scholarly journals Influence of Seasonal Vitamin D Changes on Clinical Manifestations of Rheumatoid Arthritis and Systemic Sclerosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Maurizio Cutolo ◽  
Stefano Soldano ◽  
Alberto Sulli ◽  
Vanessa Smith ◽  
Emanuele Gotelli
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Systemic Sclerosis ◽  
Connective Tissue Diseases ◽  
Clinical Manifestations ◽  
Serum Concentrations ◽  
Fibrotic Disease ◽  
Biologic Effects ◽  
Clinical Conditions ◽  
Complex Influence

Vitamin D [1,25(OH)2D—calcitriol] is basically a steroid hormone with pleiotropic biologic effects, and its impact on the regulation of immune system may influence several clinical conditions. Calcidiol (25OHD), as precursor of calcitriol, derives, for the most part (80%), from cutaneous cholesterol (7-dehydrocholesterol) under the action of UV-B (sunlight). Consequently, serum concentrations fluctuate during the year following the circannual rhythm of sun exposition. We will update about the available evidence regarding the complex influence of seasonal vitamin D changes on two different chronic connective tissue diseases, namely rheumatoid arthritis (RA) and systemic sclerosis (SSc). Notably, RA is an emblematic model of autoimmune disease with prevalent joint inflammatory features, while SSc is mainly an autoimmune progressive pro-fibrotic disease. However, in both conditions, low serum concentrations of 25OHD are involved in the pathogenesis of the diseases, and emerging data report their impact on clinical manifestations.

scholarly journals Knee myopericytoma-case report and literature review

2020 ◽  
Vol 12 (6) ◽  
pp. 127-128
Author(s):  
Susana Rodrigues ◽  
Catrine Ferreira ◽  
Tiago Coelho ◽  
Diogo Gaspar ◽  
Jean Fallah ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Systemic Sclerosis ◽  
Middle Age ◽  
Subcutaneous Tissue ◽  
Connective Tissue Diseases ◽  
Systemic Lupus Erythematous ◽  
Systemic Lupus ◽  
Calcinosis Cutis ◽  
Substantial Morbidity

Calcinosis cutis is a rare disorder characterized by of deposition of insoluble calcium salts in the skin and subcutaneous tissue. Five subtypes of calcinosis cutis are described: dystrophic, metastatic, idiopathic, iatrogenic, and calciphylaxis.1 Of these subtypes, dystrophic calcinosis (DC) is the most common, and it is the most frequently seen in association with underlying autoimmune connective tissue diseases.2 Dermatomyositis, systemic sclerosis and less commonly systemic lupus erythematous were described to be complicated by DC. However, DC associated with rheumatoid arthritis (RA) is extremely rare.2 The condition causes substantial morbidity and is associated with pain and limitation of movement when the process involves areas close to joints or when ulceration occurs.2 We report a middle age Sudanese woman with good controlled RA who developed dystrophic calcinosis cutis.

scholarly journals Trichoscopic Signs in Dermatomyositis, Systemic Lupus Erythematosus, and Systemic Sclerosis: A Comparative Study of 150 Patients

Dermatology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Kumutnart Chanprapaph ◽  
Preeyachat Limtong ◽  
Pintip Ngamjanyaporn ◽  
Poonkiat Suchonwanit
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Regression Analysis ◽  
Systemic Sclerosis ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Multinomial Logistic Regression ◽  
Connective Tissue Diseases ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Brown Pigmentation

<b><i>Background:</i></b> Hair and scalp involvement is prevalent in connective tissue diseases (CTDs). Trichoscopic features may provide a diagnostic implementation and enable differentiation among CTDs; however, a direct comparison of these signs among CTD patients is lacking. <b><i>Objectives:</i></b> To compare trichoscopic findings in dermatomyositis (DM), systemic lupus erythematosus (SLE), and systemic sclerosis (SSc) as well as determine their distinctive features and associations with disease activity. <b><i>Methods:</i></b> Trichoscopic photographs were taken from DM, SLE, and SSc patients and further evaluated for hair shaft and scalp surface abnormalities. Data regarding patients’ clinical manifestations, laboratory results, and disease activity were analyzed. <b><i>Results:</i></b> One hundred fifty participants, consisting of 30 DM, 60 SLE, and 60 SSc patients, were included. Perifollicular red-brown pigmentation, brown scattered pigmentation, and white patches were exclusive findings in DM, SLE, and SSc, respectively (<i>p</i> &#x3c; 0.001). A multinomial logistic regression analysis revealed that DM demonstrated higher odds for having microaneurysmal blood vessels than SLE and SSc (odds ratio [OR] = 22.22, 95% confidence interval [CI] = 1.73–285.13, <i>p</i> = 0.017, and OR = 15.34, 95% CI = 1.36–177.59, <i>p</i> = 0.029, respectively). Polymorphic vessels forming a telangiectatic network suggested SSc over SLE (OR = 12.83, 95% CI = 1.35–121.98, <i>p</i> = 0.026), while avascular areas were more pronounced in SSc than DM and SLE (OR = 43.24, 95% CI = 5.17–361.67, <i>p</i> = 0.001, and OR = 0.03, 95% CI = 0.01–0.24, <i>p</i> = 0.001, respectively). In a quantile regression analysis, perifollicular red-brown pigmentation, reduction in hair diameter, and the absence of thin arborizing vessels were linked to higher disease activity in DM, SLE, and SSc, respectively (all <i>p</i> &#x3c; 0.05). <b><i>Conclusions:</i></b> Trichoscopy is a valuable tool possessing diagnostic and prognostic values for CTDs. Specific trichoscopic features allow adequate distinction between DM, SLE, and SSc and may help identify active disease.

Clinical associations of the positive anti Ro52 without Ro60 autoantibodies: undifferentiated connective tissue diseases

2017 ◽  
Vol 71 (1) ◽  
pp. 12-19 ◽  
Author(s):  
Sai H K Murng ◽  
Moira Thomas
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Sjogren's Syndrome ◽  
Systemic Lupus ◽  
Autoimmune Conditions ◽  
Clinical Conditions ◽  
Undifferentiated Connective Tissue Diseases

AimsAutoantibodies targeting Ro52 and Ro60 antigens are historically reported as anti SSA/Ro. In general anti SSA/Ro results are either anti Ro52+Ro60+ or anti Ro52−Ro60+ antibodies. Anti Ro52 without anti Ro60 (Ro52+ Ro60−) antibodies are often not reported routinely. This study intends to review the potential significance of these autoantibodies in the management of connective tissue diseases.MethodA retrospective survey of Ro52+Ro60− was carried out as part of the service evaluation of extractable nuclear antigen antibodies (ENA) reporting from the immunology laboratory, the NHS Greater Glasgow and Clyde (GGC), UK. The clinical documents and laboratory results of 97 patients with Ro52+Ro60− and 100 patients with Ro52+Ro60+ were reviewed.ResultsSeventy-one patients (73%) with anti Ro52+Ro60− antibodies have been diagnosed with autoimmune conditions including undifferentiated connective tissue diseases (n=14, 14%), systemic lupus erythematosus (n=10, 10%), Sjögren’s syndrome (n=10, 10%) and rheumatoid arthritis (n=13, 13%). Twenty-three patients (24%) with anti Ro52+Ro60− antibodies have no autoimmune features but were found to have significant clinical conditions including malignancies. In contrast, 87 patients (87%) with anti Ro52+Ro60+ antibodies have autoimmune conditions including Sjögren’s syndrome (n=34, 34%), systemic lupus erythematosus (SLE; n=23, 23%), undifferentiated connective tissue diseases (n=12, 12%) and rheumatoid arthritis (n=6, 6%).ConclusionAnti Ro52 without anti Ro60 (Ro52+Ro60−) antibodies should be reported. In the majority of patients these autoantibodies were associated with various autoimmune diseases. Anti Ro52+Ro60− antibodies were also found in patients with significant clinical conditions including malignancies even though there was no suggestion of autoimmunity at the time of testing.

scholarly journals Association between vitamin D and fatigue in patients with rheumatoid arthritis: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034935
Author(s):  
Lars Petter Jelsness-Jørgensen ◽  
Lars Grøvle ◽  
Anne Julsrud Haugen
Keyword(s):  
Rheumatoid Arthritis ◽  
Vitamin D ◽  
Psychological Distress ◽  
Disease Activity ◽  
Cross Sectional Study ◽  
Serum Concentrations ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hydroxyvitamin D ◽  
Liquid Chromatography Tandem Mass

ObjectivesIn rheumatoid arthritis (RA), fatigue is an important complaint with a significant impact on quality of life. Vitamin D has modulatory effects on cells of the immune system and may potentially affect RA disease activity and thereby RA-related fatigue. The purpose of this study was to explore associations between fatigue and vitamin D status in patients with RA.DesignHypothesis-generating cross-sectional study.SettingScheduled follow-up visits at a hospital-based general rheumatology clinic.ParticipantsPatients (n=169) with established RA.Primary outcome measures and anlysesFatigue, assessed by the Chalder fatigue questionnaire, and serum concentrations of 25-hydroxyvitamin D (25(OH)D), assessed by liquid chromatography–tandem mass spectrometry. Associations were analysed by correlation, and multivariate linear regression with adjustments for age, sex, body mass index, RA disease activity as measured by the Disease Activity Score 28-joint count C reactive protein (DAS28-CRP), psychological distress, pain and sleep. Fatigue was also compared across four groups based on the levels of serum 25(OH)D with cut points at 30, 50 and 75 nmol/L using one-way analysis of variance.ResultsTwo-thirds of the patients (116/169, 69%) were classified with low RA disease activity, that is, a DAS28-CRP score below 3.2. Their mean (SD) serum 25(OH)D concentration was 56.3 (21.2) nmol/L, with 77 (45.6%) having values below 50 nmol/L and 12 patients (7.1%) below 30 nmol/L. The correlation between fatigue and serum concentrations of 25(OH)D was weak and not statistically significant, r = −0.14 (95% CI: −0.29 to 0.03, p=0.08). In the multivariate model, fatigue was significantly associated with RA disease activity, psychological distress and pain, but not with serum 25(OH)D. Fatigue did not differ across groups with varying levels of serum 25(OH)D.ConclusionThis cross-sectional study found no evidence of association between vitamin D and fatigue in patients with RA.

Telomerase activity in connective tissue diseases: elevated in rheumatoid arthritis, but markedly decreased in systemic sclerosis

2007 ◽  
Vol 28 (6) ◽  
pp. 579-583 ◽  
Author(s):  
Figen Tarhan ◽  
Filiz Vural ◽  
Buket Kosova ◽  
Kenan Aksu ◽  
Ozgur Cogulu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Sclerosis ◽  
Connective Tissue ◽  
Connective Tissue Diseases ◽  
Telomerase Activity

Clinical and epidemiological features of visual organ damage in systemic connective tissue diseases

2020 ◽  
Vol 1-2 (211-212) ◽  
pp. 67-74
Author(s):  
Akmarzhan Rystanbayeva ◽  
◽  
Aigul Balmukhanova ◽  
Olga Mashkunova ◽  
Kuralay Kaynazarova ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Connective Tissue ◽  
Systemic Vasculitis ◽  
Connective Tissue Diseases ◽  
Clinical Manifestations ◽  
Posterior Uveitis ◽  
Behçet’S Syndrome ◽  
Behçet's Syndrome ◽  
Behcet’S Syndrome ◽  
Behcet's Syndrome

To this date, uveitis associated with connective tissue diseases remain relevant due to serious complications that significantly reduce vision and thus worsen the quality of life of patients. Aim. To study the frequency and prevalence, as well as clinical manifestations of ophthalmopathology in connective tissue diseases. Material and methods. A retrospective and prospective study of 534 patients (144 men and 390 women) with connective tissue diseases was conducted, in which ophthalmological disorders were detected. The patients underwent standard rheumatological examination in the department. And also, ophthalmological examination with the determination of visual acuity, intraocular pressure and the use of biomicroscopy, ophthalmoscopy (or cycloscopy). If necessary and possible, additional studies were performed such as: ultrasound B-scan, optical coherence tomography, perimetry. The study examined the type of common disease, age of onset and gender of the patient. Of particular interest were patients with uveal inflammation, in which the localization and nature of the course of inflammation were evaluated. Results and discussion. The most common diseases with eye damage were rheumatoid arthritis (RA) – 129 (24.1%), systemic lupus erythematosus (SLE) – 92 (17.2%), inflammatory bowel disease (IBD) – 95 (17.8%), systemic scleroderma (SDS) – 54 (10.1%) and spondylarthritis (Spa) – 41 (7.8%). In a small percentage of cases, other connective tissue diseases were diagnosed, such as: mixed connective tissue diseases (MCTS) – 24 (4.5%), Overlap syndrome – 21 (3.9%), systemic vasculitis – 23 (4.3%), Behcet's syndrome -18 (3.4%), Sjogren disease – 14 (2.6%) and juvenile idiopathic arthritis - 7 (1.3%). All ophthalmic disorders were divided into four general groups and distributed as follows: inflammatory 27.7%, degenerative 4.9%, vascular 48.7%, side effects of glucocorticoids 18.7%. Uveitis accounted for 52 (9.7%) of all ophthalmopathology, occurring in connective tissue diseases. Unilateral acute anterior uveitis (AAU) was diagnosed in 13 (25%) patients with ankylosing spondylitis, of which 4 (7.8%) had a relapse in the paired eye. Simultaneously, bilateral AAU was detected in 3 (5.7%) patients with Behcet's syndrome. Chronic, recurrent posterior uveitis was diagnosed in 13 (25%) patients with Behcet's systemic vasculitis. All patients with Behcet's syndrome were male at the age of 31±3.1 years. The uveal process approximately started 3.2±1.16 years after the onset of systemic disease. Generalization of inflammation in all departments of uvea was detected in patients with PSA-5 (9.6%), AC – 3 (5.7%), DS – 2 (3.8%) and SLE – 2 (3.8%). In 5 (9.6%) patients, the process was bilateral. Inflammation of the paired eye by the type of AAU was observed in 1 patient and posterior uveitis - in 2 patients. Conclusions. Ophthalmic disorders in the structure of systemic diseases make up 20.2% and vary widely in their clinical manifestations. Chronic blepharoconjunctivitis, combined with rheumatoid arthritis (46%) is a common inflammation of the accessory structures of the eye. About 20% of patients have complications from general immunosuppressive therapy, leading to impaired visual function. The frequency of uveitis in the structure of ophthalmopathology associated with connective tissue disease is 9.7%. Uveitis associated with ankylosing spondylitis and systemic vasculitis of Behcet occurs in men at a younger age and is 31%. More than half (63%) of patients with uveitis have a severe course with the development of panuveitis and neuropathy. An increase in the thickness of the choroid (up to 2 mm) according to two-dimensional ultrasound is an early diagnostic criterion for the development of uveitis and the underlying disease of connective tissue. Keywords: inflammatory eye diseases, uveitis, connective tissue diseases, spondyloarthritis, Behcet's syndrome, complications.

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