Pub Date : 2025-12-01Epub Date: 2025-11-12DOI: 10.1016/j.reuma.2025.502017
Ayfer Altıntas , Emre Ali Acar , Sadettin Uslu , Ihsan Sebnem Orgüc , Zeliha Hekimsoy , Timur Pirildar
Objective
To investigate the frequency of diffuse idiopathic skeletal hyperostosis (DISH) in patients with prediabetes.
Material and methods
A total of 166 prediabetic patients were prospectively evaluated, of whom 67 with symptoms suggestive of DISH underwent thoracic and lumbar radiography. DISH was diagnosed according to Resnick and Niwayama criteria. Demographic, clinical and laboratory data were analyzed.
Results
DISH was diagnosed in 9 patients (13.4% of symptomatic; 5.4% overall). Patients with DISH were older and more frequently hypertensive compared to those without DISH (p = 0.004 and p = 0.047, respectively). Other parameters such as body mass index, fasting glucose, and smoking showed higher trends in the DISH group but did not reach statistical significance.
Conclusion
This is the first study to examine DISH in a prediabetic population. Our findings suggest a possible association between DISH and prediabetic status, although further studies are needed to confirm this relationship.
{"title":"Diffuse idiopathic skeletal hyperostosis in patients with prediabetes","authors":"Ayfer Altıntas , Emre Ali Acar , Sadettin Uslu , Ihsan Sebnem Orgüc , Zeliha Hekimsoy , Timur Pirildar","doi":"10.1016/j.reuma.2025.502017","DOIUrl":"10.1016/j.reuma.2025.502017","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the frequency of diffuse idiopathic skeletal hyperostosis (DISH) in patients with prediabetes.</div></div><div><h3>Material and methods</h3><div>A total of 166 prediabetic patients were prospectively evaluated, of whom 67 with symptoms suggestive of DISH underwent thoracic and lumbar radiography. DISH was diagnosed according to Resnick and Niwayama criteria. Demographic, clinical and laboratory data were analyzed.</div></div><div><h3>Results</h3><div>DISH was diagnosed in 9 patients (13.4% of symptomatic; 5.4% overall). Patients with DISH were older and more frequently hypertensive compared to those without DISH (<em>p</em> <!-->=<!--> <!-->0.004 and <em>p</em> <!-->=<!--> <!-->0.047, respectively). Other parameters such as body mass index, fasting glucose, and smoking showed higher trends in the DISH group but did not reach statistical significance.</div></div><div><h3>Conclusion</h3><div>This is the first study to examine DISH in a prediabetic population. Our findings suggest a possible association between DISH and prediabetic status, although further studies are needed to confirm this relationship.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 502017"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-13DOI: 10.1016/j.reuma.2025.501993
Carlos Valera-Ribera , Juan José Alegre-Sancho , Àngels Martínez-Ferrer , Montserrat Robustillo-Villarino
Objectives
To describe the prevalence of sexual dysfunction (SD) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and a control group, and identify associated factors.
Methods
Adults of any sexual orientation with PsA (CASPAR criteria) or RA (EULAR/ACR 2010 criteria) were consecutively included in this cross-sectional observational study. The Changes in Sexual Functioning Questionnaire (CSFQ-14) was self-administered to evaluate variations in sexual function due to disease or medication. We also evaluated the potential association of sociodemographic and clinical data with SD. Results were compared with a control group of healthy individuals.
Results
Overall 188 individuals were included, 72 with PsA and 27 with RA. In total, 30.43%, 48.15% and 5.88% of the PsA, RA and control groups, respectively, had scores within the SD range. The overall patient population had a mean CSFQ-14 score 8.2 points lower than the control group. All domains of the CSFQ-14 questionnaire were negatively affected by PsA or RA (p < 0.001). The risk of SD is associated with age, sex, perceived health, employment situation, and economic status. The estimated odds ratio of having SD was 8.7 times higher in patients diagnosed with PsA and 10 times higher in patients diagnosed with RA.
Conclusions
Patients with RA or PsA have a poorer sexual life in all sexual sphere domains, compared to a healthy population. Our study confirms the value of the CSFQ-14 questionnaire for assessing sexual health and as a tool for the integral management of patients with chronic joint diseases.
{"title":"Prevalence and impact of chronic joint diseases on the sexual sphere compared to a healthy population: A multicenter cross-sectional study","authors":"Carlos Valera-Ribera , Juan José Alegre-Sancho , Àngels Martínez-Ferrer , Montserrat Robustillo-Villarino","doi":"10.1016/j.reuma.2025.501993","DOIUrl":"10.1016/j.reuma.2025.501993","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the prevalence of sexual dysfunction (SD) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and a control group, and identify associated factors.</div></div><div><h3>Methods</h3><div>Adults of any sexual orientation with PsA (CASPAR criteria) or RA (EULAR/ACR 2010 criteria) were consecutively included in this cross-sectional observational study. The Changes in Sexual Functioning Questionnaire (CSFQ-14) was self-administered to evaluate variations in sexual function due to disease or medication. We also evaluated the potential association of sociodemographic and clinical data with SD. Results were compared with a control group of healthy individuals.</div></div><div><h3>Results</h3><div>Overall 188 individuals were included, 72 with PsA and 27 with RA. In total, 30.43%, 48.15% and 5.88% of the PsA, RA and control groups, respectively, had scores within the SD range. The overall patient population had a mean CSFQ-14 score 8.2 points lower than the control group. All domains of the CSFQ-14 questionnaire were negatively affected by PsA or RA (<em>p</em> <!--><<!--> <!-->0.001). The risk of SD is associated with age, sex, perceived health, employment situation, and economic status. The estimated odds ratio of having SD was 8.7 times higher in patients diagnosed with PsA and 10 times higher in patients diagnosed with RA.</div></div><div><h3>Conclusions</h3><div>Patients with RA or PsA have a poorer sexual life in all sexual sphere domains, compared to a healthy population. Our study confirms the value of the CSFQ-14 questionnaire for assessing sexual health and as a tool for the integral management of patients with chronic joint diseases.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 501993"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-09-24DOI: 10.1016/j.reuma.2025.501974
Adriana Lucía Vanegas-García , Mauricio Restrepo-Escobar , Álvaro Arbeláez-Cortés , Gina Sicilia Ochoa Galeano , Luis Lira Weldt , Guillermo Andrés Quiceno , Virginia Pascual-Ramos
Background
Shared decision-making (SDM) has been linked to improved patient- and physician-reported outcomes. To achieve these benefits, both parties need to agree on implementing SDM. The objective of the study was to compare the perception of SDM process implementation in daily practice between patients with rheumatic diseases (RMDs) and rheumatologists.
Methods
This cross-sectional study was conducted in April 2024 in Latin America (LATAM). Adult patients diagnosed with RMDs and rheumatologists were invited to participate in a web-based survey based on the Spanish patient version of the 9-item SDM questionnaire (SDM-Q-9) and the physician version (SDM-Q-Doc). Both versions were validated tools for evaluating patients’ and physicians’ perceived levels of SDM. Descriptive statistics and comparative tests (e.g., chi-square or Mann–Whitney U test) were used to analyze the data. Statistical significance was set at p < 0.05, and analyses were conducted using STATA 17 software.
Results
We received surveys from 369 patients, primarily systemic lupus erythematosus (51.8%) and rheumatoid arthritis (19.5%), across 17 countries. The largest number of responses was from Mexico (42%) and Colombia (11.9%). The survey was completed by 144 rheumatologists from 10 countries, primarily from Colombia (52.8%) and Chile (23.6%). Physicians most frequently strongly agree/agree that they engaged in the different steps of the SDM process, compared to patients, and this difference was less evident for the step “sharing with the patient the different options for treating the condition.” Also, a higher percentage of rheumatologists (96.5%) reported engaging in SDM during clinical practice compared to patients (62.3%), p = 0.001.
Conclusions
In LATAM, rheumatologists more frequently referred to implementing the SDM process during clinical care than patients with RMDs. Further research is needed to improve patient-centered care.
{"title":"Patients’ and rheumatologists’ perceptions about shared decision-making implementation: A Latin-American survey","authors":"Adriana Lucía Vanegas-García , Mauricio Restrepo-Escobar , Álvaro Arbeláez-Cortés , Gina Sicilia Ochoa Galeano , Luis Lira Weldt , Guillermo Andrés Quiceno , Virginia Pascual-Ramos","doi":"10.1016/j.reuma.2025.501974","DOIUrl":"10.1016/j.reuma.2025.501974","url":null,"abstract":"<div><h3>Background</h3><div>Shared decision-making (SDM) has been linked to improved patient- and physician-reported outcomes. To achieve these benefits, both parties need to agree on implementing SDM. The objective of the study was to compare the perception of SDM process implementation in daily practice between patients with rheumatic diseases (RMDs) and rheumatologists.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted in April 2024 in Latin America (LATAM). Adult patients diagnosed with RMDs and rheumatologists were invited to participate in a web-based survey based on the Spanish patient version of the 9-item SDM questionnaire (SDM-Q-9) and the physician version (SDM-Q-Doc). Both versions were validated tools for evaluating patients’ and physicians’ perceived levels of SDM. Descriptive statistics and comparative tests (e.g., chi-square or Mann–Whitney <em>U</em> test) were used to analyze the data. Statistical significance was set at <em>p</em> <!--><<!--> <!-->0.05, and analyses were conducted using STATA 17 software.</div></div><div><h3>Results</h3><div>We received surveys from 369 patients, primarily systemic lupus erythematosus (51.8%) and rheumatoid arthritis (19.5%), across 17 countries. The largest number of responses was from Mexico (42%) and Colombia (11.9%). The survey was completed by 144 rheumatologists from 10 countries, primarily from Colombia (52.8%) and Chile (23.6%). Physicians most frequently strongly agree/agree that they engaged in the different steps of the SDM process, compared to patients, and this difference was less evident for the step “sharing with the patient the different options for treating the condition.” Also, a higher percentage of rheumatologists (96.5%) reported engaging in SDM during clinical practice compared to patients (62.3%), <em>p</em> <!-->=<!--> <!-->0.001.</div></div><div><h3>Conclusions</h3><div>In LATAM, rheumatologists more frequently referred to implementing the SDM process during clinical care than patients with RMDs. Further research is needed to improve patient-centered care.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 501974"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-18DOI: 10.1016/j.reuma.2025.501997
Olga Rusinovich-Lovgach , Luz Morán , Oscar Toldos-Gonzalez , Marta Vaquero Martínez , Borja Cabal-Paz , José Luis Andréu Sánchez
We describe a young man with persistent hyperCKemia and MRI findings initially suggestive of inflammatory myopathy, in whom genetic testing confirmed Bethlem myopathy. This case illustrates how collagen VI-related myopathies can mimic idiopathic inflammatory myopathies (IIM), underlining the need for integrated clinical, imaging, biopsy, and genetic data to ensure diagnostic accuracy and avoid unnecessary immunosuppression.
{"title":"Diagnostic challenge: Bethlem myopathy mimicking inflammatory myopathy","authors":"Olga Rusinovich-Lovgach , Luz Morán , Oscar Toldos-Gonzalez , Marta Vaquero Martínez , Borja Cabal-Paz , José Luis Andréu Sánchez","doi":"10.1016/j.reuma.2025.501997","DOIUrl":"10.1016/j.reuma.2025.501997","url":null,"abstract":"<div><div>We describe a young man with persistent hyperCKemia and MRI findings initially suggestive of inflammatory myopathy, in whom genetic testing confirmed Bethlem myopathy. This case illustrates how collagen VI-related myopathies can mimic idiopathic inflammatory myopathies (IIM), underlining the need for integrated clinical, imaging, biopsy, and genetic data to ensure diagnostic accuracy and avoid unnecessary immunosuppression.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 501997"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-10-18DOI: 10.1016/j.reuma.2025.501995
Wilmer Gerardo Rojas-Zuleta, Yesith Guillermo Toloza-Pérez, Carolina Becerra Arias, Jorge Donado Gómez, Jeixa Jennifer Canizales Rodríguez, Oscar Jair Felipe Díaz
Introduction
Rheumatoid arthritis is associated with an increased risk of chronic kidney disease, which complicates the safe use of disease-modifying antirheumatic drugs, particularly in patients with severe renal impairment. Our aim was to describe treatment patterns and clinical outcomes in this population.
Methods
Descriptive study of a cohort of rheumatoid arthritis patients with an estimated glomerular filtration rate < 30 ml/min/1.73 m2, managed in a comprehensive care program between 2022 to 2024. Clinical, therapeutic, and safety data were collected.
Results
A total of 38 patients were identified, most of whom were elderly women with a high burden of comorbidities. Leflunomide was the most frequently used conventional synthetic disease-modifying antirheumatic drug. Biologic therapy was used in 42% of cases, with rituximab being the most commonly prescribed agent. Most patients achieved remission or low disease activity, with no serious adverse events reported.
Conclusions
These findings provide real-world evidence on the effectiveness and safety of disease-modifying antirheumatic drugs in a population often excluded from clinical trials, underscoring the need for prospective studies to inform long-term therapeutic decisions.
{"title":"Tratamiento de la artritis reumatoide en pacientes con enfermedad renal crónica: una experiencia de vida real","authors":"Wilmer Gerardo Rojas-Zuleta, Yesith Guillermo Toloza-Pérez, Carolina Becerra Arias, Jorge Donado Gómez, Jeixa Jennifer Canizales Rodríguez, Oscar Jair Felipe Díaz","doi":"10.1016/j.reuma.2025.501995","DOIUrl":"10.1016/j.reuma.2025.501995","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis is associated with an increased risk of chronic kidney disease, which complicates the safe use of disease-modifying antirheumatic drugs, particularly in patients with severe renal impairment. Our aim was to describe treatment patterns and clinical outcomes in this population.</div></div><div><h3>Methods</h3><div>Descriptive study of a cohort of rheumatoid arthritis patients with an estimated glomerular filtration rate<!--> <!--><<!--> <!-->30<!--> <!-->ml/min/1.73<!--> <!-->m<sup>2</sup>, managed in a comprehensive care program between 2022 to 2024. Clinical, therapeutic, and safety data were collected.</div></div><div><h3>Results</h3><div>A total of 38 patients were identified, most of whom were elderly women with a high burden of comorbidities. Leflunomide was the most frequently used conventional synthetic disease-modifying antirheumatic drug. Biologic therapy was used in 42% of cases, with rituximab being the most commonly prescribed agent. Most patients achieved remission or low disease activity, with no serious adverse events reported.</div></div><div><h3>Conclusions</h3><div>These findings provide real-world evidence on the effectiveness and safety of disease-modifying antirheumatic drugs in a population often excluded from clinical trials, underscoring the need for prospective studies to inform long-term therapeutic decisions.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 501995"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-20DOI: 10.1016/j.reuma.2025.502016
Cristóbal Orellana , Silvia Garcia Cirera , Albert Rodrigo Parés , Laia Uriel Brotons , Àlex Arqué Corredor , Cristina Aymerich , Rafael Gómez , Anna Carreras , Antoni Berenguer-Llergo , Joan Calvet
Background
At present, there is a lack of treatments specifically designed to target knee osteoarthritis (KOA). Various intra-articular products have widespread and become commonplace in clinical practice, despite a scarcity of evidence supporting this procedure. Among these, SARC stands out as a novel Autologous Cytokine-Rich Serum derived from the patient's own platelets and white blood cells. This pilot study aims to assess the effectiveness of SARC treatment by measuring improvements in pain and physical disability in patients with symptomatic KOA.
Methods
We recruited 40 symptomatic KOA patients with Kellgren–Lawrence stage 2 or 3, who had been refractory to glucocorticoid intra-articular treatment in the past year. They were assigned to two regimens (single vs. three-dose administrations), and were evaluated for their change in pain and physical function using the KOOS questionnaires at various time points over one year.
Results
At one year after treatment, 36% and 33% of patients achieved a 20% improvement in pain and functional disability, respectively. Patients treated with three intra-articular SARC injections showed a slightly higher improvement (40%) than the single-dose group (26–32%), although differences were not statistically significant. In average, both reversed KOOS scores showed significant improvements compared to baseline, especially for the three-dose group (14 and 16 points, respectively; p-values <0.0001). No adverse events were reported during the study.
Conclusion
A notable proportion of patients with KOA refractory to a previous glucocorticoid injection responded positively to intra-articular SARC treatment. Further studies are required to validate these findings and identify biomarkers of treatment response.
{"title":"A novel Autologous Cytokine-Rich Serum (SARC) to treat knee osteoarthritis patients’ refractory to a previous glucocorticoid intra-articular injection. A pilot study","authors":"Cristóbal Orellana , Silvia Garcia Cirera , Albert Rodrigo Parés , Laia Uriel Brotons , Àlex Arqué Corredor , Cristina Aymerich , Rafael Gómez , Anna Carreras , Antoni Berenguer-Llergo , Joan Calvet","doi":"10.1016/j.reuma.2025.502016","DOIUrl":"10.1016/j.reuma.2025.502016","url":null,"abstract":"<div><h3>Background</h3><div>At present, there is a lack of treatments specifically designed to target knee osteoarthritis (KOA). Various intra-articular products have widespread and become commonplace in clinical practice, despite a scarcity of evidence supporting this procedure. Among these, SARC stands out as a novel Autologous Cytokine-Rich Serum derived from the patient's own platelets and white blood cells. This pilot study aims to assess the effectiveness of SARC treatment by measuring improvements in pain and physical disability in patients with symptomatic KOA.</div></div><div><h3>Methods</h3><div>We recruited 40 symptomatic KOA patients with Kellgren–Lawrence stage 2 or 3, who had been refractory to glucocorticoid intra-articular treatment in the past year. They were assigned to two regimens (single vs. three-dose administrations), and were evaluated for their change in pain and physical function using the KOOS questionnaires at various time points over one year.</div></div><div><h3>Results</h3><div>At one year after treatment, 36% and 33% of patients achieved a 20% improvement in pain and functional disability, respectively. Patients treated with three intra-articular SARC injections showed a slightly higher improvement (40%) than the single-dose group (26–32%), although differences were not statistically significant. In average, both reversed KOOS scores showed significant improvements compared to baseline, especially for the three-dose group (14 and 16 points, respectively; <em>p</em>-values <0.0001). No adverse events were reported during the study.</div></div><div><h3>Conclusion</h3><div>A notable proportion of patients with KOA refractory to a previous glucocorticoid injection responded positively to intra-articular SARC treatment. Further studies are required to validate these findings and identify biomarkers of treatment response.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 502016"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-11-03DOI: 10.1016/j.reuma.2025.501998
Maha S.I. Abdelrahman , Doaa Abdeltawab , Rasha Hamed Shehata
Introduction and objectives
Inflammatory bowel disease (IBD) has systemic consequences that extend beyond the gastrointestinal tract. While nailfold capillaroscopy (NFC) is widely utilized in many rheumatological disorders, its significance in evaluating microvascular changes in IBD remains unknown. This study aimed to standardize NFC use in IBD patients and relate NFC results to clinical and laboratory criteria.
Methods
This observational case–control study included histology- and colonoscopy-diagnosed IBD patients. We performed NFC on eight fingers of each subject using a Dino-Lite digital microscope, adhering to European Alliance of Associations for Rheumatology guidelines. Capillary characteristics, including density, morphology, and dimensions, as well as microhemorrhages, were assessed at 200×.
Results
The study included 50 IBD patients and 30 healthy controls. IBD patients had significantly lower capillary density (7.52 ± 0.68 capillaries/mm) than controls (8.18 ± 0.63 capillaries/mm, p < 0.001), with 26% of IBD patients exhibiting densities below seven capillaries/mm. In IBD patients, microhemorrhages were more prevalent than in controls (p = 0.032). Raynaud's phenomenon was more commonly detected in patients with low mean capillary density (p = 0.04).
Conclusion
IBD patients had reduced mean capillary density and increased microhemorrhages. These changes suggested that NFC could be a non-invasive way provides unique insights into IBD microvascular health.
.
简介和目的炎症性肠病（IBD）具有超越胃肠道的全身性后果。虽然甲襞毛细血管镜（NFC）被广泛应用于许多风湿病，但其在评估IBD微血管变化方面的意义尚不清楚。本研究旨在规范IBD患者NFC的使用，并将NFC结果与临床和实验室标准联系起来。方法本观察性病例对照研究纳入了经组织学和结肠镜诊断的IBD患者。根据欧洲风湿病协会联盟的指导方针，我们使用Dino-Lite数码显微镜对每位受试者的八个手指进行了近距离接触检查。在200x下评估毛细血管特征，包括密度、形态和尺寸，以及微出血。结果本研究包括50例IBD患者和30例健康对照。IBD患者的毛细血管密度（7.52±0.68支/mm）明显低于对照组（8.18±0.63支/mm， p < 0.001）， 26%的IBD患者的毛细血管密度低于7支/mm。在IBD患者中，微出血比对照组更普遍（p = 0.032）。雷诺现象多见于平均毛细血管密度较低的患者（p = 0.04）。结论ibd患者平均毛细血管密度降低，微出血增加。这些变化表明，NFC可能是一种非侵入性的方法，为IBD微血管健康提供了独特的见解。
{"title":"Nailfold capillaroscopy in inflammatory bowel disease: A shared approach in gastroenterology and rheumatology","authors":"Maha S.I. Abdelrahman , Doaa Abdeltawab , Rasha Hamed Shehata","doi":"10.1016/j.reuma.2025.501998","DOIUrl":"10.1016/j.reuma.2025.501998","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Inflammatory bowel disease (IBD) has systemic consequences that extend beyond the gastrointestinal tract. While nailfold capillaroscopy (NFC) is widely utilized in many rheumatological disorders, its significance in evaluating microvascular changes in IBD remains unknown. This study aimed to standardize NFC use in IBD patients and relate NFC results to clinical and laboratory criteria.</div></div><div><h3>Methods</h3><div>This observational case–control study included histology- and colonoscopy-diagnosed IBD patients. We performed NFC on eight fingers of each subject using a Dino-Lite digital microscope, adhering to European Alliance of Associations for Rheumatology guidelines. Capillary characteristics, including density, morphology, and dimensions, as well as microhemorrhages, were assessed at 200×.</div></div><div><h3>Results</h3><div>The study included 50 IBD patients and 30 healthy controls. IBD patients had significantly lower capillary density (7.52<!--> <!-->±<!--> <!-->0.68<!--> <!-->capillaries/mm) than controls (8.18<!--> <!-->±<!--> <!-->0.63<!--> <!-->capillaries/mm, <em>p</em> <!--><<!--> <!-->0.001), with 26% of IBD patients exhibiting densities below seven capillaries/mm. In IBD patients, microhemorrhages were more prevalent than in controls (<em>p</em> <!-->=<!--> <!-->0.032). Raynaud's phenomenon was more commonly detected in patients with low mean capillary density (<em>p</em> <!-->=<!--> <!-->0.04).</div></div><div><h3>Conclusion</h3><div>IBD patients had reduced mean capillary density and increased microhemorrhages. These changes suggested that NFC could be a non-invasive way provides unique insights into IBD microvascular health.</div><div>.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 10","pages":"Article 501998"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-10-15DOI: 10.1016/j.reuma.2025.501969
Beatriz Tejera Segura, Adrián Quevedo Rodriguez, María García González, Judith Hernández Sánchez, Marta Hernández Díaz, Íñigo Rua-Figueroa de Larrinoa
Introduction
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variable course. There is a need for simple and accessible biomarkers to assess disease activity and prognosis.
Objectives
To analyze the relationship between hematological indices NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) with disease activity and organ damage in patients with SLE.
Materials and methods
A multicenter retrospective study including 319 patients with SLE. Associations between NLR and PLR with disease activity (SLEDAI-2K), organ damage (SLICC/SDI), hypocomplementemia, mortality, and clinical manifestations were evaluated.
Results
Both indices showed a significant association with disease activity, even after adjusting for confounding factors. No associations were found with organ damage or specific clinical manifestations. NLR was associated with hypocomplementemia, and both indices were linked to mortality.
Conclusions
NLR and PLR may serve as useful, low-cost, and complementary tools for monitoring disease activity in SLE. Prospective studies are needed to confirm their value as independent biomarkers.
{"title":"Asociación de índices hematológicos, actividad y daño orgánico en el lupus eritematoso sistémico: análisis multicéntrico de 319 casos","authors":"Beatriz Tejera Segura, Adrián Quevedo Rodriguez, María García González, Judith Hernández Sánchez, Marta Hernández Díaz, Íñigo Rua-Figueroa de Larrinoa","doi":"10.1016/j.reuma.2025.501969","DOIUrl":"10.1016/j.reuma.2025.501969","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a variable course. There is a need for simple and accessible biomarkers to assess disease activity and prognosis.</div></div><div><h3>Objectives</h3><div>To analyze the relationship between hematological indices NLR (neutrophil-to-lymphocyte ratio) and PLR (platelet-to-lymphocyte ratio) with disease activity and organ damage in patients with SLE.</div></div><div><h3>Materials and methods</h3><div>A multicenter retrospective study including 319 patients with SLE. Associations between NLR and PLR with disease activity (SLEDAI-2K), organ damage (SLICC/SDI), hypocomplementemia, mortality, and clinical manifestations were evaluated.</div></div><div><h3>Results</h3><div>Both indices showed a significant association with disease activity, even after adjusting for confounding factors. No associations were found with organ damage or specific clinical manifestations. NLR was associated with hypocomplementemia, and both indices were linked to mortality.</div></div><div><h3>Conclusions</h3><div>NLR and PLR may serve as useful, low-cost, and complementary tools for monitoring disease activity in SLE. Prospective studies are needed to confirm their value as independent biomarkers.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501969"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-10-02DOI: 10.1016/j.reuma.2025.501973
Ana Victoria Villarreal-Treviño , Claudia Saad-Magalhãnes , Marcela Álvarez , Nadina Rubio-Pérez , Fernando García Rodríguez
Juvenile-onset systemic lupus erythematosus (jSLE) is an autoimmune disease that presents with greater severity and higher mobility than adult-onset SLE. In Latin America, data on its incidence, prevalence and clinical phenotypes are limited. Specialized care is available only in a few centers with trained pediatric rheumatologists leading to substantial diagnostic delays and barriers to timely treatment. This review highlights the urgent need for region-specific strategies to improve early diagnosis, expand access to specialized care and reduce disparities in outcomes for children and adolescents with jSLE in Latin America.
{"title":"Juvenile systemic lupus erythematosus: Challenge for equity in Latin America","authors":"Ana Victoria Villarreal-Treviño , Claudia Saad-Magalhãnes , Marcela Álvarez , Nadina Rubio-Pérez , Fernando García Rodríguez","doi":"10.1016/j.reuma.2025.501973","DOIUrl":"10.1016/j.reuma.2025.501973","url":null,"abstract":"<div><div>Juvenile-onset systemic lupus erythematosus (jSLE) is an autoimmune disease that presents with greater severity and higher mobility than adult-onset SLE. In Latin America, data on its incidence, prevalence and clinical phenotypes are limited. Specialized care is available only in a few centers with trained pediatric rheumatologists leading to substantial diagnostic delays and barriers to timely treatment. This review highlights the urgent need for region-specific strategies to improve early diagnosis, expand access to specialized care and reduce disparities in outcomes for children and adolescents with jSLE in Latin America.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501973"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01Epub Date: 2025-10-15DOI: 10.1016/j.reuma.2025.501972
Danton Magri , Clisten Fátima Staffen , Ticiana Della Justina Farias , Ilíada Rainha de Souza , Yara Costa Netto Muniz , Ivânio Alves Pereira , Lia Kubelka de Carlos Back , Luciano Santos Pinto Guimarães , Juliana Dal-Ri Lindenau
Introduction and objectives
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies, inflammation processes, and tissue damage. There are several genetic factors associated with the disease, many of them single nucleotide polymorphisms (SNPs). Interleukin-18 is a pro-inflammatory cytokine encoded by the IL18 gene, and the SNP −137 G/C (rs187238) has been studied in several populations. This case control study analyzed whether rs187238 is associated with SLE susceptibility and its clinical manifestations in a Brazilian population.
Materials and methods
153 patients fulfilling the American College of Rheumatology classification criteria for SLE were recruited, as well as 147 controls. Genotyping was performed by sequence-specific polymerase chain reaction (SSP-PCR). To assess SLE susceptibility a logistic regression test was conducted. Clinical aspects were tested through Poisson regression and clustered by Principal Component Analysis.
Results
An association between the rs187238*C_ carriers genotypes and SLE was found, these genotypes were associated with a 127% increased chance of developing the disease (OR = 2.27, 95% CI = 1.32–3.98, p = 0.003). The *C_ genotypes were also associated with photosensitivity (PR = 1.39, 95% CI = 1.1–1.8, p = 0.017), malar rash (PR = 1.37, 95% CI = 1.1–1.8, p = 0.014) and Raynaud phenomenon (PR = 1.37, 95% IC = 1.1–1.8, p = 0.015).
Discussion and conclusions
These findings suggest the potential of rs187238 as a genetic marker for SLE risk and clinical stratification in admixed Latin American populations.
系统性红斑狼疮（SLE）是一种以自身抗体产生、炎症过程和组织损伤为特征的慢性自身免疫性疾病。有几个遗传因素与该病有关，其中许多是单核苷酸多态性（snp）。白细胞介素-18是一种由il -18基因编码的促炎细胞因子，SNP - 137 G/C （rs187238）已在多个人群中进行了研究。本病例对照研究分析了rs187238是否与巴西人群SLE易感性及其临床表现相关。材料和方法：153例符合美国风湿病学会SLE分类标准的患者和147例对照。采用序列特异性聚合酶链反应（SSP-PCR）进行基因分型。为了评估SLE易感性，进行了逻辑回归检验。临床方面通过泊松回归和主成分分析聚类进行检验。结果rs187238*C_携带者基因型与SLE存在相关性，其发病几率增加127% （OR = 2.27, 95% CI = 1.32 ~ 3.98, p = 0.003）。*C_基因型还与光敏（PR = 1.39, 95% CI = 1.1 ~ 1.8, p = 0.017）、颧部皮疹（PR = 1.37, 95% CI = 1.1 ~ 1.8, p = 0.014）、雷诺现象（PR = 1.37, 95% IC = 1.1 ~ 1.8, p = 0.015）相关。讨论和结论这些发现提示rs187238可能作为拉丁美洲混合人群SLE风险和临床分层的遗传标记。
{"title":"Impact of the IL18 −137 G/C (rs187238) polymorphism on susceptibility and clinical manifestations in women systemic lupus erythematosus","authors":"Danton Magri , Clisten Fátima Staffen , Ticiana Della Justina Farias , Ilíada Rainha de Souza , Yara Costa Netto Muniz , Ivânio Alves Pereira , Lia Kubelka de Carlos Back , Luciano Santos Pinto Guimarães , Juliana Dal-Ri Lindenau","doi":"10.1016/j.reuma.2025.501972","DOIUrl":"10.1016/j.reuma.2025.501972","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by the production of autoantibodies, inflammation processes, and tissue damage. There are several genetic factors associated with the disease, many of them single nucleotide polymorphisms (SNPs). Interleukin-18 is a pro-inflammatory cytokine encoded by the <em>IL18</em> gene, and the SNP <em>−137 G/C (rs187238)</em> has been studied in several populations. This case control study analyzed whether <em>rs187238</em> is associated with SLE susceptibility and its clinical manifestations in a Brazilian population.</div></div><div><h3>Materials and methods</h3><div>153 patients fulfilling the American College of Rheumatology classification criteria for SLE were recruited, as well as 147 controls. Genotyping was performed by sequence-specific polymerase chain reaction (SSP-PCR). To assess SLE susceptibility a logistic regression test was conducted. Clinical aspects were tested through Poisson regression and clustered by Principal Component Analysis.</div></div><div><h3>Results</h3><div>An association between the <em>rs187238*C_</em> carriers genotypes and SLE was found, these genotypes were associated with a 127% increased chance of developing the disease (OR<!--> <!-->=<!--> <!-->2.27, 95% CI<!--> <!-->=<!--> <!-->1.32–3.98, <em>p</em> <!-->=<!--> <!-->0.003). The <em>*C_</em> genotypes were also associated with photosensitivity (PR<!--> <!-->=<!--> <!-->1.39, 95% CI<!--> <!-->=<!--> <!-->1.1–1.8, <em>p</em> <!-->=<!--> <!-->0.017), malar rash (PR<!--> <!-->=<!--> <!-->1.37, 95% CI<!--> <!-->=<!--> <!-->1.1–1.8, <em>p</em> <!-->=<!--> <!-->0.014) and Raynaud phenomenon (PR<!--> <!-->=<!--> <!-->1.37, 95% IC<!--> <!-->=<!--> <!-->1.1–1.8, <em>p</em> <!-->=<!--> <!-->0.015).</div></div><div><h3>Discussion and conclusions</h3><div>These findings suggest the potential of rs187238 as a genetic marker for SLE risk and clinical stratification in admixed Latin American populations.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"21 9","pages":"Article 501972"},"PeriodicalIF":1.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145365779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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