Rheumatology International最新文献

{"title":"Sirolimus-induced improvement of immune dysregulation associated hepatosplenomegaly in common variable immunodeficiency: a case-based review.","authors":"Jagoda Rogowska, Olga Brzezińska, Joanna Makowska, Anna Lewandowska-Polak","doi":"10.1007/s00296-026-06329-4","DOIUrl":"10.1007/s00296-026-06329-4","url":null,"abstract":"<p><p>Common variable immunodeficiency (CVID) is the most common primary immune defficiency in adults. Patients with CVID present with predominant antibody deficiency and reduced serum levels of immunoglobulin class G, A and/ or M. The disease is frequently complicated by non-infectious organ involvement, including hepatosplenomegaly secondary to immune dysregulation and lymphoproliferation. Sirolimus is a mTORC1 inhibitor, used as immunosuppressant in transplant medicine, increasingly inborn errors of immunity with lymphoproliferation and autoimmunity, including CVID and monogenic CVID-like disorders. Therefore, we describe the case of a 50-year-old patient diagnosed with CVID for 5 years, on regular IVIG (intravenous immunoglobulins) replacement who developed progressive hepatosplenomegaly and cytopenias despite adequate infection preventive healthcare. The patient reported increasing abdominal enlargement, dyspnea, and fatigue. She had also noted excessive daytime and nighttime sweating, initially partly attributed to menopausal status. Physical examination confirmed marked hepatosplenomegaly. Initial evaluation excluded acute infection and overt lymphoma. Abdominal imaging revealed hepatosplenomegaly without focal lesions, raising suspicion of immune-mediated lymphoproliferation related to CVID. Sirolimus was introduced as a steroid-sparing agent for presumed immune dysregulation. During sirolimus treatment, spleen length decreased from 23 cm before initiation to 13 cm after 5 months and 12 cm after 7 months, while liver size fell from 18 cm to 15 cm. Platelet count rose from 37 to 75 × 10³/µL, and aspartate aminotransferase activity declined from 77 to 58 U/L, with alanine aminotransferase dropping from 93 to 47 U/L. Leukopenia, neutropenia, and elevated alkaline phosphatase activity, however, persisted. The patient reported improvement in constitutional and abdominal symptoms,and no serious infectious complications occurred during treatment. This case demonstrates a marked organ response and a partial platelet response to sirolimus in complicated CVID, suggesting that mTOR inhibition may be considered in carefully selected patients with CVID-associated immune dysregulation and lymphoproliferative hepatosplenic involvement, although its efficacy and safety require confirmation in larger studies.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13740097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149343454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incident generalized anxiety and common mental disorders in rheumatoid arthritis: a 12-year case-cohort analysis from ELSA-Brasil.","authors":"Patrícia Fonseca Estrada, Marcos Rafael Nogueira Cavalcante, Itamar de Souza Santos, Andre Russowsky Brunoni, Vandrize Meneghini, William Rodrigues Tebar, Paulo Andrade Lotufo, Alessandra de Carvalho Goulart, Isabela Judith Martins Bensenor","doi":"10.1007/s00296-026-06339-2","DOIUrl":"10.1007/s00296-026-06339-2","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is associated with mental health disorders, but longitudinal evidence remains limited. To examine the association of RA with depressive episode, generalized anxiety disorder (GAD), and common mental disorders (CMD) in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). This case-cohort analysis included 1,795 participants: 252 in the RA case group and 1,543 in a randomly selected reference sample. For each incident outcome, participants with the condition at baseline or without follow-up information were excluded. Outcomes were assessed over 12 years of follow-up. Logistic regression estimated odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for sociodemographic and clinical covariates. At baseline, depressive episode was present in 19 (7.5%) participants in the RA group and 60 (3.9%) in the reference sample, GAD in 45 (18.1%) and 186 (12.2%), and CMD in 92 (36.5%) and 411 (26.6%), respectively. Fully adjusted ORs for the association of RA with depressive episode, GAD, and CMD were 1.52 (95% CI 0.85-2.74), 1.30 (0.89-1.90), and 1.41 (1.04-1.90), respectively. During follow-up, depressive episode occurred in 24 (14.4%) participants in the RA group and 94 (9.4%) in the reference sample, GAD in 37 (25.2%) and 120 (13.3%), and CMD in 43 (36.4%) and 164 (20.9%), respectively. Corresponding fully adjusted ORs were 1.41 (0.84-2.36), 2.04 (1.30-3.18), and 2.06 (1.33-3.18), respectively. RA was associated with baseline CMD and incident GAD and CMD, but not with baseline depressive episode, baseline GAD, or incident depressive episode after adjustment.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13739927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149343491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Milwaukee shoulder syndrome: a neglected and underrecognized basic calcium phosphate crystal arthropathy.","authors":"Nikolaos Kougkas, Paraskevi Avgerou, Apostolos H Karantanas","doi":"10.1007/s00296-026-06307-w","DOIUrl":"10.1007/s00296-026-06307-w","url":null,"abstract":"<p><p>Milwaukee Shoulder Syndrome (MSS) is a rare but extremely aggressive form of destructive arthropathy, primarily affecting elderly women. Despite its distinct clinical profile, it remains an under-recognized and frequently misdiagnosed entity. This review synthesizes current knowledge on pathogenesis, clinical presentation, and diagnostic nuances of MSS to improve clinical recognition. The condition is defined by the intra-articular deposition of basic calcium phosphate (BCP) crystals, such as hydroxyapatite. These crystals trigger the release of proteolytic enzymes, leading to massive rotator cuff tears, superior migration of the humeral head, and rapid joint destruction. A hallmark of MSS is the \"inflammatory paradox\": a striking dissociation between severe structural damage and a non-inflammatory or minimally inflammatory synovial fluid profile (typically < 2,000 cells/mm3), which often is hemorrhagic. Diagnosis is challenged by the nanocrystalline nature of BCP crystals, which are non-birefringent and invisible under standard polarized light microscopy, requiring specialized staining (Alizarin Red) or advanced analytics for confirmation. Multimodal imaging is essential, with plain radiography showing advanced degeneration and MRI or CT delineating the extent of soft tissue and bony destruction. Treatment is currently limited to supportive measures, including recurrent joint aspiration, analgesia, and physical therapy. In advanced cases, reverse total shoulder arthroplasty remains the primary surgical intervention for functional restoration. As the aging population grows, increasing clinician awareness of MSS-particularly its unique synovial fluid characteristics-is vital for reducing diagnostic delay and optimizing patient care.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149343492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical accuracy and applicability of YouTube videos on rheumatic diseases and pregnancy.","authors":"Tugba Ozudogru Celik","doi":"10.1007/s00296-026-06343-6","DOIUrl":"10.1007/s00296-026-06343-6","url":null,"abstract":"","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149343489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitral valve disease in rheumatic heart disease, systemic lupus erythematosus, antiphospholipid syndrome, and rheumatoid Arthritis.","authors":"Mateusz Lucki, Bogna Grygiel-Górniak, Ewa Lucka, Maciej Lesiak","doi":"10.1007/s00296-026-06345-4","DOIUrl":"10.1007/s00296-026-06345-4","url":null,"abstract":"<p><p>Mitral valve disease occurs in rheumatic heart disease (RHD) and selected systemic autoimmune rheumatic diseases, but similar lesions may have different underlying mechanisms. This structured narrative review examines epidemiological, mechanistic, imaging, and management evidence, distinguishing established pathways from incompletely validated mechanisms and hypotheses. In RHD, post-streptococcal valvulitis leads to fibrotic remodeling, commissural fusion, and chordal shortening, producing mitral stenosis, regurgitation, or mixed disease. A meta-analysis of 215,552 children and adolescents in endemic settings reported echocardiographically detected RHD in 24 per 1000. In systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), typical findings include leaflet thickening, Libman-Sacks vegetations, and regurgitation; embolic complications may occur despite mild valve dysfunction. Among 508 clinically selected patients with SLE undergoing echocardiography, 27.4% had heart valve involvement and 11.2% had mitral involvement. Immunothrombotic mechanisms may contribute to these lesions, but direct validation in human valve tissue remains incomplete. In rheumatoid arthritis (RA), a prospective cohort found an association with incident mitral regurgitation (adjusted hazard ratio 1.54, 95% confidence interval 1.32-1.81), but not mitral stenosis. Myocardial imaging findings do not establish a causal link to regurgitation. These findings support anatomy- and severity-based assessment in RHD, combined valvular and thromboembolic evaluation in SLE/APS, and assessment of conventional regurgitation mechanisms in RA. The framework informs clinical interpretation within existing guidelines, while proposed disease-specific mechanisms require further validation.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13740100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149343453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of generalized joint hypermobility, hypermobility spectrum disorders and Ehlers-Danlos syndrome: systematic review and meta-analysis.","authors":"Ida Carnerup, Elisabeth Bondesson, Eric Ahl, Anna Trulsson Schouenborg, Anna Saxne Jöud","doi":"10.1007/s00296-026-06346-3","DOIUrl":"10.1007/s00296-026-06346-3","url":null,"abstract":"<p><p>Generalized joint hypermobility, GJH is common. Hypermobility can have various negative consequences and comorbidities, especially when criterion for Hypermobility Spectrum Disorder, HSD and Ehlers-Danlos syndrome, EDS are met.The prevalence of these different conditions is lacking. Therefore, the aim of this study was to assess the prevalence of these hypermobility disorders. A systematic search was conducted January 25, 2024 and updated May 28, 2025. It included the databases Ovid MEDLINE, Ovid Embase, CINAHL, and PEDro and followed a predefined search strategy adapted for each database (PROSPERO CRD42024505862) and included the MESH terms 'Ehlers Danlos Syndrome','Prevalence', 'Epidemiology' and keywords 'Hypermobility Spectrum Disorder';'Generalized joint hypermobility' and 'Systematic review'. 3633 unique records were screened, and 17 studies were included. From the meta-analysis the pooled prevalence across included studies of GJH in females were 9.5% (95% CI: 5.5; 15.8) with an I² of 95.5 % and 5.2% (95% CI: 3.0; 9.0) in males with an I² of 94.8). The evidence base for the age group 51 and older was insufficient for a robust estimate. Only one single study assessed HSD and hypermobile Ehlers-Danlos syndrome, hEDS in individuals aged 18-50 years and reported a prevalence of HSD of 38% in females and 39% in males, and the prevalence of hEDS as 2% in females and 0% in males. Hence, the available evidence did not allow for robust conclusions regarding the population-level prevalence of HSD/hEDS. This study shows that GJH is common, but with considerable heterogeneity and broad prediction intervals, which makes it crucial to interpret the pooled prevalence with caution. Moreover, a significant knowledge gap in the prevalence of GJH but particularly for HSD and EDS was identified. Our findings highlight the difficulties yet the need for more prevalence data on these conditions to understand the impact on the individual patient, health care services, and society.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13739981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149335160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foot and ankle involvement is common across the spondyloarthritis spectrum with distinct anatomical and clinical patterns: a post hoc cross-sectional analysis of the ASAS-PerSpA study.","authors":"Halise Hande Gezer, Mehmet Tuncay Duruöz, Ilknur Aktas, Servet Akar, Nilay Sahin, Ozgur Akgul, Sami Hizmetli, Meltem Alkan Melikoglu, Umut Kalyoncu, Erhan Capkin, Fatma Gülçin Ural Nazlıkul, Figen Yilmaz, Ilhan Sezer, Sebnem Ataman","doi":"10.1007/s00296-026-06344-5","DOIUrl":"10.1007/s00296-026-06344-5","url":null,"abstract":"<p><p>Foot and ankle involvement is a common but frequently overlooked manifestation of spondyloarthritis (SpA). This study aimed to evaluate the frequency, anatomical patterns, and factors associated with foot and ankle involvement in a SpA cohort. This post hoc analysis included 489 patients from the Turkish cohort of the ASAS-PerSpA study. Foot and ankle involvement was defined as the presence of arthritis, enthesitis, and/or dactylitis. Anatomical distribution of each manifestation was analyzed, and demographic and clinical characteristics were compared between patients with and without involvement. Multivariable logistic regression was performed to identify factors independently associated with foot and ankle involvement. Foot and ankle involvement was identified in 229 of 489 patients (46.8%). Enthesitis was the predominant manifestation (184/489, 37.6%), followed by arthritis (122/489, 24.9%) and dactylitis (27/489, 5.5%). Overall involvement was most frequent in peripheral SpA (28/35, 80.0%) and psoriatic arthritis (PsA) (52/73, 71.2%). The ankle represented the predominant site of arthritis, whereas the plantar fascia and Achilles tendon were the most frequently involved entheses. Isolated enthesitis was the most common presentation, although arthritis and enthesitis frequently coexisted. Patients with foot and ankle involvement had significantly higher disease activity, greater peripheral structural damage, and worse health status than those without involvement (p < 0.05). In multivariable analysis, psoriasis (OR 2.04, 95% CI 1.11-3.76) and higher ASAS Health Index scores (OR 1.11 per point, 95% CI 1.04-1.18) were independently associated with foot and ankle involvement, whereas axial involvement showed an inverse association (OR 0.48, 95% CI 0.24-0.97). Foot and ankle involvement affects nearly half of patients with SpA and is particularly frequent in peripheral SpA and PsA. Enthesitis is the most common manifestation, and poorer overall health status is independently associated with foot and ankle involvement. These findings highlight the clinical relevance of foot and ankle manifestations across the SpA spectrum.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149343490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical patterns and major organ involvement in Behçet's syndrome: a latent class analysis of a regional cohort.","authors":"Gizem Varkal, Gül Şahika Gökdemir","doi":"10.1007/s00296-026-06338-3","DOIUrl":"10.1007/s00296-026-06338-3","url":null,"abstract":"<p><p>Behçet's syndrome is a heterogeneous disease with diverse patterns of organ involvement. We aimed to identify clinical subgroups using latent class analysis and evaluate clinical characteristics and treatment patterns across the identified subgroups and sex. We retrospectively evaluated 136 patients fulfilling the International Criteria for Behçet's Disease. Latent class analysis (LCA) based on six clinical indicators was used to identify clinical subgroups. Clinical manifestations, major organ involvement, and current treatments were compared between the identified latent classes and by sex. Major organ involvement occurred in 79 patients (58.1%). Among the standard LCA models, the two-class solution had the lowest BIC. Class 1 (40.4%) was characterized by absence of pathergy positivity and a very low probability of papulopustular lesions (1.3%), but a higher probability of ocular involvement (60.0%). Class 2 (59.6%) showed high probabilities of pathergy positivity (90.7%) and papulopustular lesions (57.7%). Major organ involvement was more frequent in Class 1 than in Class 2 (70.9% vs. 49.4%, p = 0.020). Male patients had significantly higher rates of ocular (52.7% vs. 35.5%, p = 0.044), vascular (28.4% vs. 8.1%, p = 0.003), and major organ involvement (73.0% vs. 40.3%, p < 0.001), as well as current anti-TNF therapy (23.0% vs. 8.1%, p = 0.019), than female patients. Patients with major organ involvement had significantly lower rates of genital ulcer history (51.9% vs. 84.2%, p < 0.001), pathergy positivity (45.6% vs. 70.2%, p = 0.004), and joint involvement (11.4% vs. 28.1%, p = 0.013). The BIC-selected solution identified two main patient groups, but the class structure was highly sensitive to indicator selection. Overall, our findings support exploratory clinical patterns rather than fixed Behçet phenotypes, with major organ involvement being significantly more frequent among men.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149324552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe ARDS and secondary haemophagocytic lymphohistiocytosis complicating a flare of adult-onset Still's disease: a case-based review.","authors":"Lohith Karigowda, Vanessa Wong, Anna Tran, Wendy Lau","doi":"10.1007/s00296-026-06327-6","DOIUrl":"10.1007/s00296-026-06327-6","url":null,"abstract":"<p><p>Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder in which parenchymal lung disease is an increasingly recognised complication, and macrophage activation syndrome (MAS) - that is, haemophagocytic lymphohistiocytosis (HLH) secondary to an autoinflammatory or autoimmune condition (MAS-HLH) is a well-established one. Both carry disproportionately high morbidity and mortality. Although AOSD-associated lung disease and MAS-HLH are increasingly recognised as co-occurring manifestations of the same hyperinflammatory process, their combination, and acute respiratory distress syndrome (ARDS) as the most severe form of lung involvement, remain under-reported. We report a 42-year-old woman with a background of AOSD who developed severe ARDS in the context of a five-week interruption of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) around incision and drainage of a perianal abscess with complicating fistulous disease and a flare during that period. She developed severe hypoxaemic respiratory failure requiring intubation on the day of admission and later prone positioning, subsequently complicated by development of MAS-HLH, evidenced by hyperferritinaemia, hypertriglyceridaemia, fever and bone marrow-confirmed haemophagocytosis. Her disease trajectory was further complicated by Epstein-Barr virus (EBV) and cytomegalovirus (CMV) reactivation. Management required sequential multi-target immunomodulation with corticosteroids, anakinra, ruxolitinib, tocilizumab and rituximab. She was mechanically ventilated for 19 days in intensive care and discharged from ICU on day 34 and from hospital following clinical stabilisation on day 73. This case illustrates that AOSD-related pulmonary disease can present as fulminant ARDS rather than the more indolent infiltrative patterns typically described and may be associated with other manifestations of AOSD including MAS-HLH. Because of concomitant infection and viral reactivation, the illness could not be attributed to AOSD alone. The case also describes survival following early multidisciplinary, multi-target immunomodulation delivered alongside antimicrobial cover, although the overlapping use of several agents precludes any conclusion about their individual or combined efficacy.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149324554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life in patients with systemic lupus erythematosus: positive associations with younger age, higher education, low disease activity, and corticosteroid and cyclophosphamide treatment-cross-sectional study in northwestern Poland.","authors":"Danuta Bobrowska-Snarska, Weronika Snarska-Pękała, Zuzanna Jurkowska, Marek Brzosko, Hanna Przepiera-Będzak","doi":"10.1007/s00296-026-06337-4","DOIUrl":"https://doi.org/10.1007/s00296-026-06337-4","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) - chronic autoimmune disease affecting health-related quality of life (QoL). To estimate the associations between QoL and age, disease activity, education level, and treatment in patients with SLE. We studied 200 SLE patients. Data collected: sex, age, disease duration, socioeconomic status, disease activity, and treatment. QoL was assessed using the Lupus Quality of Life Questionnaire (LupusQoL), 36-Item Short Form Health Survey (SF-36), and Health Assessment Questionnaire (HAQ). Younger patients reported better QoL (all p < 0.001). Disease duration correlated positively with pain (p = 0.002) and role limitations due to physical health (p = 0.03) in the SF-36. Low SLEDAI correlated positively with QoL in most of the domains assessed by the LupusQoL (all p < 0.05), despite physical health, pain and burden to others, and intimate relationships (all p > 0.05). The use of CS improved physical health (p = 0.01) and physical functioning (p = 0.03) in the LupusQoL and SF-36, respectively. Intravenous cyclophosphamide improved physical health (p = 0.01), oral cyclophosphamide improved intimate relationships (p = 0.003) in the LupusQoL. Secondary and higher education correlated positively with planning (p = 0.007 and p = 0.005, respectively) and intimate relationships (p = 0.0001 and p = 0.0002, respectively) in the LupusQoL and with role limitations due to emotional problems (p = 0.01 and p = 0.007, respectively) in the SF-36. QoL assessment in patients with SLE was positively associated with younger age, higher education, low disease activity, and treatment.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"46 11","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13723675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149324553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}