Open Access Rheumatology-Research and Reviews最新文献

{"title":"Infections as Risk Factor of Sjögren's Syndrome.","authors":"Suyud Warno Utomo,&nbsp;Jemima Fajarin Putri","doi":"10.2147/OARRR.S276727","DOIUrl":"https://doi.org/10.2147/OARRR.S276727","url":null,"abstract":"<p><strong>Purpose: </strong>Sjögren's syndrome (SS) is an autoimmune disease targeting exocrine glands, leading to low body fluids production, especially on the salivary and lacrimal glands. Due to the low saliva and tear production, the common symptoms of Sjögren's syndrome are dry eyes and dry mouth, later on leading to uncomfortable sensations on the eye surface, cornea destruction, dental caries, and oral cavity infections. Several infections are known to cause similar side-effects to Sjögren's syndrome symptoms, including low saliva flow; therefore, infection is hypothesized as one of the risk factors of Sjögren's syndrome.</p><p><strong>Results: </strong>Based on our literature research, there are several infectious agents which cause similar disease manifestations to Sjögren's syndrome, including infections of hepatitis C virus, Epstein-Barr virus, cytomegalovirus, and human T-lymphotropic virus-1 (HTLV-1), and these four agents are found to cause persistent infection on the salivary gland after the first infection and later lead to organ destruction, thus causing sicca syndrome in the oral cavity. Other findings show possible <i>Heliobacter pylori</i> infection might lead on the increasing level of anti-Ro/SSA and anti-La/SSB of infected individuals.</p><p><strong>Conclusion: </strong>Some research has shown persistent infection could trigger autoimmune disorders due to continuous T-cells and B-cells activation in an attempt of infected cells eradication, leading to autoimmune reaction and high autoreactive cells concentration around the healthy cells causing the immune cells to eradicate the healthy cells nearby. However, the results in this literature study found persistent infection is not the only risk factor of Sjögren's syndrome but there are various unknown factors that trigger infection to develop into Sjögren's syndrome.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"257-266"},"PeriodicalIF":2.1,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S276727","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38616874","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 Outcomes of Patients with Rheumatoid Arthritis Treated in a Disease Management Program: Real-World Results.","authors":"Pedro Santos-Moreno,&nbsp;Paola Castillo,&nbsp;Laura Villareal,&nbsp;Carlos Pineda,&nbsp;Hugo Sandoval,&nbsp;Omaira Valencia","doi":"10.2147/OARRR.S270700","DOIUrl":"https://doi.org/10.2147/OARRR.S270700","url":null,"abstract":"<p><strong>Background: </strong>Care models can affect the clinical outcome of patients with rheumatic and musculoskeletal diseases.</p><p><strong>Objective: </strong>We aimed to compare how an innovative model of a rheumatoid arthritis disease-management program can improve the clinical outcomes of patients compared to a conventional assessment approach.</p><p><strong>Methods: </strong>We performed a retrospective analysis of real-world data from clinical records of a cohort of 5078 patients diagnosed with rheumatoid arthritis who were followed up at the Center of Excellence in Rheumatoid Arthritis vs the clinical outcomes reported in the Colombian National Registry of Rheumatoid Arthritis.</p><p><strong>Results: </strong>We found significant differences in the diagnosis and follow-up between the specialized Center program and the usual care reported by the Colombian National Registry (p<0.005), including the evaluation of rheumatoid factor, Anti-citrullinated antibodies Disease Activity Score, Health Assessment Questionnaire, number of visits to the rheumatologist, and clinical outcomes measured by the level of disease activity. In addition, when comparing the Center's clinical outcomes - from baseline to the last follow-up, we found an improvement in the level of disease activity, with patients classified in remission increasing from 20.8% to 58.5% (p<0.005), and a reduction in those with high disease activity from 18% to 4.7% (p<0.005).</p><p><strong>Conclusion: </strong>Real-world evidence showed that patients with rheumatoid arthritis who underwent follow-up under an innovative disease-management model improved their clinical outcomes compared with those patients in a conventional assessment program. These results could suggest a way of improving health policies for patients with rheumatoid arthritis.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"249-256"},"PeriodicalIF":2.1,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S270700","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38612396","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":"Value of Albumin-Fibrinogen Ratio and CRP-Albumin Ratio as Predictor Marker of Disease Activity in Egyptian RA Patients, Correlated with Musculoskeletal Sonography.","authors":"Naglaa Afifi,&nbsp;Basma M Medhat,&nbsp;Amani Mohamed Abdel Ghani,&nbsp;Hend Galal Eldeen Mohamed Ali Hassan,&nbsp;Mervat E Behiry","doi":"10.2147/OARRR.S268668","DOIUrl":"https://doi.org/10.2147/OARRR.S268668","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the albumin-fibrinogen ratio (AFR) and C-reactive protein-albumin ratio (CAR) as inflammatory markers in rheumatoid arthritis (RA) and to investigate their association with disease activity correlating with musculoskeletal ultrasonographic findings.</p><p><strong>Patients and methods: </strong>A total of 125 cases of RA patients were consecutively enrolled in a multicenter cross-sectional study compared to 100 healthy controls, all subjects were investigated for fibrinogen, albumin, CRP, erythrocyte sedimentation rate, AFR, and CAR measurements. Patients' disease activity was assessed by disease activity score (DAS28-ESR), and they were subjected to high-frequency ultrasound both in greyscale and power Doppler.</p><p><strong>Results: </strong>RA patients had lower AFR and higher CAR than those in the control group (P < 0.001). A positive correlation was demonstrated between CAR and DAS score (r=0.589, P = 0.0001), whilst there was a precise negative correlation between AFR and DAS 28-ESR (r=-0.74, p<0.001). ROC curve analyses revealed fibrinogen showed the best sensitivity (92.1%) for the area under the curve of 0.928, at a criterion of 2.47, while AFR has an area under the curve of 0.826 with sensitivity and specificity (86.84% and 75%, respectively) at cut-off value 1.46. Actively diseased patients had elevated CAR than those in remission (P < 0.001). Patients with synovial thickening and bone erosions had lower AFR than those without, CAR was higher in patients with power doppler changes than those without (p=0.015).</p><p><strong>Conclusion: </strong>Higher CAR and lower AFR were expressed in active RA than those in remission. CAR and AFR could be useful markers of ongoing inflammation and joint affection detected by musculoskeletal ultrasonography.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"241-248"},"PeriodicalIF":2.1,"publicationDate":"2020-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S268668","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38683045","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, Echocardiographic Characteristics and Management Practices in Patients with Rheumatic Valvular Heart Disease.","authors":"Temesgen Mulugeta,&nbsp;Kabaye Kumela,&nbsp;Legese Chelkeba","doi":"10.2147/OARRR.S274519","DOIUrl":"https://doi.org/10.2147/OARRR.S274519","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) is the long-term consequence of acute rheumatic fever (ARF), continues unabated among middle-income and low-income countries. Thus, this study aimed to assess clinical characteristics, echocardiographic characteristics, and management practice of RHD patients.</p><p><strong>Methods: </strong>Hospital-based prospective cross-sectional study was used. The data were collected from medical records of consecutive patients admitted to medical wards during the study period. The data were cleaned and analyzed using SPSS version 20. Descriptive statistics were used to describe the data. Chi-square was used to compare proportions between categorical variables.</p><p><strong>Results: </strong>Forty-seven patients with a median (IQR) age of 28.0 (17.0-40.0) years were included. Pan systolic murmur was reported in 91.50% of patients. Forty-two (89.4%) of patients were presented with congestive heart failure and 23 (48.9%) with atrial fibrillation. Mitral valve leaflet thickening and calcification with restriction of motion were reported in 91.5% of patients. Mitral regurgitation (MR) (87.2%) and stenosis (MS) (85.1%) were the most common valvular lesions. The combinations of three (MR+MS+TR) 14 (29.8%) and four (MR+MS+TR+AR) 13 (27.7%) valve diseases were most commonly reported. Diuretics (95.7%), anticoagulants (38.3%), digoxin (36.2%), and beta-blockers (34.0%) were among the commonly prescribed medications.</p><p><strong>Conclusion: </strong>Rheumatic heart disease affected younger adults. Pansystolic murmur was reported in nearly all patients. Congestive heart failure and atrial fibrillation were common clinical presentations. Morphologic changes in mitral valve and pathologic mitral regurgitation were the most common echocardiographic reports. Cardiovascular medications were commonly utilized for symptomatic management of complications Therefore, echocardiography should be done routinely for patients with RHD, focusing on younger adults, to facilitate diagnosis and treatment before complications develop.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"233-239"},"PeriodicalIF":2.1,"publicationDate":"2020-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S274519","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38539778","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":"Assessment of Serum Lipid Profiles and High-sensitivity C-reactive Protein Among Patients Suffering from Rheumatoid Arthritis at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: A Cross-Sectional Study.","authors":"Gashaw Dessie,&nbsp;Yewondwossen Tadesse,&nbsp;Birhanu Demelash,&nbsp;Solomon Genet","doi":"10.2147/OARRR.S264466","DOIUrl":"https://doi.org/10.2147/OARRR.S264466","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by severe joint pain, swelling, damage, and disability which leads to joint destruction and loss of function. The complication of RA is associated with cardiovascular diseases, particularly due to systemic inflammation and dyslipidemia. The purpose of this study was to assess the development of atherosclerosis, which acts as a major risk factor for cardiovascular complications in RA patients.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted at the Rheumatology Clinic of Tikur Anbessa Specialized Hospital. The study made a comparison of risk factors (dyslipidemia and inflammatory status) between individuals having RA as a case group and apparently healthy individuals as a control group. Simple descriptive statistics, one-way ANOVA, independent sample <i>t</i>-test and multivariate analysis were utilized for statistical analysis. p-value of <0.05 at the 95% confidence level was considered as statistically significant.</p><p><strong>Results: </strong>The result of this study demonstrated that there was a significant elevation of mean ±SD of TC, TC/HDL, LDL/HDL, and lowered value of HDL-C was seen among RA patients than controls (<i>P</i>-value <0.05). The mean ±SD of inflammatory marker, high-sensitivity C-reactive protein (hsCRP), was significantly higher among RA patients compared to controls (<i>P</i><0.05). HDL-C had a significant negative correlation with a hsCRP whereas TC/HDL-C and LDL/HDL-C had a significant positive correlation with hsCRP (<i>P</i><0.05).</p><p><strong>Conclusion: </strong>In this study, RA patients had lipid abnormalities and elevated systemic inflammation than controls. An increase in hsCRP and dyslipidemia status among RA patients indicates the possible development of an atherosclerotic event. Therefore, assessment of lipid profiles and hsCRP in early RA patients may be helpful to assess the possible development of cardiovascular complications.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"223-232"},"PeriodicalIF":2.1,"publicationDate":"2020-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S264466","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38595575","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":"Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus.","authors":"Cherica A Tee, Evelyn O Salido, Patrick Wincy C Reyes, Roger C Ho, Michael L Tee","doi":"10.2147/OARRR.S269889","DOIUrl":"10.2147/OARRR.S269889","url":null,"abstract":"<p><strong>Background: </strong>Patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) are perceived to be more vulnerable to worse COVID-19 infection outcome. Furthermore, severe shortage in hydroxychloroquine supply was experienced.</p><p><strong>Objective: </strong>We presented the psychological responses of Filipino SLE and RA patients to the COVID-19 pandemic and shortage of hydroxychloroquine supply.</p><p><strong>Methods: </strong>A total of 512 completed online surveys from SLE and RA patients were gathered from May 19 to 26, 2020. The online survey collected data on socio-demographics, health status, contact history, health service utilization, use of hydroxychloroquine, COVID-19 knowledge and concerns, precautionary measures, information needs, the validated Impact of Events Scale-Revised (IES-R) and Depression, Anxiety and Stress Scales (DASS-21) ratings.</p><p><strong>Results: </strong>The psychological impact of COVID-19 outbreak was at least moderate in 20%. The mean IES-R score was higher among SLE (22.34, SD=14.39) than RA (18.85, SD=13.24) patients. Stress, anxiety and depression were moderate to severe in 12.3%, 38.7%, and 27.7% of respondents. The mean stress subscale score was 10.11 (SD=7.95), mean anxiety subscale score was 6.79 (SD=6.57) and mean depression subscale score was 9.03 (SD=8.77). The risk factors for adverse mental health during the COVID-19 pandemic include the presence of comorbidity of hypertension and asthma; being a healthcare worker; and presence of specific symptoms of myalgia, cough, breathing difficulty, dizziness and sore throat. The protective factors for mental health during the pandemic include satisfaction with available health information and wearing of face masks.</p><p><strong>Conclusion: </strong>In the third month of the pandemic in the Philippines, 20% of the respondents with lupus and RA experienced moderate to severe psychological impact. There was moderate to severe anxiety in 38.7% and moderate to severe depression in 27%. Identification of factors that affect mental health in lupus and RA is useful in implementation of effective psychological support strategies.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"215-222"},"PeriodicalIF":2.1,"publicationDate":"2020-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b0/cd/oarrr-12-215.PMC7520098.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38595574","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 Silicone Breast Implants, Breast Cancer and Anti-RNA Polymerase III Autoantibodies in Systemic Sclerosis: Case-Based Review.","authors":"Rossella De Angelis,&nbsp;Jacopo Di Battista,&nbsp;Gianluca Smerilli,&nbsp;Edoardo Cipolletta,&nbsp;Marco Di Carlo,&nbsp;Fausto Salaffi","doi":"10.2147/OARRR.S262428","DOIUrl":"https://doi.org/10.2147/OARRR.S262428","url":null,"abstract":"<p><p>Some case reports and small case series of patients with silicone breast implant (SBI) have reported the development of systemic sclerosis (SSc) many years later, despite conflicting evidence of this association in the literature. Recently, patients with SSc and anti-RNA polymerase III antibodies positivity have been associated with previous silicone implants and/or breast cancer, showing clinical features that differ from the classic SSc, such as rapid and diffuse cutaneous involvement and scleroderma renal crisis (SRC). The specific autoimmune reaction is not yet fully understood, although knowledge in this regard is increasing. We describe a case that can support these previous observations, strengthening this association which must be taken into account. Clinicians should be aware of this new clinical entity, given the widespread use of silicone implants.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"207-213"},"PeriodicalIF":2.1,"publicationDate":"2020-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S262428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38595573","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":"Tuberculosis Arthritis in the Wrist While Using Rituximab for Rheumatoid Arthritis Treatment.","authors":"Hasan Ulusoy,&nbsp;Özge Acar Cakan,&nbsp;Tibel Tuna","doi":"10.2147/OARRR.S268852","DOIUrl":"https://doi.org/10.2147/OARRR.S268852","url":null,"abstract":"<p><strong>Introduction: </strong>Data from clinical trials indicate that there are no increased risk of tuberculosis (TB) infections in rheumatoid arthritis (RA) patients while using rituximab (RTX). Herein, we report a RA patient who developed TB arthritis while using RTX.</p><p><strong>Case report: </strong>A 49-year-old patient was treated with methotrexate and prednisolone along with RTX for two years. Later, she presented with increasing pain, swelling, redness and cutaneous fistulization in her left wrist for two months. The lesion on the wrist was debritted. Histopathologic evaluation revealed the presence of acid-fast bacilli. Polymerase chain reaction test and culture confirmed mycobacterium tuberculosis. RTX, methotrexate and prednisolone were withdrawn. The patient was treated with 12-month course of antituberculous treatment and responded well. The patient, who did not have pain or swelling in her other joints, was not given any treatment for RA after antituberculous treatment.</p><p><strong>Conclusion: </strong>Clinicians should keep in mind that TB infections may be encountered while using RTX. Latent TB screening may be appropriate in patients using concomitant corticosteroid and living in TB endemic areas.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"203-206"},"PeriodicalIF":2.1,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S268852","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38427830","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":"Risk Factors Associated with Methotrexate Intolerance in Rheumatoid Arthritis Patients.","authors":"Haya Almalag,&nbsp;Hanan H Abouzaid,&nbsp;Lamya Alnaim,&nbsp;Jawza Albaqami,&nbsp;Rawan Al Shalhoub,&nbsp;Ibrahim Almaghlouth,&nbsp;Maha Dessougi,&nbsp;Amal Al Harthi,&nbsp;Mohamed Bedaiwi,&nbsp;Eman Alfi,&nbsp;Mohammed A Omair","doi":"10.2147/OARRR.S263287","DOIUrl":"https://doi.org/10.2147/OARRR.S263287","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate (MTX) Intolerance Severity Score (MISS) has been previously validated in the Arabic language and has helped to detect high levels of intolerance in rheumatoid arthritis (RA) patients. The aim of the current study was to evaluate patient and disease characteristics associated with a high risk of MTX intolerance.</p><p><strong>Materials and methods: </strong>A cross-sectional interview-based survey was conducted using adult RA patients as a study group, who were visiting a specialized rheumatology clinic at King Saud University Medical City. The Arabic MISS was used in this survey. Statistical analyses were performed to understand associations between MTX-intolerant and MTX-tolerant patients.</p><p><strong>Results: </strong>A total of 117 patients were involved in this study. Of those, 101 (86.3%) were females with a mean (SD) disease duration of 6.6 (5.7) years. The median (interquartile range (IQR)) Disease Activity Score-28 (DAS28) was 3.6 (3.6-4.1). MTX intolerance was observed in 55 (47%) patients. The most predominant component in patients with a positive test was the behavioral component. Intolerant patients had a higher median of pain (47.3 vs. 50.0; P = 0.010) and patient global assessment (50.0 vs. 60.0; P = 0.004) scales compared to those in tolerant patients. Additionally, MTX intolerance was associated with the female gender (adjusted odds ratio (AOR) 6.724; 95% CI 1.420, 31.843, P = 0.016), marital status (AOR 2.549; 95% CI 1.037, 6.270, P = 0.042) and DAS28 (AOR 1.612; 95% CI 1.032, 2.517, P = 0.036). There was no significant difference between the two groups in the remaining disease activity parameters, background therapies, seropositivity, and smoking status (P > 0.05).</p><p><strong>Conclusion: </strong>Patient characteristics, rather than disease activity, significantly impact MTX intolerance. Behavioral component is the main driver of intolerance. Intolerant patients have higher patient-reported outcomes. Qualitative studies are needed to explore causes and potential solutions to MTX intolerance.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"193-202"},"PeriodicalIF":2.1,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S263287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38525487","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":"Determination of the Relationship Between Kobayashi, Sano, and Egami Criteria and Prevalence of Intravenous Immunoglobulin Resistance and Coronary Artery Aneurysm in Iranian Children with Kawasaki Disease.","authors":"Niloufar Shashaani,&nbsp;Reza Shiari,&nbsp;Abdullah Karimi,&nbsp;Shima Salehi,&nbsp;Roxana Ghanaei,&nbsp;Mehrnoush Hassas Yeganeh,&nbsp;Sara Shiari,&nbsp;Khosro Rahmani,&nbsp;Vadood Javadi Parvaneh","doi":"10.2147/OARRR.S255138","DOIUrl":"https://doi.org/10.2147/OARRR.S255138","url":null,"abstract":"<p><strong>Introduction: </strong>Kawasaki disease (KD) is a systemic vasculitis that occurs mostly in children under five years old. Kawasaki affects the middle-size arteries, especially the coronary arteries. Therefore, without adequate treatment, it may cause coronary artery aneurysm in 25% of patients. The purpose of this study was to investigate the relationship between Kobayashi, Sano, and Egami criterions with coronary artery aneurysm in KD patients during the last ten years and to identify risk factors in patients with intravenous immunoglobulin (IVIG)-resistant and coronary artery aneurysms.</p><p><strong>Methodology: </strong>Medical records of 363 Kawasaki patients referred during 2008-2017 were reviewed. Patients' demographic data and Kobayashi, Sano, and Egami scores of each patient were calculated. Based on echocardiographic findings, cases of coronary artery aneurysm were determined. Sensitivity, specificity, positive and negative predictive value, and the accuracy of each criterion were determined to predicting IVIG resistance and detect coronary artery aneurysm.</p><p><strong>Results: </strong>There was a slight relationship between IVIG-resistance in Kawasaki children and its prediction based on the Kobayashi risk score, but no relationship was found between the Egami and Sano criteria. Sixty-three patients (17.4%) had coronary artery lesions (CALs) on time of diagnosis. There were no statistically significant differences between gender and mean age of children with and without CALs. Also, there was no significant relationship between coronary artery aneurysm in Kawasaki children and its prediction based on the above three risk factors. The area under the ROC-curve of all three risk measures of Kobayashi, Egami, and Sano indicated that all three criteria were not useful in predicting CALs.</p><p><strong>Conclusion: </strong>Despite the low accuracy of the three above criteria to predictive of patients with IVIG resistance, it seems that the variables of age, duration of fever, and C-reactive protein (CRP) are more useful than other variables and may be utilized to evaluate patients by establishing a more appropriate cut-off point.</p>","PeriodicalId":45545,"journal":{"name":"Open Access Rheumatology-Research and Reviews","volume":"12 ","pages":"187-192"},"PeriodicalIF":2.1,"publicationDate":"2020-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2147/OARRR.S255138","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38391633","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}