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ID PMID Title PublicationDate abstract
30997350 LncRNA: An All-rounder in Rheumatoid Arthritis. 2019 Mar Rheumatoid arthritis (RA) is a chronic autoimmune disease and is supposed to have both genetic and environmental backgrounds. Plenty of studies have demonstrated the roles of long non-coding RNAs (lncRNAs) in the initiation and development of RA. Numerous lncRNAs have been found to be dysregulated in RA and to be correlated with disease activity of RA, which indicates potential diagnostic roles of lncRNAs. In addition to working as biomarkers for RA, lncRNAs participate in many specific pathological processes including inflammation, aberrant proliferation, migration, invasion and apoptosis. Further screenings and researches are required to validate the clinical potentials of lncRNAs as diagnostic and therapeutic targets in RA.
31497770 Accelerated Nodulosis in a Patient With Rheumatoid Arthritis. 2019 Jun In patients with rheumatoid arthritis (RA), subcutaneous nodules are the most frequently seen extra-articular findings that are seen in areas of extensor pressure. In this article, we present the case of a RA patient with accelerated nodulosis that started with the use of methotrexate and exacerbated with etanercept and leflunomide treatment.
31606270 Anti-arthritic potential of ethanol and aqueous extracts of stem bark of Cleistopholis pat 2021 Jan BACKGROUND: Traditional medicine intervention has been used in rheumatoid arthritis (RA) treatment due to limitations of conventional drugs. OBJECTIVE: This study aimed at evaluating the anti-arthritic potentials of ethanol and aqueous extracts of stem bark of Cleistopholis patens (SBCP) in complete Freund's adjuvant (CFA) induced rheumatoid arthritis in rats. MATERIALS AND METHODS: Rheumatoid arthritis was induced in groups 2 to 9 by intradermal injection of 0.1 mlkg(-1) chicken type II collagen in CFA into the left hind paw of the rats. Group 1 served as normal control. Group 2 (negative control) received 5 mlkg(-1) body weight normal saline while group 3 (positive control) received 10 mg/kg body weight standard drug (indomethacin). Groups 4 to 9 received varied doses of the extracts. After 10 days of RA induction, rats were treated with ethanol and aqueous extracts of SBCP orally at a dose of 400, 600 and 800 mgkg(-1) for 21 days. The paw size, body weight changes, inflammatory parameters, lipid peroxidation maker and malondialdehyde (MDA) were assessed. RESULTS: Rheumatoid arthritis induction caused marked (p < 0.05) increase in paw size, inflammatory makers and MDA while significant (p < 0.05) reduction was observed in body weight relative to normal control. Treatment with extracts analogous to indomethacin markedly (p < 0.05) decreased the paw size and caused weight gain while the altered inflammatory parameters and MDA were reversed relative to negative control. CONCLUSION: The findings suggest that the extracts of SBCP have good antiarthritic potentials comparable to indomethacin and hence could be used in rheumatoid arthritis management.
30635202 Total Elbow Arthroplasty. 2019 Jun Total elbow arthroplasty design has evolved in recent decades. Indications for total elbow arthroplasty include advanced rheumatoid arthritis to osteoarthritis, post-traumatic arthritis, adverse sequelae of trauma, and unreconstructable acute fractures. This article summarizes the current evidence for total elbow arthroplasty, including the history of total elbow arthroplasty, an overview of the recent trends and designs, and current evidence-based outcomes. Outcomes are assessed for specific indications, namely rheumatoid arthritis, osteoarthritis, post-traumatic arthritis, acute trauma, and younger patients. Complication rates, reoperation rates, and survivorship of modern prostheses are discussed. Technical pearls and pitfalls are discussed for primary and revision cases.
30539586 Determination of Rheumatoid Factors by ELISA. 2019 IgM and IgA autoantibodies binding to IgG are called rheumatoid factors (RFs) and occur with high frequency in rheumatoid arthritis (RA) and with lower frequency in other autoimmune diseases. RFs have diagnostic and prognostic value in RA, but they also have a high potential to cause false positive reactions in other immunoassays, especially sandwich assays. For these reasons it is imperative to be able to measure RFs in serum samples from patients suspected of RA or other autoimmune diseases and in serum samples to be analyzed by sandwich immunoassay for various clinical parameters. Here, a simple ELISA for IgM and IgA RFs is described.
31367417 Widespread pain and pain intensity in patients with early rheumatoid arthritis. A cross-se 2019 Jul AIM: The aim was to investigate if smoking status at time for diagnoses of rheumatoid arthritis was associated with pain intensity or pain spread. DESIGN: A cross-sectional study conducted in 2012-2013. METHODS: Seventy-eight patients, of whom 16 were current smokers and 62 never or previous smokers, with newly diagnosed rheumatoid arthritis were assessed as to pain intensity, widespread pain and disease activity. RESULTS: Of the participants, 56% had unacceptable pain, 77% had spread pain and 28% had chronic widespread pain. There were no differences in pain intensity, widespread pain or chronic widespread pain between smoking status groups. However, there was a positive association between pain intensity and disease activity, r = 0.52. CONCLUSION: In this study, patients with early rheumatoid arthritis had a high-frequency unacceptable pain and wide spread pain, irrespective of smoking status. However, we cannot exclude that the inflammatory-associated pain overshadowed a possible negative effect of smoking.
31522080 Tuberculosis of the wrist mimicking rheumatoid arthritis - A rare case. 2019 INTRODUCTION: Mycobacterium tuberculosis causes infection in approximately one-third of the world's population. Arthritis due to Mycobacteriurn tuberculosis usually presents as a chronic, slowly progressive, monoarticular infection that predominantly involves the weight-bearing joints and the spine. The hand and wrist are rare sites for tuberculosis (TB) and comprises of < 1% of all skeletal TB. Even though it is rare, TB of the wrist is a cause of great morbidity. We presented a case of wrist TB treated with debridement and synovectomy. PRESENTATION OF CASE: A 35 years old woman came with the chief complaint of pain and swelling on the right wrist since 1 year ago and was diagnosed with rheumatoid arthritis of the wrist. Patient then was given methylprednisolone 4 mg twice a day and methotrexate 175 mg once a week. However, the pain and swelling of her right wrist became worse. Subsequently patient was admitted to hospital and laboratory findings suggested a tuberculous arthritis of the wrist. Debridement, synovectomy, and biopsy, in addition to antituberculosis therapy, were then performed. DISCUSSION: Tuberculous arthritis is generally a monoarticular disease that typically involves the spine or large and medium-sized joints. Rheumatoid arthritis (RA) and tuberculous arthritis may have similar clinical characteristics, which consists of a chronic course with periarticular soft-tissue swelling. CONCLUSION: Tuberculous arthritis and RA can have similar characteristic but laboratory examination can help in establishing diagnosis.
30858634 Laugier-Hunziker syndrome in a patient with rheumatoid arthritis. 2019 Laugier-Hunziker syndrome is a rare benign idiopathic condition characterized by acquired macular pigmentation of the lips and buccal mucosa, often accompanied by melanonychia. Although the etiopathogenesis is not fully known, tyrosine is thought to be responsible for the pathogenesis of enzyme hyperactivity in melanin biosynthesis. We present the case of a 66-year-old woman diagnosed with Laugier-Hunziker syndrome and rheumatoid arthritis.
31044037 'Preclinical' rheumatoid arthritis in patients with celiac disease: A cross-sectional stud 2019 Apr Objective: Preclinical or latent RA is characterized by the presence of autoantibodies in the absence of clinical symptoms. The objective of this study was to identify the prevalence of preclinical RA in patients with Celiac disease in order to determine whether or not such individuals should be screened for RA based on the high-risk. Method: A cross-sectional study was carried out on patients with celiac disease in a tertiary care center in Rawalpindi, Pakistan. After initial assessment, RA-autoantibody levels (Rheumatoid factor and anti-CCP) were checked. Descriptive analysis was performed on the data gathered. Results: Sixteen patients with known celiac disease were identified to have positive rheumatoid factor and/or anti-CCP levels with an overall prevalence rate of 35%. This trend was significant for celiac patients having history of inflammatory arthritis and active celiac disease. No statistical significance was seen in baseline characteristics for categories of patients with positive rheumatoid factor versus with positive anti-CCP antibodies. Conclusion: Patients with CD can be considered as a high-risk group based on the high prevalence rate of rheumatoid factor/anti-CCP positivity observed in this study and should be considered for further RA screening/preventive studies. Abbreviations: RA = Rheumatoid arthritis; CD = Celiac disease; anti-CCP = anti-citrullinated cyclic peptide) antibodies; RF = Rheumatoid factor; GFD = Gluten-free diet.
32010597 The Role of Calprotectin in Rheumatoid Arthritis. 2019 Dec Rheumatoid arthritis (RA) is an inflammatory autoimmune disease characterized by inflammatory cell infiltration, high levels of cytokines, and erosion of cartilage and bone in joints. Calprotectin (CLP), as a recently described member of S100 family proteins, is a heterodimeric complex of S100A8 and S100A9. Currently, plenty of studies have indicated significantly increased serum and synovial fluid levels of CLP in patients with RA. It was reported that CLP was related to cell differentiation, migration, apoptosis, and production of pro-inflammatory factors in RA. In addition, there are the positive relationships between serum, synovial CLP and traditional acute phase reactants, disease activity, ultrasound and radiographic progression of joints, and treatment response of RA. In this review, we mainly discuss the role of CLP in the pathogenesis of RA as well as its potential to estimate clinical disease progression of RA patients.
32015973 Palmoplantar Pustulosis-like Eruption Induced by Baricitinib for Treatment of Rheumatoid A 2020 OBJECTIVES: Baricitinib is an orally active Janus kinase (JAK) inhibitor used in the treatment of moderate to severe rheumatoid arthritis (RA). MATERIALS AND METHODS: Here, we report the case of a 56-year-old Caucasian male diagnosed with RA who developed palmoplantar pustulosis (PPP) while being treated with baricitinib. RESULTS: The patient's PPP resolved after discontinuation of baricitinib and recurred when this was restarted. Based on causality assessment, it was considered a drug-induced PPP. CONCLUSION: To the authors' knowledge, this is the first case of baricitinib-induced PPP. LEARNING POINTS: Baricitinib is a small, orally active molecule that inhibits JAK-1 and JAK-2, which is used in the treatment of rheumatoid arthritis.Baricitinib has been also used in the treatment of psoriasis, alopecia areata and atopic dermatitis.Palmoplantar pustulosis is a rare cutaneous side effect of baricitinib.
31044046 When the plot thickens: a rare complication of rheumatoid arthritis. 2019 Apr Introduction: Rheumatoid arthritis (RA) is a common illness with many extraarticular manifestations. Rheumatoid pachymeningitis is a rare neurologic complication of this common disease. Here in we present a patient with longstanding RA who developed this uncommon complication. Case description: A 75-year-old woman with longstanding RA presented to the clinic with multiple seizure-like spells per day. Upon admission to the hospital, brain MRI showed enhancement of the meninges. After an extensive workup for possible other infectious or inflammatory causes, the patient was diagnosed with rheumatoid pachymeningitis. Conclusion: Rheumatoid pachymeningitis is a rare complication of RA that usually occurs late in the disease course. It may have many neurologic manifestations include mimicking seizure or stroke and must be considered in patients with RA presenting with neurologic symptoms. Pachymeningitis is treated distinctly from articular RA, so early recognition can lead to appropriate treatment.
31864446 Adult-onset Still's disease as a cutaneous marker of systemic disease. 2019 Nov Adult-onset Still's disease (AOSD) is a rare, systemic, inflammatory disorder characterized by spiking fevers, an evanescent eruption, arthritis, and multiorgan involvement. The disease has been recently classified as a polygenic autoinflammatory disorder at the "crossroads" of autoinflammatory and autoimmune diseases. The highly characteristic salmon-colored eruption is a cutaneous manifestation of a generalized inflammatory reaction and an important diagnostic criterion. In addition to the evanescent eruption, there are atypical persistent papules and plaques in many patients with AOSD. Emerging data suggest that AOSD with this typical evanescent eruption has a different clinicopathologic presentation and clinical course than AODS with atypical cutaneous manifestations. It appears that there are two subtypes of AOSD with different immunologic profiles, including (1) a systemic disease with high fever, organ involvement, and elevated levels of ferritin, and (2) a chronic disease course with arthritis as the predominant finding. These observations provide novel insight into the disease pathogenesis, suggesting that the underlying mechanisms might differ between these two forms, partially explaining the reported differences in drug response. Recent advances in the understanding of AOSD are summarized with a focus on the spectrum of cutaneous manifestations and its relationship to systemic inflammation.
30858628 Cardiac and vascular complications in rheumatoid arthritis. 2019 Rheumatoid arthritis (RA) is an independent risk factor for the development of a variety of cardiovascular diseases, with a 1.5-factor increase in risk. This literature review aims to provide a global overview of the pathogenesis, effects of anti-rheumatoid treatment on cardiovascular risk, a description of the cardiovascular complications associated with RA, and current opinion on cardiovascular risk assessment and management in patients with RA. Author conducted a literature search in PubMed, Scopus, Web of Science and Embase regarding RA and associated cardiovascular complications. The mechanism of increased risk of cardiovascular disease in patients with RA is complex. There are specific genetic factors associated with both diseases, and traditional cardiovascular risk factors may be more prevalent in patients with RA. Most anti-rheumatic drugs decrease cardiovascular risk, and general recommendations focus on reduction of disease activity and strict management of cardiovascular risk as per the general population.
35154753 Rheumatoid arthritis and systemic lupus erythematosus: Pathophysiological mechanisms relat 2019 Rheumatoid arthritis and systemic lupus erythematosus are two highly prevalent autoimmune diseases that generate disability and low quality of life. The innate immune system, a long-forgotten issue in autoimmune diseases, is becoming increasingly important and represents a new focus for the treatment of these entities. This review highlights the role that innate immune system plays in the pathophysiology of rheumatoid arthritis and systemic lupus erythematosus. The role of the innate immune system in rheumatoid arthritis and systemic lupus erythematosus pathophysiology is not only important in early stages but is essential to maintain the immune response and to allow disease progression. In rheumatoid arthritis, genetic and environmental factors are involved in the initial stimulation of the innate immune response in which macrophages are the main participants, as well as fibroblast-like synoviocytes. In systemic lupus erythematosus, all the cells contribute to the inflammatory response, but the complement system is the major effector of the inflammatory process. Detecting alterations in the normal function of these cells, besides its contribution to the understanding of the pathophysiology of autoimmune diseases, could help to establish new treatment strategies for these diseases.
32185350 Diagnostic value of Ultrasonography in the detection of Bone Erosions in patients with Rhe 2019 Jun OBJECTIVE: Rheumatoid arthritis (AR) is the most common systemic inflammatory disease of joints, with prevalence of 1% worldwide. Bone erosion (BE) is a central feature of rheumatoid arthritis and is associated with disease severity and poor functional outcome. Conventional Radiography (CR) and Ultrasonography (US) play an important role in the diagnosis of RA. The aim of this study was to compare the value of two methods in the detection of BE in AR patients. METHODS: In this cross-sectional study, 111 patients with confirmed RA have been randomly selected and were studied. A checklist which includes demographic information such as age, gender, place of residence, history of smoking, education level and history of rheumatologic disease was completed for all patients, and then radiography and high-resolution US of dominant hands and wrists of metacarpophalangeal (MCP) joint were performed. Collected data was analysed by statistical methods in SPSS version 22. RESULTS: The results of this study showed that there is no significant difference between these two methods in detection of BE. In age groups < 44 years old, US with 98% had more sensitivity than CR with 89%. CONCLUSION: Results showed that there is no significant difference in diagnostic value of US in bone erosion in patients with rheumatoid arthritis, in comparison with CR in terms of gender and diagnosis for the existence of erosions; however, in determining the amount of BE in age groups < 44 years old, US has better performance than CR.
30221483 Biopsy-Proven Small-Fiber Neuropathy in Primary Sjögren's Syndrome: Neuropathic Pain Char 2019 Jul OBJECTIVE: Painful small-fiber neuropathies (SFNs) in primary Sjögren's syndrome (SS) may present as pure or mixed with concurrent large-fiber involvement. SFN can be diagnosed by punch skin biopsy results that identify decreased intra-epidermal nerve-fiber density (IENFD) of unmyelinated nerves. METHODS: We compared 23 consecutively evaluated patients with SS with pure and mixed SFN versus 98 patients without SFN. We distinguished between markers of dorsal root ganglia (DRG) degeneration (decreased IENFD in the proximal thigh versus the distal leg) versus axonal degeneration (decreased IENFD in the distal leg versus the proximal thigh). RESULTS: There were no differences in pain intensity, pain quality, and treatment characteristics in the comparison of 13 patients with pure SFN versus 10 patients with mixed SFN. Ten patients with SFN (approximately 45%) had neuropathic pain preceding sicca symptoms. Opioid analgesics were prescribed to approximately 45% of patients with SFN. When compared to 98 patients without SFN, the 23 patients with SFN had an increased frequency of male sex (30% versus 9%; P < 0.01), a decreased frequency of anti-Ro 52 (P = 0.01) and anti-Ro 60 antibodies (P = 0.01), rheumatoid factor positivity (P < 0.01), and polyclonal gammopathy (P < 0.01). Eleven patients had stocking-and-glove pain, and 12 patients had nonstocking-and-glove pain. Skin biopsy results disclosed patterns of axonal (16 patients) and DRG injury (7 patients). CONCLUSION: SS SFN had an increased frequency among male patients, a decreased frequency of multiple antibodies, frequent treatment with opioid analgesics, and the presence of nonstocking-and-glove pain. Distinguishing between DRG versus axonal injury is significant, especially given that mechanisms targeting the DRG may result in irreversible neuronal cell death. Altogether, these findings highlight clinical, autoantibody, and pathologic features that can help to define mechanisms and treatment strategies.
31363308 Immunomodulatory drugs in pregnancy and lactation. 2019 Jun Pregnancy presents challenges for women with autoimmune diseases. It is associated with significant physiological, hormonal and immunomodulatory changes which are complex and vary according to the stage of pregnancy Pregnancy planning and counselling should be offered Autoimmune diseases such as rheumatoid arthritis tend to improve in pregnancy while systemic lupus erythematosus may increase in activity During pregnancy the chosen regimen should control or prevent underlying disease activity and minimise risk to the fetus. Ideally, women should be on a stable regimen before conception Poorly controlled disease is associated with poor outcomes for both mother and fetus, such as higher risks of pre-eclampsia, early delivery and growth restriction of the fetus Postpartum, there is a sudden fall in hormone concentrations, and a switch to a pro-inflammatory state. This increases the risk of relapse of many autoimmune diseases in particular rheumatoid arthritis, Crohn’s disease and autoimmune hepatitis Many drugs are compatible with breastfeeding, but there are limited data on many of the new drugs
32185356 Twenty Years of Targeted Treatment in Rheumatoid Arthritis in the Greek Databases: Achieve 2019 Sep Rheumatoid arthritis (RA) is a chronic autoimmune disease associated with substantial morbidity and mortality especially in difficult to treat cases. Biologic agents were introduced 20 years ago in Greece and RA management has paralleled the European experience. Several publications from the country have captured important aspects of the disease from its epidemiology to the clinical use of biologics and management of comorbidities. In this communication we review the management of RA and its evolution over the last 20 years in Greece, discussing the major achievements and the unmet needs of the disease in an effort to put this into a perspective. We conclude that introduction of biologic therapy has substantially changed the treatment of difficult to treat rheumatoid arthritis in-spite of the multiple unmet needs. While striving for even better outcomes, we cannot lose sight of the major impact of biologic therapies on the lives of patients with rheumatoid arthritis.
31853259 Serum anti-Müllerian hormone levels in women with rheumatoid arthritis during tumor necro 2019 Dec BACKGROUND: We evaluated serum anti-Müllerian hormone in women with rheumatoid arthritis newly introduced to tumor necrosis factor-α inhibitor treatment for 54 weeks to investigate the treatment's effect on ovarian reserve. METHODS: A total of 12 premenopausal women with rheumatoid arthritis aged 20-50 years were recruited at our division, who had been newly treated with tumor necrosis factor-α inhibitor (infliximab or etanercept) from 1 April 2008 to 31 March 2014. Serial serum anti-Müllerian hormone levels and disease activity scores (DAS28-CRP) were examined at defined periods: start of treatment and 14, 30, and 54 weeks after start of treatment. RESULTS: DAS28-CRP scores in 12 women were significantly decreased from a mean of 4.6 (±SD: 0.4) to 2.3 (±0.4) after 54 weeks of treatment (p < 0.001). Serum anti-Müllerian hormone levels and its z scores did not change significantly. CONCLUSION: Treatment with a tumor necrosis factor-α inhibitor did not affect serum anti-Müllerian hormone levels in 12 women with rheumatoid arthritis during 54-week treatment.