{"title":"Guillain - Barre syndrome as the first presentation in a patient with systemic lupus erythromatous; case report","authors":"Z. Taha, Shaima N. Elgenaid, M. Ahmed","doi":"10.37532/1758-4272.2021.16(2).079","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).079","url":null,"abstract":"Systemic Lupus Erythromatous (SLE) is an auto immune disease characterized by multi-organ affection, Guillain–Barre syndrome (GBS) is considered as an unusual and one of the least neuropsychiatric syndromes in SLE, this case report aiming to report a rare association of GBS as an initial presentation for an SLE in a female patient. A middle age female was presented with palpitation, shortness of breath and body weakness, she was admitted for four days and diagnosed with atypical GBS. She received Intravenous immunoglobulin (IVIG) for three days but no improvement was been noticed. The patient complained of dry cough, shortness of breath, palpitations and generalized weakness in association with back pain and paraesthesia of the fingers. General examination and lab workup were done and revealed a presence of SLE in relation to GBS. IVIG was then commenced 0.4 g/kg body/weight/day with Hydroxychloroquine 200mg tabs BID, Prednisolone 40mg, calcicare and Mycophenolatemofetil. Significant improvement was noted after receiving the above-mentioned medications and over a period of three months all her symptoms and complains were subside.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"71 1","pages":"079"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78722420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chondrocyte Implantation for Treatment of Articular Cartilage","authors":"A. Khodiev","doi":"10.37532/1758-4272.2021.16(8).239","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).239","url":null,"abstract":"Background: Because articular chondrocyte-based Autologous Chondrocyte Implantations (ACIs) have restrictively restored articular cartilage defects, alternative cell sources as a new therapeutic option for cartilage repair have been introduced. Purpose: To assess whether implantation of a Costal Chondrocyte–Derived Pellet-Type (CCP) ACI allows safe, functional, and structural restoration of full-thickness cartilage defects in the knee. Study Design Case series: Level of evidence, Methods: In this first-in-human study, 7 patients with symptomatic, full-thickness cartilage lesions were enrolled. The chondrocytes isolated from the patients’ costal cartilage were expanded, followed by 3-dimensional pellet culture to prepare the CCP-ACI. Implantation of the pellets was performed via minimal arthrotomy and secured with a fibrin sealant. Clinical scores, including the International Knee Documentation Committee (IKDC) subjective, Lysholm, and Tegner activity scores, were estimated preoperatively and at 1, 2, and 5 years postoperatively. High-resolution magnetic resonance imaging was also performed to evaluate cartilage repair as well as to calculate the MOCART (magnetic resonance observation of cartilage repair tissue) score. Results: The costal chondrocytes of all patients formed homogeneous-sized pellets, which showed the characteristics of the hyaline cartilaginous tissue with lacunae-occupied chondrocytes surrounded by glycosaminoglycan and type II collagen-rich extracellular matrix. There were no treatment-related serious adverse events during the 5-year follow-up period. Significant improvements were seen in all clinical scores from preoperative baseline to the 5-year follow-up (IKDC subjective score, 34.67 to 75.86; Lysholm score, 34.00 to 85.33; Tegner activity score, 1.17 to 4.67; and MOCART score, 28.33 to 83.33). Two patients had complete defect filling on magnetic resonance imaging evaluation at 1 year. Moreover, at 5 years postoperatively, complete defect filling was observed in 4 patients, and hypertrophy or incomplete defect filling (50%-100%) was observed in 2 patients. Conclusion: The overall results of this clinical study suggest that CCP-ACI can emerge as a promising therapeutic option for articular cartilage repair with good clinical outcomes and structural regeneration and with stable results at midterm follow-up.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"32 1","pages":"239"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80914581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Are subdeltoid bursitis and polymyalgia rheumatica preferances of COVID-19 vaccine?","authors":"Àlex, P. erRozin","doi":"10.37532/1758-4272.2021.16(2).088","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).088","url":null,"abstract":"COVID-19 vaccine became clear card life-saving medication. Due to over world vaccination a rate of prevalence and incidence of coronal infection is going to back down. However, we meet different side effects of the vaccine. Two cases of subdeltoid bursitis after COVID-19 vaccination discussed.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"167 1","pages":"088"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77829433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The role of trabecular bone score, inaddition to FRAX, for the measurementof fracture risk in patients withdegenerative lumbar spine stenosis","authors":"H. A. Aldaoseri","doi":"10.37532/1758-4272.2021.16(6).172","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(6).172","url":null,"abstract":"Objectives: To investigate the relevance of Concomitant Trabecular Bone Score (TBS) and Areal Bone Mineral Density (aBMD) assessments to estimate fracture risk in patients with Degenerative Lumbar Spine Stenosis (DLSS). Methods: A cross-sectional prospective study was performed. Dual energy X-ray absorptiometry scans of the lumbar spine and hip were acquired in 50 patients with DLSS. TBS and aBMD were calculated from the anteroposterior views of L1-L4 vertebrae. The World Health Organisation Fracture Risk Assessment Tool (FRAX) was utilised to estimate hip or Major Osteoporotic Fracture (MOF) risk. Results: L1-L4 TBS scores revealed degraded microarchitecture, (TBS ≤ 1.20), partially degraded microarchitecture (TBS >1.20 and <1.35) or normal appearances (TBS ≥ 1.35) in 9 (18%), 14 (28%) and 27 (54%) patients, respectively. L1-L4 aBMD assessment demonstrated osteoporosis (T-score ≤- 2.5), osteopenia (T-score between -1.1 and -2.4) or normal bone density in 15 (30%), 11 (22%) and 24 (48%) patients, respectively. There was no relationship seen between L1-L4 aBMD and TBS measurements (r = 0.046; p = 0.75). A negative relationship was observed between TBS and body mass index (r = -0.438; p = 0.001) andbetween L1-L4 aBMD and FRAX (r = -0.617; p < 0.001); the latter included MOF and risk of hip fracture (r = -0.497; p < 0.001).No relationship was observed between TBS and FRAX included MOF and risk of hip fracture (r = -0.118; p = 0.416 and r = -0.014; p = 0.926, respectively) Conclusion: In patients with DLSS, TBS is a reliable, strong and standalone indicator of fracture risk","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"11 1","pages":"172"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81425818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Relationship Between Foot Symptoms With Disease Activity And Functional State In Patients With Rheumatoid Arthritis","authors":"Halime Ki̇bar, Derya Bugayci Nurdan Paker","doi":"10.37532/1758-4272.2021.16(8).228","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).228","url":null,"abstract":"Aim: Foot and ankle joints are among the joints evaluated in Rheumatoid Arthritis (RA), but not for the calculation of Disease Activity Score-28 (DAS28). The aim of the study is to evaluate the frequency of foot complaints in RA patients and to investigate the relationship between DAS28 and foot complaints and functional statuses. Method: DAS28 (with Erythrocyte Sedimentation Rate), Health Assessment Questionnaire (HAQ), Foot Function Index (FFI), Foot Function Index Pain subscale (FPI), Foot Function Index Deficiency subscale (FDI), Foot Function Index Limitation subscale (FLI), 6-meter (mt) walking time, Visual Analog Scale (VAS) are used to investigate the relationship between DAS28 and other index and scales. Results: 103 patients with RA are included in the study. 91.3% of the patients are female and 8.7 % are male. 66% of the patients have foot and ankle complaints and 34% have no complaints. It is observed that DAS28 is correlated positively with VAS (p<0.001, r=0.702), HAQ (p<0.001, r=0.530 ), FPI (p<0.001, r=0.490 ), FLI (p=0.002, r=0.311 ), FDI (p<0.001, r=0.495 ), FFI (p<0.001, r=0.485 ), 6 mt walking time (p=0.049, r= 0.198) and Erythrocyte Sedimentation Rate (p<0.001, r=0.57) respectively . In addition, it is observed that FFI is correlated positively with duration of disease (p=0.015, r=0.226), body mass index (p=0.002, r=0.292), VAS (p<0.001, r=0.639), HAQ (p<0.001, r=0.376), 6 mt walking time ( p<0.001, r =0.551 ) and the Erythrocyte Sedimentation Rate ( p<0.001, r=0.247). Conclusion: Foot complaints in patients with RA are seen at high rates. Despite the extent of the problem, the rheumatoid foot is neglected. Patients with foot complaints are more likely to have higher inflammatory levels and have more functional limitations. The DAS28 score can also be used for follow-up in patients with foot complaints. In addition, foot complaints must be questioned and clinical and functional follow-up should be done. FFI and subscores can be used in evaluating and following foot complaints in patients with RA.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"62 1","pages":"228"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90614110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adam Kilian, Ma Ch, Maha Almackenzie, NadineMbuyi, S. Bilal, Gelareh Atefi Victoria K. Shanmugam
{"title":"COVID catalyst: telemedicine in rheumatology protects patient care beyond just the pandemic","authors":"Adam Kilian, Ma Ch, Maha Almackenzie, NadineMbuyi, S. Bilal, Gelareh Atefi Victoria K. Shanmugam","doi":"10.37532/1758-4272.2021.16(2).084","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).084","url":null,"abstract":"During January 2021, rheumatologic care in Washington DC was affected by both the peak of the COVID-19 pandemic in the United States as well as a deadly insurrection and attack on the US Capitol. As rheumatologists practicing a few blocks from the White House, the authors discuss the crucial role that telemedicine served in delivering healthcare to patients with rheumatic diseases during and after the attack on the US Capitol as threats of violence, physical barriers, military vehicles, and armed troops challenged traditional means of caring for patients. The authors also discuss the role for telemedicine in safely providing future healthcare delivery.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"74 1","pages":"084"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77182256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ultrasound findings in Reactive arthritis after COVID-19: Case Report","authors":"J. M. Torres","doi":"10.37532/1758-4272.2021.16(8).249","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).249","url":null,"abstract":"Reactive arthritis is classified in the group of spondyloarthritis, it has been frequently associated with bacterial infections, however, it has also been linked with viral infections. Recently, different patterns of arthritis have been reported in convalescent COVID-19 patients, with involvement of large and small joints. We report the first case of post-covid 19 arthritis evaluated with ultrasound, highlighting the examination of tendons and entheses. We found an asymmetric polyarticular inflammatory pattern characterized by synovial hypertrophy, effusion, tenosynovitis, and ultrasound signs of enthesitis, based on OMERACT definitions. Ultrasound is a tool that has greater sensitivity than physical examination for the diagnosis as well as for the follow-up of patients with autoimmune diseases.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80886673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of platelet-rich plasma therapy in conjunction with physical therapy for rotator cuff tendinopathy","authors":"Pooja Pithadia, Pratham Singh","doi":"10.37532/1758-4272.2021.16(7).216","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(7).216","url":null,"abstract":"Objective: To evaluate the effect of combining ultrasound-guided Platelet-Rich Plasma (PRP) therapy with physical therapy for rotator cuff tendinopathy. Design: We present a case report of rotator cuff tendinopathy treated with ultrasound-guided Platelet-Rich Plasma (PRP) injections followed by physical therapy. Methods: After undergoing conventional treatment modalities, a patient underwent a course of ultrasound guided PRP injection followed by physical therapy (core strengthening) for 10 weeks. The patient outcome was measured using the numerical Pain Rating Scale (NPRS), Oxford Scoring System (OSS), and the Western Ontario and McMaster Universities Arthritis (WOMAC) Index. Radiological examination using Magnetic Resonance Imaging (MRI) was also performed before and after PRP treatment. Results: Following treatment, the patient reported pain relief within a week. As the patient continued core strengthening exercise for 10 weeks, he showed drastic improvement in function with no pain and discomfort as determined by NPRS, OSS, and WOMAC index respectively. At the same time, there were no significant complications. Even the repeat MRI performed after 18 m showed no supraspinatus tendinopathy tear. Conclusion: In this case report, PRP injections in combination with physical therapy for the treatment of rotator cuff tendinopathy demonstrated improvement in all outcome measures. This highlights the need for conducting more controlled trials to determine the effect of this combinational treatment.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"29 1","pages":"216"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76146685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of neurofibramatosis presenting with jaccoud arthropathy","authors":"M. Limon","doi":"10.37532/1758-4272.2021.16(6).187","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(6).187","url":null,"abstract":"Jaccoud artropathy is a syndrome that is characterized by progressive, painless and reversible deformities involving especially the hands. Jaccoud artropathy may occur idiopathicallly as well as being associated with rheumatological diseases, lung malignancy, infections and Parkinson’s disease. Neurofibromatosis is a genetic chilhhood disease which presents with skin, eye, neurological and musculokeletal system manifestations. So far, no case of coexistence of neurofibromatosis and Jaccoud artropathy has been reported. This case is presented due to establishment of Jaccoud arthropathy in a patient with the diagnosis of neurofibromatosis.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"26 1","pages":"187"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78891852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effectiveness of adalimumab versus infliximab in patients with ankylosing spondylitis: A randomized double blinded clinical trial","authors":"R. Salesi","doi":"10.37532/1758-4272.2021.16(2).073","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).073","url":null,"abstract":"Objective: To compare the efficacy of Adalimumab versus Infliximab in patients with active Ankylosing Spondylitis. Method: 80 patients with active AS who were candidates for receiving anti TNF drugs were randomly assigned to Adalimumab receiving group (group A) or Infliximab receiving group (group B). At beginning, BASDAI score, ESR level, CRP level, presence or absence of peripheral arthritis and enthesitis, need for NSAID use, schober test and occiput to wall distance were recorded. A second rheumatologist who was unaware of the type of drug used, evaluated patients 2 months and 4 months after initiating treatment and new data was recorded. Data were analyzed using SPSS software version 26 with T-test, Mann-Whitney U test, Chi-squared test, McNemar and Wilcoxon test. Results: after 2 and 4 months treatment, patients of both groups showed significant improvement in the BASDAI score, ESR level, CRP level and Schober test. They all needed less NSAID to control their pain. Both drugs had similar effects on clinical and laboratory variables. Conclusion: Adalimumab and Infliximab are both effective for improving clinical and physical status and quality of life in patients with active AS. Since there is no significant difference for the effectiveness of these 2 drugs, accessibility, price and administration of these drugs can help physicians decide between these drugs.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":"17 1","pages":"073"},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75258853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}