Clinical Rheumatology最新文献

{"title":"Computed tomography-based quantitative scoring system for rheumatoid arthritis-associated interstitial lung disease: a retrospective diagnostic accuracy study for progressive fibrosis detection.","authors":"Mehmet Cihan Karacaoğlu, Betül Kızıldağ, Burak Okyar, Gözde Yıldırım Çetin, Adem Doğaner, Nurhan Atilla","doi":"10.1007/s10067-025-07511-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07511-y","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the ability of quantitative parameters to assess the severity of rheumatoid arthritis (RA)-associated interstitial lung disease (ILD).</p><p><strong>Methods: </strong>Thorax CT images and pulmonary function tests of RA patients followed up in a tertiary reference center were retrospectively examined. Radiologically, patients were divided into two groups as limited and extensive ILD, using two semiquantitative scoring systems. Two different methods (Method 1, Method 2) were used for quantitative image analysis, in which different Hounsfield unit values were selected as thresholds. Spearman's correlation test was used to evaluate the relationship between variables. The diagnostic performance of quantitative methods for the ability to distinguish limited ILD from extensive ILD was calculated using ROC analysis.</p><p><strong>Results: </strong>Forty-four patients, 29 female and 15 male, were included in the study. A significant correlation was found between diffusion capacity of the lungs carbonmonoxide (DLCO) and total lung capacity (TLC), which are clinical markers, and both quantitative methods (p < 0.001). In terms of the performance of diagnostic tests, the power of Method 1 and Method 2 to distinguish limited and extensive disease classified based on semiquantitative scores was found to be strong (Method 1 AUC = 0.945, Method 2 AUC = 0.785 based on \"ILD score\"; Method 1 AUC = 0.911, Method 2 AUC = 0.700 based on \"modified coarseness of reticular disease (MCRD) score\").</p><p><strong>Conclusion: </strong>This study demonstrates that quantitative methods (Method 1 [- 700 to - 200 HU] and Method 2 [- 800 to - 500 HU]) play a significant role in assessing the severity of RA-associated ILD (RA-ILD). Both methods showed significant correlations with pulmonary function tests (DLCO [r<sub>1</sub> = - 0.338, p<sub>1</sub> = 0.025; r<sub>2</sub> = - 0.452, p<sub>2</sub> = 0.002] and TLC [r<sub>1</sub> = - 0.567, p<sub>1</sub> < 0.001; r<sub>2</sub> = - 0.576, p<sub>2</sub> < 0.001), with Method 1 (AUC<sub>ILD</sub> = 0.945 and AUC<sub>MCRD</sub> = 0.911) demonstrating superior performance in distinguishing between limited and extensive ILD. Our findings suggest that Hounsfield unit threshold-based quantitative CT analysis may serve as a more objective and reproducible alternative to semiquantitative systems (e.g., Goh score) in the standard evaluation of RA-ILD. Specifically, Method 1 may enable early detection of progression by mechanism, e.g., \"tracking subtle density changes.\" However, further validation in multicenter prospective cohorts is needed to address limitations such as bias. Key Points • Interobserver and intraobserver variability poses a significant challenge in the objective assessment of rheumatoid arthritis-associated interstitial lung disease. • User independent quantitative methods can be used instead of user-dependent semiquantitative methods in assessing rheumatoid arthritis-associated i","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246786","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 role of granulocyte colony-stimulating factor in Takayasu arteritis.","authors":"Taotao Li, Zixuan Yang, Na Gao, Junming Zhu, Haiou Hu, Zhiyu Qiao, Lili Pan","doi":"10.1007/s10067-025-07524-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07524-7","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have suggested that granulocyte colony-stimulating factor (G-CSF) treatment may trigger large vessel vasculitis (LVV). However, the role of G-CSF in Takayasu arteritis (TAK), a form of LVV, remains unclear. This study aims to investigate the potential role of G-CSF in TAK.</p><p><strong>Methods: </strong>This cross-sectional study included 40 TAK patients who met the 1990 American College of Rheumatology (ACR) classification criteria for Takayasu arteritis and 27 healthy controls (HCs). Group differences and correlations between G-CSF level, clinical parameters, and cytokine profiles were analyzed using appropriate tests. Aortic tissues from TAK patients were also examined for G-CSF expression using immunohistochemistry.</p><p><strong>Results: </strong>G-CSF levels were significantly higher in TAK patients compared to controls (p < 0.0001), but no difference was found between active and inactive TAK. G-CSF levels positively correlated with neutrophil (R = 0.350, p = 0.028) and platelet counts (R = 0.466, p = 0.005). Elevated G-CSF levels were associated with several cytokines, including IL-6 (R = 0.672, p < 0.001), IL-17 (R = 0.692, p < 0.001), and IFN-γ (R = 0.897, p < 0.001).</p><p><strong>Conclusion: </strong>G-CSF may contribute to the inflammatory process and pathogenesis of TAK, offering new perspectives for its diagnosis and treatment. Key Points • This study systematically evaluated the role of G-CSF in TAK. • G-CSF level was significantly higher in TAK patients. • G-CSF level was found to have a significant positive correlation with neutrophil and platelet counts, as well as several cytokines in TAK patients. • G-CSF may contribute to the TAK process through the PI3 K-Akt pathway.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246791","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":"Pan-immune-inflammatory value in patients with hyperuricemia: a population-based study.","authors":"Qian Zhang, Lin Li, Jing Zhou, Shuang Wang, Luyan Chang, Gong Wang, Ruiqin Du","doi":"10.1007/s10067-025-07512-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07512-x","url":null,"abstract":"<p><strong>Purpose: </strong>The pan-immune-inflammation value (PIV) is a promising biomarker that reflects systemic inflammation and aids in disease prognosis. We sought to explore the potential association between PIV and hyperuricemia in the adult population of the USA.</p><p><strong>Methods: </strong>The data were collected from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. PIV was calculated as follows: (neutrophil × platelet × monocyte)/lymphocyte (10⁹/L). Hyperuricemia is defined as uric acid levels ≥ 420 mmol/L in males and ≥ 360 mmol/Ls in females. The association between PIV and the prevalence of hyperuricemia, as well as its impact on all-cause and cardiovascular mortality, was investigated.</p><p><strong>Results: </strong>A total of 31,151 adult participants were included in this study. The prevalence of hyperuricemia increased progressively with higher PIV levels (13.41% vs. 14.87% vs. 15.75% vs. 20.02%, P < 0.001). Participants in the fourth quartile of PIV had a greater risk of hyperuricemia compared to those in the first quartile (OR = 1.19, 95% CI: 1.07-1.32, P = 0.001). Smooth curve fitting also indicated a dose-response relationship between PIV levels and hyperuricemia risk. Additionally, elevated PIV levels were linked to an increased risk of all-cause and cardiovascular mortality in patients with hyperuricemia (P < 0.001).</p><p><strong>Conclusions: </strong>PIV is an emerging biomarker reflecting systemic inflammation, with the potential for assessing hyperuricemia and its prognostic risk. Key Points • Pan-immune-inflammation value (PIV) holds potential as an epidemiological tool for analyzing immune-inflammatory responses tied to hyperuricemia and its long-term mortality risk.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246789","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":"Reply to \"Letter to the Editor\": radiographic entheseal lesions of the pelvic region are more prevalent in radiographic axSpA than in age- and sex-matched controls and are associated with more severe spinal disease.","authors":"F R Wink, S Arends, A Spoorenberg","doi":"10.1007/s10067-025-07515-8","DOIUrl":"https://doi.org/10.1007/s10067-025-07515-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246790","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":"Management of newly diagnosed lupus nephritis in China: An implementation study based on the 2023 EULAR recommendations.","authors":"Wei Bai, Yinli Gui, Jia Liu, Yunzhuan Chen, Xinwang Duan, Hongbin Li, Wei Wei, Lijun Wu, Shengyun Liu, Yanhong Wang, Shangyi Jin, Chanyuan Wu, Jiuliang Zhao, Qian Wang, Xiaomei Leng, Xinping Tian, Mengtao Li, Xiaofeng Zeng","doi":"10.1007/s10067-025-07520-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07520-x","url":null,"abstract":"<p><strong>Background: </strong>Current evidence demonstrates that rigorous adherence to the standardized diagnostic and therapeutic protocols outlined in the European League Against Rheumatism (EULAR) guidelines can markedly enhance renal survival rates in patients with lupus nephritis (LN) and lead to improved overall outcomes. Data on the real-world implementation of LN management guideline in China was limited. This study aimed to examine the implementation of the 2023 EULAR recommendations for systemic lupus erymatosus (SLE) and LN in China.</p><p><strong>Methods: </strong>Based on the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) cohort, patients with newly diagnosed active LN (24-h Urine Protein ≥ 0.5 g/L) from April 2009 to March 2022 were included. The initial immunosuppressant therapy, the adjustment of immunosuppressant, and the implementation of renal biopsy at baseline were assessed. The patients' general conditions, clinical manifestations, the condition of rheumatologists and hospitals were included in the analysis.</p><p><strong>Results: </strong>Of the 1518 enrolled patients, 787 (52%) underwent cyclophosphamide or mycophenolate mofetil as the initial immunosuppressant, which was consistent with the EULAR recommendations. It was associated with longer disease duration, higher disease activity, more mucocutaneous involvement, and younger age of onset. Thirty out of 166 patients (18.1%) failed to achieve renal remission after 6 or 12 months of treatment, and 9 of whom had immunosuppressive therapy adjusted as recommended. Overall, 251 patients (16.5%) underwent renal biopsy at baseline, which were associated with significant renal involvement, unremarkable systemic involvement, and treated by senior rheumatologists.</p><p><strong>Conclusions: </strong>Management of LN in China showed poor alignment with the 2023 EULAR recommendations regarding initial and adjusted therapy, as well as renal biopsy. The improvement of LN management requires both the patients and the rheumatologists to work together. Key Points • To the best of our knowledge, this is the first real-world implementation study of LN in China. This is also the first real-world implementation study for the newly updated EULAR 2023 recommendation for SLE. • We not only examined the consistency between LN management in China and EULAR recommendations, but also identified potential factors associated with the implementation of the recommendations. • We believe that our study makes a significant contribution to the management of LN.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246787","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":"Artificial intelligence-based prediction of organ involvement in Sjogren's syndrome using labial gland biopsy whole-slide images.","authors":"Yong Ren, Wenqi Xia, Jiayun Wu, Zheng Yang, Ye Jiang, Ya Wen, Qiuquan Guo, Jieruo Gu, Jun Yang, Jun Luo, Qing Lv","doi":"10.1007/s10067-025-07518-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07518-5","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to develop a deep learning-based model to predict the risk of high-risk extra-glandular organ involvement (HR-OI) in patients with Sjogren's syndrome (SS) using whole-slide images (WSI) from labial gland biopsies.</p><p><strong>Methods: </strong>We collected WSI data from 221 SS patients. Pre-trained models, including ResNet50, InceptionV3, and EfficientNet-B5, were employed to extract image features. A classification model was constructed using multi-instance learning and ensemble learning techniques.</p><p><strong>Results: </strong>The ensemble model achieved high area under the receiver operating characteristic (ROC) curve values on both internal and external validation sets, indicating strong predictive performance. Moreover, the model was able to identify key pathological features associated with the risk of HR-OI.</p><p><strong>Conclusions: </strong>This study demonstrates that a deep learning-based model can effectively predict the risk of HR-OI in SS patients, providing a novel basis for clinical decision-making. Key Points 1. What is already known on this topic? • Sjogren's syndrome (SS) is a chronic autoimmune disease affecting the salivary and lacrimal glands. • Accurate prediction of high-risk extra-glandular organ involvement (HR-OI) is crucial for timely intervention and improved patient outcomes in SS. • Traditional methods for HR-OI prediction rely on clinical data and lack objectivity. 2. What this study adds? • This study proposes a novel deep learning-based model using whole-slide images (WSI) from labial gland biopsies for predicting HR-OI in SS patients. • Our model utilizes pre-trained convolutional neural networks (CNNs) and a Vision Transformer (ViT) module to extract informative features from WSI data. • The ensemble model achieves high accuracy in predicting HR-OI, outperforming traditional methods. • The model can identify key pathological features in WSI data associated with HR-OI risk. 3. How this study might affect research, practice or policy? • This study provides a novel and objective approach for predicting HR-OI in SS patients, potentially leading to improved clinical decision-making and personalized treatment strategies. • Our findings encourage further investigation into the role of deep learning and WSI analysis in SS diagnosis and risk stratification. • The development of a non-invasive and objective diagnostic tool based on WSI analysis could benefit clinical practice and inform policy decisions regarding patient care for SS.The development of a non-invasive and objective diagnostic tool based on WSI analysis could benefit clinical practice and inform policy decisions regarding patient care for SS.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224589","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":"Association between serum creatinine/cystatin C ratio and symptomatic knee osteoarthritis incidents in Chinese middle-aged and older adults, considering sex variations: findings from the CHARLS.","authors":"Boran Sun, Aerman Nuer, Lemeng Ma, Yasi Yang, Wenbo Xiao, Huanli Jiao, Xiaochen Huai, Yun Zhu, Yuan Wang, Yongjie Chen, Wenli Lu","doi":"10.1007/s10067-025-07517-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07517-6","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Symptomatic knee osteoarthritis (KOA) and muscle-related disorders are prevalent and interrelated among middle-aged and elderly people. Serum creatinine/cystatin C (Cr/CysC) ratio is a promising biomarker for identifying low muscle mass or sarcopenia. The aim of this study was to investigate the association between serum Cr/CysC and the incident risk of symptomatic knee osteoarthritis in Chinese middle-aged and older adults, considering sex variations.</p><p><strong>Methods: </strong>This prospective cohort study included 4155 participants aged ≥ 45 years from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Cr/CysC ratio was calculated by serum creatinine (mg/dL)/cystatin C (mg/L) *100. The incidence of symptomatic KOA was defined as participants who were free of symptomatic KOA at baseline and diagnosed with symptomatic KOA at the 4-year follow-up. Logistic regression models were used to explore the relationship between Cr/CysC ratio and incidence of KOA in both sexes. Restricted cubic analysis was employed to analyze the nonlinear relationship.</p><p><strong>Results: </strong>Then, 420 participants (10.1%) developed KOA during the 4-year follow-up. Higher Cr/CysC ratio was associated with a lower risk of symptomatic KOA incidents (per 1 SD increase, OR = 0.85, 95% CI = 0.74-0.98, P < 0.001), with significant effect modification by sex (P-interaction = 0.013). The highest tertile of Cr/CysC ratio was significantly linked with a lower incidence of symptomatic KOA in males (OR = 0.50, 95% CI = 0.29-0.88, P = 0.015), but not in females (OR = 0.88, 95% CI = 0.61-1.29, P = 0.522) compared with the lowest tertile. A significant nonlinear relationship was identified for males, with 75.0 of Cr/CysC ratio being an inflection point.</p><p><strong>Conclusions: </strong>Our findings provided new insights that the Cr/CysC ratio might serve as a promising biomarker for KOA among Chinese males. The clinical utility of applying the Cr/CysC ratio to routine clinical screening for KOA warranted further strictly designed randomized controlled trials and health economics studies. Key points • This study elucidated the longitudinal association between serum creatinine/cystatin C (Cr/CysC) ratio and symptomatic knee osteoarthritis (KOA) and sex differences among middle-aged and older Chinese people. • There was a significant relationship between the lower Cr/CysC ratio and increasing risk of symptomatic KOA in males, but not in female adults. A significant nonlinear relationship was identified for males, with 75.0 of the Cr/CysC ratio being an inflection point. • Cr/CysC ratio may serve as a biomarker for predicting the risk of symptomatic KOA in Chinese middle-aged and older males.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215143","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 features of anti-RNP-positive primary Sjögren's syndrome.","authors":"Fang Cheng, Yan-Ling Wang, Xiang-Yan Ai, Yang Liu, Zhen-Hang Zhu, Ke-Ke Zhang, Fu-Tao Zhao","doi":"10.1007/s10067-025-07499-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07499-5","url":null,"abstract":"<p><strong>Objective: </strong>This study sought to explore the clinical features exhibited by individuals with anti-RNP antibodies who had primary Sjögren's syndrome (pSS).</p><p><strong>Methods: </strong>Various clinical data of 410 pSS patients from our hospital between September 2018 and August 2023 were retrospectively analysed. Each individual fulfilled the 2016 American College of Rheumatology/European League Against Rheumatism (EULAR) classification criteria for pSS. Comparative analyses were conducted between pSS individuals with and without anti-RNP antibodies. Logistic regression analysis was utilized to ascertain relevant factors.</p><p><strong>Results: </strong>Among the cohort, 38 (9.3%) of pSS patients were anti-RNP positive and 372 were anti-RNP negative. Anti-RNP-positive individuals had a higher median EULAR Sjögren's syndrome disease activity index at diagnosis (p = 0.001) and more frequent extraglandular manifestations (p < 0.001), including articular, pulmonary and muscular involvement (p = 0.001, p < 0.001 and p = 0.024, respectively) and Raynaud's phenomenon (p < 0.001). Additionally, patients possessing anti-RNP antibodies had a higher frequency of hypergammaglobulinemia and positive antinuclear and anti-Ro/SSA antibodies (p < 0.001, p = 0.006 and p = 0.042, respectively), but a lower frequency of anti-centromere positivity (p = 0.010). Multivariate analysis identified anti-RNP positivity as independent variable significantly associated with interstitial lung disease (OR = 2.60, 95% CI 1.22-5.53; p = 0.014) and Raynaud's phenomenon (OR = 6.26, 95% CI 3.01-13.01; p < 0.001) in pSS patients.</p><p><strong>Conclusion: </strong>The presence of anti-RNP antibodies may defined a specific subset of pSS patients characterized by distinct phenotypic attributes, especially in terms of higher prevalence of interstitial lung disease and Raynaud's phenomenon. Key Points • Anti-RNP antibodies were detected in 9.3% of patients with primary Sjögren's syndrome (pSS), which was related to increased systemic disease activity and more frequent extraglandular manifestations. • pSS patients carrying anti-RNP antibodies displayed higher prevalence of interstitial lung disease, Raynaud's phenomenon and hypergammaglobulinemia. • Anti-RNP positivity was identified as independent predictors of interstitial lung disease and Raynaud's phenomenon in pSS.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215144","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":"Lansoprazole associated with a relatively lower gout risk among PPI users: a nationwide retrospective study.","authors":"Hung-Kai Shih, Yu-Te Su, Sy-Jou Chen, Chen-Chih Chu, Yu-Ching Chou, Tsung-Kun Lin, Ching-Kuo Huang, Wen-Tung Wu, Ming-Hsun Lin","doi":"10.1007/s10067-025-07502-z","DOIUrl":"https://doi.org/10.1007/s10067-025-07502-z","url":null,"abstract":"<p><strong>Introduction: </strong>Proton pump inhibitors (PPIs) used for gastrointestinal-related disorders are associated with increased insulin resistance, a risk factor for worsening hyperuricemia. However, lansoprazole has shown potential in reducing insulin resistance by increasing the expression of peroxisome proliferator-activated receptor gamma and CCAAT/enhancer-binding protein alpha mRNA in adipogenesis. This study aims to investigate the effects of lansoprazole compared to other PPIs in reducing the risk of gout.</p><p><strong>Method: </strong>We conducted a retrospective cohort study on patients using lansoprazole from 2000 to 2005, based on the Taiwan National Health Insurance Database, with follow-up until 2013. A comparison cohort on other PPIs was selected through propensity score matching for age, sex, comorbidities, and concomitant medications. Gout risk was analyzed using survival analysis and a Cox proportional hazards model.</p><p><strong>Results: </strong>Among 1816 lansoprazole users, 139 developed gout (7.7%), compared to 968 (13.3%) out of 7264 in the other PPIs group. The average age was 53.33 (± 14.79) in the lansoprazole group and 52.71 (± 14.81) in the other PPIs group. The cumulative incidence of gout was lower in the lansoprazole cohort, with a significantly reduced gout risk (adjusted hazard ratio, 0.64; 95% CI, 0.56-0.73). This lower risk remained after stratification by gender and among individuals over 30 years old.</p><p><strong>Conclusions: </strong>Among PPI users, lansoprazole is associated with a significantly lower risk of gout. For patients at risk of gout who require PPI therapy, lansoprazole may be considered the treatment of choice.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207863","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":"Cutaneous lesions and articular manifestations in multicentric reticulohistiocytosis: a diagnostic challenge.","authors":"Carlos Marques-Gomes, Inês Rodrigues, Catarina Rua, Rúben Costa, Mariana Lopes, Gilberto Rosa, Sofia Magina, José Manuel Lopes, Iva Brito","doi":"10.1007/s10067-025-07522-9","DOIUrl":"https://doi.org/10.1007/s10067-025-07522-9","url":null,"abstract":"<p><p>A 56-year-old woman presented with a one-year history of polyarthralgia and skin lesions. Examination revealed polyarthritis and reddish-brown nodules on interphalangeal (IF) joints. Histopathology confirmed a diagnosis of multicentric reticulohistiocytosis (MRH) with characteristic histiocytes and multinucleated giant cells positive for PAS, PASD, CD45, and CD68. Imaging showed periarticular osteopenia and erosions. Immunosuppressive therapy with prednisolone (PDN) and methotrexate (MTX) led to significant improvement in symptoms within two months. MRH, a rare non-Langerhans cell histiocytosis, is marked by papulonodular skin lesions and symmetric polyarthritis, potentially erosive. It may be associated with rheumatic diseases and necessitates malignancy screening. Diagnosis is based on clinical and histological findings due to the absence of specific biomarkers. Immunosuppressive treatment remains the cornerstone of management.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215145","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}