Psoriatic arthritis is a chronic, seronegative spondyloarthropathy associated with psoriasis, depending on patient presentation treatment options range from non-pharmacologic measures to NSAIDs, ...DMARDs, and biologics. Secukinumab is a human monoclonal antibody that specifically targets interleukin-17 and has been shown to be highly effective in the treatment of psoriatic arthritis. As the use of IL-17 inhibitors has been approved in the treatment of psoriatic arthritis, clinicians need to be aware of unusual adverse events not previously observed in clinical trials. We report a rare case of Henoch-Schönlein purpura vasculitis induced by secukinumab in a 39-year-old patient. Therefore, using biologic drugs in clinical practice should be aware that cutaneous vasculitis may be triggered by anti-IL17 treatment, and early diagnosis always helps to decrease morbidity and reduce the amount of time to recovery as well as the impact on the quality of life disruption.
Catestatin (CST) is an important peptide that influences various inflammatory diseases. Our goal was to investigate CST concentrations in patients with RA compared to healthy subjects. This ...cross-sectional observational study included 80 patients with RA and 80 healthy control subjects. Demographic characteristics and laboratory parameters were recorded. Serum CST levels were determined by an enzyme-linked immunosorbent assay (ELISA). Serum CST levels were significantly higher in RA patients than in the control group (10.53 ± 3.90 vs 5.24 ± 2.37 ng/mL, p < 0.001). In RA patients, there was a statistically significant correlation between CST and patient age (r = 0.418, p < 0.001) and both DAS28 (r = 0.469, p < 0.001) and HAQ scores (r = 0.483, p < 0.001). There was a statistically significant correlation between serum CST levels and RA duration (r = 0.583, p < 0.001). Multiple linear regression analysis showed that serum CST levels retained a significant association with RA duration (β ± SE, 0.13 ± 0.04, p = 0.002) and DAS28 score (0.94 ± 0.45, p = 0.039) after model adjustment for age, body mass index (BMI) and HAQ score, with serum CST levels as a dependent variable. These findings imply that CST is possibly associated with RA complex pathophysiology and disease activity. However, future larger multicentric longitudinal studies are necessary to define the role of CST in RA.
Adropin is a secretory protein that mainly modulates metabolic homeostasis and endothelial function. There is growing evidence supporting association of adropin with various inflammatory diseases, ...including rheumatoid arthritis (RA). This study aimed to compare serum adropin levels between 70 patients with RA and 70 matched healthy controls. Furthermore, we explored adropin correlations with RA disease activity, glucose metabolism parameters and inflammatory biomarkers. Serum adropin levels were determined by a competitive enzyme-linked immunosorbent assay. Serum adropin levels were significantly lower in RA patients than in the control group (2.85 ± 0.91 vs. 4.02 ± 0.99 ng/mL,
< 0.001). In the RA group, serum adropin levels had a significant negative correlation with total cholesterol (r = -0.172,
= 0.043), HbA1c (r = -0.406,
< 0.001), fasting glucose (r = -0.377,
< 0.001) and HOMA-IR (the homeostasis model assessment-estimated insulin resistance; (r = -0.315,
= 0.008)). Multiple linear regression analysis showed that serum adropin levels retained a significant association with levels of fasting glucose (β ± SE, -0.450 ± 0.140,
= 0.002) and HbA1c (-0.528 ± 0.223,
= 0.021) after model adjustments. These findings imply that adropin could have an impact on metabolic homeostasis in RA, although further well-designed studies are warranted in order to establish this.
Aims/Introduction
Prediabetes (PD) represents a transitional state where the glucose levels are higher than normal, but not enough for diabetes mellitus diagnosis. As there is a growing number of the ...population with PD, its early detection and treatment could prevent the development of diabetes mellitus and its complications. We aimed to assess the overall knowledge of PD among medical professionals of different varieties.
Materials and Methods
A questionnaire‐based study addressing PD and type 2 diabetes mellitus knowledge among Southeastern European general practitioners, postgraduates, physicians and superior specialists was carried out.
Results
A total of 397 physicians completed the questionnaire. The total rate of correct answers from diabetologists, non‐diabetologist internists, residents and general practitioners was 69, 56.1, 54 and 53%, respectively. Questions related to the PD definition achieved a total of 46.6% correct answers. Correct responses considering the numerical definition of impaired fasting glucose and impaired glucose tolerance were 46.3 and 46.8%, respectively. Younger physicians had better knowledge of numerical values regarding PD and type 2 diabetes mellitus criteria (P < 0.001).
Conclusions
The present results show that overall knowledge of PD is poor among Southeastern European physicians, which necessitates adequate educational programs on PD in this region.
Prediabetes (PD) represents a transitional state where the glucose levels are higher than normal but not significant enough to be diagnosed with diabetes mellitus (DM). A questionnaire based study addressing knowledge on PD and type 2 DM was conducted among South‐Eastern Europe practitioners, and results indicated insufficient general knowledge on PD with only 55.5% of total correct answers. Prediabetes overall knowledge is poor among South‐Eastern physicians which might require adequate educational programs on PD in this region.
Uvod. Najčešći vaskulitisi gastrointestinalnog trakta (GIV) su oni posredovani imuno-kompleksima u sistemskom eritemskom lupusu, Sjögrenovoj bolesti, miješanoj bolesti vezivnog tkiva, IgA-vaskulitisu ...(IgAV). Gastrointestinalne (GI) manifestacije rijetko su vodeći simptom sustavnih vaskulitisa. Samo 1–5% bolesnika s reumatoidnim artritisom razvija kliničku sliku vaskulitisa gastrointestinalnoga trakta (GIV), dok ih do 40% ima GI simptome. GIV je rijetka, ali životno ugrožavajuća komplikacija u bolesnika sa sistemskim eritemskim lupusom (SLE ), s prevalencijom do 2,5%. Vodeći simptomi u bolesnika s GIV-om su bol u trbuhu, mučnina, povraćanje, proljev, opstrukcija tankog crijeva i obilno GI krvarenje. Cilj ovog rada bio je ispitati učestalost i klinička očitovanja GIV-a u bolesnika s različitim sustavnim autoimunim (AI) bolestima liječenih u KBC -u Split u desetogodišnjem razdoblju. Materijali i metode. R etrospektivno su analizirani podatci iz medicinske dokumentacije bolesnika koji su se liječili od SLE -a, Sjögrenovog sindroma (SjS), miješane bolesti vezivnog tkiva (MCTD ), sindroma vaskulitisa, IgA-vaskulitisa (IgAV) i i RA , a imali su anamnestičke podatke o boli u trbuhu ili endoskopske ili/i radiografske znakove GIV-a, u razdoblju od 1/2009. do 12/2018. Rezultati. Od ukupno 12 bolesnika s potvrđenom dijagnozom GIV-a, 9 su bili muškarci. Osam ih je imalo GIV u sklopu IgAV-a, dvije bolesnice u sklopu SLE -a, MPA jedna bolesnica, primarnog SS-a jedan bolesnik. U 6 slučajeva GIV je dokazan MSCT-om trbuha, u jednom PET -CT-om, u jednom patohistološki, a u 4 slučaja endoskopski. Vodeći simptom u četvoro bolesnika bila je bol u trbuhu s mučninom i povraćanjem, dva su imala su obilno GI krvarenje, jedna bolesnica je imala umor bez GI simptoma, a preostali kliničku sliku akutnog abdomena s radiološki verificiranim edemom i raslojavanjem stijenke crijeva uz ascites. GIV je bio uzrok smrti jedne bolesnice sa SLE -om. Ostali su imali dobar ili umjeren odgovor na liječenje glukokortikoidima i imunosupresivima. Zaključak. Zaključno, GIV je rijetka manifestacija sustavnih AI bolesti, ali klinička slika može biti vrlo teška i dovesti do fatalnog ishoda te je nužna brza dijagnoza i agresivno imunosupresivno liječenje.
Iz epidemioloških studija i longitudinalnih kohortnih praćenja proizlazi da bolesnici sa psorijatičnim artritisom
(PsA) češće od očekivanog obolijevaju od pridruženih komorbiditeta koji u znatnoj ...mjeri utječu na mortalitet, ukupni
morbiditet i kvalitetu života ovih bolesnika. Među navedenim komorbiditetima najčešće se pojavljuju pretilost, metabolički
sindrom, šećerna bolest, bolesti srca i krvnih žila, osteoporoza, autoimunosna bolest oka, upalna bolest crijeva,
depresija i anksioznost, maligne bolesti i oportunističke infekcije, fi bromialgija i nealkoholna masna bolest jetre.
Pravodobno prepoznavanje komorbidnih stanja znatno utječe na skrb za bolesnike, izbor terapijske strategije i uključivanje
drugih kliničara radi postizanja što boljega kliničkog ishoda. Stoga je za bolesnike sa PsA ključan multidisciplinarni
pristup kojim se, osim kožne i zglobne upale, evaluiraju svi aspekti njihove složene bolesti.
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