Archives of rheumatology最新文献

Objectives: The study aimed to investigate the variation of brain-derived neurotrophic factor (BDNF) levels following acute exercise in patients with rheumatoid arthritis (RA).

Patients and methods: This cross-sectional study was conducted with 88 participants (25 males, 63 females; mean age: 45.1±8.3 years; range, 18 to 65 years) between July 2020 and May 2021. Of the participants, 44 were RA patients, and 44 were age-and sex-matched healthy controls. Aerobic exercise was utilized in all participants for a single session. Depression and anxiety levels were evaluated with the Beck Depression Inventory and Hospital Anxiety and Depression Scale. Blood samples were collected from all subjects before and immediately after the intervention.

Results: Serum BDNF levels (both baseline and after exercise) were similar in the RA and control groups. Although serum BDNF levels significantly decreased in both groups after aerobic exercise (Wilcoxon rank p<0.05), ΔBDNF levels were significantly higher in the RA group than in the control group (p=0.047). Additionally, ΔBDNF levels were significantly correlated with the Hospital Anxiety and Depression Scale scores in the RA group (p<0.05) but not in the control group.

Conclusion: A single bout of exercise may effectively decrease serum BDNF levels in patients with RA and healthy subjects. The long-term effect of exercise on BDNF levels should be investigated in prospective studies.

Objectives: This study aimed to investigate the risk factors of lung progression in patients with connective tissue disease-associated interstitial lung disease (ILD).

Patients and methods: A total of 91 ILD patients (28 males, 63 females; mean age: 54.9±11.3 years; range, 30 to 77 years) were included in the prospective follow-up study conducted throughout 2020. They were divided into progressors (n=27) and nonprogressors (n=64) according to whether the pulmonary disease progressed during a six-month follow-up period. The clinical data of the two groups were analyzed, and a logistic regression model was constructed to analyze the risk factors of the progression of ILD in all patients.

Results: Univariate analysis revealed significant differences (p<0.05) between the two groups in smoking history, serum ferritin, FVC% (the percentage of forced vital capacity), DLCO% (the percentage of diffusion capacity for carbon monoxide), and computed tomography involvement range. Further application of a logistic regression model revealed that increased serum ferritin level was an independent risk factor for ILD progression (odds ratio=1.002, 95% confidence interval: 1.000-1.003, p=0.004). The optimal critical value of serum ferritin was 303.25 ng/mL, the sensitivity and specificity were 81.5% and 54.7%, respectively, and the area under the curve was 0.747.

Conclusion: The level of serum ferritin may be an independent predictor for ILD progression.

Antiphospholipid syndrome (APS) is a thromboinflammatory syndrome characterized by thrombotic, microvascular, obstetric, or non-thrombotic events in the setting of persistent antiphospholipid antibodies (aPL), namely anticardiolipin antibody (aCL), anti-β2 glycoprotein-I antibody (aβ2GPI), and lupus anticoagulant (LA). The diagnosis of APS requires careful assessment of the aPL profile, the clinical phenotype, and additional risk factors. The standard management of aPL-related thrombosis is anticoagulation, which is not effective for microvascular and non-thrombotic events. In parallel to our improved understanding of aPL-related mechanisms, the role of immunosuppression has been increasingly investigated. In this review, we summarize the basic concepts and future perspectives in APS.

Objectives: There is no clear information in the literature about causes of reactivation of multisystem inflammatory syndrome in children (MIS-C) or indications for readmissions for MIS-C after discharge; as a result, the conditions that may develop after infection in children with MIS-C were discussed, and the reasons for hospitalization were screened.

Patients and methods: This single-center retrospective study was conducted with 95 patients (65 males, 30 females; mean age: 92.8±55.5 months; range, 5 to 17 months) between November 11, 2020, and December 30, 2021. Children who were rehospitalized in the study center after their discharge with the diagnosis of MIS-C were included in the study, and the indications for readmissions were evaluated.

Results: During the study period, six (6.3%) patients (4 males, 2 females; median age: 114.5 months [interquartile range: 122 months]) had to be rehospitalized. Four of these patients had an underlying disease, while the other two were previously healthy children. Fever was the most common reason for readmissions in half of the patients, while the remaining patients were readmitted with the indications of myocarditis, pneumonia, and posttraumatic pain syndrome.

Conclusion: Although no evidence for the reactivation of MIS-C was detected in patients in the literature, it should also be emphasized that close follow-up of these patients is a must, considering possible cardiac complications.

Objectives: This study aims to investigate a genetic panel in patients with periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome and examine its performance for an accurate differential diagnosis.

Patients and methods: Between January 2021 and January 2022, a total of 104 children with PFAPA syndrome (63 males, 41 females; mean age: 4.8±2.3 years; range, 1.2 to 8.9 years) were retrospectively analyzed. Next-generation sequencing test was performed using a custom QIAGEN- QIAseq™ Targeted DNA Panel which includes six genes namely ELANE, LPIN2, MEFV, MVK, NLRP3, and TNFRSF1A.

Results: Of 104 patients, 38 (36.5%) had variants in the genetic panel. The most common variants were found in the MEFV gene (n=35, 33.6%), the most frequent genotype was E148Q heterozygosity (n=16). Four and two patients were eventually diagnosed with Familial Mediterranean fever (FMF) and hyperimmunoglobulin D syndrome (HIDS), since they had confirmative biallelic pathogenic in the MEFV and MVK genes, respectively.

Conclusion: A genetic panel, including MEFV and MVK genes, may be useful in patients, clinically resembling PFAPA, since they may have HIDS or FMF, but lack typical features of the exact disease. Nonetheless, we believe that distinct genetic panels should be developed for different populations.

Objectives: Hearing loss has been described in patients with radiographic axial spondyloarthropathies (R-AxSpA) but has not been studied in patients with non-radiographic axial spondyloarthropathies (NR-AxSpA); accordingly, the aim of the study was to compare hearing loss in patients with NR-AxSpA, R-AxSpA, and healthy individuals.

Patients and methods: This cross-sectional observational study was conducted with 68 participants (30 males, 38 females; mean age: 39.8±7.4 years) between March 2021 and March 2022. Of the participants, 16 were patients with NR-AxSpA, 15 were patients with R-AxSpA, and 37 were healthy controls. Disease activity and radiological and audiological features were analyzed. The audiological assessment included pure-tone audiometric tests at octave frequencies of 250 to 8000 Hz and transient evoked otoacoustic emissions.

Results: Hearing loss was found in three (8%) in the healthy group, five (31.3%) in the NR-AxSpA group, and 10 (66.7%) in the R-AxSpA group. The chi-square analysis showed a statistical significance (p=0.001). Values of audiometric tests yielded significant differences between the control and R-AxSpA group and also the control and NR-AxSpA group. For the air conduction studies, the statistical significance began at 1000 Hz in the R-AxSpA group. It was found that in the NR-AxSpA group, the statistical difference started in higher frequencies. The bone conduction audiometric studies were similar to air conduction studies. Transient evoked otoacoustic emission studies showed that the R-AxSpA group was significantly affected compared to the control and NR-AxSpA groups. There was no statistical difference between the control and NR-AxSpA groups.

Conclusion: Both NR-AxSpA and R-AxSpA patients had hearing loss; however, in pure-tone audiometric tests, the abnormalities began in lower frequencies in the R-AxSpA group than in the NR-AxSpA group.

Objectives: This study aimed to explore the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic among patients with juvenile systemic sclerosis (JSS).

Patients and methods: Twenty-seven patients (22 females, 5 males; mean age: 20 years; range, 17 to 22 years) diagnosed with JSS and followed up at the department of pediatric rheumatology were included in the cross-sectional study. A web-based survey was performed by focusing on patients' complaints, accessibility to health care, and compliance with routine treatment from January 1, 2021, to January 10, 2021.

Results: Five (18.5%) patients had deterioration of the disease, while six (22.2%) patients reported irregular usage of their routine scleroderma treatment during the last six months. Nine (33.3%) patients had missed their routine clinic control since the proclamation of the SARS-CoV-2 pandemic. Seven (25.9%) patients had household contact with coronavirus disease 2019 (COVID-19). Four (14.8%) patients were diagnosed with COVID-19, and only one (3.7%) was hospitalized. Nine patients were under biological treatment (tocilizumab); however, only one of them was diagnosed with COVID-19.

Conclusion: The COVID-19 pandemic has not significantly disrupted the medical care of JSS patients. Telemedicine could be an acceptable option for JSS patients disenabled to come to the hospital.

Objectives: This study aimed to determine whether maternal diagnosis of Fibromyalgia syndrome (FMS) affects the sleep quality of children.

Patients and methods: This prospective study was conducted with 80 female participants (mean age: 36.2±5.9 years; range 25 to 50 years) and their 80 children (27 males, 53 females; mean age: 6.6±2.6 years; range 2 to 12 years) between August 2019 and November 2020. The FMS group included 40 female FMS patients and their children, whereas the control group consisted of 40 healthy females and their children. In addition to sociodemographic variables, functional status was evaluated by the Fibromyalgia Impact Questionnaire (FIQ), which was completed by mothers with FMS, and the Children's Sleep Habits Questionnaire (CSHQ) was used to evaluate the sleep quality of all children.

Results: There was no statistically significant difference between the two groups in terms of demographic characteristics (p>0.05). The CSHQ score of the two groups was above 41 points and was at a clinically significant level. The median value for the CSHQ score was 60.5 and 52 in the FMS and control groups, respectively. Sleep time, waking up at night, parasomnias, disrupted breathing during sleep, and sleepiness scores were higher in the FMS group than in the control group, and the differences were statistically significant (p<0.001). The delayed falling asleep score, which was reversely coded, was lower in the FMS group than in the control group, and the difference was statistically significant (p<0.001).

Conclusion: This pilot study showed that the children of mothers with high Fibromyalgia Impact Questionnaire scores had sleep disorders. Maternal diagnosis of FMS negatively affects the sleep quality of children.

Objectives: This study aimed to investigate the characteristics of the gut microbiota in Chinese patients with ankylosing spondylitis (AS) and healthy controls in Quanzhou aiming to explore the correlation between microbiome changes and AS activities.

Patients and methods: In this study, high-throughput sequencing of the gene of 16S ribosomal RNA (16S rRNA) in fecal samples from 40 AS patients and 40 healthy controls, for a total of 80 participants (70 males, 10 females; mean age 33.7±10.7 years; range, 15 to 58 years), was conducted between January 2018 and January 2019. Alpha and beta diversity were analyzed using the QIIME (Quantitative Insights Into Microbial Ecology) software, and differences were analyzed using Student's t-test, linear discriminant analysis coupled with effect size and Metastats. Finally, a correlation network was constructed using Pearson's analysis.

Results: The alpha index values of the AS group were not significantly different from those of the control group. At the genus level, eight genera, Ruminiclostridium_9, Fusicatenibacter, Adlercreutzia, CAG-56, Intestinimonas, Lachnospira, Bacteroides, and Pseudoflavonifractor, were significantly enriched in patients with AS, whereas the abundance of uncultured_bacterium_f_Saccharimonadaceae, Prevotella_7, uncultured_bacterium_f_ Enterobacteriaceae, Cronobacter, Prevotellaceae_NK3B31_group, and Weissella were significantly decreased in patients with AS. In addition, diseaserelated gut microbial communities were detected in patients with AS.

Conclusion: We found differences in the gut microbiome between the patients with AS and controls and identified potential disease activity-related bacterial communities.