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Zeitschrift Fur Rheumatologie Mar 2021We report the case of a 42-year-old male patient with acute onset of asymmetrical polyarthritis of the medium and large joints as well as fever and elevated serological...
We report the case of a 42-year-old male patient with acute onset of asymmetrical polyarthritis of the medium and large joints as well as fever and elevated serological inflammation markers. The symptoms began shortly after initiation of thiamazole treatment for newly diagnosed Graves' disease. Antithyroid arthritis syndrome (AAS) is a rare but serious adverse side effect of antithyroid treatment with thioamides such as thiamazole. Clinically, AAS may present with myalgia, arthralgia, fever, exanthema and polyarthritis. In the case of suspected AAS, when possible the thionamide medication should be rapidly discontinued or modified in consultation with the endocrinologist. In some cases anti-inflammatory therapy with NSAID or corticosteroids may be required for symptom control.
Topics: Adult; Antithyroid Agents; Arthralgia; Arthritis; Graves Disease; Humans; Male; Methimazole
PubMed: 33196862
DOI: 10.1007/s00393-020-00921-0 -
RMD Open Jun 2022A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the... (Meta-Analysis)
Meta-Analysis
Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs.
BACKGROUND
A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed.
METHODS
Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage).
RESULTS
In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression.
CONCLUSION
The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.
Topics: Arthritis, Rheumatoid; Diet; Humans; Life Style; Muscular Diseases; Musculoskeletal Diseases; Osteoarthritis; Rheumatic Diseases
PubMed: 35654458
DOI: 10.1136/rmdopen-2021-002167 -
Rheumatology (Oxford, England) Oct 2021IL-23 is a cytokine member of the IL-12 superfamily. These heterodimeric cytokines offer broad immune regulatory activity with potential effector function in...
IL-23 is a cytokine member of the IL-12 superfamily. These heterodimeric cytokines offer broad immune regulatory activity with potential effector function in inflammatory arthritis. IL-23 is a pro-inflammatory cytokine secreted by dendritic cells and macrophages. It plays a key role in both innate and adaptive immunity. By promoting and maintaining T cell differentiation into Th17 T cells, IL-23 is a key player in the pathogenesis of rheumatic diseases. Data from pre-clinical IL-23 knockout models show the major importance of IL-23 in development of arthritis. The induction and maintenance of type 17 cells, which secrete IL-17A and other pro-inflammatory cytokines, contributes to local synovial inflammation and skin inflammation in PsA, and perhaps in RA. Commensurate with this, therapeutic strategies targeting IL-23 have proven efficient in PsA in several studies, albeit not yet in RA.
Topics: Animals; Arthritis; Humans; Interleukin-23; Molecular Targeted Therapy
PubMed: 34668017
DOI: 10.1093/rheumatology/keab266 -
Frontiers in Immunology 2020Inflammatory arthritis (IA) refers to a group of chronic diseases, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and other... (Review)
Review
Inflammatory arthritis (IA) refers to a group of chronic diseases, including rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), and other spondyloarthritis (SpA). IA is characterized by autoimmune-mediated joint inflammation and is associated with inflammatory cytokine networks. Innate lymphocytes, including innate-like lymphocytes (ILLs) expressing T or B cell receptors and innate lymphoid cells (ILCs), play important roles in the initiation of host immune responses against self-antigens and rapidly produce large amounts of cytokines upon stimulation. TNF (Tumor Necrosis Factor)-α, IFN (Interferon)-γ, Th2-related cytokines (IL-4, IL-9, IL-10, and IL-13), IL-17A, IL-22, and GM-CSF are involved in IA and are secreted by ILLs and ILCs. In this review, we focus on the current knowledge of ILL and ILC phenotypes, cytokine production and functions in IA. A better understanding of the roles of ILLs and ILCs in IA initiation and development will ultimately provide insights into developing effective strategies for the clinical treatment of IA patients.
Topics: Animals; Arthritis; Cytokines; Disease Management; Disease Susceptibility; Humans; Immunity, Innate; Inflammation Mediators; Lymphocyte Subsets; T-Lymphocyte Subsets
PubMed: 33072104
DOI: 10.3389/fimmu.2020.565275 -
Current Allergy and Asthma Reports Feb 2021The purpose of this review is to provide a framework to distinguish Blau syndrome/Early Onset Sarcoidosis and Sarcoidosis clinically. We also discuss relevant... (Review)
Review
PURPOSE OF REVIEW
The purpose of this review is to provide a framework to distinguish Blau syndrome/Early Onset Sarcoidosis and Sarcoidosis clinically. We also discuss relevant differences in genetics, pathogenesis, and management of these diseases.
RECENT FINDINGS
Blau syndrome and Sarcoidosis share the characteristic histologic finding of noncaseating granulomas as well as some similar clinical characteristics; nevertheless, they are distinct entities with important differences between them. Blau syndrome and Early Onset Sarcoidosis are due to one of numerous possible gain-of-function mutations in NOD2, commonly presenting before age 5 with a triad of skin rash, arthritis, and uveitis. However, as more cases are reported, expanded clinical manifestations have been described. In systemic Sarcoidosis, there are numerous susceptibility genes that have been identified, and disease is thought to result from an environmental exposure in a genetically susceptible host. It most often presents with constitutional symptoms and pulmonary involvement and typically affects adolescents and adults. This paper reviews the similarities and differences between Blau syndrome and Sarcoidosis. We also discuss the importance of distinguishing between them, particularly with regard to prognosis and outcomes.
Topics: Arthritis; Diagnosis, Differential; Granuloma; Humans; Mutation; Nod2 Signaling Adaptor Protein; Prognosis; Sarcoidosis; Synovitis; Uveitis
PubMed: 33560445
DOI: 10.1007/s11882-021-00991-3 -
Current Rheumatology Reports Oct 2020Synovial inflammation is characteristic of inflammatory chronic arthropathies and can cause progressive articular damage, chronic pain, and functional loss. Scientific... (Review)
Review
PURPOSE OF REVIEW
Synovial inflammation is characteristic of inflammatory chronic arthropathies and can cause progressive articular damage, chronic pain, and functional loss. Scientific research has increasingly focused on investigating anti-inflammatory micronutrients present in fruits, vegetables, spices, seeds, tea, and wine. This review aims to examine the anti-inflammatory effect of polyphenols (phytonutrients present in plants) and other micronutrients described in randomized clinical trials conducted in patients with chronic inflammatory arthropathies.
RECENT FINDINGS
There is an increasing evidence that differences in micronutrient intake might play an essential role in pathogenesis, therapeutic response, and remission of synovitis. Randomized clinical trials with specific micronutrient- or nutrient-enriched food intake show improvement of symptoms and modulation of both pro- and anti-inflammatory mediators. We found convincing evidence of the anti-inflammatory effect of several micronutrients in arthritis symptoms and inflammation. Although in clinical practice nutritional recommendations to patients with chronic joint inflammation are not consistently prescribed, the addition of these nutrients to day-to-day eating habits could potentially change the natural history of inflammatory arthritis. Future research is needed for a consensus on the specific nutritional recommendations for patients with chronic synovial inflammation.
Topics: Arthritis; Humans; Inflammation; Joints; Micronutrients; Synovitis
PubMed: 33104882
DOI: 10.1007/s11926-020-00962-z -
Journal of Clinical Rheumatology :... Mar 2023In this case series, we present 5 cases of autoimmune rheumatic disease onset shortly after receiving mRNA vaccination against coronavirus disease 2019 (COVID-19).
OBJECTIVES
In this case series, we present 5 cases of autoimmune rheumatic disease onset shortly after receiving mRNA vaccination against coronavirus disease 2019 (COVID-19).
METHODS
We identified 5 patients from Brooke Army Medical Center who developed new manifestations of rheumatic disease following the second dose of the Pfizer-BioNTech or Moderna COVID-19 vaccinations. All patients were initially seen in primary care and then referred to rheumatology for further evaluation and management. Clinical data were obtained through review of the electronic medical record.
RESULTS
Three cases involve elderly women with insidious onset of symmetric wrist and hand polyarthritis with seropositivity for rheumatoid factor. One case involves an elderly woman with a subacute onset of lower extremity-predominant, symmetric polyarthritis. One case involves an elderly man with insidious onset of bilateral shoulder and hip stiffness and arthralgias in the setting of elevated erythrocyte sedimentation rate and a rapid response to glucocorticoid therapy.
CONCLUSION
Whether there exists a causal or contributory relationship between COVID-19 mRNA vaccination and the development of autoimmune rheumatic disease remains to be determined. Ultimately, further research is needed to establish if there is a true connection between the two.
Topics: Aged; Male; Humans; Female; COVID-19; Rheum; Arthritis; Autoimmune Diseases; RNA, Messenger; Rheumatic Diseases; Vaccination
PubMed: 36219608
DOI: 10.1097/RHU.0000000000001906 -
Best Practice & Research. Clinical... Dec 2019Mucosal surfaces are a unique symbiotic environment between a host and a vast and diverse ecology of microbes. These microbes have great immunomodulatory potential with... (Review)
Review
Mucosal surfaces are a unique symbiotic environment between a host and a vast and diverse ecology of microbes. These microbes have great immunomodulatory potential with respect to the host organism. Indeed, the mucosal immune system strikes a delicate balance between tolerance of commensal organisms and overt inflammation to ward off pathogens. Disruptions of the microbial ecology at mucosal surfaces has been described in a vast number of different human disease processes including many forms of arthritis, and the resulting implications are still being understood to their fullest. Herein, we review the current state of knowledge in microbe-host interactions as it relates to the development of arthritis through bacterial translocation, bacterial metabolite production, education of the immune response, and molecular mimicry.
Topics: Arthritis; Humans; Immune Tolerance; Immunity, Mucosal; Inflammation; Microbiota
PubMed: 32151461
DOI: 10.1016/j.berh.2020.101492 -
Jornal de Pediatria 2022In this article, the authors aimed to review the different tools used in the monitoring of enthesitis-related arthritis. (Review)
Review
OBJECTIVES
In this article, the authors aimed to review the different tools used in the monitoring of enthesitis-related arthritis.
SOURCES
The authors performed a literature review on PubMed, Google Scholar, and Scopus databases. The dataset included the original research and the reviews including patients with enthesitis-related arthritis or juvenile spondylarthritis up to October 2020.
SUMMARY OF FINDING
Enthesitis-related arthritis is a category of juvenile idiopathic arthritis. It is characterized by the presence of enthesitis, peripheral arthritis, as well as axial involvement. The only validated tool for disease activity measurement in juvenile idiopathic arthritis is the Disease Activity Score: It has proven its reliability and sensitivity. Nevertheless, due to an absence of validated evaluation tools, the extent of functional impairment, as well as the children and parents' perception of the disease, could not be objectively perceived. Despite the great progress in the field of imaging modalities, the role they play in the evaluation of disease activity is still controversial. This is partially due to the lack of validated scoring systems.
CONCLUSIONS
Further work is still required to standardize the monitoring strategy and validate the outcome measures in enthesitis-related arthritis.
Topics: Arthritis, Juvenile; Child; Humans; Reproducibility of Results; Spondylarthritis
PubMed: 34597529
DOI: 10.1016/j.jped.2021.08.002 -
Frontiers in Endocrinology 2023The aim of this study was to determine causal associations between inflammatory arthritis and eye diseases (disorders of sclera, cornea, iris, and ciliary body [DSCIC]...
OBJECTIVES
The aim of this study was to determine causal associations between inflammatory arthritis and eye diseases (disorders of sclera, cornea, iris, and ciliary body [DSCIC] and disorders of choroid and retina [DCR]).
METHODS
Genome-wide association studies' summary data of rheumatoid arthritis (RA) from a large-scale meta-analysis were used to identify genetically predicted RA. UK Biobank source data predicted ankylosing spondylitis (AS), psoriatic arthritis (PsA), and juvenile idiopathic arthritis (JIA). Furthermore, data from the FinnGen Biobank were used to identify genetically predicted eye diseases. Two-sample Mendelian randomization analysis was used to assess the causal relationship between inflammatory arthritis and eye diseases in the European population. Inverse-variance weighting (IVW) was used as the primary method, while MR-Egger, weighted median, and MR-PRESSO outlier test were used to detect heterogeneity and pleiotropy.
RESULTS
Genetically determined RA was indeed observed to have a causal effect on DSCIC (odds ratio [OR] = 1.084, = 2.353 × 10) and DCR (OR = 1.151, = 1.584 × 10). AS was causally associated with DSCIC (OR = 1.068, < 2.024 × 10). In addition, PsA was also found to have a causal association with an increased risk of 17.9% for the development of DSCIC (OR = 1.179, = 0.003). On the flip side, DSCIC increased the risk of JIA (OR = 2.276, = 0.003).
CONCLUSION
Our study provided genetic evidence for the causal associations of RA, AS, and PsA with an increased risk of DSCIC, and a causal association between RA and DCR was also identified. In addition, DSCIC greatly increased the risk of JIA.
Topics: Humans; Arthritis, Psoriatic; Arthritis, Rheumatoid; Eye Diseases; Genome-Wide Association Study; Mendelian Randomization Analysis; Retinal Diseases; Spondylitis, Ankylosing
PubMed: 37876547
DOI: 10.3389/fendo.2023.1251167