Rituximab for refractory rapidly progressive interstitial lung disease related to anti-MDA5 antibody-positive amyopathic dermatomyositis
AbstractTo report our experience in using rituximab (RTX) for treating refractory rapidly progressive interstitial lung disease (RP-ILD) complicating anti-melanoma differentiation-associated gene 5 antibody (anti-MDA5 Ab)-positive amyopathic dermatomyositis (ADM). Medical records of four ADM patients with refractory RP-ILD treated with RTX therapy were reviewed retrospectively. All four patients were tested positive for anti-MDA5 Ab and failed to respond to high-dose systemic steroid and other intensive immunosuppressive therapies. Respiratory symptoms, lung function tests, and high-resolution computed tomography (HRCT) of...
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Brief communication: use of the minimal important difference for a meta-analysis on exercise and anxiety in adults with arthritis
The objective of this study was to use the more recently developed and clinically relevant minimal important difference (MID) approach to examine this association. Data from a previous meta-analysis of 14 randomized controlled trials representing 926 initially enrolled adults ≥ 18 years of age (539 exercise, 387 control) was used to calculate the ES using the MID approach. Minimal important difference data were derived from previously reported anchor-based values that represented the different instruments used to assess anxiety. Effect sizes were pooled using the in verse heterogeneity (IVhet) model. Overall...
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Correction to: Regional differences in baseline disease activity and remission rates following golimumab treatment for RA: results from the GO-MORE trial
The original publication contains two areas which require correcting. None of these errors change the results or conclusions of the article, but the authors wish to highlight the areas of change to the reader. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Advances in the diagnosis and treatment of Sjogren ’s syndrome
This article reviews the recent classification criteria for primary SS and briefly discusses the conventional and novel therapies of the disease. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Late-onset Pneumocystis jirovecii pneumonia (PJP) in patients with ANCA-associated vasculitis
AbstractImmunosuppression in anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is complicated by increasing risk of infections including opportunistic infections like Pneumocystis jirovecii pneumonia (PJP). Available evidence on risk factors and indications for prophylaxis in AAV is derived from PJP occurring early in the course of AAV. In this retrospective study, we characterized the profile of PJP in patients with AAV. PJP cases were identified retrospectively based on positive polymerase chain reaction test from electronic record followed by confirmation from medical records over a 10-year period....
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Neuropathic pain: is it an underestimated symptom in systemic sclerosis?
This study aimed to investigate the frequency of neuropathic pain (NP) and to evaluate its interference with the quality of life (QoL) in SSc patients. Diffuse and Limited SSc patients diagnosed by American College of Rheumatology 2013 criteria were included in the study. Pain was evaluated with Visual Analogue Scale (VAS); presence of NP was screened with The Leeds Assessment of Neuropathic Symptoms and Signs (LANNS) questionnaire; disease activity was evaluated with modified Medsger Severity Scale (MSS) and QoL with short-form 36 (SF-36). One hundred twenty patients were included in the study (mean age 53.64  &plu...
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Clinical relevance of ANCA in small-vessel vasculitis: positioning of antigen-specific immunoassays
(Source: Clinical Rheumatology)
Source: Clinical Rheumatology - June 18, 2018 Category: Rheumatology Source Type: research

Molecular genetic analysis for periodic fever syndromes: a supplemental role for the diagnosis of adult-onset Still ’s disease
AbstractAdult-onset Still ’s disease (AOSD) represents a systemic autoinflammatory disease (SAID), and its diagnostic criteria are clinical without genetic testing. Given shared manifestations between AOSD and hereditary SAIDs, molecular analysis may help differentiate these diseases. A PubMed literature search was conduct ed using key words “adult-onset Still’s disease,” “autoinflammatory disease,” and “genetic mutation” between 1970 and February 2018. Articles on genetic mutations in the genes MEFV, TNFRSF1A, mevalonate kinase, or NOD2 for hereditary SAIDs in AOSD/systemic ...
Source: Clinical Rheumatology - June 16, 2018 Category: Rheumatology Source Type: research

Comparison of splinting and Kinesio taping in the treatment of carpal tunnel syndrome: a prospective randomized study
AbstractThe aim of this study was to investigate and compare the effectiveness of splinting and Kinesio taping (KT) as forms of treatment for patients with mild to moderate idiopathic carpal tunnel syndrome (CTS) by evaluating the symptoms and measuring the range of function and electrophysiological findings. This single-blind, randomized, prospective study included 44 patients (58 hands) suffering mild to moderate idiopathic CTS according to nerve conduction studies (NCS). The patients were randomized into two groups and evaluated before treatment and 6  weeks after treatment by means of physical examination findings...
Source: Clinical Rheumatology - June 15, 2018 Category: Rheumatology Source Type: research

Clinical characteristics of a concurrent condition of IgG4-RD and Castleman ’s disease
In this study, we aim to review the clinical features of IgG4-CD. This s tudy is based on a retrospective analysis of a prospectively acquired database. IgG4-CD was defined histopathologically in patients who fulfilled the diagnosis of both IgG4-RD and CD. Forty-five definite IgG4-RD and 16 multicentric CD (MCD) patients were recruited as controls. Clinical features incl uding organ involvement, serum IgG4, IgG, IgE, ESR, CRP, and IL-6 levels were collected and analyzed. Fifteen patients (2.8%) out of 534 patients with IgG4-RD in China’s largest prospective IgG4-RD and Mimicry cohort fulfilled the definition of IgG4-...
Source: Clinical Rheumatology - June 14, 2018 Category: Rheumatology Source Type: research

Ultrasound-guided synovial biopsy improves diagnosis of septic arthritis in acute arthritis without enough analyzable synovial fluid: a retrospective analysis of 176 arthritis from a French rheumatology department
AbstractTo assess the diagnostic value of ultrasound-guided (US-guided) synovial biopsy in routine clinical practice in cases of acute and chronic arthritis. A retrospective, single-center study of US-guided synovial biopsies between 2003 and 2013. The clinical, laboratory, radiographic, synovial fluid, and histological and bacteriological results of synovial biopsies were analyzed. Arthritis was classified according to disease duration
Source: Clinical Rheumatology - June 14, 2018 Category: Rheumatology Source Type: research

Axial psoriatic arthritis: the impact of underdiagnosed disease on outcomes in real life
In this study, we aimed to investigate factors associated with being underdiagnosed for axial psoriatic arthritis (axPsA) and its impacts on outcomes. Disease features and outcomes of axPsA according to the physician (n = 415) were compared with patients with imaging findings only (sacroiliitis fulfilling the modified New York criteria,n = 112), using data from a real-life PsA registry. Patients with imaging findings only were more frequently women (83/220 (37.7%) vs 29/122 (23.8%);p = 0.008). This group also had higher peripheral disease activity (imaging only vs clinical AxPsA: m...
Source: Clinical Rheumatology - June 13, 2018 Category: Rheumatology Source Type: research

Development and application of a questionnaire to assess patient beliefs in rheumatoid arthritis and axial spondyloarthritis
The objective of this study was to develop a questionnaire to assess patients ’ beliefs about their disease and its treatment, and to identify patient characteristics associated with these beliefs. All beliefs reported by>  5% of 50 patients in a previous study were reformulated with a partnering patient organization into statements with which participants could rate their agreement on a scale of 0–10 (totally disagree to totally agree). The resulting Questionnaire for Arthritis Dialogue (QuAD) was made available to patients with RA or axSpA. A score ≥ 7 was considered a strongly held...
Source: Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Socio-economic gradients in the presence of musculoskeletal and other chronic diseases: results from a cross-sectional study in the Netherlands
AbstractSocio-economic gradients in occurrence of diseases have been reported for many chronic conditions. However, whether the magnitude of socio-economic gradients differs across diseases and the extent to which lifestyle mediates such relationships are not known. Cross-sectional data from The National Monitor on Musculoskeletal System was used. Respondents (>  18 years) completed a questionnaire including gender, education, social status, lifestyle, and physician-diagnosed diseases. Logistic regressions investigated the relationship between education and the major chronic diseases (musculoskeletal disease...
Source: Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Recognition and control of hypertension, diabetes, and dyslipidemia in patients with systemic lupus erythematosus
AbstractSystemic lupus erythematosus (SLE) patients have a high risk for cardiovascular events, but few studies have evaluated the recognition and none have evaluated the control of cardiovascular risk factors (RF) in SLE patients. The study aims to describe the recognition and control frequencies of systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM) in SLE patients. Of the female patients with SLE, 137 answered a questionnaire focused on general knowledge of the RF for coronary artery disease (CAD) and on recognition of the risk factors that they possess. The patient ’s information collec...
Source: Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Anti-annexin A5 antibodies and 25-hydroxy-cholecalciferol in female patients with primary antiphospholipid syndrome
AbstractVascular antiphospholipid syndrome (VAPS) and obstetric (OAPS) are different entities because some patients only develop thrombosis (without recurrent pregnancy losses) and vice versa. Only two articles have reported that low 25-hydroxy-cholecalciferol (vitamin D3, VD3) levels were not correlated with the presence of conventional antiphospholipid antibodies (aPL Abs: anticardiolipin (aCL), anti-beta2glycoprotein I (a β2gpI), and lupus anticoagulant (LA)), but no article analyzed the association of VD3 and anti-annexin A5 (aanxA5) Abs. The aim of our study was to investigate the association between VD3, multipl...
Source: Clinical Rheumatology - June 12, 2018 Category: Rheumatology Source Type: research

Disease and management beliefs of elderly patients with rheumatoid arthritis and comorbidity: a qualitative study
AbstractTo explore in elderly patients with rheumatoid arthritis (RA) and comorbidity (1) in which order and why patients prioritize their morbidities with regard to functioning and health, (2) their beliefs about common (age-related) musculoskeletal complaints, and (3) experiences about the influence of comorbidity on medication treatment of RA. Patients between 50 and 85  years with RA and ≥ 1 comorbidity or lifestyle risk factor were invited for a semi-structured interview. Two readers coded the transcripts of the interviews, by using NVivo11 software. Fifteen patients (14 women; mean age 67 years (r...
Source: Clinical Rheumatology - June 9, 2018 Category: Rheumatology Source Type: research

Association between the -174 C/G polymorphism in the interleukin-6 (IL-6) gene and gastrointestinal involvement in patients with systemic sclerosis
AbstractGenetic predisposition to systemic sclerosis (SSc) has still not been fully revealed. Interleukin-6 (IL-6) is a mediator of T cell proliferation and fibrotic events in SSc. Polymorphisms in the IL-6 are found to be important in susceptibility to development of SSc. We aimed to assess the frequency of -174 C/G ofIL-6 gene polymorphism in SSc patients and healthy controls, as well as correlation with disease manifestations. In the case-control study, 102 patients with SSc and 93 controls were included. PCR-RFLP method was performed for genotyping promotor variants -174 C/G ofIL-6 gene. The expression level ofIL-6 was...
Source: Clinical Rheumatology - June 8, 2018 Category: Rheumatology Source Type: research

Basic calcium phosphate and pyrophosphate crystals in early and late osteoarthritis: relationship with clinical indices and inflammation
AbstractThe current study aimed to investigate the association of calcium pyrophosphate (CPP) and basic calcium phosphate (BCP) crystals in synovial fluid (SF) of patients with osteoarthritis (OA) with disease severity, clinical symptoms, and synovial inflammation. One-hundred-and-ten patients with knee OA completed the Western Ontario and McMaster Universities Arthritis Index (WOMAC) self-assessment questionnaire, the Lequesne algofunctional index survey, and the visual analogic scale forms; they also underwent power Doppler ultrasonography (PDUS) to assess synovial inflammation. Scanning electron microscopy (SEM) was use...
Source: Clinical Rheumatology - June 7, 2018 Category: Rheumatology Source Type: research

Niclosamide as an adjuvant to etanercept in treatment patients with active rheumatoid arthritis: an 8-week randomized controlled pilot study
This study designed to identify the therapeutic efficacy of niclosamide (NCL) in Iraqi patients suffering from active rheumatoid arthritis (RA) who were using etanercept (ETN) for more than 3  months and still had high or moderate active RA. One hundred ten patients suffering from active rheumatoid arthritis (RA) who were using etanercept (ETN) for more than 3 months and still had high or moderate active RA were allocated randomly into two equal groups: one of them treated with 1000 m g/day NCL and the other treated with 1000 mg/day lactose in capsule dosage form. The study duration was 8 weeks. Cl...
Source: Clinical Rheumatology - June 7, 2018 Category: Rheumatology Source Type: research

Differences in clinical Pneumocystis pneumonia in rheumatoid arthritis and other connective tissue diseases suggesting a rheumatoid-specific interstitial lung injury spectrum
AbstractTo comparePneumocystis pneumonia (PCP) in patients with rheumatoid arthritis (RA) with PCP in patients with non-RA connective tissue diseases (CTDs) in order to clarify the characteristics of the former. We extracted consecutive patients satisfying the following criteria for “clinical PCP”: (1) positive plasma β-d-glucan, (2) PCP-compatible computed tomography findings of the lung, and (3) successful treatment with antipneumocystic antibiotics. Patients who underwent methylprednisolone “pulse” therapy or sufficient antibiotics to cure bacterial pneumonia were excluded. We used thet test...
Source: Clinical Rheumatology - June 6, 2018 Category: Rheumatology Source Type: research

Disease activity and biologic use in patients with psoriatic arthritis or rheumatoid arthritis
AbstractTo compare disease burden and biologic use among psoriatic arthritis (PsA) or rheumatoid arthritis (RA) patients recruited to the Corrona registry. Retrospective study of patients with PsA or RA enrolled in Corrona between January 2002 and March 2013 and grouped in 2-year intervals. Clinical outcomes and biologic use were assessed. Biologic use increased over time in both cohorts, with 62 and 52% of patients with PsA and RA, respectively, receiving biologics by 2012 –2013. However, 25 and 35% of patients with PsA and RA, respectively, continued to experience moderate/high disease activity. Overall, the progre...
Source: Clinical Rheumatology - June 4, 2018 Category: Rheumatology Source Type: research

Hearing loss in patients with scleroderma: associations with clinical manifestations and capillaroscopy
In this study, we evaluated hearing problems in scleroderma patients and determined its association with clinical manifestations and capillaroscopy. We evaluated 54 patients with scleroderma referred to Hafez Hospital clinic of scleroderma related to Shiraz University of Medical Science; they fulfilled the LeRoy and ACR/EULAR criteria for scleroderma. Control group consisted of 60 normal individuals. All clinical manifestations, nail fold capillaroscopy, pure tone audiometry, speech reception threshold, and speech audiometry were recorded during evaluation. Subjective hearing loss and objective hearing loss were seen in 10...
Source: Clinical Rheumatology - June 2, 2018 Category: Rheumatology Source Type: research

Systemic lupus erythematosus, gender differences in Colombian patients
The objective of this study was to compare the clinical and immunological presentation of SLE between males and females in a Colombian SLE population. A cross-sectional, retrospective study was performed that evaluated patients with SLE over 6  years. The dependent variables were systemic complications, duration of hospitalization, readmission, and death. Descriptive, group comparison, bivariate, and multivariate analysis were performed using Stata 12.0 software 200 patients were included in this study, 84.5% were females and 15.5% males . Longer hospitalizations, readmissions, respiratory compromise, higher activity ...
Source: Clinical Rheumatology - June 2, 2018 Category: Rheumatology Source Type: research

Evaluation of quality of life in patients with axial spondyloarthritis and its association with disease activity, functionality, mobility, and structural damage
AbstractTo evaluate quality of life (QoL) in patients with axial spondyloarthritis (axSpA) and its association with disease activity, functionality, structural damage, and spinal mobility, using patient-reported outcomes. This was an observational, cross-sectional, and single-center study in which 100 consecutive patients with axSpA were included. We obtained from all patients ’ sociodemographic data and values related to disease activity, functionality, structural damage, mobility, and quality of life. The Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) was considered as the primary outcome. Pearsonr st...
Source: Clinical Rheumatology - May 11, 2018 Category: Rheumatology Source Type: research

Association between characteristics of pain and stiffness and the functional status of patients with incident polymyalgia rheumatica from primary care
AbstractThis paper aims to examine the relationship between different characteristics of pain and stiffness and the functional status of patients with newly diagnosed polymyalgia rheumatica (PMR). Baseline analysis of an inception cohort study was conducted. Patients aged ≥18 years, with a new diagnosis of PMR were recruited from 382 English general practices. Participants were mailed a baseline questionnaire, including separate pain and stiffness manikins and numerical rating scales (NRS), a question on their ability to raise their arms above their head and the m odified Health Assessment Questionnaire (mHAQ) to e...
Source: Clinical Rheumatology - May 11, 2018 Category: Rheumatology Source Type: research

Tocilizumab reduces complement C3 and C4 serum levels in rheumatoid arthritis patients
AbstractTocilizumab, an anti-interleukin-6 receptor monoclonal antibody, is known to be able to rapidly reduce acute phase reactants. Although complement components are part of the acute phase, no data are available on a possible effect of tocilizumab on complement proteins. Serum levels of complement components C3 and C4 were retrospectively assessed in 19 consecutive rheumatoid arthritis patients eligible for tocilizumab treatment. Tocilizumab was found to reduce all known acute phase reactants, including C3 and C4 levels. C3 and C4 were found to decrease as early as 4  weeks after the first tocilizumab infusion. On...
Source: Clinical Rheumatology - May 11, 2018 Category: Rheumatology Source Type: research

Impact of pre-transplant time on dialysis on survival in patients with lupus nephritis
AbstractLupus nephritis (LN) is an important cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE) often leading to end-stage renal failure (ESRF) and necessitating renal transplantation (rTp). Optimal timing of rTp in SLE patients with ESRF is uncertain and could potentially affect survival. We investigated the time spent on dialysis before rTp and survival following rTp in a cohort of SLE patients. Retrospective analysis of all adult SLE patients receiving rTp over a 40-year period (1975 –2015) in two tertiary UK centres. Cox proportional hazard regression and receiver operator curves...
Source: Clinical Rheumatology - May 11, 2018 Category: Rheumatology Source Type: research

A theory of planned behavior-based intervention to improve quality of life in patients with knee/hip osteoarthritis: a randomized controlled trial
The objective of the current study was to examine the efficacy of an intervention based on a theory of planned behavior (TPB) in improving health-related quality of life in middle-age and older adults with this condition. One hundred twenty patients diagnosed with knee/hip OA were recruited from a general hospital. Measures administered at baseline were the SF-12, EuroQol (EQ-5D), Osteoarthritis Knee and Hip Quality of Life (OAKHQoL), and TPB questionnaire. Also assessed were body mass index (BMI), Kellgren –Lawrence Scale, six-minute walk test (SMWT), muscle strength, range of motion (ROM), and joint tenderness and ...
Source: Clinical Rheumatology - May 10, 2018 Category: Rheumatology Source Type: research

The first case of bacillus Calmette-Gu érin-induced small-vessel central nervous system vasculitis
AbstractTo present an unrecognized vascular complication of bacillus Calmette-Gu érin (BCG) therapy administered for superficial bladder carcinoma. We also review the potential mimickers for primary angiitis of the central nervous system (PACNS) as well as complications of intravesical BCG therapy. An 89-year-old Caucasian man with a history of relapsing high-grade bladder carc inoma treated with intravesical BCG presented with recurring episodes of right upper limb paresthesia with clumsiness and dysarthria. Magnetic resonance imaging of the head revealed multiple predominantly left-sided frontotemporal micronodula...
Source: Clinical Rheumatology - May 9, 2018 Category: Rheumatology Source Type: research

Can we predict thrombotic tendency in rheumatoid arthritis? A thromboelastographic analysis (with ROTEM)
AbstractThe higher incidence of arterial and venous events is well established in patients with rheumatoid arthritis (RA). Our aim here was to investigate whether there is a prothrombotic state in RA patients by using rotational thromboelastometry(ROTEM) method and to demonstrate whether the disease variables play a role in this process. A total of 85 patients who met the 2010 RA classification criteria were consecutively included in the study. The patients with RA who have been using antiaggregant, anticoagulant, or nonsteroidal anti-inflammatory drugs (NSAIDs) and had a history of arterial or venous thromboembolism were ...
Source: Clinical Rheumatology - May 7, 2018 Category: Rheumatology Source Type: research

Polymyalgia rheumatica and diverticular disease: just two distinct age-related disorders or more? Results from a case-control study
AbstractIn a previous report of two married cohabiting couples affected by polymyalgia rheumatica (PMR), we noticed that the wife of one couple and both members of the other couple suffered from symptomatic diverticular disease (DD), whose diagnosis was made before the onset of PMR. We investigated whether DD might be a risk factor for the development of PMR. We conducted a case-control study informed on a database containing the prospectively collected medical records of consecutive PMR patients. Among comorbidities, attention was focused on symptomatic DD, provided that the diagnosis had been made by colonoscopy and/or c...
Source: Clinical Rheumatology - May 7, 2018 Category: Rheumatology Source Type: research

Is balneotherapy effective for fibromyalgia? Results from a 6-month double-blind randomized clinical trial
AbstractThe aim of this study was to assess the efficacy and tolerability of balneotherapy (BT) in patients with primary fibromyalgia syndrome (FS). In a prospective, randomized, controlled, double-blind trial with a 6-month follow-up, 100 FS patients were randomized to receive a cycle of BT with highly mineralized sulfate water (BT group) or with tap water (control group). Clinical assessments were performed at screening visit, at basal time, and after treatment (2  weeks, 3 and 6 months). The primary outcome measures were the change of global pain on the Visual Analogue Scale (VAS) and Fibromyalgia Impact Quest...
Source: Clinical Rheumatology - May 5, 2018 Category: Rheumatology Source Type: research

The prevalence of dysphonia and dysphagia in patients affected by immunomediated diseases and the role of psychometric tests
AbstractThis cross-sectional investigation examined the prevalence and severity of dysphonia, globus pharyngeus, and dysphagia in patients affected by immunomediated (IM) diseases. Seventy subjects were administered theVoice Handicap Index (VHI) (scale 0 –4),Glasgow-Edinburgh Throat Scale (GETS) (scale from 0 to 7) for globus pharyngeus assessment, and modifiedSwallowing Outcomes After Revised Laryngectomy (SOAL) (scale 0, 1, 2) to test swallowing symptoms. VHI: the mean percentage of answers with a score greater than 1 (corresponding to a frequency of situation ’s occurrence “sometimes,” “alm...
Source: Clinical Rheumatology - May 5, 2018 Category: Rheumatology Source Type: research

Running does not increase symptoms or structural progression in people with knee osteoarthritis: data from the osteoarthritis initiative
AbstractHigher levels of moderate to vigorous physical activity improve all-cause mortality and cardiovascular events. However, the effect of running, a moderate to vigorous activity, in those with knee osteoarthritis (OA), a common arthritis that occurs with aging, a high-risk group for mortality and cardiovascular events, is unclear. Therefore, we aimed to evaluate the association of self-selected running on OA symptom and structure progression in people with knee OA. This nested cohort study within the Osteoarthritis Initiative (OAI) (2004 –2014) included those at least 50 years old with OA in at least one kn...
Source: Clinical Rheumatology - May 4, 2018 Category: Rheumatology Source Type: research

Medicaid or Medicare insurance payer status and household income are associated with outcomes after primary total hip arthroplasty
AbstractOur objective was  to examine if Medicaid/Medicare health insurance and household income were associated with poorer outcomes after primary total hip arthroplasty (THA). We used multivariable-adjusted Cox regression analyses to assess whether insurance payer type and household income were independently associated wi th health care utilization outcomes or complications post-THA in a cohort of hospital discharges from the 1998–2014 US National Inpatient Sample, adjusting for demographics, underlying diagnosis for THA, medical comorbidity, and hospital characteristics. In a national cohort of 4,116,485 prim...
Source: Clinical Rheumatology - May 3, 2018 Category: Rheumatology Source Type: research

A retrospective analysis of medication prescription records for determining the levels of compliance and persistence to urate-lowering therapy for the treatment of gout and hyperuricemia in The Netherlands
AbstractUrate-lowering therapy (ULT) is a recommended life-long treatment for gout patients. However, despite these recommendations, recurrent gout attacks are commonly observed in clinical practice. The purpose of this study was to assess the levels of compliance and persistence to ULT in The Netherlands, in order to reflect on the current gout care delivered by health professionals. Anonymous prescription records were obtained from IQVIA ’s Dutch retrospective longitudinal prescription database, containing ULT dispensing data for allopurinol, febuxostat, and benzbromarone from November 2013 to July 2017. Compliance...
Source: Clinical Rheumatology - May 2, 2018 Category: Rheumatology Source Type: research

Acute fibrinous and organizing pneumonia as initial presentation of primary Sj ögren’s syndrome: a case report and literature review
AbstractAcute fibrinous and organizing pneumonia (AFOP) is a new histopathological pattern of acute lung injury first described by Beasley et al. in 2002. Hallmarks of pathological findings are characterized by the presence of intra-alveolar fibrin in the form of fibrin “balls” within the alveolar spaces and organizing pneumonia with a patchy distribution. Patients with AFOP may have an acute or subacute clinical presentation. Although the pathogenesis of AFOP is not fully elucidated, it may be associated with autoimmune diseases. Reported herein is a patient d iagnosed of acute AFOP associated with primary Sj&...
Source: Clinical Rheumatology - May 2, 2018 Category: Rheumatology Source Type: research

Cerebellar involvement in patients withprimary Sj ögren’s syndrome: diagnosis and treatment
AbstractThe aim of this study is to describe the clinical features of cerebellar involvement in patients with primary Sj ögren’s syndrome (pSS). We retrospectively analyzed the manifestations, treatments, and outcomes in patients with pSS-cerebellar complication in Peking Union Medical College Hospital and cases reported in literature. Altogether 13 patients were identified. They were 2 males and 11 females with a mean age at disease onset of 45.2 ± 14.6 years. Nine (69.2%) patients went to the clinic because of ataxia, and pSS was not suspected until accidental screening for autoantibo...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Prevalence of vitamin D deficiency in chronic and subacute low back pain patients in India: a triple-arm controlled study
This study was designed as triple-arm case-control study comprising of CLBP, SLBP, and controls. SLBP and CLBP cases were consecutively enrolled over 3  months of winter season from November 2016 to January 2017. Serum 25- (OH) vitamin D was estimated for the study subjects and categorical comparison of severity of vitamin D deficiency was done for the cases and controls. A total of 250 CLBP, 177 SLBP cases, and 248 controls were included in the s tudy. Mean (± SD) serum vitamin D levels among CLBP, SLBP, and controls were 20.36 (± 12.56), 21.42 (± 13.20), and 20.84 (± 6...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Sj ögren’s syndrome initially presented as thrombotic thrombocytopenic purpura in a male patient: a case report and literature review
AbstractThrombotic thrombocytopenic purpura (TTP) is a potentially lethal multisystem disorder which could be caused by autoimmune diseases. However, the concomitant occurrence of TTP and Sj ögren’s syndrome (SS) is an extremely uncommon scenario, especially in male patients. A 56-year-old Chinese male was admitted for the appearance of diffuse ecchymosis. Then he gradually developed transient slurred speech, progressive confusion, agitation, extremity weakness, and fever. Laboratory investigations suggested anemia, thrombocytopenia, significantly increased lactic dehydrogenase, schistocytes in peripheral blood ...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Increased frequency of temporal acoustic window failure in rheumatoid arthritis: a manifestation of altered bone metabolism?
AbstractAssessment of intracranial vessels includes transcranial Doppler (TCD). TCD performance requires intact temporal acoustic windows (TAW). Failure of TAW (TAWF) is present in 8 –20% of people. There have been no reports on TAWF in rheumatoid arthritis (RA). Altogether, 62 female RA patients were included. Among them, 20 were MTX-treated and biologic-free, 20 received infliximab, and 22 tocilizumab. The controls included 60 non-RA women. TAWF, temporal bone thickness, and texture were determined by ultrasound and CT. BMD and T-scores of multiple bones were determined by DEXA. Several bone biomarkers were assesse...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Comparison of hyaluronic acid and PRP intra-articular injection with combined intra-articular and intraosseous PRP injections to treat patients with knee osteoarthritis
AbstractThe aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration (Kellgren-Lawrence score II –III) compared with other treatments, specifically intra-articular injection of PRP and of HA. Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were randomly assigned to intra-articular combined with intraosseous injection of PRP (group A), i ntra-articular PRP (group B), or intra-articular HA (group C). Patients in g...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Clinical characteristics and thrombosis outcomes of paediatric antiphospholipid syndrome: analysis of 58 patients
AbstractThe study aims to analyse the clinical and immunological manifestations of paediatric antiphospholipid syndrome (APS) in patients, based on the 2006 revised classification criteria of definite APS. Fifty-eight paediatric patients with APS were enrolled and analysed retrospectively. A total of 37 female and 21 male patients with a mean age of 14  ± 3 years at disease onset were included. Fourteen (24%) cases were primary APS, and 40 (69%) cases were secondary to systemic lupus erythaematosus (SLE). Anti-nuclear antibody (ANA) positivity and hypocomplementemia were more common in secondary APS t...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Secretory sphingomyelinase (S-SMase) activity is elevated in patients with rheumatoid arthritis
AbstractThe goals of this study were to determine if secretory sphingomyelinase (S-SMase) activity is elevated in patients with rheumatoid arthritis (RA) compared to control subjects and to examine the relationships of S-SMase activity with functional status, quality of life, and RA disease activity measurements. We collected data on 33 patients who were diagnosed with RA and 17 non-RA controls who were comparable in terms of age, sex, and race. Demographic, clinical data and self-reported measures of fatigue, pain, and physical function were obtained directly from patients and controls. RA patients also completed quantita...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Clinical characteristics associated with subcutaneous tophi formation in Chinese gout patients: a retrospective study
The objective of this study is to analyze clinical characteristics associated with the formation of subcutaneous tophi among Chinese gout patients. It was a retrospective outpatient cohort study. Five thousand six hundred ninety-three gout patients treated at the Affiliated Hospital of Qingdao University from March 2011 to February 2016 were included and divided into the tophus group and non-tophus group according to the presence of megascopic tophus. Relevant clinical information and biochemical parameters were analyzed to identify potential risk factors for the incidence of subcutaneous tophi. There are significant difference (P 
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Unexplained cough: it is time to rule out Sjogren ’s syndrome
We describe patients in whom unexplained chronic cough was associated with dry eyes. Focused workup revealed undiagnosed Sjogren’s syndrome in 36%. Dry eyes, with or without SS, is under-recognized and should be added to diagnostic algorithms for unexplained cough. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Correction to: Henoch-Sch önlein purpura nephritis: initial risk factors and outcomes in a Latin American tertiary center
AbstractOne of the author ’s name on this article was incorrectly spelled as “Sylvia C. L. Fahrat” . The correct spelling is “Sylvia C. L. Farhat” and is now presented correctly in this article. The original article has been corrected. (Source: Clinical Rheumatology)
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Increased serum levels of adhesion molecules ICAM-1 and VCAM-1 in systemic sclerosis are not specific for pulmonary manifestations
AbstractStudies suggest elevated serum intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) levels may be markers of pulmonary arterial hypertension in systemic sclerosis (SSc-PAH). We sought to evaluate whether ICAM-1 and VCAM-1 levels are useful screening biomarkers for incident SSc-PAH. In this cross-sectional study, four groups were selected from the Australian Scleroderma Cohort Study: group 1 (n = 15) had definite PAH; group 2 (n = 19) had interstitial lung disease (ILD); group 3 (n = 30) were SSc-controls; and group 4 (n = 3...
Source: Clinical Rheumatology - April 23, 2018 Category: Rheumatology Source Type: research

Predictors of activity limitation in people with gout: a prospective study
The objective of the study was to determine clinical factors associated with activity limitation and predictors of a change in activity limitation after 1  year in people with gout. Two hundred ninety-five participants with gout (disease duration
Source: Clinical Rheumatology - April 21, 2018 Category: Rheumatology Source Type: research