Palindromic Rheumatism with Positive Anticitrullinated Peptide/Protein Antibodies Is Not Synonymous with Rheumatoid Arthritis. A Longterm Followup Study

2012 ◽  
Vol 39 (10) ◽  
pp. 1929-1933 ◽  
Author(s):  
RAIMON SANMARTÍ ◽  
SONIA CABRERA-VILLALBA ◽  
JOSÉ A. GÓMEZ-PUERTA ◽  
VIRGINIA RUIZ-ESQUIDE ◽  
M. VICTORIA HERNÁNDEZ ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Characteristic Curve ◽  
Significant Proportion ◽  
Positive Likelihood Ratio ◽  
Outcome Variable ◽  
Palindromic Rheumatism ◽  
The Difference ◽  
Acpa Status

Objective.To analyze longterm progression to rheumatoid arthritis (RA) and the predictive value of anticitrullinated peptide/protein antibodies (ACPA) in palindromic rheumatism (PR).Methods.We selected all patients in our clinic with PR who had at least 1 ACPA measurement. We included only patients with pure PR, defined as no evidence of associated rheumatic disease at the first serum ACPA measurement. Clinical characteristics, serum ACPA levels, duration of PR until serum ACPA measurement, and total followup time were recorded. The outcome variable was the definitive diagnosis of RA. The prognostic value of ACPA status in pure PR for a definite diagnosis of RA was analyzed by different statistical methods.Results.Seventy-one patients (54 women/17 men) with a PR diagnosis were included. Serum ACPA were positive in 52.1%. After a mean followup of 7.6 ± 4.7 years since the first ACPA measurement, 24 patients (33.8%) progressed to chronic disease: 22% RA, 5.6% systemic lupus erythematosus, and 5.6% other diseases. The positive likelihood ratio of ACPA status for RA was 1.45, and the area under the receiver-operating characteristic curve of ACPA titers was 0.60 (95% CI 0.45−0.75). Progression to RA was more frequently seen in ACPA-positive than in ACPA-negative patients (29.7% vs 14.7%), but the difference was not significant (hazard ratio 2.46, 95% CI 0.77−7.86). Mean ACPA levels of patients with pure PR did not differ significantly from those of patients who progressed to RA.Conclusion.ACPA are frequently found in the sera of patients with PR, and a significant proportion of these patients do not progress to RA in the long term.

High disease activity is associated with higher blood pressure in recent onset rheumatoid arthritis patients, post-hoc analyses of IMPROVED study

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
M Gegenava ◽  
SA Bergstra ◽  
H Maassen ◽  
CF Allaart
Keyword(s):  
Rheumatoid Arthritis ◽  
Blood Pressure ◽  
Disease Activity ◽  
Classification Criteria ◽  
Recent Onset ◽  
American College Of Rheumatology ◽  
Cardiovascular Morbidity And Mortality ◽  
The Difference ◽  
Post Hoc ◽  
Acpa Status

Abstract Funding Acknowledgements Type of funding sources: None. Background Rheumatoid arthritis (RA) is a chronic autoimmune disease with a high prevalence of cardiovascular morbidity and mortality. Purpose: purpose of our project was to investigate the association between disease activity and systolic and diastolic blood pressure (SBP, DBP) in patients with recent-onset rheumatoid arthritis (RA 2010 criteria) or undifferentiated arthritis (UA) who were treated to target disease activity score (DAS)<1.6 in the IMPROVED study. Methods: The associations between disease activity and SBP/DBP were tested for 610 patients (364 RA, 246 UA), cross-sectionally and over time. GEE analyses were performed with both SBP and DBP as outcome measures and disease activity categories (DAS<1.6;>1.6 but ≤2.4; >2.4), CRP level, treatment arms or the number of visits on a certain drug as potential predictors in separate analyses. Separate analyses tested potential contributions of gender, anti-cyclic citrullinated peptide antibodies (ACPA) status, and fulfilling the 2010 ACR/EULAR (American college of rheumatology/ European league against rheumatism) classification criteria. In addition association of BP with various levels of disease activity was tested with T-test. Results: At the baseline mean (SD) SBP was 133 (20) and DBP mean (SD) was 80 (10).  SBP > 140mm Hg was observed in 40% of patients and DBP > 90 mm Hg  in 21% of patients. SBP and DBP statistically significantly decreased during 5 years follow up (mainly during year 1), but the difference in mm Hg was small. Estimates from GEE analysis showed that patients with high DAS >2.4 (HDAS) had a statistically significantly higher SBP (average 3 mm Hg higher, 95% CI 1.7; 4.2, p < 0.01), than the patients in with DAS ≤2.4. ANOVA analyses showed a statistically significant association between SBP and DAS. In addition, post hoc analyses showed that patients with HDAS had a statistically significantly higher  SBP (mean (SD) 132 (19) than the patients with DAS < 1.6 (remission) (mean (SD) 129 (20), p < 0.01), and patients in LDAS but DAS≥1.6 had a statistically significantly higher SBP (mean (SD) 131 (19) than the patients in remission (mean (SD)  129 (20), p = 0.02) (Figure 1), whereas no association was found between DAS category and DBP. Gender, ACPA status or fulfilling the 2010 classification criteria did not influence the relation between DAS and blood pressure. Conclusions: In patients with RA or UA, a higher DAS is associated with higher blood pressure, but the clinical impact is unclear. Abstract Figure 1

scholarly journals Development and Validation of a MicroRNA Panel to Differentiate Between Patients with Rheumatoid Arthritis or Systemic Lupus Erythematosus and Controls

2019 ◽  
Vol 47 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Michelle J. Ormseth ◽  
Joseph F. Solus ◽  
Quanhu Sheng ◽  
Fei Ye ◽  
Qiong Wu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Noncoding Rna ◽  
Characteristic Curve ◽  
Systemic Lupus ◽  
Control Subjects ◽  
Development And Validation ◽  
And Control ◽  
Bioinformatic Approach

Objective.MicroRNA (miRNA) are short noncoding RNA that regulate genes and are both biomarkers and mediators of disease. We used small RNA (sRNA) sequencing and machine learning methodology to develop an miRNA panel to reliably differentiate between rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) and control subjects.Methods.Plasma samples from 167 RA and 91 control subjects who frequency-matched for age, race, and sex were used for sRNA sequencing. TIGER was used to analyze miRNA. DESeq2 and random forest analyses were used to identify a prioritized list of miRNA differentially expressed in patients with RA. Prioritized miRNA were validated by quantitative PCR, and lasso and logistic regression were used to select the final panel of 6 miRNA that best differentiated RA from controls. The panel was validated in a separate cohort of 12 SLE, 32 RA, and 32 control subjects. Panel efficacy was assessed by area under the receiver operative characteristic curve (AUC) analyses.Results.The final panel included miR-22-3p, miR-24-3p, miR-96-5p, miR-134-5p, miR-140-3p, and miR-627-5p. The panel differentiated RA from control subjects in discovery (AUC = 0.81) and validation cohorts (AUC = 0.71), seronegative RA (AUC = 0.84), RA remission (AUC = 0.85), and patients with SLE (AUC = 0.80) versus controls. Pathway analysis showed upstream regulators and targets of panel miRNA are associated with pathways implicated in RA pathogenesis.Conclusion.An miRNA panel identified by a bioinformatic approach differentiated between RA or SLE patients and control subjects. The panel may represent an autoimmunity signature, perhaps related to inflammatory arthritis, which is not dependent on active disease or seropositivity.

scholarly journals A DNA-Methylated Sight on Autoimmune Inflammation Network across RA, pSS, and SLE

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Xingqiang Wang ◽  
Dongyun Lei ◽  
Jie Ding ◽  
Shuang Liu ◽  
Li Tao ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Inflammatory Process ◽  
Methylation Status ◽  
Differential Methylation ◽  
Promoter Regions ◽  
Bioinformatics Analyses ◽  
Epigenetic Biomarkers ◽  
The Difference ◽  
Autoimmune Tautology

Methylation variabilities of inflammatory cytokines play important roles in the development of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and primary Sjögren’s syndrome (pSS). With heightened focus on personalized and precise medicine, it is necessary to compare and contrast the difference and similarity of cytokine methylation status between the 3 most classic autoimmune diseases (AIDs). In this study, we integrated 5 Cytokine-Chips from genome-wide DNA methylation datasets of the 3 kind of AIDs, delta-beta value was calculated for intergroup difference, and comprehensive bioinformatics analyses of cytokine genes with aberrant methylations were performed. 125 shared differential methylation variabilities (DMVs) were identified. There were 102 shared DMVs with similar methylation status; 3 hypomethylated differential methylation regions (DMRs) across the AIDs were found, and all 3 DMRs were hypomethylated. DMRs (AZU1, LTBR, and RTEL1) were likely to serve as activator in the inflammatory process. Particularly, AZU1 and LTBR with hypomethylated TSS and first exon located in the promoter regions were able to trigger inflammation signaling cascades and play critical roles in autoimmune tautology. Moreover, functional epigenetic module (FEM) algorithm showed that different inflammatory networks are involved in different AIDs; 5 hotspots were identified as biologically plausible pathways in inducing or perpetuating of inflammation which are epigenetically deregulated in AIDs. We concluded methylation variabilities among the same cytokines can greatly impact the perpetuation of inflammatory process or signal pathway of AIDs. Differentiating the cytokine methylation status will serve as valuable resource for researchers alike to gain better understanding of the epigenetic mechanisms of the three AIDs. Even more importantly, better understanding of cytokine methylation variability existing between the three classic AIDs will aid in identification of potential epigenetic biomarkers and therapeutic targets. This trial is registered with ChiCTR-INR-16010290, a clinical trial for the treatment of rheumatoid arthritis with Warming yang and Smoothening Meridians.

scholarly journals DEPRESI INDUCED STEROID: STUDI KASUS

2019 ◽  
Vol 1 (2) ◽  
pp. 1-4
Author(s):  
Saiful Batubara
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Immune Response ◽  
Depressed Mood ◽  
Lupus Erythematosus ◽  
Natural Disturbance ◽  
Systemic Lupus ◽  
The Past ◽  
Back Ground

Back Ground: Depression is a natural disturbance of feeling that is characterized by feelings of sadness, loss of interest and easily tired. Steroids are drugs that can reduce swelling, pain and heat due to inflammation through reducing the immune response. Steroids are often used in cases of systemic Lupus Erythematosus in the long term. Therefore management of the disease must be done well because steroids can cause depression. Case Report:Women, 37 years old, depressed mood, disappointment in life, loss of enthusiasm, fatigue, decreased appetite and difficulty sleeping for 1 year. 4 years ago I took steroids for 2 years at a dose of 20mg / day, because rheumatoid arthritis was stopped by os, and for the past 1 year, steroid consumption was due to Systemic Lupus Erythematosus around 60 mg / day. . Before the os consumes steroids, the OS has never experienced depression.BP: 110/70 mmHg , HR 88x/menit, RR 20x/menit, Temp 37°C. Skor BDI 21. Laboratorium Hb 11,8 g/dl, Leukosit 7500/mm3, trombosit 201.000/mm3,,Kalium 2,8, KGDad 99 mg/dlSGOT 29 ,SGPT32, Ureum 15,78 mg/dl, Creatinin 0,65 mg/dl.  Tot Colesterol 198mg/dl,  LDL 128 mg/dl, HDL 35 mg/dl Fototoraks : Jantung dan Parudalambatas normal, FotoLumbosakral : SpondilosisLumbalis. The patient is diagnosed with depression. Given psychotherapy, sandepril 2 x 25 mg for 3 months. Patients show clinical improvement marked by reduced sadness and can understand the disease. Conclusion :Steroid-induced depression has been reported after psychotherapy and sandepril 2 x 25 mg of the patient's condition showed improvement.

scholarly journals Fractures in Corticosteroid- and Bisphosphonate-treated Subjects With Longstanding Rheumatoid Arthritis

2021 ◽  
Author(s):  
Atie Moghtadaie ◽  
Seyed Amir Miratashi Yazd ◽  
Ahmad Salimzadeh
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Femoral Fractures ◽  
Bone Diseases ◽  
Multiple Fractures ◽  
Metabolic Bone Diseases ◽  
Atypical Femoral Fractures ◽  
Therapy Assessment ◽  
History Of

Background: Bisphosphonates are the most widely prescribed agents for the treatment of postmenopausal osteoporosis and other metabolic bone diseases. Atypical femoral fractures in bisphosphonate-treated patients have raised concerns regarding the long-term safety of this class of medications. Case Presentation: In this study, we report two patients suffering from fractures while receiving biphosphonates; a postmenopausal patient with rheumatoid arthritis and a history of long-term use of bisphosphonates and glucocorticoids presenting with multiple fractures as case one and another 52-year-old female patient diagnosed with Systemic Lupus Erythematosus (SLE) who suffered from a femoral shaft fracture without any history of prior traumatic incidents as case two. Conclusions: Considering the low risk for atypical femoral fractures, further careful screening for these types of fractures should be undertaken. In addition, in order to lower the rate of fractures in patients on long-term bisphosphonate therapy, assessment of patients’ contralateral side should be considered to prevent further fractures, especially in patients with prodromal pain.

Development of sulfasalazine-associated drug-induced lupus erythematosus in patient with rheumatoid arthritis (clinical case)

2021 ◽  
pp. 26-29
Author(s):  
A. N. Kovshik ◽  
E. P. Kiseleva ◽  
N. G. Klyukvina ◽  
G. V. Lukina
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Drug Induced ◽  
Reliable Diagnosis ◽  
Term Administration ◽  
Lupus Syndrome

Drug-induced lupus syndrome (DLS) is a rare adverse event with a variety of drugs. More than a hundred of drugs are known that can cause the development of DLS, and this list is growing as new drugs appear. Physicians of any specialty can face such complications of therapy and should be aware of this pathology. The article presents an analysis of a clinical case of DLS development against the background of long-term administration of sulfasalazine in a patient with a reliable diagnosis of rheumatoid arthritis, as well as a literature review, which includes data on the prevalence, drug groups, clinical manifestations, diagnosis and treatment of this pathology.

scholarly journals Patchy Alopecia in a Patient with Rheumatoid Arthritis: A Practical Application of Trichoscopy

2021 ◽  
pp. 42-46
Author(s):  
Ahmad Vafaeian ◽  
Elham Taghizadeh ◽  
Maryam Daneshpazhooh ◽  
Hamidreza Mahmoudi
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Tinea Capitis ◽  
Skin Diseases ◽  
Cutaneous Lupus Erythematosus ◽  
Proper Treatment ◽  
Practical Application ◽  
History Of ◽  
Cutaneous Lupus

Trichoscopy is an efficient, convenient, and accurate diagnostic dermatological procedure which is widely used in the examination of patients with skin diseases. Herein, we report a 56-year-old woman with a long-term history of rheumatoid arthritis complaining of pruritic patchy alopecia on her scalp who was referred for biopsy to exclude cutaneous lupus erythematosus. Taking advantage of trichoscopy, we were able to quickly diagnose tinea capitis. Following administration of the proper treatment the disease resolved completely.

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