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undifferentiated arthritis

Arsenio Spinillo, Fausta Beneventi, Elena Locatelli, Vèronique Ramoni, Roberto Caporali, Claudia Alpini, Giulia Albonico, Chiara Cavagnoli, Carlomaurizio Montecucco
BACKGROUND: The burden of pregnancy complications associated with well defined, already established systemic rheumatic diseases preexisting pregnancy such as rheumatoid arthritis, systemic lupus erythematosus or scleroderma is well known. Systemic rheumatic diseases are characterized by a long natural history with few symptoms, an undifferentiated picture or a remitting course making difficult a timely diagnosis. It has been suggested that screening measures for these diseases could be useful but the impact of unrecognized systemic rheumatic disorders on pregnancy outcome is unknown...
October 18, 2016: BMC Pregnancy and Childbirth
Aurélie Najm, Carl Orr, Marie-Françoise Heymann, Géraldine Bart, Douglas J Veale, Benoît Le Goff
OBJECTIVE: The utility of synovial biopsy in increasing our understanding of the pathogenesis of inflammatory arthropathies, as well as in evaluating treatments, is well established. Ultrasound (US) allows synovial assessment and therefore assists in biopsying synovial tissue in a safe and well-tolerated manner. This study's objectives were to (1) determine the rate of success in retrieving synovial tissue using US guidance, (2) describe the indications for US-guided synovial biopsies in the clinical setting, (3) determine how frequently the synovial biopsy can lead to a clear diagnosis, and (4) assess the quality of the synovial tissue obtained using this technique...
October 15, 2016: Journal of Rheumatology
Jitesh Ahuja, Deepika Arora, Jeffrey P Kanne, Travis S Henry, J David Godwin
Connective tissue diseases (CTDs) are a heterogeneous group of conditions characterized by circulating autoantibodies and autoimmune-mediated organ damage. Common CTDs with lung manifestations are rheumatoid arthritis, scleroderma or systemic sclerosis, Sjögren syndrome, polymyositis/dermatomyositis, systemic lupus erythematosis, mixed connective tissue disease, and undifferentiated connective tissue disease. The most common histopathologic patterns of CTD-related interstitial lung disease are nonspecific interstitial pneumonia, usual interstitial pneumonia, organizing pneumonia, and lymphoid interstitial pneumonia...
November 2016: Radiologic Clinics of North America
G Akdemir, I M Markusse, Y P M Goekoop-Ruiterman, G M Steup-Beekman, B A M Grillet, P J S M Kerstens, W F Lems, T W J Huizinga, C F Allaart
To compare rheumatologists' adherence to treatment protocols for rheumatoid arthritis (RA) targeted at Disease Activity Score (DAS) ≤2.4 or <1.6. The BeSt-study enrolled 508 early RA (1987) patients targeted at DAS ≤2.4. The IMPROVED-study included 479 early RA (2010) and 122 undifferentiated arthritis patients targeted at DAS <1.6. We evaluated rheumatologists' adherence to the protocols and assessed associated opinions and conditions during 5 years. Protocol adherence was higher in BeSt than in IMPROVED (86 and 70 %), with a greater decrease in IMPROVED (from 100 to 48 %) than in BeSt (100 to 72 %)...
September 28, 2016: Clinical Rheumatology
Alicia Beatriz Costantino, Cristina Del Valle Acosta, Laura Onetti, Eduardo Mussano, Ignacio Isaac Cadile, Paola Virginia Ferrero
INTRODUCTION: Rheumatoid arthritis (RA) is a chronic autoimmune disease that is characterized by the presence of different autoantibodies such as rheumatoid factor (RF) and anti-citrullinated protein antibodies. CD4T cells expressing CXCR5, referred as follicular helper T cells (Tfh), collaborate with B cells to produce antibodies. Differential expression of CXCR3 and CCR6 within CD4(+)CXCR5(+) T cells defines three mayor subsets: CXCR3(+)CCR6(-) (Tfh1), CXCR3(-)CCR6(-) (Tfh2) and CXCR3(-)CCR6(+) (Tfh17)...
August 29, 2016: Reumatología Clinica
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
Bradley T Williamson, Lynda Foltz, Heather A Leitch
Autoimmune manifestations (AIM) are reported in up to 10-30% of myelodysplastic syndromes (MDS) patients; this association is not well defined. We present herein a retrospective chart review of single center MDS patients for AIM, a case discussion and a literature review. Of 252 MDS patients examined, 11 (4.4%) had AIM around MDS diagnosis. International Prognostic Scoring System scores were: low or intermediate (int)-1 (n=7); int-2 or high (n=4). AIM were: culture negative sepsis (n=7); inflammatory arthritis (n=3); vasculitis (n=4); sweats; pericarditis; polymyalgia rheumatica (n=2 each); mouth ulcers; pulmonary infiltrates; suspicion for Behcet's; polychondritis and undifferentiated (n=1 each)...
May 10, 2016: Hematology Reports
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
Maurizio Benucci, Francesca Li Gobbi, Francesca Bandinelli, Arianna Damiani, Maria Infantino, Valentina Grossi, Mariangela Manfredi, Simone Parisi, Enrico Fusaro, Alberto Batticciotto, Piercarlo Sarzi-Puttini, Fabiola Atzeni, Francesca Meacci
Biosimilar infliximab (INX) was recently approved by the European Medicine Agency for the treatment of rheumatoid arthritis, ankylosing spondylitis (AS), Crohn's disease, ulcerative colitis, psoriatic arthritis (PsA), and psoriasis on the grounds that its pharmacokinetics, safety, and efficacy were comparable to those of innovator INX. The aim of this study was to investigate the real-life efficacy, safety, and immunogenicity of switching from innovator to biosimilar INX in patients with spondyloarthritis (SpA)...
July 23, 2016: Immunologic Research
Iwona Sudoł-Szopińska, Grzegorz Pracoń
Plain radiography reveals specific, yet late changes of advanced psoriatic arthritis. Early inflammatory changes are seen both on magnetic resonance imaging and ultrasound within peripheral joints (arthritis, synovitis), tendons sheaths (tenosynovitis, tendovaginitis) and entheses (enthesitis, enthesopathy). In addition, magnetic resonance imaging enables the assessment of inflammatory features in the sacroiliac joints (sacroiliitis), and the spine (spondylitis). In this article, we review current opinions on the diagnostics of some selective, and distinctive features of psoriatic arthritis concerning magnetic resonance imaging and ultrasound and present some hypotheses on psoriatic arthritis etiopathogenesis, which have been studied with the use of magnetic resonance imaging...
June 2016: Journal of Ultrasonography
Rajni Srivastava, Sanat Phatak, Akhilesh Yadav, Preeti Bajpai, Amita Aggarwal
The enthesitis-related arthritis (ERA) category of juvenile idiopathic arthritis (JIA) is the most common category in India. HLA B27 has a high prevalence in ERA, and ILAR classification includes it in exclusion criteria for other categories, but due to its cost, it is not routinely done. We undertook this study to assess the prevalence of HLA B27 in ERA and other groups of juvenile arthritis in India. Consecutive patients of JIA ERA and select patients from other categories were recruited from a single tertiary care hospital over a span of 3 years...
October 2016: Rheumatology International
Marine Ferreyra, Guillaume Coiffier, Jean-David Albert, Claire David, Aleth Perdriger, Pascal Guggenbuhl
OBJECTIVE: To evaluate the performance of combined cytology and microcrystal detection in joint fluid for diagnosing septic arthritis. METHODS: Retrospective single-center study of joint fluid samples from patients with manifestations suggesting acute or chronic arthritis. The absolute leukocyte count (/mm(3)) was recorded; as well as the differential counts, particularly of neutrophils (%). Microcrystals were sought and bacteriological cultures performed. Septic arthritis was defined as positive cultures of joint fluid or blood samples...
June 2, 2016: Joint, Bone, Spine: Revue du Rhumatisme
Michael Samycia, Collette McCourt, Kam Shojania, Sheila Au
BACKGROUND: The Dermatology and Rheumatology Treatment Clinic is a novel multidisciplinary clinic where patients are concomitantly assessed by a rheumatologist and dermatologist. OBJECTIVES: To determine the number of patients seen in clinic, patient demographics, and most common diagnoses. METHOD: A retrospective review was performed over a 2-year period. Data collected included patient age, sex, dermatologic diagnosis, rheumatologic diagnosis, biopsies performed, and number of follow-up visits...
September 2016: Journal of Cutaneous Medicine and Surgery
Karin Hellgren, Lene Dreyer, Elizabeth V Arkema, Bente Glintborg, Lennart T H Jacobsson, Lars-Erik Kristensen, Nils Feltelius, Merete Lund Hetland, Johan Askling
BACKGROUND: Safety data on cancer risks following tumour necrosis factor α inhibitors (TNFi) in patients with spondyloarthritis (SpA) (here defined as ankylosing spondylitis (AS), undifferentiated spondarthropaties (SpA UNS), psoriatic arthritis (PsA)) are scarce. Our objective was to assess risks for cancer overall and for common subtypes in patients with SpA treated with TNFi compared with TNFi-naïve patients with SpA and to the general population. METHODS: From the Swedish (Anti-Rheumatic Therapy in Sweden (ARTIS)) and Danish (DANBIO) biologics registers, we assembled 8703 (ARTIS=5448, DANBIO=3255) patients with SpA initiating a first TNFi 2001-2011...
May 4, 2016: Annals of the Rheumatic Diseases
Hua Ye, Yin Su, Ru Li, Jinxia Zhao, Xiangyuan Liu, Yifang Mei, Zhiyi Zhang, Jialong Guo, Liqi Bi, Xia Liu, Guochun Wang, Jinjing Liu, Xiaomei Leng, Fei Gu, Lingyun Sun, Qinghua Zou, Yongfei Fang, Quan Jiang, Zhanguo Li
The aim of this study is to compare the three classification criteria for rheumatoid arthritis (RA) in a large cohort of early arthritis patients. Patients who had at least one clinically swollen joint with disease duration no more than 1 year and age more than 18 years were enrolled. The clinical and laboratory parameters were recorded. The patients were diagnosed by two experienced rheumatologists. Undiagnosed patients were followed up every 3 months until 1 year. The sensitivity, specificity, and predictive value were compared among the early RA (ERA) criteria, the 1987 ACR criteria, and the 2010 ACR/EULAR criteria in this inception cohort of early arthritis patients...
October 2016: Clinical Rheumatology
Zane Dāvidsone, Jeļena Eglīte, Arina Lazareva, Sarmīte Dzelzīte, Ruta Šantere, Dace Bērziņa, Valda Staņēviča
BACKGROUND: Temporomandibular joint (TMJ) arthritis is seen very often (38-87 %) in children with juvenile idiopathic arthritis (JIA). With contrast enhanced magnetic resonance imaging (MRI) we can detect more cases of TMJ arthritis than ever before. Previous studies show that HLA II class alleles may have protective or risk importance in JIA subtypes. Our objective is to identify HLA II class alleles of risk and protection in JIA patients with TMJ arthritis. METHODS: During the period from 2010 to 2015 MRI for TMJ was performed in 85 JIA patients who were genotyped for HLA- DRB1; DQB1 and DQA1 using RT-PCR with sequence-specific primers...
2016: Pediatric Rheumatology Online Journal
Liesbeth M De Winter, Wendy L J Hansen, Hanna W van Steenbergen, Piet Geusens, Jan Lenaerts, Klaartje Somers, Piet Stinissen, Annette H M van der Helm-van Mil, Veerle Somers
OBJECTIVES: Despite recent progress in biomarker discovery for RA diagnostics, still over one-third of RA patients-and even more in early disease-present without RF or ACPA. The aim of this study was to confirm the presence of previously identified autoantibodies to novel Hasselt University (UH) peptides in early and seronegative RA. METHODS: Screening for antibodies against novel UH peptides UH-RA.1, UH-RA.9, UH-RA.14 and UH-RA.21, was performed in two large independent cohorts...
August 2016: Rheumatology
S Chaurasia, A K Shasany, A Aggarwal, R Misra
In developing countries, one-third of patients with reactive arthritis (ReA) and undifferentiated spondyloarthropathy (uSpA) are triggered by Salmonella typhimurium. Synovial fluid mononuclear cells (SFMCs) of patients with ReA and uSpA proliferate to low molecular weight fractions (lmwf) of outer membrane proteins (Omp) of S. typhimurium. To characterize further the immunity of Omp of Salmonella, cellular immune response to two recombinant proteins of lmwf, OmpA and OmpD of S. typhimurium (rOmpA/D-sal) was assessed in 30 patients with ReA/uSpA...
August 2016: Clinical and Experimental Immunology
C C Okwara, G Ozoh, B C Nwatu
BACKGROUND: HIV infection may be associated with different arthropathies that are often underdiagnosed. There is also paucity of reported studies of relationship between clinical and laboratory features of HIV-infected patients and articular disorders. AIMS: To determine the predictors of articular disorders among HIV-infected patients seen at tertiary hospital Nigeria. SUBJECTS AND METHODS: Hospital-based cross-sectional descriptive study...
November 2015: Annals of Medical and Health Sciences Research
James Dale, Anne Stirling, Ruiqi Zhang, David Purves, Jonathan Foley, Martin Sambrook, Philip G Conaghan, Désirée van der Heijde, Alex McConnachie, Iain B McInnes, Duncan Porter
OBJECTIVE: To investigate whether an intensive early rheumatoid arthritis (RA) treat-to-target (T2T) strategy could be improved through the use of musculoskeletal ultrasound (MSUS) assessment of disease activity. METHODS: 111 newly diagnosed patients with RA or undifferentiated arthritis (symptom duration <1 year) were randomised to strategies that aimed to attain either DAS28-erythrocyte sedimentation rate (ESR)<3.2 (control) or a total power Doppler joint count≤1 during a combined DAS28-ESR/MSUS assessment (intervention)...
June 2016: Annals of the Rheumatic Diseases
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