Clinical and experimental rheumatology最新文献

{"title":"Analysis of clinical features and risk factors for patients with idiopathic inflammatory myopathy complicated by Pneumocystis jirovecii pneumonia.","authors":"Junqi Li, Wenhan Huang, Feifeng Ren, Lei Luo, Dandan Chen, Dongmei Huang, Jun Zhou, Lin Tang","doi":"10.55563/clinexprheumatol/fpbkc8","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/fpbkc8","url":null,"abstract":"<p><strong>Objectives: </strong>To analyse the clinical characteristics and risk factors for Pneumocystis jirovecii pneumonia (PJP) in idiopathic inflammatory myopathy patients (IIM).</p><p><strong>Methods: </strong>Retrospective analysis was conducted in 432 patients with idiopathic inflammatory myopathy by evaluation of demographic information, clinical characteristics, and treatment data. Receiver operating characteristic curves were used to evaluate the predictive value of (1-3)-β-DG-glucan for diagnosis of PJP. Multiple logistic regression analysis was used to identify independent risk factors for PJP occurrence.</p><p><strong>Results: </strong>Of the enrolled patients, 34 had PJP and were defined as the PJP+IIM group. The other patients that did not have PJP were defined as the PJP-IIM group. By univariate analysis, dermatomyositis, anti-MDA5 antibodies, rash, concomitant respiratory symptoms, decreased absolute lymphocyte count, increased erythrocyte sedimentation rate, increased ferritin levels and concurrent bacterial or viral infections were found to be risk factors for PJP in these patients. Among these, dermatomyositis, rash, decreased absolute lymphocyte count, and concurrent viral infection were the most important independent risk factors for PJP.</p><p><strong>Conclusions: </strong>Dermatomyositis, rash, decreased absolute lymphocyte count, and concurrent viral infection are independent risk factors for the occurrence of PJP in idiopathic inflammatory myopathy patients.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224526","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":"Fibromyalgia: one year in review 2025.","authors":"Cristina Iannuccelli, Martina Favretti, Giulio Dolcini, Marco Di Carlo, Greta Pellegrino, Laura Bazzichi, Fabiola Atzeni, Daniela Lucini, Giustino Varassi, Matteo Luigi Giuseppe Leoni, Diego Maria Michele Fornasari, Fabrizio Conti, Fausto Salaffi, Piercarlo Sarzi Puttini, Manuela Di Franco","doi":"10.55563/clinexprheumatol/buhd2z","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/buhd2z","url":null,"abstract":"<p><p>Fibromyalgia (FM) is a chronic syndrome characterised by widespread pain, high prevalence, and a significant impact on quality of life. Despite extensive research, its pathogenesis and treatment remain only partially understood, driving continued investigation throughout 2024. Dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system has been linked to chronic stress responses and neuroinflammation, with neuroimaging and preclinical studies confirming altered pain and stress processing. Low-grade inflammation and metabolic disturbances, including cytokine imbalance and increased adipose tissue infiltration, further exacerbate symptoms. Alterations in the gut microbiota contribute to immune and emotional dysregulation. MRI studies continue to reveal brain changes that differentiate FM from other chronic pain disorders. Multi-omics approaches, including transcriptomic and metabolomic analyses, show promise as diagnostic biomarkers. Mitochondrial dysfunction also emerges as a key factor, since impaired energy metabolism seems to correlate with symptom severity. From a clinical perspective, recent studies have explored under-recognised aspects of FM, such as sexual and cognitive dysfunction, the role of gender, environmental exposures, and the disease's impact on relationships and family life. The differential diagnosis of FM and long COVID has ignited discussion about potential shared mechanisms. Conversely, residual pain in inflammatory diseases remains insufficiently addressed. Therapeutically, non-pharmacological strategies, particularly physical activity and psychosocial interventions, remain fundamental. Emerging areas such as non-invasive neuromodulation, psychedelic therapies, and the integration of technologies like virtual reality and artificial intelligence are opening new frontiers in treatment, patient care, and research. These advances underscore the multifactorial nature of FM and the need for personalised, interdisciplinary approaches.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224533","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":"Inflammatory arthritis as an atypical manifestation of Coffin-Siris syndrome linked to a novel ARID1B variant.","authors":"Sigal Matza-Porges, Zahala Bar-On, Atar Lev, Amos J Simon, Hagit Peleg, Oded Shamriz","doi":"10.55563/clinexprheumatol/833pi0","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/833pi0","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224535","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":"Isolated positivity for anti-ribosomal P antibodies and its utility in clinical practice: a literature review and description of 16 cases.","authors":"Teresa Blázquez-Sánchez, Maria Begoña Just-Balerdi, Karina Guzmán-López, Arantxa Torres-Roselló, Elena Heras-Recuero, Antía García-Fernández, Fernando Rengifo-García, Claritza Caraballo-Salazar, María José Martínez-Becerra, María Carmen Vegas-Sánchez, Miguel Ángel González-Gay","doi":"10.55563/clinexprheumatol/b5v910","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/b5v910","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224536","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":"Pneumocystis jirovecii pneumonia in anti-MDA5-positive dermatomyositis: characterisation, risk factors and prognosis.","authors":"Lu Yang, Qihua Yang, Jing Li, Lijuan Zhang, Shengyun Liu, Chaofeng Lian","doi":"10.55563/clinexprheumatol/hpx173","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/hpx173","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify risk and prognostic factors of Pneumocystis jirovecii pneumonia (PJP) in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+DM).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of anti-MDA5+DM patients who underwent metagenomic next-generation sequencing analysis of bronchoalveolar lavage fluid or lung tissue at our center between January 2019 and February 2023. Eligible patients were stratified into PJP+ and PJP- groups based on PJP status. Potential risk factors and prognostic indicators for PJP were analysed using univariate and multivariate logistic regression analysis.</p><p><strong>Results: </strong>A total of 107 anti-MDA5+DM patients were enrolled, of whom 47 were assigned to the PJP+ group. Multivariate logistic regression analysis revealed older age and high cumulative dosage of glucocorticoids within 3 months preceding PJP diagnosis were independent risk factors for PJP development. Conversely, prophylactic-dose trimethoprim-sulfamethoxazole (TMP/SMZ) was associated with a significantly reduced risk of PJP (all p<0.05). The 30-day mortality rate in the PJP+ group was 55.3%. Short disease duration and immunosuppressive therapy exposure, severe hypoxia, extensive radiological interstitial lung disease, moderate to severe acute respiratory distress syndrome, mechanical ventilation were associated with unfavourable prognosis (all p<0.05). Glucocorticoids therapy was more frenquently administered in survivors (p<0.05).</p><p><strong>Conclusions: </strong>PJP significantly increases early mortality of anti-MDA5+DM patients. Clinicians should identify high-risk patients early and administer prophylactic-dose TMP/SMZ for PJP prophylaxis.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224540","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":"The Thumb Rule - an approach to optimise musculoskeletal ultrasound scanning in Rheumatology.","authors":"Emilio Filippucci, Lene Terslev, Søren T Torp-Pedersen, Edoardo Cipolletta","doi":"10.55563/clinexprheumatol/dpq2qm","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/dpq2qm","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224543","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":"Novel use of abrocitinib in refractory ulcerative panniculitis with vasculitis: a case report.","authors":"Sheng Qiu, Zhenhua Ying","doi":"10.55563/clinexprheumatol/13rf0m","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/13rf0m","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224538","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":"The performance of histological criteria for IgG4-related disease in clinical practice.","authors":"Alojzija Hočevar, Aleš Grošelj, Gregor Hawlina, Matic Koželj, Andrej Škoberne, Jože Pižem, Vesna Jurčić","doi":"10.55563/clinexprheumatol/peqyb4","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/peqyb4","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224542","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":"From pain catastrophising to multidimensional psychological distress: unravelling the complexity of difficult-to-treat psoriatic arthritis.","authors":"Damiano Currado, Francesca Saracino, Francesco De Vincenzo, Francesca Trunfio, Annalisa Marino, Lyubomyra Kun, Erika Corberi, Ludovica Lamberti, Leonardo Frascà, Onorina Berardicurti, Marta Gatti, Marta Vomero, Roberto Giacomelli, Luca Navarini","doi":"10.55563/clinexprheumatol/2pmt67","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/2pmt67","url":null,"abstract":"<p><strong>Objectives: </strong>Pain catastrophising (PC), a maladaptive cognitive response to pain, has been implicated in poor outcomes in inflammatory arthritis, but its relationship with psoriatic arthritis difficult-to-treat (D2T) remains underexplored. This study aimed to investigate how the D2T phenotype impacts pain catastrophising (PC) and its domains (helplessness, rumination, magnification), along with other psychosocial and functional dimensions in PsA patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in a cohort of 182 PsA patients. Clinical and psychosocial data were collected, including Disease Activity for Psoriatic Arthritis (DAPSA), Minimal Disease Activity (MDA), Pain Catastrophising Scale (PCS), HADS anxiety and HADS depression. Univariable and multivariable regressions were used to evaluate psychometric variables associated with D2T.</p><p><strong>Results: </strong>Univariable analysis showed a significant association between high PCS scores and D2T status. Multivariable models, adjusted for age, sex, disease duration, BMI, fibromyalgia, and disease activity, confirmed this relationship (b=7.637, 95% CI 3.261-12.014, p=0.001), specifically with PCS' dimensions helplessness and rumination, but not magnification. Additionally, D2T predicted higher HADS anxiety scores, while its association with HADS depression was not statistically significant.</p><p><strong>Conclusions: </strong>Our results indicate that D2T status remains a significant predictor of PC, even when controlling for relevant clinical characteristics, including fibromyalgia and disease activity, highlighting the intricate relationship between D2T PsA and psychological dimensions, which may exacerbate disease burden and hinder treatment targets.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224534","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":"Peritenon extensor tendon inflammation at metacarpophalangeal joints level: a valuable ultrasound finding in the differential diagnosis between psoriatic arthritis and rheumatoid arthritis?","authors":"Tadashi Okano, Marco Di Carlo, Fausto Salaffi, Emilio Filippucci","doi":"10.55563/clinexprheumatol/b90gug","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/b90gug","url":null,"abstract":"<p><strong>Objectives: </strong>Ultrasound (US) detection of peritenon extensor tendon inflammation (PTI) was found highly specific for spondyloarthropathies (SpA), including psoriatic arthritis (PsA). However, this finding has not been extensively investigated. This study aimed to investigate the value of PTI at metacarpophalangeal (MCP) joint level in the differential diagnosis between rheumatoid arthritis (RA) and PsA, and analyse the differences between early (less than 1 year of disease duration) and established (more than 1 year of disease duration) disease groups.</p><p><strong>Methods: </strong>Consecutive RA and PsA patients with clinical involvement of at least one MCP joint were enrolled. The 2nd to the 5th MCP joints of both hands were scanned on the dorsal aspect to detect intra-articular and peri-tendinous inflammatory findings using both B-mode and power Doppler (PD) mode.</p><p><strong>Results: </strong>The study included a total of 69 patients, 37 patients with RA and 32 patients with PsA. PTI was found in a significantly higher number of patients with PsA rather than in RA patients. Conversely, there was no statistical difference in terms of PTI prevalence between RA and PsA patients in the early disease groups. On the other hand, no statistically significant difference was found in terms of synovitis prevalence between RA and PsA patients.</p><p><strong>Conclusions: </strong>PTI was found more frequently in PsA rather than in RA patients. Nevertheless, since no statistically significant difference was found between RA and PsA patients with less than 1 year of disease duration, PTI may represent an inflammatory feature of the early phases of both the diseases.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224539","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}