Reumatologia clinica最新文献

{"title":"Does sacroiliitis is a mandatory criterion for enthesitis-related arthritis diagnosis?","authors":"Hanene Lassoued Ferjani ,&nbsp;Lobna Kharrat ,&nbsp;Dorra Ben Nessib ,&nbsp;Dhia Kaffel ,&nbsp;Kaouther Maatallah ,&nbsp;Wafa Hamdi","doi":"10.1016/j.reumae.2023.12.008","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.12.008","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA).</p><p>We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype.</p></div><div><h3>Results</h3><p>ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1<!--> <!-->=<!--> <!-->16 versus G2<!--> <!-->=<!--> <!-->3, <em>p</em> <!-->=<!--> <!-->0.005).</p><p>Sacroiliac joints MRI's sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68–28.09; <em>p</em> <!-->=<!--> <!-->0.006).</p></div><div><h3>Conclusion</h3><p>Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 187-192"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620852","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":"SER recommendations on treatment of refractory Behçet's syndrome","authors":"Clara Moriano Morales ,&nbsp;Jenaro Graña Gil ,&nbsp;Noé Brito García ,&nbsp;José Luis Martín Varillas ,&nbsp;Vanesa Calvo del Río ,&nbsp;Patricia Moya Alvarado ,&nbsp;Francisco Javier Narváez García ,&nbsp;Gerard Espinosa ,&nbsp;Petra Díaz del Campo Fontecha ,&nbsp;Mercedes Guerra Rodríguez ,&nbsp;José Mateo Arranz ,&nbsp;Manuela López Gómez ,&nbsp;Félix Manuel Francisco Hernández ,&nbsp;M. Mar Trujillo ,&nbsp;Raquel dos Santos Sobrín ,&nbsp;Juan Ignacio Martín Sánchez ,&nbsp;Jesús Maese Manzano ,&nbsp;Julio Suárez Cuba","doi":"10.1016/j.reumae.2023.12.006","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.12.006","url":null,"abstract":"<div><h3>Objective</h3><p>To develop multidisciplinary recommendations based on available evidence and expert consensus for the therapeutic management of patients with refractory Behçet’s syndrome (BS) (difficult to treat, severe resistant, severe relapse) to conventional treatment.</p></div><div><h3>Methods</h3><p>A group of experts identified clinical research questions relevant to the objective of the document. These questions were reformulated in PICO format (patient, intervention, comparison and outcome). Systematic reviews of the evidence were conducted, the quality of the evidence was evaluated following the methodology of the international working group <em>Grading of Recommendations Assessment, Development, and Evaluation</em> (GRADE). After that, the multidisciplinary panel formulated the specific recommendations.</p></div><div><h3>Results</h3><p>4 PICO questions were selected regarding the efficacy and safety of systemic pharmacological treatments in patients with BS with clinical manifestations refractory to conventional therapy related to mucocutaneous and/or articular, vascular, neurological parenchymal and gastrointestinal phenotypes. A total of 7 recommendations were made, structured by question, based on the identified evidence and expert consensus.</p></div><div><h3>Conclusions</h3><p>The treatment of most severe clinical manifestations of BS lacks solid scientific evidence and, besides, there are no specific recommendation documents for patients with refractory disease. With the aim of providing a response to this need, here we present the first official Recommendations of the Spanish Society of Rheumatology for the management of these patients. They are devised as a tool for assistance in clinical decision making, therapeutic homogenisation and to reduce variability in the care of these patients.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 204-217"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620856","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":"The Latin-American rheumatology community needs to put the eye on ocular cicatricial pemphigoid","authors":"Ariana Ringer ,&nbsp;Andrea María Smichowski ,&nbsp;José Maximiliano Martínez Pérez ,&nbsp;Ignacio Javier Gandino","doi":"10.1016/j.reumae.2024.04.006","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.04.006","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 227-228"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620644","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":"p.(Tyr135His), a new variant associated with familial Mediterranean fever","authors":"Francisco José Nicolás-Sánchez ,&nbsp;Lluis Eleuteri Pons i Ferré ,&nbsp;Francesc Josep Nicolás-Sarrat ,&nbsp;Alberto González Barranquero","doi":"10.1016/j.reumae.2024.04.001","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.04.001","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 226-227"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620643","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":"Investigating the comparative effect of vitamin D level with the type of complications in Henoch Schönlein purpura and Kawasaki disease","authors":"Mehrnoush Hassas Yeganeh ,&nbsp;Reza Sinaei ,&nbsp;Mitra Rouhi ,&nbsp;Reza Shiari ,&nbsp;Vadood Javadi Parvaneh ,&nbsp;Khosro Rahmani ,&nbsp;Erfan Sheikhbahaei","doi":"10.1016/j.reumae.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.04.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Henoch Schönlein purpura (HSP) and Kawasaki disease (KD) are two main inflammatory diseases among childhood vasculitis. Considering the anti-inflammatory effects of 25-hydroxyvitamin D3, we decided to investigate the association of serum 25-hydroxy vitamin D3 level with the type and severity of these conditions.</p></div><div><h3>Materials and methods</h3><p>The present study was performed as a historical cohort of 254 affected children with KD and HSP vasculitis. The required data were extracted, using a researcher-made questionnaire from patients’ electronic file, and then they were analyzed after collecting information of the patients.</p></div><div><h3>Results</h3><p>In HSP group, 54% of participants were boys. Similarly, in KD group, boys were more affected than girls. The comparative 25-hydroxyvitamin vitamin D3 level in HSP patients with and without renal involvement (<em>P</em> <!-->=<!--> <!-->0.02), hematuria (<em>P</em> <!-->=<!--> <!-->0.14), and in two groups with and without heart disease, and also with and without coronary artery dilatation in KD patients (<em>P</em> <!-->&lt;<!--> <!-->0.001) were significant.</p></div><div><h3>Discussion and conclusions</h3><p>The findings showed that insufficient level of vitamin D3 were significantly associated with the exacerbation of complications of both diseases, and therefore it seems that vitamin D deficiency can be an effective predictive factor of severity in HSP and KD patients.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 199-203"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620855","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":"Cognitive dysfunction, depression and serum level of brain-derived neurotrophic factor (BDNF) in Egyptian patients with rheumatoid arthritis","authors":"Mona I. Nabih ,&nbsp;Noha M. Khalil ,&nbsp;Olfat Shaker ,&nbsp;Mahmoud Ghanema ,&nbsp;Sarah A. Hassan","doi":"10.1016/j.reumae.2023.12.007","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.12.007","url":null,"abstract":"<div><h3>Aim of the work</h3><p>To evaluate serum brain-derived neurotrophic factor (BDNF) in Egyptian patients with rheumatoid arthritis (RA) and its relation with cognitive dysfunction.</p></div><div><h3>Patients and methods</h3><p>The study was carried out on 60 RA patients; 30 were active (group A) and 30 were non active (group B); and 30 controls (group C). RA disease activity was assessed via DAS28 tool, cognitive function via The Montreal Cognitive Assessment and depression via the PHQ depression scale. Serum BDNF levels were measured.</p></div><div><h3>Results</h3><p>The mean age in group A was 37.8 (±<!--> <!-->9.37) years with 83.3% females, in group B was 39.97 (±<!--> <!-->8.04) years with 86.7% females and in group C was 33.17 (±<!--> <!-->3.6) years with 93.3% females. Abnormal cognitive functions test was detected in 66.7% of group A, 66.7% of group B, and in 23.3% of group C. There was a statistically significant difference in BDNF serum level between both groups of patients (1.58<!--> <!-->±<!--> <!-->0.9<!--> <!-->ng/ml for group A, 1.81<!--> <!-->±<!--> <!-->1.17<!--> <!-->ng/ml for group B) compared with the control group (3.01<!--> <!-->±<!--> <!-->1.25<!--> <!-->ng/ml, <em>p</em> <!-->&lt;<!--> <!-->0.001).</p><p>There was no statistically significant difference between BDNF and both disease duration and cognitive function, also no statistically significant difference regarding cognitive function, depression, and BNDF levels in patients with and without fibromyalgia. At a cut-off value of &lt;2<!--> <!-->ng/ml, BDNF detected RA patients with cognitive dysfunction with a sensitivity of 80%, specificity of 96.67%.</p></div><div><h3>Conclusion</h3><p>BDNF can be a potential biomarker of cognitive dysfunction in RA patients.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 175-180"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620946","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":"Spontaneous pneumomediastinum: An extra muscular manifestation of anti-MDA5 dermatomyositis. Report of 2 cases","authors":"Pablo Arango Guerra ,&nbsp;Santiago Monsalve Yepes ,&nbsp;Andrés Chavarriaga Restrepo ,&nbsp;Carlos Jaime Velasquez Franco","doi":"10.1016/j.reumae.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.04.002","url":null,"abstract":"<div><p>The use of specific antibodies in inflammatory myopathies has improved the characterization of this disease, identifying different clinical phenotypes. Patients with dermatomyositis (DM) and anti-MDA5 antibodies display typical skin symptoms, lesser muscular involvement, and a prevalence of interstitial lung disease (ILD) of up to 91%. Beyond ILD, spontaneous pneumomediastinum (SN) has been identified as a rare but potentially fatal pulmonary manifestation. Two cases of this complication in patients with anti-MDA5 DM are reported.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 218-222"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620945","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":"Cost-effectiveness analysis of the diagnosis of temporal arteritis","authors":"Isabel del Blanco Alonso,&nbsp;Álvaro Revilla Calavia,&nbsp;Laura Saiz-Viloria,&nbsp;Manuel Diez Martínez,&nbsp;Enrique San Norberto García,&nbsp;Carlos Vaquero Puerta","doi":"10.1016/j.reumae.2024.04.003","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.04.003","url":null,"abstract":"<div><p>Temporal arteritis (TA) is the most common form of systemic vasculitis. Its diagnosis is based on criteria proposed by the American College of Rheumatology (1990), and its treatment is high-dose corticosteroids.</p><p>Our objective is to assess the cost of diagnosing TA, and secondarily, cost-effective analysis of different diagnostic strategies (clinical, biopsy, doppler ultrasound) and therapeutic strategies (corticosteroid suspension).</p></div><div><h3>Material and method</h3><p>Observational, retrospective study has been carried out on patients with AT (2012–2021). Demographic data, comorbidities, signs and symptoms suggestive of AT were collected. AT was diagnosed with a score ≥ 3 according to American College of Rheumatoloy criteria (ACR-SCORE). The costs of diagnosis and treatment modification were analysed.</p></div><div><h3>Results</h3><p>Seventy-five patients have been included, median age 77 (46–87) years. Headache, temporal pain and jaw claudication were significant for the diagnosis of TA.</p><p>Patients with a halo on Doppler ultrasound and a positive biopsy have significantly elevated ESR and CRP compared to patients who do not.</p><p>The cost of the AT diagnosis was 414.7 euros/patient. If we use ACR-SCORE ≥ 3-echodoppler it is 167.2 є/patient (savings 59.6%) and ACR-SCORE ≥ 3-biopsy 339.75 є/patient (savings 18%). If the corticosteroid was removed and a biopsy was performed, 21.6 є/patient (94.7% savings), if the corticosteroid was removed and Doppler ultrasound was performed, 10.6 є/patient (97.4% savings).</p></div><div><h3>Conclusions</h3><p>Headache, temporary pain and jaw claudication are predictors of AT. Elevated ESR and CRP are predictors of positive biopsy and presence of halo on ultrasound.</p><p>The uses of ACR-SCORE ≥ 3 with Doppler ultrasound or biopsy, and with corticosteroid suspension, are cost-effective.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 181-186"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620947","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":"An update on the study of synovial fluid in the geriatric patient","authors":"Javier Fernández-Torres ,&nbsp;Víctor Ilizaliturri-Sánchez ,&nbsp;Karina Martínez-Flores ,&nbsp;Carlos Alberto Lozada-Pérez ,&nbsp;Rolando Espinosa-Morales ,&nbsp;Yessica Zamudio-Cuevas","doi":"10.1016/j.reumae.2023.12.009","DOIUrl":"https://doi.org/10.1016/j.reumae.2023.12.009","url":null,"abstract":"<div><h3>Background</h3><p>The characteristics of synovial fluid (SF) in geriatric patients differ from those in younger patients. In Mexico, epidemiologic data on the incidence of different rheumatic diseases in geriatric patients are scarce.</p></div><div><h3>Objective</h3><p>To describe the physical characteristics of geriatric SF and the prevalence of crystals in knee and other joint aspirates from patients with previously diagnosed joint disease.</p></div><div><h3>Materials and methods</h3><p>A retrospective study was performed with a baseline of 517 SF samples between 2011 and 2023. White blood cell count was performed by Neubauer chamber and crystals were identified by polarized light microscopy. Descriptive statistical analysis was performed and prevalence was reported as a percentage.</p></div><div><h3>Results</h3><p>The mean age of the adults was 73.5<!--> <!-->±<!--> <!-->5.0 years, 54.4% were women and 45.6% were men. The mean SF volume was 6.3<!--> <!-->±<!--> <!-->9.5<!--> <!-->mL in older adults and 15.3<!--> <!-->±<!--> <!-->24.9<!--> <!-->mL in those younger than 65 years. The mean viscosity in older adults was 9.5<!--> <!-->±<!--> <!-->4.5<!--> <!-->mm and the mean leukocyte count was 7352<!--> <!-->±<!--> <!-->16,402<!--> <!-->leukocytes/mm³. Seventy percent of the older adults’ SFs were referred to the laboratory for osteoarthritis (OA), with lower proportions for rheumatoid arthritis (RA) (14.6%) and gout (5.1%). Of the crystals observed in the geriatric population, 14.6% corresponded to monosodium urate crystals (CUM) and 18.9% to calcium pyrophosphate crystals (CPP).</p></div><div><h3>Conclusions</h3><p>The characteristics of LS in older adults were smaller volume, increased viscosity, and non-inflammatory. The main diagnoses were OA, RA, and gout. The crystal content of the SF of the geriatric population corresponded mainly to CPP.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 193-198"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620854","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":"Cytokine storm in Chikungunya: Can we call it multisystem inflammatory syndrome associated with Chikungunya?","authors":"Zoilo Morel ,&nbsp;Tamara Martínez ,&nbsp;Fernando Galeano ,&nbsp;Judith Coronel ,&nbsp;Lorena Quintero ,&nbsp;Rolando Jimenez ,&nbsp;Jorge Ayala ,&nbsp;Sara Amarilla ,&nbsp;Dolores Lovera ,&nbsp;Celia Martínez de Cuellar","doi":"10.1016/j.reumae.2024.04.005","DOIUrl":"https://doi.org/10.1016/j.reumae.2024.04.005","url":null,"abstract":"<div><p>Paraguay is currently facing a new outbreak of Chikungunya virus. This report summarizes two severe cases of Chikungunya (CHIKV) infection, confirmed by real-time reverse transcription polymerase chain reaction. We present the cases of patients with acute CHIKV infection and multisystem involvement, with fever, rash, abdominal pain, vomiting, myocarditis, and coronary artery anomalies, very similar to the cases described in MIS-C related to SARS-CoV-2 during the COVID-19 Pandemic. Both patients received IVIG and methylprednisolone, with good clinical response. In this setting of cytokine storm in Chikungunya, can we call it “Multisystem inflammatory syndrome associated with Chikungunya”?.</p></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 4","pages":"Pages 223-225"},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140620857","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}