Rheumatology Research Journal
Volume:5 Issue: 1, Winter 2020

Systemic sclerosis is an autoimmune disease, clinically characterized by vascular and immune dysfunction, leading to fibrosis that can damage multiple organs. The presence of non-overlapping SSc-associated autoantibodies best presents the autoimmune nature of systemic sclerosis. The primary purpose of this study was to investigate the autoantibody profile in Iranian patients with systemic sclerosis. Sera from 481 patients with systemic sclerosis were collected from 2013 to 2016. The level of anti-nuclear antibodies (ANA) was quantitatively detected using the indirect immunofluorescence (IIF) method and the level of specific autoantibodies including anti-topoisomerase I antibody (ATA), anti-centromere antibody (ACA) and anti RNA polymerase III antibody (anti-RNAP III) were also determined qualitatively by the enzyme-linked immunosorbent assays (ELISA) technique. Among all patients evaluated, we found a predominance of females (86.7%) and 434 (90.2%) of patients showed positive ANA results by IIF. ANA was detected in 87.3% and 92.0% of limited cutaneous systemic sclerosis (lcSSc) and diffuse cutaneous systemic sclerosis (dcSSc) patients, respectively, which was not significantly different. The frequency of anti-RNAP III, ACA and ATA was 5.19%, 6.02% and 72.3%, respectively. Furthermore, anti-RNAP III, ATA and ANA levels were correlated with dcSSc, whereas ACA level was correlated with lcSSc. We confirmed that ATA expression is significantly higher in dcSSc patients. Our results showed that we have a lower frequency of ACA (6.02%) than most previous cohorts. The results of this study demonstrate that the clinical subtype of systemic sclerosis may correlate positively with the presence of specific autoantibodies.

Systemic lupus erythematosus is an autoimmune disease that involves several systems of the body. Due to the chronic nature of this disease, non-adherence with medication regimen can lead to deterioration of the disease and also misinterpretation of treatment results. The aim of this study was to determine the medication adherence of patients with Systemic lupus erythematosus.

In this descriptive study, medication adherence was investigated in 209 patients with SLE who were attending lupus clinic of one of the hospitals affiliated to Tehran University of Medical Sciences. The samples who had the inclusion criteria were entered into the study in a convenience and continuous manner. Then, they completed a demographic information form and MMAS-8. Data were analyzed by SPSS software using descriptive statistics, chi-square and ANOVA tests.

The results showed that 18.7% of patients had high adherence to medication regimen, so that 94 patients (45.0%) had low adherence and 76 patients (36.4%) had moderate level of adherence to medication. Also, there was no significant relationship between the demographic and clinical variables of patients and their medication adherence.

Due to the low and moderate medication adherence of patients with Systemic lupus erythematosus, it is necessary to take measures to increase the medication adherence among these patients. It is also necessary to provide patient education by nurses and physicians in the clinic and to pay attention to this issue in medical and nursing programs.

Vasculitis is a rare disease and its prevalence varies according to age, race, time and geographical location. Due to the fact that no study has been conducted in Iran to investigate the frequency, clinical and laboratory symptoms of vasculitis in a considerable population of vasculitis patients, so the need for this study is felt. The aim of this study was to evaluate the frequency and clinical signs of granulomatosis with polyangitis (GP) patients who admited in rheumatology ward of Valiasr hospital in the last 10 years.

In this study, all patients with a possible diagnosis of vasculitis in the rheumatology ward of Valiasr Hospital during the past 10 years were evaluated. Then the GP patients were evaluated for clinical, laboratory, radiological, pathological findins, outcome, mortality, and major complications.

During the last 10 years, 223 vasculitis patients have been admitted to Valiasr hospital. Of these, 87 % were primary vasculitis and 13% were secondary vasculitis. The highest frequncy was related to GP (21.52 %) followed by Behcet's disease. Women and men were included 52.08 % and 47.91 % of GP patients, respectively. Upper and lower airway involvement and totally ear, nose and throat (ENT) involvement were the most common clinical symptoms in GP patients.

According to the finding of this study, GP vasculitis was the most common type of vasculitis that ENT involvements were the most common clinical symptoms in this patients. However, more studies are required to confirm these data in Iran.

Rheumatoid arthritis (RA) is a chronic, inflammatory autoimmune disease characterized by inflammatory arthritis, rheumatoid factor (RF) and anti-cyclic citrullinated peptide (Anti-CCP) autoantibodies. In the present study, the aim was to register RA patients in Tehran Imam Khomeini Hospital.

The study population was RA patients referred to the rheumatology clinic of Imam Khomeini Hospital in Tehran, who were visited at this clinic in 1398 and were diagnosed during the 5 years ago. Demographic, clinical, and laboratory information of patients at the beginning of referral, 3 months, 1, 2, 3, and 4 years after referral were carefully recorded in each patients’ questionnaire.

In the first visit, 79 RA patients were examined and in the other 5 visits, 73, 52, 33, 20, 13 patients and all of 270 visits were examined, respectively. RF and Anti-CCP were positive in 58.22% and 62.02% of patients, respectively.The mean age of patients was 52.5±11.25 years. The results of the present study showed that the mean morning stiffness, DAS, arthritis, arthralgia, ESR and CRP decreased from the second visit to the five visits, which indicates disease control.

Clinical and laboratory data showed considarable disease control, however, relapse of disease was seen due to drug discontinuation. Disease registry make it possible to recording the necessary information of each patient, including demographic, clinical, paraclinical findings and consultations, also gives the physician accurate access to patient information and unnecessary duplication of paraclinical examinations.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with an unknown etiology. Although there is no definite treatment for this disease but using proper prescribed medications, mortality and morbidity ratios could be decreased.

The present study has attempted to investigate the adherence to medical treatment in patients suffering from SLE and also evaluate the related factors which influenced on their adherence in order to improve patients’ prognosis. In this cross-sectional study, 132 patients with SLE referred to the rheumatology clinic of Imam Khomeini hospital (Tehran, Iran) over the period of 2012-2013 were examined using a questionnaire. The applied questionnaire included two parts; the first part pertains to adherence to medication treatments (CQR: compliance questionnaire rheumatology) and the second part was related to the factors involved in adherence to medication treatments. The obtained data was analyzed using Chi-Square test and processed by SPSS16.0 software.

In this research, the mean adherence to drug treatment was calculated as 72.48%. Among the variables of age, marital status, salary, education, distance from the clinic (accessibility), the duration of disease, the level of patient’s activity, main medications consumed and side effects, there was only a significant association between adherence level and the lack of side effects due to SLE (p

Ankylosing spondylitis (AS) is a chronic inflammatory disease, which can deteriorate the function of spine and peripheral joints. In addition to history and examination, imagin are important in diagnosing the disease. Especially, pelvic x-ray may shows pseudowidening, erosion and sclerosis sacroiliac joint. Spinal x-rays may also identify syndesmophytes. In more advanced stages, the spine may also be involved, forming a specific type of disease called “Bamboo spine”. The New York critera are used for diagnos of AS, which included radiologic and clinical criteria. The distribution of involvement in joints and bones in AS varies, but the classically is ascending involvement form sacroiliac joint, lumbar, and thoracic region.

Here is a case report of undiagnosed AS for 5 years, that despite the normal-appearing of the sacroiliac joint, has a severe involvement of the spinal column in the thoracic region, which called “Bamboo spine”. The time order of bone involvement in our patients is contrary to usual.Also, according to New York criteria for AS, our case was not included the AS definition, however, she had clinical symptome of AS, the Bamboo spine, and a dramatic respons to treatment of AS.

Paying attention to the course of the AS, as well as attention to the clinic and various imaging of the different parts (heart, lumbar spine, and sacroiliac joint) will help physicians to diagnose AS, accurately and timely manner. Also, radiologic manifestation in rheumatologic disease may occur without any predictable order.