Database : MEDLINE
Search on : Polymyalgia and Rheumatica [Words]
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[PMID]: 29380162
[Au] Autor:Charpentier A; Verhoeven F; Sondag M; Guillot X; Prati C; Wendling D
[Ad] Address:Service de Rhumatologie, CHRU Besancon, 2 Boulevard Fleming, F-25030, Besançon, France.
[Ti] Title:Therapeutic response to prednisone in relation to age in polymyalgia rheumatica: a comparison study.
[So] Source:Clin Rheumatol;37(3):819-823, 2018 Mar.
[Is] ISSN:1434-9949
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:The aim of this study was to evaluate the impact of age on the therapeutic response to prednisone. This was a retrospective, monocentric study. We included patients diagnosed with PMR, according to ACR 2012 criteria. Patients were classified into two groups according to age (above or below 60 years old). We registered demographic, clinical, biological, imaging data, and therapeutic response profile. Local inflammation was evaluated at baseline with PET/CT imaging score. The treatment was standardised. The main endpoint was a corticosteroid dependence defined by the recurrence of PMR symptoms and/or the increase of CRP at two times. We included 14 patients younger than 60 years old (mean age 54 ± 0.8) and 28 patients older than 60 (mean age 75.8 ± 1.5). The "young PMR" group was mainly male (60 vs 27%; p < 0.05). Both groups were similar regarding morning stiffness, disease duration, WBC count, and CRP. The intensity of FDG uptake was lower (score of 16.9 ± 1.7 vs 26.5 ± 3.0; p < 0.05), there were more dependence on corticosteroids (60 vs 20%; p < 0.05) and methotrexate was more necessary (35 vs 6.5%; p < 0.05) in "young PMR" group. Young patients diagnosed with PMR are mostly men, are more dependent on corticosteroids, and have a lower PET-CT score at baseline in comparison to elderly patients diagnosed with PMR.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Process
[do] DOI:10.1007/s10067-018-3988-3

  2 / 2908 MEDLINE  
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[PMID]: 29346621
[Au] Autor:Devauchelle-Pensec V; Saraux L; Berthelot JM; De Bandt M; Cornec D; Guellec D; Marhadour T; Jousse-Joulin S; Gouillou M; Saraux A
[Ad] Address:Rheumatology Department, CHU Brest, Brest.
[Ti] Title:Assessing polymyalgia rheumatica activity when C-reactive protein is unavailable or uninterpretable.
[So] Source:Rheumatology (Oxford);, 2018 Jan 15.
[Is] ISSN:1462-0332
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Objective: The PMR activity score (PMR-AS) includes the CRP value, which may be lacking or invalid owing to anti-IL-6 therapy. Our objective was to develop alternatives to PMR-AS that do not require CRP. Methods: We used the Club Rhumatisme et Inflammation (CRI; 89 patients with PMR) and the Tolerance and Efficacy of tocilizumab iN pOlymyalgia Rheumatica (TENOR; 20 patients with recent-onset PMR naive to glucocorticoid who received three tocilizumab infusions, at weeks 0, 4 and 8, followed by prednisone from weeks 12 to 24) cohorts. In the CRI cohort, we evaluated correlations between PMR-AS items to select the best item for imputing CRP. Then we calculated the PMR-AS with (PMR-AS) and without (clin-PMR-AS) CRP and we used the linear regression between PMR-AS and clin-PMR-AS to obtain CRP-imputed (CRP-imp) PMR-AS. Finally, we evaluated agreement between clin-PMR-AS, CRP-imp PMR-AS, PMR-AS and ESR-PMR-AS in the TENOR cohort during tocilizumab therapy. Results: In the CRI cohort, agreement between PMR-AS and clin-PMR-AS was excellent (κ = 0.90). Linear regression between PMR-AS and clin-PMR-AS [CRP-imp PMR-AS = 1.12(clin-PMR-AS)+0.26] allowed us to build the CRP-imp PMR-AS. Mean (s.d.) values were as follows: 8.40 (9.76) for PMR-AS, 7.24 (8.58) for clin-PMR-AS and 7.84 (9.61) for CRP-imp PMR-AS. CRP-imp PMR-AS agreed more closely with PMR-AS than did clin-PMR-AS. The results in the TENOR cohort confirmed that CRP-imp PMR-AS or ESR-PMR-AS could be used. Conclusion: Alternatives to the PMR-AS obtained without CRP can be used to monitor PMR activity in everyday practice in patients without available CRP values and in those receiving IL-6 antagonist therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1093/rheumatology/kex477

  3 / 2908 MEDLINE  
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[PMID]: 29504436
[Au] Autor:Leuchten N; Aringer M
[Ad] Address:Division of Rheumatology, Department of Medicine III, University Medical Center & Faculty of Medicine Carl Gustav Carus at the TU Dresden, Dresden, Germany.
[Ti] Title:Tocilizumab in the treatment of giant cell arteritis.
[So] Source:Immunotherapy;, 2018 Mar 05.
[Is] ISSN:1750-7448
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Giant cell arteritis is a systemic vasculitis of large vessels, manifesting mainly as temporal arteritis or large vessel vasculitis of the aorta and its branches. Glucocorticoid therapy is essential and so far had to be continued over a period of 1.5-2 years, resulting in relevant morbidity through adverse effects. With the approval of tocilizumab, an effective glucocorticoid sparing option is now available. In two randomized controlled trials, a profound reduction of cumulative glucocorticoid dose, prolonged relapse-free remission and reduced number of adverse events in the treatment groups have been demonstrated. Therefore, tocilizumab constitutes a novel therapeutic option in giant cell arteritis. Its differential role in different subgroups, timing of tocilizumab therapy and optimal treatment duration remain to be determined.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher
[do] DOI:10.2217/imt-2017-0182

  4 / 2908 MEDLINE  
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[PMID]: 29363290
[Au] Autor:Richter MD; Pinkston O; Kottschade LA; Finnes HD; Markovic SN; Thanarajasingam U
[Ad] Address:Mayo School of Graduate Medical Education, Rochester, Minnesota.
[Ti] Title:Brief Report: Cancer Immunotherapy in Patients With Preexisting Rheumatic Disease: The Mayo Clinic Experience.
[So] Source:Arthritis Rheumatol;70(3):356-360, 2018 Mar.
[Is] ISSN:2326-5205
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To determine the risk of rheumatic disease flare and adverse effects in patients with preexisting rheumatic disease who were receiving immune checkpoint inhibitor (ICI) therapy. METHODS: A retrospective medical record review was performed to identify all patients who received ICI therapy at Mayo Clinic in Rochester, Minnesota between 2011 and 2016 (~700 patients). Those with a preexisting rheumatic disease were identified using specific diagnostic codes. RESULTS: Sixteen patients were identified (81% female, median age 68.5 years). The most common rheumatic diseases were rheumatoid arthritis (n = 5), polymyalgia rheumatica (n = 5), Sjögren's syndrome (n = 2), and systemic lupus erythematosus (n = 2). Seven patients were receiving immunosuppressive therapy or glucocorticoids for their rheumatic disease at the time of initiation of the ICI. The primary malignancies were melanoma (n = 10), pulmonary (n = 4), or hematologic (n = 2). In most cases, ICIs were offered only after failure of several other therapies. Immune-related adverse effects (IRAEs) occurred in 6 patients, and all were treated successfully with glucocorticoids and discontinuation of the ICI therapy. There were no significant differences in time from cancer diagnosis to immunotherapy, duration of immunotherapy, age, or sex between the patients with and those without IRAEs. CONCLUSION: To our knowledge, this represents the largest single-center cohort of patients with rheumatic diseases who were exposed to modern cancer immunotherapy. Only a minority of these patients experienced a flare of their preexisting rheumatic disease or any other IRAE.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1801
[Cu] Class update date: 180226
[Lr] Last revision date:180226
[St] Status:In-Data-Review
[do] DOI:10.1002/art.40397

  5 / 2908 MEDLINE  
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[PMID]: 29476746
[Au] Autor:Suzuki S; Hirose Y; Takeda E; Ikusaka M
[Ad] Address:Department of General Medicine, Chiba University Hospital, 1-8-1, Inohana, Chuo-ku, Chiba-City, Chiba 260-8677, Japan. Electronic address: shngszkthk@yahoo.co.jp.
[Ti] Title:Polymyalgia Rheumatica with Normal Inflammatory Markers.
[So] Source:Am J Med;, 2018 Feb 21.
[Is] ISSN:1555-7162
[Cp] Country of publication:United States
[La] Language:eng
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180224
[Lr] Last revision date:180224
[St] Status:Publisher

  6 / 2908 MEDLINE  
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[PMID]: 29381956
[Au] Autor:Péricart S; Martin-Blondel G; Franchet C; Hitzel A; Brousset P
[Ad] Address:Departement de Pathologie, Institut Universitaire du Cancer Oncopole de Toulouse.
[Ti] Title:18F-Fluorodeoxyglucose positron emission tomography computed tomography detection threshold in follicular lymphoma: A case report.
[So] Source:Medicine (Baltimore);96(47):e8705, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Follicular Lymphoma in situ is generally identified as reactive follicular hyperplasia in which some of the hyperplastic germinal centers are colonized by few lymphoma cells. These cells can be detected through their strong 18F-Fluorodeoxyglucose avidity. PATIENT CONCERNS: We report the case of a 70 year-old patient with arthralgia, weight loss and chronic fever over two months. A paraneoplastic polymyalgia rheumatica was initially suspected on abnormal 18F fluoro-deoxyglucose positron emission tomography (PET) pictures in two inguinal lymph nodes with a standardized uptake value at 8.6 and 5.8. DIAGNOSES: The PET lymph nodes were removed and histological examination revealed subtle lymph nodes infiltration by follicular lymphoma in situ. The absolute number of the follicular lymphoma cells determined using virtual imaging and 3D reconstruction appeared very low with a total tumor cell volume estimated at around 0.026 mm for one lymph node and 0.041 mm for the other. INTERVENTIONS: The patient has been treated by corticotherapy alone. OUTCOMES: A long-time follow-up should be highly suggested for this patient to avoid any risk of clinical progression to follicular lymphoma. LESSONS: Our findings show that low amounts of follicular lymphoma cells in reactive germinal center may reach a threshold of hypermetabolism detectable with positron emission tomography imaging, suggesting that tumor microenvironment also accounts for such as strong fluoro-deoxyglucose avidity. Thus, a systematic immunohistochemistry with anti-BCL2 antibodies should be performed on PET positive lymph node with apparent normal morphological features.
[Mh] MeSH terms primary: Lymphoma, Follicular/diagnostic imaging
Lymphoma, Follicular/pathology
Positron Emission Tomography Computed Tomography/methods
[Mh] MeSH terms secundary: Adrenal Cortex Hormones/therapeutic use
Aged
Diagnosis, Differential
Fluorodeoxyglucose F18
Germinal Center/pathology
Humans
Lymphoma, Follicular/drug therapy
Male
Radiopharmaceuticals
Sensitivity and Specificity
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Nm] Name of substance:0 (Adrenal Cortex Hormones); 0 (Radiopharmaceuticals); 0Z5B2CJX4D (Fluorodeoxyglucose F18)
[Em] Entry month:1802
[Cu] Class update date: 180220
[Lr] Last revision date:180220
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008705

  7 / 2908 MEDLINE  
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[PMID]: 29456155
[Au] Autor:Castro Corredor D; Ramírez Huaranga MA; Rebollo Giménez AI; Arenal López R; Cuadra Díaz JL
[Ad] Address:Servicio de Reumatología, Hospital General Universitario de Ciudad Real, Ciudad Real, España. Electronic address: d.castrocorredor@gmail.com.
[Ti] Title:Síndromes reumáticos y tumor oculto, experiencia de 10 años en un hospital universitario. Rheumatic Syndromes and Occult Tumor: 10-year Experience in a Teaching Hospital.
[So] Source:Reumatol Clin;, 2018 Feb 15.
[Is] ISSN:1885-1398
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:OBJECTIVE: To describe the different clinical characteristics of patients admitted to the Rheumatology Department due to rheumatic manifestations as the first expression of an unknown malignant process. PATIENTS AND METHODS: Retrospective and descriptive observational study involving the review of the medical records of those admitted to rheumatology in the University Hospital of Ciudad Real between January 2007 and August 2017 for initial rheumatic manifestations with a suspicion at discharge of an unknown tumor. RESULTS: In all, 64 patients were identified from more than 500 admissions. The most common rheumatic manifestations were inflammatory low back pain, polyarthralgia, hip pain, thoracic spine pain, cervical pain, polyarthritis and polymyalgia rheumatica. Forty-four percent had low hemoglobin, 70% had elevation of acute-phase reactants, 62% had abnormal tumor markers, 76% had metastatic lesions. In 20% the primary tumor was of pulmonary origin and only 26.56% received palliative treatment; 64% died. DISCUSSION: It is important to consider the possibility of an underlying malignant process in the differential diagnosis since its early identification can be determinant for prognosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180219
[Lr] Last revision date:180219
[St] Status:Publisher

  8 / 2908 MEDLINE  
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[PMID]: 29427822
[Au] Autor:de Boysson H; Daumas A; Vautier M; Parienti JJ; Liozon E; Lambert M; Samson M; Ebbo M; Dumont A; Sultan A; Bonnotte B; Manrique A; Bienvenu B; Saadoun D; Aouba A
[Ad] Address:Department of Internal Medicine, Caen University Hospital, Caen, France; University of Normandy, Caen, France. Electronic address: deboysson-h@chu-caen.fr.
[Ti] Title:Large-vessel involvement and aortic dilation in giant-cell arteritis. A multicenter study of 549 patients.
[So] Source:Autoimmun Rev;, 2018 Feb 07.
[Is] ISSN:1873-0183
[Cp] Country of publication:Netherlands
[La] Language:eng
[Ab] Abstract:OBJECTIVES: Large-vessel involvement (LVI) can occur in giant-cell arteritis (GCA) and may represent a distinct disease subgroup with a higher risk for aortic dilation. This study aimed to better characterize the presentation and evolution of LVI in patients with GCA. PATIENTS AND METHODS: A retrospective multicenter study enrolled 248 GCA patients with LVI and 301 GCA patients without LVI on imaging. Factors associated with aortic dilation were identified in a multivariable model. RESULTS: The patients with LVI were younger (p<0.0001), more likely to be women (p=0.01), and showed fewer cephalic symptoms (p<0.0001) and polymyalgia rheumatica (p=0.001) but more extracranial vascular symptoms (p=0.05) than the patients without LVI. Glucocorticoids (GC) management did not differ between the two groups, but the GC discontinuation rate was lower in the patients with LVI (p=0.0003). Repeated aortic imaging procedures were performed at 19months [range: 5-162months] and 17months [range: 6-168months] after diagnosis in 154 patients with LVI and 123 patients without LVI, respectively, of whom 21% and 7%, respectively, presented new aortic dilations (p=0.0008). In the patients with LVI, aortic dilation occurred on an aorta segment shown to be inflammatory on previous imaging in 94% of patients. In the multivariate analysis, LVI was the strongest predictor of aortic dilation (hazard ratio: 3.16 [range: 1.34-7.48], p=0.009). CONCLUSIONS: LVI represents a distinct disease pattern of GCA with an increased risk of aortic dilation. Control of the aortic morphology during follow-up is required.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1802
[Cu] Class update date: 180218
[Lr] Last revision date:180218
[St] Status:Publisher

  9 / 2908 MEDLINE  
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[PMID]: 29450875
[Au] Autor:Aydeniz A; Akaltun MS; Gür A; Gürsoy S
[Ti] Title:Ankilozan spondilit polimiyaljia romatika birlikteligi: Olgu sunumu. [Coexistence of polymyalgia rheumatica with ankylosing spondylitis: A case report].
[So] Source:Agri;30(1):35-37, 2018 Jan.
[Is] ISSN:1300-0012
[Cp] Country of publication:Turkey
[La] Language:tur
[Ab] Abstract:Ankylosing spondylitis is a chronic inflammatory disease that affects the spine and peripheral joints. Polymyalgia rheumatica is an inflammatory disease characterized by aching and prolonged morning stiffness mainly in the shoulder and pelvic girdles. Many other diseases may mimic polymyalgia rheumatica, and thus differential diagnosis is predominantly required. A wide variety of diseases, including spondyloarthropathies, may present polymyalgia-like symptoms, and two diseases rarely coexist. We present a case of a 54-year-old man who had been followed-up for ankylosing spondylitis and presented with pain in the shoulder and pelvic girdles, restricted movement, and morning stiffness for 2 months. Physical examination revealed that the pain was located mostly in the shoulder and pelvic girdles. In addition, increased erythrocyte sedimentation rate revealed the coexistence of the two diseases. Corticosteroid treatment dramatically improved the patient's symptoms and supported the diagnosis. This case demonstrated that ankylosing spondylitis may present polymyalgia-like symptoms, and the two diseases may rarely coexist in the elderly. The coexistence of these two diseases has been rarely reported in literature. Accurate diagnosis of the two diseases is essential for improving the patient's symptoms and quality of life.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Process
[do] DOI:10.5505/agri.2016.69672

  10 / 2908 MEDLINE  
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[PMID]: 29212985
[Au] Autor:Kondo N; Fukuhara T; Watanabe Y; Miyasaka D; Yamamoto N; Sato H; Wada Y; Nakatsue T; Fujisawa J; Sakuma M; Imai N; Yoda T; Narita I; Endo N
[Ad] Address:Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences.
[Ti] Title:Bone Formation Parameters of the Biopsied Ilium Differ between Subtrochanteric and Diaphyseal Atypical Femoral Fractures in Bisphosphonate-Treated Patients.
[So] Source:Tohoku J Exp Med;243(4):247-254, 2017 12.
[Is] ISSN:1349-3329
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Atypical femoral fractures (AFFs) are defined as atraumatic or low-trauma fractures located in the subtrochanteric or diaphyseal sites. Long-term bisphosphonates (BPs) are administered to prevent fragility fractures in patients with primary osteoporosis or collagen diseases who are already taking glucocorticoids (GCs). Long-term BP use is one of the most important risk factors for AFFs. Its pathogenesis is characterized by severely suppressed bone turnover (SSBT), but whether the characteristics of patients are different regarding to location of fracture site remains unknown. In this study, we compared the characteristics and bone histomorphometric findings between subtrochanteric and diaphyseal sites in patients with BP-associated AFFs. Nine women with BP-associated AFFs were recruited, including 3 with systemic lupus erythematosus, 2 with rheumatoid arthritis, 2 with primary osteoporosis, 1 with polymyalgia rheumatica, and 1 with sarcoidosis. Patients were divided into the subtrochanteric group (n = 5; average age, 52 years; BP treatment, 5.9 years) and the diaphyseal group (n = 4; average age, 77 years; BP treatment, 2.6 years). Compared with the diaphyseal group, the subtrochanteric group had significantly higher daily GC doses (average, 10.9 vs. 2.3 mg/day) and significantly lower serum 25-hydroxyvitamin-D levels (17.8 vs. 25.6 ng/mL). Bone histomorphometry of the biopsied iliac bone showed SSBT in 3 cases (subtrochanteric, n = 1; diaphyseal, n = 2). Osteoid volume and trabecular thickness were significantly lower in the subtrochanteric group than in the diaphyseal group. Bone formation was inhibited more severely in subtrochanteric than in the diaphyseal group due to the higher GC doses used.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1712
[Cu] Class update date: 180214
[Lr] Last revision date:180214
[St] Status:In-Process
[do] DOI:10.1620/tjem.243.247


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