Clinical Rheumatology最新文献

{"title":"Answer to \"Letter to 'Clinical characteristics and risk factors analysis of abdominal symptoms in IgA vasculitis patients: a retrospective cohort study\".","authors":"Yuhan Gu","doi":"10.1007/s10067-025-07713-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07713-4","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The efficacy of a telerehabilitation-based clinical Pilates program on lumbopelvic muscle morphology and strength in female patients with fibromyalgia syndrome: a randomized controlled trial.","authors":"Fulden Sari, Yasemin Mirza, Pınar Diydem Yılmaz, Adem Küçük","doi":"10.1007/s10067-025-07712-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07712-5","url":null,"abstract":"<p><strong>Introduction: </strong>The current study aims to assess the effects of a tele-rehabilitation-based clinical Pilates exercise program on morphological structure, endurance, central sensitization, pain, fatigue, anxiety, and depression in Fibromyalgia syndrome (FMS) patients.</p><p><strong>Method: </strong>Thirty women with FMS were randomized into two groups: the telerehabilitation group (TG) or the control group (CG). An online clinical Pilates-based exercise program targeting stability and strength that was conducted for 8 weeks with 2 sessions per week was developed for TG. The same exercise programs for the CG were provided in printed brochures. Lumbopelvic muscle thickness, core endurance tests, disease activity, fatigue, central sensitization, pain, anxiety, and depression were evaluated in patients at the beginning and end of the study.</p><p><strong>Results: </strong>Decrease in lumbopelvic muscle thickness and core endurance strength in FMS patients compared to healthy individuals (p < 0.017). There was a significant effect of group × time interaction (F = 4.900, p = 0.035; F = 5.063, p = 0.032) for external oblique (right and left, respectively), fatigue (F = 15.489, p < 0.001), central sensitization (F = 17.518, p < 0.001), anxiety (F = 8.672, p = 0.006) in favor of the TG. Significant time effects were observed across all examined outcomes, covering lumbopelvic muscle thickness, fatigue, central sensitization, anxiety, depression, and core endurance strength (p < 0.05). Following the 8-week intervention, both groups exhibited significant within-group decreases in disease activity and pain. However, the TG demonstrated significantly greater improvements in disease activity and pain compared with the CG (p < 0.05).</p><p><strong>Conclusion: </strong>Telerehabilitation-based treatment programs are effective in increasing lumbopelvic muscle thickness and core muscle endurance. Accordingly, we recommend the widespread use of this innovative treatment approach in FMS. Keypoints • FMS patients indicated lower core endurance strengths compared to healthy groups • TG showed greater improvements in muscle thickness and core endurance strength • Telerehabilitation is feasible and effective for managing the complexities of FMS • The telerehabilitation program was superior and more effective than home exercises.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: \"Antinuclear antibodies as a risk factor for ischemic stroke or death in elderly patients with atrial fibrillation despite anticoagulation\".","authors":"Nedim Kaban, Yusuf Hosoglu","doi":"10.1007/s10067-025-07721-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07721-4","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of antimalarials in lupus nephritis: a narrative review.","authors":"Tarek Carlos Salman-Monte, Eva Márquez, Eva Rodríguez-García","doi":"10.1007/s10067-025-07711-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07711-6","url":null,"abstract":"<p><p>Lupus nephritis (LN) is a severe and common kidney complication of patients with systemic lupus erythematosus (SLE). The manifestations of LN include proteinuria, haematuria, arterial hypertension, and/or progressive decline in glomerular filtration. Kidney involvement in patients with SLE is associated with increased mortality, particularly in those who progress to kidney failure. Effective management of LN aims to preserve long-term renal function by reducing the renal inflammatory and autoimmune response, as well as to prevent flares, to manage comorbidities, and improve patient life expectancy and quality of life while minimising the toxicities associated with medications. Increasing evidence supports the efficacy of antimalarial drugs, particularly hydroxychloroquine (HCQ), in managing SLE and LN. HCQ is indicated in all patients with LN in the absence of contraindications, due to its ability to prevent progression to renal disease in patients with SLE, promote LN remission, prevent progression to end-stage kidney disease or chronic kidney disease, and improve survival. Additionally, HCQ is safe and well tolerated, although monitoring for ocular toxicities, skin hyperpigmentation and cardiotoxicity is recommended. Nevertheless, some uncertainties persist regarding the nature, quality, and quantity of the evidence on HCQ, its optimal use, long-term safety, and efficacy across different patient populations. Monitoring HCQ blood levels may further enhance treatment by managing adverse events, assessing patient adherence, predicting clinical outcomes, and enabling individualised drug dosing. Although the mechanisms by which HCQ reduces inflammation are complex and not fully understood, ongoing research continues to advance our knowledge. This narrative review explores the diverse roles of HCQ in the management of LN.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response by Wang to Letter Regarding Article, \"The association between serum 25-hydroxyvitamin D levels and clinical outcomes in Chinese adult inpatients: a retrospective cohort study\".","authors":"Jialu Wang, Hongyuan Cui, Renying Xu","doi":"10.1007/s10067-025-07702-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07702-7","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: CMV Reactivation in RMDs: are we capturing the full picture?","authors":"Yuqing You, Jinyan Guo, Weifeng Yao","doi":"10.1007/s10067-025-07716-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07716-1","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the effects of high-intensity laser therapy and low-level laser therapy in knee osteoarthritis.","authors":"Sıdıka Büyükvural Şen, Burhan Fatih Koçyiğit, Emine Aygül Ortaç, Meryem Kösehasanoğulları, Nilüfer Aygün Bilecik","doi":"10.1007/s10067-025-07657-9","DOIUrl":"https://doi.org/10.1007/s10067-025-07657-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the effectiveness of high-intensity laser therapy (HILT) and low-level laser therapy (LLLT) on clinical parameters and ultrasonographic cartilage measurements in patients with knee osteoarthritis.</p><p><strong>Methods: </strong>This study was designed as a double-blind, prospective, randomized controlled trial. Ninety patients diagnosed with knee osteoarthritis according to the criteria of the American College of Rheumatology were included. Following the acquisition of written informed consent, the patients were randomized into two treatment groups: HILT combined with exercise therapy (ET) and LLLT combined with ET. Each patient underwent five sessions of therapy per week for a duration of 2 weeks. Pain and functional disability levels were assessed using the visual analog scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Ultrasonographic measurement of femoral cartilage thickness was performed. Knee range of motion (ROM) in flexion was measured using goniometry.</p><p><strong>Results: </strong>In both groups, statistically significant improvements were observed in VAS and WOMAC scores, femoral cartilage thickness, and flexion ROM at the end of treatment (at weeks 2 and 6) compared to the pre-treatment period (p < 0.05). VAS and WOMAC scores at week 6 were significantly lower in the HILT + ET group compared to the LLLT + ET group (p < 0.05). Similarly, statistically significant increases in flexion ROM measurements were identified in the HILT + ET group compared to the LLLT + ET group (p < 0.05). No statistically significant difference was found between the two groups in femoral cartilage thickness measurements.</p><p><strong>Conclusion: </strong>Both HILT and LLLT, when combined with ET, were found to be effective in the treatment of knee osteoarthritis. However, HILT provided more pronounced improvements in pain, functionality, and flexion ROM. No difference was detected between the two methods in terms of cartilage thickness.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and laboratory characteristics of IgG4-related disease involving multiple organs.","authors":"Ying Luo, Huizhuang Shan, Yongxuan Hong, Yunxia Lei, Yue Meng, Huiquan Gan, Hui Li","doi":"10.1007/s10067-025-07717-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07717-0","url":null,"abstract":"<p><strong>Introduction: </strong>IgG4-RD is a rare but increasingly recognized systemic condition characterized by complex clinical manifestations and multi-organ involvement, often leading to misdiagnosis or delayed diagnosis. This study aims to elucidate the clinical features of IgG4-RD and evaluate the diagnostic and therapeutic utility of key laboratory indicators.</p><p><strong>Method: </strong>We conducted a retrospective analysis of IgG4-RD patients, comparing laboratory profiles across different organ involvement patterns. The diagnostic and therapeutic value of serum IgG4 levels in IgG4-RD was evaluated, with comparative analyses of serum IgG4 levels extended to non-IgG4-RD patients.</p><p><strong>Results: </strong>Distinct patterns of laboratory markers were observed across affected organs, with elevated IgG and ESR levels consistently noted. The optimal diagnostic cutoff for serum IgG4 in IgG4-RD was 1.94 g/L, while a cutoff of 9.05 g/L effectively identified multi-organ involvement. Following 6 months of standardized treatment, serum IgG4 levels in IgG4-RD patients decreased significantly. Notably, ANCA-associated vasculitis patients exhibited markedly elevated serum IgG4 levels, which remained unchanged post-treatment.</p><p><strong>Conclusions: </strong>The integration of serum IgG4 with other laboratory markers enhances diagnostic precision for IgG4-RD. Elevated serum IgG4 levels are associated with multi-organ involvement, underscoring their utility in assessing disease extent. Serum IgG4 is indispensable for monitoring therapeutic response. Given the overlapping clinical features between ANCA-associated vasculitis and IgG4-RD, accurate differentiation is essential for optimal clinical management. Key Points • IgG4-RD predominantly affects middle-aged and elderly males, yet its occurrence in younger individuals and less commonly involved organs (e.g., brain and heart) warrants attention. • Affected organs demonstrate distinct laboratory marker profiles, providing valuable insights for clinical diagnosis and therapeutic strategies. • Serum IgG4 levels are instrumental in diagnosing, assessing disease progression, and monitoring treatment response, though their interpretation should be integrated with other clinical indicators. • In ANCA-associated vasculitis, serum IgG4 levels are markedly elevated but remain stable post-treatment, offering a potential diagnostic criterion to differentiate it from IgG4-RD.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, clinical characteristics, and hospital course of systemic sclerosis-associated pseudo-obstruction.","authors":"Laura Ross, Lyman Lin, Dylan Hansen, Alannah Quinlivan, Wendy Stevens, Susanna Proudman, Jennifer Walker, Joanne Sahhar, Gene-Siew Ngian, Lauren Host, Mandana Nikpour, Chamara Basnayake","doi":"10.1007/s10067-025-07676-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07676-6","url":null,"abstract":"<p><strong>Objective: </strong>Gastrointestinal involvement is almost universal in patients with systemic sclerosis (SSc). Enteric dysmotility, at its most severe, can present with pseudo-obstruction. In this study, we aimed to quantify the prevalence of SSc pseudo-obstruction and evaluate risk factors for its development. In a subgroup of patients requiring admission to hospital for acute episodes of pseudo-obstruction, we evaluated the clinical course and treatments administered.</p><p><strong>Methods: </strong>Using data from 1969 Australian Scleroderma Cohort Study (ASCS) participants, we performed multivariable logistic regression analysis to identify SSc-specific risk factors for pseudo-obstruction. Descriptive statistics were used to examine the clinical course of patients admitted with pseudo-obstruction at a single ASCS centre.</p><p><strong>Results: </strong>Pseudo-obstruction occurred uncommonly, affecting 70 (3.56%) ASCS participants. Records of 14 participants with a total of 39 admissions for acute pseudo-obstruction were identified. Pseudo-obstruction was associated with longer disease duration (OR 1.03, p = 0.03), bowel dysmotility (OR 4.51, p < 0.01), small intestinal bacterial overgrowth (OR 2.81, 95% CI (1.00-1.05), p < 0.01), and gastric antral vascular ectasia (OR 2.52, 95% CI 1.28-4.94, p < 0.01). Severe diarrhoea, as measured by the UCLA Gastrointestinal 2.0 questionnaire, was the only clinical symptom significantly associated with episodes of pseudo-obstruction (OR 3.39, 95% CI 1.56-7.38, p < 0.01). Opioids were more commonly prescribed in patients with pseudo-obstruction but were not significantly associated with pseudo-obstruction in multivariable analysis (OR 1.24, 95% CI 0.62-2.48, p = 0.54). Patients with a history of pseudo-obstruction were more likely to require enteral (4.29% vs. 0.21%, p < 0.01) or parenteral nutrition (7.14% vs. 0.16%, p < 0.01).</p><p><strong>Conclusion: </strong>Pseudo-obstruction is associated with other severe gastrointestinal manifestations and is associated with malnutrition in SSc patients. Future studies are required to assess the impact of treatment of SSc-associated enteric dysmotility to prevent progression to pseudo-obstruction. Key Points • Pseudo-obstruction is an uncommon manifestation of systemic sclerosis but frequently recurs and is associated with increased mortality. • Severe diarrhoea and long disease duration are associated with an increased risk of pseudo-obstruction. • Pseudo-obstruction occurs more commonly in patients with severe enteric dysmotility and gastric antral vascular ectasia (GAVE).</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disease activity score for twenty-eight joints reflects different distribution of the inflammation as seen on ultrasound: A comparative ultrasound study in early rheumatoid and psoriatic arthritis.","authors":"Tanya Sapundzhieva, Lyubomir Sapundzhiev, Rositsa Karalilova, Anastas Batalov","doi":"10.1007/s10067-025-07701-8","DOIUrl":"https://doi.org/10.1007/s10067-025-07701-8","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the correlations of different ultrasound (US) indices with disease activity score for 28 joints (DAS28) in patients with early rheumatoid (RA) and psoriatic arthritis (PsA).</p><p><strong>Methods: </strong>The study involved 105 patients with early arthritis - 82 patients with RA and 23 with PsA. A comprehensive US examination was performed, including bilateral evaluation of the wrists, metacarpophalangeal II-V and proximal interphalangeal joints II-V, extensor compartments IV and VI of the wrists, and the flexor tendons of digits II-V. Both gray scale US (GSUS) and power Doppler US (PDUS) modalities were utilized, and the following scores were systematically recorded for each participant: Synovitis, Mini-enthesitis and Finger Flexor Tenosynovitis Score.</p><p><strong>Results: </strong>In RA patients, PDUS synovitis score demonstrated the strongest relationship with DAS28 (rs = 0.829), followed by the GSUS synovitis score (rs = 0.794). The associations with IV extensor compartment tenosynovitis and VI extensor compartment tenosynovitis were of low magnitude. In the group of PsA patients, DAS28 showed significant positive correlations with the pseudotenosynovitis (rs = 0.515), central slip enthesitis (rs = 0.446), and finger flexor tenosynovitis (rs = 0.434) scores.</p><p><strong>Conclusions: </strong>US-detected synovial inflammation accounts for the disease activity in RA, whereas inflammation of the hand mini-entheses and finger tendons has the greatest impact on DAS28 in PsA. Key Points • Ultrasound (US) of the joints, tendons and mini-entheses shows different distribution of the inflammation in patients with early rheumatoid (RA) and psoriatic arthritis (PsA). • The correlation between the Disease Activity Score for 28 joints (DAS28) and the synovitis scores on gray scale (GS) and power Doppler US (PDUS) in RA, and with the mini-enthesitis score in PsA, indicates distinct inflammatory patterns. In RA, disease activity predominantly reflects joint inflammation, whereas in PsA, it involves both articular and extra-articular components, including tendon and entheseal involvement. • Integrating US imaging with clinical assessments of disease activity may enhance rheumatologists' ability to identify distinct US-driven phenotypes, thereby supporting the development of personalized therapeutic strategies in the management of early arthritis.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145198360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}