European journal of rheumatology最新文献

Background: Gut dysbiosis may play a role in immune-mediated diseases, such as psoriasis. There is a growing interest in understanding microbiome influence, with speculations around the importance of an altered gut microbiome linked to the progression to psoriatic arthritis in psoriasis. The objective of this study is to study the gut microbiome in patients with severe psoriatic disease with or without psoriatic arthritis.

Methods: V3/V4 16S rRNA gene sequencing and bioinformatics analyses were performed with the total DNA extracted from the stool samples of 30 patients with psoriatic disease, 15 of whom had documented psoriatic arthritis.

Results: We found differences in gut microbiome composition in psoriatic arthritis patients when looking for relative and especially differential abundances. Bacteroidaceae family (P = .02), Bacteroides genus (P=.02), and Bacteroides uniformis (P=.03) were more abundant in psoriatic arthritis patients on differential abundance, adjusted for each taxonomic level. However, the present study did not show significant differences in alpha or beta diversity.

Conclusion: This study shows different patterns of gut microbiome composition in patients with psoriatic arthritis, with significant overexpression of the Bacteroides genus. This reinforces the microbiome as a field of interest in psoriasis. Nevertheless, it should be noted that some previously described findings related to lower diversity and different clustering between groups could not be demonstrated, probably due to the small number of patients. Additionally, it remains difficult to understand the magnitude of the gut microbiome influence. Is dysbiosis a cause or consequence of the disease? However, the microbiome deserves our attention, especially since it brings different opportunities for intervention through diet, prebiotics and probiotics, pretreatment analysis, prognosis, and even microbiome modulation and transplantation.

Background: The study aimed to translate the Profile of Fatigue and Discomfort-Sicca Symptoms Inventory Short Form questionnaire into the Turkish language (PROFAD-SSI-SF-T) and to investigate its psychometric properties.

Methods: The study was completed by 104 patients with primary Sjögren's syndrome (pSS), and 83 patients filled out the scale a second time after 7 days for the retest measurement. The PROFAD-SSISF-T, Functional Assessment Chronic Illness Therapy (Fatigue) (FACIT-F), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), European Quality of Life 5 Dimensions (EQ-5D), and Patient Global Assessment (PaGA) were applied to 104 patients with pSS for convergent validity.

Results: PROFAD-SSI-SF-T found excellent internal consistency (Cronbach's α=0.935) and high test- retest reliability (ICC: 0.83; 95% CI: 0.75-0.88). The standard error of measurement ranged from 1.01 to 3.52, and the minimum detectable difference ranged from 0.92 to 1.17. There was a range from low to high correlation between the PROFAD-SSI-SF-T with ESSPRI, FACIT-F, and EQ-5D. There were no floor and ceiling effects in the PROFAD-SSI-SF-T scale.

Conclusion: The PROFAD-SSI-SF-T is a valid and reliable scale to evaluate fatigue, discomfort, and sicca symptoms in Turkish patients with primary Sjögren's syndrome.

Background: Atherosclerosis is increased in patients with rheumatoid arthritis (RA) and early diagnosis of vascular disease leads to better outcome. Our aim was to evaluate whether aortic elasticity decreases in the subclinical stage of atherosclerosis in RA patients without any cardiovascular disease and to determine disease-related risk factors.

Methods: One hundred fourteen patients with RA, 50 patients with spondyloarthritis, and 50 healthy control were included in this study. Aortic elasticity was evaluated by echocardiography (ECHO). The relationship between atherosclerosis and vascular risk factors, including age, disease activity, C-reactive protein, and serum tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) levels was investigated.

Results: In ECHO evaluation, aortic stiffness was increased (P=.01), and aortic strain and elasticity were decreased (P < .01, P=.01) in RA patients compared to control groups. Serum tumor necrosis factor-like weak inducer of apoptosis levels were also significantly lower (P < .01) in RA, but no significant correlation was found with aortic strain measurement (P > .05). Aortic elasticity was shown to decrease significantly with age in all groups (P < .05).

Conclusion: In this study, we observed deterioration of aortic parameters indicating early atherosclerosis in RA. Aging was found to be the single predictive factor for vascular disease. Although a decrease in sTWEAK level was detected in the RA group, no statistically significant relationship could be demonstrated between sTWEAK level and aortic elasticity parameters. However, the cross-sectional design of the study and possible fluctuations in serum markers depending on disease activity make it difficult to draw a clear conclusion on this subject.

Giant cell arteritis (GCA) is the most frequent large vessel primary vasculitis in the elderly. Correct diagnosis and fast assessment are necessary to prevent complications as well as unnecessary treatments. Giant cell arteritis can present as classical cranial symptoms or as extracranial disease. Although temporal artery biopsy is still the gold standard, ultrasound (US) is gaining ground on evidence with good diagnostic performance as a first approach to support the clinical criteria. The "halo" sign is the most characteristic finding and should be a requisite for reporting an US assessment for GCA with a 43%- 77% sensitivity and 89%-100% specificity, when compared to American College of Rheumatology 1990 criteria. Ultrasound is a cost-effective, noninvasive test that offers bed-side results. The need for an experienced sonographer and consensus on the methodology and interpretation of US is fundamental to reduce operator-dependent errors. The diagnostic US algorithm for GCA depends on the clinical scenarios, and in some cases it may be enough to confirm or discard the GCA diagnosis. We review procedure details for cranial and extracranial arteries and technical requirements.

Soft tissue masses are very common and may appear in the context of rheumatic diseases. They usually occur alone but may occasionally be part of the syndromes and can sometimes involve periarticular tissues. Soft tissue masses can be divided into several categories. In this article, we have categorized them into 3 different groups: (1) pseudotumors, (2) benign tumors, and (3) malignant tumors. Parotid enlargement will also be discussed in this study. The majority of Soft tissue masses are pseudotumors or benign tumors, which can be easily characterized with ultrasound, therefore, considered the first screening tool in the study of this type of lesion. If the tumor is deep or poorly accessible, or present with suspected signs of malignancy, the sonographer may suggest expanding the study with magnetic resonance imaging and/or an ultrasound-guided biopsy of the lesion. Ultrasound is also a good technique for the parotid and submandibular glands and is very useful for evaluating and monitoring Sjogren's syndrome.

Cite this article as: Misra D. Special issue on osteoarthritis: Risk factors and treatment strategies. Eur J Rheumatol. 2024;11(suppl 1):S1-S2.

Background: We aimed to investigate coronavirus diease 2019 (COVID-19) outcomes in patients with amyloid A protein (AA) amyloidosis secondary to rheumatic diseases and discuss factors associated with disease course.

Methods: A retrospective cohort was formed from adult patients with a diagnosis of AA amyloidosis. In patients with a positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction (PCR) test, rates of hospitalization, intensive care unit admission and mortality due to COVID-19 were collected from medical records. Data regarding to demographics, comorbidities, laboratory tests, medical treatments, adherence to previous treatments during COVID-19 and treatment administered for COVID-19 were collected from hospital databases and patient reviews.

Results: In 96 patients with AA amyloidosis, 16 had COVID-19 with a positive PCR. Ten (62.5%) patients were hospitalized, 2 (12.5%) were admitted to ICU, 1 (6.25%) was died. Hospitalized patients tended to be older. Comorbidities seemed to be more frequent in hospitalized patients. None of the patients had rapid progression to end-stage renal disease post-COVID-19. Seven patients had pre-COVID-19 and post-COVID-19 proteinuria levels. Three had notable increase in proteinuria after COVID-19 in 2 of which amyloidosis treatment was revised accordingly.

Conclusion: Despite high rates of hospitalization in AA amyloidosis patients, mortality was observed only in 1 patient. Progression of proteinuria requiring treatment adjustment may be an issue in these patients. Cite this article as: Güven SC, Erden A, Küçük H, et al. Coronavirus disease 2019 outcomes in amyloid A protein amyloidosis secondary to rheumatic conditions and signs of post-coronavirus disease 2019 proteinuria progression. Eur J Rheumatol. Published online April 4, 2024. DOI:10.5152/eurjrheum.2024.23050.

Knee and hip osteoarthritis (OA) are highly prevalent joint diseases that lead to chronic pain, disability, and increased mortality. In this review, we provide a summary of nonsurgical treatments available for knee and hip OA that have evidence to support their use. We also provide a summary of the treatments available for knee and hip OA that do not have sufficient evidence to support their use. Treatments covered in this review include pharmacologic and nonpharmacologic modalities. Cite this article as: Misra D, Felson DT. Evidence-based review of nonsurgical treatments for knee and hip osteoarthritis. Eur J Rheumatol. Published online March 25, 2024. doi: 10.5152/ eurjrheum.2024.22096.