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Current Opinion in Rheumatology

Marco Lopez Velazquez, Kristin B Highland
PURPOSE OF REVIEW: Systemic lupus erythematosus (SLE) and Sjögren syndrome are chronic autoimmune inflammatory disorders that can present with multiorgan involvement including the lungs. This review will focus on recent literature pertaining to the epidemiology, pathogenesis, clinical presentation and diagnosis and management of SLE and Sjögren syndrome-associated pulmonary conditions. RECENT FINDINGS: Pulmonary manifestations of both disease entities have been well characterized and lung involvement can be observed during the course of the disease in most cases...
July 5, 2018: Current Opinion in Rheumatology
Jessica Neely, Emily von Scheven
PURPOSE OF REVIEW: Autoimmune haemolytic anaemia (AIHA) and autoimmune thrombocytopenia are common complications of childhood-onset lupus, which may be life-threatening. A greater understanding of the pathogenesis of these haematologic manifestations will enhance our understanding of the biology of systemic lupus erythematosus (SLE) and inform the identification of novel treatments. RECENT FINDINGS: The mechanisms underlying AIHA and autoimmune thrombocytopenia are incompletely understood and likely multifactorial...
July 3, 2018: Current Opinion in Rheumatology
Albert Selva-O'Callaghan, Xavier Martinez-Gómez, Ernesto Trallero-Araguás, Iago Pinal-Fernández
PURPOSE OF REVIEW: Despite the well-recognized association between malignancy and myositis, definite data indicating the best strategy for diagnosing cancer in myositis patients is lacking. In this article, we review the data on cancer screening in patients with myositis, and propose an algorithm for this purpose based on recently published data. RECENT FINDINGS: Evidence has recently emerged supporting blind screening in patients with certain myositis phenotypes...
June 29, 2018: Current Opinion in Rheumatology
Florence A Aeschlimann, Ronald M Laxer
PURPOSE OF REVIEW: This review aims at summarizing the current knowledge of A20 haploinsufficiency and other paediatric inflammatory disorders with mucosal involvement. RECENT FINDINGS: A20 haploinsufficiency is a newly described autoinflammatory disease caused by loss-of-function mutations in TNFAIP3 that result in the activation of the nuclear factor (NF)-kB pathway. Patients may present with dominantly inherited, early-onset systemic inflammation and a Behçet-like disease, or a variety of autoinflammatory and autoimmune features...
June 16, 2018: Current Opinion in Rheumatology
Allison J Cox, Polly J Ferguson
PURPOSE OF REVIEW: To summarize the current advances in our understanding or the genetic basis of nonbacterial osteomyelitis. RECENT FINDINGS: Chronic recurrent multifocal osteomyelitis (CRMO) is a complex genetic disorder. Past discoveries identified several single gene defects (LPIN2, Pstpip2 and IL1RN) that cause IL-1-mediated sterile multifocal osteomyelitis. Recently Lorden et al.'s studies show that LIPIN2 deficiency can activate the NLRP3 inflammasome through alterations in the function of P2X7 receptor providing evidence that Majeed syndrome is an NLRP3 inflammasomopathy...
June 13, 2018: Current Opinion in Rheumatology
Gudny Ella Thorlacius, Marie Wahren-Herlenius, Lars Rönnblom
PURPOSE OF REVIEW: Systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS) share several clinical and laboratory features, including an overexpression of type I interferon (IFN) regulated genes. The genetic background to this IFN signature and the role of the type I IFN system in the disease process have been partly clarified. Here, we summarize the latest information concerning the type I IFN system in both diseases. RECENT FINDINGS: A number of gene variants in the type I IFN signalling pathways associate with an increased risk for both SLE and pSS in several ethnicities...
June 9, 2018: Current Opinion in Rheumatology
Alexis Mathian, Micheline Pha, Zahir Amoura
PURPOSE OF REVIEW: To review the latest data in the field of vaccinations in systemic lupus erythematosus (SLE), focusing on pneumococcal, seasonal influenza, herpes zoster and human papillomavirus infections. RECENT FINDINGS: Less than 40% of patients responded adequately to the 23-valent pneumococcal polysaccharide (PPS23) vaccine. A randomized controlled trial showed that sequential administration of the pneumococcal conjugate vaccine followed by the PPS23 vaccine was well tolerated but was not superior to the PPS23 vaccine alone in terms of immunogenicity...
June 9, 2018: Current Opinion in Rheumatology
Charlie Bridgewood, Abdulla Watad, Richard J Cuthbert, Dennis McGonagle
PURPOSE OF REVIEW: The spondyloarthopathies (SpA), which encompass related diseases that were originally viewed as autoimmune, are now known to have a strong innate immune or autoinflammatory initiation phase characterized by disease localization to tissue-specific sites based on the nuances and microanatomy and immunology of those sites. This review covers recent translational advances in the field of SpA. RECENT FINDINGS: Imaging studies in SpA continue to add support for the pivotal role of enthesitis in disease initiation and expression...
June 9, 2018: Current Opinion in Rheumatology
Ye He, Amr H Sawalha
PURPOSE OF REVIEW: Rapid introduction of newly developed drugs in the absence of clear understanding of the pathophysiologic mechanisms behind drug-induced lupus erythematosus (DILE) can sometimes make DILE difficult to recognize in clinical practice. The purpose of this review is to summarize drugs most recently reported to be involved in DILE and discuss the current landscape of diverse mechanisms involved. RECENT FINDINGS: A large number of proton pump inhibitor (PPI)-induced subacute cutaneous lupus erythematosus cases have been reported, suggesting a shift over time in the spectrum of drugs implicated in DILE...
June 4, 2018: Current Opinion in Rheumatology
Shima Yasin, Grant S Schulert
PURPOSE OF REVIEW: The past decade has seen substantial progress in defining the cause and pathogenesis of the chronic childhood arthropathy systemic juvenile idiopathic arthritis (SJIA) and its related complication macrophage activation syndrome (MAS). The purpose of this review is to describe and synthesize advances in this field, particularly since 2016, with the potential to transform clinical practice. RECENT FINDINGS: Newly developed MAS classification criteria have been further studied and validated in other diseases and populations, as well as a recently proposed score to distinguish MAS from familial hemophagocytic lymphohistiocytosis...
June 4, 2018: Current Opinion in Rheumatology
Yudong Liu, Mariana J Kaplan
PURPOSE OF REVIEW: The mechanisms leading to the development of premature atherosclerosis and vascular injury in systemic lupus erythematosus (SLE) remain to be fully elucidated. This is a comprehensive review of recent research developments related to the understanding of cardiovascular disease (CVD) in lupus. RECENT FINDINGS: SLE patients with lupus nephritis display significantly increased risk of myocardial infarction and CVD mortality than SLE patients without lupus nephritis...
June 4, 2018: Current Opinion in Rheumatology
Amaia Ugarte, Alvaro Danza, Guillermo Ruiz-Irastorza
PURPOSE OF REVIEW: The purpose of this review is highlighting the most recent evidence on the clinical efficacy and toxicity of glucocorticoids and antimalarials in systemic lupus erythematosus (SLE) and provide recommendations on their current use. RECENT FINDINGS: Glucocorticoid toxicity is well known. Recent data confirm the increased risk of infection and damage accrual. An observational study form Hong Kong has seen increased mortality among users of high-dose prednisone regimes...
June 4, 2018: Current Opinion in Rheumatology
Oded Shamriz, Yehuda Shoenfeld
PURPOSE OF REVIEW: Infections play a role in the pathogenesis of autoimmune diseases (AID). Several bacterial and viral pathogens play a double role, as both inducers and inhibitors of AID. In this review, we will present current evidence and discuss different aspects of this notion. RECENT FINDINGS: Infectors that both inhibit and induce AID include Helicobacter pylori, Klebsiella pneumoniae, hepatitis B virus, group B Coxsackieviruses, Epstein-Barr virus and Lymphocytic choriomeningitis virus...
July 2018: Current Opinion in Rheumatology
Bryan P Wordsworth, Carla J Cohen, Matteo Vecellio
PURPOSE OF REVIEW: To assess the utility of recent genetic findings in ankylosing spondylitis (AS) and axial spondyloarthropathy (SpA) in relation to diagnostic testing, prognosis and responses to biologic treatment and the development of new therapies. RECENT FINDINGS: AS and other forms of SpA are polygenic with more than 100 genes contributing to disease susceptibility. The role of genes in determining the outcome of the disease and response to treatment is less clear...
July 2018: Current Opinion in Rheumatology
Marleen G H van de Sande, Ronald F van Vollenhoven
PURPOSE OF REVIEW: The present review presents an overview of the evolution in trial design from mainly randomized placebo-controlled efficacy trials to more strategic clinical trials in rheumatoid arthritis and spondyloarthritis. Additionally, it relates to how these differently designed trials have affected clinical practice. RECENT FINDINGS: Placebo-controlled clinical trials, comparing a new agent to placebo on a stable background, have resulted in the development of a wide array of therapeutic agents in rheumatoid arthritis and spondyloarthritis...
July 2018: Current Opinion in Rheumatology
Marcella D Walker, John P Bilezikian
PURPOSE OF REVIEW: The purpose of this review is to describe recent advances and changes in the evaluation and management of primary hyperparathyroidism (PHPT). RECENT FINDINGS: Although it has long been recognized that asymptomatic PHPT is associated with bone loss, particularly at cortical skeletal sites when evaluated with dual-energy X-ray absorptiometry, new imaging techniques suggest that trabecular skeletal deterioration as well as clinically silent vertebral fractures and nephrolithiasis are common...
July 2018: Current Opinion in Rheumatology
Georg Kröber, Ulrich Weber
PURPOSE OF REVIEW: To summarize recent advances and challenges of using MRI toward early recognition of axial spondyloarthritis (SpA). RECENT FINDINGS: Low-grade bone marrow edema (BME) on sacroiliac joint (SIJ) MRI is nonspecific and may be misleading in recognition of axial SpA. Structural features on SIJ MRI along with BME may not only facilitate recognition of early disease, but also enhance specificity. Structural lesions on MRI and low-dose computed tomography are highly concordant, adding to criterion validity of SIJ MRI...
July 2018: Current Opinion in Rheumatology
Atul A Deodhar
No abstract text is available yet for this article.
July 2018: Current Opinion in Rheumatology
Yahel Segal, Daniel Zohar, Yehuda Shoenfeld
No abstract text is available yet for this article.
July 2018: Current Opinion in Rheumatology
Gregory Chang, Stephen Honig
No abstract text is available yet for this article.
July 2018: Current Opinion in Rheumatology
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