No abstract available.
Antirheumatic Agents/*therapeutic use ; Arthritis, Rheumatoid/*drug therapy ; Humans ; Piperidines/*therapeutic use ; Pyrimidines/*therapeutic use ; Pyrroles/*therapeutic use

No Abstract available.
Ankle* ; Sarcoidosis* ; Tenosynovitis*

OBJECTIVE: Axial spondyloarthritis (axSpA) is often accompanied by cardiac manifestations, such as valvular heart disease. In this prospective cohort study, we evaluated the incidence of cardiac abnormalities in Korean axSpA patients by echocardiography. METHODS: AxSpA patients were prospectively recruited from a single tertiary hospital. Baseline demographic, clinical, radiographic, and echocardiographic data were collected at the time of enrollment. Echocardiography evaluations were performed with a focus on valvular heart disease and systolic and diastolic function. Logistic regression analyses were used to identify factors associated with diastolic dysfunction in axSpA. RESULTS: A total of 357 axSpA patients were included in the analyses, of whom 78 (21.8%) exhibited diastolic dysfunction, with no reports of systolic dysfunction. Thirteen patients (3.6%) had valvular heart disease, and aortic valve regurgitation (n=5) and mitral valve regurgitation (n=6) were most common. Multivariable logistic regression analyses indicated that older age and higher body mass index (BMI) were positively associated with diastolic dysfunction, whereas human leukocyte antigen (HLA)-B27 positivity was negatively associated with diastolic dysfunction. CONCLUSION Valvular heart disease is infrequent in Korean axSpA patients. However, diastolic dysfunction is common in axSpA patients, and is significantly associated with older age, higher BMI, and HLA-B27.

BACKGROUND/AIMS: Inhibition of tumor necrosis factor (TNF) is an effective treatment for rheumatoid arthritis (RA), but safety concerns about malignancy remain. The aim of this study was to evaluate cancer risk in RA patients treated with TNF inhibitors (TNFi), based on Korean Nationwide Health Insurance claims data. METHODS: Patients with seropositive RA were selected from the health insurance database containing all citizens' medical information, based on both RA diagnosis codes and medications. Between 2010 and 2014, RA patients treated with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) and TNFi were enrolled and followed up. We compared the cancer incidence between patients treated with TNFi and csDMARDs using incidence rate ratios (IRRs) after adjustment for age, gender, and observational periods. RESULTS: Of 45,423 selected patients with seropositive RA, 2,337 were treated with TNFi and 43,086 were treated with csDMARDs. The TNFi group was younger and was followed-up for a longer duration. During the observational period, 1,732 and 49 cases of cancer were detected in patients treated with csDMARDs and TNFi, respectively. Old age and male sex were associated with cancer occurrence. Adjusted IRRs for all cancers and common cancers demonstrated that cancer incidence did not differ significantly between the TNFi group and csDMARDs group (IRR = 0.913 for all cancers, p = 0.546). CONCLUSIONS This study revealed that cancer incidence was similar in RA patients treated with TNFi and csDMARDs. Anti-TNF therapy may be a safe therapeutic option for RA treatment, in terms of malignancy.

Dermatomyositis is an idiopathic inflammatory myopathy with characteristic cutaneous lesions and progressive symmetric proximal muscle weakness. An association between dermatomyositis and malignancy has long been reported on. A 73 year-old male patient with had biopsy-proven prostate cancer presented with typical skin lesions and proximal muscle weakness. On the laboratory findings, the muscle enzymes were prominently elevated. EMG and muscle biopsy showed typical findings that were consistent with dermatomyositis. The patient was successfully treated with systemic steroid, intravenous immunoglobulin and methotrexate. In Korea, dermatomyositis is frequently complicated by stomach, lung and breast cancers. To the best of our knowledge, this is the first Korean report of dermatomyositis accompanied by prostate cancer. Here, we describe the case of dermatomyositis with prostate cancer and we briefly review the relevant literatures.
Biopsy ; Breast ; Dermatomyositis ; Humans ; Immunoglobulins ; Korea ; Lung ; Male ; Methotrexate ; Muscle Weakness ; Muscles ; Myositis ; Prostate ; Prostatic Neoplasms ; Skin ; Stomach

No abstract available.
Stomach ; Vasculitis

Sjogren's syndrome is a chronic systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands resulting in a dry mouth and eyes. The disease can present either alone or in association with other autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and inflammatory myopathy. In addition to symptoms caused by exocrinopathy, about half of patients present with extraglandular (systemic) manifestations including arthritis, Raynaud's phenomenon, lymphadenopathy, vasculitis, peripheral neuropathy, and interstitial nephritis. Patients often suffer from severe fatigue, myalgia, and dryness, which lead to a poor quality of life. Physicians should be aware of the increased risk of lymphoma development in patients with Sjogren's syndrome. Currently, there are no drugs available that are able to improve the natural course of disease, making symptom relief the primary goal of therapy. Currently, pilocarpine is the only drug clinically proven for the treatment of dry eyes and mouth in patients with Sjogren's syndrome.
Arthritis ; Arthritis, Rheumatoid ; Autoimmune Diseases ; Exocrine Glands ; Fatigue ; Humans ; Lupus Erythematosus, Systemic ; Lymphatic Diseases ; Lymphoma ; Mouth ; Myalgia ; Myositis ; Nephritis, Interstitial ; Peripheral Nervous System Diseases ; Pilocarpine ; Quality of Life ; Scleroderma, Systemic ; Sjogren's Syndrome* ; Vasculitis

Infliximab is a chimeric monoclonal antibody against tumor necrosis factor-alpha (TNF-alpha) that is used to treat chronic inflammatory diseases such as ankylosing spondylitis (AS). Side effects include greater susceptibility to severe infections, such as tuberculosis. Positive diagnosis of tuberculous infections, such as tuberculous peritonitis, are often difficult due to the nonspecific nature of symptoms and the rarity of the infection, with definitive diagnoses requiring either a positive culture or histological biopsy. Here, we describe a case of tuberculous peritonitis during infliximab therapy in a 71-year-old man with AS; the disease was confirmed via histopathological examination.
Aged ; Biopsy ; Diagnosis ; Humans ; Peritonitis ; Peritonitis, Tuberculous* ; Spondylitis, Ankylosing* ; Tuberculosis ; Tumor Necrosis Factor-alpha ; Infliximab