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History of the rheumatology

Robert Szulawski, Peter J Kourlas, Marc Antonchak
BACKGROUND Systemic lupus erythematosus (SLE) has myriad manifestations that can affect any organ system in the body. Macrophage activation syndrome (MAS) is a disease of uncontrolled lymphocyte and macrophage proliferation and activation, which has various triggers, including autoimmune disorder, viral infection, and malignancy. We report here on MAS as a complication of adult SLE, a rare association in the literature, in a patient with an unknown past medical history. CASE REPORT A 38-year-old male patient presented with severe muscle weakness, diffuse abdominal cramps with vomiting and incontinence of stool, confusion, cough, and sweating increasing in severity for about 1 week...
June 22, 2018: American Journal of Case Reports
Jayaseelan Venkatachalam, Murugan Natesan, Muthurajesh Eswaran, Abel K Samuel Johnson, V Bharath, Zile Singh
Background: Osteoarthritis (OA) is one of the most common degenerative disorders among the elderly population; although aging is the most important cause, research has shown that it is a complex disease with many etiologies. It is not an inevitable part of aging but rather the result of a combination of factors, many of which can be modified or prevented. Objective: The objective of this study was to assess the burden and determinants of OA knee among the adult population...
April 2018: Indian Journal of Public Health
Weixun Zhou, Yan Huang, Jinping Lai, Jun Lu, Michael Feely, Xiuli Liu
An increasing number of drugs including monoclonal antibodies and small molecules, either anti-inflammatory or immunity-enhancing, have been developed to treat human diseases and the number of medications in these classes is likely to expand in the future. The two most commonly used categories of such therapies are the anti-inflammatory group (anti- tumor necrosis factor (TNF) α, anti-interleukins/interleukin receptors, and anti-integrin bodies) and the anti-tumoral agents (immune checkpoint inhibitors, anti-CD20, and anti-endothelial growth factor)...
June 2018: Gastroenterology Research
Aiko Saku, Shunsuke Furuta, Masaki Hiraguri, Kei Ikeda, Yoshihisa Kobayashi, Shin-Ichiro Kagami, Kazuhiro Kurasawa, Ryutaro Matsumura, Daiki Nakagomi, Takao Sugiyama, Takeshi Umibe, Norihiko Watanabe, Hiroshi Nakajima
OBJECTIVE: Patients with eosinophilic granulomatosis with polyangiitis (EGPA) frequently experience relapses, which lead to cumulative organ damage. In this retrospective observational study, we aimed to reveal the risk factors for relapse in EGPA. METHODS: A total of 188 Japanese patients with EGPA diagnosed between 1996 and 2015 were identified from medical records in 10 hospitals. The diagnosis was based on the American College of Rheumatology 1990 criteria or Lanham's criteria...
June 15, 2018: Journal of Rheumatology
Ling Li, Shu-Xia Wang, Hong-Mei Wu, Dong-Lan Luo, Guang-Fu Dong, Yuan Feng, Xiao Zhang
The aim of the present study was to assist rheumatologists in differentiating hypophosphatemic osteomalacia (HO) from mimic rheumatology diseases. Clinical data was obtained from 9 patients with acquired HO, initially misdiagnosed as mimic rheumatologic diseases. The data were retrospectively analyzed and a literature review was performed. The etiology of the cases was as follows: Adefovir dipivoxil-induced Fanconi syndrome was present in 6 of the cases, 2 were tumors and 1 case was chronic nephropathy. The chief complaint was thoracic or back pain and arthralgia, followed by progressive muscle weakness and dramatic movement limitation...
June 2018: Experimental and Therapeutic Medicine
Ruben Daniel Arellano, Lizette Sarai Aguilar, Rafael Argüello, Fernando Hernadez, Faviel Francisco Gonzalez, Javier Moran
Objectives: This study aims (i) to compare synovial fluid and serum cartilage oligomeric matrix protein levels in patients with primary knee osteoarthritis and healthy controls, (ii) compare variations of synovial fluid and serum cartilage oligomeric matrix protein levels according to sex, Kellgren-Lawrence grades, and daytime sampling, and (iii) correlate the synovial fluid and serum cartilage oligomeric matrix protein levels with age, severity of disease, and daytime sampling. Patients and methods: One hundred and twenty-four individuals (44 males, 80 females; median age 66 years; range 42 to 87 years) were diagnosed with primary knee osteoarthritis according to the American College of Rheumatology guidelines...
September 2017: Archives of Rheumatology
Philip S Helliwell, Dafna D Gladman, Alice B Gottlieb
The 2017 Annual Meeting of the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) was held in Amsterdam, the Netherlands, and was attended by rheumatologists, dermatologists, representatives of biopharmaceutical companies, and patients. As in previous years, GRAPPA members held a symposium for trainees to discuss their research in psoriatic disease with experts in the field. Other subjects featured during the annual meeting included a discussion of the history, clinical features, controversies, and immunogenetics of juvenile psoriatic arthritis; updates from working groups in Outcome Measures in Rheumatology and International Dermatology Outcome Measures; a discussion of the benefits and challenges of setting up a longitudinal psoriatic arthritis (PsA) database; 3 separate discussions of the effects of the microbiome on skin and joints in psoriasis and PsA; a discussion of options for assessing joints and entheses in PsA by ultrasonography and magnetic resonance imaging; an update on GRAPPA's research and educational projects; a discussion of patient centricity, including the incorporation of patient research partners (PRP) into psoriasis and PsA research and educational efforts, from GRAPPA's PRP; and a discussion of the GRAPPA-Collaborative Research Network's inaugural meeting...
June 2018: Journal of Rheumatology. Supplement
Keitaro Nakamoto, Takeshi Saraya, Yukari Ogawa, Haruyuki Ishii, Hajime Takizawa
BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis with eosinophilia. EGPA can occur in patients with comorbid bronchial asthma (BA) and other pulmonary diseases. However, because of its rarity, there are few reports on thoracic computed tomography (CT) findings in patients with EGPA, especially in relation to comorbid BA. The aim of this study was to compare between the clinical characteristics of EGPA, the severity and duration of BA, and the findings on thoracic CT...
June 2018: Respiratory Medicine
Boris Ehrenstein, Georg Pongratz, Martin Fleck, Wolfgang Hartung
Objectives: We aimed to study the ability of board-certified rheumatologists, blinded to all prior diagnostic test results, to establish the presence/absence of an inflammatory rheumatic disease (IRD) or RA among polyarthralgia or arthritis patients, solely relying on clinical assessment. Methods: We performed a prospective, examiner-blinded, cross-sectional study documenting the diagnostic work in four sequential steps (medical history, physical examination, musculoskeletal ultrasonography and laboratory tests) of board-certified rheumatologists in a convenience cohort of 100 patients referred for inpatient diagnostic workup to a tertiary care rheumatology centre...
May 29, 2018: Rheumatology
Starr-Mar'ee C Bedy, Jacob P Kesterson, Greg Flaker
A 65-year-old Caucasian man was hospitalized for a non-ST-elevation myocardial infarction. On discharge, the patient was started on multiple new medications, including clopidogrel and atorvastatin. Twenty-six days after discharge, he presented to the Emergency Department (ED) with polyarthralgias. He was instructed to stop atorvastatin and to follow up with rheumatology and cardiology clinic. At cardiology clinic follow-up 43 days after ED discharge, clopidogrel was discontinued and patient was switched to ticagrelor...
2018: Case Reports in Emergency Medicine
Jean-Michel Dayer
Long-term cell cultures developed early in the twentieth century allowed identification in their supernatants of biological mediators subsequently defined as migration factors, interferons, lymphokines, monokines, cytokines and interleukins. In rheumatology, early in the 1930s, synovial cell cultures revealed two major distinct populations, i.e. synovial fibroblasts and monocyte-macrophages. Discovery of the interstitial collagenase (MMP-1) and its role in tissue destruction, such as in rheumatoid arthritis (RA), raised the question of the cellular source for this enzyme...
May 30, 2018: Arthritis Research & Therapy
Eckart Mummert, Marvin J Fritzler, Christopher Sjöwall, Chelsea Bentow, Michael Mahler
Autoantibodies against double-stranded DNA (dsDNA) were first described >60 years ago and although they are still one of the most clinically relevant autoantibodies, test results may be more challenging to interpret compared to other autoantibody tests. They are a serological hallmark of systemic lupus erythematosus (SLE) and are included in both the American College of Rheumatology (ACR) and the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE. Furthermore, anti-dsDNA antibodies (a-dsDNA) have been shown to associate with SLE disease activity and coincide with renal involvement...
May 26, 2018: Journal of Immunological Methods
Douglas A Young, Annikka Frostad-Thomas, Jaana Gold, Allen Wong
BACKGROUND AND OVERVIEW: The authors describe dental treatment for a patient with a complex medical history of secondary Sjögren syndrome with systemic lupus erythematosus and rheumatoid arthritis. CASE DESCRIPTION: An 18-year-old woman's rheumatology group referred her for oral evaluation; she had secondary Sjögren syndrome, systemic lupus erythematosus, and rheumatoid arthritis. The patient had multiple advanced carious lesions, extreme sensitivity, and hyposalivation...
May 24, 2018: Journal of the American Dental Association
K A Young, M E Munroe, J B Harley, J M Guthridge, D L Kamen, G S Gilkensen, M H Weisman, D R Karp, D J Wallace, J A James, J M Norris
Background The role of sleep in the etiology of systemic lupus erythematosus (SLE) has not been well studied. We examined whether sleep duration was associated with subsequent transitioning to SLE in individuals at risk for SLE. Methods Four hundred and thirty-six relatives of SLE patients who did not have SLE themselves at baseline were evaluated again an average of 6.3 (± 3.9) years later. Fifty-six individuals transitioned to SLE (≥ 4 cumulative American College of Rheumatology (ACR) criteria). Sleep duration, medication use and medical history were assessed by questionnaire; ACR criteria were confirmed by medical record review...
January 1, 2018: Lupus
Elaine Kunzler, Linda S Hynan, Benjamin F Chong
Importance: Increased rates of autoimmune conditions have been reported in association with systemic lupus erythematosus (SLE). Little is known about coexisting autoimmune conditions in patients with cutaneous lupus erythematosus (CLE) without SLE. Objective: To determine the prevalence and risk factors of having coexisting autoimmune conditions in patients with CLE. Design, Setting, and Participants: This cross-sectional study was performed from November 2008 to February 2017 at the University of Texas Southwestern Medical Center (UTSW) and Parkland Health and Hospital System, Dallas, Texas...
May 2, 2018: JAMA Dermatology
Mathieu Jouvray, David Launay, Sylvain Dubucquoi, Vincent Sobanski, Céline Podevin, Marc Lambert, Sandrine Morell-Dubois, Hélène Maillard, Pierre-Yves Hatron, Eric Hachulla, Jonathan Giovannelli
Importance: In systemic sclerosis (SSc), to date, no study has precisely described the total number and fine distribution of telangiectases (TAs), their clinical association with the disease, and the biological mechanisms causing their development. Objectives: To describe the whole-body distribution of TAs and assess the association between the whole-body TA number and the characteristics of patients with SSc. Design, Setting, and Participants: A single-center, cross-sectional study was conducted between July 11, 2016, and March 15, 2017, at the National Referral Centre for Rare Systemic and Autoimmune Diseases in France...
May 16, 2018: JAMA Dermatology
John G Skedros, James S Smith, Marshall K Henrie, Ethan D Finlinson, Joel D Trachtenberg
We report the case of a 30-year-old Polynesian male with a severe gout flare of multiple joints and simultaneous acute compartment syndrome (ACS) of his right forearm and hand without trauma or other typical causes. He had a long history of gout flares, but none were known to be associated with compartment syndrome. He also had concurrent infections in his right elbow joint and olecranon bursa. A few days prior to this episode of ACS, high pain and swelling occurred in his right upper extremity after a minimal workout with light weights...
2018: Case Reports in Orthopedics
Carl S Wilkins, Katherine McCabe, Avnish Deobhakta, James Chelnis
Purpose: To report a rare case of isolated, unilateral CRAO in a young patient with mitral valve prolapse secondary to Barlow's disease. Observations: A 29-year-old woman with history of premature ventricular contractions and cardiac ablation presented to the emergency room after sudden onset painless visual loss in her left eye (OS). Her vision was 20/20 in her right eye and hand motion in the left. Fundus exam demonstrated a central retinal artery occlusion (CRAO) OS...
June 2018: American Journal of Ophthalmology Case Reports
Zofia Gerlicz-Kowalczuk, Jolanta D Torzecka, Elżbieta Dziankowska-Zaborszczyk, Alicja Ograczyk, Anna M Zalewska-Janowska, Anna Woźnicka, Bożena Dziankowska-Bartkowiak
Introduction: Systemic sclerosis (SSc) is a chronic autoimmune connective tissue disorder characterized by immunological deviations and generalized microvascular damage. Aim: To determine the serum level of the von Willebrand factor cleaving protease (ADAMTS13) in 39 SSc patients and healthy controls. Material and methods: ADAMTS13 serum level was determined in 39 SSc patients and 11 healthy controls. Complete history of the patients was recorded and thorough clinical, rheumatological, and dermatological examinations were performed...
April 2018: Postȩpy Dermatologii i Alergologii
Leeza Patel, Alison M Gizinski
Rheumatologic laboratory tests are frequently ordered by primary care physicians in patients who complain of joint pain. Clinicians should keep in mind the pretest probability of a rheumatologic disorder before ordering any test because laboratory tests in rheumatology are not diagnostic of any particular disease. Any rheumatologic laboratory test result should only be used to further refine the diagnosis, and it should not replace a thorough history and physical examination. In this article, the authors discuss the diagnostic utility of the commonly ordered rheumatologic laboratory tests based on their sensitivity, specificity, and likelihood ratios...
June 2018: Primary Care
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