IF 1.2

Reumatismo Pub Date : 2024-09-24 DOI: 10.4081/reumatismo.2024.1681

M D L Castro de Oliveira Figueirôa, M C Moura Costa, P Rocha Lobo, A L Souza Pedreira, M Barreto Santiago

引用次数: 0

Visceral muscle dysmotility syndrome in systemic lupus erythematosus: which is the role of 18 fluorodeoxyglucose-positron emission tomography-computed tomography? A clinical case and literature review. 系统性红斑狼疮内脏肌肉运动障碍综合征：18 氟脱氧葡萄糖正电子发射断层扫描-计算机断层扫描的作用是什么？一个临床病例和文献综述。

IF 1.2

Reumatismo Pub Date : 2024-09-24 DOI: 10.4081/reumatismo.2024.1647

S Scriffignano, F M Perrotta, M Ricci, B Carabellese, E Lubrano

{"title":"Visceral muscle dysmotility syndrome in systemic lupus erythematosus: which is the role of 18 fluorodeoxyglucose-positron emission tomography-computed tomography? A clinical case and literature review.","authors":"S Scriffignano, F M Perrotta, M Ricci, B Carabellese, E Lubrano","doi":"10.4081/reumatismo.2024.1647","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1647","url":null,"abstract":"Visceral muscle dysmotility syndrome (VMDS) is a rare syndrome, described in the systemic lupus erythematosus (SLE) clinical course. It is characterized by diffuse thickened intestinal wall and gastrointestinal-genitourinary-hepatobiliary hollow viscera dilatation and dysmotility. Due to the rarity and the heterogeneity of the clinical characteristics of this syndrome, it is not entirely clear which is the best diagnostic imaging technique for the diagnosis and/or follow-up, even if, in all the described cases, computed tomography (CT) was generally used to study visceral involvement. However, there are no cases describing the visceral metabolic activity by 18 fluorodeoxyglucose (18FDG)-positron emission tomography-CT (18FDG-PET-CT). Here, we reported the first clinical case of VMDS studied by 18FDG-PET-CT, characterizing the metabolic activity of this rare syndrome during SLE flare. We found a high intestinal metabolic burden, hyper-fixation in duodenum, and high hepatic metabolic activity. Moreover, we reviewed the literature on VMDS in SLE, focusing on imaging techniques in different anatomical sites (bowel, urinary tract, bile ducts), patients' symptoms, and treatment.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308547","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}

引用次数: 0

Cervical myelopathy as an atypical presentation of antineutrophil cytoplasmic antibody-associated vasculitis in a patient affected by silicosis: a case report and literature overview. 一名矽肺病患者的颈椎脊髓病是抗中性粒细胞胞浆抗体相关性血管炎的非典型表现：病例报告和文献综述。

IF 1.2

Reumatismo Pub Date : 2024-09-24 DOI: 10.4081/reumatismo.2024.1702

S Grazzini, R Terribili, E Conticini, S Bartalini, L Cantarini, B Frediani

引用次数: 0

Systemic lupus erythematosus induced by anti-tumor necrosis factor α therapy in inflammatory rheumatic diseases: a case series. 炎症性风湿病患者抗肿瘤坏死因子α治疗诱发的系统性红斑狼疮：一个病例系列。

IF 1.2

Reumatismo Pub Date : 2024-09-24 DOI: 10.4081/reumatismo.2024.1658

D Oliveira, A Martins, F Martins, C Gomes, S Pimenta, C Vaz, L Costa, M Bernardes

{"title":"Systemic lupus erythematosus induced by anti-tumor necrosis factor α therapy in inflammatory rheumatic diseases: a case series.","authors":"D Oliveira, A Martins, F Martins, C Gomes, S Pimenta, C Vaz, L Costa, M Bernardes","doi":"10.4081/reumatismo.2024.1658","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1658","url":null,"abstract":"This case series aims to characterize the development of systemic lupus erythematosus (SLE) induced by anti-tumor necrosis factor α (anti-TNFα) therapy in patients with inflammatory rheumatic diseases, namely rheumatoid arthritis (RA), spondylarthritis (SpA), and psoriatic arthritis (PsA). Patients with a diagnosis of SLE induced by anti-TNFα therapy and registered on the Rheumatic Diseases Portuguese Register (Reuma.pt) who started their first anti-TNFα between 2001 and 2020 were included. Demographic, clinical, and laboratory data were obtained by consulting Reuma.pt. The diagnosis of SLE induced by anti-TNFα was considered if there was a temporal relationship between the onset of anti-TNFα therapy and manifestations (clinical and immunological) in accordance with the American College of Rheumatology/European League Against Rheumatism criteria (2019). A total of 607 patients with inflammatory rheumatic diseases and six cases of SLE induced by anti-TNF-α therapy were reviewed: two patients were affected by RA, three patients by SpA, and one by PsA. All these patients had articular and constitutional symptoms that improved after discontinuation of the anti-TNFα agent. After switching to a second anti-TNFα agent, there was no recurrence of SLE over time. The development of SLE secondary to anti-TNFα agents in inflammatory rheumatic patients is rare. In this case series, all patients had a mild disease that improved after therapy discontinuation without recurrence of the disease. SLE induced by anti-TNFα should be considered in the follow-up of RA, SpA, and PsA patients.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308545","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}

引用次数: 0

Assessment of liver and kidney function in patients with ankylosing spondylitis on long-term non-steroidal anti-inflammatory drug therapy. 评估长期服用非甾体抗炎药的强直性脊柱炎患者的肝肾功能。

IF 1.2

Reumatismo Pub Date : 2024-09-24 DOI: 10.4081/reumatismo.2024.1732

S Sülükcü, S Uslu

{"title":"Assessment of liver and kidney function in patients with ankylosing spondylitis on long-term non-steroidal anti-inflammatory drug therapy.","authors":"S Sülükcü, S Uslu","doi":"10.4081/reumatismo.2024.1732","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1732","url":null,"abstract":"Objective: This study aimed to analyze the status of liver [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] and kidney (serum creatine) function in ankylosing spondylitis (AS) patients assuming continuously non-steroidal anti-inflammatory drugs (NSAIDs) alone over a long period.Methods: Between 2013 and 2022, there were records of 385 AS patients. Of them, 56 were receiving only NSAIDs, and the files of these patients were retrospectively analyzed. Demographic and clinical characteristics were collected. Blood tests, including serum creatinine, AST, and ALT, were assessed at each visit.Results: Of the 56 patients, 39 were male. The mean age was 45.30 years, and the follow-up period was 9.80 years. Of them, 44.6% used indomethacin, 26.8% naproxen, 17.9% diclofenac, 5.4% acemethazine, 3.6% meloxicam, and 1.8% celecoxib. The mean baseline serum creatinine was 0.71 mg/dL. The mean baseline serum AST and ALT were 19.6 u/L and 22.9 u/L, respectively. Baseline creatinine, AST, and ALT were not statistically significantly different between sexes. There was a statistically significant difference between mean creatinine concentrations at baseline and at year 3. One patient on naproxen discontinued treatment due to elevated creatinine. The creatinine level decreased during the patient's follow-up. Liver enzymes above 3 times the normal value were not seen in any patient.Conclusions: Based on real-world data, long-term use of NSAIDs has generally not led to acute liver and kidney injury or progressive impairment of hepatorenal function requiring discontinuation of treatment.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308543","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}

引用次数: 0

Ultrasound assessment of Achilles enthesitis: a dedicated training program. 跟腱炎的超声波评估：一项专门的培训计划。

IF 1.2

Reumatismo Pub Date : 2024-09-24 DOI: 10.4081/reumatismo.2024.1717

G Smerilli, E Cipolletta, G M Destro Castaniti, G Pieroni, G Sartini, A Cenci, A Di Matteo, M Di Carlo, G Guggino, W Grassi, E Filippucci

{"title":"Ultrasound assessment of Achilles enthesitis: a dedicated training program.","authors":"G Smerilli, E Cipolletta, G M Destro Castaniti, G Pieroni, G Sartini, A Cenci, A Di Matteo, M Di Carlo, G Guggino, W Grassi, E Filippucci","doi":"10.4081/reumatismo.2024.1717","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1717","url":null,"abstract":"Objective: To describe an intensive and multimodal ultrasound (US) training program focused on Achilles enthesitis and to illustrate the learning curve of trainees without experience.Methods: Three medical students (trainees) and two rheumatologists experienced in musculoskeletal US (trainers) were involved in the training program, which encompassed one preliminary theoretical-practical meeting and five scanning sessions (two patients per session). The students and one expert performed the US examination of the Achilles enthesis bilaterally. The trainees acquired representative images and assessed the presence of Outcome Measures in Rheumatology (OMERACT) US abnormalities of enthesitis. The experts provided feedback addressing trainees' misinterpretations, and the quality of the acquired images was evaluated. A dedicated questionnaire was used to evaluate the students' confidence. After each session, five sets of static images (total=100 images of most commonly scanned entheses) were provided and scored by the students according to OMERACT US definitions. Total agreement and prevalence and bias adjusted kappa (PABAK) were used to evaluate the concordance between the trainees and the expert sonographer.Results: The total agreement and PABAK significantly improved between the first and fifth scanning sessions (76.2% versus 92.9%, p<0.01, and 0.5 versus 0.79, p<0.01) and between the first and fifth static image sets (64.5% versus 81.9%, p<0.01, and 0.29 versus 0.74, p<0.01). Image quality did not significantly improve (p=0.34). A significant increase in trainees' confidence was registered (p<0.01).Conclusions: The described training program rapidly improved the students' performance in the US assessment of Achilles enthesitis, appearing to be an effective starting model for the future development of pathology-oriented teaching programs for the US in rheumatology.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308546","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}

引用次数: 0

Inflammatory bowel diseases and spondyloarthritis: a focus on female patients. 炎症性肠病和脊柱关节炎：关注女性患者。

IF 1.2

Reumatismo Pub Date : 2024-09-11 DOI: 10.4081/reumatismo.2024.1770

C Caranfil, G Lorenzon, B Barberio, R Ramonda, E V Savarino, F Zingone

{"title":"Inflammatory bowel diseases and spondyloarthritis: a focus on female patients.","authors":"C Caranfil, G Lorenzon, B Barberio, R Ramonda, E V Savarino, F Zingone","doi":"10.4081/reumatismo.2024.1770","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1770","url":null,"abstract":"Objective: Ulcerative colitis and Crohn's disease are chronic inflammatory diseases and represent the two most important types of inflammatory bowel diseases (IBD), while spondyloarthritis (SpA) comprises a heterogeneous group of systemic inflammatory chronic rheumatic diseases, including peripheral SpA and axial SpA. Joint manifestations are the most commonly observed extraintestinal manifestations, and they can precede or not the diagnosis of IBD. Notably, in women, misdiagnoses of IBD as irritable bowel syndrome and SpA as fibromyalgia are common, leading to delayed diagnoses, increased disease burden, and poorer prognoses. This narrative review emphasizes the critical role of diagnostic tools in facilitating early referrals of IBD patients with suspected SpA and vice versa to rheumatologists and gastroenterologists, respectively. Special attention is given to the multidisciplinary approach for more effective management of these conditions, particularly in female patients.Methods: In this narrative review, we critically evaluated the literature on this topic, focusing on papers written in English that address female issues in IBD and SpA.Results: IBD and SpA are chronic inflammatory disorders often occurring in the same patients. Female patients are often misdiagnosed, and this delay in diagnosis is associated with a higher disease burden and a poorer prognosis.Conclusions: A multidisciplinary approach is needed to enable early referral between gastroenterologists and rheumatologists, as this means a better prognosis for patients with a reduction in the economic and social burden associated with IBD and SpA.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294223","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}

引用次数: 0

The role of sacro-iliac joint magnetic resonance imaging in the diagnosis of axial spondyloarthritis: focus on differential diagnosis in women. 骶髂关节磁共振成像在轴性脊柱关节炎诊断中的作用：关注女性的鉴别诊断。

IF 1.2

Reumatismo Pub Date : 2024-09-11 DOI: 10.4081/reumatismo.2024.1768

G Besutti, C Marvisi, F Muratore, L Spaggiari

{"title":"The role of sacro-iliac joint magnetic resonance imaging in the diagnosis of axial spondyloarthritis: focus on differential diagnosis in women.","authors":"G Besutti, C Marvisi, F Muratore, L Spaggiari","doi":"10.4081/reumatismo.2024.1768","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1768","url":null,"abstract":"Objective: To review the role of sacro-iliac magnetic resonance imaging (MRI) in the diagnosis of axial spondyloarthritis (AxSpA), with a focus on gender differences.Methods: The experience of the authors and the results of an informal literature review are reported.Results: Inflammatory changes of the sacro-iliac joint are the hallmark of AxSpA. Early, non-radiographic sacroiliitis may be diagnosed with MRI through the assessment of bone marrow edema (BMO) as well as concomitant structural damage. The MRI protocol should include three necessary sequences, i.e., fat-saturated T2-weighted sequences on two orthogonal planes, T1-weighted semi-coronal sequence, and fat-suppressed T1-weighted semi-coronal sequence. Inflammatory changes comprise required signs (BMO and/or osteitis) and additional signs, including synovitis (better defined as joint space enhancement), enthesitis, and capsulitis. Structural changes consist of erosions, sclerosis, fat metaplasia, and ankylosis. Due to mechanical axial strain, inflammatory changes in the sacro-iliac joint can be found in healthy individuals, runners, and patients with nonspecific low back pain. The prevalence of BMO is higher in women during pregnancy and postpartum, even 12 months after childbirth, but the extent and distribution of MRI findings may help in the differential diagnosis. Other challenges in the MRI diagnosis of sacroiliitis are subchondral T2 hyperintensity during developmental age, periarticular sclerosis in healthy subjects, or osteitis condensans ilii, and several pathological conditions that may mimic AxSpA, some of which are more frequently found in women.Conclusions: The described diagnostic challenges impose a multidisciplinary approach combining imaging findings with clinical and laboratory data.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294234","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}

引用次数: 0

Reproductive health in women with ankylosing spondylitis: contraception and fertility. A narrative review. 强直性脊柱炎妇女的生殖健康：避孕与生育。叙述性综述。

IF 1.2

Reumatismo Pub Date : 2024-09-11 DOI: 10.4081/reumatismo.2024.1778

L Marin, A Andrisani

{"title":"Reproductive health in women with ankylosing spondylitis: contraception and fertility. A narrative review.","authors":"L Marin, A Andrisani","doi":"10.4081/reumatismo.2024.1778","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1778","url":null,"abstract":"Objective: The knowledge of ankylosing spondylitis is rising, and more and more attention is being paid to the diagnosis of this pathology in females. The purpose of this narrative review is to emphasize the role of reproductive health in women with ankylosing spondylitis, with particular attention to contraception and fertility.Methods: A comprehensive review of the literature was performed to evaluate the reproductive health of women with ankylosing spondylitis.Results: Oral contraception has been shown to be safe in women with ankylosing spondylitis, with no contraceptive benefits that should be evaluated during counseling. In the literature, there is no strong data regarding fertility in women with ankylosing spondylitis. It seems that these women may have impaired fertility due to reduced ovarian reserve, pharmacological treatments, and reduced sexual activity due to the concern that offspring may contract the disease. A multidisciplinary approach is needed in these women to ensure an adequate evaluation of sexual activity as an important aspect of quality of life and to counsel regarding family planning to address patients' concerns on contraception, fertility desire, and fertility preservation.Conclusions: Lifestyle factors should be investigated to improve fertility and disease activity without medications. Further trials are needed to investigate the reproductive health of women with ankylosing spondylitis.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294231","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}

引用次数: 0

Sex and gender differences in comorbidities in spondyloarthritis: a focus on psoriatic arthritis. 脊柱关节炎合并症的性别差异：聚焦银屑病关节炎。

IF 1.2

Reumatismo Pub Date : 2024-09-11 DOI: 10.4081/reumatismo.2024.1769

F Atzeni, C Siragusano, A Tropea, A Alciati

{"title":"Sex and gender differences in comorbidities in spondyloarthritis: a focus on psoriatic arthritis.","authors":"F Atzeni, C Siragusano, A Tropea, A Alciati","doi":"10.4081/reumatismo.2024.1769","DOIUrl":"https://doi.org/10.4081/reumatismo.2024.1769","url":null,"abstract":"Objective: Spondyloarthritis is a family of inflammatory diseases subdivided into those affecting the spine, called axial spondyloarthritis, and those involving peripheral joints, such as psoriatic arthritis (PsA). Several studies have reported differences in clinical manifestations, outcomes, and treatment responses between male and female PsA patients. The aim of our review was to evaluate if differences may also be identified in the context of cardiovascular (CV) risk factors and diseases.Methods: Patients with PsA have a higher CV risk than the general population. The increased CV risk associated with PsA is likely caused by the complex interplay of traditional CV risk factors, chronic systemic inflammation, and side effects related to the use of certain anti-rheumatic drugs.Results: Sex differences in CV risk factors in PsA patients, according to several studies, are controversial. However, the few studies that reported sex-stratified estimates did not find differences in the risk of stroke and myocardial infarction between sexes. The same also holds true for CV mortality. These mixed results may be related to the different study designs and case definitions, as well as genetic and geographical variability across the investigated populations.Conclusions: In conclusion, our review suggests that the evaluation of sex-gender aspects of CV comorbidities in PsA should be a central step in the context of personalized medicine in order to prevent and treat properly associated comorbidities.","PeriodicalId":21222,"journal":{"name":"Reumatismo","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142294232","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}

引用次数: 0

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