<p><strong>Objectives: </strong>To characterise patients with trisomy 8 presenting with autoinflammatory features, comparing them to patients with Behçet's disease (BD).</p><p><strong>Methods: </strong>We comprehensively reviewed studies on trisomy 8-associated autoinflammatory symptoms from four online databases and analysed clinical data from both published cases and our institution. We then compared the clinical features of these patients with those of 657 BD patients from the Yokohama City University Registry.</p><p><strong>Results: </strong>Of 1,542 screened articles, 88 involving 181 patients were eligible, along with six additional patients from our institution, resulting in a total of 187 patients included. Fever was the most common symptom in patients with trisomy 8 (85.8%), followed by oral ulcers (80.8%), gastrointestinal lesions (76.1%), genital ulcers (54.7%), and skin lesions (53.7%). Compared to BD patients, trisomy 8 patients exhibited higher rates of fever and gastrointestinal involvement (p<0.001), but lower rates of oral and genital ulcers, uveitis, and skin involvement (p<0.001), with no significant difference in joint symptoms. Trisomy 8 patients were older and had lower haemoglobin levels, increased mean corpuscular volume, decreased platelet counts, and higher C-reactive protein levels than BD patients. Additionally, the mortality rate was significantly higher in trisomy 8-positive patients (odds ratio, 11.74; 95% confidence interval, 5.94-22.82).</p><p><strong>Conclusions: </strong>Trisomy 8-associated autoinflammatory disease patients were older and had poorer prognoses, more gastrointestinal involvement, and less frequent oral and genital ulcers and skin involvement, making BD diagnosis less likely. Bone marrow examination should be considered for late-onset BD-like disease patients, particularly with recurrent fever.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cluster analysis identifies the differential impact of disease activity and severity on functional status and patient satisfaction in rheumatoid arthritis: the FRANK registry.","authors":"Yukio Akasaki, Hisakata Yamada, Masakazu Kondo, Jun-Ichi Fukushi, Koji Sakuraba, Tomoya Miyamura, Motoko Ishida, Masataka Nakamura, Yasushi Inoue, Tomomi Tsuru, Toshihide Shuto, Seiji Yoshizawa, Masanobu Ohishi, Kenta Kamo, Akihisa Haraguchi, Akira Maeyama, Yojiro Arinobu, Hiroki Mitoma, Masahiro Ayano, Nobuyuki Ono, Toshifumi Fujiwara, Daisuke Hara, Ryosuke Yamaguchi, Ryosuke Tsurui, Keitaro Yasumoto, Takahiro Natori, Toshiaki Sugita, Hiroaki Niiro, Yasuharu Nakashima","doi":"10.55563/clinexprheumatol/7emd6z","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/7emd6z","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of the present study was to investigate the differential impact of disease activity and severity on functional status and patient satisfaction in rheumatoid arthritis (RA) using cluster analysis on data from the FRANK registry.</p><p><strong>Methods: </strong>Data from 3,619 RA patients in the FRANK registry were analysed. Patients were grouped using hierarchical and k-means cluster analyses based on age, physician's global assessment (PhGA), patient's pain assessment (PtPA), and Steinbrocker stage. Clusters were evaluated for differences in functional status (mHAQ), quality of life (EQ5D), and patient satisfaction.</p><p><strong>Results: </strong>Five distinct patient clusters were identified. In hierarchical cluster analysis, Cluster 1 (n=1195, 33.0%) and 2 (n=641, 17.7%) with lower disease activity and severity demonstrated better functional outcomes (mHAQ: 0.18±0.30 and 0.15±0.26, respectively) and higher satisfaction, with treatment efficacy scores of 1.9±0.7 and 2.0±0.7, respectively (1: very satisfied to 6: very unsatisfied). Cluster 3 (n=1117, 30.9%), characterised by less activity and more severity, showed significant joint damage (Steinbrocker stage III-IV: 95.4%) despite controlled inflammation. Cluster 4 (n=385, 10.6%), characterised by patient-physician discordance in disease activity (mean PhGA: 0.9±0.5; mean PtPA: 5.0±2.1), had a more pronounced negative effect on satisfaction. Cluster 5 (n=281, 7.8%), with more activity and moderate severity, had the poorest outcomes in functional status (mHAQ: 0.87±0.65), quality of life (EQ5D: 0.60±0.17), and satisfaction, with a treatment efficacy score of 2.9±0.9. k-Means clustering produced overall similar clusters to hierarchical clustering, allowing the same labels for Cluster 1 to Cluster 5.</p><p><strong>Conclusions: </strong>The study highlights the importance of understanding the heterogeneous nature of RA and its impact on patient outcomes. Personalised treatment approaches that address both objective disease measures and subjective patient experiences are essential for optimising RA management. Identification of distinct patient phenotypes, particularly those in Clusters 3, 4, and 5, may guide tailored interventions to improve treatment satisfaction and long-term outcomes in RA.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}