Modern rheumatology case reports最新文献_第9页

A case of juvenile-onset ankylosing spondylitis effectively treated with tumour necrosis factor-alpha inhibitor agents. 一例使用肿瘤坏死因子-α抑制剂有效治疗的幼年强直性脊柱炎病例。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae006

Akira Sakaguchi, Naoki Kondo, Rika Kakutani, Eiji Kinoshita, Yasufumi Kijima, Hiroyuki Kawashima

{"title":"A case of juvenile-onset ankylosing spondylitis effectively treated with tumour necrosis factor-alpha inhibitor agents.","authors":"Akira Sakaguchi, Naoki Kondo, Rika Kakutani, Eiji Kinoshita, Yasufumi Kijima, Hiroyuki Kawashima","doi":"10.1093/mrcr/rxae006","DOIUrl":"10.1093/mrcr/rxae006","url":null,"abstract":"A 15-year-old girl had experienced hip pain at 11 years of age. At 15 years of age, the patient complained of persistent generalised pain. Her rheumatoid factor and serum matrix metalloproteinase-3 levels were below standard values; there were no inflammatory responses, and the human leukocyte antigen test was negative for B27 and positive for B52 and B62. The bath ankylosing spondylitis disease activity index (BASDAI) value was 8.0 at the time of induction and 3.1 at 6 months after the introduction of adalimumab (at a dose of 40 mg). The BASDAI value improved with an increase in the dose of adalimumab to 80 mg at 8 months after the initial introduction of adalimumab (at 40 mg), although it remained at 4.8 at 16 months after the dose increase. The BASDAI value was 2.6 at 6 months, 2.7 at 1 year, and 1.8 at 1.5 years after the introduction of infliximab, indicating that the patient had progressed well without any adverse events. Based on this case, juvenile ankylosing spondylitis is a differential diagnosis for low back pain and generalised pain since childhood. Tumour necrosis factor (TNF) inhibitors were promptly introduced in this case, although it took 4 years from the initial presentation. TNF inhibitors were effective in treating juvenile ankylosing spondylitis in the present case without any adverse events. This case is notable because juvenile onset ankylosing spondylitis is one of the reasons for severe lumbago since childhood and because TNF inhibitors were administered promptly after diagnosis.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"259-263"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725470","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

Treatment for complete extensor tendon rupture: A case report on extensor pollicis longus tendon transfer and tenodesis procedure to radius for a patient with rheumatoid arthritis. 伸肌腱完全断裂的治疗：类风湿性关节炎患者伸拇肌肌腱转移和桡骨腱鞘切除术的病例报告。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae015

Kazuhiro Kohata, Takafumi Miyake, Yutaka Morizaki, Takahiro Sasaki, Sakae Tanaka

{"title":"Treatment for complete extensor tendon rupture: A case report on extensor pollicis longus tendon transfer and tenodesis procedure to radius for a patient with rheumatoid arthritis.","authors":"Kazuhiro Kohata, Takafumi Miyake, Yutaka Morizaki, Takahiro Sasaki, Sakae Tanaka","doi":"10.1093/mrcr/rxae015","DOIUrl":"10.1093/mrcr/rxae015","url":null,"abstract":"The complete loss of finger extension leads to significant inconvenience in daily life and often requires surgical treatment. Despite some disadvantages, the Boyes method, which uses the flexor digitorum superficialis tendon, is commonly performed for complete extensor rupture. We report the case of a 73-year-old woman living alone diagnosed with a subcutaneous rupture of all extensor tendons from the index to the little finger. The favourable range of motion of her wrist allowed us to perform extensor tenodesis. Additionally, the patient had a dislocated thumb interphalangeal (IP) joint, enabling us to use the extensor pollicis longus tendon for tendon transfer in combination with thumb IP joint fusion. The patient demonstrated favourable finger range-of-motion outcomes at the 6-month postoperative assessment. The case shows that extensor pollicis longus tendon transfer and tenodesis may be a viable treatment option for patients with complete extensor rupture accompanied by thumb IP joint deformity and normal wrist range of motion.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"237-242"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320312","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

Long-term clinical course of two rare cases of synovitis-acne-pustulosis-hyperostosis-osteomyelitis syndrome involving only unilateral femur. 两例仅累及单侧股骨的滑膜炎-痤疮-脓疱病-骨质增生-骨髓炎综合征罕见病例的长期临床过程。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae024

Hiroki Ito, Yuji Hirano

{"title":"Long-term clinical course of two rare cases of synovitis-acne-pustulosis-hyperostosis-osteomyelitis syndrome involving only unilateral femur.","authors":"Hiroki Ito, Yuji Hirano","doi":"10.1093/mrcr/rxae024","DOIUrl":"10.1093/mrcr/rxae024","url":null,"abstract":"Synovitis-acne-pustulosis-hyperostosis-osteomyelitis (SAPHO) syndrome is characterised by aseptic osteitis and is often complicated by pustular dermatitis, such as palmoplantar pustulosis or acne. Although bone lesions are most found in the anterior thoracic region or spine, femoral lesions are not well documented in the literature. There is no established treatment for this condition, and few reports have described its long-term course. Here, we describe two cases of SAPHO syndrome involving the femur and discuss their long-term follow-up. A 40-year-old man (Case 1) presented with right thigh pain. Fifteen years after the initial diagnosis, the pain could be controlled with minomycin, salazosulfapyridine, and methotrexate. X-rays of the femur showed gradual cortical thickening. Although there were waves of pain, it gradually improved with the adjustment of drugs 25 years following the initial diagnosis. A 35-year-old man (Case 2) with right thigh pain was prescribed salazosulfapyridine and methotrexate; however, these were ineffective. Alendronate and guselkumab also proved ineffective. Ultimately, infliximab was started 9 years following disease onset, and pain became manageable. X-rays of the femur showed cortical thickening. SAPHO syndrome can be managed with drug therapies, such as nonsteroidal anti-inflammatory drugs, methotrexate, and conventional synthetic disease-modifying antirheumatic drugs; however, there are occasional treatment-resistant cases.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"373-377"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924120","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

Urinary bladder involvement in IgG4-related disease: A case-based review. IgG4 相关疾病的膀胱受累：病例回顾

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae011

Parag Vijayvergia, Sayan Mukherjee, Lily Singh, Urmila Dhakad

{"title":"Urinary bladder involvement in IgG4-related disease: A case-based review.","authors":"Parag Vijayvergia, Sayan Mukherjee, Lily Singh, Urmila Dhakad","doi":"10.1093/mrcr/rxae011","DOIUrl":"10.1093/mrcr/rxae011","url":null,"abstract":"Immunoglobulin G4-related disease (IgG4-RD) is an immune-driven fibroinflammatory disease that presents as tumefactive lesions that not only commonly affects the pancreas, lacrimal and salivary glands, lung, liver and kidney but can also affect any organs. However, involvement of the urinary bladder in IgG4-RD is rarely reported. We describe a case of IgG4-RD involving the urinary bladder mimicking carcinoma and review the published literature-a 39-year-old male presented with complaints of dysuria, urgency and hesitancy. Ultrasound revealed a hyperechoic lesion protruding from the anterior of the urinary bladder wall with partial obstruction to bladder outflow, likely to be a pedunculated bladder mass with high suspicion for malignancy. A contrast-enhanced computed tomography abdomen showed a large irregular lobulated heterogeneously enhancing lesion involving the anteroinferior wall of the urinary bladder extending from mid-body up to the neck region with significant perivesical fat stranding and multiple ill-defined perivesical deposits along with hypodense soft tissue lesion in the perigastric region at the level of the body of the stomach. CT-guided perigastric and ultrasound-guided biopsy from the urinary bladder mass confirmed the diagnosis of IgG4-RD. The patient was treated with glucocorticoids. He is doing well after a 1-year follow-up without recurrence, and a repeat ultrasound showed a significant reduction in the size of the urinary bladder mass. The diagnosis of IgG4-RD should be considered in the differential diagnosis of a urinary bladder mass. High index of suspicion and prompt initiation of therapy are required to minimise residual damage and the need for surgical intervention.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"344-347"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308454","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

Unprecedented coexistence of autoinflammatory myositis and chronic thrombosis with heterozygotic M694V mutation: An atypical presentation of familial Mediterranean fever. 史无前例的自体炎性肌炎和慢性血栓形成与杂合子 M694V 突变共存：家族性地中海热的非典型表现。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxad072

Furkan Bahar, Serdal Ugurlu

{"title":"Unprecedented coexistence of autoinflammatory myositis and chronic thrombosis with heterozygotic M694V mutation: An atypical presentation of familial Mediterranean fever.","authors":"Furkan Bahar, Serdal Ugurlu","doi":"10.1093/mrcr/rxad072","DOIUrl":"10.1093/mrcr/rxad072","url":null,"abstract":"Familial Mediterranean Fever (FMF) is a hereditary autoinflammatory disorder predominantly characterised by periodic fever, abdominal pain, and joint manifestations. It can exhibit various atypical presentations. However, cases of FMF concurrently presenting with chronic thrombosis and myositis have not been previously reported. A 41-year-old male presented with alternating severe bilateral leg pain, stiffness, and localised swellings without fever or abdominal symptoms. His history included inflammatory joint pain treated with prednisolone. Physical examination revealed leg pain, limited ankle joint movement, and tender swellings in thighs, forearms, and feet. Collateral abdominal veins were also observed. Unresponsive to prednisolone and colchicine, the patient underwent MRI, revealing muscle inflammation in both legs and thighs and chronic thrombosis in the infrarenal inferior vena cava. Genetic testing confirmed the heterozygotic M694V mutation, diagnosing an atypical FMF. This case uniquely showcases coexisting myositis and chronic thrombosis in FMF. Myalgia is common in FMF, with M694V mutation associated with severe muscular symptoms. The lack of fever and myositis findings differentiate our case from protracted febrile myalgia syndrome. FMF's chronic inflammatory state is known to influence thrombosis risk, and our findings align with this association. Chronic thromboembolism and myositis together signify an unusual clinical presentation of FMF. This case highlights the potential for FMF to present with complex manifestations beyond the conventional symptoms. Myositis and vascular involvement should prompt consideration of FMF diagnosis when combined with patient history, clinical features, and laboratory results. These rare associations underscore the need for further research to enhance understanding of FMF's diverse clinical spectrum.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"383-385"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833786","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

Neuro-Behçet's disease with atypical subcortical nodular lesions: A case report and treatment approach. 伴有非典型皮层下结节性病变的神经-贝赫切特病：病例报告和治疗方法。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxad070

Kiyomi Yoshimoto, Tadanao Kobayashi, Hidetoshi Matsuoka, Nobushiro Nishimura, Hiromasa Kawashima, Ryo Yoneima, Emiko Tsushima, Shiro Ono, Kenji Nishio

{"title":"Neuro-Behçet's disease with atypical subcortical nodular lesions: A case report and treatment approach.","authors":"Kiyomi Yoshimoto, Tadanao Kobayashi, Hidetoshi Matsuoka, Nobushiro Nishimura, Hiromasa Kawashima, Ryo Yoneima, Emiko Tsushima, Shiro Ono, Kenji Nishio","doi":"10.1093/mrcr/rxad070","DOIUrl":"10.1093/mrcr/rxad070","url":null,"abstract":"Neuro-Behçet's disease (NB) is a rare complication of Behçet's disease (BD) characterised by central nervous system involvement. While NB typically presents with brainstem lesions, we report an unusual case of NB in a 27-year-old male with multiple subcortical nodular brain lesions but without brainstem, thalamic, or basal ganglia involvement, making this presentation exceptionally rare. The patient had a prior diagnosis of BD and was HLA-B51 positive. He presented with a sudden loss of consciousness, which was attributed to a seizure. Imaging studies showed low-density areas in the white matter of the bilateral temporal lobes and the right frontoparietal lobe on brain CT. Cerebrospinal fluid examination indicated elevated initial pressure and protein concentration, along with increased interleukin-6. Despite presenting with nodular brain lesions, distinguishing between NB and infectious diseases such as tuberculosis (TB) was challenging, and required brain biopsy revealing vasculitis. However, even with this biopsy result, TB could not be ruled out, so TB was treated at the same time. Treatment with anti-TB drugs and standard steroid therapy initially failed to improve the patient's condition. However, increasing the steroid dosage considering the increased steroid degradation by rifampicin, including pulse therapy with 2 g of methylprednisolone, followed by 18 mg of betamethasone, led to remission of the nodular brain lesions and resolution of the nasopharyngeal ulcer. This case highlights the diagnostic challenge of differentiating between NB and TB based on imaging alone and the potential efficacy of high-dose steroid therapy in cases of steroid-resistant NB with subcortical nodular brain lesions.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"348-351"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138815964","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

Stress fracture of the clavicle associated with sternocostoclavicular hyperostosis combined with bony ankylosis of the acromioclavicular joint and ossification of the coracoclavicular ligament. 锁骨应力性骨折，伴有胸锁关节骨质增生、肩锁关节骨性强直和锁骨韧带骨化。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae017

Rie Kurose, Yuji Wakai

引用次数: 0

Streptococcal toxic shock syndrome due to Streptococcus dysgalactiae subsp. equisimilis from retroperitoneal panniculitis during the treatment with anti-IL-6 receptor antibody: A case report. 抗IL-6受体抗体治疗期间腹膜后泛起的赤痢链球菌亚种引起的链球菌中毒性休克综合征：病例报告。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae001

Sho Fujimoto, Yoshihiro Eriguchi, Rinto Nakamura, Sota Kamikawa, Akiko Yonekawa, Noriko Miyake, Nobuyuki Ono, Hiroaki Niiro

引用次数: 0

Bilateral hand dactylitis: An unusual presentation of the great imitator: Tuberculosis. 双侧手掌畸形：大模仿者的不寻常表现：结核病。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae003

Dilara Bulut Gökten, Fatma Yümün Kavak, Rıdvan Mercan

{"title":"Bilateral hand dactylitis: An unusual presentation of the great imitator: Tuberculosis.","authors":"Dilara Bulut Gökten, Fatma Yümün Kavak, Rıdvan Mercan","doi":"10.1093/mrcr/rxae003","DOIUrl":"10.1093/mrcr/rxae003","url":null,"abstract":"The incidence of tuberculosis in developed countries has decreased over the years due to the use of effective tuberculosis drugs and improvements in socio-economic conditions. However, with the ease of global transport and increased travel to countries with high tuberculosis prevalence, the reduction in extrapulmonary tuberculosis cases has been less significant compared with the overall decrease in tuberculosis cases. Extrapulmonary tuberculosis can manifest in a variety of ways. Tuberculous dactylitis, a rare form of tuberculous osteomyelitis, was first described by Rankin in 1886. It mainly affects the short tubular bones in the hands and feet of children and is sometimes called 'spina ventosa'. A 42-year-old male patient initially presented to an external centre reporting swelling and pain in the hand joints of one year's duration. Despite one year of treatment with leflunomide and methylprednisolone (16 mg) and a history of methotrexate use during this period, he experienced no improvement. The patient's condition worsened after the start of sulfasalazine. Dermatological examination was performed due to the presence of haemorrhagic crusted papules and plaques on the ventral surface of both hands. A wound culture was taken, but no bacterial growth was observed. One week after the initial evaluation, the patient complained of persistent foul-smelling nasal discharge, which led to an evaluation by the infectious disease department. At this time, the Quantiferon test was positive. Mycobacterial culture on Days 1 and 3 showed growth of the Mycobacterium tuberculosis complex.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"365-367"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139473108","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

Lymphoproliferative disorder progressing after partial remission following immunosuppressive drugs withdrawal in a patient with rheumatoid arthritis. 一名类风湿性关节炎患者在停用免疫抑制剂后病情部分缓解，但淋巴组织增生性疾病仍在发展。

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Modern rheumatology case reports Pub Date : 2024-07-08 DOI: 10.1093/mrcr/rxae007

Kazuo Fukumoto, Ryu Watanabe, Minako Tsutsumi, Teruhito Takakuwa, Masafumi Miyamoto, Noriyuki Hayashi, Shinsuke Yamada, Yutaka Furumitsu, Masayuki Hino, Motomu Hashimoto

{"title":"Lymphoproliferative disorder progressing after partial remission following immunosuppressive drugs withdrawal in a patient with rheumatoid arthritis.","authors":"Kazuo Fukumoto, Ryu Watanabe, Minako Tsutsumi, Teruhito Takakuwa, Masafumi Miyamoto, Noriyuki Hayashi, Shinsuke Yamada, Yutaka Furumitsu, Masayuki Hino, Motomu Hashimoto","doi":"10.1093/mrcr/rxae007","DOIUrl":"10.1093/mrcr/rxae007","url":null,"abstract":"Lymphoproliferative disorders (LPDs) are serious complications that arise in patients with rheumatoid arthritis (RA) receiving immunosuppressive drugs (ISDs). Here, we reported a 73-year-old woman diagnosed with RA at 60 years of age and treated with methotrexate, bucillamine, prednisolone, and infliximab. She was referred to our hospital, Osaka Metropolitan University Hospital, with general malaise, pancytopenia, a right adrenal mass, and enlarged periaortic lymph nodes. Epstein-Barr virus was detected in serum. We suspected LPD development and performed a bone marrow biopsy, on which no malignant cells could be detected. Upon ISDs withdrawal, her symptoms and blood counts improved, and the right adrenal mass and enlarged lymph nodes regressed. The patient was followed up for clinical LPD. However, 7 months after the initial visit to our hospital, she developed fever and pancytopenia. A repeat bone marrow biopsy confirmed the diagnosis of Epstein-Barr virus-positive diffuse large B-cell lymphoma complicated by haemophagocytic syndrome. After pulse steroid therapy, the patient received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, which resulted in a complete response. In conclusion, when LPDs develop in patients with RA during ISD treatment, LPDs can progress and complicate haemophagocytic syndrome after partial remission following ISDs withdrawal. Therefore, we should carefully follow up RA patients with LPDs, and aim to achieve an early diagnosis of LPD and promptly initiate chemotherapy.","PeriodicalId":94146,"journal":{"name":"Modern rheumatology case reports","volume":" ","pages":"243-248"},"PeriodicalIF":0.9,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139725471","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