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Alexandre Dumusc, Thomas Hügle
Reactive arthritis is usually regarded as a form of spondylarthritis. Patients generally present with an acute asymmetrical oligoarthritis following an episode of diarrhea or urethritis. The most frequent involved pathogens are Salmonella, Shigella, Campylobacter and Chlamydia trachomatis. Additional causative pathogens have been described. Non-steroidal anti-inflammatory drugs are the first line treatment for reactive arthritis, associated with physiotherapy. Occasionally, a short course of glucocorticoids or an intra-articular injection is needed...
March 7, 2018: Revue Médicale Suisse
João Eurico Fonseca, José António Pereira da Silva, Miguel Bernardes, Rui Cernadas, José Canas da Silva, Lúcia Costa, Taciana Videira, Luís C Miranda, Anabela Barcelos, Pedro A Laires, Raquel Dezerto, Marília D Pereira, Filomena Vidal, Esmeralda Cunha, Ana Morais, Carla Martins, Rui Mesquita
OBJECTIVES: Early diagnosis and treatment of Rheumatoid Arthritis (RA) and axial Spondylarthritis (axial SpA) can limit the impact of disease outcomes. This study evaluated the effectiveness of a referral program on the identification of patients with RA and axial SpA. METHODS: This was an observational, prospective, randomized (by clusters) study conducted in Portugal to evaluate the impact of the implementation of a set of referral support actions (RSA). The study was divided in two sub-studies, the RA sub-study and the axial SpA sub-study...
March 5, 2018: Acta Reumatológica Portuguesa
Loukman Omarjee, Vincent Jaquinandi, Guillaume Mahe
Spondylarthritis (SpA) is an inflammatory rheumatic disease associated with increased incidence of major adverse cardiovascular events (MACEs). Recently, Paramarta et al. proposed the use of the tyrosine kinase inhibitor Nilotinib in Spondyloarthritis to target certain inflammatory pathways. However, Nilotinib, which is highly effective for the treatment of patients with chronic myeloid leukaemia (CML), is also associated with an increased risk of MACEs. The authors suggest that Nilotinib may be effective in peripheral SpA by modulating inflammation, but not in axial SpA...
December 15, 2017: Journal of Translational Medicine
Pauline Hoelt, Cyrille Confavreux, Denis Jullien, Axel P Villani
Psoriatic arthritis (PsA) is an inflammatory rheumatism belonging to spondylarthritis family and which occurs in about 30% of patients with psoriasis. The pathogenesis entails a genetic predisposition, environmental and immunologic factors. Most of the time, cutaneous lesions precede apparition of articular manifestations and dermatologists who treat psoriatic patients have to regularly screen for early PsA, especially in patients with risk factors (notably nail psoriasis). Early detection greatly increases the chances for successful treatment and can prevent slow joint destruction...
May 23, 2017: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
Aleksandra Barac, Tatjana Adzic Vukicevic, Aleksandra Dudvarski Ilic, Salvatore Rubino, Vladimir Zugic, Goran Stevanovic
Chronic necrotizing pulmonary aspergillosis (CNPA), a form of chronic pulmonary aspergillosis (CPA), affects immunocompetent or mildly immunocompromised persons with underlying pulmonary disease. These conditions are associated with high morbidity and mortality and often require long-term antifungal treatment. The long-term prognosis for patients with CNPA and the potential complications of CNPA have not been well documented. The aim of this study was to review published papers that report cases of CNPA complications and to highlight risk factors for development of CNPA...
April 13, 2017: Revista do Instituto de Medicina Tropical de São Paulo
Jamila Essouiri, Abourazzak Fatima Ezzahra, Kona Irene, Khoussar Ikram, Harzy Taoufik
OBJECTIVES: to describe the characteristics of our population with spondyloarthritis: diagnostic time, clinical manifestations and laboratory investigations, activity, functional impairment, severity and therapeutic management. The authors were also interested to investigate factors associated with severe disease. METHODS: A retrospective observational study, conducted in the rheumatology department at university hospital center Hassan II of Fez, analyzing the records of patients diagnosed as spondylarthritis during the period extending from January 2009 to June 2014...
April 6, 2017: Current Rheumatology Reviews
Alexis Lacout, Robert Yves Carlier, Mostafa El Hajjam, Pierre Yves Marcy
Spondyloarthritis refers to a group of chronic inflammatory rheumatic diseases that predominantly affects the axial skeleton, causing pain and stiffness. Human bone is highly dynamic organ that interacts with a wide array cells and tissues. Process of bone remodelling relies on a delicate balance between bone formation and bone resorption, orchestrated by osteoblasts and osteoclasts. Disruption of this homeostatic balance of bone removal and replacement can manifest as inappropriate new bone formation found in spondylarthritis...
April 2017: Medical Hypotheses
Johannes Bethge, Silvia Meffert, Mark Ellrichmann, Claudio Conrad, Susanna Nikolaus, Stefan Schreiber
Inflammatory bowel disease is frequently associated with spondylarthritis (SpA). It has been discussed that α4/β7 expressing lymphocytes are involved in the aetiology of SpA. We report a case of a successful combination therapy of vedolizumab (VDZ) and etanercept (ETA) in a patient with ulcerative colitis with pouchitis and SpA. In our case VDZ was effective for pouchitis and ineffective for SpA. The combination with ETA might be a useful treatment strategy to control both diseases and first indications suggest that it is safe...
2017: BMJ Open Gastroenterology
Johan K Wallman, Anna Jöud, Tor Olofsson, Lennart T H Jacobsson, Henning Bliddal, Lars E Kristensen
Objective.: The aim was to assess work-loss days before and after commencement of anti-TNF treatment in patients with non-radiographic axial spondylarthritis (nr-axSpA). Methods.: Bionaïve nr-axSpA patients (n = 75), aged 17-62 years, fulfilling the Assessment of SpondyloArthritis international Society criteria for axial spondyloarthritis and starting anti-TNF treatment during 2004-11, were retrieved from the observational South Swedish Arthritis Treatment Group study...
May 1, 2017: Rheumatology
H Marotte
Some inflammatory rheumatic diseases can involve the temporomandibular joint, such as rheumatoid arthritis and spondylarthritis. The aim of our work was to evaluate the current prevalence of these inflammatory TMJ diseases, to indicate the new therapeutics and to describe the collaboration between rheumatologist and maxillofacial surgeon in these pathologies.
September 2016: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Pascal Zufferey
The only biological treatments recognized and reimbursed for spondylarthritis in Switzerland are anti TNF. Other effective agents in rheumatoid arthritis were found to be of little use in this indication. Fortunately, in recent years appeared biological molecules blocking cytokines involved in new pathways of inflammation in particular that of IL7. They have been very effective against psoriasis and have a high potential in psoriatic arthritis and spondylarthritis. In parallel, synthetic small molecules capable of modulating the production of intracellular cytokines begin to be marketed...
March 9, 2016: Revue Médicale Suisse
Alexandre Dumusc, Alexander So
Non-steroidal anti-inflammatory drugs (NSAID) are the first line treatment for spondylarthritis. NSAIDs are effective when used continuously or on demand, in short or long-term use. An effect on radiologic progression of the spine is still controversial. However, physicians have to be aware of potential cardiovascular, renal or gastro-intestinal secondary effects when prescribing NSAIDs. DMARDs like methotrexate or systemic corticosteroids are generally not recommended for the treatment of spondylarthritis...
March 9, 2016: Revue Médicale Suisse
Mihaela Cosmina Micu, Daniela Fodor
Enthesitis is the key pathological lesion in the spondyloarthritides group and an important element for early diagnosis with a predictive and prognostic value. The recognition of enthesitis on a clinical basis alone remains a challenge and creates unnecessary delays in diagnosis and adequate treatment commencement. Musculoskeletal ultrasound is a valid, reliable, and feasible imaging tool valuable for identifying inflammatory and structural lesions at enthesis level, helpful in establishing a diagnosis, evaluating disease activity and therapy monitoring...
March 2016: Medical Ultrasonography
Mathieu Leuenberger, Jeanne Berner, Julie Di Lucca, Lara Fischer, Nikolaos Kaparos, Curdin Conrad, Daniel Hohl, Alexander So, Michel Gilliet
PASS syndrome is a rare inflammatory disease characterized by a chronic-relapsing course of pyoderma gangrenosum, acne vulgaris, hidradenitis suppurativa and ankylosing spondylitis. Here, we describe a case of a patient with spontaneously recurrent purulent skin lesions along with seronegative spondylarthritis consistent with the PASS syndrome. During his disease exacerbation, the patient displayed episodes of fever along with elevated serum levels of interleukin (IL)-1β. Skin lesions were characterized by sterile neutrophilic infiltrates and showed a rapid response to the IL-1 receptor antagonist anakinra (Kineret®) consistent with the autoinflammatory nature of this disease...
2016: Dermatology: International Journal for Clinical and Investigative Dermatology
Zsuzsa Schmidt, Gyula Poór
Polymyalgia rheumatica is an inflammatory musculoskeletal disorder of people aged 50 years or over, characterised by pain, aching and morning stiffness in the shoulder girdle and often hip girdle and neck. Marked systemic inflammation and rapid response to corticosteroid therapy are characteristic features. Giant cell arteritis is a well-known association of polymyalgia rheumatica. Recent clinical evidence and scientific results in the field have provided new challenges for rheumatologists. Besides the aspecific - although characteristic - proximal syndrome, less well recognizable and more variable distal musculoskeletal manifestations were observed...
January 3, 2016: Orvosi Hetilap
Marcelo P Castro, Simon M Stebbings, Stephan Milosavljevic, Melanie D Bussey
The study aimed to determine, using systematic review and meta-analysis, the level of evidence supporting the construct validity of spinal mobility tests for assessing patients with ankylosing spondylitis. Following the guidelines proposed in the Preferred Reporting Items for Systematic reviews and Meta-Analyses, three sets of keywords were used for data searching: (i) ankylosing spondylitis, spondyloarthritis, spondyloarthropathy, spondylarthritis; (ii) accuracy, association, construct, correlation, Outcome Measures in Rheumatoid Arthritis Clinical Trials, OMERACT, truth, validity; (iii) mobility, Bath Ankylosing Spondylitis Metrology Index-BASMI, radiography, spinal measures, cervical rotation, Schober (a further 19 keywords were used)...
July 2016: Clinical Rheumatology
Jose M Ramos, Francisco Pasquau, Nora Galipienso, Beatriz Valero, Angela Navarro, Agustín Martinez, José Rosas, Ana Gutiérrez, Rosario Sanchez-Martínez
INTRODUCTION: Whipple's disease is a rare infectious disease caused by Tropheryma whipplei with protean clinical manifestations. This infection may mimic chronic inflammatory rheumatisms. CASE PRESENTATION: We report two cases of Whipple's disease diagnosed in the context of an inflammatory disease with anti-tumor necrosis factor alpha failure. The first patient was a 58-year-old white man with psoriatic spondylarthritis, who was treated with adalimumab, etanercept, infliximab, tocilizumab and golimumab...
July 28, 2015: Journal of Medical Case Reports
C Herren, M Pishnamaz, P Lichte, F Hildebrand, R M Sellei, H-C Pape, P Kobbe
INTRODUCTION: In geriatric patients the management of odontoid type II fractures is complicated by osteoporosis and atlantoaxial arthritis (spondylarthritis C1/C2) with an increased lever arm. Furthermore, a few of the odontoid fractures are accompanied by an atlas fracture resulting in the "atlantoaxial unhappy triad". Posterior C1/C2 spondylodesis with bilateral Magerl screws and C1 hooks is a strong biomechanical construct, however, the posterior approach is associated with several drawbacks such as increased risk of infection and increased blood loss...
October 2015: Zeitschrift Für Orthopädie und Unfallchirurgie
Daniela Kaiser, Isabel Bolt, Michael Hofer, Christa Relly, Gerald Berthet, Dieter Bolz, Traudel Saurenmann
BACKGROUND: To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. METHODS: Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome...
2015: Pediatric Rheumatology Online Journal
Ignacio Marín-Jiménez, Javier P Gisbert, José L Pérez-Calle, Valle García-Sánchez, Susana Tabernero, Rosario García-Vicuña, Cristina Romero, Berta Juliá, Francisco Vanaclocha, Luis Cea-Calvo
OBJECTIVE: To describe the 2-year incidence of new immune-mediated inflammatory diseases (spondylarthritis, uveitis, psoriasis) in the cohort of patients with inflammatory bowel disease (IBD) included in the AQUILES study. MATERIALS AND METHODS: Over a 2-year period, 341 patients with IBD (53% women, mean age 40 years) diagnosed with Crohn's disease (60.5%), ulcerative colitis (38.1%) and indeterminate colitis (1.4%) were followed up. New diagnoses made during follow-up were based on reports of the corresponding specialists (rheumatologists, ophthalmologists, and dermatologists)...
December 2015: Gastroenterología y Hepatología
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