Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases最新文献

{"title":"The Usefulness of Antinuclear Antibody Multiplex Immunoassay for Screening of Rheumatological Diseases: A Real-World Population-Based Study.","authors":"Eman Hijaze, Talish Razi, Ronen Arbel, Shlomit Yaron, Iftach Sagy, Orit Rozenberg, Ziv Paz","doi":"10.1097/RHU.0000000000002372","DOIUrl":"10.1097/RHU.0000000000002372","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of BioPlex 2200 multiplex immunoassay (BI) for detecting antinuclear antibodies (ANA), compared with the gold standard, the indirect immunofluorescence assay (IIF), as a screening methodology for autoimmune diseases within a general population.</p><p><strong>Methods: </strong>Cross-sectional, database-based analysis of the Clalit Health Services nationwide registry. Data were extracted from the Clalit Health Services database between 2014 and 2023. We included adult outpatients without a known rheumatic disease who underwent both IIF and BI testing simultaneously, ordered for nonspecific signs and symptoms primarily by primary-care physicians.</p><p><strong>Results: </strong>Among the 391,366 individuals tested, 67% were female, and the median age at testing was 49 years. Annual ANA testing volume increased from 23,802 in 2014 to 76,898 in 2023 (3.2-fold). Of the total, 33,234 (8.4%) tests were false negatives (BI-negative while IIF-positive), 42,021 (10.7%) were false positives (BI-positive while IIF-negative), 302,439 (77.2%) were true negatives, and 13,672 (3.5%) were true positives. BI demonstrated a sensitivity of 29.1% (95% CI: 28.7-29.6) and a specificity of 87.8% (95% CI: 87.7-87.9). The positive predictive value was 24.5% and the negative predictive value 90.1%.</p><p><strong>Conclusion: </strong>Our findings do not support the use of the BI multiplex immunoassay as a primary ANA screening tool in the primary-care setting. On the basis of these findings, the Clalit Health Services laboratory network discontinued simultaneous IIF and BI testing.</p><p><strong>Key findings: </strong>The BI showed low sensitivity despite relatively high specificity, resulting in a substantial proportion of false-negative results compared with IIF. These findings indicate that it is not suitable as a primary screening tool for ANA in the primary-care setting.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"192-196"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160416","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":"Understanding Gaps in Methotrexate Education in the Adolescent and Young Adult Population.","authors":"Matthew Sholdice, Heather Bollegala, Meghan Pancucci, Karen Beattie, Michelle Batthish","doi":"10.1097/RHU.0000000000002380","DOIUrl":"10.1097/RHU.0000000000002380","url":null,"abstract":"<p><strong>Background: </strong>Adolescents and young adults (AYAs) with rheumatic diseases (RD) may face challenges accessing and understanding information about methotrexate (MTX) and certain lifestyle choices, including drinking alcohol, using drugs, and sexual activity. We aimed to determine the knowledge, behaviours, and informational needs of AYAs taking MTX regarding alcohol/drug use and contraception.</p><p><strong>Methods: </strong>AYAs 16 to 25 years old taking MTX completed a questionnaire codesigned by AYAs with RD. Questionnaires were accessed through rheumatology clinics and social media.</p><p><strong>Results: </strong>Of 58 respondents, 78% were females, and 85% had JIA. In assessing knowledge of MTX, 28% were unaware that MTX can cause liver damage, and 87% agreed that alcohol should be avoided when taking MTX. The majority (80%) stated that contraception should be used if a female is taking MTX. Approximately one-quarter were unaware of the risk of birth defects while taking MTX. In assessing behaviours, 37% report drinking an average of 1 to 5 alcoholic drinks weekly. Sexual activity was reported by 58% of respondents, and almost all used contraception. Discomfort discussing alcohol use and sexual activity with their rheumatologist was reported by 20% and 32%, respectively. Respondents preferred to receive information from their rheumatologist/health care provider, the internet, and educational pamphlets. One-third reported not having access to accurate information regarding managing MTX side effects.</p><p><strong>Conclusion: </strong>AYAs often participate in at-risk behaviours while on MTX, which they do not discuss often with their rheumatologist. This study identified gaps and educational opportunities about MTX for AYAs, which can be shared through health care providers, online resources, or pamphlets.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"169-175"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335470","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":"Prevalence of Attention Deficit Hyperactivity Disorder in Adult Patients With Fibromyalgia.","authors":"Sebastián Moyano, Waleska Berrios, Nuria Cámpora, Ángel Golimstok, Javier Eduardo Rosa, Enrique Roberto Soriano","doi":"10.1097/RHU.0000000000002369","DOIUrl":"10.1097/RHU.0000000000002369","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of attention deficit hyperactivity disorder (ADHD) in patients with fibromyalgia (FM) without a prior diagnosis of ADHD, compared with the general population, and to assess its relationship with FM impact.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted in adults diagnosed with FM (ACR 2016 criteria) without known cognitive impairment, compared with age-matched, sex-matched, and education-matched controls. Participants completed the Fibromyalgia Impact Questionnaire (FIQ-R), the Argentine version of the Health Assessment Questionnaire (HAQ-A), the Montreal Cognitive Assessment (MoCA) for cognitive impairment, the Conners Continuous Performance Test II (CPT II) for adult ADHD, and the Wender-Utah Rating Scale (WURS) for retrospective childhood ADHD symptoms. Cognitive and neuropsychological tests were performed by specialized staff from the neurology service. Statistical analysis included univariate tests and multivariate logistic regression.</p><p><strong>Results: </strong>Sixty FM patients and 71 controls were included. Adult ADHD was present in 61.7% of FM patients, with 48.6% undiagnosed in childhood. ADHD presence was not associated with higher FIQ-R or HAQ-A scores. Childhood ADHD symptoms were significantly associated with adult ADHD (OR: 62.3; p =0.003). FM patients had a higher prevalence of cognitive impairment (43.3% vs. 16.9%), childhood ADHD symptoms (31.7% vs. 14.1%), and adult ADHD (61.7% vs. 23.9%) compared with controls.</p><p><strong>Conclusions: </strong>Adult ADHD was highly prevalent in FM patients and often missed in childhood. Its presence was associated with prior childhood symptoms but not with greater disease impact or functional disability. FM patients also showed increased cognitive impairment and ADHD symptoms compared with the general population.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"182-187"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335476","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":"Efficacy and Safety of Intravenous Golimumab in Ankylosing Spondylitis Patients With Early and Late Disease Through One Year of the GO-ALIVE Study: Erratum.","authors":"","doi":"10.1097/RHU.0000000000002365","DOIUrl":"10.1097/RHU.0000000000002365","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e228"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379569","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":"Microbiome Dysbiosis as a Potential Driver of Inflammatory Mimicry in Pachydermoperiostosis-associated Hypertrophic Osteoarthropathy.","authors":"Muhammad Zeeshan Ghani, Pari Kotak, Amna Raza, Sai Han Htun","doi":"10.1097/RHU.0000000000002387","DOIUrl":"10.1097/RHU.0000000000002387","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e227"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379565","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":"Efficacy and Safety of Intravenous Golimumab in Patients With Ankylosing Spondylitis and Complete Spinal Ankylosis: Results Through Week 52 of the GO-ALIVE Study: Erratum.","authors":"","doi":"10.1097/RHU.0000000000002366","DOIUrl":"10.1097/RHU.0000000000002366","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e229"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379556","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":"Systemic Sclerosis-associated Interstitial Lung Disease at 2 Tertiary Centers in the USA and Greece: A Comparative Study of Demographics, Management, and Radiologic Progression.","authors":"Nikolaos Koletsos, Amit Syal, Nafsika Gerolymatou, Meryem Nursoy, Nikolaos Zintziovas, Konstantinos Parperis, Paraskevi V Voulgari, Chris T Derk","doi":"10.1097/RHU.0000000000002396","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002396","url":null,"abstract":"<p><strong>Objective: </strong>To compare demographics, clinical features, treatment approaches, and outcomes of patients with systemic sclerosis-interstitial lung disease (SSc-ILD) at 2 geographically distinct tertiary centers: the University of Pennsylvania (UPenn), USA, and the University of Ioannina (UOI), Greece.</p><p><strong>Methods: </strong>A cohort of 789 SSc patients (2013 ACR/EULAR criteria) was evaluated through medical records review at both institutions. Patients initially diagnosed with SSc-ILD between January 2020 and December 2024 with at least 72 weeks of follow-up were included. Sociodemographic, clinical, serological, and treatment data were systematically collected. ILD progression was defined as radiographic worsening on serial HRCT-comprising new or increased ground-glass opacification, reticulation, or traction bronchiectasis-as assessed at each center. PFTs were obtained at baseline and at 24, 48, and 72 weeks.</p><p><strong>Results: </strong>Sixty-six patients were included (35 UPenn, 31 UOI). Arthritis (32.3% vs. 11.4%) and anti-Scl-70 positivity (64.5% vs. 40.0%) were more frequent at UOI. UOI patients had higher rates of rituximab (35.5% vs. 5.7%) and corticosteroid use (77.4% vs. 42.9%). ILD progression at 48 weeks was significantly greater in UPenn (57.1% vs. 17.2%, p<0.001). UOI patients reached specialist care faster (median 0.25 vs. 1.2 y from SSc diagnosis, p=0.001). On multivariate analysis, dcSSc, male sex, and study center were independent predictors of ILD progression.</p><p><strong>Conclusions: </strong>This study compares SSc-ILD presentation, management, and outcomes at 2 tertiary centers. UPenn showed a higher radiologic ILD progression rate, likely due to baseline disease severity, treatment differences, and referral timing. Nonetheless, these findings are observational; prospective, internationally standardized studies are needed to confirm these results.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820512","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":"Sociodemographic Characteristics of Speakers at PANLAR Congresses: Is There a Homogeneous Sex Distribution?","authors":"Emilce E Schneeberger, Marina Scolnik, María L Brance, María C De la Vega, Alejandra M Babini, Gustavo Citera","doi":"10.1097/RHU.0000000000002400","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002400","url":null,"abstract":"<p><strong>Introduction: </strong>In recent years, PANLAR has addressed gender equity.</p><p><strong>Objectives: </strong>To analyze the characteristics of speakers participating in PANLAR congresses and to compare the distribution of speakers by gender.</p><p><strong>Methods: </strong>Speakers who participated in the annual PANLAR congresses from 2021 to 2024 were identified by reviewing the corresponding scientific programs. The following data were recorded: age, sex, nationality, country of residence, speaker category, type of participation (moderator, speaker at general conferences, or speaker at industry-sponsored symposia), years in the specialty, and workplace. Statistical analyses included descriptive statistics, the χ2 or Fisher exact test, and the Student t test.</p><p><strong>Results: </strong>A total of 430 speakers participated in the four annual PANLAR congresses held from 2021 to 2024. The median age was 48 years (IQR: 40 to 60), and 231 speakers (53.7%) were men. Of these, 337 were adult rheumatologists (79.3%). The main countries of origin of the speakers were Colombia (21.6%), Brazil (20.9%), and Argentina (13.7%). Among the speakers, 114 participated as moderators, 337 as speakers at general conferences, and 67 as speakers at pharmaceutical industry-sponsored symposia. Among rheumatologists who treated adult patients, the proportion of men was higher than that of women in both moderator roles and general conferences, although these differences were not statistically significant (men 58.4% vs. women 41.2%, and men 53.6% vs. women 46.4%, respectively; p=NS). Men participated significantly more often than women in pharmaceutical industry-sponsored symposia (men 71.4% vs. women 28.6%; p=0.005). The mean numbers of moderator roles, general lectures, and industry-sponsored symposia were also significantly higher among men than among women.</p><p><strong>Conclusion: </strong>Men accounted for a higher proportion of moderators and speakers at PANLAR annual meetings during the study period, with a more pronounced gender disparity in pharmaceutical industry-sponsored symposia.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805238","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":"Clinical Presentation and Longitudinal Outcomes of Individuals With Down Syndrome-Associated Arthritis in the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) Registry.","authors":"Jordan T Jones, Irene Chern, Julia Harris, Jade Singleton, Xing Wang","doi":"10.1097/RHU.0000000000002399","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002399","url":null,"abstract":"<p><strong>Background/objective: </strong>Down syndrome-associated arthritis (DA) is an underrecognized, inflammatory arthritis that occurs in individuals with Down syndrome. The clinical course, optimal treatment and outcomes are currently unclear. The objective of this study was to identify the clinical presentation and longitudinal outcomes of DA compared with those of juvenile idiopathic arthritis (JIA) using the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN) registry.</p><p><strong>Methods: </strong>A retrospective case-control study design matched patients with DA to those with JIA on age, gender, arthritis subtype, and medication exposure. Groups were compared at multiple visits (clinical and patient-reported outcomes). Mann-Whitney U test, Fisher's exact test, and generalized linear mixed-effect models were used to compare outcomes between groups.</p><p><strong>Results: </strong>Twenty patients with DA were matched to 100 with JIA. The average intervals between the first and last visits were 3.2 years and 4.6 years for those with JIA and DA, respectively. Most had polyarticular arthritis (70%), while those with DA had more comorbid autoimmune conditions (20% vs. 0%), but no uveitis (0% versus 4%). At the last visit, those with DA had lower arthritis disease activity scores compared with those with JIA [1.8 (2.5) vs. 3.9 (4.2); p=0.02]. The DA group had pain scores that improved over time and trended with disease activity scores. The JIA group had pain scores that increased over time and did not trend with disease activity scores.</p><p><strong>Conclusions: </strong>With similar disease severity and initial treatment, patients with DA have improved clinical outcomes over time with less active arthritis and reported pain compared with those with JIA.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805221","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":"Retroperitoneal Mass: B-Cell Lymphoma Mimicking Retroperitoneal Fibrosis.","authors":"Yoshinori Taniguchi, Hirotaka Yamamoto","doi":"10.1097/RHU.0000000000002398","DOIUrl":"https://doi.org/10.1097/RHU.0000000000002398","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148805246","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}