Pub Date : 2023-01-01DOI: 10.4103/injr.injr_201_22
K. Nagarajan, Maddiah Kiran, V. Negi, C. Kavadichanda
{"title":"Rapidly resolving orbital pseudotumor in systemic lupus erythematosus","authors":"K. Nagarajan, Maddiah Kiran, V. Negi, C. Kavadichanda","doi":"10.4103/injr.injr_201_22","DOIUrl":"https://doi.org/10.4103/injr.injr_201_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70776712","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 : 2023-01-01DOI: 10.4103/injr.injr_181_21
K. Choudhury, M. Gandhi, U. Kumar, S. Chatterjee, R. Purty
Background: Rheumatoid arthritis (RA) is a chronic, autoimmune disease that progressively leads to joint destruction and functional disability which eventually affects the quality of life of the people suffering from it. Deleted in malignant brain tumor 1 (DMBT1) role has been explored in progression of Sjögren's syndrome (SS) and other autoimmune diseases, whereas it has yet to be reported in RA. In this study, we have analyzed and evaluated the expression of DMBT1 protein and the dmbt1 genes' methylation status in healthy volunteers, RA, and SS patients. Methods: In the present investigation, the case–control study of 25 healthy volunteers and 17 RA- and 10 SS-confirmed patients was performed. Results: It was observed that the concentration of DMBT1 protein in saliva decreases in both the disease conditions compared to healthy volunteers, while methylation status of dmbt1 gene was low in both patient cohorts in comparison to the healthy controls. Conclusion: Results obtained from this study indicate that DMBT1 protein has the potential to qualify as a specific salivary biomarker as identified in RA and SS patients. DMBT1 protein can therefore be explored further as a noninvasive tool for diagnosis and prognosis.
{"title":"Evaluation of the deleted in malignant brain tumor 1 protein expression and DNA methylation profile in rheumatoid arthritis patients","authors":"K. Choudhury, M. Gandhi, U. Kumar, S. Chatterjee, R. Purty","doi":"10.4103/injr.injr_181_21","DOIUrl":"https://doi.org/10.4103/injr.injr_181_21","url":null,"abstract":"Background: Rheumatoid arthritis (RA) is a chronic, autoimmune disease that progressively leads to joint destruction and functional disability which eventually affects the quality of life of the people suffering from it. Deleted in malignant brain tumor 1 (DMBT1) role has been explored in progression of Sjögren's syndrome (SS) and other autoimmune diseases, whereas it has yet to be reported in RA. In this study, we have analyzed and evaluated the expression of DMBT1 protein and the dmbt1 genes' methylation status in healthy volunteers, RA, and SS patients. Methods: In the present investigation, the case–control study of 25 healthy volunteers and 17 RA- and 10 SS-confirmed patients was performed. Results: It was observed that the concentration of DMBT1 protein in saliva decreases in both the disease conditions compared to healthy volunteers, while methylation status of dmbt1 gene was low in both patient cohorts in comparison to the healthy controls. Conclusion: Results obtained from this study indicate that DMBT1 protein has the potential to qualify as a specific salivary biomarker as identified in RA and SS patients. DMBT1 protein can therefore be explored further as a noninvasive tool for diagnosis and prognosis.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"18 1","pages":"68 - 73"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45740854","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 : 2023-01-01DOI: 10.4103/injr.injr_233_21
D. Maikap, Amrita Pradhan, P. Padhan
{"title":"Isolated oculomotor nerve palsy: A rare initial presentation of granulomatosis with polyangitis","authors":"D. Maikap, Amrita Pradhan, P. Padhan","doi":"10.4103/injr.injr_233_21","DOIUrl":"https://doi.org/10.4103/injr.injr_233_21","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"18 1","pages":"106 - 107"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47367110","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 : 2023-01-01DOI: 10.4103/injr.injr_186_21
ArindamNandy Roy, A. Darapureddy, Y. Kumar
Background: Long-term methotrexate (MTX) use is associated with hepatic fibrosis in patients with rheumatic diseases. Liver biopsy (invasive conventional diagnostic procedure for hepatic fibrosis) is associated with sampling errors and procedural risks. Magnetic resonance elastography (MRE) is a novel, reliable, and noninvasive imaging technique with excellent diagnostic accuracy for staging hepatic fibrosis and cirrhosis. Till date, studies are scarce on its use in staging MTX-induced liver fibrosis and cirrhosis. The aim of this study is to assess the usefulness of MRE in detecting and quantifying liver fibrosis and to compare these with biochemical parameters in patients with rheumatic diseases on long-term MTX therapy. Methods: Patients with different rheumatic diseases, aged ≥18 years and on MTX treatment for >5 years were included in the study. Their medical records were reviewed, and data regarding demographics, diagnosis, disease duration, MTX dosage and duration were collected. On the day of MRE examination, series of biochemical parameters were conducted in patients. Predefined cutoff MRE values were used for staging liver fibrosis. Results: A total of 48 subjects diagnosed with different rheumatic diseases on long-term MTX were recruited in the study, and majority of them were female (n = 41). The mean age and body mass index of the patients were 53.56 ± 8.36 years and 28.08 ± 4.43, respectively. Around 37.5% (n = 18) of the patients had abnormal aspartate transaminase (AST)-to-platelet count ratio index (APRI) score. The mean MRE value of the study group was 2.83 ± 0.90 kPa. Around 45.83% (n = 22) of the patients had normal liver stiffness values (<2.5) whereas stages F0 (2.5–2.9 kPa), F1 (2.9–3.5 kPa), F2 (3.5–4.0 kPa), F3 (4.0–5.0 kPa), and F4 (>5.0 kPa) were observed in 12.5% (n = 6), 18.75% (n = 9), 10.42% (n = 5), 10.42% (n = 5), and 2.08% (n = 1) of the patients, respectively. MRE values did not correlate with disease duration and cumulative dose of MTX. However, a positive correlation was observed between MRE and liver biochemical parameters (AST: Alanine transaminase [ALT] ratio, ALT, platelet count, APRI, albumin, and mean liver size; P > 0.05). Conclusion: Considering the risk for complications with liver biopsy, MRE provides a reliable, highly accurate, noninvasive assessment of hepatic fibrosis in patients with rheumatic diseases receiving long-term MTX therapy.
{"title":"Noninvasive Assessment of Liver Fibrosis by Magnetic Resonance Elastography in Patients with Rheumatic Disease on Long-Term Methotrexate Treatment","authors":"ArindamNandy Roy, A. Darapureddy, Y. Kumar","doi":"10.4103/injr.injr_186_21","DOIUrl":"https://doi.org/10.4103/injr.injr_186_21","url":null,"abstract":"Background: Long-term methotrexate (MTX) use is associated with hepatic fibrosis in patients with rheumatic diseases. Liver biopsy (invasive conventional diagnostic procedure for hepatic fibrosis) is associated with sampling errors and procedural risks. Magnetic resonance elastography (MRE) is a novel, reliable, and noninvasive imaging technique with excellent diagnostic accuracy for staging hepatic fibrosis and cirrhosis. Till date, studies are scarce on its use in staging MTX-induced liver fibrosis and cirrhosis. The aim of this study is to assess the usefulness of MRE in detecting and quantifying liver fibrosis and to compare these with biochemical parameters in patients with rheumatic diseases on long-term MTX therapy. Methods: Patients with different rheumatic diseases, aged ≥18 years and on MTX treatment for >5 years were included in the study. Their medical records were reviewed, and data regarding demographics, diagnosis, disease duration, MTX dosage and duration were collected. On the day of MRE examination, series of biochemical parameters were conducted in patients. Predefined cutoff MRE values were used for staging liver fibrosis. Results: A total of 48 subjects diagnosed with different rheumatic diseases on long-term MTX were recruited in the study, and majority of them were female (n = 41). The mean age and body mass index of the patients were 53.56 ± 8.36 years and 28.08 ± 4.43, respectively. Around 37.5% (n = 18) of the patients had abnormal aspartate transaminase (AST)-to-platelet count ratio index (APRI) score. The mean MRE value of the study group was 2.83 ± 0.90 kPa. Around 45.83% (n = 22) of the patients had normal liver stiffness values (<2.5) whereas stages F0 (2.5–2.9 kPa), F1 (2.9–3.5 kPa), F2 (3.5–4.0 kPa), F3 (4.0–5.0 kPa), and F4 (>5.0 kPa) were observed in 12.5% (n = 6), 18.75% (n = 9), 10.42% (n = 5), 10.42% (n = 5), and 2.08% (n = 1) of the patients, respectively. MRE values did not correlate with disease duration and cumulative dose of MTX. However, a positive correlation was observed between MRE and liver biochemical parameters (AST: Alanine transaminase [ALT] ratio, ALT, platelet count, APRI, albumin, and mean liver size; P > 0.05). Conclusion: Considering the risk for complications with liver biopsy, MRE provides a reliable, highly accurate, noninvasive assessment of hepatic fibrosis in patients with rheumatic diseases receiving long-term MTX therapy.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"18 1","pages":"54 - 60"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42059565","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 : 2023-01-01DOI: 10.4103/injr.injr_101_22
B. Harish, R. Sahoo, G. Sudhish, J. Samanta, P. Patro
{"title":"Silicosis and rapidly progressive systemic sclerosis","authors":"B. Harish, R. Sahoo, G. Sudhish, J. Samanta, P. Patro","doi":"10.4103/injr.injr_101_22","DOIUrl":"https://doi.org/10.4103/injr.injr_101_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"18 1","pages":"98 - 99"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44628291","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 : 2023-01-01DOI: 10.4103/injr.injr_169_22
P. Acharya, D. Sharma, Sindhu Kamath, S. Shenoy, R. Magazine
{"title":"Microscopic polyangiitis with an atypical presentation","authors":"P. Acharya, D. Sharma, Sindhu Kamath, S. Shenoy, R. Magazine","doi":"10.4103/injr.injr_169_22","DOIUrl":"https://doi.org/10.4103/injr.injr_169_22","url":null,"abstract":"","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"1 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70775539","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 : 2023-01-01DOI: 10.4103/injr.injr_129_21
Sathish Kumar, S. Vyasam, Anu Punnen, V. Jeyaseelan, J. Prakash
Introduction: In children with Systemic Lupus Erythematosus (SLE), autoantibodies are considered as biomarkers for specific organ involvement or tissue damage. Some autoantibodies are used for diagnosis, disease activity, and few for disease characterisation. By using cluster analysis, we identified antibody clustering in children with SLE with specific subsets of clinical manifestations at the time of diagnosis. Materials and Methods: All pediatric SLE (pSLE) who fulfilled 4/11 ACR criteria were included in this study. Their autoantibodies profiles were noted. We recruited 212 patients with newly diagnosed pSLE and cluster analysis was done. We identified 3 clusters which were used for analysis. Results: Cluster 1 had ANA and anti-dsDNA antibodies a low prevalence of all other antibodies. Children in cluster 2 had autoantibodies such as ANA, anti-dsDNA, anti-RNP, and anti-Sm. Cluster 3 was had autoantibodies such as dsDNA, ANA, anti-cardiolipin and anti-SSA antibodies. On analysis, there was statistically significant difference among the 3 clusters for hair loss (P = 0.006), oral ulcers (P = 0.024), arthritis (P = 0.025), neurological symptoms (P = 0.037), renal manifestations (P = 0.003), AIHA (P = 0.012). Conclusion: In pSLE, autoantibodies clusters with distinct clinical phenotypes. Hence, all autoantibodies should be done at time of diagnosis. It will help in predicting the clinical course of pSLE and also to identify patients at risk of developing major organ involvement later.
{"title":"Autoantibodies in pediatric systemic lupus erythematosus: Cluster analysis and its clinical implications in Indian children","authors":"Sathish Kumar, S. Vyasam, Anu Punnen, V. Jeyaseelan, J. Prakash","doi":"10.4103/injr.injr_129_21","DOIUrl":"https://doi.org/10.4103/injr.injr_129_21","url":null,"abstract":"Introduction: In children with Systemic Lupus Erythematosus (SLE), autoantibodies are considered as biomarkers for specific organ involvement or tissue damage. Some autoantibodies are used for diagnosis, disease activity, and few for disease characterisation. By using cluster analysis, we identified antibody clustering in children with SLE with specific subsets of clinical manifestations at the time of diagnosis. Materials and Methods: All pediatric SLE (pSLE) who fulfilled 4/11 ACR criteria were included in this study. Their autoantibodies profiles were noted. We recruited 212 patients with newly diagnosed pSLE and cluster analysis was done. We identified 3 clusters which were used for analysis. Results: Cluster 1 had ANA and anti-dsDNA antibodies a low prevalence of all other antibodies. Children in cluster 2 had autoantibodies such as ANA, anti-dsDNA, anti-RNP, and anti-Sm. Cluster 3 was had autoantibodies such as dsDNA, ANA, anti-cardiolipin and anti-SSA antibodies. On analysis, there was statistically significant difference among the 3 clusters for hair loss (P = 0.006), oral ulcers (P = 0.024), arthritis (P = 0.025), neurological symptoms (P = 0.037), renal manifestations (P = 0.003), AIHA (P = 0.012). Conclusion: In pSLE, autoantibodies clusters with distinct clinical phenotypes. Hence, all autoantibodies should be done at time of diagnosis. It will help in predicting the clinical course of pSLE and also to identify patients at risk of developing major organ involvement later.","PeriodicalId":54167,"journal":{"name":"Indian Journal of Rheumatology","volume":"18 1","pages":"35 - 39"},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43600399","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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