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

{"title":"Delays in Lupus Diagnosis and Treatment in the Southern Cone: A Qualitative Study of Patient and Rheumatologist Perspectives.","authors":"Muhammad Rafay Shahzad Cheema","doi":"10.1097/RHU.0000000000002360","DOIUrl":"10.1097/RHU.0000000000002360","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e189"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849268","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":"Developing and Piloting a Standardized Thermography Protocol to Expedite Rheumatology Referrals for Possible Inflammatory Arthritis.","authors":"Giovanna Rosas Chavez, Laura B Hughes, Rahima Begum, Jeffrey R Curtis, Maria I Danila","doi":"10.1097/RHU.0000000000002356","DOIUrl":"10.1097/RHU.0000000000002356","url":null,"abstract":"<p><strong>Objective: </strong>Inflammatory arthritis, especially rheumatoid arthritis (RA), imposes substantial morbidity that diminishes quality of life and escalates health care costs when left untreated. Timely diagnosis and treatment are pivotal. However, limited access to rheumatologists underscores the importance of triaging referrals based on symptom severity. We developed a protocol for using infrared thermography (IRT) to detect joint inflammation and implemented it in an academic primary care clinic as a screening tool for rheumatology referrals.</p><p><strong>Materials and methods: </strong>We enrolled people with RA, osteoarthritis (OA), and controls to undergo joint power doppler ultrasound (PDUS) and IRT. IRT image analysis employed manual segmentation with specialized software to determine surface joint temperatures. IRT temperature cutoff points using PDUS as the gold standard for joint inflammation were established. Subsequently, we recruited people with hand or foot joint pain and fast-tracked to rheumatology those surpassing IRT cutoff points for joint inflammation.</p><p><strong>Results: </strong>Thirty-two people with RA, 10 with OA, and 9 controls were enrolled. Most participants (86.3%) were females, and 37.3% were black. Temperature measurements showed robust interrater reliability. Cutoff points at metacarpophalangeal (MCP) (T center ≥32.93 °C, T mean ≥32.67 °C) and wrist (T center ≥33.76 °C, T mean ≥33.79 °C) joints discriminated between inflamed and noninflamed joints. Of the 20 pilot participants, N = 10 (50%) were referred to rheumatology using IRT findings, with N = 8 (80%) seen within 4 weeks. Diagnoses included osteoarthritis, gout, and calcium pyrophosphate deposition disease.</p><p><strong>Conclusion: </strong>IRT demonstrates potential as a reliable tool for identifying inflamed joints and offers a feasible pathway for identifying patients with joint-level thermal abnormalities who may benefit from expedited rheumatologic evaluation. Further research is needed to refine IRT-based rheumatology referral protocols and optimize their utilization.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e166-e172"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147944619","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":"Linear Gingival Erythema Presenting in Systemic Lupus Erythematous.","authors":"Brianna Ashley Green, Jimmy Lam","doi":"10.1097/RHU.0000000000002351","DOIUrl":"10.1097/RHU.0000000000002351","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e184"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335467","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":"Association Between Serum Syndecan-1 Levels and Relapse in Patients With Antineutrophil Cytoplasmic Antibody-associated Vasculitis: A Medical Record-based Cohort Study in Japan.","authors":"Makoto Yamaguchi, Hirokazu Sugiyama, Hiroshi Kinashi, Kentaro Imai, Keisuke Kamiya, Takayuki Katsuno, Takahiro Imaizumi, Shogo Banno, Yasuhiko Ito, Takuji Ishimoto","doi":"10.1097/RHU.0000000000002331","DOIUrl":"10.1097/RHU.0000000000002331","url":null,"abstract":"<p><strong>Background/objectives: </strong>Despite previous reports on the risk factors for relapse in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV), none have evaluated the relationship between serum syndecan-1 levels and AAV relapse. Therefore, this study aimed to investigate the association between serum syndecan-1 levels at AAV diagnosis and subsequent relapses in patients with AAV, hypothesizing that higher levels would be associated with increased risk of relapse.</p><p><strong>Methods: </strong>This single-center, medical record-based cohort study included 60 consecutive patients with microscopic polyangiitis or granulomatosis with polyangiitis treated at Aichi Medical University Hospital in Japan in 2018-2022. The relationship between serum syndecan-1 levels at diagnosis and subsequent first relapse was assessed using multivariable Cox proportional hazards models after adjusting for age, sex, estimated glomerular filtration rate, antineutrophil cytoplasmic antibody (ANCA) titers, Birmingham Vasculitis Activity Score, and AAV classification. The cumulative probability of relapse was calculated using the Kaplan-Meier method and log-rank test. Statistical significance was set at p <0.05.</p><p><strong>Results: </strong>During a median follow-up period of 48 (range, 24 to 64) months, 20 (33.3%) patients experienced at least one relapse. Patients with high-serum syndecan-1 levels (adjusted hazard ratio=19.0, 95% CI: 1.17-307.8) were associated with an increased risk of relapse compared with those with low serum syndecan-1 levels.</p><p><strong>Conclusions: </strong>Among patients with ANCA-associated vasculitis, high-serum syndecan-1 levels at diagnosis were associated with an increased risk of relapse.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"141-146"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147535509","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":"Frailty in Rheumatoid Arthritis: Associations With Performance Tests, Psychological Resilience, and the Geriatric 8 Screening Tool.","authors":"Bulent Akyuz, Oyku Tomay Aksoy, Gizem Basak, Betul Sena Cimen, Ramazan Mert, Ilhan Sezer","doi":"10.1097/RHU.0000000000002349","DOIUrl":"10.1097/RHU.0000000000002349","url":null,"abstract":"<p><strong>Objective: </strong>To compare frailty-related performance and G8 screening results between adults with rheumatoid arthritis (RA) and matched controls, and to examine associations of DAS28-CRP and resilience with these outcomes in RA.</p><p><strong>Methods: </strong>This cross-sectional study included 100 adults with RA and 100 age-matched and sex-matched controls. Participants completed timed up and go (TUG), 4-m gait speed, and G8. Within RA, multivariable models assessed continuous outcomes and prespecified thresholds (TUG ≥13.5 s, gait speed ≤0.8 m/s, G8 ≤14).</p><p><strong>Results: </strong>Compared with controls, the RA group had longer TUG times (11.4±4.4 vs. 6.6±2.9 s), slower gait speed (0.79±0.24 vs. 0.86±0.19 m/s), lower G8 scores (14.2±2.5 vs. 15.4±1.7), and more frequent G8 ≤14 (42% vs. 26%; all p ≤0.026). In RA, higher DAS28-CRP was associated with longer TUG time (12.6% increase, 95% CI: 6.5-19.1), lower gait speed (-0.06 m/s, 95% CI: -0.09 to -0.02), and lower G8 score (-0.62, 95% CI: -1.05 to -0.20). Higher resilience per 10-point increase was associated with shorter TUG time (-4.6%, 95% CI: -7.3 to -1.7), faster gait speed (0.03 m/s, 95% CI: 0.02-0.05), and higher G8 score (0.53, 95% CI: 0.35-0.71). Threshold-based analyses were directionally consistent.</p><p><strong>Conclusions: </strong>Adults with RA showed less favorable performance and G8 profiles than matched controls. Within RA, disease activity and resilience were independently associated with objective performance and G8 outcomes. Longitudinal studies are needed to determine temporal relationships and prognostic relevance.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e150-e158"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795168","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":"Real-world Clinical and Diagnostic Features of Patients With Isolated Anti-SSB Antibodies Compared With Those With Combined Anti-SSA and Anti-SSB Antibodies.","authors":"Massiel Jimenez, Asim Khanfar, Pratibha Chaudhary, Anthony Ocon","doi":"10.1097/RHU.0000000000002338","DOIUrl":"10.1097/RHU.0000000000002338","url":null,"abstract":"<p><strong>Background/objective: </strong>Anti-SSA and/or anti-SSB antibodies are commonly seen in Sjögren disease but lack disease specificity. Isolated anti-SSB may have a limited association with Sjögren, while dual anti-SSA/SSB positivity may indicate more severe disease. This study compared clinical and serologic features of patients with isolated anti-SSB versus dual anti-SSA/SSB positivity in a real-world setting.</p><p><strong>Methods: </strong>A retrospective medical records review study from January 1, 2018, to December 31, 2022, was conducted. Adults with positive serologic testing for anti-SSA and anti-SSB antibodies were included. Patients with isolated anti-SSA, negative repeat serology within 6 months, or insufficient data were excluded. Demographic data, clinical manifestations, autoantibody profiles, and diagnostic outcomes were compared. Continuous variables were analyzed using Student t test and categorical variables using χ 2 test; logistic regression was applied for odds ratios.</p><p><strong>Results: </strong>Three hundred fifteen patients were included: 109 with isolated anti-SSB and 206 with anti-SSA/SSB positivity. Compared with the dual-positive anti-SSA/anti-SSB, patients with isolated anti-SSB antibody were significantly less likely to exhibit anemia, leukopenia, proteinuria, or positive ANA. Other autoantibodies (anti-Smith, anti-RNP, RF, anti-CCP) were also less frequent in the isolated anti-SSB group. This group had lower rates of xerophthalmia and diagnoses of Sjögren disease, systemic lupus erythematosus, and rheumatoid arthritis, and were more often without a rheumatologic diagnosis.</p><p><strong>Conclusions: </strong>Isolated anti-SSB positivity is associated with a significantly lower likelihood of Sjögren disease, SLE, and RA. These findings suggest that isolated anti-SSB may lack diagnostic utility and could represent a clinically insignificant serologic finding in many patients.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"147-151"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597551","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":"Asymmetric Osteitis and Pustulosis.","authors":"Maria D Pascoal, Ana C Silva","doi":"10.1097/RHU.0000000000002348","DOIUrl":"10.1097/RHU.0000000000002348","url":null,"abstract":"","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e182-e183"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826057","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":"Association of the 2022 ACR/EULAR Classification Criteria for Eosinophilic Granulomatosis With Polyangiitis With Disease Activity and Damage Accrual: A Retrospective Cohort Study.","authors":"Erik Cimé-Aké, Eduardo Rojas-Milán, Gabriela Medina, María Del Pilar Cruz-Domínguez, Olga Vera-Lastra","doi":"10.1097/RHU.0000000000002335","DOIUrl":"10.1097/RHU.0000000000002335","url":null,"abstract":"<p><strong>Objective: </strong>To explore whether the 2022 ACR/EULAR Classification Criteria (2022 AECC) for eosinophilic granulomatosis with polyangiitis (EGPA) are associated with disease activity at diagnosis and damage accrual during follow-up in a real-world cohort.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including patients with a clinical diagnosis of EGPA and at least one year of follow-up. The 2022 AECC score was calculated at the time of diagnosis. Disease activity at baseline was assessed with the Birmingham Vasculitis Activity Score (BVAS), and damage at the last visit with the Vasculitis Damage Index (VDI); severe damage was defined as VDI ≥3. The performance of the AECC score for identifying patients with severe damage was examined descriptively.</p><p><strong>Results: </strong>Thirty patients were included. Their clinical features were broadly comparable to those described in previous EGPA cohorts. According to the 2022 AECC, 90% of patients met classification criteria, and 80% had severe damage. Higher AECC scores were more frequently observed in patients with obstructive airway disease, marked eosinophilia, and P-ANCA/anti-MPO positivity. The AECC score showed a positive correlation with BVAS at diagnosis (ρ=0.756, p <0.001) and with VDI at the last visit (ρ=0.663, p <0.001). The cutoff of 8 points appeared to discriminate against patients with severe damage.</p><p><strong>Conclusion: </strong>In this exploratory study, higher 2022 AECC scores at diagnosis were associated with greater disease activity and damage accrual. These findings should be interpreted as exploratory observations. A prospective evaluation of the clinical implications of classification scores beyond their intended purpose is needed.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"163-167"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147597538","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":"Systematic Review of Chimeric Antigen Receptor T-cell Therapy in Autoimmune Diseases.","authors":"Nicole Hershkowitz, Anna Andrzejczyk, Vincent DeStefano, Michael Schuster, Qingping Yao","doi":"10.1097/RHU.0000000000002354","DOIUrl":"10.1097/RHU.0000000000002354","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to systematically summarize available clinical data on the use of chimeric antigen receptor (CAR) T-cell therapy in autoimmune diseases (ADs).</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed and other literature databases to identify publications on CAR-T therapy in ADs published since 2020. Eligible studies included single-case reports and case series from clinical trials, while studies involving duplicated patient populations were excluded in accordance with PRISMA guidelines. Extractable patient-level data were analyzed for key clinical outcomes.</p><p><strong>Results: </strong>A total of 32 studies encompassing 124 patients with ADs who received CAR-T therapy were included. The primary diseases treated were systemic lupus erythematosus (SLE) and myasthenia gravis (MG), with smaller numbers of patients reported in other ADs. In SLE trials, 83% achieved clinical remission or low disease activity following CAR-T therapy, within the first few months following infusion. In MG trials, minimal symptom expression was achieved in 73%. CAR-T disappearance and B-cell reconstitution generally occurred within the first few months following infusion and were predominantly of a naïve phenotype. Mild cytokine release syndrome was the most common adverse event; serious adverse events were reported in 4.8% of patients without treatment-related deaths.</p><p><strong>Conclusion: </strong>Preliminary clinical evidence suggests that CAR-T therapy is associated with meaningful clinical response in selected ADs. Larger studies with standardized outcome measures and longer follow-up are needed to better define its safety and efficacy.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"e173-e181"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148160390","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":"Comparison of Clinical Features Between Early-onset (≤2 Years) and Later-onset Familial Mediterranean Fever.","authors":"Emine Özçelik, Yasemin Uğur Es, Şeyma Erdem Torun, Didem Öztürk, Sultan Nilay Yoğun, Merve Cansu Polat, Mehveş Işıklar Ekici, Elif Çelikel, Zahide Ekici Tekin, Şeyma Ertem, Cüneyt Karagöl, Banu Çelikel Acar","doi":"10.1097/RHU.0000000000002345","DOIUrl":"10.1097/RHU.0000000000002345","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to investigate differences between familial Mediterranean fever (FMF) patients with symptom onset at aged 2 years or younger and those with later onset, with a focus on clinical presentation, disease course, and treatment outcomes.</p><p><strong>Materials and methods: </strong>The medical records of FMF patients aged 0 to 18 years who were followed in the Pediatric Rheumatology Department between 2013 and 2024 were reviewed. Patients with symptom onset at aged 2 years or younger were classified as having early-onset, and patients with missing data or <6 months of follow-up were excluded.</p><p><strong>Results: </strong>A total of 1255 patients with FMF were divided into 2 groups according to the age at symptom onset: ≤2 years (early-onset FMF, n = 346) and >2 years (later-onset FMF, n = 909). Early-onset FMF patients exhibited longer diagnostic delays, higher attack frequency, and more frequent fever attacks compared with later-onset patients ( p < 0.05). Disease severity and the prevalence of colchicine-resistant FMF were higher in the early-onset group ( p = 0.021 and p = 0.002). M694V homozygosity was more common among early-onset FMF patients (29.9% vs. 22.1%, p = 0.005). In multivariate analysis, a family history of colchicine-resistant FMF (OR = 2.64, 95% CI: 1.48-4.71) and fever (OR = 3.05, 95% CI: 2.12-4.40) were identified as independent predictors of early disease onset FMF.</p><p><strong>Conclusion: </strong>Early-onset FMF is associated with a more severe clinical presentation, including higher disease severity, increased colchicine resistance, and a greater frequency of M694V homozygosity. A family history of colchicine-resistant FMF is an independent predictor of early onset, highlighting the importance of detailed family history assessment in clinical practice.</p>","PeriodicalId":520664,"journal":{"name":"Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases","volume":" ","pages":"157-162"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147950643","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}