ARP Rheumatology最新文献

{"title":"Sexual health in rheumatic diseases: an unmet need in patient-centered care.","authors":"Miguel Gomes Guerra, Henrique Pereira, Ana Vieira, Alexandre Sepriano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sexual health is increasingly recognized as an important component of patient-centered care in rheumatology. Despite its relevance to quality of life, relationships, emotional well-being, and social participation, it remains insufficiently addressed in both clinical practice and research. Current assessment approaches often focus on sexual dysfunction and physiological performance, overlooking broader dimensions of sexual health. Furthermore, available patient-reported outcome measures were not developed specifically for most rheumatic diseases and frequently fail to capture disease-specific challenges. This editorial discusses the limitations of existing approaches, highlights the need for more comprehensive assessment strategies, and argues for the integration of sexual health into routine rheumatology care and research agendas.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 3","pages":"142-144"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170010","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":"Correspondence on: Real-world safety data of first-line drugs for rheumatoid arthritis: insights from the Portuguese Reuma.pt database.","authors":"Bodhisatwa Choudhuri, Jay Prakash","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":" ","pages":"None"},"PeriodicalIF":1.3,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388194","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":"Disease activity in systemic lupus erythematosus in relation to direct Coombs test positivity without haemolytic anaemia: a single-centre cross-sectional study.","authors":"Muppalla Mowlika, Vijaya Prasanna Parimi, Adapa Ramakrishnam Naidu, Revanth Chakravarthy","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of Direct Coombs test (DCT) positivity in systemic lupus erythematosus (SLE) ranges from 12.8% to 65.2%. Approximately 5-11% of people with SLE have autoimmune haemolytic anaemia (AIHA), characterised by autoantibodies against erythrocytes that cause haemolysis. In about half of the SLE patients, DCT positivity occurs even in the absence of AIHA, likely due to immune complexes binding to red blood cells via complement receptor 1 (CR1), suggesting a higher immune complex load.</p><p><strong>Objectives: </strong>To determine the DCT positive rate in SLE patients without AIHA and its association with disease activity, as measured by the SLE Disease Activity Index 2000 (SLEDAI-2K) score.</p><p><strong>Methods: </strong>This descriptive cross-sectional study was conducted at a tertiary care centre in South India from March 2023 to March 2025. SLE patients who met the 2019 ACR/EULAR classification criteria without AIHA were included. Disease activity was measured using the SLEDAI-2K. The DCT was performed using the standard antihuman globulin, and a reaction grade of 1+ or higher was considered positive. The study compared DCT-positive and DCT-negative groups using statistical analysis.</p><p><strong>Results: </strong>The study included 92 SLE patients, most of whom were female (97.8%), with a mean age of 35.1 ± 9.49 years, and a mean disease duration of 4.56 ± 4.36 years. DCT positivity without AIHA was found in 33.6% of the patients. DCT-positive patients had a higher median SLEDAI-2K score than DCT-negative patients (8 [IQR 3.5-10.5] vs 0 [IQR 0-5]; p < 0.001). DCT positivity was also strongly associated with arthritis (p < 0.001) and with higher anti-double-stranded DNA antibody levels (p = 0.008).</p><p><strong>Conclusion: </strong>In individuals with SLE, DCT positivity without AIHA was common and was associated with higher contemporaneous disease activity, arthritis, and elevated anti-double-stranded DNA antibody levels. These findings suggest that DCT positivity may reflect increased immune activity at a single point in time. However, its utility in predicting future flares or monitoring longitudinal disease activity remains uncertain and requires prospective validation.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"117-122"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388190","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 tuberculosis presenting as polyarthritis: a diagnostic challenge.","authors":"Catarina Rua, Francisca Bartilotti Matos, Lourenço Resende, Catarina Silva, Diogo Fonseca, Flávio Costa, Tiago Meirinhos","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Polyarthritis in the elderly encompasses a broad range of differential diagnoses, including rheumatic diseases, infections, and malignancy.</p><p><strong>Case description: </strong>A 72-year-old woman with a 2-year history of persistent, asymmetrical additive hand polyarthralgias, initially responsive to a short course of low-dose corticosteroids (5 mg), presented with polyarthritis involving the hands and wrists. She denied inflammatory back pain, skin lesions, or family history of psoriasis, and had no history of uveitis or gastrointestinal symptoms. Laboratory tests revealed iron-deficiency anemia, elevated inflammatory markers, and negative rheumatoid factor and anti-citrullinated protein antibodies. Screening for both active and latent tuberculosis was negative. Radiographs demonstrated bilateral radiocarpal joint space narrowing and osteoarthritic changes of the hand joints, and musculoskeletal ultrasound revealed tenosynovitis of the 5th and 6th extensor compartments of the right wrist. MRI confirmed inflammatory changes. Seven months later, the patient developed painful cutaneous lesions on the right forearm and wrist. CT imaging revealed enlarged axillary lymph nodes, and biopsy confirmed Mycobacterium tuberculosis infection. Anti-tuberculous therapy resulted in clinical improvement, normalization of inflammatory markers, and resolution of cutaneous lesions. Despite treatment, some degree of functional limitation persisted, particularly at the right wrist, likely reflecting the impact of diagnostic delay.</p><p><strong>Discussion/conclusions: </strong>This case highlights the importance of considering infectious aetiologies, particularly tuberculosis, in elderly patients presenting with polyarthritis, especially in the absence of typical autoimmune markers. Early recognition and prompt treatment are essential to prevent complications and improve outcomes. Key Messages Musculoskeletal tuberculosis is a rare but important differential diagnosis in elderly patients presenting with polyarthritis. Tuberculosis may mimic inflammatory rheumatic diseases, particularly in seronegative cases, leading to diagnostic delay. Early recognition and appropriate treatment are essential to prevent irreversible joint damage and functional impairment.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"129-130"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388175","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":"Idiopathic inflammatory myopathies: new therapeutic horizons.","authors":"Raquel Campanilho Marques","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"87-89"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388205","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":"Parvovirus B19 infection presenting as polyarthritis: a nationwide clinical and epidemiological study.","authors":"Sara Dias Rodrigues, Mariana Emília Santos, Ana Catarina Moniz, Daniel Melim, Joana Tremoceiro, Ana Leão, Teresa Melo, Beatriz Mendonça, Carla Campinho Ferreira, Fernando Albuquerque, Maria Helena Lourenço, Maria de Sá Pacheco, Miguel Correia Natal, Jaime Cunha Branco, Carina Alves Lopes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Viral arthritis accounts for approximately 1% of acute arthritis cases and may be caused by several viruses, particularly parvovirus B19 (B19V). Diagnosis relies on clinical presentation, B19V immunoglobulin M (IgM) and/or immunoglobulin G (IgG) seropositivity, and the exclusion of other infectious and non-infectious etiologies. Following a European outbreak of B19V between March and May 2024, we conducted a multicenter retrospective study. The primary outcomes were the clinical and laboratory manifestations of B19V-associated arthritis; secondary outcomes included progression to chronic inflammatory disease and the need for escalation to disease-modifying antirheumatic drugs (DMARDs). A total of 28 patients (25 women and 3 men) were included, with a mean age of 44±11.4 years; 16 patients (57.1%) reported epidemiological risk factors. Acute, additive, symmetrical inflammatory polyarthralgia was the predominant clinical feature (26 patients, 92.9%), while axial inflammatory pain was reported by four patients (14.3%). Laboratory evaluation revealed positivity for antinuclear antibody (ANA) in 32.1%, rheumatoid factor (RF) in 19.7%, and HLA-B27 in 7.1% of patients. Anti-double-stranded DNA (dsDNA) and anti-cyclic citrullinated peptide antibodies (ACPA) were negative in all cases. Complement consumption was observed in a minority of patients, with low C3 levels in four (14.3%) and low C4 levels in three patients (10.7%). Regarding treatment, 39.3% of patients received nonsteroidal anti-inflammatory drugs (NSAIDs), while 60.7% were treated with systemic corticosteroids (prednisolone 10-40 mg/day); one patient required intravenous methylprednisolone (125 mg). Clinical remission was achieved in 24 patients (85.7%) after a mean duration of 34±47.0 days. However, four patients experienced relapse during corticosteroid tapering, suggesting potential progression to a chronic inflammatory condition. Among these, one patient achieved adequate symptom control with intermittent courses of NSAID alone, whereas the remaining three required initiation of DMARD therapy. This study provides one of the most comprehensive characterizations of B19V-associated arthritis in immunocompetent adults. Our findings emphasizes B19V infection as a significant viral mimic of early inflammatory rheumatic diseases and suggests considering it in the differential diagnosis of acute polyarthritis. Moreover, our study highlights the uncommon but notable potential of B19V infection to induce persistent inflammatory responses requiring immunosuppressive therapy.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"123-128"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388243","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":"Diagnostic performance of lung ultrasound for the detection of interstitial lung disease in patients with rheumatoid arthritis: comparison with risk scoring systems.","authors":"Julia Recalde Reyes, José Santiago Cortés, Luis Javier Cajas","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Interstitial lung disease (ILD) is a frequent and severe complication of rheumatoid arthritis (RA), often remaining subclinical and associated with substantial morbidity and mortality. Given the limitations of high-resolution computed tomography (HRCT) for widespread screening, alternative tools for early detection are needed.</p><p><strong>Aim: </strong>The objective of this study was to assess the diagnostic performance of lung ultrasound (LUS) for the detection of ILD in patients with RA, compared with HRCT and established clinical risk scores, stratified by symptom status.</p><p><strong>Methods: </strong>A diagnostic test study was conducted in RA patients fulfilling the ACR 2010 criteria who had undergone HRCT within the previous six months. LUS was performed using a 14-point protocol, with abnormal findings defined as >5 B-lines or pleural irregularities in ≥2 windows. Two validated RA-ILD risk scores were applied. LUS findings were compared with HRCT, and logistic regression was used to identify clinical and imaging predictors of ILD.</p><p><strong>Results: </strong>A total of 147 patients were included (23.8% male; mean age 62.3 years; mean disease duration 12.3 years), of whom 68 had HRCT-confirmed ILD. Abnormal LUS findings were present in 58.5% of patients. Factors associated with RA-ILD included male sex (OR 2.8), dyspnea (OR 2.5), and velcro crackles (OR 47.5). Abnormal LUS (OR 59.8), >5 B-lines (OR 37.6), and pleural irregularities (OR 29.5) were strongly associated with ILD. In asymptomatic patients, LUS showed high sensitivity (95.4%) and specificity (77.7%), with a +LR of 4.3 and a -LR of 0.06. Risk scores showed limited diagnostic value (Spanish consensus ≥5: +LR 0.97; Pierre ≥25: +LR 1.45). Combining LUS with risk scores increased sensitivity to 100%.</p><p><strong>Conclusion: </strong>LUS outperforms clinical risk scores for the detection of RA-associated ILD, including in asymptomatic patients. Its integration with risk scores may optimize screening strategies for the early identification of RA-ILD.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"100-108"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388226","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":"Serum caspase-1 is correlated with vasculitis activity at diagnosis and associated with all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis.","authors":"Jang Woo Ha, Oh Chan Kwon, Jihye Chung, Min-Chan Park, Yong-Beom Park, Sang-Won Lee","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Caspase-1, a key protein involved in the inflammasome activation pathway, induces pyroptosis and inflammasome-mediated cytokine activation and release. In this study, we investigated whether serum caspase-1 could guess cross-sectional vasculitis activity and predict future all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV).</p><p><strong>Methods: </strong>This study included 73 patients with AAV. Their clinical data at AAV diagnosis and during follow-up were collected and recorded. Disease activity was assessed using the Birmingham vasculitis activity score (BVAS). Serum caspase-1 was measured from the stored sera collected at AAV diagnosis. The end-point of a poor outcome in this study was set as all-cause mortality.</p><p><strong>Results: </strong>The median age of the 73 patients was 64.0 years, and 30 and 43 patients were male and female, respectively. The median BVAS was 5.0, and the median levels of serum caspase-1 were 124.2 pg/mL. During follow-up, the rate of all-cause mortality was identified as 8.2%. Serum caspase-1 was positively correlated with BVAS (r = 0.241, P = 0.040). In multivariable Cox proportional analysis, serum caspase-1 (hazard ratio [HR] 1.003, 95% confidence interval [CI] 1.000, 1.006) along with dyslipidaemia (HR 36.610, 95% CI 2.050, 653.701) at AAV diagnosis were significantly and independently associated with all-cause mortality during follow-up in patients with AAV.</p><p><strong>Conclusion: </strong>This study demonstrated that serum caspase-1 at AAV diagnosis could guess cross-sectional AAV activity, as represented by BVAS and further predict future all-cause mortality during follow-up in patients with AAV.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"90-99"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388241","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":"Validation of systemic lupus erythematosus disease activity score (SLE-DAS) in a Russian cohort of patients.","authors":"Anastasiia Shumilova, Luís Inês, Polina Sholkina, Aleksander Lila, Tatiana Reshetnyak","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterized by fluctuating activity affecting multiple organ systems. Timely and accurate assessment of disease activity is critical for guiding clinical decisions and implementing treat-to-target strategies. The Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) is a recently developed, continuous, and weighted index for disease activity, though it has not yet been validated in Russian patients.</p><p><strong>Objective: </strong>To validate SLE-DAS in a Russian cohort of patients with SLE.</p><p><strong>Methods: </strong>We prospectively enrolled 200 SLE patients followed for ≥12 months at the V.A. Nasonova Research Institute of Rheumatology. The median age was 35.0 [26.0-43.0] years; 84.5% were female. Median disease duration was 63.0 [22.0-158.0] months. Clinical and laboratory data were analyzed to asses SLE-DAS performance. Internal consistency of SLE-DAS was assessed using Cronbach's alpha. Convergent validity was evaluated via correlation with the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Physician Global Assessment (PGA). To compare the ability of SLE-DAS and SLEDAI-2K to identify active SLE, we performed a receiver operating characteristic (ROC) analysis with determination of the area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen's kappa. Responsiveness was analyzed using the Wilcoxon test, SRM, and Cohen's d.</p><p><strong>Results: </strong>At baseline, the median SLEDAI-2K was 8.0, PGA 0.99, and SLE-DAS 8.38. SLE-DAS showed excellent convergent validity (ρ = 0.878 with both SLEDAI-2K and PGA). Internal consistency was moderate for binary components (α = 0.663), while quantitative variables showed low agreement. According to DORIS remission framework, 90.5% of patients had active SLE. ROC analysis showed high diagnostic accuracy: AUC = 0.899 for SLE-DAS and 0.870 for SLEDAI-2K. After reclassifying 23 patients on glucocorticoids >5 mg/day without clinical activity as inactive, SLE-DAS showed superior performance: AUC = 0.973, sensitivity 96.2%, specificity 97.6%, PPV 99.3%, NPV 82.4%, κ = 0.86. Responsiveness at 6 and 12 months was also confirmed (SRM = -0.78 and -0.66, both p < 0.0001).</p><p><strong>Conclusion: </strong>SLE-DAS is a valid, responsive, and accurate tool for assessing SLE activity in Russian patients and may improve clinical monitoring in routine practice.</p>","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"109-116"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388218","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":"Relapsing polychondritis in a patient treated with Dupilumab.","authors":"Margarida Areia, Liliana Dias, Susana Cadinha, Patrícia Pinto, Ana Ferreira","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":29669,"journal":{"name":"ARP Rheumatology","volume":"5 2","pages":"131-132"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388196","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}