Open Rheumatology Journal最新文献

{"title":"Sex Differences in the Effects of a Biological Drug for Rheumatoid Arthritis on Depressive State.","authors":"Takahiro Tokunaga,&nbsp;Yusuke Miwa,&nbsp;Airi Nishimi,&nbsp;Shinichiro Nishimi,&nbsp;Mayu Saito,&nbsp;Nao Oguro,&nbsp;Yoko Miura,&nbsp;Sho Ishii,&nbsp;Ryo Takahashi,&nbsp;Tsuyoshi Kasama,&nbsp;Kenji Sanada","doi":"10.2174/1874312901409010051","DOIUrl":"https://doi.org/10.2174/1874312901409010051","url":null,"abstract":"<p><strong>Objective: </strong>Sex-specific medicine has attracted attention in recent years, but no report on rheumatoid arthritis (RA) has examined sex differences in the effectiveness of biologics on activities of daily living (ADL), quality of life (QOL), or depressive state.</p><p><strong>Methods: </strong>The study subjects were 161 RA patients (female: 138; male: 23) attending regular doctor visits at our hospital. We compared the changes in disease activity, which was evaluated using the simplified disease activity index (SDAI), ADL (using the modified health assessment questionnaire; mHAQ), QOL (using short form-36; SF-36), and the Hamilton Depression Rating Scale (HAM-D) for RA patients between each sex over a six-month observation period while administering biologic treatment.</p><p><strong>Results: </strong>The female patients reported significant improvements in the following metrics: SDAI: from 22.1 ± 11.9 to 8.9 ± 7.8 (p < 0.001); mHAQ: from 0.46 ± 0.50 to 0.32 ± 0.45 (p < 0.001); and HAM-D: from 6.2 ± 4.8 to 3.8 ± 4.1 (p < 0.001). Moreover, all eight items of the SF-36 were significantly improved (p < 0.01). In contrast, the male patients improved on the SDAI (from 27.9 ± 11.7 to 12.7 ± 8.6 (p < 0.001)), but we did not observe significant improvements in the mHAQ or HAM-D scores or in any items on the SF-36.</p><p><strong>Conclusion: </strong>Both male and female patients with RA improved when using a biological drug. Sex differences in the improvement of depressive state were observed.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"51-6"},"PeriodicalIF":0.0,"publicationDate":"2015-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/70/31/TORJ-9-51.PMC4541463.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33955912","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 Adalimumab on Work Ability Assessed in Rheumatoid Arthritis Disease Patients in Saudi Arabia (AWARDS).","authors":"Waleed Hussain,&nbsp;Nahid Janoudi,&nbsp;Abdulsalam Noorwali,&nbsp;Narges Omran,&nbsp;Matouqa Baamer,&nbsp;El Hussain Assiry,&nbsp;Hanan Alrayes,&nbsp;Hanan Alosaimi,&nbsp;Ashraf Ibrahim,&nbsp;Shereen Gohary,&nbsp;Joan Mignuet,&nbsp;Hani Almoallim","doi":"10.2174/1874312901409010046","DOIUrl":"https://doi.org/10.2174/1874312901409010046","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) is a chronic disabling disease that can jeopardize the ability of affected individuals to participate in paid work. Our objective was to evaluate the effectiveness of a 6-month course of tumor necrosis factor (TNF) antagonist (adalimumab) on work ability, overall health, and fatigue in RA patients.</p><p><strong>Methods: </strong>Between October 2012 and February 2014, this prospective, observational study enrolled 63 consecutive patients with established adult RA at outpatient clinics in Makkah, Jeddah, Riyadh and Abha (Saudi Arabia). Patients received subcutaneous injections of adalimumab (40 mg every 2 weeks). Outcomes were measured at baseline and 6 months using the following tools: Work Productivity and Activity Impairment (WPAI), Health Assessment Questionnaire Disability Index (HAQ-DI), Fatigue Severity Scale (FSS), Visual Analog Scale for Fatigue (VAS-F), and work disability self-assessment.</p><p><strong>Results: </strong>All outcomes showed improvements after 6 months of adalimumab therapy. Significant improvements from baseline were observed in absenteeism (64% ± 11.62 to 11.60% ± 11.17 [p<0.0001]), presenteeism (62.15% ± 20.11 to 34.92% ± 20.61 [p<0.0001]), overall work impairment (69.08% ± 18.86 to 40.73% ± 22.29 [p<0.0001]), overall activity impairment (68.46% ± 18.58 to 36.46% ± 20.79 [p<0.0001]), HAQ score (1.69 ± 0.57 to 0.81 ± 0.61 [p<0.0001]), and FSS score (47.08 ± 9.55 to 27.86 ± 13.43 [p<0.0001]).</p><p><strong>Conclusion: </strong>A 6-month course of adalimumab improved work ability, fatigue, and overall health assessments in patients with established RA. Our findings encourage randomized controlled trials investigating the cost-effectiveness and long-term effects of TNF inhibitors on work disability.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"46-50"},"PeriodicalIF":0.0,"publicationDate":"2015-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6e/c8/TORJ-9-46.PMC4541458.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33955911","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 Case Report of Successful Treatment of Recalcitrant Childhood Localized Scleroderma with Infliximab and Leflunomide.","authors":"Ian D Ferguson,&nbsp;Peter Weiser,&nbsp;Kathryn S Torok","doi":"10.2174/18743129014090100030","DOIUrl":"https://doi.org/10.2174/18743129014090100030","url":null,"abstract":"<p><p>Herein we report successful treatment of an adolescent Caucasian female with severe progressive localized scleroderma (mixed subtype, including generalized morphea and linear scleroderma of the trunk/limb) using infliximab and leflunomide. The patient demonstrated improvement after the first 9 months of therapy based on her clinical examination, objective measures, and patient and parent global assessments. Infliximab is a potential treatment option for pediatric localized scleroderma patients who have progression of disease or who are unable to tolerate the side effect profile of more standard systemic therapy. Larger longitudinal studies or case series are needed to confirm and further investigate infliximab's role in localized scleroderma. </p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"30-5"},"PeriodicalIF":0.0,"publicationDate":"2015-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/18743129014090100030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33892662","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":"Clinical Characteristics and Outcome of Primary Sjogren's Syndrome: A Large Asian Indian Cohort.","authors":"Pulukool Sandhya,&nbsp;Lakshmanan Jeyaseelan,&nbsp;Robert Hal Scofield,&nbsp;Debashish Danda","doi":"10.2174/1874312901409010036","DOIUrl":"https://doi.org/10.2174/1874312901409010036","url":null,"abstract":"<p><strong>Objective: </strong>To characterise the clinical features, immunological profile and outcome in a cohort of Asian Indian patients with primary Sjögren's syndrome (SS).</p><p><strong>Methods: </strong>Electronic medical records from a tertiary care teaching hospital in south India were screened for SS between 2004 and 2011. Patients fulfilling American European Consensus group (AECG) 2002 or American College of Rheumatology (ACR) 2012 classification criteria were included. Agglomerative hierarchical cluster analysis to identify patterns of associations between clinical and immunological features was done. Multivariate logistic regression to identify predictors of major systemic involvement was performed. Data on treatment and outcome were retrieved from electronic records.</p><p><strong>Results: </strong>Of 423 patients suspected to have SS, 332 fulfilled inclusion criteria. Only 8.3% of patients complained of sicca symptoms on their own at initial presentation. Younger age of onset, higher female to male ratio, paucity of cryoglobulinemia, Raynaud's phenomenon and hyperglobulinemia were unique to this cohort. Cluster analysis revealed two subsets: The first cluster comprised of patients having a major systemic illness with high antibody titers and the second comprised of seronegative patients with mild disease. Over a third of SS cases had severe systemic manifestations necessitating treatment with immunosuppressants. In multivariate logistic regression analysis, anti-Ro and anti-La antibody positivity was associated with higher odds for systemic disease features (OR=2.67, P=0.03 and OR=3.25, P=0.003, respectively) whereas chronic pain was associated with lower odds (OR=0.4, p=0.032). Clinical improvement including symptomatic benefit in sicca and musculoskeletal features was noted with immunomodulators in the majority.</p><p><strong>Conclusion: </strong>Our cohort of patients with SS has characteristic clinical features; some of them are in contrast with previous observations reported in European patients. This cohort consisted of two distinct patient clusters. The first cluster was associated with major systemic illness and high antibody titers, where as the second cluster comprised of seronegative patients with mild disease. Association of antibody positivity with systemic features was further confirmed on logistic regression analysis.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"36-45"},"PeriodicalIF":0.0,"publicationDate":"2015-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/4e/TORJ-9-36.PMC4493630.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33892663","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":"Diagnosis and Treatment of Acute Gout at a University Hospital Emergency Department.","authors":"Naomi Schlesinger,&nbsp;Diane C Radvanski,&nbsp;Tina C Young,&nbsp;Jonathan V McCoy,&nbsp;Robert Eisenstein,&nbsp;Dirk F Moore","doi":"10.2174/18743129014090100021","DOIUrl":"https://doi.org/10.2174/18743129014090100021","url":null,"abstract":"<p><strong>Background: </strong>Acute gout attacks account for a substantial number of visits to the emergency department (ED). Our aim was to evaluate acute gout diagnosis and treatment at a University Hospital ED.</p><p><strong>Methods: </strong>Our study was a retrospective chart review of consecutive patients with a diagnosis of acute gout seen in the ED 1/01/2004 - 12/31/2010. We documented: demographics, clinical characteristics, medications given, diagnostic tests, consultations and whether patients were hospitalized. Descriptive and summary statistics were performed on all variables.</p><p><strong>Results: </strong>We found 541 unique ED visit records of patients whose discharge diagnosis was acute gout over a 7 year period. 0.13% of ED visits were due to acute gout. The mean patient age was 54; 79% were men. For 118 (22%) this was their first attack. Attack duration was ≤ 3 days in 75%. Lower extremity joints were most commonly affected. Arthrocentesis was performed in 42 (8%) of acute gout ED visits. During 355 (66%) of ED visits, medications were given in the ED and/or prescribed. An anti-inflammatory drug was given during the ED visit during 239 (44%) visits. Medications given during the ED visit included: NSAIDs: 198 (56%): opiates 190 (54%); colchicine 32 (9%) and prednisone 32 (9%). During 154 (28%) visits an anti-inflammatory drug was prescribed. Thirty two (6%) were given no medications during the ED visit nor did they receive a prescription. Acute gout rarely (5%) led to hospitalizations.</p><p><strong>Conclusion: </strong>The diagnosis of acute gout in the ED is commonly clinical and not crystal proven. Anti-inflammatory drugs are the mainstay of treatment in acute gout; yet, during more than 50% of ED visits, anti-inflammatory drugs were not given during the visit. Thus, improvement in the diagnosis and treatment of acute gout in the ED may be required.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"21-6"},"PeriodicalIF":0.0,"publicationDate":"2015-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/18743129014090100021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33416338","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":"An Unusual Mimicker of Systemic Lupus Erythematosus: A Case Report.","authors":"Aloice O Aluoch,&nbsp;Mathew Farbman,&nbsp;Heather Gladue","doi":"10.2174/18743129014090100027","DOIUrl":"https://doi.org/10.2174/18743129014090100027","url":null,"abstract":"<p><p>We present a case of a 47 year-old African American female with 15 pack-years of tobacco use and heavy alcohol use who presented with arthritis and was found to have a positive antinuclear antibodies (ANA), anti double stranded DNA antibodies (anti-dsDNA), and anti-Sjogren's syndrome-related antigen A and antigen B (anti-SSA and anti-SSB). She was subsequently found to have a lung adenocarcinoma associated with hypertrophic pulmonary osteoarthropathy (HPO). This demonstrates a case of positive antinuclear antibodies and arthritis in a patient with lung adenocarcinoma, which can be falsely diagnosed as systemic lupus erythematosus. </p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"27-9"},"PeriodicalIF":0.0,"publicationDate":"2015-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/18/TORJ-9-27.PMC4475692.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33416339","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":"Development of Canadian Recommendations for the Management of ANCA-Associated Vasculitides: Results of the National Needs Assessment Questionnaire.","authors":"Leilani Famorca,&nbsp;Marinka Twilt,&nbsp;Lillian Barra,&nbsp;Volodko Bakowsky,&nbsp;Susanne Benseler,&nbsp;David Cabral,&nbsp;Simon Carette,&nbsp;Navjot Dhindsa,&nbsp;Aurore Fifi-Mah,&nbsp;Michelle Goulet,&nbsp;Nader Khalidi,&nbsp;Majed Khraishi,&nbsp;Lucy McGeoch,&nbsp;Nataliya Milman,&nbsp;Christian Pineau,&nbsp;Kam Shojania,&nbsp;Regina Taylor-Gjevre,&nbsp;Tanveer Towheed,&nbsp;Judith Trudeau,&nbsp;Elaine Yacyshyn,&nbsp;Patrick Liang,&nbsp;Christian Pagnoux","doi":"10.2174/18743129014090100016","DOIUrl":"https://doi.org/10.2174/18743129014090100016","url":null,"abstract":"<p><strong>Objectives: </strong>To study variations in Canadian clinical practice patterns for the management of ANCA-associated vasculitis (AAV) and identify points to consider for the development of national recommendations.</p><p><strong>Material and methodology: </strong>A 30-item needs assessment questionnaire was sent to all members of the Canadian Vasculitis network (CanVasc), Canadian Rheumatology Association (CRA), Canadian Thoracic Society (CTS) and Canadian Society of Nephrology (CSN). Respondent characteristics, practice patterns, concerns and expectations were analyzed.</p><p><strong>Results: </strong>Among 132 physicians who followed at least 1 vasculitis patient and responded to the survey, 39% stated that they felt confident in their management of AAV. Several variations in practice were observed regarding diagnostic procedure, induction and maintenance treatments and use of biologics; some were due to logistic constraints (difficulties in access to some specific tests, drugs or care; lack of health care coverage for the costs). The top 5 topics for which recommendations are expected involve treatment for remission induction, maintenance, refractory disease, and relapse as well as biologics.</p><p><strong>Conclusion: </strong>Practice variations identified in this needs assessment survey will serve to formulate key questions for the development of CanVasc recommendations.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"16-20"},"PeriodicalIF":0.0,"publicationDate":"2015-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e7/4f/TORJ-9-16.PMC4397821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33234324","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":"Comparing Five Year Out-Come in Two Cohorts of Patients with Early Rheumatoid Arthritis - A BARFOT Study.","authors":"Maria L E Andersson,&nbsp;Kristina Forslind,&nbsp;Ingiäld Hafström","doi":"10.2174/1874312901409010008","DOIUrl":"https://doi.org/10.2174/1874312901409010008","url":null,"abstract":"<p><strong>Unlabelled: </strong>The objective of the study was to compare disease characteristics over the first 5 years of disease in patients with RA, with disease onset in 1990s and 2000s, respectively.</p><p><strong>Methods: </strong>All 2235 patients with early RA (disease duration ≤12 months) were recruited from the BARFOT prospective observational study. These patients were divided into group 1 included 1992 to 1999 (N=1084, 66% women) and group 2 included 2000 to 2006 (N=1151, 69% women). Disease Activity Score (DAS28), VAS pain and Health Assessment Questionnaire (HAQ) were assessed during 5 years. Remission was defined as DAS28 <2.6.</p><p><strong>Results: </strong>At inclusion, both women and men in group 2 had higher mean DAS28 (SD) than group 1, 5.42 (1.22) vs 5.26 (1.19), p=0.004 and 5.28 (1.22) vs 5.00 (1.27), p=0.004, respectively, mainly dependant on pain and not on inflammatory related measures. Over time DAS28 decreased and was in both genders, from 6 months to the 5-year follow-up, significantly lower in group 2. At 5-year, both women and men in group 2 had higher rate of remission than women and men in group 1. However, despite reduction of VAS pain and HAQ there were no differences in pain and HAQ between groups at any time point.</p><p><strong>Conclusion: </strong>Patients included in the 2000s achieved higher frequency of remission at the 5 year follow-up compared with those included in the 1990s, suggested to reflect the more active medical treatment. Interestingly, however, improvement in pain and HAQ did not differ between the two patient cohorts.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"8-15"},"PeriodicalIF":0.0,"publicationDate":"2015-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/50/f5/TORJ-9-8.PMC4319195.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33048740","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":"Comparisons of Body Image Perceptions of a Sample of Black and White Women with Rheumatoid Arthritis and Fibromyalgia in the US.","authors":"Josephine E A Boyington,&nbsp;Britta Schoster,&nbsp;Leigh F Callahan","doi":"10.2174/1874312901409010001","DOIUrl":"https://doi.org/10.2174/1874312901409010001","url":null,"abstract":"<p><strong>Objective: </strong>To explore the disease-related, body image (BI) perceptions of women diagnosed with, rheumatoid arthritis (RA) and fibromyalgia (FM).</p><p><strong>Methods: </strong>A purposive sample of twenty-seven females participated in individual semi-structured phone interviews to elicit BI perceptions relative to pain, activity limitations and coping measures. Sessions were digitally recorded, transcribed verbatim, and content analyzed.</p><p><strong>Results: </strong>Body image perceptions relative to 5 major themes emerged in the analysis. They focused on Pain, Disease Impact on Physical and Mental Function, Weight, Diseased-Induced Fears and, Coping measures. Pain was a common experience of all participants. Other troubling factors verbalized by participants included dislike and shame of visibly affected body parts, and disease-induced social, psychological and physical limitations. RA participants thought that manifested joint changes, such as swelling and redness, undergirded their prompt diagnosis and receipt of health care. Contrarily, women with fibromyalgia perceived that the lack of visible, disease-related, physical signs led to a discounting of their disease, which led to delayed health care and subsequent frustrations and anger. All but one participant used prayer and meditation as a coping measure.</p><p><strong>Conclusion: </strong>The body image perceptions evidenced by the majority of participants were generally negative and included specific focus on their disease-affected body parts (e.g. joints), mental function, self-identity, health care experiences, activity limitations and overall quality of life. Given the global effect of RA and FM, assessment and integration of findings about the BI perceptions of individuals with FM and RA may help define suitable interdisciplinary strategies for managing these conditions and improving participants' quality of life.</p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"9 ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2015-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/d0/TORJ-9-1.PMC4319189.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33048739","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":"Felty's Syndrome, Insights and Updates.","authors":"Mohammad Bagher Owlia,&nbsp;Kam Newman,&nbsp;Mojtaba Akhtari","doi":"10.2174/1874312901408010129","DOIUrl":"https://doi.org/10.2174/1874312901408010129","url":null,"abstract":"<p><p>Felty's syndrome (FS) is characterized by the triad of seropositive rheumatoid arthritis (RA) with destructive joint involvement, splenomegaly and neutropenia. Current data shows that 1-3 % of RA patients are complicated with FS with an estimated prevalence of 10 per 100,000 populations. The complete triad is not an absolute requirement, but persistent neutropenia with an absolute neutrophil count (ANC) generally less than 1500/mm3 is necessary for establishing the diagnosis. Felty's syndrome may be asymptomatic but serious local or systemic infections may be the first clue to the diagnosis. FS is easily overlooked by parallel diagnoses of Sjӧgren syndrome or systemic lupus erythematosus or lymphohematopoietic malignancies. The role of genetic (HLA DR4) is more prominent in FS in comparison to classic rheumatoid arthritis. There is large body of evidence that in FS patients, both cellular and humoral immune systems participate in neutrophil activation, and apoptosis and its adherence to endothelial cells in the spleen. It has been demonstrated that proinflammatory cytokines may have inhibitory effects on bone marrow granulopoiesis. Binding of IgGs to neutrophil extracellular chromatin traps (NET) leading to neutrophil death plays a crucial role in its pathophysiology. In turn, \"Netting\" neutrophils may activate auto-reactive B cells leading to further antibody and immune complex formation. In this review we discuss on basic pathophysiology, epidemiology, genetics, clinical, laboratory and treatment updates of Felty's syndrome. </p>","PeriodicalId":39124,"journal":{"name":"Open Rheumatology Journal","volume":"8 ","pages":"129-36"},"PeriodicalIF":0.0,"publicationDate":"2014-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874312901408010129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32997834","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}