Clinical Rheumatology最新文献

{"title":"Clinical and laboratory characteristics of Sjögren's syndrome-associated autoimmune liver disease: a real-world, 10-year retrospective study.","authors":"Peixuan Liang, Yanli Huang, Ziwei Hu, Liang Zhou, Shaozhe Cai, Jixin Zhong, Lingli Dong","doi":"10.1007/s10067-024-07273-z","DOIUrl":"https://doi.org/10.1007/s10067-024-07273-z","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the clinical and laboratory features of Sjögren's syndrome-associated autoimmune liver disease (SS-ALD) patients and identify potential risk and prognostic factors.</p><p><strong>Methods: </strong>SS patients with or without ALD, who visited Tongji Hospital between the years 2011 and 2021 and met the 2012 American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome, were retrospectively enrolled. The clinical and laboratory data of the enrolled patients, including autoimmune antibodies, were collected and analyzed with principal component analysis, correlation analysis, LASSO regression, and Cox regression.</p><p><strong>Results: </strong>A total of 117 SS-ALD patients were confirmed out of 568 SS patients. Compared to SS-non-ALD patients (n = 451), SS-ALD patients exhibited more severe involvement of the hepatic and hematologic systems, albeit with less pronounced typical SS symptoms. Disease activity was higher in SS-ALD patients, as indicated by elevated ESR, CRP, and IL-6 levels, particularly in the SS-overlap subgroup. Furthermore, SS-AIH patients without AIH-specific autoantibody testing or with negative testing results had higher AST and ALT levels than those who were autoantibody-positive. Our predictive model, incorporating IgG, IgM, AST, GGT, ALT, and C4, effectively identified ALD complications in SS patients, achieving an AUC of 0.924. Additionally, a grimmer prognosis was associated with higher baseline AST and ALT levels.</p><p><strong>Conclusions: </strong>SS-ALD patients often manifest with an insidious onset and atypical SS symptoms, yet frequently exhibit severe systemic involvement, intense inflammatory and immune responses, and a poor prognosis. To improve the clinical outcomes in SS-ALD patients, regular monitoring, early identification, and active treatment should be applied. Key Points • The study provided a detailed profile of clinical and laboratory features of SS-ALD and SS-non-ALD patients, contributing to a predictive model of ALD complications in SS patients • SS-ALD patients manifested with an insidious onset but exhibited severe systemic involvement, robust inflammatory and immune responses, and poor prognosis • SS-AIH patients without available testing for AIH-specific autoantibodies or with negative results demonstrated worse liver function, thus routine screening for autoimmune liver antibodies is recommended in SS patients • More severe baseline liver function status was associated with poorer therapeutic responses to routine medications, so early detection and timely intervention are essential for SS patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000625","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 editor \"Health‑related quality of life (HRQoL) loss associated with self‑perceived anxiety/depression in seropositive rheumatoid arthritis\".","authors":"Bing Xu, Cao Yu","doi":"10.1007/s10067-024-07260-4","DOIUrl":"https://doi.org/10.1007/s10067-024-07260-4","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001035","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":"Serology and histology in Sjögren's syndrome diagnosis: a retrospective accuracy study.","authors":"Luiz Claudio Viegas-Costa, Reid Friesen, Hollis Lai, Timothy McGaw","doi":"10.1007/s10067-025-07302-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07302-5","url":null,"abstract":"<p><strong>Introduction: </strong>Sjögren's syndrome (SS) presents complex diagnostic challenges due to its multi-organ involvement, often leading to misdiagnosis, which can result in unnecessary treatments, elevated healthcare costs, and significant impacts on patient quality of life. Accurate diagnosis is therefore critical, utilising ACR/EULAR criteria that include both labial minor salivary gland (LMSG) biopsy and anti-SSA antibodies.</p><p><strong>Methods: </strong>This retrospective study analysed medical records of 87 adults suspected of primary SS, who underwent both anti-SSA serology and LMSG biopsy. We evaluated the diagnostic accuracy of these tests under existing ACR/EULAR criteria and a newly proposed 'modified ACR/EULAR criteria - ClinDx'. Statistical analysis included Pearson's chi-square test for the association between test results and disease status and receiver operating characteristic (ROC) curves to assess the sensitivity and specificity of the diagnostic models.</p><p><strong>Results: </strong>Utilising ACR/EULAR criteria, 40 patients were diagnosed with SS, while 47 were categorised as non-diseased. The ClinDx criteria application resulted in 32 SS diagnoses and 55 non-diseased classifications, highlighting discrepancies in patients with low anti-SSA titers (< 200 MFU). Statistical analysis confirmed a significant association (p < 0.001) between test results and disease status, indicating the robustness of the modified criteria in enhancing diagnostic accuracy.</p><p><strong>Conclusions: </strong>This study underscores the utility of integrating serological tests and histological biopsies in diagnosing SS. While anti-SSA antibodies provide a good preliminary screening tool, the specificity of LMSG biopsies is indispensable. Refining both serological and histological assessments per ClinDx criteria can improve diagnostic accuracy, aiding in better management of SS and reducing healthcare burdens.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001293","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: Inadequate identification of high cardiovascular risk and carotid plaques in rheumatoid arthritis patients by the 2024 Predicting Risk of Cardiovascular EVENTs and the 2013 Atherosclerotic Cardiovascular Disease algorithms: findings from a Mexican cohort.","authors":"Seher Sener, Yusuf Ziya Sener","doi":"10.1007/s10067-025-07330-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07330-1","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001033","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":"Correlation of systemic immune inflammation and serum uric acid with gout: based on NHANES.","authors":"Youssef Roman","doi":"10.1007/s10067-025-07329-8","DOIUrl":"https://doi.org/10.1007/s10067-025-07329-8","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000729","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":"Transition-related outcomes among a cohort of patients with juvenile idiopathic arthritis.","authors":"Laura De Nardi, Serena Pastore, Hajar Benaly, Francesco Rispoli, Ivan Giovannini, Luca Quartuccio, Salvatore De Vita, Alen Zabotti, Alberto Tommasini, Andrea Taddio","doi":"10.1007/s10067-025-07317-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07317-y","url":null,"abstract":"<p><p>A major goal in juvenile idiopathic arthritis (JIA) long-term management is to ensure a successful transition to adult age. This study aims to assess transition outcomes in a group of JIA patients during their passage from pediatric to adult healthcare assistance at a single center. This is a cross-sectional study. All patients with JIA undergoing a transition from the Pediatric Rheumatology Service of the IRCCS \"Burlo Garofolo\" Hospital, Trieste, to the adult Rheumatology Service of \"Santa Maria della Misericordia\" Hospital, Udine, between 2017 and 2022, were enrolled. Clinical and laboratory data were collected. A semi-structured survey exploring patients' satisfaction was distributed through email. Numerical variables were compared using Student's t-test or Mann-Whitney test. Categorical variables were compared with Fisher's exact test. We recruited 36 patients (26 female, 72.2%): 9 with polyarticular course JIA, 13 oligoarticular, 8 psoriatic arthritis, 3 systemic JIA, and 3 enthesitis-related arthritis. The mean age at transition was 18.6 (Q1-Q3, 18.3-19.1). JADAS-27 score significantly decreased after the transition, with a mean difference of 2.6 (p = 0.014). No patients were lost to follow-up, and in 8 out of 36 (22.2%), a step-up therapy was needed within the first 12 months. Among these, no correlation was found with the JIA subtype, age at onset, type of involved joints, and other variables explored. Finally, the 15 patients who answered the survey (response rate 50%) were satisfied about the transition process. This study described a real-life transition experience from pediatric to adult rheumatology care, showing good transition outcome measures, with no patients lost to follow-up and a reduction of JADAS-27 score after completing the process.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001308","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":"Malar leukocytoclastic vasculitis in systemic lupus erythematosus.","authors":"Hirokazu Taguchi, Yoshiki Nagai, Miyuki Kato, Naoto Yokogawa","doi":"10.1007/s10067-025-07314-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07314-1","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977940","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":"Hepatitis B vaccine and juvenile idiopathic arthritis: comparison of the seropositivity rates with healthy children at the time of diagnosis and booster dose response under treatment.","authors":"Merve Işeri Nepesov, Güşta Uysal Gür, Rabia Gönül Sezer Yamanel, Mustafa Çakan","doi":"10.1007/s10067-025-07313-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07313-2","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>The study aimed to determine whether in children with newly diagnosed juvenile idiopathic arthritis (JIA) hepatitis B surface antibody (anti-HBs) differs from healthy children and to see whether the revaccination is safe and effective under JIA treatment.</p><p><strong>Methods: </strong>Patients who were followed up with a diagnosis of JIA between January 2020 and February 2024 were included. The control group consisted of healthy children matched for age and gender. Patients with JIA who were seronegative and revaccinated against hepatitis B virus (HBV) at follow-up visits were evaluated in terms of antibody responses and side effects after vaccination.</p><p><strong>Results: </strong>The study included 187 patients with JIA, 104 (55.6%) girls. In the JIA group, the mean anti-HBs levels were 120.8 ± 228.3 IU/L, and 64.7% of patients had anti-HBs levels ≥ 10 mIU/ml, while in the control group, the mean anti-HBs levels were 184.9 ± 304.4 IU/L, and 68.7% of children had protective antibody level against HBV. Sixty-six patients with JIA in whom anti-HBs level < 10 IU/L received an additional three doses of HBV vaccine. After booster vaccination, only one patient had anti-HBs level < 10 IU/L; in the other 65 JIA patients, the mean anti-HBs levels were 530.4 ± 320.8 IU/L. None of the patients observed serious side effects or JIA exacerbation after vaccination.</p><p><strong>Conclusions: </strong>Although the mean anti-HBs levels in newly diagnosed JIA patients were lower than in healthy children, no difference was found in the seropositivity rates. Vaccination against HBV during JIA treatment is safe and effective and should be encouraged. Key Points • Hepatitis B virus infection remains a public health problem and publications are indicating that vaccine responses may be lower in autoimmune diseases such as juvenile idiopathic disease. • The mean antibody levels against the HBV vaccine in newly diagnosed JIA patients were lower than in healthy children. • The fact that patients diagnosed with JIA were revaccinated under treatment and no side effects were observed will support the vaccination of these patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977938","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":"Immune thrombocytopenia in patients with systemic lupus erythematosus.","authors":"Ziqiang Zheng, Jiali Liu, Mingzhu Yun, Li Deng, Pingping Xiang, Miao Jiang, Rui Wang, Chang Liu","doi":"10.1007/s10067-024-07235-5","DOIUrl":"10.1007/s10067-024-07235-5","url":null,"abstract":"<p><p>Immune thrombocytopenia (ITP) is a common hematological manifestation of systemic lupus erythematosus (SLE). The diversity of its clinical features and treatment responses may reveal the complex pathophysiological mechanisms of the disease. To enhance the therapeutic response rate and improve the prognosis for SLE patients with concurrent ITP, while reducing adverse events during the treatment process, it is crucial to accurately identify and apply clinical parameters to predict patients' responses to treatment. In addition to conventional therapeutic approaches such as glucocorticoids, immunosuppressants, and intravenous immunoglobulin (IVIG), a range of emerging therapies are gradually becoming the focus of research. These innovative therapeutic strategies include thrombopoietin receptor agonists (TPO-RAs), targeted therapies against B-cells, and plasma cell-targeted treatments. With a deepening understanding of the role of platelets in immune and inflammatory responses, novel platelet-targeted therapeutic agents in the field of SLE-ITP treatment may demonstrate significant potential. Despite this, to ensure the clinical efficacy and safety of these therapeutic approaches, we must rely on rigorously designed randomized controlled trials (RCTs) for further validation. This article provides a systematic review of the pathogenesis of systemic lupus erythematosus (SLE) complicated by immune thrombocytopenia (ITP) and conducts a comprehensive overview of current treatment strategies. The article also provides an in-depth exploration of the key biomarkers that may influence the therapeutic response in SLE-ITP patients. This comprehensive analysis aims to elucidate the factors that potentially affect the efficacy of treatments and contribute to a more personalized approach to patient care.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"97-104"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766911","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":"A rebuttal to \"The ineffectiveness of stretching exercises in patients with fibromyalgia: A systematic review discussion\" - comments on \"The effectiveness of stretching exercises in patients with fibromyalgia\".","authors":"Morten Pallisgaard Støve, Anne Mette Lücke Dissing, Janus Laust Thomsen, Stig Peter Magnusson, Allan Riis","doi":"10.1007/s10067-024-07223-9","DOIUrl":"10.1007/s10067-024-07223-9","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"529-530"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603629","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}