International Journal of Rheumatic Diseases最新文献

{"title":"A Case Report of Atypical Presentation of Systemic Lupus Erythematosus in a Young Child","authors":"Saurabh Agarwal,&nbsp;Kalyana Prabhakaran,&nbsp;Aasma Nalwa,&nbsp;Jagdish Prasad Goyal,&nbsp;Prawin Kumar","doi":"10.1111/1756-185x.70426","DOIUrl":"https://doi.org/10.1111/1756-185x.70426","url":null,"abstract":"<div>\u0000 \u0000 <p>Systemic lupus erythematosus is a chronic multisystem autoimmune disorder with varied etiology and clinical presentation. It is unusual during infancy. We describe a 2-year-old boy who presented with progressive mucocutaneous lesions with arthralgia and limb pain. He had hepatomegaly, Raynaud's phenomenon, brisk deep tendon reflexes, and bilateral upper and lower limb weakness. On evaluation, he was positive for ANA and SSA only without any complement activation and was subsequently diagnosed with mixed features of both subacute and chronic cutaneous lupus erythematosus. Infantile onset lupus is rare and should be suspected in children with mucocutaneous and musculoskeletal involvement.</p>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinoid-Associated Severe Posterior Ligamentous Predominant Soft Tissue Inflammation: A Phenotype Beyond Diffuse Idiopathic Skeletal Hyperostosis","authors":"Sena Uslu,&nbsp;Kerem Abacar,&nbsp;Harun Gupta,&nbsp;Mike Green,&nbsp;Benjamin Walker,&nbsp;Tom Macleod,&nbsp;Dennis McGonagle","doi":"10.1111/1756-185x.70411","DOIUrl":"https://doi.org/10.1111/1756-185x.70411","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Metabolic Syndrome in Gout Patients and Its Relationship With Metabolic Markers: A Propensity Score Matching Study","authors":"Wanping Lv,&nbsp;Huixiang Chen,&nbsp;Hongmei Zhu,&nbsp;Dong Han,&nbsp;Yu Lei","doi":"10.1111/1756-185x.70424","DOIUrl":"https://doi.org/10.1111/1756-185x.70424","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the association between metabolic markers and metabolic syndrome (MetS) in gout patients, and to assess the predictive performance of the triglyceride-glucose (TyG) index and triglyceride/high-density lipoprotein cholesterol (THR) ratio.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cross-sectional study, 502 gout patients (97.8% male) admitted between February 2023 and February 2024 were enrolled. MetS was defined according to the International Diabetes Federation criteria. Four metabolic markers—TyG, THR, serum uric acid/creatinine (SUA/Cr) ratio, and C-reactive protein/HDL-C ratio—were measured. Multivariate logistic regression identified independent predictors of MetS, while receiver operating characteristic (ROC) curves evaluated diagnostic accuracy. Propensity score matching and restricted cubic spline analyses were also performed to adjust for confounders and explore dose–response relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of MetS was 62.4%. Patients with MetS exhibited significantly higher weight, systolic blood pressure (SBP), TyG, and THR values compared to non-MetS subjects (all <i>p</i> &lt; 0.05). After adjustment, TyG (OR = 3.94, 95% CI: 2.60, 5.98) and THR (OR = 1.66, 95% CI: 1.33, 2.07) remained independently associated with MetS. ROC analysis revealed AUCs of 0.771 for TyG and 0.776 for THR; a combined model achieved an AUC of 0.820. A non-linear dose–response relationship was also observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated TyG and THR indices are robust, independent predictors of MetS in gout patients. These cost-effective markers may facilitate early screening and risk stratification in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145230660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cases Report: Spontaneous Intramuscular Hemorrhage in Anti-MDA5 Positive Dermatomyositis","authors":"Mingli Zhao,&nbsp;Changyan Liu,&nbsp;Yida Xing,&nbsp;Yan Zhang,&nbsp;Xiaodan Kong","doi":"10.1111/1756-185x.70425","DOIUrl":"10.1111/1756-185x.70425","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: “Who Is the Convict: COVID-19 or Corticosteroid? Late-Onset Avascular Necrosis of the Hips After COVID-19. A Case Report With Literature Review”","authors":"Alperen Kahraman,&nbsp;Zühre Kaya,&nbsp;Murat Zinnuroğlu,&nbsp;Hakan Selek","doi":"10.1111/1756-185x.70420","DOIUrl":"10.1111/1756-185x.70420","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal Ultrasound Assessment Changes Management Decisions in Rheumatoid Arthritis Patients With Moderate Disease Activity","authors":"Helena Crawshaw,&nbsp;Laura Rubio-Cirilo,&nbsp;Hilary Johnson,&nbsp;Safwan Jamal,&nbsp;Sarah Hickey,&nbsp;Jessica Gunn,&nbsp;Iman Ali,&nbsp;Gill Coombes,&nbsp;Carlos Acebes","doi":"10.1111/1756-185x.70415","DOIUrl":"10.1111/1756-185x.70415","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Musculoskeletal ultrasound (MSUS) provides valuable information about disease activity and anatomical damage in rheumatoid arthritis (RA); therefore, in combination with clinical assessment, it may be a useful tool in clinical decision-making with treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>(1) To evaluate the impact of MSUS assessment on treatment decisions in patients with moderately active RA receiving conventional synthetic disease-modifying antirheumatic drugs (csDMARDs). (2) To determine the level of concordance between MSUS assessment and DAS28 in these patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RA patients with a DAS-28 ranging from 3.22–5.1, inadequate response to csDMARDs, and indication for escalating treatment were enrolled. All patients underwent an ultrasound (US) examination (B and PD modes) of the bilateral 5-joint count (5USJC), the symptomatic joints of the DAS-28 score (28USJC), and of a comprehensive 78-joint count (78USJC). A Likert scale (pre- and post-MSUS) was used to assess patients' and clinicians' desires to escalate treatment. The outcome of the treatment decision based on US assessment was reviewed at 24 months' follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 27 patients included, the mean (SD) DAS-28 score was 4.4 (0.7). Following US assessment, there was a change in the decision to escalate treatment in 18 patients (66.7%), and at a median follow-up of 24 months, only in 5 of the 18 patients had the treatment had been escalated. Treatment escalation was associated with a higher US score across all assessments (5USJC, 28USJC, 78USJC) (<i>p</i> &lt; 0.05). The 78USJC was the most reliably aligned with the treatment decision (<i>p</i> = 0.009). A comparison of the US and clinical assessment revealed poor concordance between all variables of the DAS-28 and US scores, except for the swollen joint count.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The addition of MSUS assessment to the DAS-28 score affected management decisions in 66.7% of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Targeting of Apoptosis-Driven Inflammation in Rheumatoid Arthritis: A Biochemical and Molecular Modeling Approach Using Plant-Derived Compounds","authors":"Zafer Saad Alshehri","doi":"10.1111/1756-185x.70423","DOIUrl":"10.1111/1756-185x.70423","url":null,"abstract":"<div>\u0000 \u0000 <p>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by persistent synovial inflammation, joint destruction, and resistance to apoptosis in fibroblast-like synoviocytes and immune cells. This apoptotic imbalance promotes unchecked cell proliferation and invasive pannus formation, contributing to disease progression. Current therapies predominantly target inflammatory pathways, often overlooking the crucial role of restoring apoptosis. Our study explores the potential of plant-derived phytochemicals to modulate both inflammation and apoptosis in RA. Using an integrated computational approach, 12 bioactive compounds were evaluated for their interactions with key apoptosis-associated proteins MMP9, SRC, and EGFR, which are known to influence cell survival, matrix degradation, and invasive behavior in RA. Molecular docking revealed that quercetin, apigenin, resveratrol, and naringenin exhibit strong binding affinities with MMP9, SRC, and EGFR. These interactions were further supported by stable molecular dynamics (MD) simulations, indicating favorable binding stability and structural compatibility. The modulation of these targets suggests a dual therapeutic effect—suppressing inflammation and restoring apoptotic signaling, thus potentially reversing pathological synovial hyperplasia. This study underscores the importance of targeting apoptosis-related proteins in RA and highlights plant-derived compounds as promising candidates for multi-target therapeutic development. By addressing both inflammatory and apoptotic dysregulation, these natural agents may offer a safer and more effective strategy for RA management.</p>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Get OUT: Factors Associated With a Longer Length of Stay in Patients Admitted With an Acute Gout Flare, and the Effects of Anakinra on Length of Stay","authors":"Hansaja Weerawardena,&nbsp;Cameron Louis Adams,&nbsp;Narainraj Kamalaraj,&nbsp;Kevin Pile","doi":"10.1111/1756-185x.70418","DOIUrl":"10.1111/1756-185x.70418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Acute gout flares (AGF) are a significant burden to healthcare systems globally, due to the prolonged length of stay (LOS). The study's aim was to audit patients admitted to our facility with AGF, then re-audit after the introduction of interleukin-1 receptor antagonist anakinra in select patients to assess whether it would result in a reduced LOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A single-center retrospective audit was conducted on 62 hospitalizations for AGF in 2019 that met inclusion criteria. Data on patient demographics, comorbidities, and clinical parameters (number of joints involved, C-reactive protein (CRP), urate levels, and tophi) were analyzed using multivariable Poisson regression models to determine predictors of LOS. We then compared patients that received anakinra in 2020 (<i>n</i> = 7) with a historical control group (<i>n</i> = 13).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average LOS in 2019 for AGF was 3.36 days (1.22–4.28). CRP, prior use of allopurinol, and impaired mobility levels were significant predictors of prolonged LOS, with respective coefficients of 0.0036 (95% CI: 0.0023–0.0050, <i>p</i> &lt; 0.0001), 0.321 (95% CI: 0.043–0.599, <i>p</i> = 0.023), and 0.708 (95% CI: 0.416–1.000, <i>p</i> &lt; 0.0001). When CRP was treated as a controlled variable, patients treated in 2020 with anakinra demonstrated a 0.493-day reduction in LOS compared to the control group, which was statistically significant (<i>p</i> = 0.043).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CRP levels, allopurinol use, and impaired mobility are key predictors of prolonged LOS in AGF. Although the use of anakinra shows promise in reducing LOS and costs, larger studies are needed to confirm its efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic and Hospital-Level Disparities in Cardiovascular Hospitalizations Among Adults With Systemic Lupus Erythematosus: A Retrospective Cohort Study","authors":"Song Peng Ang,&nbsp;Jia Ee Chia,&nbsp;Jose Iglesias,&nbsp;Kanan Jahangirli,&nbsp;Debabrata Mukherjee","doi":"10.1111/1756-185x.70416","DOIUrl":"10.1111/1756-185x.70416","url":null,"abstract":"&lt;p&gt;Survival in systemic lupus erythematosus (SLE) has improved, yet cardiovascular morbidity and mortality remain disproportionately high [&lt;span&gt;1-3&lt;/span&gt;]. Chronic inflammation, endothelial dysfunction, and traditional risk factors synergistically accelerate atherosclerosis in SLE, with systemic inflammation independently predicting adverse cardiovascular events [&lt;span&gt;4&lt;/span&gt;]. Although hospitalization rates for cardiovascular complications are rising, the drivers of these admissions and the role of social determinants of health are incompletely understood [&lt;span&gt;5&lt;/span&gt;]. We therefore examined sociodemographic and hospital-level predictors of cardiovascular-related hospitalizations in a contemporary, national SLE cohort.&lt;/p&gt;&lt;p&gt;This retrospective cohort study utilized hospitalization records from the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) from January 1, 2016, to December 31, 2021 [&lt;span&gt;6&lt;/span&gt;]. This database is the largest publicly available all-payer inpatient database in the United States, which, when weighted, provides national estimates representing more than 35 million hospitalizations annually. As publicly available, de-identified data were used, informed consent or local institutional review board approval was waived. Hospitalizations were identified for adults aged ≥ 18 years with a diagnosis of SLE using the International Classification of Diseases, Tenth Revision (ICD-10) codes—M32.1x, M32.8, and M32.9. Cardiovascular hospitalization was determined by the principal diagnosis (ICD-10-CM codes I00–I99) recorded for each admission. The primary outcome of interest was cardiovascular-related hospitalization, categorized into specific events, including heart failure (HF), coronary artery disease (CAD), atrial fibrillation (AF), and stroke. National-level estimates were generated from discharge weights assigned to each hospitalization. Descriptive statistics were used to characterize the cohort, with categorical variables reported as counts and percentages. Multivariable modified Poisson regression with robust variance estimates was used to assess associations between sociodemographic and hospital-level factors and cardiovascular hospitalizations. We constructed a model that adjusted for sociodemographic factors and comorbid conditions. Generalized estimating equations (GEEs) with a compound symmetry correlation matrix were used to account for clustering at the hospital level. Effect sizes were expressed as relative risk (RRs) and their corresponding 95% confidence intervals (CIs). Statistical significance was set at a two-sided &lt;i&gt;p&lt;/i&gt; &lt; 0.05.&lt;/p&gt;&lt;p&gt;A total of 165 290 cardiovascular hospitalizations from 2016 to 2021 for patients with SLE were identified (Table 1). Most patients were women (84.8%) and either 45–64 years (38.4%) or ≥ 65 years (37.2%). Non-Hispanic White (NHW) patients accounted for 48.2% of admissions, non-Hispanic Black (NHB) 34.7%, and Hispanics 12.0%. Over one-third (36.5%)","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: A Challenging Case of Seronegative Catastrophic Antiphospholipid Syndrome","authors":"Rohan Singh,&nbsp;Imari Patel,&nbsp;Kathyrn Brimanson,&nbsp;Jennie Y. Law","doi":"10.1111/1756-185x.70417","DOIUrl":"https://doi.org/10.1111/1756-185x.70417","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 9","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}