International Journal of Clinical Rheumatology最新文献

{"title":"Coronavirus disease 2019 (COVID-19) an emerging trigger for primary fibromyalgia syndrome: A tale of three cases post-COVID-19","authors":"T. Gheita, H. Fathi, Suzan S ElAdle, Nahla N Eesa Nevin H Hammam","doi":"10.37532/1758-4272.2021.16(2).129","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).129","url":null,"abstract":"Background: Corona virus (COVID-19) is an emerging worldwide infectious disease that may be followed in some patients by post COVID-19 syndrome; patients who experience symptom of disease long time after their recovery. Among the frequent post-COVID-19 symptoms are fatigue, headache, sleep disorder, anxiety and musculoskeletal pain which coincide with features of Fibromyalgia Syndrome (FMS). This study reports out of the ordinary scenarios and outcomes for three cases who developed primary FMS post COVID-19. Method: Three females, not known to have previous FMS or any other rheumatic disease, post COVID-19 were referred for rheumatology consultation due to the prolonged persistence of symptoms after recovery from COVID-19. Results: The cases presented with anxiety and depression, headache, generalized musculoskeletal pain, paresthesia and non-restorative sleep. General examination and various laboratory investigation including autoimmune profile as well as radiological investigation were all normal. Tender points on examination lead to the diagnosis of FMS. Non-pharmacological and pharmacological management with antidepressant therapy were prescribed with improvement. Conclusions: We are presenting the first three cases of COVID-19 infection as an emerging trigger for FMS. This association should be considered during management of post COVID-19 syndrome to improve pain care and prevent worsening of symptom during the COVID-19 pandemic.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79041139","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":"Inferior subluxation of humeral head mimicking shoulder dislocation: case report and review of literature","authors":"Archisha Marya, Kirti MohanMarya, Hareesha RishabBharadwaj An, Gupta","doi":"10.37532/1758-4272.2021.16(7).203","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(7).203","url":null,"abstract":"We report a case of 54-year-old female patient who presented with right shoulder pain and stiffness for routine follow -up after having sustained a non-displaced humeral neck fracture. Surprisingly, her X-rays showed completely dissociated glenohumeral joint similar to a dislocation. On further evaluation, it was confirmed to be a case of inferior subluxation of humeral head because of prolonged immobilization and muscular atony. Few weeks of rehabilitation led to full recovery. Physicians working in Accident & Emergency department, as well as radiologists need to be equally aware of this condition to avoid unnecessary diagnostic evaluations and orthopedic maneuvers/ interventions.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75887838","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 infective trigger for macrophage activation syndrome in rheumatic diseases. A retrospective analysis in a tertiary pediatric care centre and review of the literature","authors":"M. Errico, P. Capetti, MartinaCucchetti, D. Rossetti, A. Petaccia, StefanoLanni, F. Minoia, CarloAgostoni Giovanni Filocamo","doi":"10.37532/1758-4272.2021.16(8).234","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(8).234","url":null,"abstract":"Background: The role of infection in Macrophage Activation Syndrome (MAS) is controversial. In order to evaluate the prevalence of infections preceding the onset of MAS, we retrospectively analysed the cases of MAS complicating rheumatic diseases recorded in our tertiary hospital between 2005 and 2015. Methods: The clinical records of patients diagnosed with MAS and hospitalised between January 2005 and December 2015 were reviewed in order to identify their demographic characteristics, underlying rheumatological diseases, clinical and laboratory data, treatments, and complications. There was considered if an infection was documented during the 15 days preceding the onset of MAS. The presence of specific immunoglobulin M was considered separately as a possible indirect sign of recent infection Findings: Twelve children (eight females and four males) with underlying rheumatic disorders developed MAS during the study period: six were affected by systemic-onset juvenile idiopathic arthritis, three by systemic lupus erythematosus, two by dermatomyositis, and one by undifferentiated arthritis. There were 14 MAS-related events (one patient experienced three episodes). MAS occurred within 30 days of the onset of rheumatic disease in five cases, and during disease relapses in nine. In two cases, it followed the start of treatment with a new drug. Twelve of the 14 MAS episodes were suspected to be preceded by infections due to various pathogens, including Clostridium difficile, group A Streptococcus, Staphylococcus hominis, Escherichia coli, Entamoeba histolytica, Endolimax nana, Pseudomonas aeruginosa, Borrelia burgdorferi, Adenovirus, Coxsackie virus, Epstein-Barr virus, and Cytomegalovirus. Conclusions: The prevalence of infections in patients developing MAS may be underestimated, and their pathogenetic role should be considered also in patients with underlining rheumatic diseases.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76881285","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":"Optic neuritis in an ankylosing spondylitis patient treated with adalimumab: a case report","authors":"A. Sadeghi","doi":"10.37532/1758-4272.2021.16(2).136","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).136","url":null,"abstract":"Subjective: To describe a case of optic neuritis following intiating treatment with Adalimumab Method: this case was evaluated by visual field testing, fundoscopic examination and brian Magnetic Resonance Imaging (MRI). Results: After receiving Methylprednisolone and tapering with Prednisolone this patient had a complete recovery. There was no sign of recurrence after 6 months of follow-up. Conclusion: In this case the proximity of starting the symptoms to initiating the treatment with Adalimumab and complete recovery after cessation of the drug and corticosteroid treatment can suggest a causal association.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78284738","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":"Synovitis with pitting edema as the presenting manifestation of antisynthetase syndrome","authors":"S. Boussaid, K. Zouaoui, M. Hassayoun, S. Rekik, S. Jammali, E. Cheour, Hela Elleuch","doi":"10.37532/1758-4272.2021.16(6).179","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(6).179","url":null,"abstract":"Introduction: rnThe Anti-Synthetases Syndrome (ASS) is an autoimmune disease associating inflammatory myopathy, interstitial pneumonitis, polyarthritis, raynaud syndrome, characteristic cutaneous involvement (\"hands of mechanics\") and autoantibodies antiaminoacyl transfer RNA synthetases including anti-JO-1. On can also observe general manifestations like fever or asthenia. We report the case of a patient who presented acute oedematous polyarthritis that revealed an anti-synthetase syndrome. rn. Observation: rnThis is a 65-year-old patient with a history of hospitalization in pneumology for acute respiratory distress syndrome related to infectious hypoxemic pneumonitis, admitted in 2017 to the rheumatology department for exploration of acute polyarthritis, evolving for 1 month, affecting the elbows, knees, wrists, small joints of the hands and ankles associated with distal edema at the 4 members keeping the bucket. The patient was afebrile. On neurological examination, he had weak osteotendinous reflexes in the lower limbs without associated muscular deficit. The rest of the somatic examination was without notable abnormalities. rnIn biology, he had a biological inflammatory syndrome (CRP 37.7 mg/l), lymphopenia at 1000 El/mm3, LDH at 2 times normal and CPK at 3 times the normal. In the immunoassay, antinuclear antibodies were positive at 1/800 as well as anti-ENA, anti-JO-1. The tumor markers were negative. rnrnX-rays of the affected joints were without abnormalities. Thoraco-abdominopelvic Computed Tomography (CT) showed ventilatory disturbances of both basal pyramids with bronchiectasis and low abundance left pleural effusion. The functional respiratory explorations had objectified a restrictive syndrome. Muscle biopsy revealed a discrete perivascular inflammatory infiltrate with no type of necrosis or regeneration. Faced with these elements, the diagnosis of ASS was retained and the patient was put on corticosteroids at the dose of 1 mg/kg/day with a clear clinical-biological improvement. The patient was lost to follow-up for 5 months, then he was referred to rheumatology in a febrile state associated with a muscular deficit of the 2 scapular and pelvic belts, following the abrupt cessation of his treatment on his own. He also had a biological inflammatory syndrome (CRP 166.5 mg/l) with myolysis (CPK at 4 times normal and LDH at 3 times normal). He received 3 bols of methylprednisolone (1 gram/bolus) relayed by prednisolone at a dose of 1 mg/kg/day for one week. However, at a dose rate of 0.3 mg/kg/day, the patient relapsed and presented with fever and biological inflammatory syndrome; hence the decision to switch to cyclophosphamide as a monthly infusion at a dose of 0.7 mg/m2 body surface area combined with corticosteroid therapy at a dose of 0.3 mg/kg/day. The patient received a total of 6 courses of cyclophosphamide with a poor response to treatment. It was recommended, therefore, to put him on rituximab and while waiting for this treatm","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75282039","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":"Severe coronal re-infection and issuesof mechanisms, monitoring and therapy","authors":"R. Alex, P. Er","doi":"10.37532/1758-4272.2021.16(5).146","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(5).146","url":null,"abstract":"Recurrent COVID-19 infection with severe lung disease and periarthritis presented. Possible mechanisms for recurrent disease, periarthritis, and treatment options discussed.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72944935","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":"Chronic nonbacterial osteomyelitis: report of thirteen cases","authors":"G. Balbi, D. Piotto, A. Aihara, Artur da Rocha Correa Fern, Es, M. Fraga, ro Perazzio, G. Terreri","doi":"10.37532/1758-4272.2021.16(2).114","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).114","url":null,"abstract":"Introduction: Chronic Nonbacterial Osteomyelitis (CNO), also known as Chronic Recurrent Multifocal Osteomyelitis (CRMO), is a rare autoinflammatory bone disorder that causes multifocal or unifocal aseptic lytic lesions in bone biopsy and is characterized by periodic exacerbations and remissions of sterile osteomyelitis. The aim of this report was to describe clinical features, subsidiary exams, treatment and outcome of thirteen cases of CNO followed in a tertiary center in Brazil. Methods: We carried out a single-center retrospective descriptive review of clinical records, including thirteen children and adolescents with CNO followed between 2010 and 2020 in our tertiary service in Brazil. Medical records were reviewed in order to collect data about clinical presentation, inflammatory markers, radiological and histological findings, treatment and outcome.The diagnosis of CNO was based on the Bristol diagnostic criteria for CRMO. Results: Thirteen patients were included in this study, of whom 46% were female. Median of current age and of follow-up time were 11 years (range 8.5-20.4) and 40 months (range 9-123), respectively. Median age at disease onset was 8.1 years (range 0.8–15.3) and median age at diagnosis was 11 years (range 7-16.1). The most affected sites were metaphysis and diaphysis of long bones. Median number of initially affected bones was 4.0 (range 1-7). Five patients had recurrences. All patients had increased acute phase reactants at disease onset. All patients had at least one of the characteristic findings on MRI (lytic lesions, osteitis, hyperostosis and periostitis). Five patients received systemic glucocorticoids, eight received methotrexate and seven received bisphosphonates (alendronate). Conclusion: The awareness of the features of CNO is important for an early diagnosis and may avoid unnecessary diagnostic procedures and prolonged antibiotic therapies.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77678349","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":"Long-term results of joint damage in patients with rheumatoid arthritis treated with abatacept: 5-year results of a clinical observational study","authors":"T. Mochizuki, KoichiroYano, K. Ikari, KenOkazaki","doi":"10.37532/1758-4272.2021.16(2).090","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).090","url":null,"abstract":"Background: In abatacept treatment for RA, there are no studies investigating the long-term results of joint damage in daily clinical practice. We aimed to investigate the long-term efficacy of abatacept in Japanese patients with rheumatoid arthritis. Methods: We examined 120 patients who received abatacept for 5 years. Joint damage was radiographically analyzed using the van der Heijde-modified total Sharp score. Disease activity score was assessed using the disease activity score in 28 joints-erythrocyte sedimentation rate (DAS28-ESR). The data analyses were used by observed case analysis. Results: Changes in the Sharp score was 0.60 ± 2.03, 0.93 ± 2.40, 1.23 ± 2.92, 1.53 ± 3.38, and 1.71 ± 3.84 at years 1, 2, 3, 4, and 5, respectively. Progression of joint damage did not differ significantly between the Bio-naA¯ve and Bio-switch groups and methotrexate [MTX](+) and MTX(MTX(-)) groups. DAS28-ESR at baseline was associated with radiographic progression (p = 0.035). In all patients, the remission rates of DAS28-ESR were 44.6% and 50.0% at years 1 and 5, respectively. These rates were 45.2% and 50.8% in the biological disease-modifying anti-rheumatic drugs (Bio)-naive¯ve group, and 42.9% and 47.1% in the Bio-switch group, respectively. Moreover, these rates were 45.2% and 52.6% in the MTX(+) group and 43.6% and 47.6% in the MTX(-) group, respectively. The remission rates were not significantly different between the groups at any of time points. Conclusions: we have analyzed the efficacy of abatacept treatment in patient with RA for 5 years in daily clinical practice. The present study suggested that improvement of joint damage, disease activity, and physical function are maintained in the long-term.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86896198","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":"Vitamin D deficiency: supplementation or test & treat?","authors":"Kirti Mohan Marya","doi":"10.37532/1758-4272.2021.16(2).127","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(2).127","url":null,"abstract":"The relation between lack of sunshine and rickets is known since the end of the 19th century. In the 1890s, Dr Palm, a Scottish medical missionary, working in Japan noted the absence of rickets. Back in England, he was intrigued by the very high prevalence of rickets. From other medical missionaries, Palm learnt that children in tropical zones, such as China, India and Ceylon were free of rickets. Palm came to the conclusion that “the geography of rickets appears to involve the temperate latitudes of Europe, and he attributed the absence of rickets in tropical countries to plenty of sunshine.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77398926","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":"Chronic tophaceous gout arthritis with infected giant podagra on first ray: a case report","authors":"Wayan Subawa, P. Astawa, Nico Lie, Claudia Santosa Richard Af","doi":"10.37532/1758-4272.2021.16(7).197","DOIUrl":"https://doi.org/10.37532/1758-4272.2021.16(7).197","url":null,"abstract":"Gout Arhritis is a purine metabolism disorder that leads to hyperuricemia and monosodium urate monohydrate crystal deposition in musculoskeletal system and others. Tophaceous deposits are well-known to lead joint destruction, which can be complicated by secondary infection condition. The prevalence and incidence of gout vary from a prevalence of < 1% to < 6.8% and an incidence of 0.58 per 1,000 person/years to 2.89 per 1,000 person/years. We presented a case of 56-years-old male came with the complained of lumps on both ankles and feet since 9 y. From physical examination, we found multiple tophi on his feet and infected giant podagra on the right foot associated with secondary infection. This symptoms is enhanced by laboratory result and imaging that confirming chronic gout arthritis. For clinician, diagnosing gout arthritis sometimes quite challenging which requiring investigation through joint or tophi aspirations. There are some other diagnosis that often mimicking the clinical feature of gout arthritis like, cellulitis, Reiter's disease, Pseudogout and Rheumatoid Arthritis (RA). Gout arthritis itself commonly treated with conservative treatment but 10% of patients with clinical gout developed destructive tophi. This kind of stage will need further surgical intervention, including; surgical reconstruction debridement and resection arthroplasty, joint fusion and even amputation.","PeriodicalId":13740,"journal":{"name":"International Journal of Clinical Rheumatology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77658738","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}