Modern rheumatology case reports最新文献_第2页

A case of Schnitzler syndrome complicated by rheumatoid arthritis treated with methotrexate. 甲氨蝶呤治疗Schnitzler综合征合并类风湿关节炎1例。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf026

Kensuke Irino, Yu Kochi, Sakurako Imamura, Chika Nabeshima, Naoya Oka, Takuya Sawabe

{"title":"A case of Schnitzler syndrome complicated by rheumatoid arthritis treated with methotrexate.","authors":"Kensuke Irino, Yu Kochi, Sakurako Imamura, Chika Nabeshima, Naoya Oka, Takuya Sawabe","doi":"10.1093/mrcr/rxaf026","DOIUrl":"10.1093/mrcr/rxaf026","url":null,"abstract":"Schnitzler syndrome (SchS) is a rare autoinflammatory disorder characterised by recurrent urticaria, monoclonal gammopathy, fever, and arthralgia. We herein report a case of SchS complicated by rheumatoid arthritis (RA). A 78-year-old man presented to our hospital with fever, myalgia, and urticaria, each lasting for ~1 week over the past 8 years. He was diagnosed with SchS based on monoclonal immunoglobulin G gammopathy, chronic urticaria, an intermittent fever, arthritis, high inflammatory markers, and neutrophil infiltration in the dermis on skin biopsy. Although colchicine improved the symptoms slightly, the patient subsequently developed arthritis and was diagnosed with RA based on elevated anti-cyclic citrullinated peptide antibody and rheumatoid factor levels. Methotrexate (MTX), a first-line therapy for RA, was initiated, resulting in a remarkable improvement in both RA and SchS symptoms. This case highlights the rare coexistence of SchS and RA as well as the efficacy of MTX in treating both conditions. Although interleukin (IL)-1 inhibitors are considered the most effective treatment for SchS, they are not approved for SchS in Japan and are expensive. The efficacy of IL-6 inhibitors in SchS has also been reported, and MTX suppresses inflammatory cytokines, including IL-1 and IL-6. As shown in our case, drugs that modulate IL-6 levels, such as MTX, may be a viable treatment option for SchS.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164399","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}

引用次数: 0

Utility of external fixation for traumatic periprosthetic fracture after total ankle arthroplasty in patients with rheumatoid arthritis: A report of two cases. 类风湿性关节炎患者全踝关节置换术后创伤性假体周围骨折外固定的实用性：两个病例的报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae084

Gensuke Okamura, Takaaki Noguchi, Yuki Etani, Kosuke Ebina, Seiji Okada, Jun Hashimoto, Makoto Hirao

引用次数: 0

Macrophage migration inhibitory factor as a potential 'missing important factor' driving inflammatory arthritis in adrenocorticotropic hormone deficiency. 巨噬细胞迁移抑制因子是促肾上腺皮质激素缺乏症引发炎症性关节炎的潜在 "缺失的重要因素"。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae070

Lisa Wang, Akihiro Nakamura

引用次数: 0

Intracranial invasion of granulomatous sinusitis: report of a rare case of granulomatosis with polyangiitis. 肉芽肿性鼻窦炎颅内侵犯：一例罕见的肉芽肿病合并多血管炎。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf058

Takumi Saito, Wataru Nakamura, Yujin Nishioka, Erika Matsuda, Mariko Yamana, Rina Takahashi, Masahiro Kogami, Ayako Makiyama, Goh Murayama, Yoshiyuki Abe, Takuo Hayashi, Makio Kusaoi, Kurisu Tada, Ken Yamaji, Naoto Tamura

{"title":"Intracranial invasion of granulomatous sinusitis: report of a rare case of granulomatosis with polyangiitis.","authors":"Takumi Saito, Wataru Nakamura, Yujin Nishioka, Erika Matsuda, Mariko Yamana, Rina Takahashi, Masahiro Kogami, Ayako Makiyama, Goh Murayama, Yoshiyuki Abe, Takuo Hayashi, Makio Kusaoi, Kurisu Tada, Ken Yamaji, Naoto Tamura","doi":"10.1093/mrcr/rxaf058","DOIUrl":"10.1093/mrcr/rxaf058","url":null,"abstract":"The involvement of the central nervous system with granulomatosis with polyangiitis (GPA) is uncommon, and the formation of intracranial mass lesions is particularly rare. We describe the case of a Japanese woman in her thirties with GPA initially limited to the upper respiratory tract. Twelve years after the disease was onset, brain magnetic resonance imaging revealed a lobulated mass in the frontal lobe, and computed tomography findings suggested direct extension of granulomatous inflammation from the paranasal sinuses through the cribriform plate. Due to the risk of infection associated with cribriform plate destruction, surgical resection was performed for both diagnostic and preventive purposes. Histopathological examination of the resected intracranial lesion revealed necrotising granulomas without evidence of infection, consistent with GPA. Postoperatively, a moderate dose of prednisolone and rituximab was administered, resulting in clinical and serological remission. This case highlights a rare intracranial manifestation of GPA caused by direct contiguous spread from the paranasal sinuses, which can occur in the absence of systemic symptoms. Although sinonasal involvement is typically regarded as non-severe, the presence of bony destruction may signal a potentially organ-threatening course.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088667","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}

引用次数: 0

Effective use of ultra-high molecular weight polyethylene cable and Krackow suture for stretched out patellar tendon due to scarring in a case with rheumatoid arthritis post-total knee arthroplasty. 超高分子量聚乙烯电缆和Krackow缝线有效治疗类风湿性关节炎全膝关节置换术后瘢痕性髌腱拉伸1例。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae074

Eiji Kinoshita, Naoki Kondo, Osamu Tanifuji, Rika Kakutani, Nariaki Hao, Hiroyuki Kawashima

{"title":"Effective use of ultra-high molecular weight polyethylene cable and Krackow suture for stretched out patellar tendon due to scarring in a case with rheumatoid arthritis post-total knee arthroplasty.","authors":"Eiji Kinoshita, Naoki Kondo, Osamu Tanifuji, Rika Kakutani, Nariaki Hao, Hiroyuki Kawashima","doi":"10.1093/mrcr/rxae074","DOIUrl":"10.1093/mrcr/rxae074","url":null,"abstract":"Patellar tendon rupture is a severe complication following total knee arthroplasty (TKA). We encountered a case of rheumatoid arthritis with an incomplete rupture of the patellar tendon post-TKA. An 84-year-old woman was diagnosed with an incomplete rupture of the right patellar tendon 3 months post-TKA of her right knee. The patient exhibited a 45° extension lag 6 months post-TKA, necessitating reconstruction surgery. Intraoperative findings revealed incomplete rupture of the patellar tendon that was stretched out, diagnosed as incomplete patellar tendon rupture. Due to knee valgus instability (passive knee valgus showed 20°), the thickness of the tibial insert was adjusted from 11 to 15 mm, resulting in improved valgus instability. The scarring region of the patellar tendon was resected to 10 mm in length, and the tendon was repaired using an ultra-high molecular weight polyethylene cable (Nesplon cable) and Krackow suture. The repair was secured by making an 8-figure pattern with the cable. After the reconstruction surgery, the knee was immobilised at 0° extension for 3 weeks, followed by the initiation of range-of-motion exercises. Three months later, the extension lag was reduced to -15°, and the patient could walk without orthosis and reported neither instability nor surgical site infection at 8 months after the surgery. In conclusion, this case is notable due to the rarity of incomplete (stretched out) patellar tendon rupture post-TKA and demonstrates the effectiveness of Nesplon cable with Krackow suture in reconstruction surgery.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815391","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}

引用次数: 0

A case report of a 14-year-old male patient with large vessel vasculitis following COVID-19. 14岁男性新冠肺炎合并大血管炎1例报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae081

Hiroki Nemoto, Yoshihiro Nozaki, Takashi Matsumoto, Kaori Kiyoki, Takumi Ishiodori, Atsushi Morita, Kazuo Imagawa, Takashi Murakami, Miho Takahashi, Hironori Imai, Hidetoshi Takada

{"title":"A case report of a 14-year-old male patient with large vessel vasculitis following COVID-19.","authors":"Hiroki Nemoto, Yoshihiro Nozaki, Takashi Matsumoto, Kaori Kiyoki, Takumi Ishiodori, Atsushi Morita, Kazuo Imagawa, Takashi Murakami, Miho Takahashi, Hironori Imai, Hidetoshi Takada","doi":"10.1093/mrcr/rxae081","DOIUrl":"10.1093/mrcr/rxae081","url":null,"abstract":"Most reported cases of large vessel vasculitis (LVV) following coronavirus disease 2019 (COVID-19) have involved adults, with paediatric cases being rare. We present the case of a 14-year-old boy who developed LVV following COVID-19. Initially, he presented with fever and cough, and nasopharyngeal polymerase chain reaction testing confirmed COVID-19. His symptoms spontaneously resolved without specific COVID-19 treatments. However, 10 days after contracting COVID-19, his fever recurred and his inflammatory markers were significantly elevated. His condition did not meet the criteria for Kawasaki disease or multisystem inflammatory syndrome in children associated with COVID-19. Contrast-enhanced computed tomography revealed arterial wall thickening in the aorta and carotid arteries, indicative of LVV. Upon initiation of high-dose immunoglobulin therapy and aspirin, his fever subsided and his inflammatory markers and imaging findings normalised. Differential diagnosis ruled out infections, immune disorders, and Takayasu arteritis (TAK), a common cause of aortitis in children. Over a 1-year follow-up period, there were no recurrence and no stenotic lesions in large vessels. This finding suggests that the patient experienced transient LVV following COVID-19. Cytokine profile analysis performed before and after treatment revealed elevated levels of interleukin (IL)-6, IL-8, and IL-12/IL-23p40, typically associated with the active phase of TAK. Importantly, IL-17A and tumour necrosis factor-α levels were normal, as elevations in these cytokines have been linked to TAK recurrence. Notably, some cases of LVV following COVID-19 do not respond well to treatment; further research, including case accumulation and cytokine profile analysis, is needed to better predict prognosis.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815435","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}

引用次数: 0

MPO-ANCA-positive eosinophilic granulomatosis with polyangiitis complicated by alveolar haemorrhage treated with mepolizumab as an induction therapy: Case report. mpo - anca阳性嗜酸性粒细胞肉芽肿病合并多血管炎合并肺泡出血，mepolizumab作为诱导治疗：病例报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxae088

Mana Yoshida, Shigeru Iwata, Kayoko Tabata, Aya Hashimoto, Ryo Matsumiya, Katsunori Tanaka, Ryuta Iwamoto, Masatoshi Jinnin, Takao Fujii

{"title":"MPO-ANCA-positive eosinophilic granulomatosis with polyangiitis complicated by alveolar haemorrhage treated with mepolizumab as an induction therapy: Case report.","authors":"Mana Yoshida, Shigeru Iwata, Kayoko Tabata, Aya Hashimoto, Ryo Matsumiya, Katsunori Tanaka, Ryuta Iwamoto, Masatoshi Jinnin, Takao Fujii","doi":"10.1093/mrcr/rxae088","DOIUrl":"10.1093/mrcr/rxae088","url":null,"abstract":"Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis preceded by bronchial asthma or allergic sinusitis and accompanied by peripheral blood eosinophilia. Immunosuppressive drugs, such as cyclophosphamide in addition to high-dose glucocorticoids (GCs), are recommended for induction of remission in patients with severe EGPA. Although mepolizumab is widely recognised as remission induction therapy in nonfatal/nonorgan disabling or relapsed/refractory EGPA, its efficacy and safety in induction of remission for severe cases have been ambiguous. In this context, we report a case of myeloperoxidase antineutrophil cytoplasmic antibody-positive severe EGPA in which the patient had a favourable course using mepolizumab as an induction remission therapy. The patient, a 74-year-old man, had myeloperoxidase antineutrophil cytoplasmic antibody-positive severe EGPA with alveolar haemorrhage. High-dose GCs and intravenous cyclophosphamide were started as remission induction therapy. However, after the initiation of intravenous cyclophosphamide, alveolar haemorrhage worsened, and there was development of opportunistic infections, such as aspergillus and cytomegalovirus antigenaemia. Treatment with the antifungal drug voriconazole and the antiviral drug ganciclovir was started for opportunistic infection, and the treatment for EGPA was switched from intravenous cyclophosphamide to mepolizumab. As a result, alveolar haemorrhage improved, GCs were reduced, and the infection also improved. Mepolizumab as remission induction therapy for severe EGPA were thought to be appropriate and effective treatment in this case. However, the efficacy and safety of mepolizumab for this purpose require comprehensive evaluation.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873758","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}

引用次数: 0

Successful switching treatment of mepolizumab for refractory eosinophilic granulomatosis with polyangiitis and multiple organ dysfunction under benralizumab treatment: A case report. 在贝那利珠单抗治疗下，mepolizumab成功转换治疗难治性嗜酸性肉芽肿病合并多血管炎和多器官功能障碍：1例报告。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf008

Toshitaka Yukishima, Haruka Yonezawa, Yuya Aono, Kazuyuki Yamaguchi, Yoshiro Otsuki, Shin-Ichiro Ohmura

{"title":"Successful switching treatment of mepolizumab for refractory eosinophilic granulomatosis with polyangiitis and multiple organ dysfunction under benralizumab treatment: A case report.","authors":"Toshitaka Yukishima, Haruka Yonezawa, Yuya Aono, Kazuyuki Yamaguchi, Yoshiro Otsuki, Shin-Ichiro Ohmura","doi":"10.1093/mrcr/rxaf008","DOIUrl":"10.1093/mrcr/rxaf008","url":null,"abstract":"Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare necrotising vasculitis affecting small vessels accompanied by eosinophilic inflammation. Biological therapies, particularly anti-interleukin-5 (IL-5) monoclonal antibodies, have been shown to be effective in treating refractory EGPA. Mepolizumab, an anti-IL-5 monoclonal antibody, has been approved in Japan for the treatment of EGPA and has a significant glucocorticoid-sparing effect. Benralizumab, an anti-IL-5 receptor monoclonal antibody, has also been reported to reduce the glucocorticoid dose in patients with EGPA. However, several investigators have reported the development of EGPA during biologic treatment. Herein, we present a case of development of refractory EGPA under benralizumab treatment. Although the initial treatment with high-dose glucocorticoids and the administration of benralizumab were temporally effective, the patient's condition did not improve, and the eosinophil count reelevated. After switching benralizumab to mepolizumab, the patient's condition improved, and remission was achieved. Our report suggested that mepolizumab may be an effective treatment option for refractory EGPA after failure of benralizumab treatment.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043965","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}

引用次数: 0

Coexistence of eosinophilic fasciitis and systemic lupus erythematosus: a case-based review. 嗜酸性筋膜炎和系统性红斑狼疮共存：基于病例的回顾。

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf052

Rajat Kumar Sahu, Kishan Majithiya, Abhishek Gollarahalli Patel, Vishal Anand, Nishant Kamble, Prasanna Kumar Dogga, Urmila Dhakad

{"title":"Coexistence of eosinophilic fasciitis and systemic lupus erythematosus: a case-based review.","authors":"Rajat Kumar Sahu, Kishan Majithiya, Abhishek Gollarahalli Patel, Vishal Anand, Nishant Kamble, Prasanna Kumar Dogga, Urmila Dhakad","doi":"10.1093/mrcr/rxaf052","DOIUrl":"10.1093/mrcr/rxaf052","url":null,"abstract":"Eosinophilic fasciitis involves collagenous thickening of the subcutaneous fascia, hypergammaglobulinaemia, and peripheral eosinophilia, manifesting as erythema and oedema of the extremities and trunk. Rarely, it coexists with systemic lupus erythematosus. Eosinophilic fasciitis mimics scleroderma, making early diagnosis crucial. Its association with paraproteinaemia necessitates prompt recognition and treatment. Here, we report the case of a 56-year-old female with systemic lupus erythematosus in remission with methotrexate and hydroxychloroquine who presented with a 1-month history of sudden-onset, progressive skin tightening of the extremities and trunk. There was no history of Raynaud's phenomenon, digital ischaemia, or contractures. Based on histopathology and magnetic resonance imaging findings, eosinophilic fasciitis was diagnosed. She responded significantly to treatment with glucocorticoids and mycophenolate mofetil. This case adds to the evidence of eosinophilic fasciitis in lupus. The diagnosis was based on clinical, imaging, and biopsy findings, emphasizing its link to other connective tissue disorders. Future research should explore larger datasets and innovative treatments.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839536","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}

引用次数: 0

Scleroderma renal crisis with overlap to dermatomyositis triggered by COVID-19 infection: a case report. COVID-19感染引发的硬皮病肾危象合并皮肌炎1例

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Modern rheumatology case reports Pub Date : 2025-07-25 DOI: 10.1093/mrcr/rxaf040

Takuya Kakutani, Hideaki Harada, Yutaro Imoto, Kyohei Momoura, Riko Kamada

引用次数: 0