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Systemic lupus erythematosus in a 15-year-old female with multiple splenic nodules:A case report

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World Journal of Clinical Cases 2024年第12期12卷 2128-2133页

作者： Mi Il Kang Hyeok Chan Kwon Division of rheumatology Department of Internal MedicineDankook University College of MedicineCheonan-si 31116South Korea Division of rheumatology Department of Internal MedicineDankook University HospitalDankook University College of MedicineCheonan-si 31116South Korea

BACKGROUND Systemic lupus erythematosus(SLE)is a chronic inflammatory disease primarily affecting young females.SLE can invade any organ,and various forms of splenic invasion have been reported.Manifestations include splenomegaly and splenic infarction,rupture,and calcification.The study encountered a rare case of splenic involvement,with nodules of various sizes without calcifications or ruptures.CASE SUMMARY A 15-year-old girl presented with arthralgia,weight loss,fever,increased levels of inflammatory markers,and positive antinuclear antibody test results.The patient was diagnosed with SLE.She was asymptomatic while taking steroids and hydroxychloroquine.Ten months after discharge,the patient developed a fever and abdominal pain.Lupus enteritis was suspected,and abdominopelvic computed tomography(AP-CT)was performed.There were no specific findings in the gastrointestinal tract,but multiple splenic nodules were observed.Infection or hemangioma was considered;however,no specific radiological findings were observed.A biopsy of the spleen was performed to determine the possibility of malignancy.The histological findings of the spleen included extensive periarteriolar necrosis with hematoxylin bodies and numerous karyorrhectic debris.Based on the biopsy results,the patient was diagnosed with an SLE flare-up and was maintained on high-dose steroids and immunosuppressants.CONCLUSION As disease activity increased,multiple nodules in the spleen that were previously unseen were observed using AP-CT and histologically confirmed.Spleen invasion by SLE can appear in multiple nodular forms and patterns.Therefore,physicians should consider these findings when differentiating these nodules from infections and malignancies.

关键词： Multiple nodules Spleen Splenectomy Systemic lupus erythematosus Differential diagnosis Case report

Characteristics of Elderly-Onset Rheumatoid Arthritis Patients With COVID-19

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Infectious Microbes & Diseases 2024年第1期6卷 36-42页

作者： Lanlan Xiao Xinlei Ma Jinzhi Wu Junyu Liang Weiqian Chen Jin Lin Department of rheumatology the First Affiliated HospitalZhejiang University School of MedicineHangzhouChina

This study aimed to investigate the clinical characteristics of elderly-onset rheumatoid arthritis(EORA)patients with COVID-19.We ret-rospectively enrolled EORA patients diagnosed with COVID-19 from December 2022 through February 2023 and followed them up.Demographic characteristics of the patients and clinical data on COVID-19 were collected,and EORA-related data at the onset of rheu-matoid arthritis and during COVID-19 episodes were evaluated.A total of 102 EORA outpatients were enrolled and stratified into the COVID-19 group(n=60)and the non–COVID-19 group(n=42).In the COVID-19 group,56(93.3%)had symptoms,8(13.3%)had viral pneumonia,and 4(6.7%)developed severe COVID-19.Multivariate logistic regression analysis showed that lack of COVID-19 vac-cination(P=0.016 and P=0.030,respectively)and having interstitial lung disease(P=0.013 and P=0.001,respectively)were inde-pendent risk factors for viral pneumonia and severe COVID-19.Compared with the general population,EORA patients did not show significantly higher susceptibility to COVID-19 or a higher risk of severe COVID-19.However,EORA patients with interstitial lung disease require special consideration during COVID-19 episodes.

关键词： COVID-19 elderly-onset rheumatoid arthritis COVID-19 vaccine interstitial lung disease

Effectiveness of craniosacral therapy,Bowen therapy,static touch and standard exercise program on sleep quality in fibromyalgia syndrome:A randomized controlled trial

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Journal of Integrative Medicine 2024年第4期22卷 473-483页

作者： Reepa Avichal Ughreja Prem Venkatesan Dharmanand Balebail Gopalakrishna Yogesh Preet Singh Vani Lakshmi R Department of Physiotherapy Manipal College of Health ProfessionsManipal Academy of Higher Education Department of rheumatology Manipal Hospital Department of Clinical Immunology and rheumatology All India Institute of Medical Sciences Department of Data Science Prasanna School of Public HealthManipal Academy of Higher Education

Background:Sleep disturbance is commonly seen in fibromyalgia syndrome (FMS);however,high quality studies involving manual therapies that target FMS-linked poor sleep quality are lacking for the Indian population.Objective:Craniosacral therapy (CST),Bowen therapy and exercises have been found to influence the autonomic nervous system,which plays a crucial role in sleep physiology.Given the paucity of evidence concerning these effects in individuals with FMS,our study tests the effectiveness of CST,Bowen therapy and a standard exercise program against static touch (the manual placebo group) on sleep quality in FMS.Design,setting,participants and intervention:A placebo-controlled randomized trial was conducted on132 FMS participants with poor sleep at a hospital in Bangalore.The participants were randomly allocated to one of the four study groups,including CST,Bowen therapy,standard exercise program,and a manual placebo control group that received static touch.CST,Bowen therapy and static touch treatments were administered in once-weekly 45-minute sessions for 12 weeks;the standard exercise group received weekly supervised exercises for 6 weeks with home exercises until 12 weeks.After 12 weeks,all study participants performed the standard exercises at home for another 12 weeks.Main outcome measures:Sleep quality,pressure pain threshold (PPT),quality of life and fibromyalgia impact,physical function,fatigue,pain catastrophizing,kinesiophobia,and positive–negative affect were recorded at baseline,and at weeks 12 and 24 of the intervention.Results:At the end of 12 weeks,the sleep quality improved significantly in the CST group (P=0.037) and Bowen therapy group (P=0.023),and the PPT improved significantly in the Bowen therapy group(P=0.002) and the standard exercise group (P<0.001),compared to the static touch group.These improvements were maintained at 24 weeks.No between-group differences were observed for other secondary outcomes.Conclusion:CST and Bowen therapy improved sleep quality,and Bowen therapy and standard

关键词： Chronic pain Complementary therapies Exercise Fibromyalgia Musculoskeletal manipulations Sleep

Metabolic reprogramming by Syntenin-1 directs RA FLS and endothelial cell-mediated inflammation and angiogenesis

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Cellular & Molecular Immunology 2024年第1期21卷 33-46页

作者： Anja Meyer Stephanie R.Zack Wes Nijim Adel Burgos Vishwa Patel Brian Zanotti Michael V.Volin M.Asif Amin Myles J.Lewis Costantino Pitzalis Shiva Arami Joseph A.Karam Nadera J.Sweiss Shiva Shahrara Jesse Brown VA Medical Center ChicagoILUSA Department of Medicine Division of RheumatologyThe University of Illinois at ChicagoChicagoILUSA Department of Microbiology and Immunology Midwestern UniversityDowners GroveILUSA Division of rheumatology and Clinical Autoimmunity Center of Excellence University of MichiganAnn ArborMIUSA Centre for Experimental Medicine and rheumatology William Harvey Research InstituteBarts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUnited Kingdom Centre for Experimental Medicine&rheumatology William Harvey Research InstituteQueen Mary University of London and Barts NIHR BRC&NHS TrustLondonUK Department of Biomedical Sciences Humanitas Universityand Humanitas Research HospitalMilanItaly Department of Orthopedic Surgery the University of Illinois at ChicagoChicagoILUSA

A novel rheumatoid arthritis(RA)synovial fluid protein,Syntenin-1,and its receptor,Syndecan-1(SDC-1),are colocalized on RA synovial tissue endothelial cells and fibroblast-like synoviocytes(FLS).Syntenin-1 exacerbates the inflammatory landscape of endothelial cells and RA FLS by upregulating transcription of IRF1/5/7/9,IL-1β,IL-6,and CCL2 through SDC-1 ligation and HIF1α,or mTOR activation.Mechanistically,Syntenin-1 orchestrates RA FLS and endothelial cell invasion via SDC-1 and/or mTOR signaling.In Syntenin-1 reprogrammed endothelial cells,the dynamic expression of metabolic intermediates coincides with escalated glycolysis along with unchanged oxidative factors,AMPK,PGC-1α,citrate,and inactive oxidative phosphorylation.Conversely,RA FLS rewired by Syntenin-1 displayed a modest glycolytic-ATP accompanied by a robust mitochondrial-ATP capacity.The enriched mitochondrial-ATP detected in Syntenin-1 reprogrammed RA FLS was coupled with mitochondrial fusion and fission recapitulated by escalated Mitofusin-2 and DRP1 expression.We found that VEGFR1/2 and Notch1 networks are responsible for the crosstalk between Syntenin-1 rewired endothelial cells and RA FLS,which are also represented in RA explants.Similar to RA explants,morphological and transcriptome studies authenticated the importance of VEGFR1/2,Notch1,RAPTOR,and HIF1αpathways in Syntenin-1 arthritic mice and their obstruction in SDC-1 deficient animals.Consistently,dysregulation of SDC-1,mTOR,and HIF1αnegated Syntenin-1 inflammatory phenotype in RA explants,while inhibition of HIF1αimpaired synovial angiogenic imprint amplified by Syntenin-1.In conclusion,since the current therapies are ineffective on Syntenin-1 and SDC-1 expression in RA synovial tissue and blood,targeting this pathway and its interconnected metabolic intermediates may provide a novel therapeutic strategy.

关键词： Syntenin-1 Syndecan-1 RA FLS RA explants immunometabolism

Efficacy of interleukin-17 inhibitors on radiographic progression in psoriatic arthritis:A systematic review and meta-analysis

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Chinese Medical Journal 2024年第4期137卷 473-475页

作者： Han-Lei Jiang Yu Du Qiang Tong Sheng-Ming Dai Department of rheumatology and Immunology Shanghai Sixth People’s HospitalShanghai Jiao Tong University School of MedicineShanghai 200233China

To the Editor:Psoriatic arthritis(PsA)is a highly heterogeneous inflammatory arthritis.It occurs in up to 30%of patients with psoriasis and can have severe impacts on peripheral joints,spine,tendon insertions,and fingers. ^([1])Radiographic progression is currently the preferred method for assessing structural damage of PsA. ^([2])Biologic treatment options for PsA include tumor necrosis factor-αinhibitors(TNFi),interleukin-12/23 inhibitors,and interleukin-17(IL-17)inhibitors.The therapeutic effects of IL-17 inhibitors on structural damage were not consistent over multiple trials.Therefore,a systematic review and meta-analysis of the available randomized controlled trials(RCTs)was conducted to quantify the overall effect of IL-17 inhibitors on structural damage in PsA.This study was registered with PROSPERO(No.CRD42022301774).

关键词： damage analysis inhibitors

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Crossroads:Pathogenic role and therapeutic targets of neutrophil extracellular traps in rheumatoid arthritis

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BIOCELL 2024年第1期48卷 9-19页

作者： YANG LI JIAN LIU YUEDI HU CHENGZHI CONG YIMING CHEN QIAO ZHOU Department of rheumatology The First Affiliated Hospital of Anhui University of Chinese MedicineHefei230031China First Clinical Medical School Anhui University of Chinese MedicineHefei230031China Institute of rheumatology Anhui Academy of Chinese MedicineHefei230031China

Rheumatoid arthritis(RA)is a prevalent autoimmune disease whose main features include chronic synovial inflammation,bone destruction,and joint degeneration.Neutrophils are often considered to be the first responders to inflammation and are a key presence in the inflammatory milieu of RA.Neutrophil extracellular traps(NETs),a meshwork of DNA-histone complexes and proteins released by activated neutrophils,are widely involved in the pathophysiology of autoimmune diseases,especially RA,in addition to playing a key role in the neutrophil innate immune response.NETs have been found to be an important source of citrullinated autoantigen antibodies and inflammatory factor release,which can activate RA synovial fibroblasts(FLS)and cause joint damage.This article reviews the role of NETs in the pathophysiology of RA,demonstrating the application of multiple molecules with various therapies,with a view to informing the discovery and development of novel biomarkers and therapeutic targets for RA.

关键词： Rheumatoid arthritis Neutrophil extracellular traps Review

Magnetic resonance imaging characteristics of patients with neuropsychiatric systemic lupus erythematosus

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Chinese Medical Journal 2024年第3期137卷 373-375页

作者： Yanli Huang Shuoqi Zhang Shaozhe Cai Bingxia Ming Rongfen Gao Ziwei Hu Lingli Dong Department of rheumatology and Immunology Tongji Hospital of Tongji Medical College of Huazhong University of Science and TechnologyWuhanHubei 430030China Department of rheumatology and Immunology Yueyang Central HospitalYueyangHunan 414000China Department of Radiology Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430030China

To the Editor:Neuropsychiatric systemic lupus erythematosus(NPSLE)is a group of serious complications of systemic lupus erythematosus(SLE)with poor prognosis and high mortality.^([1])Therefore,identifying risk factors for NPSLE is particularly crucial for the improvement of the outcomes of patients.Magnetic resonance imaging(MRI)is currently the imaging test of choice for diagnosing patients with NPSLE.However,almost half of the patients with NPSLE show no abnormalities on conventional MRI.^([2])Therefore,the correlation between neuropsychiatric symptoms,which refer to multiple neuropsychiatric manifestations directly related to SLE,and MRI findings should be urgently studied.In this study,we investigated the clinical features,outcomes,and prognostic factors of NPSLE and analyzed the correlation of neuropsychiatric symptoms with MRI features.

关键词： psychiatric patients erythematosus

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“FISH VERTEBRA” about 3 Sickle Cell Patients Followed at Laquintinie Hospital, Douala

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Open Journal of rheumatology and Autoimmune Diseases 2024年第1期14卷 20-25页

作者： Same Bebey Francine Mbono Betoko Ritha Eloundou Onomo Paul Mantho Fopa Pauline Eposse Ekoube Charlotte Megne Tamo Estelle Ebene Mbende Romain Singwe Ngandeu Madeleine rheumatology unit Laquintinie Hospital Douala Douala Cameroon Paediatric unit Laquintinie Hospital Douala Douala Cameroon La Cite Verte Hospital Yaounde Yaounde Cameroon Paediatric Surgery unit Laquintinie Hospital Douala Douala Cameroon La Cite des palmiers Hospital Douala Douala Cameroon rheumatology unit Central Hospital Yaounde Yaounde Cameroon

Vertebral involvement in particular is common in sickle cell patients. We report 3 cases of “fish vertebra” fractures in sickle cell patients aged 16, 18, and 24 years old respectively at Laquintinie Hospital, Douala. When the vertebral fractures were diagnosed, the 3 patients had back pain and kyphosis deformities of the dorsal spine. Treatment with an infusion of biphosphonates (zoledronic acid at a dose of 0.5 mg·per·kg) was offered to all three patients. Two out of three patients received treatment with biphosphonates with a successful outcome. Profound vitamin D deficiency is associated with increased bone remodeling and a history of fractures. In sickle cell anemia, vertebral fractures may also result from bone fragility, which is often overlooked as aseptic osteonecrosis and osteomyelitis, which are very often suspected.

关键词： Vertebral Fractures Sickle Cell Anemia Vertebral Bone Fragility

Ovarian function in patients with systemic lupus erythematosus:Pathogenesis,drug application and prospective therapies

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World Journal of Experimental Medicine 2024年第2期14卷 29-34页

作者： Min Xu Li-Li Tian Xiao-Liu Li Cheng Bao Hai-Wei Zhang Hong-Wei Chen Department of rheumatology and Immunology Nanjing Drum Tower HospitalClinical College of Nanjing University of Chinese MedicineNanjing 210008Jiangsu ProvinceChina School of Life Science Nanjing Normal UniversityNanjing 210023Jiangsu ProvinceChina Department of rheumatology and Immunology Nanjing Drum Tower HospitalNanjing 210008Jiangsu ProvinceChina Department of rheumatology and Immunology Nanjing Pukou People’s HospitalNanjing 211800Jiangsu ProvinceChina Department of rheumatology and Immunology Nanjing Drum Tower HospitalThe Affiliated Hospital of School of MedicineNanjing UniversityNanjing 210008Jiangsu ProvinceChina

Systemic lupus erythematosus(SLE)is a chronic autoimmune disease in which multiple organs are damaged that prevails in fertile women.Currently,glucocorticoids and immunosuppressants are widely used to treat SLE patients.However,ovarian dysfunction occurs following the use of these drugs in women with SLE.Here,we summarize recent progress in terms of understanding ovarian injury,the effects of drug application and strategies to improve ovarian function in women with SLE.This review could be helpful to precisely cure SLE in women desiring to have offspring.

关键词： Systemic lupus erythematosus Ovarian reserve Ovarian insufficiency Mesenchymal stem cells Fertility Autoimmune disease