PP15. CHRONIC PERIAORTITIS – A MISSED RHEUMATOLOGICAL DISEASE!

BACKGROUND: Fibromyalgia syndrome (FMS) is an extra-articular rheumatological disease characterised by widespread chronic musculoskeletal pain. Metal-induced oxidative stress contributes to the severity of FMS. AIMS: First, this study evaluated the association between plasma levels of toxic heavy metals and essential metals with oxidative stress (OS) markers. Second, the OS markers and metal contents were correlated with the disease severity by assessing the Fibromyalgia Impact Questioner Revised (FIQR) and tender points (TP). METHOD: A total of 105 FMS patients and 105 healthy controls of similar age and sex were recruited. OS parameter such as lipid peroxidation (LPO), protein carbonyl group (PCG), nitric oxide (NO) and essential metals such as zinc (Zn), magnesium (Mg), manganese (Mn), copper (Cu) and toxic heavy metals such as aluminium (Al), arsenic (As), lead (Pb) were estimated. RESULTS: Levels of LPO, PCG, NO (p< 0.001) and Cu, Mn, and Al (p< 0.001), were significantly higher, and Mg (p< 0.001) and Zn (p< 0.001) were significantly lower in patients compared to controls. A positive association was observed between OS parameters, FIQR and TP with Cu, Al and Mn. A significant negative association was observed between Zn and Mg with FIQR, TP and OS parameters. CONCLUSION: Heavy metals such as Al induce OS parameters and decrease the levels of essential trace elements such as Mg and Zn, which may be responsible for the severity of FMS.

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Staphylococcus-associated acute glomerulonephritis in a patient with dermatomyositis

BMJ Case Reports ◽

10.1136/bcr-2020-236695 ◽

2021 ◽

Vol 14 (1) ◽

pp. e236695 ◽

Cited By ~ 1

Author(s):

Rasmi Ranjan Sahoo ◽

Sourav Pradhan ◽

Akhil Pawan Goel ◽

Anupam Wakhlu

Keyword(s):

Infective Endocarditis ◽

Kidney Biopsy ◽

Kidney Injury ◽

Staphylococcal Infection ◽

Left Knee ◽

The Body ◽

Acute Glomerulonephritis ◽

Disease Course ◽

Rheumatological Disease ◽

Per Se

Staphylococcus-associated glomerulonephritis (SAGN) occurs as a complication of staphylococcal infection elsewhere in the body. Dermatomyositis (DM) can be associated with glomerulonephritis due to the disease per se. We report a case of a 40-year-old male patient with DM who presented with acute kidney injury, and was initially pulsed with methylprednisolone for 3 days, followed by dexamethasone equivalent to 1 mg/kg/day prednisolone. He was subsequently found to have SAGN on kidney biopsy along with staphylococcus bacteraemia and left knee septic arthritis. With proof of definitive infection, intravenous immunoglobulin 2 g/kg over 2 days was given and steroids were reduced. He was treated with intravenous vancomycin. With treatment, the general condition of the patient improved. On day 38, he developed infective endocarditis and died of congestive heart failure subsequently. Undiagnosed staphylococcal sepsis complicating a rheumatological disease course can lead to complications like SAGN, infective endocarditis and contribute to increased morbidity and mortality, as is exemplified by our case.

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Chronic periaortitis ? a new interpretation of Ormond's disease

Urological Research ◽

10.1007/bf00295841 ◽

1990 ◽

Vol 18 (3) ◽

pp. 165-167 ◽

Cited By ~ 7

Author(s):

B. Martina

Keyword(s):

Ormond’S Disease ◽

New Interpretation ◽

Chronic Periaortitis

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Real-world observational study of assessment of CHA2DS2-VASc, C2HEST and HAVOC scores for atrial fibrillation among patients with rheumatological disorders: a nationwide analysis

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140754 ◽

2021 ◽

pp. postgradmedj-2021-140754

Author(s):

Wei Syun Hu ◽

Cheng Li Lin

Keyword(s):

Atrial Fibrillation ◽

Retrospective Study ◽

Predictive Models ◽

Operating Characteristic ◽

Predictive Accuracy ◽

Scoring Systems ◽

Gray Model ◽

Discriminative Ability ◽

Discriminatory Ability ◽

Rheumatological Disease

PurposeThis is a nationwide-based retrospective study aiming to compare the three different scoring systems (CHA2DS2-VASc, C2HEST and HAVOC scores) in the prediction of atrial fibrillation (AF) in patients with rheumatological disease.MethodsWe used the Fine and Gray model to estimate the risk of AF (subhazard ratio and 95% CI). The predictive accuracy and discriminatory ability of the predictive model were evaluated by receiver operating characteristic (ROC) curve.ResultsAmong the three predictive models, the model using CHA2DS2-VASc score had the better discriminative ability with an ROC of 0.79. The model with C2HEST score had an ROC of 0.78. The discriminative ability of the HAVOC score was 0.77, estimated by ROC.ConclusionWe concluded the CHA2DS2-VASc score has better performance in predicting AF compared with C2HEST score or HAVOC score.

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Near-germline human monoclonal antibodies neutralize and protect against multiple arthritogenic alphaviruses

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2100104118 ◽

2021 ◽

Vol 118 (37) ◽

pp. e2100104118

Author(s):

Ryan J. Malonis ◽

James T. Earnest ◽

Arthur S. Kim ◽

Matthew Angeliadis ◽

Frederick W. Holtsberg ◽

...

Keyword(s):

Monoclonal Antibodies ◽

Neutralizing Antibodies ◽

Natural Infection ◽

Human Mabs ◽

Isolation And Characterization ◽

Neutralizing Capacity ◽

Rheumatological Disease ◽

Mayaro Virus ◽

Alphavirus Infection ◽

Globally Distributed

Arthritogenic alphaviruses are globally distributed, mosquito-transmitted viruses that cause rheumatological disease in humans and include Chikungunya virus (CHIKV), Mayaro virus (MAYV), and others. Although serological evidence suggests that some antibody-mediated heterologous immunity may be afforded by alphavirus infection, the extent to which broadly neutralizing antibodies that protect against multiple arthritogenic alphaviruses are elicited during natural infection remains unknown. Here, we describe the isolation and characterization of MAYV-reactive alphavirus monoclonal antibodies (mAbs) from a CHIKV-convalescent donor. We characterized 33 human mAbs that cross-reacted with CHIKV and MAYV and engaged multiple epitopes on the E1 and E2 glycoproteins. We identified five mAbs that target distinct regions of the B domain of E2 and potently neutralize multiple alphaviruses with differential breadth of inhibition. These broadly neutralizing mAbs (bNAbs) contain few somatic mutations and inferred germline–revertants retained neutralizing capacity. Two bNAbs, DC2.M16 and DC2.M357, protected against both CHIKV- and MAYV-induced musculoskeletal disease in mice. These findings enhance our understanding of the cross-reactive and cross-protective antibody response to human alphavirus infections.

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