Reumatismo 2019-07-19T16:00:43+02:00 Paola Granata Open Journal Systems <p>Official <em>Journal Of The Italian Society Of Rheumatology</em>. Founded In 1949.</p> <p><strong>Reumatismo</strong> is the Official Journal of the Italian Society of Rheumatology (SIR). It publishes Abstracts and Proceedings of Italian Congresses and original papers concerning rheumatology. Reumatismo is published quarterly and is sent free of charge to the Members of the SIR who regularly pay the annual fee. Those who are not Members of the SIR as well as Corporations and Institutions may also subscribe to the Journal.</p> <p>This journal does not apply the article processing charge&nbsp;to Authors as it is supported by institutional funds.</p> Vitamin D: no efficacy without deficiency. What’s new? 2019-07-19T16:00:41+02:00 A. Fassio M. Rossini D. Gatti <p>Not available</p> 2019-07-09T09:43:08+02:00 ##submission.copyrightStatement## Health-related quality of life burden in scleroderma patients treated with two different intravenous iloprost regimens 2019-07-19T16:00:41+02:00 T. Schioppo L. Scalone P. Cozzolino L. Mantovani G. Cesana O. De Lucia A. Murgo F. Ingegnoli <p>Systemic sclerosis (SSc)-related Raynaud’s phenomenon (RP) and digital ulcers (DU) can impair health-related quality of life (HRQoL). The aim of our study was to estimate HRQoL in SSc patients treated with two different intravenous (IV) iloprost (ILO) regimens and in patients not treated with IV ILO. 96 consecutive SSc patients were enrolled in a pragmatic, prospective and non-randomized study, and divided into 3 groups: not requiring therapy with IV ILO (N=52), IV ILO once monthly (N=24) or IV ILO for 5 consecutive days every 3 months (N=20). Patients were followed up for three months. We assessed HRQoL using the generic preference-based questionnaire EQ-5D-5L. We conducted multiple regression analyses to estimate, in each treatment group, the mean general health (GH) and the mean utility index of the EQ-5D-5L, adjusting for possible confounders. The mean adjusted utility index and GH score, after three months’ follow-up, were not different in the three groups: IV ILO was able to make patients requiring IV ILO similar to those not requiring it. Moreover, there was no difference in this model between the two ILO regimens (1 day monthly vs 5 consecutive days every 3 months). The two different IV ILO regimens (the most appropriate regimen was decided according to patients’ characteristics and needs) were able to stabilize HRQoL in RP secondary to SSc non-adequately controlled by oral therapy.</p> 2019-07-09T10:00:42+02:00 ##submission.copyrightStatement## Pain and quality of life in knee osteoarthritis, chronic low back pain and fibromyalgia: a comparative cross-sectional study 2019-07-19T16:00:43+02:00 M. de Oliveira Paes Leme S.L.K. Yuan M. Oliveira Magalhães S.R. Ferreira de Meneses A.P. Marques <p>The objective of our study was to compare pain and health-related quality of life among patients with knee osteoarthritis (OA), chronic nonspecific low back pain (CNLBP) and fibromyalgia (FM). This cross-sectional study included 87 subjects, who were divided into three groups according to their diagnosis: knee OA (n=29), CNLBP (n=29) and FM (n=29), between March 2013 and March 2014. Pain intensity was measured using the Numeric Pain Rating Scale (NPRS), quality of pain using the McGill Pain Questionnaire (MPQ) and health-related quality of life using the 36-item Short-Form Health Survey (SF-36). Painful body areas were marked on a pain map. No statistically significant differences between groups were found for NPRS. Regarding MPQ, the knee OA group presented a lower pain-rating index in contrast to the CNLBP and FM groups, and no significant differences were found between the CNLBP and FM groups. A greater number of characteristic pain descriptors and painful locations were found in the FM group than in the CNLBP or knee OA groups. Regarding SF-36, the FM group presented statistically significant lower values for bodily pain in contrast to the knee OA group. Even though the global pain intensity was similar between groups, the findings suggest that the FM group presented the worst pain experience and a lower health-related quality of life than the knee OA group in terms of bodily pain. They also suggest that the pain experience was worse for the CNLBP group than for the knee OA group but health-related quality of life was similar.</p> 2019-07-09T00:00:00+02:00 ##submission.copyrightStatement## Tophi reduction: ultrasound imaging and correlation with plasma levels of uric acid in patients undergoing treatment for tophaceous gout 2019-07-19T16:00:40+02:00 A.J.L. Ferrari A.R. Corrêa Fernandes R. de Almeida Agustinelli H. Seike E. de Ávila Fernandes <p>The objective was to determine the reduction of tophi in patients undergoing drug therapy in correlation with urate serum levels through ultrasound examination. A total of 31 male patients, between the ages of 33 to 77 years, with tophaceous gout were evaluated between 2005 and 2009, 11 of which were selected. Ultrasound examinations of visible tophi and evaluations of serum uric acids levels were performed annually on each patient. There was a statistically significant difference between measurements 1, 2, 3 and measurement 4 and between measurements 4 and 5. A strong significant positive association was seen between variation of tophus size and the reduction of serum uric acid levels.</p> 2019-07-09T10:30:30+02:00 ##submission.copyrightStatement## Radiological features of knee joint synovial chondromatosis 2019-07-19T16:00:39+02:00 E. Boninsegna A. Fassio M. Testoni D. Gatti O. Viapiana G. Mansueto M. Rossini <p>Synovial chondromatosis (SC) is a rare condition with a very variable clinical presentation, thus making the diagnosis not immediate. We report a case of massive primary SC of the knee, properly evaluated with X-rays, ultrasonography and magnetic resonance imaging and successfully treated with an arthroscopic approach.</p> 2019-07-09T10:39:00+02:00 ##submission.copyrightStatement## A new MEFV gene mutation in an Iranian patient with familial Mediterranean fever 2019-07-19T16:00:38+02:00 S. Farjadian F. Bonatti A. Soriano M. Reina A. Adorni C. Graziano M. Moghtaderi A. Percesepe G. Romeo D. Martorana <p>Familial mediterranean fever (FMF) is an inherited autoinflammatory disorder characterized by recurrent episodes of fever and painful inflammation involving the intra-abdominal organs, the lungs and the joints, which is highly prevalent in specific ethnic groups including the Iranians. We report a 12-year-old boy from Iran, with a clinical history of recurrent fever. Based on the suggestive clinical data, mutational analysis revealed the presence of the novel c.1945C&gt;T heterozygous variant in exon 10, which leads to a leucine to phenylalanine change at position 649 of the protein. The mutation was inherited from the mother. This novel mutation lies in exon 10 of the <em>MEFV</em> gene, which encodes for a domain called B30.2-SPRY, located in the C-terminal region of the pyrin protein and contains the most frequent mutations associated with FMF. The present report expands the spectrum of <em>MEFV</em> gene mutations associated with FMF. The uniqueness of this study, compared with other published case reports, consists in the new mutation found in the <em>MEFV</em> gene. In fact, new mutations in this gene are of high interest, in order to better understand the role of this gene in autoinflammation.</p> 2019-07-09T10:58:48+02:00 ##submission.copyrightStatement## Occult axial involvement in patients with psoriatic arthritis mutilans: a case report 2019-07-19T16:00:38+02:00 F.M. Perrotta S. Scriffignano A. De Socio E. Lubrano <p>We present the case of a patient with psoriatic arthritis (PsA) mutilans and occult axial involvement. The patient had suffered from PsA mutilans for more than a decade, with severe residual articular damage, but had been in clinical remission for years. Clinical axial involvement was never reported; however, magnetic resonance imaging of the sacroiliac joints, performed for other reasons, documented active inflammation and damage even without clinical symptoms. These findings corroborated the hypothesis that axial involvement could be asymptomatic, subclinical and, furthermore, underdiagnosed or even occult in patients with PsA mutilans, in which cases it should be carefully evaluated.</p> 2019-07-09T11:10:56+02:00 ##submission.copyrightStatement## Catastrophic antiphospholipid syndrome as a complication of systemic sclerosis 2019-07-19T16:00:37+02:00 D.J. Manzella L. Vicente A.A. Pérez de la Hoz R.J. Zamora G. De Rosa A.A. Pisarevsky <p>A 62-year-old man with a history of systemic sclerosis was admitted with diffuse alveolar hemorrhage and acute kidney injury without clinical data suggestive of glomerulonephritis. Laboratory tests showed anemia, leukocytosis with neutrophilia, thrombocytopenia, elevated serum creatinine and metabolic acidosis. Antinuclear antibodies were positive at a titer of 1/640 (speckled, 1/160; nucleolar, 1/320) while rheumatoid factor, anti Scl-70, anti-centromere, anti-neutrophil cytoplasmic antibody and anti-glomerular basement membrane antibodies were negative and serum complement levels were within normal range. During the following days, the patient developed multiple organ failure and, eventually, died. Lupus anticoagulant was revealed positive after the patient’s death, suggesting a catastrophic antiphospholipid syndrome. Clinical data and autopsy were consistent with this diagnosis.</p> 2019-07-09T11:23:31+02:00 ##submission.copyrightStatement## Etanercept biosimilar associated with Guillain-Barré syndrome: insights from a case 2019-07-19T16:00:35+02:00 V. Shobha A.M. Desai T. Matthew <p>Anti-tumor necrosis factor drugs are used routinely according to treatment guidelines for several chronic rheumatologic problems. However, a rare and usually unpredictable adverse drug reaction namely peripheral nervous system demyelination is being increasingly recognized. Biosimilars are gaining momentum especially in countries like India. Hence, we report a case of Guillain-Barré syndrome secondary to an etanercept biosimilar, probably the first case reported so far.</p> 2019-07-09T11:35:14+02:00 ##submission.copyrightStatement## Pulmonary multiple cystic lesions in a patient with Behçet’s syndrome 2019-07-19T16:00:34+02:00 M.E. Tezcan B. Isci <p>Pulmonary involvement, mainly originating from vasculitis, is one of the features of Behçet’s syndrome (BS). We describe, for the first time in literature, computerised tomography images of a male BS patient with multiple pulmonary cystic lesions possibly originated from vasculitis or bronchiolar stenosis.</p> 2019-07-09T11:50:12+02:00 ##submission.copyrightStatement## Kikuchi-Fujimoto disease with multiple extra-nodal features - A clinical mimic 2019-07-19T16:00:33+02:00 C.A. Mansoor Z. Shemin <p>Extranodal involvement in Kikuchi’s disease is uncommon. A 31-year-old previously healthy Indian woman was admitted with high grade fever, multiple joint pain and skin rash for 3 weeks. She had negative anti-nuclear antibodies and had features of Kikuchi’s disease on lymph node biopsy. She also had multiple extranodal manifestations including erythematous maculopapular rash, symmetric polyarthritis and hepatosplenomegaly. Kikuchi’s disease with extranodal involvement can clinically mimic diseases like hematological malignancies, connective tissue disorders and certain infections. A lymph node biopsy plays a crucial role in making an accurate diagnosis by excluding other diseases. A discussion on the importance of differentiating Kikuchi’s disease from systemic lupus erythematosus is included.</p> 2019-07-09T11:58:28+02:00 ##submission.copyrightStatement## Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus 2019-07-19T16:00:33+02:00 G. Tansir P. Kumar A. Pius S.K. Sunny M. Soneja <p>Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.</p> 2019-07-09T12:07:23+02:00 ##submission.copyrightStatement## Angioleiomyoma as a rare cause of a painful subcutaneous nodule in the leg: a case report 2019-07-19T16:00:30+02:00 A.A. Younis R.A. Hamed I.H. Abdulkareem <p>Angioleiomyomas are benign tumors originating in the vascular smooth muscles. The tumor typically presents as a painful, solitary, small subcutaneous nodule. Herein, we have described a case report of chronic leg pain due to angioleiomyoma. We outline the clinical, radiological and histopathological features of this rare diagnosis for a painful nodule of extremity. Although rare, angioleiomyoma should be included in the differential diagnosis of chronic leg pain.</p> 2019-07-09T12:14:35+02:00 ##submission.copyrightStatement##