JCR: Journal of Clinical Rheumatology最新文献

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Lymphoid Interstitial Pneumonia in a Patient With Sjögren Syndrome. Sjögren综合征患者的淋巴样间质性肺炎。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-04-04 DOI: 10.1097/RHU.0000000000002235
Derek Ross Soled
{"title":"Lymphoid Interstitial Pneumonia in a Patient With Sjögren Syndrome.","authors":"Derek Ross Soled","doi":"10.1097/RHU.0000000000002235","DOIUrl":"10.1097/RHU.0000000000002235","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e95"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788342","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}
引用次数: 0
Skin Lesions in Acute Hemorrhagic Edema of Infancy. 婴儿急性出血性水肿的皮肤损害。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-02-17 DOI: 10.1097/RHU.0000000000002215
Lucy Emery, Derek Ross Soled
{"title":"Skin Lesions in Acute Hemorrhagic Edema of Infancy.","authors":"Lucy Emery, Derek Ross Soled","doi":"10.1097/RHU.0000000000002215","DOIUrl":"10.1097/RHU.0000000000002215","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e91"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440975","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}
引用次数: 0
Validation of the ANCA-Associated Vasculitis Patient-Reported Outcomes Questionnaire in a Latin American Vasculitis Cohort. 拉丁美洲血管炎队列中anca相关血管炎患者报告结果问卷的验证
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-02-25 DOI: 10.1097/RHU.0000000000002217
Victor R Pimentel-Quiroz, Rocío V Gamboa-Cárdenas, Zoila Rodríguez-Bellido, Risto Perich-Campos, Graciela S Alarcón, Manuel F Ugarte-Gil
{"title":"Validation of the ANCA-Associated Vasculitis Patient-Reported Outcomes Questionnaire in a Latin American Vasculitis Cohort.","authors":"Victor R Pimentel-Quiroz, Rocío V Gamboa-Cárdenas, Zoila Rodríguez-Bellido, Risto Perich-Campos, Graciela S Alarcón, Manuel F Ugarte-Gil","doi":"10.1097/RHU.0000000000002217","DOIUrl":"10.1097/RHU.0000000000002217","url":null,"abstract":"<p><strong>Background/objectives: </strong>The aim of this work is to validate the ANCA-associated vasculitis patient-reported outcome (AAV-PRO) questionnaire in a Latin American (Peru) AAV cohort.</p><p><strong>Methods: </strong>We included patients from the Almenara vasculitis cohort who had at least 1 visit between December 2022 and June 2024. Sociodemographic features, disease activity (Birmingham Vasculitis Activity Score version 3 [BVASv3] score), damage (Vasculitis Damage Index [VDI] score), the AAV-PRO (Spanish version), and the Short Form 36 (SF-36) were obtained. The AAV-PRO includes 6 domains (organ-specific symptoms, systemic symptoms, treatment side effects, social and emotional impact, concerns about the future, and physical function); the score ranges from 0 to 100: the higher the value, the worse the health-related quality of life. Correlations between domains of the AAV-PRO and clinical and sociodemographic variables were evaluated using Spearman correlation.</p><p><strong>Results: </strong>Eighty-two patients were included; 60 (73.2%) of them were female. Their age and disease duration were 55.3 (14.3) and 5.7 (5.2) years, respectively. The BVASv3 and the VDI scores were 6.1 (9.0) and 2.4 (1.7), respectively. Overall, every domain of the AAV-PRO correlated strongly and inversely with the global scores of the SF-36 (physical component summary and mental component summary) (all r < -0.4 and p < 0.001). Physical function, role physical, role emotional, and physical component summary correlated inversely with the BVASv3, whereas the organ-specific symptoms score correlated positively with the VDI.</p><p><strong>Conclusions: </strong>The Spanish version of the AAV-PRO questionnaire correlated with the SF-36 in AAV patients from a Peruvian cohort. These findings may support the use of this instrument in other Latin American populations.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"175-180"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501394","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}
引用次数: 0
Association Between Vascular Calcifications on Joint Radiographs and Calcium Pyrophosphate Crystal Arthritis: A Medical Records Review Study. 关节x线片血管钙化与焦磷酸钙晶体关节炎之间的关系:一项医疗记录综述研究。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-02-24 DOI: 10.1097/RHU.0000000000002214
Shay Brikman, Hani Tannous, Irina Novofastovski, Ran Abuhasira, Reuven Mader, Amir Bieber
{"title":"Association Between Vascular Calcifications on Joint Radiographs and Calcium Pyrophosphate Crystal Arthritis: A Medical Records Review Study.","authors":"Shay Brikman, Hani Tannous, Irina Novofastovski, Ran Abuhasira, Reuven Mader, Amir Bieber","doi":"10.1097/RHU.0000000000002214","DOIUrl":"10.1097/RHU.0000000000002214","url":null,"abstract":"<p><strong>Objective: </strong>Previous studies have shown an association between chondrocalcinosis (CC) and vascular calcifications (VCs). This study aimed to investigate the association of VCs detected on joint radiographs (XRs) of older patients diagnosed with calcium pyrophosphate (CPP) arthritis compared with a control group with osteoarthritis (OA).</p><p><strong>Methods: </strong>A medical records review study of joint radiographs (knee and wrist) was conducted. CPP crystal arthritis was diagnosed based on at least 1 documented episode of arthritis with synovial fluid analysis positive for CPP crystals or imaging showing CC at 1 or more sites, with no alternative inflammatory arthritis diagnosis. The control group comprised patients with OA and no CC, matched 1:1 for age and sex. All participants were over 60 years of age. XRs were reviewed for CC, OA, and VCs at the affected joint by 2 independent observers.</p><p><strong>Results: </strong>A total of 98 patients were enrolled in both the CPP arthritis group and the OA group. VCs adjacent to the affected joint were detected in 69 patients of the CPP group and 19 patients of the control group (70.4% vs 19.4%, p < 0.001). Among patients aged 60 to 80 years, the presence of VCs on XRs was highly indicative of CPP, demonstrating a specificity of 89.2% (95% confidence interval: 79.1%-95.6%). In the CPP group, patients with VCs had a significantly higher prevalence of cardiovascular (CV) comorbidities.</p><p><strong>Conclusions: </strong>The detection of VCs on XRs was strongly associated with CPP crystal arthritis. The presence of VCs may further serve as a biomarker for an increased burden of CV comorbidities.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"194-198"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492077","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}
引用次数: 0
Complete Ossification of the Acetabular Roof in a Patient With Mild Hip Osteoarthritis. 轻度髋关节骨关节炎患者髋臼顶完全骨化。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-04-03 DOI: 10.1097/RHU.0000000000002223
Angelo Nigro
{"title":"Complete Ossification of the Acetabular Roof in a Patient With Mild Hip Osteoarthritis.","authors":"Angelo Nigro","doi":"10.1097/RHU.0000000000002223","DOIUrl":"10.1097/RHU.0000000000002223","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e93"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542222","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}
引用次数: 0
Pneumomediastinum and Subcutaneous Emphysema in a Patient with Dermatomyositis Dermatomyositis. 皮肌炎患者的纵隔气肿和皮下肺气肿。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-02-24 DOI: 10.1097/RHU.0000000000002218
Hirotaka Yamamoto, Yoshinori Taniguchi
{"title":"Pneumomediastinum and Subcutaneous Emphysema in a Patient with Dermatomyositis Dermatomyositis.","authors":"Hirotaka Yamamoto, Yoshinori Taniguchi","doi":"10.1097/RHU.0000000000002218","DOIUrl":"10.1097/RHU.0000000000002218","url":null,"abstract":"","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e92"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492086","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}
引用次数: 0
Mortality Trends in Polymyositis and Dermatomyositis in Mexico: A General Population-Based Study From 2000 to 2019. 墨西哥多发性肌炎和皮肌炎的死亡率趋势:2000年至2019年的一项基于一般人群的研究
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-03-12 DOI: 10.1097/RHU.0000000000002211
Claudia Mendoza-Pinto, Pamela Munguía-Realpozo, Ivet Etchegaray-Morales, Miguel Ángel Saavedra-Salinas, Paulina Cortés-Hernández, Jorge Ayón-Aguilar, Edith Ramírez-Lara, Socorro Méndez Martínez, Mario García-Carrasco
{"title":"Mortality Trends in Polymyositis and Dermatomyositis in Mexico: A General Population-Based Study From 2000 to 2019.","authors":"Claudia Mendoza-Pinto, Pamela Munguía-Realpozo, Ivet Etchegaray-Morales, Miguel Ángel Saavedra-Salinas, Paulina Cortés-Hernández, Jorge Ayón-Aguilar, Edith Ramírez-Lara, Socorro Méndez Martínez, Mario García-Carrasco","doi":"10.1097/RHU.0000000000002211","DOIUrl":"10.1097/RHU.0000000000002211","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with polymyositis and dermatomyositis (PM/DM) are prone to multiple complications that may lead to increased mortality rates. Data about PM/DM mortality in Mexico are lacking.</p><p><strong>Objective: </strong>The aim of this study was to assess mortality trends in PM/DM in Mexico across 2 decades (2000-2019), overall, by sex, age group, and geographic region.</p><p><strong>Methods: </strong>From 2000 to 2019, PM/DM deaths were identified in Mexican open-access health databases using the International Classification of Diseases , 10th Revision . Age-standardized mortality rates (ASMRs) per 100,000 inhabitants were calculated for PM/DM and non-PM/DM deaths by sex and geographic region. The annual percent change (APC) in ASMR was calculated using Joinpoint Regression Software.</p><p><strong>Results: </strong>We found 11.3 million non-PM/DM deaths and 1456 PM/DM deaths in Mexico during the period 2000-2019. Seventy percent of PM/DM deaths occurred in females. PM/DM ASMR was 0.06-0.07/100,000 inhabitants and higher in females (0.08-0.11/100,000). Remarkably, 40% of PM/DM deaths happened in individuals younger than 45 years. This was almost double the percentage than in non-PM/DM deaths. A significant PM/DM ASMR downtrend was identified from 2007 to 2017 (APC, -3.2%; 95% confidence interval, -5.3 to -1.0; p = 0.008), whereas mortality trends were stable for non-PM/DM deaths. No significant changes through time were identified in PM/DM mortality by geographic region in Mexico; however, an increment in PM/DM to non-PM/DM ASMR ratio was detected in the north (+17.6%) and southeast (+84.9%) of Mexico.</p><p><strong>Conclusions: </strong>Mexico's PM/DM mortality rates have significantly decreased over the past 2 decades, particularly from 2007 to 2017. This trend is more pronounced among younger individuals and those outside the country's southeastern region.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"188-193"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615043","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}
引用次数: 0
Noninfectious Uveitis in Pediatric Rheumatology: Long-term Follow-up at Tertiary Centers. 儿童风湿病学非感染性葡萄膜炎:三级中心的长期随访。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-03-12 DOI: 10.1097/RHU.0000000000002220
Nergis Akay, Umit Gul, Oya Koker, Mustafa Asim Erol, Mehmet Yildiz, Elif Kilic Konte, Ebru Altinok, Aybuke Gunalp, Esma Aslan, Fatih Haslak, Amra Adrovic, Sezgin Sahin, Kenan Barut, Didar Ucar, Ilknur Tugal-Tutkun, Ozgur Kasapcopur
{"title":"Noninfectious Uveitis in Pediatric Rheumatology: Long-term Follow-up at Tertiary Centers.","authors":"Nergis Akay, Umit Gul, Oya Koker, Mustafa Asim Erol, Mehmet Yildiz, Elif Kilic Konte, Ebru Altinok, Aybuke Gunalp, Esma Aslan, Fatih Haslak, Amra Adrovic, Sezgin Sahin, Kenan Barut, Didar Ucar, Ilknur Tugal-Tutkun, Ozgur Kasapcopur","doi":"10.1097/RHU.0000000000002220","DOIUrl":"10.1097/RHU.0000000000002220","url":null,"abstract":"<p><strong>Objectives: </strong>Our study aimed to identify potential predictors for additional systemic involvement in patients with noninfectious uveitis, specifically focusing on their demographic, etiological, clinical, and laboratory data features from the pediatric rheumatology perspective.</p><p><strong>Methods: </strong>Patients with noninfectious uveitis before the age of 18 years and followed up for at least 3 months in 2 tertiary centers of pediatric rheumatology and ophthalmology departments were included in the study. Demographics, etiology, clinical features, laboratory data, and treatments administered were evaluated and compared based on the etiology (idiopathic and systemic disease-related uveitis [SD-U]) and the use of biologic disease-modifying antirheumatic drugs.</p><p><strong>Results: </strong>Of 244 patients (131 with idiopathic uveitis and 113 with SD-U), 141 (57.8%) were female. The median (min-max) age at uveitis diagnosis was 8 (1-17) years, with a median (min-max) follow-up period of 36 (3-216) months. We observed that uveitis was mostly anterior (n = 140, 57.4%), chronic (n = 122, 67.4%), and bilateral (n = 146, 59.8%). Patients with SD-U showed a higher prevalence of female predominance, younger age at diagnosis, bilateral involvement, chronic course, increased erythrocyte sedimentation rate value, and antinuclear antibody positivity compared with patients with idiopathic uveitis ( p < 0.05). Uveitis-related complications occurred in 105 (43%) patients, with the most common being posterior synechiae (n = 60, 24.6%). Ocular surgery was required for 7 patients (5.3%) in idiopathic uveitis and for 14 patients (12.4%) in SD-U group.</p><p><strong>Conclusion: </strong>Our study demonstrated that the antinuclear antibody positivity and the high erythrocyte sedimentation rate values were identified as significant, independent predictors for SD-U in patients referred with noninfectious uveitis.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"181-187"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615255","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}
引用次数: 0
Outcomes in Mexican Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Involvement. 墨西哥抗中性粒细胞细胞质抗体相关血管炎累及肾脏患者的预后
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-03-13 DOI: 10.1097/RHU.0000000000002227
Adriana Hernández-Andrade, María Fernanda Zavala-Miranda, Andrea Hinojosa-Azaola, Valeria Navarro-Sánchez, Alberto Nordmann-Gomes, Emiliano Rivero-Otamendi, Bertha M Córdova-Sánchez, Juan M Mejia-Vilet
{"title":"Outcomes in Mexican Patients With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis With Kidney Involvement.","authors":"Adriana Hernández-Andrade, María Fernanda Zavala-Miranda, Andrea Hinojosa-Azaola, Valeria Navarro-Sánchez, Alberto Nordmann-Gomes, Emiliano Rivero-Otamendi, Bertha M Córdova-Sánchez, Juan M Mejia-Vilet","doi":"10.1097/RHU.0000000000002227","DOIUrl":"10.1097/RHU.0000000000002227","url":null,"abstract":"<p><strong>Background/objective: </strong>This study assessed the outcomes of patients with antineutrophil cytoplasm antibody-associated vasculitis glomerulonephritis (AAV-GN).</p><p><strong>Methods: </strong>This historical cohort study included patients with AAV-GN evaluated from 2000 to 2022. The outcomes included recovery of kidney function from kidney replacement therapy, incidence of kidney relapses, and early or late progression to kidney failure. All outcomes were assessed by time-to-event analyses, and predictors were evaluated through Cox proportional hazards regression.</p><p><strong>Results: </strong>Among 154 patients, 104 (68%) were female with a median age of 52 years (interquartile range [IQR], 38-61 years). The median creatinine and estimated glomerular filtration rate at presentation were 2.5 mg/dL (IQR, 1.8-4.5 mg/dL) and 23 mL/min per 1.73 m 2 (IQR, 12-36 mL/min per 1.73 m 2 ), respectively. Fifty patients (32%) initially required kidney replacement therapy, with 22 (44%) of them subsequently recovering kidney function. Higher serum creatinine and a lower percentage of normal glomeruli were associated with lower rates of kidney function recovery. The kidney relapse rate was 24.9% by 5 years and 31.4% by 7 years. Proteinase 3-antineutrophil cytoplasm antibody positivity, kidney function, and persistent hematuria were associated with relapses. Kidney failure rates were 19.6% by 1 year and 30.5% by 5 years. Higher serum creatinine and proteinuria and a lower percentage of normal glomeruli were associated with higher rates of early kidney failure. Kidney relapses, persistent proteinuria, and kidney function posttreatment were associated with higher rates of late kidney failure.</p><p><strong>Conclusions: </strong>The parameters at presentation of an episode of AAV-GN (creatinine, proteinuria, percentage of normal glomeruli) associate with progression to kidney failure within the first year. However, progression to kidney failure after the first year depends on posttreatment parameters and kidney relapses.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e34-e41"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623733","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}
引用次数: 0
The Impact of Social Inequities on Presentation of Juvenile-Onset Systemic Lupus Erythematosus at a Large Tertiary Center. 社会不平等对大型三级中心青少年发病系统性红斑狼疮的影响。
IF 2.4 4区 医学
JCR: Journal of Clinical Rheumatology Pub Date : 2025-08-01 Epub Date: 2025-03-19 DOI: 10.1097/RHU.0000000000002228
Emily F Beil, Marietta DeGuzman, Andrea Ramirez, Cagri Yildirim-Toruner, Abiodun Oluyomi, Omar Rosales, Danielle Guffey, Eyal Muscal, Erin Peckham-Gregory
{"title":"The Impact of Social Inequities on Presentation of Juvenile-Onset Systemic Lupus Erythematosus at a Large Tertiary Center.","authors":"Emily F Beil, Marietta DeGuzman, Andrea Ramirez, Cagri Yildirim-Toruner, Abiodun Oluyomi, Omar Rosales, Danielle Guffey, Eyal Muscal, Erin Peckham-Gregory","doi":"10.1097/RHU.0000000000002228","DOIUrl":"10.1097/RHU.0000000000002228","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of juvenile-onset systemic lupus erythematosus (JSLE) differs by race/ethnicity with environmental, genetic, and social factors implicated in disease severity and outcomes. Yet, the role of social determinants of health (SDoH) in disease presentation is not well understood. We hypothesized that in an urban center with a large, diverse catchment area, SDoH influence the severity of JSLE at diagnosis.</p><p><strong>Methods: </strong>We completed an institutional review board-approved medical record review of children newly diagnosed with JSLE between January 1, 2018, and May 31, 2022, at Texas Children's Hospital in Houston, TX. We collected demographic data, clinical severity measures, and SDoH variables such as Area Deprivation Index (ADI), insurance status, pollution burden, and food accessibility. Statistical analysis to compare SDoH with JSLE severity included Kruskal-Wallis test, Fisher exact test, and univariable and multivariable regression.</p><p><strong>Results: </strong>Mean diagnosis age for 136 patients was 13.4 years, with 82.4% female, 52.9% Hispanic, and 25.7% non-Hispanic (NH) Black. One-third of patients did not have a documented primary care provider, and one-third preferred non-English language. We found NH Black patients had worse clinical severity measures, with highest Systemic Lupus Erythematosus Disease Activity Index and more central nervous system involvement and cyclophosphamide therapy. Uninsured and publicly insured patients were more likely to use inpatient resources at diagnosis and live in neighborhoods with higher pollution levels and higher ADI. Hispanic patients reside in communities with higher ADI scores and limited access to supermarkets.</p><p><strong>Conclusion: </strong>In children with JSLE from a large urban catchment area, we observed significant association of nonmodifiable (race/ethnicity) and modifiable (insurance status, access to care, food accessibility) factors on disease severity at presentation.</p>","PeriodicalId":14745,"journal":{"name":"JCR: Journal of Clinical Rheumatology","volume":" ","pages":"e84-e90"},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657023","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}
引用次数: 0
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