فهرست مطالب

Rheumatology Research - Volume:2 Issue: 4, 2017
  • Volume:2 Issue: 4, 2017
  • تاریخ انتشار: 1396/06/04
  • تعداد عناوین: 7
  • Sasan Fallahi Page 113
    This article is as a brief commentary to another manuscript which recently has been published in an internal medicine journal (La revue de médecine interne 2017) about thymoma and autoimmune diseases. The present article gives explanation about the increased risk of appearance of SLE as an autoimmune disease after removing the thmus from the body.
    The probable responsible pathologic mechanisms will be clarified and also, few clinical characteristics which may predict SLE after thymectomy will be pointed out. However, these features should be evaluated in future research studies.
    Keywords: pure red cell aplasia, systemic lupus erythematosus, thymectomy, thymoma
  • Mohammadhassan Jokar, Zahra Mirfeizi Pages 115-118
    Granulomatosis with polyangiitis (Wegener's granulomatosis) is a type of vasculitis which can be categorized as a sub-branch of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides. This study examined the demographic, clinical, radiographic and laboratory characteristics of patients with granulomatosis with polyangiitis (GPA) in Imam Reza Hospital, Mahshad, Iran. The medical records of patients admitted to the Department and Clinic of Rheumatology who were diagnosed with granulomatosis with polyangiitis between January 1, 2006 and December 31, 2016 were retrospectively studied. Patients were classified according to the American College of Rheumatology (ACR) 1990 classification criteria for Wegener's granulomatosis. A total of 59 GPA-diagnosed patients (55.9% male, 44.1% female) were identified. The male-to-female ratio of the patients was 1.32:1. The mean age was 35.58±15.09 years, with the youngest and oldest patients being 10 and 71 years old, respectively. The mean disease duration was 47.5±32.88 months. The most common involved organs were the upper respiratory tract in 77.9%, lower respiratory tract in 62.7%, kidney in 59.3%, joint/muscle in 49.15%, and eye in 28.8% of patients. Four (6.7%) patients died during the follow-up which had a mean of 3.9 years. In the studied region, GPA inflicts the younger population, and it is more common in males. Instances of upper respiratory tract, lower respiratory tract, and kidney involvement are less common in the present study than in most other studies. GPA might have less severe manifestations in the studied area than in other regions.
    Keywords: Granulomatosis with polyangiitis (GPA), Wegener's granulomatosis, vasculitis, Anti-Neutrophil Cytoplasmic Antibody (ANCA)
  • Rasol Roshan, Azadeh Tavoli, Neda Sedighimornani, Zahra Goljani, Seyed Shamsia Shariatpanahi Pages 119-126
    This study compared the effectiveness of relaxation training and stress management training in treating anxiety, depression, stress, and pain in women with fibromyalgia. Twenty-two women with fibromyalgia participated in this randomized, controlled trial. They were assigned to stress management (n=7), relaxation training (n=7), and control (n=8) groups. All participants completed the Depression, Anxiety, and Stress Scale (DASS-42) and the Visual Analog Scale (VAS) for pain. The stress management group participated in eight weekly two-hour sessions of a stress management program; the relaxation group participated in eight weekly sessions of relaxation training. Then, participants completed the DASS-42 and VAS again. Analyses of Covariance (ANCOVA) and post hoc analyses were used to compare the participants’ pre- and post-therapy responses and the two treatment types. Both relaxation training and stress management training were found to be effective in treating patients’ anxiety (P= 0.005), depression (P= 0.006), stress (P= 0.002), and pain (P= 0.001). Post hoc analyses indicated that participants in the treatment groups showed improvement compared with those in the control group (all P values
    Keywords: fibromyalgia, relaxation, stress management
  • Maryam Sahebari, Masoud Pezeshki Rad, Mohammad Ali Nahayati, Morteza Saeidi, Reza Boostani, Yaser Hamidian, Mahdieh Baghaei Pages 127-131
    Carpal tunnel syndrome is a common chronic entrapment neuropathy. The present study evaluated the diagnostic ability of ultrasound (US) in measuring the cross-sectional area of the median nerve in the entrance of the carpal tunnel area in comparison with electrodiagnostic testing for diagnosing carpal tunnel syndrome. In this cross-sectional study, 253 patients with carpal tunnel syndrome based on American Academy of Neurology clinical symptoms were selected for participation. After screening, 200 patients were enrolled in the study. Wrist US and electrodiagnostic findings for patients were compared. Data were analyzed by SPSS. There was a good agreement between sonographic and electrodiagnostic findings [right hand (kappa= 0.71), left hand (kappa= 0.78)]. For the right and left hands, respectively, ultrasound sensitivity (89% vs 90%), specificity (90% vs 89.2%), positive predictive value (84.7% vs 94.7%), and negative predictive value (75.7% vs 81.6%) were calculated. High-resolution ultrasound of the median nerve cross-sectional area is an accurate test for diagnosing carpal tunnel with an acceptable level of diagnostic ability. In comparison with the electrodiagnostic test, ultrasonography can provide more practical information about anatomical changes in the tunnel, which can be considered in selecting treatment options.
    Keywords: carpal tunnel syndrome, electromyography, entrapment neuropathy, Ultrasonography
  • Maryam Masoumi, Mahdi Mahmoudi, Zahra Malekshahi, Jafar Karami, Mahdi Vojdanian, Ahmadreza Jamshidi Pages 133-138
    Ankylosing spondylitis (AS) isan inflammatory arthritis with unknown etiology. AS mostly affects the axial skeleton and peripheral joints. The genetic contribution is believed to be a major attributable reason of overall susceptibility to AS. ETS1, also known as the avian erythroblastosis virus E26 (v-ets) oncogene homolog-1 gene, is essential in the development of immune cells in both adaptive and innate immunity. This study investigated the association of single nucleotide polymorphisms (SNPs) in the ETS1 gene (rs1128334 and rs10893872) with ankylosing spondylitis in Iranian population. The study samples comprised 495 AS patients and 490 controls. All samples were selected from the Iranian population. Two SNPs were chosen from the ETS1 gene (rs1128334 and rs10893872), and their association with AS was examined by applying the Real-time PCR allelic discrimination method. The results showed no significant associations between rs1128334 and rs10893872 SNPs and the risk of AS. However, the association between rs10893872 and the Bath Ankylosing Spondylitis Functional Index (BASFI) was significant (p=0.02) after Bonferroni correction, while BASFI was significantly increased in cases with CT in comparison to CC genotype. The results of this study on the Iranian population did not confirm the association of the ETS1 gene SNPs with AS susceptibility; however, the association was significant in Han Chinese populations. The diversity in results among different populations is common in gene association studies of multifactorial diseases. Further investigations will be needed to identify other risk variants of the ETS1 genewhich are correlated with AS susceptibility.
    Keywords: ankylosing spondylitis, ETS1, Single Nucleotide Polymorphism (SNP)
  • Saman Ghalamkari, Mahboobeh Nasiri, Saideh Ariannia, Reza Farrokhseresht Pages 139-143
    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with unknown etiology. G-protein-coupled receptor 65 (GPR65) candidates as an SLE-locus for functioning in T cell receptor-mediated self-reactive T cell death in the thymus. This is also involved in anti-inflammatory actions and apoptosis as remarkable features of autoimmune diseases. This study investigated the relationship between the rs10139328 polymorphism at the 5´UTR of a GPR65 gene and SLE. This case-control study consisted of 102 SLE patients (98 females, 4 males) and 118 age- and gender-matched healthy controls (113 females, 5 males). Genotyping of the rs10139328 polymorphism was determined using an amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Data was analyzed using SPSS software. The Pearson chi-square was the test of choice for assessing the association between the rs10139328 polymorphism and SLE. The probable influences of sunlight and family history on SLE were evaluated by performing logistic regression. Except for one heterozygote subject among the control group, the study population was homozygote for the selected polymorphism. No statistical difference was seen in genotype distribution between the cases and the controls (P> 0.05). Statistical analysis revealed that sun exposure directly increased SLE susceptibility (P
    Keywords: systemic lupus erythematosus, G-protein-coupled receptor 65, polymorphism
  • Ali Javinani, Farhad Gharibdoost, Ahmadreza Jamshidi, Hoda Kavosi Pages 145-149
    Scleromyxedema (SM) is a rare disorder which initially presents with waxy skin stiffness and maculopapular lesions. It also has non-dermatologic manifestations, such as serum paraproteinemia and myopathies, and is sometimes associated with other autoimmune disorders. A 52-year-old man was referred for treatment because of torso-dominant skin stiffness. He also had a neglected history of bilateral inflammatory back pain and chronic Helicobacter pylori-negative gastritis. Skin histopathology confirmed a diagnosis of SM. A grade 4 bilateral sacroilitis and a positive human leukocyte antigen B27 led to the patient also being diagnosed with ankylosing spondylitis (AS). Upon further analysis, monoclonal gammopathy of immunoglobulin (Ig) G/kappa (lower than 3 g/dl) and a normal percentage of plasma cells in his bone marrow aspiration sample were discovered. Due to the patient’s IgA deficiency, intravenous immunoglobulin (IVIG) could not be used to treat his SM; due to his positive tuberculin skin test (25 mm) and history of gastritis, anti-tumor necrosis factor alpha and non-steroid anti-inflammatory drugs were also withheld. The patient received a drug regimen of cyclosporine (3mg/kg/day) and high-dose prednisolone (0.5mg/kg/day) which successfully controlled both his SM and AS disorders. In this paper, we report a previously unreported case of SM-associated gammopathy and AS. We also show the efficacy of cyclosporine and high-dose prednisolone in the treatment of both of these conditions.
    Keywords: ankylosing spondylitis, cyclosporine, prednisolone, scleromyxedema