Revista Romana de Reumatologie最新文献

{"title":"Metabolic syndrome in a cohort of rheumatoid arthritis patients","authors":"D. Ciobanu, A. Bărbulescu, Beatrice Andreea Trasca, C. D. Pârvănescu, S. Firulescu, Ș. Dinescu, C. Bita, Laura-Ioana Crînguș, A. Tica, Florentin Ananu Vreju","doi":"10.37897/rjr.2022.3.7","DOIUrl":"https://doi.org/10.37897/rjr.2022.3.7","url":null,"abstract":"Objectives. We aimed to assess the presence of MetS and traditional CV risk factors in a group of RA patients, compared to controls and their possible inter-relation with disease activity variables. Methods. We performed an observational study on 38 consecutive patients diagnosed with RA in Rheumatology Department of the Emergency County Hospital Craiova, based on ACR/EULAR criteria, in a one year interval between 2019-2020, and a control group including 30 subjects. Patients’ data were obtained from each subject according to the study protocol and included demographic, clinical, laboratory parameters. The presence of MetS was assessed according to the National Cholesterol Education Program Adult Treatment Panel (NCPATP) III. Results. Regarding the components of metabolic syndrome, as defined by NCPATP III, the differences established for the RA vs control groups were: increased waist circumference in 21 (52.25%) vs 13 (43.33%) subjects (p=0.002); high triglycerides (or under treatment) in 10 (26.31%) vs 6 (20%) subjects, p=0.004; low HDL cholesterol in 15 (39.47%) vs 7 (23.33%) subjects, p=0.002; high blood pressure (or under treatment) in 25 (65.79%) vs 12 (40%) subjects, p<0.0001; high blood glucose (or under treatment) in 7 (18.42%) vs 8 (26.66%) subjects, p= 0.08. Our data revealed a positive correlation between disease activity index and smoking (r=0.432, p=0.02), as well as between DAS 28-CRP and LDL cholesterol (r=0.454, p=0.004), or triglycerides (r=0.337, p=0.03). We also observed a strong, positive correlation between the presence of MetS and disease activity score (r=0.645, p<0.0001). Conclusions. Metabolic syndrome is associated with a high cardiovascular risk, the main cause of mortality in RA patients. Due to the chronic inflammatory state and the intervention of both traditional and non-traditional cardiovascular risk factors, each patient should undergo periodic evaluations, in order to apply an adequate and early therapeutic intervention and reduce further cardiovascular morbidity and mortality rates.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41338980","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}

{"title":"Total spleen calcification - a rare clinical manifestation in systemic lupus erythematosus","authors":"P. Richter, A. Cardoneanu, A. Burlui, L. Macovei, I. Bratoiu, R. Mihai, E. Rezus","doi":"10.37897/rjr.2022.3.5","DOIUrl":"https://doi.org/10.37897/rjr.2022.3.5","url":null,"abstract":"Splenomegaly, infarction, spontaneous rupture and hyposplenism are among the frequently manifestations of splenic involvement in systemic lupus erythematosus (SLE) patients. Exceptionally, extensive splenic calcifications are found in SLE. This aspect is due to the periarterial thickening in an “onion-skin” model. Discrete, small, circular and diffuse nodules that are distributed at the level of the parenchyma, but that are missing at the capsular and subcapsular level, are the main characteristics of these calcifications. The aim of this report is to present the case of a SLE patient with this rare splenic calcifications association.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44528117","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}

{"title":"What can be hidden behind a persistent fever syndrome?","authors":"A. Cardoneanu, A. Leça, A. Burlui, L. Macovei, E. Rezus","doi":"10.37897/rjr.2022.2.8","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.8","url":null,"abstract":"Fever is a defense mechanism of the body that occurs in various pathological situations, most often being secondary to an infectious disease. A prolonged febrile syndrome can hide many clinical problems, thus delaying a correct diagnosis and treatment. We present the case of a 52-year-old patient who addressed with a high fever associated with a generalized skin rash, arthralgia, myalgia and fatigue. Initially, the patient was referred to the infectious disease clinic where numerous paraclinical investigations were performed which ultimately ruled out an infectious cause of fever. Prompt response to corticosteroid therapy after performing numerous combinations of antibiotics, led to a possible autoimmune disease, the patient being redirected to the rheumatology clinic. Following the biological, immunological and radiological investigations, the diagnosis of adult Still’s disease was supported and the corresponding immunosuppressive treatment was initiated with good clinical-biological evolution.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44608670","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}

{"title":"Psoriasis, inflammatory bowel disease, and uveitis as paradoxical adverse effects induced by TNF inhibitors in patients with immune-inflammatory rheumatic conditions","authors":"Damiana Margineanu, A. Burlui, A. Cardoneanu, L. Macovei, I. Bratoiu, P. Richter, E. Rezus","doi":"10.37897/rjr.2022.2.4","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.4","url":null,"abstract":"Despite their known benefits, tumor necrosis factor alpha inhibitors (TNFi) may cause certain unexpected side effects, such as the aggravation of pre-existing autoimmune conditions or inducing the onset of new inflammatory conditions, these reactions being called “paradoxical adverse effects’’ (PAEs). The spectrum of TNFi-induced PAEs is vast and may include dermatological disease (frequently - psoriasiform skin reactions), gastroenterological disease (inflammatory bowel disease), ophthalmological disease (uveitis) and other autoimmune conditions (lupus-like reactions, vasculitis). PAEs are characterized by complex physio-pathological mechanisms which remain a matter of further research and may significantly impact the patients’ evolution and quality of life. Importantly, a large number of patients require the cessation of TNFi treatment, as well as other types of therapeutic interventions. The present review aimed to analyze recent findings regarding certain paradoxical adverse effects (psoriasis, inflammatory bowel disease, and uveitis) in patients with RA, ankylosing spondylitis (AS), and PsA treated with TNFi.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41329101","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}

{"title":"Secondary antiphospholipid syndrome in systemic lupus erythematosus – screening, diagnosis and treatment methods","authors":"A. Mihailescu, I. Saulescu, D. Opriș-Belinski, A. Balanescu, V. Bojinca, F. Berghea, L. Groșeanu, C. Constantinescu, A. Borangiu, S. Daia-Iliescu, D. Mazilu, M. Negru, C. Cobilinschi, D. Predețeanu, R. Ionescu","doi":"10.37897/rjr.2022.2.2","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.2","url":null,"abstract":"Systemic Lupus Erythematosus is the hallmark of autoimmune diseases, being characterized by multiple organ involvements and immune abnormalities, amongst which the presence of antiphospholipid antibodies with or without specific clinical manifestations (vascular thromboses and pregnancy morbidities) has a significant impact on the disease course, both short and long term, causing the accumulation of irreversible damage. This study evaluates the aforementioned impact, highlighting the importance of very early screening for these antibodies.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47697417","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}

{"title":"Fetal cardiofibroelastosis - a consequence of anti-Ro maternal transfer during pregnancy. Case report and review of the literature","authors":"Ana Duminica Turcu, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rjr.2022.2.5","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.5","url":null,"abstract":"With scarcely any reports published on the association of fetal endocardial fibroelastosis and Ro antibodies maternal transfer during pregnancy, this subject continues to raise concern among health care providers around the world, especially when neonatal lupus syndrome is taken into consideration as the main diagnosis. Fetuses with congenital atrioventricular block have a risk of intrauterine fetal demise and the concern comes from a variety of factors that show significant association between the presence of maternal antibodies to SS-A/Ro during pregnancy and their children serum level of these antibodies. Nevertheless, fetal endocardial fibroelastosis plays an important role in altering ventricular diastolic function and ventricular development in children and neonates. Methods. Medical literature was searched on PubMed and Medline using key words such as fetal endocardial fibroelastosis, anti-Ro antibodies in pregnancy and neonatal lupus syndrome and over 200 articles were taken into consideration, with 17 of them included in the final review. The clinical case included in this paper was referred to the Department of Maternal Fetal Medicine, Filantropia Clinical Hospital in Bucharest, during the second pregnancy after a first pregnancy that resulted in stillbirth with congenital heart block and fibroelastosis as a result of the maternal diagnosis of Sjogren’s syndrome with transplacental transfer of SS-A/Ro antibodies.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44695296","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}

{"title":"Novel biomarkers in the differential diagnosis of preeclampsia and lupus flare in pregnancy","authors":"Ilinca Ilie, N. Gică, R. Botezatu, G. Peltecu, A. Panaitescu","doi":"10.37897/rjr.2022.2.1","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.1","url":null,"abstract":"Preeclampsia and systemic lupus erythematosus are medical conditions with established elevated risks of pregnancy complications and fetal compromise. Active lupus during pregnancy can trigger the appearance of preeclampsia. Research has demonstrated an increase in lupus disease flares during pregnancy, secondary to hormonal shifts required in order to maintain pregnancy. Hemolytic anemia, leucopenia, thrombocytopenia, sudden onset of hypertension after 20 weeks of gestation and decreasing complement components such as C3, C4 and CH50 are hallmarks of lupus flares during pregnancy. Timely and accurate prediction of preeclampsia is now feasible through estimation of novel placental and endothelial biomarkers, chiefly sFlt-1 and PIGF. A sFlt-1 to PIGF ratio under 38, in patients under 34 weeks of gestation suspected of disease, boasts the highest negative predictive value for preeclampsia and can successfully rule out preeclampsia development in the following 4 weeks in patients with normal values. Moreover, the sFlt-1 to PIGF ratio has proven its utility in the differential diagnosis of preeclampsia and active lupus nephritis, with normal ratio values noted in cases of lupus flares during pregnancy. Further research is required in order to identify other novel potential biomarkers.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43233902","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}

{"title":"Statins and muscle – friends or foes? Discussions based on a case report","authors":"A. Stanciu, C. Niță, L. Groșeanu","doi":"10.37897/rjr.2022.2.6","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.6","url":null,"abstract":"Immune-mediated necrotizing myopathy (IMNM) is a type of autoimmune myopathy characterized by relatively severe proximal weakness, myofiber necrosis with minimal inflammatory cell infiltrate on muscle biopsy, and infrequent extra-muscular involvement Anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) myopathy is a distinct subtype of INMN, often associated with statin exposure. Treatment of IMNM consists of immunosuppression with steroids, steroid-sparing agents, intravenous immune globulin and/or biologics. We present here a case of anti-HMCGR-associated IMNM and a brief review the pathophysiology, diagnosis and treatment to increase physician awareness of this rare and debilitating condition.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47156652","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}

{"title":"Rheumatoid arthritis overlapping systemic sclerosis with interstitial lung disease","authors":"C. Ionescu, C. Mogoșan, L. Enache, C. Popescu, B. Dumitrescu, G. Dinache, C. Codreanu","doi":"10.37897/rjr.2022.2.7","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.7","url":null,"abstract":"Lung disease is the second most frequent extra articular manifestation in rheumatoid arthritis (RA) patients. It can be present in up to 80% RA cases and represents a major cause of morbidity and mortality. One of the most common types of lung involvement in RA patients is the interstitial lung disease (ILD). Computed tomography studies show evidence of ILD in a large proportion of patients with RA (over 50% in some studies) and it can be clinically symptomatic in 5% of cases. The CT aspect classifies four forms of ILD, listed in order of frequency: usual interstitial pneumonia (UIP) - the most common form, non-specific interstitial pneumonia (NSIP), organizing pneumonia (OP) and diffuse alveolar damage (DAD) which is the least common form. We present a long-standing case of rheumatoid arthritis overlapping systemic sclerosis with interstitial lung disease.","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46182668","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}

{"title":"Can CRP and ESR values may be influenced by rehabilitation therapy in patients with psoriatic arthritis?","authors":"Diana Maghiar, N. Paşcalău, Florian Maghiar, L. Lazăr","doi":"10.37897/rjr.2022.2.3","DOIUrl":"https://doi.org/10.37897/rjr.2022.2.3","url":null,"abstract":"Objective. Psoriatic arthritis (PsA) is a type of chronic inflammatory arthritis that is linked to psoriasis and affects 20 to 30 percent of those who have it. Clinical symptoms vary and can change over time as one articular pattern evolves into another. This condition has a significant financial and psychological cost attached to it, not to mention the mental state of the patient in relation to the disease. Inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are frequently used in primary care to diagnose and monitor inflammatory illnesses such as infections, autoimmune diseases, and malignancies. Our main goal was to see whether or not there was a difference between inflammatory markers in patients with psoriatic arthritis who benefited balneotherapy and kinesiotherapy, compared to those who remained only on the fund treatment. Material and methods. We performed a comparative retrospective study regarding the evolution of 110 patients diagnosed with psoriatic arthritis who underwent or not a rehabilitation program that was performed in Rehabilitation Hospital Baile Felix. Outcomes. One of the results we wanted to demonstrate was whether this type of treatment influences the values of CRP and ESR, thus proving the benefits or disadvantages of this treatment. Conclusion. To answer the major question, rehabilitation therapy DOES influence the values of CRP and ESR values in patients with psoriatic arthritis in the sense of decreasing their values. The 2 week-long rehabilitation therapy was capable of reducing the inflammatory process, a conclusion indicated by the decreasing of CRP and ESR values (mean value difference p <0.001).","PeriodicalId":33518,"journal":{"name":"Revista Romana de Reumatologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48763092","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}