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Mumtaz S, Valecha J, Hochwald A, Berianu F, Majithia V, Abril A. Investigating the concomitance of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides and inflammatory bowel disease (IBD). Semin Arthritis Rheum 2024; 66:152452. [PMID: 38677223 DOI: 10.1016/j.semarthrit.2024.152452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE To assess relationship between Anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis and inflammatory bowel disease (IBD). METHODS This is a retrospective study design. The patients were identified using a preset criteria of patients who have the diagnosis of ANCA associated vasculitis including a diagnosis of granulomatosis with polyangiitis (GPA) or microscopic polyangiitis (MPA) or eosinophilic granulomatosis with polyangiitis (EGPA) with overlapping inflammatory bowel disease (Crohn's disease or ulcerative colitis) in the time period from 01/01/2020 to 08/03/2023. Subsequently data from each patient was collected that will include baseline demographics, disease characteristics, disease activity, treatment information, multiorgan involvement, and pathology findings which were then analyzed. RESULTS 39 patients were identified that met criteria. 20 patients carried a diagnosis of GPA, 6 had MPA and 4 patients had EGPA. 20 patients with GPA had inflammatory bowel disease, 13 with ulcerative colitis and 6 with Crohn's disease while 1 GPA patient had unspecified inflammatory bowel disease. 4 patients with EGPA had inflammatory bowel disease, 2 with ulcerative colitis and 2 with Crohn's disease. 6 patients with MPA had inflammatory bowel disease, 4 with ulcerative colitis and 2 with Crohn's disease. IBD diagnosis preceded the diagnosis of ANCA vasculitis in 77.8 % of the cases. CONCLUSION Objective observation and deductions from this study raise the concern for a possible pathogenic association of ANCA associated vasculitis and inflammatory bowel disease and more research is needed to identify any causal association or influence of the two systemic disease on each other.
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Affiliation(s)
- Sehreen Mumtaz
- Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States.
| | - Jayesh Valecha
- Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States
| | - Alex Hochwald
- Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States; Department of Biostatistics (Hochwald), Mayo Clinic Florida, United States
| | - Florentina Berianu
- Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States
| | - Vikas Majithia
- Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States
| | - Andy Abril
- Division of Rheumatology (Mumtaz, Valecha, Berianu, Majithia and Abril), Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States
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Schneider A, Sadhana J, Menindez MD, Jeveratnam S, Balistreri L, Thomas C, Chirila R, Berianu F. Hydroxychloroquine Induced Cardiotoxicity: A Case Series. Rom J Intern Med 2024; 0:rjim-2024-0005. [PMID: 38377065 DOI: 10.2478/rjim-2024-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Indexed: 02/22/2024]
Abstract
Hydroxychloroquine (HCQ) induced cardiotoxicity is a rare diagnosis and is often associated with chronic use of the medication. It has been shown that chronic HCQ use is associated with a drug-induced cardiomyopathy mainly driven by acquired lysosomal storage defects leading to hypertrophy and conduction abnormalities. As the only proven treatment is the discontinuation of the offending agent, prompt recognition is required to avoid further exposure to the drug and potential progression of disease. History, physical examination and advanced imaging modalities are useful diagnostic tools, but more invasive testing with an endomyocardial biopsy is required for definitive diagnosis. We present a descriptive case series of ten patients that were diagnosed with biopsy proven HCQ cardiotoxicity.
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Affiliation(s)
- Artur Schneider
- 1Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Jonna Sadhana
- 2Department of Critical Care Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Suren Jeveratnam
- 1Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Lisa Balistreri
- 3Department of Rheumatology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Colleen Thomas
- 4Department of Quantitative Health Science, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Razvan Chirila
- 1Department of Internal Medicine, Mayo Clinic, Jacksonville, FL 32224, USA
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Cardona-Cardona AF, Mumtaz S, Balistreri L, Stanbourough R, Butendieck R, Wang B, Abril A, Vikas M, Berianu F. Bilateral Lumbosacral Plexopathy As the Initial Manifestation of Systemic Sarcoidosis: A Case Report. Cureus 2024; 16:e54086. [PMID: 38487149 PMCID: PMC10937216 DOI: 10.7759/cureus.54086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2024] [Indexed: 03/17/2024] Open
Abstract
Neurosarcoidosis is one of the most relevant involvements in systemic sarcoidosis and can be the initial presentation. Its diagnosis is often considered difficult because of unusual clinical manifestations or diagnostic mimics. The peripheral nervous system is less frequently involved than the central nervous system, although it may also lead to irreversible neurologic impairment. Lumbosacral plexopathy in sarcoidosis is a rare presentation and has been scarcely described in anecdotal case reports and small case series. We describe the case of a 61-year-old female who presented with right inguinal pain, right thigh weakness, and gait limitation, with imaging evidence of bilateral lumbosacral plexopathy as the initial manifestation of systemic sarcoidosis and subsequently developed joint and pulmonary involvement. This case report aims to bring awareness of this involvement as a possible initial manifestation of systemic sarcoidosis and mention key features of the differential diagnosis. Prompt recognition and treatment may prevent neurologic impairment.
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Affiliation(s)
| | | | | | | | | | - Benjamin Wang
- Rheumatology, Mayo Clinic Florida, Jacksonville, USA
| | - Andy Abril
- Rheumatology, Mayo Clinic Florida, Jacksonville, USA
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Mumtaz S, Candelo E, Krishna M, Jiang L, Bhatt AA, Bridges M, Cardona A, Rutt A, Berianu F, Butendieck RR. Submucosal Epstein-Barr Virus Positive Polymorphic B-cell Lymphoproliferative Disorder of the Larynx: A Case Report. Ear Nose Throat J 2024:1455613231226017. [PMID: 38264837 DOI: 10.1177/01455613231226017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Epstein-Barr virus (EBV) belongs to the group of human herpes virus and can cause clinical and subclinical infections. Although EBV-related disease presentations are similar, they can lead to oncogenic transformation with various clinical manifestations. A thorough workup with morphology, immunohistochemistry, and molecular studies is crucial for the diagnosis of EBV-positive polymorphic B-cell lymphoproliferative disorder, not otherwise specified (NOS), which is a new entity introduced by International Consensus Classification in 2022. We describe an interesting presentation of EBV-positive polymorphic B-cell lymphoproliferative disorder with laryngeal involvement to bring awareness to this entity and we would like to address the need for more accessible treatment options.
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Affiliation(s)
- Sehreen Mumtaz
- Department of Rheumatology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Estephania Candelo
- Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Murli Krishna
- Department of Pathology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Liuyan Jiang
- Department of Pathology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Alok A Bhatt
- Department of Radiology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Margaret Bridges
- Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Andres Cardona
- Department of Rheumatology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Amy Rutt
- Department of Otolaryngology/Head and Neck Surgery, Mayo Clinic Florida, Jacksonville, FL, USA
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Sullivan MM, Abril A, Aslam N, Ball CT, Berianu F. Nailfold videocapillaroscopy in antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Res Ther 2024; 26:4. [PMID: 38167073 PMCID: PMC10759672 DOI: 10.1186/s13075-023-03227-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a group of illnesses that cause inflammation and alterations to small vessels in the body. Some of the most common and detrimental manifestations, including alveolar hemorrhage and glomerulonephritis, are caused by this capillary inflammation. We sought to clarify whether patients with AAV would have abnormal nailfold capillaries when evaluated with nailfold videocapillaroscopy. METHODS Patients with a current diagnosis of AAV and a control group were identified for enrollment. Nailfold videocapillaroscopy images were used for a semiquantitative analysis on capillary density, morphology, dilation, and microhemorrhage after review by 2 rheumatologists. Disease characteristics, occurrence of recent disease flare, and presence of ANCA were recorded. RESULTS Thirty-three patients with a diagnosis of AAV and 21 controls were recruited. The AAV group had a median age of 59 and 17 (52%) were women. Granulomatosis with polyangiitis was the most common diagnosis (19 [58%]), followed by eosinophilic granulomatosis with polyangiitis (7 [21%]) and microscopic polyangiitis (7 [21%]). Twenty-seven patients (82%) had positive ANCA tests. After assessment of capillary density, dilation, morphology, microhemorrhages, and disorganization, there were no statistically significant differences between the 2 groups. CONCLUSION There was no evidence of differences in nailfold capillaroscopy abnormalities between those diagnosed with AAV and the control group. While this cohort was relatively small, we did not find a high enough prevalence or specific phenotype of capillary abnormalities that could aid in diagnosis or prognostication of these diseases in the clinical setting.
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Affiliation(s)
- Megan M Sullivan
- Division of Rheumatology, Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, 13400 E Shea Boulevard, Scottsdale, AZ, 85259, USA.
| | - Andy Abril
- Division of Rheumatology, Mayo Clinic, Jacksonville, FL, USA
| | - Nabeel Aslam
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL, USA
| | - Colleen T Ball
- Division of Clinical Trials and Biostatistics, Mayo Clinic, Jacksonville, FL, USA
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Diaz-Menindez M, Sullivan MM, Wang B, Majithia V, Abril A, Butendieck RR, Ball CT, Berianu F. Dermatomyositis in Association With SARS-CoV-2 Infection or COVID-19 Vaccine. Arthritis Care Res (Hoboken) 2024; 76:98-104. [PMID: 37728071 DOI: 10.1002/acr.25236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/31/2023] [Accepted: 09/13/2023] [Indexed: 09/21/2023]
Abstract
OBJECTIVE New-onset and relapsed dermatomyositis (DM) has been reported following SARS-CoV-2 infection or COVID-19 vaccination. This study aims to show the characteristics of a DM cohort after COVID-19 infection and vaccination. METHODS A retrospective review was performed on patients treated for DM between March 1, 2020, and October 31, 2022. Charts were evaluated for the presence of new-onset DM or relapse of preexisting DM following either SARS-CoV-2 infection or COVID-19 vaccination. Data on symptom onset, timing of vaccination, type of vaccination, and disease characteristics were collected. RESULTS Ninety-eight patients treated for DM at our institution in the Division of Rheumatology were included. In total, 12 of 98 patients (12.2%) experienced DM symptoms (either incident or relapse) following either infection or vaccination. Of the 12 patients who developed incident disease or relapse, 7 (58.3%) developed postinfection symptoms, and 8 (66.7%) developed symptoms after vaccination (3 patients had symptoms following both infection and vaccination). The mean onset of symptoms following COVID-19 infection was 3.2 days (median 0.5 days), and mean onset following COVID-19 vaccination was 5.75 days (median 3.5 days). Nine of 12 patients (75%) had a positive myositis-specific antibody, and the remaining 3 (25%) had myositis-associated antibodies. There was no predominant vaccine associated with the development of postvaccination DM symptoms. CONCLUSION This retrospective review revealed a strong temporal relationship between DM symptoms and COVID-19 infection or vaccination in 12.2% of all patients with DM evaluated in our clinic during the pandemic. Additional studies are required to understand the possible pathophysiology behind this association.
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Sullivan MM, Salem F, Albadri S, Berianu F. Clinical Images: Dacryoadenitis as the herald symptom for systemic lupus erythematosus. ACR Open Rheumatol 2023; 5:436. [PMID: 37280175 PMCID: PMC10502808 DOI: 10.1002/acr2.11553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/20/2023] [Accepted: 04/17/2023] [Indexed: 06/08/2023] Open
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Sullivan M, Sokumbi O, Berianu F. Abnormal nailfold capillaroscopy in chronic graft versus host disease. Semin Arthritis Rheum 2023; 60:152196. [PMID: 36990006 DOI: 10.1016/j.semarthrit.2023.152196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/20/2023] [Indexed: 03/29/2023]
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Schneider A, Jhawar N, Balistreri L, Chirila R, Berianu F. A Rare Case of Cardiac Tamponade in a Patient With Anti-RNA Polymerase III Scleroderma. Cureus 2023; 15:e38533. [PMID: 37273403 PMCID: PMC10239203 DOI: 10.7759/cureus.38533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2023] [Indexed: 06/06/2023] Open
Abstract
Scleroderma is a chronic, progressive autoimmune disease that often presents with multiorgan involvement. Cardiac manifestations are common and include microvascular coronary artery disease, conduction abnormalities, autonomic insufficiency, and pericardial effusions. Although rare, pericardial effusions may progress and lead to cardiac tamponade. Patients diagnosed with scleroderma can be further prognosticated based on the presence of serologic scleroderma-specific antibodies. The anti-RNA polymerase III autoantibody (anti-RNAP3) is associated with an aggressive subtype of scleroderma. Looking at the current literature, no association has been reported between anti-RNAP3 and the development of cardiac tamponade in patients with underlying scleroderma. We discuss a unique case of a patient with scleroderma who was found to be anti-RNAP3 positive and signs of cardiac tamponade. This case illustrates the importance of an expeditious diagnosis and timely interventions to treat cardiac tamponade. Additionally, we share a rare but important association between anti-RNAP3 and the formation of tamponade physiology in scleroderma.
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Li Y, Berianu F, Brumble L, Calamia KT. Synovitis due to Histoplasma capsulatum: a case series and literature review. Rheumatol Int 2023; 43:763-769. [PMID: 34164701 DOI: 10.1007/s00296-021-04912-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/03/2021] [Indexed: 10/21/2022]
Abstract
Musculoskeletal manifestations of Histoplasma capsulatum infection are uncommon but can mimic inflammatory arthritis. Early diagnosis of this complication is of critical importance in the era of potent immunosuppression for rheumatologic diseases. We conducted a retrospective chart review for patients with histoplasmosis and tenosynovitis, synovitis, or arthritis, diagnosed and treated at our institution between January 1, 2000, and December 31, 2019. We also reviewed the relevant literature. Four patients with biopsy-proven, culture-proven histoplasma tenosynovitis were identified at our institution. All four patients had wrist or hand involvement in an asymmetric pattern, and one patient had lower extremity involvement as well. Two patients were not immunocompromised at baseline. One patient underwent a lengthy evaluation and received immunosuppression for 4 years without improvement prior to the diagnosis of histoplasmosis. Histoplasma serologic tests varied among patients with localized infection. Pathologic findings revealed non-caseating granulomatous inflammation. Three patients recovered after 6-12 months of antifungal treatment. One patient still had recurrent infection despite 20 months of treatment. Histoplasma tenosynovitis and synovitis are rare causes of inflammatory arthritis. Infectious causes should be considered and carefully evaluated when patients present with asymmetric oligoarthritis. Early recognition is crucial for successful treatment, especially in patients with concomitant rheumatologic diseases receiving immunosuppressive treatment.
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Affiliation(s)
- Yan Li
- Mayo Clinic School of Graduate Medical Education, Mayo Clinic College of Medicine and Science, Jacksonville, FL, USA
| | - Florentina Berianu
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
| | - Lisa Brumble
- Division of Infectious Diseases, Mayo Clinic, Jacksonville, FL, USA
| | - Kenneth T Calamia
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA
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Diaz-Menindez M, Sullivan MM, Butendieck RR, Abril A, Majithia V, Wang B, Berianu F. Diffuse alveolar hemorrhage secondary to sarcoidosis. Clin Rheumatol 2023; 42:1701-1704. [PMID: 36847928 PMCID: PMC9969929 DOI: 10.1007/s10067-023-06556-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/01/2023]
Abstract
Diffuse alveolar hemorrhage (DAH) is a pulmonary condition that can be caused by autoimmune disorders such as lupus, small vessel vasculitis, and antiphospholipid syndrome. Sarcoidosis as a cause of DAH has been reported; however, the literature remains limited. We performed a chart review for patients with a diagnosis of both sarcoidosis and DAH. Seven patients met inclusion criteria. Mean (range) patient age was 54 years (39-72), and 3 patients had a history of tobacco use. Diagnosis of DAH and sarcoidosis were concurrent for 3 patients. Corticosteroids were used for treatment of DAH in all patients; 2 (including 1 with refractory DAH) were successfully treated with rituximab. We believe sarcoidosis-associated DAH is more common than previously reported. It is essential to consider sarcoidosis in the differential diagnosis of immune-mediated DAH. Key Points • Sarcoidosis can cause diffuse alveolar hemorrhage (DAH); more extensive studies are needed to estimate this condition's prevalence. • BMI of 25 or higher appears to be a risk factor for the development of sarcoidosis-associated DAH.
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Affiliation(s)
| | - Megan M. Sullivan
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
| | - Ronald R. Butendieck
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
| | - Andy Abril
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
| | - Vikas Majithia
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
| | - Benjamin Wang
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL 32224 USA
| | - Florentina Berianu
- Division of Rheumatology, Mayo Clinic, 4500 San Pablo Rd, Jacksonville, FL, 32224, USA.
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Chirila RM, Berianu F, Abril A, Butendieck RR. Extra-articular involvement of rheumatoid arthritis in three seropositive patients in the absence of initial joint involvement. Immun Inflamm Dis 2021; 9:1613-1617. [PMID: 34473908 PMCID: PMC8589363 DOI: 10.1002/iid3.514] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/06/2021] [Accepted: 08/10/2021] [Indexed: 12/27/2022] Open
Abstract
Introduction Extra‐articular involvement (EAI) in rheumatoid arthritis (RA) is rare, severe and usually presents after years of joint involvement. Onset of RA as lung involvement has been published. We describe a series of three patients with strongly positive anti‐citrullinated peptide antibodies (ACPA) and rheumatoid factor (RF) positive in the absence of joint symptoms, but with significant EAI. Methods This is a descriptive case series of three patients evaluated in an academic medical center rheumatology clinic. Results A 50‐year‐old female presented with severe recurrent scleritis in the background of strongly positive ACPA, but no joint involvement. Her ocular disease responded well to rituximab. Four years later, she developed peripheral inflammatory arthritis consistent with RA. A 74‐year‐old male presented after developing recurrent steroid‐dependent serositis (pleuro‐pericarditis) and interstitial lung disease (ILD). Serology was notable for strongly positive ACPA, but no joint involvement. Serositis responded well to adalimumab. Two years after initial symptoms, he developed peripheral joint involvement after holding adalimumab. A 56‐year‐old female presented with an isolated, biopsy‐proven subcutaneous rheumatoid nodule. Subsequently, she developed pancytopenia and fatigue. She tested strongly positive for ACPA and RF. Bone marrow biopsy was negative for malignancy and she had no evidence of infection. She responded to steroids and hydroxychloroquine and had not developed joint involvement after 2 years of follow‐up. Conclusion EAI as an onset of RA is a complex and not easily recognized entity if typical joints involvement is not yet present. Early diagnosis may help guide specific therapy and prevent sequelae and co‐morbidities.
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Affiliation(s)
- Razvan M Chirila
- Division of General Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | | | - Andy Abril
- Division of Rheumatology, Mayo Clinic, Jacksonville, Florida, USA
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Bruce BK, Allman ME, Rivera FA, Wang B, Berianu F, Butendieck RR, Calamia KT, Hines SL, Rummans TA, Niazi SK, Abril A. Intensive Multicomponent Fibromyalgia Treatment: A Translational Study to Evaluate Effectiveness in Routine Care Delivery. J Clin Rheumatol 2021; 27:e496-e500. [PMID: 32897994 DOI: 10.1097/rhu.0000000000001555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The current study was designed to evaluate the translation of clinical trial outcomes and clinical guidelines for the treatment of fibromyalgia (FM) into an intensive multicomponent clinical program embedded in routine care delivery. The study aimed to assess the adaptation of these recommended strategies into routine clinical care while evaluating their effectiveness and durability in improving functional status and level of distress in a large clinical sample of FM patients. METHODS Four hundred eighty-nine patients with FM completed a 2-day program that incorporated best practice recommendations for the treatment of FM. Patients completed the Fibromyalgia Impact Questionnaire-Revised, the Center for Epidemiologic Studies Depression Scale, and the Pain Catastrophizing Scale at admission to the program and at follow-up on average 5 months posttreatment. RESULTS Significant improvements were seen in functional status (p < 0.0001), depressive symptoms (p < 0.0001), and pain catastrophizing (p < 0.0001) after participation in the intensive multicomponent treatment program. CONCLUSIONS The present study shows that an intensive multicomponent treatment program embedded in routine care delivery is effective in significantly improving functional status and psychological distress in a large sample of FM patients. The significant improvements were durable and maintained at follow-up.
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Affiliation(s)
- Barbara K Bruce
- From the Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
| | | | | | | | | | | | | | | | - Teresa A Rummans
- From the Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL
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Al Awqati MZ, Sluzevich JC, Berianu F. Ulcerative Paraneoplastic Dermatomyositis in the Setting of Positive Transcriptional Intermediary Factor 1-γ Antibody. J Rheumatol 2021; 48:1340. [PMID: 34329179 DOI: 10.3899/jrheum.200399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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15
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Narula NG, Abril A, Calamia KT, Berianu F. Musculoskeletal ultrasound as a diagnostic tool for eosinophilic fasciitis and correlation with magnetic resonance imaging findings. Int J Rheum Dis 2021; 24:721-723. [PMID: 33890386 DOI: 10.1111/1756-185x.14099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/02/2021] [Accepted: 03/06/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Neha G Narula
- Division of Rheumatology, Mayo Clinic, Jacksonville, FL, USA
| | - Andy Abril
- Division of Rheumatology, Mayo Clinic, Jacksonville, FL, USA
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Al-Awqati MZ, Sokumbi O, Gold KG, Berianu F. Periorbital masses in dermatomyositis. Rheumatology (Oxford) 2020; 59:e136-e137. [DOI: 10.1093/rheumatology/keaa421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/30/2020] [Accepted: 06/17/2020] [Indexed: 11/14/2022] Open
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Tolaymat OA, Pinkston O, Wang B, Schenk WB, Joseph RW, Mergo PJ, Berianu F. Drug-associated vasculitis occurring after treatment with pembrolizumab. Rheumatology (Oxford) 2019; 58:1501-1503. [PMID: 30892627 DOI: 10.1093/rheumatology/kez051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | | | | | - Richard W Joseph
- Division of Hematology and Medical Oncology, Mayo Clinic, Jacksonville, FL, USA
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Berianu F, Ginsburg W. AB0696 Hypereosinophilia and Disease Flare in Eosinophilic Fasciitis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
| | - Marc D. Cohen
- Department of Rheumatology; Mayo Clinic; Jacksonville Florida USA
| | - Andy Abril
- Department of Rheumatology; Mayo Clinic; Jacksonville Florida USA
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Berianu F, Ginsburg W, Trigg S, Wang B. Destructive arthritis of the hand after diving. J Rheumatol 2014; 41:2486. [PMID: 25452182 DOI: 10.3899/jrheum.140567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Stephan Trigg
- Associate Professor of Orthopedics, Department of Orthopedics
| | - Benjamin Wang
- Assistant Professor of Medicine, Department of Medicine, Mayo Graduate School of Medicine, Mayo Clinic, Jacksonville, Florida, USA
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Hurst RL, Berianu F, Ginsburg WW, Klein CJ, Englestad JK, Kennelly KD. Cryoglobulinemic vasculitis in a patient with CREST syndrome. J Clin Neurosci 2014; 21:1821-3. [DOI: 10.1016/j.jocn.2014.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2013] [Revised: 01/08/2014] [Accepted: 01/15/2014] [Indexed: 10/25/2022]
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Abril A, Berianu F. AB0946 Absence of Infections in Outpatient Ultrasound Guided Musculoskeletal Procedures Performed at A Rheumatology Clinic Using Either Sterile Gel or Iodine Cleaning Solution: Are Sterile Ultrasound Probe Covers Needed? Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Berianu F, Ginsburg WW, Amoateng-Adjepong Y. Herniated lumbar disk as the initial presentation of sarcoidosis. Am J Med 2014; 127:e3-4. [PMID: 24661970 DOI: 10.1016/j.amjmed.2014.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/27/2013] [Accepted: 01/02/2014] [Indexed: 10/25/2022]
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Berianu F, Cohen MD, Abril A, Ginsburg WW. FRI0401 Eosinophilic fasciitis (EF) clinical characteristics and response to mtx therapy. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gheorghe C, Dadu R, Blot C, Barrantes F, Vazquez R, Berianu F, Feng Y, Feintzig I, Amoateng-Adjepong Y, Manthous CA. Hyperchloremic Metabolic Acidosis Following Resuscitation of Shock. Chest 2010; 138:1521-2. [DOI: 10.1378/chest.10-1458] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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