Mediterranean Journal of Rheumatology最新文献

{"title":"Pre-Pulseless Takayasu Arteritis is Associated with Distinct Clinical and Angiographic Features but Similar Outcomes - A Cohort Study.","authors":"Durga Prasanna Misra, Upendra Rathore, Swapnil Jagtap, Prabhaker Mishra, Darpan R Thakare, Kritika Singh, Tooba Qamar, Deeksha Singh, Juhi Dixit, Manas Ranjan Behera, Neeraj Jain, Manish Ora, Dharmendra Singh Bhadauria, Sanjay Gambhir, Vikas Agarwal, Sudeep Kumar","doi":"10.31138/mjr.301223.ppt","DOIUrl":"10.31138/mjr.301223.ppt","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the presentation, angiographic features, evolution, and prognosis of prepulseless Takayasu arteritis (TAK) with TAK with pulse loss.</p><p><strong>Methods: </strong>Pre-pulseless TAK (defined as without pulse loss in the upper limbs, lower limb, carotid, or subclavian arteries) were identified from a cohort of TAK. Demographic characteristics, clinical features, angiographic involvement, baseline and longitudinal patterns of disease activity, medication use, and mortality rates were compared between pre-pulseless TAK and TAK with pulse loss. Adjusted odds ratios (aOR, with 95%CI) for categorical variables between pre-pulseless TAK and TAK with pulse loss were computed using multivariable-adjusted logistic regression models. Time-to-event data was compared using hazard ratios (HR) with 95%CI.</p><p><strong>Results: </strong>Compared with TAK with pulse loss, pre-pulseless TAK (91/238, 38.24%) more frequently had deranged renal function (aOR 4.43, 95%CI 1.58-12.37) and Hata's type IV disease (aOR 8.02, 95%CI 2.61-24.65), and less often had pulse or blood pressure asymmetry (aOR 0.34, 95%CI 0.18-0.63), limb claudication (aOR for upper limb 0.38, 95%CI 0.18-0.82, for lower limb 0.28, 95%CI 0.12-0.68), right subclavian (aOR 0.45, 95%CI 0.23-0.90) or left carotid artery involvement (aOR 0.42, 95%CI 0.21-0.84). Only two patients with pre-pulseless TAK developed pulse loss on follow-up. Despite fewer pre-pulseless TAK having active disease at presentation, similar proportions of patients in both groups had active disease on follow-up. Survival was similar in both groups (HR for mortality 0.41, 95%CI 0.09-1.90).</p><p><strong>Conclusion: </strong>Pulse loss on follow-up is uncommon in those with prepulseless TAK. Pre-pulseless TAK is associated with similar long-term outcomes to TAK with pulse loss.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"34 4","pages":"427-435"},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10815540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571597","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":"Transient Aortitis after COVID-19 mRNA Vaccination.","authors":"Hiroaki Nishioka, Yuuki Okumura","doi":"10.31138/mjr.231020.nht","DOIUrl":"10.31138/mjr.231020.nht","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 1","pages":"195-196"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912979","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":"Tofacitinib as a Promising Therapeutic Option in Refractory Autoimmune-Mediated Vascular and Sclera Inflammation.","authors":"Theodoros Dimitroulas","doi":"10.31138/mjr.20230929.taa","DOIUrl":"10.31138/mjr.20230929.taa","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"34 3","pages":"282-283"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10628872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522813","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":"Identification and Clinical Correlation of Circulating MAIT, γδ T, ILC3, and Pre-Inflammatory Mesenchymal Cells in Patients with Rheumatoid Arthritis and Spondyloarthritis.","authors":"Maria Kyriakidi, Eleni-Kyriaki Vetsika, Georgios E Fragoulis, Maria Tektonidou, Petros P Sfikakis","doi":"10.31138/mjr.251022.iac","DOIUrl":"https://doi.org/10.31138/mjr.251022.iac","url":null,"abstract":"<p><p>Inflammatory rheumatic diseases (IRDs), such as rheumatoid arthritis (RA) and spondyloarthropathy (SpA), comprise a heterogeneous group of immune-mediated disorders, characterised by the presence of localised and/or systemic inflammation. The limited knowledge of the pathogenesis and the complex mechanisms involved in the induction and maintenance of inflammation in IRDs have impeded the development of reliable biomarkers and the discovery of new therapeutic targets. Although the involvement of heterogeneous cell populations in the pathogenesis of IRDs has been recognised, the characterisation of these cellular subsets in the peripheral blood of patients has not been studied yet. Mass cytometry, allowing the simultaneous detection of more than 120 different parameters in single-cell resolution, will enable the identification of circulating cell subpopulations that might play a pivotal role in IRDs pathophysiology and their potential use as therapeutic targets.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 2","pages":"312-315"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112733","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":"Association of the Spectrum of Cutaneous Lupus Erythematosus with Disease Activity and Systemic Manifestations in Patients with Systemic Lupus Erythematosus.","authors":"Herwinda Brahmanti, Cesarius Singgih Wahono, Mirza Zaka Pratama, Perdana Aditya Rahman, Riski Bagus Suhendra, Amalia Novia Rizky, Nabilah Hanifah Mukti","doi":"10.31138/mjr.200423.aos","DOIUrl":"10.31138/mjr.200423.aos","url":null,"abstract":"<p><strong>Background: </strong>Cutaneous involvement is common in systemic lupus erythematosus (SLE) patients and may be essential to the disease activity. This study aimed to describe cutaneous manifestations spectrum and determine the association of cutaneous lesions with the disease activity and systemic involvement among SLE patients in Malang, Indonesia.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using 54 SLE patients from rheumatology outpatient clinic at Saiful Anwar General Hospital Malang, Indonesia. Cutaneous features were classified according to Gilliam and Sontheimer classification of cutaneous lupus. Disease activity and clinical manifestations were documented according to Mexican-SLE disease activity index (Mex-SLEDAI).</p><p><strong>Results: </strong>Among 54 subjects, 50% of the patients had cutaneous manifestations. Subacute cutaneous lupus erythematosus (SCLE) was observed in 11.1% of patients, and malar rash in 20.4%. Subjects with cutaneous lesions had significantly higher Mex-SLEDAI scores, especially those who had SCLE (p<0.001), malar rash (p=0.002), alopecia (p=0.002), and photosensitivity (p=0.032). Six patients (11.1%) had skin infections with higher disease activity (9[8-11]vs.2[0-4];p<0.001). SCLE was significantly associated with malar rash (OR 11.7[1.8-76.5]), vasculitis (OR 43.0[4.1-445.6]), and fatigue (OR 15.0[2.1-108.8]). Malar rash was associated with photosensitivity (OR 8.4[1.6-44.0]), while oral or nasal ulcer was associated with fatigue (OR 8.6 [1.4-54.6]). Vasculitis (OR 5.9[1.0-35.1]) and nephritis (OR 11.7 [1.8-76.5]) were associated with the presence of skin infection.</p><p><strong>Conclusion: </strong>SCLE and malar rash are the most common cutaneous lesions among subjects. Subjects with cutaneous lesions have relatively higher disease activity. Several skin lesions are also associated with SLE patients' systemic manifestations.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 1","pages":"143-149"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912912","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":"Ultrasonography Enthesitis and Synovitis Screening in Psoriatic Patients: A Case Control Study.","authors":"Soumaya Boussaid, Rania Ben Aissa, Sonia Rekik, Safa Rahmouni, Samia Jammali, Khaoula Zouaoui, Hela Sahli, Mohamed Elleuch","doi":"10.31138/mjr.180923.ues","DOIUrl":"10.31138/mjr.180923.ues","url":null,"abstract":"<p><strong>Background: </strong>The clinical screening of enthesitis and synovitis in patients with psoriasis lacks specificity and sensitivity during the preclinical phase.</p><p><strong>Aims: </strong>to assess US subclinical synovitis and enthesitis in psoriatic patients compared with healthy controls.</p><p><strong>Methods: </strong>A cross-sectional study on 40 psoriatic patients and 40 healthy sex- and age-matched controls. US examination of 18 joints was performed along with 22 entheseal sites on the upper and lower limbs. US subscores were established according to the US abnormalities: inflammatory score (tendon thickening, hypoechogenicity, bursitis, Doppler signal), damage score (calcification, enthesophytes, bone erosion) and total score (the sum of inflammatory and damage scores).</p><p><strong>Results: </strong>US synovitis were more frequent in psoriatic patients (0.68%) than in controls (0.29%), but the difference was not significant. Patients with psoriasis had more US enthesitis (92,5%) compared to controls (40%)(p<0.001). The total number of enthesitis was higher in the psoriatic group (20.90%) compared to controls (4,78%)(p<0.001). There were more US abnormalities in the psoriatic group compared to controls for calcaneal tendon enthesis(p<0.001), distal patellar tendon enthesis(p<0.001) and deep flexor tendons of the finger enthesis(p<0.001). Compared to controls, psoriatic patients had a significantly higher inflammatory score (Mean±SD) (2.85±3.34 versus 0.58±1.17), damage score (3±2.57 versus 0.60±1.41), and total score (5.85±5.20 versus 1.18±2.07) (p < 0.001 each). Patients with scalp psoriasis had more US enthesitis (p=0.020).</p><p><strong>Conclusion: </strong>Our results indicate that US enthesitis and synovitis are more frequent in patients with psoriasis. Prospective studies with larger sample size are needed to define the contribution of US in predicting the clinical onset of PsA.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"34 4","pages":"495-505"},"PeriodicalIF":0.0,"publicationDate":"2023-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10815525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571613","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":"Hemichorea as the First and Sole Manifestation in Lupus: Case-Based Review.","authors":"Harikrishnan Gangadharan, Rahul Peter, Vineetha Vs, Varghese Punnoose, Josemon George","doi":"10.31138/mjr.180323.haf","DOIUrl":"10.31138/mjr.180323.haf","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 1","pages":"156-163"},"PeriodicalIF":0.0,"publicationDate":"2023-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11082775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912920","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":"Forestier Disease as a Cause of Dysphagia.","authors":"Catarina Dantas Soares, Nuno Madureira, Daniela Santos-Faria","doi":"10.31138/mjr.140923.fdd","DOIUrl":"10.31138/mjr.140923.fdd","url":null,"abstract":"","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"34 4","pages":"573-574"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10815542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571549","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":"A Comparison of Nailfold Video Capillaroscopy Findings in Mixed Connective Tissue Disease Interstitial Lung Disease vs Systemic Sclerosis Interstitial Lung Disease: A Single-Centre Study.","authors":"Aarthi Rajendran, Debashis Maikap, Prasanta Padhan, Ramnath Misra, Pratima Singh","doi":"10.31138/mjr.260423.cnv","DOIUrl":"https://doi.org/10.31138/mjr.260423.cnv","url":null,"abstract":"<p><strong>Objective: </strong>To differentiate the nailfold capillaroscopy (NFC) findings in patients with MCTD-ILD and SSc-ILD and correlate the NFC changes and lung functions among them.</p><p><strong>Methods: </strong>In this observational study from Oct 2020 to Oct 2022, 27 patients with MCTD-ILD and 27 patients with SSc-ILD were included. NFC was performed using Jiangsu Jiahua, JH 1004, China. Statistical analysis was conducted using IBM SPSS software, version 26, and tests including Mann-Whitney U-test, student t-test, chi-square test, or Fisher's exact test were used to compare between groups.</p><p><strong>Results: </strong>In this study, major capillaroscopic changes were more frequent in SSc-ILD group (92%) than in MCTD-ILD group (72.3%), with normal capillaries seen in 7.4% of MCTD-ILD cases. The mean FVC was higher in SSc-ILD group compared to MCTD-ILD group, and patients with capillary loss had a lower mean FVC. Loss of capillaries was more frequent in SSc-ILD group, while dilated capillaries were predominantly observed in MCTD-ILD group. A significant association was found between the severity of restriction in spirometry and NFC.</p><p><strong>Conclusion: </strong>There is an important role for NFC in detecting the severity of lung involvement, as the grading of restrictive severity in spirometry is strongly associated with capillaroscopic abnormalities.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"35 2","pages":"263-271"},"PeriodicalIF":0.0,"publicationDate":"2023-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11350414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112801","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":"Effect of Hypertension on Bone Mineral Density of Patients with Rheumatoid Arthritis.","authors":"Praveen Pratap Jadhav, Vivek Gajanan Patwardhan","doi":"10.31138/mjr.120923.eoh","DOIUrl":"10.31138/mjr.120923.eoh","url":null,"abstract":"<p><strong>Objective: </strong>Patients with rheumatoid arthritis (RA) are associated with low bone mineral density (BMD). Chronic comorbidities such as type II diabetes mellitus have shown to affect BMD parameters in patients with RA. Hypertension (HT) is a chronic disease and its coexistence with RA can alter bone health. The aim of this study was to investigate if HT affected BMD parameters in RA patients diagnosed for the first time.</p><p><strong>Methods: </strong>Patients with the diagnosis of RA who underwent BMD studies formed the study population. Patients with HT were sorted from this population and formed a separate group. Healthy controls were drawn from subjects who came for a check-up. BMD was done with the GE Lunar DPX machine. Mean T Scores at spine, femur neck and total femur were recorded. Data from the three groups were analysed and compared. Linear regression analyses were performed.</p><p><strong>Results: </strong>Analysis suggested that the age had inverse and BMI had direct correlation with BMD T scores in all groups. The additional diagnosis of HT in RA patients was associated with higher BMD as compared to patients with RA, but lower than controls. R² values were 0.341, 0.402 and 0.436 for mean T scores at spine, femur neck and femur total respectively. Figures from multiple regression analysis suggest that BMI alone did not explain the higher T score values in HT patients.</p><p><strong>Conclusion: </strong>Additional morbidity of HT in RA patients negates the porotic effect of RA as judged by bone densitometry. Hence, BMD reports should be read with caution in these patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"34 4","pages":"479-485"},"PeriodicalIF":0.0,"publicationDate":"2023-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10815520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571541","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}