scholarly journals The Increased Levels of Faecal Calprotectin in Children With Active Enthesitis Related Arthritis and Mri Signs of Sacroiliitis: the Results of A Single Centre Cross-Sectional Study in Juvenile Idiopathic Arthritis Patients

2020 ◽  
Author(s):  
Lovro Lamot ◽  
Marijana Miler ◽  
Rudolf Vukojevic ◽  
Mandica Vidovic ◽  
Mirta Lamot ◽  
...  

Abstract Background: Enthesitis related arthritis (ErA) is a specific subtype of juvenile idiopathic arthritis (JIA) which is often regarded as an undifferentiated form of juvenile spondyloarthritis (jSpA). Beside the arthritis of the peripheral joints, the crucial features of jSpA include enthesitis and/or arthritis of axial joints. Moreover, in adult onset spondyloarthritis gut is increasingly recognized as origin and/or target of inflammation, while the incidence of gut involvement in ErA patients is still largely unknown. The aim of this study was to assess the fCAL concentration, a surrogate marker of gut inflammation, in patients with various subtypes of JIA and non-inflammatory musculoskeletal conditions and to assess the correlation with various demographic, clinical, laboratory, imaging and treatment characteristics.Methods: This was a cross-sectional study involving 71 patients with various forms of JIA and other noninflammatory musculoskeletal diseases (NI-MSD). Along with detailed clinical and laboratory examination, fCAL and magnetic resonance imaging (MRI) of sacroiliac joints, thoracic and lumbar spine was routinely performed in all ErA patients, as well as in other patients who complained of abdominal and/or back pain, respectively. In all JIA patients, disease activity was measured using the juvenile arthritis (JADAS) or spondyloarthritis (jSpADA) disease activity score. Results: The median concentration of fCAL was highest in ErA subgroup (33.2 mg/kg, p=0.043), with a significant difference between patients with inactive and active disease (20.0 mg/kg vs 57.4 mg/kg, p=0.01), as well as between those with or without MRI signs of SIJ inflammation (22.6 mg/kg vs 54.3 mg/kg, p=0.048). In all patients, the fCAL concentration did not significantly differ among those receiving and not receiving NSAIDs (23 mg/kg vs 20 mg/kg, p=0.18), although weak correlation was found with the duration of the use (r=0.25, p=0.03).Conclusion: The (subclinical) gut inflammation might not be present only in adults with SpA, but also in children with undifferentiated forms of the jSpA, especially with active disease and/or MRI signs of SI inflammation.

2016 ◽  
Vol 8 (4) ◽  
pp. 396-400 ◽  
Author(s):  
Bolaji Fatai OYEYEMI ◽  
John Oluwafemi ADEBAYO ◽  
Abass Toba ANIFOWOSHE ◽  
Oluyinka Ajibola IYIOLA

Digit ratio (2D:4D) denotes the relative length of the second and fourth digits. There are contradicting reports on its relationship with ethnicity/race, whereas convincing studies show it is related to obesity. This cross-sectional study was undertaken to demystify ethnic difference in 2D:4D ratio and to analyze its relationship with obesity among adults in Ilorin Nigeria. The cross-sectional study included 701 individuals. Finger lengths were measured with electronic calipers and other anthropometric traits were measured with standard procedure. Student t test and one-way ANOVA were used to detect differences among groups and relationship was computed with Pearson correlation. The receiver operator characteristic curves were used to detect the diagnostic effect of 2D:4D for obesity. The obtained results showed sexual dimorphism in 2D:4D ratio and other anthropometrics at p < 0.01. Obesity was associated with significantly higher mean of 2D:4D in both genders (female 0.9814 ± 0.012:0.9700 ± 0.012; male 0.9700 ± 0.010:0.9592 ± 0.010 at p < 0.001). The area under the curve was 0.753 (95% CI 0.677-0.829, p < 0.01) and 0.798 (95% CI 0.756-0.804, p < 0.01) in female and male R2D:4D respectively for obesity, implying that 2D:4D might be a surrogate marker for obesity in future.  No significant difference was found in 2D:4D among different ethnic groups studied (p >0.05); this result proved that there was no ethnic specificity in 2D:4D ratio among study’ participants. Thus, it can be reported that the digit ratio was related to high 2D:4D, but this cannot be said for different ethnic groups. The results imply that 2D:4D might be a good surrogate indicator for obesity, but not ethnicity.  


2021 ◽  
Vol 8 ◽  
Author(s):  
Lovro Lamot ◽  
Marijana Miler ◽  
Rudolf Vukojević ◽  
Mandica Vidović ◽  
Mirta Lamot ◽  
...  

Enthesitis related arthritis (ERA) is a specific subtype of juvenile idiopathic arthritis (JIA), often regarded as an undifferentiated form of juvenile spondyloarthritis (jSpA). While gut is increasingly recognized as origin and/or target of inflammation in adult onset spondyloarthritis (SpA), the incidence of gut involvement in ERA patients is largely unknown. The aim of this study was to measure the concentration of fecal calprotectin (fCAL), a surrogate marker of gut inflammation, in patients with different subtypes of JIA, as well as to correlate the results with various demographic, clinical, laboratory, imaging, and treatment characteristics. The cross-sectional exploratory study involving 71 patients with ERA, other forms of JIA and children complaining musculoskeletal symptoms was therefore conducted. Along with fCAL assessment, a detailed clinical and laboratory examination was performed, including the calculation of a composite disease activity scores. Moreover, MRI of the sacroiliac joints was performed in all ERA and other patients complaining of low back pain. The median concentration of fCAL was highest in ERA patients (33.2 mg/kg, p = 0.02), with a significant difference between those with inactive and active disease (20.0 vs. 57.4, p = 0.01), as well as those with and without MRI signs of sacroiliitis (22.6 vs. 54.3, p = 0.04). The fCAL did not differ depending on the NSAID use (23 vs. 20, p = 0.18), although weak correlation was observed with the treatment duration (r = 0.25, p = 0.03). In conclusion, our findings indicate that a parallel inflammation in musculoskeletal system and gut can occur not just in adults with SpA, but in children with ERA as well.


2020 ◽  
Vol 50 (6) ◽  
pp. 1540-1545
Author(s):  
Ömer Faruk ELMAS ◽  
Mehmet OKÇU ◽  
Abdullah DEMİRBAŞ ◽  
Necmettin AKDENİZ

Background/aim: Nailfold video capillaroscopy is considered as a reliable method for evaluating peripheral microangiopathy in rheumatologic diseases. In this study, we aimed to demonstrate the utility of handheld dermatoscopy as an easy-to-use nailfold capillaroscopic instrument in patients with rheumatoid arthritis.Materials and methods: This cross-sectional study included patients with rheumatoid arthritis and healthy subjects. A handheld dermatoscopic examination of proximal nail fold was performed in each subject. The possible correlation of capillaroscopic findings with disease activity was evaluated using the disease activity score 28 (DAS28).Results: A total of 59 patients with rheumatoid arthritis and 60 healthy subjects were enrolled in the study. The presence of capillaryenlargement, avascular areas, capillary deformities, and capillary vascular anomalies in the group of patients showed a statistically significant difference when compared with the healthy subjects. No correlation was found between the nail fold capillaroscopic findings and DAS28 score.Conclusion: Hand-held dermatoscopy seems to be a useful technique in the evaluation of nail fold capillary changes. We suggest that in patients with rheumatoid arthritis, when capillaroscopic examination is needed, it can be evaluated using handheld dermatoscopy. Selected patients who showed findings using this method can be further examined with classical capillaroscopy to obtain more quantitative data.


Author(s):  
Hala Salah El Din Talaat ◽  
Mohamed Farouk Mohamed ◽  
Asmaa Ismael Ahmed ◽  
Eman Shafik Shafie

Background: Juvenile idiopathic arthritis (JIA) represents a heterogeneous group of autoimmune diseases that arises before the age of 16 years and lasts more than 6 months. During acute inflammation of the disease, serum copper concentration increases and zinc decreases, that could point to the possible pharmacological properties of these trace elements. Aim: To measure the serum level of zinc and copper in patients with juvenile idiopathic arthritis (JIA) with different subtypes and correlate the levels of zinc and copper with the disease activity. Methods: This cross-sectional study was done on 40 patients already diagnosed clinically with JIA; patients were followed-up at the Rheumatology Outpatient Clinic, Children's Hospital, Cairo University. Results: Out of forty patients, 16 were males (40%) and 24 were females (60%) with a male to female ratio (M: F) of 1:1.5. Out of the forty patients 17 were in activity and 23 were without activity. Thirty age and sex matched controls were included for comparison. Serum copper level was significantly higher in patients with JIA than those of the controls (P= 0.017) while there were no significant difference in serum level of zinc between JIA patients and that of the controls. Conclusion: Alteration of serum copper and zinc probably is a defense response against JIA; increased copper may be due to inflammation associated, these elements could serve as biomarkers for the disease activity.


2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S271-S271
Author(s):  
K Hrabric Sonje ◽  
V Domislović ◽  
M Brinar ◽  
S Cukovic-Cavka ◽  
N Turk ◽  
...  

Abstract Background Magnetic resonance index of activity (MaRIA) is composed of features independently associated with endoscopic disease activity and is surrogate marker of disease activity. The aim of this study was to evaluate correlation of global MaRIA (gMaRIA) with clinical and biochemical disease activity indices and diagnostic accuracy for active disease in patients with terminal ileum disease and ileocolonic disease. Methods This is a cross-sectional study which included 251 patients with diagnosed CD. Global MaRIA (gMaRIA) index was calculated on 6 bowel segments (the distal ileum, ascending, transverse, descending, sigmoid colon and rectum) using following parameters: bowel wall thickness, ulcers, edema and relative contrast enhancement. Disease activity was defined as combination of clinical and biochemical disease activity (CRP&gt;5 or HBI≥5). Disease extension was classified using Montreal classification (L1 ileum, L2 colon, L3 ileum and colon). Results This study included 251 CD patients [age 35 (25–47), 55.3% males, BMI 21.8 (18–25) kg/m2, median disease duration 7 (2–15) years]. Ileal disease (L1) was present in 84 (33.5%) and ileocolonic disease (L3) in 151 (60.1%) patients. Correlation of gMARIA with biochemical indices of disease activity (CRP) was r=0.48, p&lt;0.001 and with HBI r=0.33, p&lt;0.001. Diagnostic accuracy of gMARIA in defining active disease in patients with L1 disease was considerably high [AUC 0.83 (95%CI 0.72–0.91)]. On the other hand, diagnostic accuracy in defining active disease in patients with L3 disease was good [AUC 0.71 (95%CI 0.62–0.79)], which is lower compared to L1 disease. In surgically naïve patients diagnostic accuracy of L1 disease was [AUC 0.88 (95%CI 0.72–0.96)], and for L3 disease [AUC 0.78 (95%CI 0.64–0.89)]. Conclusion Global MaRIA index showed higher diagnostic accuracy in detecting clinically and biochemically active disease in terminal ileum compared to ileocolic disease. These results emphasize the important role of magnetic resonance enterography in monitoring disease activity in patients with isolated ileal disease. Global MaRIA score correlates better with biochemical disease activity compared to clinical disease activity, which points out to the significance of biochemical remission.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1277.1-1277
Author(s):  
F. Majdoub ◽  
M. Sellami ◽  
S. Miladi ◽  
A. Fazaa ◽  
L. Souabni ◽  
...  

Background:The occurrence of Spondyloarthritis (SpA) often conditions patients’ quality of life and hinders their well-being. Physical activity (PA) is associated with various health-related benefits among adults with chronic inflammatory rheumatism but may be insufficiently performed.Objectives:This study aimed to assess PA in patients with SpA and explore its associated factors.Methods:This is a single-center cross-sectional study, involving patients with SpA, visiting our outpatient hospital over eight weeks. Patients responded to the International Physical Activity Questionnaire-Short form (IPAQ-S).Results:Sixty patients were included (39 M/21 F) with an average age of 45.8 years [25-78]. The mean duration of SpA was 13.2 years [1-25]. About 80% of patients were from an urban setting. Sixty-three percent of patients had a professional activity, while 13.3% were retired. Twenty-nine patients (48.3%) had axial and peripheral form, 18 patients (30%) had SpA with enteropathic arthritis, 8 (13.3%) with psoriatic arthritis, 3 patients (5%) had axial spondyloarthritis, and only 2 patients (3.3%) with SAPHO-Syndrom. About 23% of patients had hip arthritis and only 5% had uveitis. Fifty-eight patients were on TNF-inhibitor (21/58 Adalimumab, 15/58 Infliximab, 14/58 Etanercept, 8/58 Golimumab). The average BASDAI was 2.7/10. The average ASDASCRP was 2.1/10. The average BASFI was 3.3/10. IPAQ results were distributed as follows: 78.3% of patients were in the « low physical activity » category, 21.7% were in the « moderate physical activity » while none of the patients were in the « high physical activity ». Patients without employment had lower levels of physical activity (29.7%) but no association was observed between those two items (p=0.082). Disease activity objectified with BASDAI was related to low physical activity (p=0.045) whereas no association was observed with ASDASCRP (p=0.870) or BASFI (p=0.056). Otherwise, TNF-inhibitor treatment was not related to different levels of PA (p=0.09).Conclusion:Tunisian patients with SpA don’t perform enough physical activity. Except for high disease activity, the different levels of PA did not appear to be explained by other disease-related variables. Thereby, physical activity should be encouraged in SpA.References:[1]Fabre, S., Molto, A., Dadoun, S. et al. Physical activity in patients with axial spondyloarthritis: a cross-sectional study of 203 patients. Rheumatol Int 36, 1711–1718 (2016).Disclosure of Interests:None declared.


BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e046265
Author(s):  
Shotaro Doki ◽  
Shinichiro Sasahara ◽  
Daisuke Hori ◽  
Yuichi Oi ◽  
Tsukasa Takahashi ◽  
...  

ObjectivesPsychological distress is a worldwide problem and a serious problem that needs to be addressed in the field of occupational health. This study aimed to use artificial intelligence (AI) to predict psychological distress among workers using sociodemographic, lifestyle and sleep factors, not subjective information such as mood and emotion, and to examine the performance of the AI models through a comparison with psychiatrists.DesignCross-sectional study.SettingWe conducted a survey on psychological distress and living conditions among workers. An AI model for predicting psychological distress was created and then the results were compared in terms of accuracy with predictions made by psychiatrists.ParticipantsAn AI model of the neural network and six psychiatrists.Primary outcomeThe accuracies of the AI model and psychiatrists for predicting psychological distress.MethodsIn total, data from 7251 workers were analysed to predict moderate and severe psychological distress. An AI model of the neural network was created and accuracy, sensitivity and specificity were calculated. Six psychiatrists used the same data as the AI model to predict psychological distress and conduct a comparison with the AI model.ResultsThe accuracies of the AI model and psychiatrists for predicting moderate psychological distress were 65.2% and 64.4%, respectively, showing no significant difference. The accuracies of the AI model and psychiatrists for predicting severe psychological distress were 89.9% and 85.5%, respectively, indicating that the AI model had significantly higher accuracy.ConclusionsA machine learning model was successfully developed to screen workers with depressed mood. The explanatory variables used for the predictions did not directly ask about mood. Therefore, this newly developed model appears to be able to predict psychological distress among workers easily, regardless of their subjective views.


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