Mediterranean Journal of Rheumatology最新文献

{"title":"Atlantoaxial Subluxation Related to Axial Spondylarthritis: A Case-Based Systematic Review.","authors":"Maroua Slouma, Soumaya Rezgui, Houssem Tbini, Achraf Abdennadher, Mohamed Dehmani Yedeas, Lamjed Msolli, Khalil Amri, Leila Metoui, Rim Dhahri, Imen Gharsallah","doi":"10.31138/mjr.070624.asr","DOIUrl":"10.31138/mjr.070624.asr","url":null,"abstract":"<p><strong>Aim: </strong>Atlantoaxial dislocation is a loss of stability between the atlas and axis. It is rarely reported in patients with axial spondylarthritis. We present an axial spondylarthritis case revealed by atlantoaxial subluxation. Case Report: We report the case of a 30-year-old man diagnosed with ankylosing spondylitis (AS) after being admitted to our department for acute atlantoaxial subluxation-related symptoms.</p><p><strong>Methods: </strong>We conducted a literature review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the MEDLINE database, including case reports and case series of atlantoaxial dislocation in axial spondylarthritis patients.</p><p><strong>Results: </strong>We included 16 articles. There were 134 patients (including our case), mainly male (n=119). The mean age was 34.43±12.96 years. Atlantoaxial dislocation revealed axial spondylarthritis in 4 cases. The main clinical manifestations were neck pain (12 cases), limb weakness with numbness (7 cases), cervical range of motion limitation (6 cases), neck stiffness (4 cases), muscle dystonia (2 cases), and dyspnoea (1 case). Specific neurologic signs were found in 4 patients. The atlantoaxial dislocation was anterior in 118 cases, rotatory in 5 cases, lateral in 1 case, and posterior in 1 case. Surgical treatment was the preferred option in most cases, consisting of C1-C2 arthrodesis. Outcomes were not detailed in 121 cases and were favourable for the rest. Only one patient died following a recurrence of spinal cord compression.</p><p><strong>Conclusion: </strong>Physicians need to be aware of atlantoaxial dislocation, as it could lead to spinal cord compression, vascular compression, and other serious life-threatening complications that may require surgical management.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"563-572"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Hyaluronic Acid in Osteoarthritis and Low Back Pain: A Systematic Review.","authors":"Jozélio Freire de Carvalho, Josy Davidson","doi":"10.31138/mjr.240724.oha","DOIUrl":"10.31138/mjr.240724.oha","url":null,"abstract":"<p><strong>Background: </strong>Hyaluronic acid (HA) has been largely used in clinical practice for rheumatic diseases. However, the effects of oral HA on these diseases are poorly understood.</p><p><strong>Aim: </strong>To review articles evaluating oral HA's effects on rheumatic patients.</p><p><strong>Methods: </strong>PubMed was searched for articles on oral HA and rheumatic diseases between 1966 and May 2024.</p><p><strong>Results: </strong>Eleven articles were found with 597 patients. The diseases investigated were OA (n=10) and low back pain (n=1). Age varied from 40 to 70 years old, and female gender ranged from 43% to 75%. Follow-up ranged from 4 weeks to 12 months. The oral HA dosage varied from 30 mg to 300 mg/day. Concerning outcome, 9/11 articles observed improvement in rheumatic diseases in the following parameters: VAS pain, WOMAC, joint function, SF-36, Lequesne index, and stiffness. Two studies evaluated cytokines and observed a reduction of them after oral HA therapy. Adverse effects were rare and mild.</p><p><strong>Conclusion: </strong>Oral HA seems to be a safe and effective therapy for OA and low back pain patients, although more studies should be done on the latter condition.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"557-562"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline Ultrasound Assessment Improves the Response to Apremilast in Patients with Psoriatic Arthritis: Results from a Multicentre Study.","authors":"Antonella Farina, Patrizia Del Medico, Simone Parisi, Andrea Becciolini, Elisa Visalli, Aldo Biagio Molica-Colella, Federica Lumetti, Rosalba Caccavale, Palma Scolieri, Romina Andracco, Francesco Girelli, Elena Bravi, Matteo Colina, Alessandro Volpe, Aurora Ianniello, Veronica Franchina, Ilaria Platè, Eleonora Di Donato, Giorgio Amato, Carlo Salvarani, Gianluca Lucchini, Francesco De Lucia, Ylenia Dal Bosco, Francesco Molica Colella, Daniele Santilli, Giulio Ferrero, Antonio Marchetta, Eugenio Arrigoni, Michele Riva, Rosario Foti, Gilda Sandri, Vincenzo Bruzzese, Marino Paroli, Enrico Fusaro, Alarico Ariani","doi":"10.31138/mjr.271223.bua","DOIUrl":"10.31138/mjr.271223.bua","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic arthritis (PsA) phenotypes show different responses to the many available drugs. For a tailored medicine, it is important to choose the most effective treatment according to patients' characteristics. Apremilast is recommended in PsA with moderate activity. In clinical practice, the most suitable PsA patients for apremilast are those affected by the peripheral oligo-articular arthritis. However, it is not so straightforward to definitely identify this phenotype. Musculoskeletal ultrasound (MUS) is a good tool for detecting the joints actually involved by PsA. The aim of this study is to verify if MUS assessment is useful in selecting the best PsA responders to apremilast.</p><p><strong>Methods: </strong>The following data of all consecutive PsA patients from 15 centres were recorded: anamnestic data, disease activity, PsA phenotype, apremilast treatment duration and reason of suspension. MUS assessment before apremilast treatment was the criteria which clustered patients in two groups. Apremilast retention rate estimate the drug's effectiveness. The Cox analysis revealed the risk factors associated with treatment persistence. Mann-Whitney U and Chi-squared tests assessed the intergroup differences.</p><p><strong>Results: </strong>Only 40% of 356 patients (M:F: 152/204; median age 60 yrs) received MUS examination. In MUS group the moderate disease (median DAPSA 22.9 vs 26.9; p=0.0006) and the oligo-articular phenotype (63.6% vs 36.1%, p<0.0001) were more common. The retention rate was higher in MUS group (HR 0.55 IC95% 0.32-0.94; p=0.03).</p><p><strong>Conclusion: </strong>In apremilast treated PsA patients, baseline MUS assessment is related to an increased retention rate. MUS may identify patients' characteristics favourable to apremilast response.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"639-644"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Major Systemic Lupus Erythematosus Exacerbation after Severe Clostridium Difficile Infection: A Case Report.","authors":"Styliani Partalidou, Ioanna Katsigianni, Vasiliki Tara, Elpiniki Retzeperi, Anastasios Radounislis, Ioannis Eleftherios Neofytou, Ioannis Valsamidis, Anthimos Pehlivanidis","doi":"10.31138/mjr.190224.msl","DOIUrl":"10.31138/mjr.190224.msl","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease presenting with remission and flares. Relapses may be triggered by various factors, with infections being one of the most common. The following case is the first clostridium difficile infection (CDI)-induced SLE flare that resulted in involvement of organs not previously affected in patient's history before, such as lupus nephritis.</p><p><strong>Case presentation: </strong>We present a case of a 77-year-old woman, who experienced a major flare, involving renal impairment, cardiorespiratory deterioration and pleuritis, along with signs of haemolytic anaemia, three weeks after a severe CDI. She received corticosteroids, rituximab (RTX), and cyclophosphamide (CYC), but the outcome was still fatal.</p><p><strong>Conclusion: </strong>CDI infections are highly increasing in frequency and severity, given the antibiotic tolerance, so clinicians should bear in mind the risk of immune-mediated disorders reactivation.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"684-687"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Significance and Potential Role of C-Reactive Protein and Albumin in Antineutrophil Cytoplasmic Antibody Associated Vasculitis.","authors":"Zohreh Jadali","doi":"10.31138/mjr.280124.tcs","DOIUrl":"10.31138/mjr.280124.tcs","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"690-691"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methotrexate-Induced Accelerated Nodulosis: A Case Series.","authors":"Ramaswamy Subramanian, Nikita Chettri, Rahul Bisaralli, Purna Bansa, Mahabaleshwar Mamadapur","doi":"10.31138/mjr.08424.mia","DOIUrl":"10.31138/mjr.08424.mia","url":null,"abstract":"<p><p>Methotrexate-induced nodulosis, also known as methotrexate-induced accelerated nodulosis (MIAN), is a rare side effect of methotrexate therapy. Methotrexate (MTX) is commonly used to treat various autoimmune diseases, such as rheumatoid arthritis, psoriasis, and inflammatory bowel disease. In this case series, we present patients with MIAN, discussing their clinical features, diagnostic approaches, and management strategies. We aim to increase recognition of this rare side effect of MTX therapy, facilitate early diagnosis, and improve clinical management, thus minimising the burden of this debilitating complication on affected individuals.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"680-683"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Sarcopenia in Connective Tissue Disease Associated Interstitial Lung Diseases: A Single-Centre Study from India.","authors":"M Jeeshitha, Debashis Maikap, Prasanta Padhan, Jayanti Mishra, Pratima Singh","doi":"10.31138/mjr.260423.pof","DOIUrl":"10.31138/mjr.260423.pof","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, a progressive loss of skeletal muscle strength and mass, can lead to decreased quality of life, physical disability, and mortality. Early identification of sarcopenia is crucial in limiting morbidity and mortality in connective tissue disease associated interstitial lung diseases (CTDILD) patients.</p><p><strong>Objective: </strong>The objectives of this study are to determine the prevalence of sarcopenia in CTD-ILD patients and to correlate the severity of sarcopenia with pulmonary function tests, spirometry, and 6-minute walk test (6MWT).</p><p><strong>Materials and methods: </strong>The study involved 32 CTD-ILD patients, documenting their demographic, clinical, and medical history, and conducting various tests, including spirometry, 6MWT, ANA, ENA, MSA profile, and HRCT thorax. Sarcopenia was evaluated using the SARC-F questionnaire, while muscle mass, strength, and physical performance were assessed using the BODYSTAT Quad scan 4000, chair stand test, and gait speed test.</p><p><strong>Results: </strong>Pre-sarcopenia was the most common condition, followed by sarcopenia and severe sarcopenia. MCTD-ILD and SSc-ILD were the most commonly observed types of CTD-ILD. Patients with pre-sarcopenia had the highest mean FVC, FEV1 (in litres), FVC (%) and FEV1 (%) compared to patients with sarcopenia. The mean distance walked in 6MWT was lowest in patients with severe sarcopenia and highest in patients with sarcopenia, but the difference was not statistically significant.</p><p><strong>Conclusion: </strong>This study highlights a higher prevalence of sarcopenia in CTD-ILD patients, and its effects on lung function and physical performance. Early identification and intervention for sarcopenia could improve the quality of life and survival in these patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"617-622"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proceedings of the 1st Symposium \"Autoimmune Diseases: Clinical Unmet Needs in Systemic Autoimmune Diseases Guide Clinical, Translational and Basic Research\".","authors":"Loukas Chatzis, Alexandra Koutsogianni, Panagiota Palla, Dimitrios Palamidas, Panagiotis Panagopoulos, Papadaki Maria, Evangelos Andreakos, Athanasios G Tzioufas","doi":"10.31138/mjr.121124.pts","DOIUrl":"10.31138/mjr.121124.pts","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 4","pages":"692-703"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11778608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Difficult to Treat Psoriatic Arthritis: The Road So Far.","authors":"Angeliki E Dimopoulou, Konstantinos D Vassilakis, George E Fragoulis","doi":"10.31138/mjr.2506241.dtt","DOIUrl":"10.31138/mjr.2506241.dtt","url":null,"abstract":"<p><p>Psoriatic Arthritis (PsA) is a multifaceted, immune-mediated disease marked by chronic musculoskeletal inflammation (peripheral arthritis and axial disease, dactylitis, and enthesitis), extra-musculoskeletal manifestations (psoriasis, nail involvement, Inflammatory Bowel Disease [IBD], and uveitis) and multi-comorbidity (cardiovascular disease, metabolic syndrome, mental health disorders, and fibromyalgia). Immunological and non-immunological factors have led, despite the progress made in the understanding, treatment and management of PsA, to a minority of patients being able to achieve satisfactory outcomes. Following the establishment of the definition for difficult to treat rheumatoid arthritis, efforts are underway for difficult to treat PsA (D2T PsA). Defining D2T PsA and its predictors is crucial for advancing clinical trials, treatment strategies, and patient care. Proposed definitions and criteria for D2T PsA vary, but the few available data indicate that extensive psoriasis, axial involvement, obesity, female gender, and comorbidities like IBD, depression, and fibromyalgia are involved. Concerns are also raised for the lack of a universally accepted index for disease activity measurement and for the inclusion of a time-related criterion in the definition of D2T. Moreover, the potential need for distinction between D2T and refractory-to-treatment PsA has also been suggested. In this narrative review, we summarise the current knowledge on the D2T PsA field, highlighting the gaps and the necessity of the \"D2T\" concept, providing further considerations on the matter.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 3","pages":"513-518"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Cutting Edge: A Recap of EULAR & ACR 2023 Highlights for Spondyloarthritis, including Psoriatic Arthritis.","authors":"Nafsika Gerolymatou, Paraskevi V Voulgari","doi":"10.31138/mjr.040524.aeh","DOIUrl":"10.31138/mjr.040524.aeh","url":null,"abstract":"<p><p>As the field of rheumatology continues to advance, the European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR) annual meetings stand as pivotal events, showcasing the latest research, treatments, and insights into various rheumatic diseases. Among these, Inflammatory Spondyloarthritis presents a unique challenge, characterised by its elusive diagnostic markers and diverse clinical manifestations. In this article, we delve into the highlights and findings from EULAR 2023 and ACR 2023, shedding light on the latest advancements in understanding and managing these complex rheumatic conditions.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 Suppl 3","pages":"534-541"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}