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undifferentiated spondyloarthritis

Polina Putrik, Sofia Ramiro, Juan F Orueta, Andras Keszei, Edurne Alonso Moran, Roberto Nuño Solinis, Annelies Boonen
OBJECTIVES: To explore and compare the impact of socio-economic deprivation on the occurrence of the major rheumatic and musculoskeletal diseases (RMDs) and health care costs. METHODS: Data on diagnoses, socio-demographics and health care costs of the entire adult population of the Basque Country (Spain) was used. Area deprivation index included five categories (1 to 5 (most deprived)). Cost categories included primary and specialist care, emergency room, hospitalisations, and drug prescriptions...
January 31, 2018: Clinical and Experimental Rheumatology
Riccardo Terenzi, Sara Monti, Giulia Tesei, Linda Carli
The term spondyloarthritis (SpA) represents a condition characterised by a broad spectrum of clinical manifestations, laboratory abnormalities and imaging features; in particular, SpA is an inflammatory condition in which both peripheral and axial joints might be affected. The majority of people with this disease have either psoriatic arthritis or axial spondyloarthritis, which includes ankylosing spondylitis. Less common subgroups are enteropathic SpA, which is associated with inflammatory bowel diseases (Crohn's disease and ulcerative colitis), reactive arthritis, which can occur in people following gastrointestinal or genitourinary infections and undifferentiated SpA, that does not meet the diagnostic criteria of the other subgroups at onset, but that may evolve to do so later...
January 2018: Clinical and Experimental Rheumatology
Christopher Ritchlin
The inclusion of the imaging arm in the Assessment of SpondyloArthritis International Society (ASAS) Classification Criteria catalyzed a transformation in the classification, diagnosis and treatment of axial SpA (1). A majority of patients with inflammatory back pain do not demonstrate radiographic changes and some were classified as undifferentiated spondyloarthritis (SpA) based on associated clinical features. (2). This nebulous classification was confusing at best and not recognized by many clinicians. As a result, the therapeutic approach to this group of patients was not well-defined...
February 12, 2018: Arthritis & Rheumatology
A Bremander, E Haglund, S Bergman, M Ndosi
OBJECTIVES: The aim of the present study was to validate the Swedish version of the educational needs assessment tool (SwENAT) in undifferentiated spondyloarthritis (USpA) and use it to study the educational needs of patients with USpA. METHODS: This was a cross-sectional study, recruiting a random sample of patients with USpA from a hospital register in Sweden. Educational needs data were collected, together with disease activity and function indices (Bath Ankylosing Spondylitis Disease Activity Index [BASDAI] and Bath Ankylosing Spondylitis Functional Index [BASFI])...
February 7, 2018: Musculoskeletal Care
Mariam Siala, Markus Rihl, Hanen Sellami, Abir Znazen, Nadia Sassi, Lilia Laadhar, Radhouane Gdoura, Imen Belghuith, Dalila Mrabet, Sofien Baklouti, Slaheddine Sellami, Jean Sibilia, Hela Fourati, Adnene Hammami, Ilhem Cheour
Enterobacterial components in the joints of patients are believed to contribute to a perpetuating inflammation leading to a reactive arthritis (ReA), a condition in which microbial agents cannot be recovered from the joint. At present, it is unclear whether nucleic acids from Shigella spp. are playing a pathogenic role in causing not only ReA but also other forms of arthritis. Quantitative real-time polymerase chain reaction assay (qPCR) is the method of choice for the identification of bacteria within the synovium...
February 5, 2018: Rheumatology International
Karin Bengtsson, Helena Forsblad-d'Elia, Elisabeth Lie, Eva Klingberg, Mats Dehlin, Sofia Exarchou, Ulf Lindström, Johan Askling, Lennart T H Jacobsson
OBJECTIVES: To describe the incidence of atrioventricular (AV) block II-III, atrial fibrillation (AF), pacemaker implantation (PM) and aortic regurgitation in patients with ankylosing spondylitis (AS), undifferentiated spondyloarthritis (uSpA) and psoriatic arthritis (PsA) compared with the general population (GP) and with each other. METHODS: A prospective nationwide study with cohorts of patients with AS (n=6448), PsA (n=16 063) and uSpA (n=5190) and a GP (n=2 66 435) cohort, identified in 2001-2009 in the Swedish National Patient and Population registers...
December 19, 2017: Annals of the Rheumatic Diseases
Atul Deodhar, Pierre Miossec, Xenofon Baraliakos
The concept of undifferentiated spondyloarthritis has been introduced recently to describe a clinical setting where the classical features of spondyloarthritis (SpA) are not fully present. Whether this is a discrete entity was the basis of a debate during the 4th International Congress on Controversies in Rheumatology & Autoimmunity held in Bologna, Italy 9-11 March 2017. The pro and con aspects of the debate are presented. The implications of the debate are important ranging from diagnostic aspects to consequences for the society and the payers...
November 3, 2017: Autoimmunity Reviews
Mayra Rauseo Vera, Luis Arturo Gutiérrez-González, Irama Maldonado, Soham Al Snih
INTRODUCTION: Spondyloarthropathies (SpA) are disabling diseases with a prevalence of 1.9% in the general population. The indices designed for monitoring the disease should be valid, reliable and cross-culturally adapted for decision-making concerning the appropriate treatment. Changing an adjective or pronoun in a self-administered questionnaire could be the big difference in condensing an idea in a few words and transmitting that concept to all those who share the same language. OBJECTIVES: To develop a Venezuelan version of the original English version of the BASDAI/BASFI and to evaluate its reliability and validity in Venezuelan patients with SpA...
September 21, 2017: Reumatología Clinica
Se Jin Byun, William Han Bae, Seung Min Jung, Sang-Won Lee, Yong-Beom Park, Jason Jungsik Song
OBJECTIVES: We aimed to evaluate a wide spectrum of clinical features of adult patients with spondyloarthritis (SpA) whose initial manifestation was fever, using the Assessment of SpondyloArthritis international Society (ASAS) classification criteria. METHODS: We retrospectively collected the electronic medical records of hospitalized SpA patients who initially presented to the Severance Hospital (Seoul, Korea) with fever from January 2010 to May 2016. As a control group, we also recruited one-hundred consecutive patients who were diagnosed with SpA in our outpatient clinic...
2017: PloS One
Jjl Meesters, S Bergman, E Haglund, Lth Jacobsson, I F Petersson, A Bremander
OBJECTIVES: Anxiety and depression symptoms are more common in patients with spondyloarthritis (SpA) than in the general population. This study describes prognostic factors for change in self-reported anxiety and depression over 2 years in a well-defined SpA cohort. METHOD: In 2009, 3716 adult patients from the SpAScania cohort received a postal questionnaire to assess quality of life (QoL) and physical and mental functioning. A follow-up survey was performed in 2011...
August 16, 2017: Scandinavian Journal of Rheumatology
M Lorenzin, A Ortolan, S Vio, M Favero, F Oliviero, M Zaninotto, C Cosma, C Lacognata, L Punzi, R Ramonda
The study aimed to evaluate biomarkers facilitating early diagnosis of axial spondyloarthritis (axSpA) and correlations between them and disease activity parameters and imaging indexes. Patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years) participating in the Italian arm of the SpondyloArthritis-Caught-Early SPACE study underwent a physical examination, questionnaires, laboratory tests, X-rays and MRI of the spine and sacroiliac joints (SIJ). An expert rheumatologist formulated axSpA diagnosis in accordance with Assessment of SpondyloArthritis International Society (ASAS) criteria...
August 3, 2017: Reumatismo
Louise T Bendahan, Natália P Machado, Jamille G Mendes, Thauana L Oliveira, Marcelo M Pinheiro
AIM: To evaluate the performance of four different classification criteria for spondyloarthritis (SpA) in patients with late-onset symptoms and to compare the clinical, laboratory and radiographic outcomes among the patients with symptoms before and after 45 years of age. PATIENTS AND METHODS: A total of 329 patients with SpA were enrolled in this prospective cohort. Patients with psoriatic arthritis, reactive arthritis, colitis associated arthritis and peripheral or undifferentiated SpA were excluded...
June 1, 2017: Modern Rheumatology
Zofia Guła, Tacjana Barczyńska, Marek Brzosko, Jerzy Gąsowski, Sławomir Jeka, Katarzyna Jodłowska-Cicio, Beata Kwaśny-Krochin, Piotr Leszczyński, Łukasz Lubiński, Katarzyna Łosińska, Katarzyna Pawlak-Buś, Hanna Przepiera-Będzak, Włodzimierz Samborski, Małgorzata Schlabs, Maciej Siedlar, Dorota Sikorska, Jerzy Świerkot, Małgorzata Węgierska, Piotr Wiland, Mariusz Korkosz
OBJECTIVES: Report on one-year results from the Polish Spondyloarthritis Initiative registry (PolSPI), containing the cross-sectional analysis of clinical and imaging data as well as database methodology. MATERIAL AND METHODS: The PolSPI registry includes patients with axial (axSpA) and peripheral (perSpA) spondyloarthritis according to ASAS classification criteria, and/or patients with ankylosing spondylitis according to modified New York criteria, psoriatic arthritis according to CASPAR criteria, arthropathy in inflammatory bowel disease, reactive arthritis, juvenile spondyloarthritis or undifferentiated spondyloarthritis...
2017: Reumatologia
Karin Bengtsson, Helena Forsblad-d'Elia, Elisabeth Lie, Eva Klingberg, Mats Dehlin, Sofia Exarchou, Ulf Lindström, Johan Askling, Lennart T H Jacobsson
BACKGROUND: To investigate the risk of first-time acute coronary syndrome (ACS), stroke and venous thromboembolism (VTE) in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) and undifferentiated spondyloarthritis (uSpA), compared to each other and to the general population (GP). METHODS: This is a prospective nationwide cohort study. Cohorts with AS (n = 6448), PsA (n = 16,063) and uSpA (n = 5190) patients and a GP (n = 266,435) cohort, were identified 2001-2009 in the Swedish National Patient and Population registers...
May 18, 2017: Arthritis Research & Therapy
Fabián Salas-Cuestas, Wilson Bautista-Molano, Juan M Bello-Gualtero, Ivonne Arias, Diana Marcela Castillo, Lorena Chila-Moreno, Rafael Valle-Oñate, Daniel Herrera, Consuelo Romero-Sánchez
INTRODUCTION: Both reactive arthritis (ReA) and undifferentiated spondyloarthritis (uSpA) belong to the group of autoinflammatory diseases called spondyloarthritis (SpA). Hypotheses have been proposed about a relationship between the intestinal mucosa and inflammation of joint tissues. The role of immunoglobulin IgA or secretory immunoglobulin A (SIgA) in the inflammatory and/or clinical activity of patients with SpA remains poorly understood. OBJECTIVE: To evaluate the status of total IgA and SIgA, and the association among the levels of SIgA, IgA, IgA anti-Chlamydia trachomatis, and anti-Shigella spp...
2017: Frontiers in Immunology
Abhra Chandra Chowdhury, Smriti Chaurasia, Shravan Kumar Mishra, Amita Aggarwal, Ramnath Misra
The IL-17/1L-23 axis is important in the pathogenesis of spondyloarthropathy. Innate cells produce IL-17 in addition to Th17 cells. We studied the frequencies of natural killer (NK) (total, CD56bright , CD56dim , perforin+ and granzyme+), NK-T, γδ-T, and IFN-γ+, IL-17+ NK and γδ-T cells in peripheral blood (PB) and synovial fluid (SF) of ReA/uSpA patients. PB from 45 patients and paired SF from 39 patients were studied, together with PB from 18 healthy controls (HC). The frequency of γδ-T cells was decreased (p<0...
October 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Qing Xia, Dazhi Fan, Xiao Yang, Xiaona Li, Xu Zhang, Mengmeng Wang, Shengqian Xu, Faming Pan
BACKGROUND: The idea that undifferentiated spondyloarthritis (uSpA) represents the early undifferentiated stage of ankylosing spondylitis (AS) and other well-defined SpA subtypes is well known. The gist of this study is to assess the rate estimate of patients with uSpA evolved to AS during long-term follow-up. METHODS: A systematic search was implemented to identify pertinent articles. The primary outcome was the rate estimate that patients with uSpA fulfilling the diagnosis of AS according to the modified New York criteria during follow-up...
January 2017: Medicine (Baltimore)
Ana M Santos, Paola Peña, Mabel Avila, Ignacio Briceño, Carlos Jaramillo, Gilberto Vargas-Alarcon, Juan C Rueda, Eugenia-Lucia Saldarriaga, Jose-Ignacio Angarita, Nancy Martinez-Rodriguez, John Londono
There is substantial evidence that non-B27 major histocompatibility complex (MHC) genes are associated with spondyloarthritis (SpA). Studies in Mexican and Tunisian populations demonstrated the association of SpA and human leukocyte antigen (HLA) B15. The purpose of this study was to evaluate the association of HLA-A, B, and DR antigens in a group of Colombian patients with a diagnosis of SpA. A total of 189 patients and 100 healthy subjects were included in the present study. All subjects underwent a complete characterization of HLA alleles A, B, and DR...
April 2017: Clinical Rheumatology
York Kiat Tan, Li-Ching Chew, John C Allen, Weng Kit Lye, Lei Lei Htay, Ali Hassan, Philip G Conaghan, Julian Thumboo
OBJECTIVE: To determine the utility of ultrasonography in guiding modification of disease-modifying anti-rheumatic drug (DMARD) and steroid therapy for inflammatory arthritis (IA) in routine clinical practice. METHODS: In this retrospective study, we analyzed DMARD and steroid use in IA patients referred to a rheumatologist-led ultrasound clinic. Power Doppler (PD) vascularity and greyscale (GS) synovial hypertrophy joint findings were categorized as positive/negative for each patient...
August 19, 2016: International Journal of Rheumatic Diseases
Simon Krabbe, Cigdem Gül, Bjarne Andersen, Niels Tvede
This case report describes a patient with arthritis of the large joints, bilateral sacroiliitis, and positive anti-SSA and anti-dsDNA antibody, who received sulfasalazine and shortly thereafter became critically ill. He developed toxic epidermal necrolysis, hemolytic anemia, lymphopenia, markedly elevated ferritin, and muscle wasting. A diagnosis of systemic lupus erythematosus was made, and mycophenolate mofetil and systemic glucocorticoids brought this severe disease under control. Toxic epidermal necrolysis-like lesions and hemophagocytic syndrome have been reported as manifestations of systemic lupus erythematosus...
2016: Case Reports in Rheumatology
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