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Pistone F, Testa D, Martelli I, Sciascia G, Rizzelli GML, Tripoli A, De Marco S, Migliorini P, Tavoni AG. Mucocutaneous and gastrointestinal involvement of MIS-A in a 67-year-old man: a case report. Clin Exp Rheumatol 2024; 42:202. [PMID: 37706334 DOI: 10.55563/clinexprheumatol/5ox5gj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 07/21/2023] [Indexed: 09/15/2023]
Affiliation(s)
- Francesca Pistone
- Clinical Immunology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
| | - Davide Testa
- Clinical Immunology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Irene Martelli
- Clinical Immunology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Gabriella Sciascia
- Clinical Immunology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | | | | | | | - Paola Migliorini
- Clinical Immunology Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
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2
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Ursini F, Ruscitti P, Raimondo V, De Angelis R, Cacciapaglia F, Pigatto E, Olivo D, Di Cola I, Galluccio F, Francioso F, Foti R, Tavoni AG, D’Angelo S, Campochiaro C, Motta F, De Santis M, Bilia S, Bruno C, De Luca G, Visentini M, Ciaffi J, Mancarella L, Brusi V, D’Onghia M, Cuomo G, Fusaro E, Cipriani P, Dagna L, Guiducci S, Meliconi R, Iannone F, Iagnocco A, Giacomelli R, Ferri C. Systemic syndromes of rheumatological interest with onset after COVID-19 vaccine administration: a report of 30 cases. Clin Rheumatol 2022; 41:2261-2267. [PMID: 35091783 PMCID: PMC8799447 DOI: 10.1007/s10067-022-06078-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 01/05/2023]
Affiliation(s)
- Francesco Ursini
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Piero Ruscitti
- Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, Università degli studi Dell’Aquila, L’Aquila, Italy
| | - Vincenzo Raimondo
- Rheumatology Unit, Rheumatology Hospital “Madonna Dello Scoglio,” Traversa Mola, 88836 Cotronei, KR Italy
| | - Rossella De Angelis
- Rheumatology Clinic, Università Politecnica Delle Marche, Ospedale “Carlo Urbani”, Jesi, Italy
| | - Fabio Cacciapaglia
- Department of Emergence Medicine and Transplantation (DETO), Rheumatology Unit, University of Bari Aldo Moro, Bari, Italy
| | - Erika Pigatto
- Rheumatology Outpatient Clinic, Ospedale Villa Salus, Mestre, Italy
| | - Domenico Olivo
- Rheumatology Outpatient Clinic, San Giovanni di Dio Hospital, Crotone, Italy
| | - Ilenia Di Cola
- Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, Università degli studi Dell’Aquila, L’Aquila, Italy
| | - Felice Galluccio
- Department of Rheumatology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - Francesca Francioso
- Rheumatology Clinic, Università Politecnica Delle Marche, Ospedale “Carlo Urbani”, Jesi, Italy
| | - Rosario Foti
- Rheumatology Unit, A.O.U. Policlinico S. Marco - University of Catania, Catania, Italy
| | | | - Salvatore D’Angelo
- Rheumatology Institute of Lucania (IReL)-Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna Delle Grazie Hospital of Matera, Potenza, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele & Vita-Salute San Raffaele University, Milan, Italy
| | - Francesca Motta
- Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Maria De Santis
- Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy
| | - Silvia Bilia
- Department of Clinical Immunology, University of Pisa, Pisa, Italy
| | - Caterina Bruno
- Rheumatology Outpatient Clinic, Azienda Ospedaliera “Pugliese-Ciaccio”, Catanzaro, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele & Vita-Salute San Raffaele University, Milan, Italy
| | - Marcella Visentini
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Jacopo Ciaffi
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Luana Mancarella
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Veronica Brusi
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Martina D’Onghia
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Giovanna Cuomo
- Clinical Immunology Outpatient Clinic, Department of Medicine, “Luigi Vanvitelli” University of Campania, Napoli, Italy
| | - Enrico Fusaro
- Rheumatology Unit, Azienda Ospedaliero Universitaria Città Della Salute E Della Scienza Di Torino, Torino, Italy
| | - Paola Cipriani
- Department of Biotechnological and Applied Clinical Sciences, Rheumatology Unit, Università degli studi Dell’Aquila, L’Aquila, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS Ospedale San Raffaele & Vita-Salute San Raffaele University, Milan, Italy
| | - Serena Guiducci
- Department of Rheumatology, Azienda Ospedaliero Universitaria Careggi, Firenze, Italy
| | - Riccardo Meliconi
- Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Florenzo Iannone
- Department of Emergence Medicine and Transplantation (DETO), Rheumatology Unit, University of Bari Aldo Moro, Bari, Italy
| | - Annamaria Iagnocco
- Academic Rheumatology Centre, MFRU, Dipartimento Scienze Cliniche E Biologiche, Università Degli Studi Di Torino, Torino, Italy
| | - Roberto Giacomelli
- Unit of Allergology, Immunology, Rheumatology, Università Campus Bio-Medico Di Roma, Roma, Italy
| | - Clodoveo Ferri
- Rheumatology Unit, Rheumatology Hospital “Madonna Dello Scoglio,” Traversa Mola, 88836 Cotronei, KR Italy
- Rheumatology Unit, University of Modena and Reggio Emilia, Modena, Italy
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3
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Coi A, Barsotti S, Santoro M, Almerigogna F, Bargagli E, Caproni M, Emmi G, Frediani B, Guiducci S, Matucci Cerinic M, Mosca M, Parronchi P, Prediletto R, Selvi E, Simonini G, Tavoni AG, Bianchi F, Pierini A. Epidemiology of systemic sclerosis: a multi-database population-based study in Tuscany (Italy). Orphanet J Rare Dis 2021; 16:90. [PMID: 33596949 PMCID: PMC7890847 DOI: 10.1186/s13023-021-01733-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/03/2021] [Indexed: 12/12/2022] Open
Abstract
Background Systemic Sclerosis (SSc) is a chronic autoimmune disease with a complex pathogenesis that includes vascular injury, abnormal immune activation, and tissue fibrosis. We provided a complete epidemiological characterization of SSc in the Tuscany region (Italy), considering prevalence and incidence, survival, comorbidities and drug prescriptions, by using a multi-database population-based approach. Cases of SSc diagnosed between 1st January 2003 and 31st December 2017 among residents in Tuscany were collected from the population-based Rare Diseases Registry of Tuscany. All cases were linked to regional health and demographic databases to obtain information about vital statistics, principal causes of hospitalization, complications and comorbidities, and drug prescriptions. Results The prevalence of SSc in Tuscany population resulted to be 22.2 per 100,000, with the highest prevalence observed for the cases aged ≥ 65 years (33.2 per 100,000, CI 95% 29.6–37.3). In females, SSc was predominant (86.7% on the total) with an overall sex ratio F/M of 6.5. Nevertheless, males presented a more severe disease, with a lower survival and significant differences in respiratory complications and metabolic comorbidities. Complications and comorbidities such as pulmonary involvement (HR = 1.66, CI 95% 1.17–2.35), congestive heart failure (HR = 2.76, CI 95% 1.80–4.25), subarachnoid and intracerebral haemorrhage (HR = 2.33, CI 95% 1.21–4.48) and malignant neoplasms (HR = 1.63, CI 95% 1.06–2.52), were significantly associated to a lower survival, also after adjustment for age, sex and other SSc-related complications. Disease-modifying antirheumatic drugs, endothelin receptor antagonists, and phosphodiesterase-5 inhibitors were the drugs with the more increasing prevalence of use in the 2008–2017 period. Conclusions The multi-database approach is important in the investigation of rare diseases where it is often difficult to provide accurate epidemiological indicators. A population-based registry can be exploited in synergy with health databases, to provide evidence related to disease outcomes and therapies and to assess the burden of disease, relying on a large cohort of cases. Building an integrated archive of data from multiple databases linking a cohort of patients to their comorbidities, clinical outcomes and survival, is important both in terms of treatment and prevention.
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Affiliation(s)
- Alessio Coi
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.
| | - Simone Barsotti
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Michele Santoro
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy
| | - Fabio Almerigogna
- Immunoallergology Unit, , Careggi University Hospital, Florence, Italy
| | - Elena Bargagli
- Respiratory Diseases and Lung Transplantation, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Siena, Italy
| | - Marzia Caproni
- Rare Dermatological Diseases Unit, USL Toscana Centro, Firenze, Italy.,ERN-SKIN Diseases Centre, Department of Health Sciences, University of Florence, Firenze, Italy
| | - Giacomo Emmi
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, "Le Scotte" Hospital, Siena, Italy
| | - Serena Guiducci
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Marco Matucci Cerinic
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paola Parronchi
- Department of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy
| | - Renato Prediletto
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Enrico Selvi
- Rheumatology Unit, Azienda Ospedaliero Universitaria Senese, Siena, Italy
| | - Gabriele Simonini
- Rheumatology Unit, A. Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Antonio Gaetano Tavoni
- Clinical Immunology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Fabrizio Bianchi
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
| | - Anna Pierini
- Institute of Clinical Physiology, National Research Council, Via Moruzzi 1, Pisa, Italy.,Fondazione Toscana "Gabriele Monasterio", Pisa, Italy
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Fiacchini G, Cambi C, Tavoni AG, Bruschini L, Castellana R, Dallan I, Berrettini S. Skull-Base Inflammatory Pseudotumor Involving the Trigeminal and Facial Nerves: A Singular Presentation of a Rare Disease. Surg J (N Y) 2020; 6:e33-e36. [PMID: 32133412 PMCID: PMC7054056 DOI: 10.1055/s-0040-1702921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 01/14/2020] [Indexed: 11/18/2022] Open
Abstract
Inflammatory pseudotumor (IPT) is a rare disease that is often misinterpreted as a lymphoma or carcinoma. It may involve different body regions but most commonly the lungs and the orbital cavity. We report the case of a patient affected by an IPT of the trigeminal and facial nerves. A 69-year-old male presented to our hospital with a right facial palsy arisen suddenly 2 days before. A magnetic resonance imaging (MRI) of the head showed an abnormal mass with homogeneous enhancement involving the deep lobe of the parotid gland, the parapharyngeal space, and the infratemporal fossa, extending along the trigeminal nerve and the facial nerve. The patient was planned for multiple transnasal biopsies in the nasopharynx, the region of the foramen ovale, and the deep lobe of the parotid gland, but the results were inconclusive, with no evidence of a malignant process. We considered the possibility that the lesion could be an IPT, and the patient was treated with prednisone and cyclophosphamide. Three months after the conclusion of the treatment, an MRI showed a complete radiological response.
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Affiliation(s)
- Giacomo Fiacchini
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Christina Cambi
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Antonio Gaetano Tavoni
- Clinical Immunology Unit, Department of Clinical and Experimental Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Luca Bruschini
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Roberto Castellana
- Radiology Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Iacopo Dallan
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Stefano Berrettini
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
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5
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Moriconi D, Giannese D, Capecchi R, Cupisti A, Barsotti S, Morganti R, Orsitto E, Gaetano Tavoni A, Francesca Egidi M. Risk factors for relapse and long-term outcome of idiopathic retroperitoneal fibrosis. Clin Exp Nephrol 2019; 23:1147-1153. [PMID: 31230189 DOI: 10.1007/s10157-019-01759-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/20/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Retroperitoneal fibrosis (RF) is a rare disease of unclear etiology characterized by the presence of fibroinflammatory tissue in the retroperitoneal space, which can entrap and obstruct retroperitoneal structures, notably the ureters. The disease responds well to steroid therapy, but tends to recur even after years. The aim of our study was to evaluate the long-term renal outcome of patients affected by idiopathic retroperitoneal fibrosis looking for predictive risk factors for recurrence of the disease and progression to end-stage renal disease. METHODS Retrospective observational study of patients with idiopathic RF diagnosed from 2004 to 2017 and follow-up of at least 1 year after the end of first course therapy with steroid, with or without tamoxifen (TMX) and with urological procedures when applicable. RESULTS Forty-three patients were included in the study. The follow-up was 93 ± 52 months. All the patients obtained remission after therapy that was maintained until the last observation in 26 of them. In 17 patients, there was at least one recurrence. Risk factors associated with relapse were identified and resulted in smoking habit, onset with acute kidney injury (AKI), low back pain and antinuclear antibodies (ANA) positivity. Renal function remained fairly stable during the long-term follow-up. The renal end-point (doubling of serum creatinine or ESRD) occurred in 8% of the patients; however, eGFR in patients with relapse was similar to that of non-recurrent at the diagnoses, but it decreased over time more in the relapsing than in non-relapsing patients (p group = 0.20; p time = 0.001; p time × group interactions = 0.04). Based on these 4 predictor conditions, patients were divided into "low risk" (with 0-1 risk factor), and "high risk" (3-4 risk factors). The renal end-point occurred in 40% of high-risk patients, while none of the low-risk patients reached it (p = 0.02). CONCLUSIONS Smoking habit, AKI at diagnosis, ANA positivity and lumbar pain were associated with relapse of RF after initial remission due to steroid and/or TMX therapy; the combination of these conditions was also predictive of worse renal function outcome. Identification of risk factors for relapse can be useful not only to modulate the choice, the dosage of first-line treatment and the duration of maintenance therapy but also for preventing a progressive loss of kidney function, as well.
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Affiliation(s)
- Diego Moriconi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy.
| | | | - Riccardo Capecchi
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Simone Barsotti
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | | | - Eugenio Orsitto
- Radiology Unit, Emergency Department, AOUP Pisa, Pisa, Italy
| | - Antonio Gaetano Tavoni
- Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56126, Pisa, Italy
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6
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Moriconi D, Giannese D, Capecchi R, Barsotti S, Lucchese T, Tavoni AG, Egidi MF. FP078LONG-TERM EFFECTS AND OUTCOME OF IDIOPATHIC RETROPERITONEAL FIBROSIS MANAGEMENT. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Diego Moriconi
- Clinical and Experimental Medicine, Pisa University, PISA, Italy
| | | | | | - Simone Barsotti
- Clinical and Experimental Medicine, Pisa University, PISA, Italy
| | - Teresa Lucchese
- Clinical and Experimental Medicine, Pisa University, PISA, Italy
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7
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Moriconi D, Giannese D, Capecchi R, Barsotti S, Tavoni AG, Egidi MF. TO043RETROPERITONEAL FIBROSIS AND IGG4 RELATED DISEASE: TWO SIDES OF THE SAME COIN? Nephrol Dial Transplant 2017. [DOI: 10.1093/ndt/gfx134.to043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Barsotti S, Zampa V, Talarico R, Minichilli F, Ortori S, Iacopetti V, D'ascanio A, Tavoni AG, Bombardieri S, Mosca M, Neri R. Thigh magnetic resonance imaging for the evaluation of disease activity in patients with idiopathic inflammatory myopathies followed in a single center. Muscle Nerve 2016; 54:666-72. [PMID: 27279002 DOI: 10.1002/mus.25099] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 02/26/2016] [Accepted: 03/07/2016] [Indexed: 11/06/2022]
Abstract
INTRODUCTION In patients with idiopathic inflammatory myopathies (IIM), magnetic resonance imaging (MRI) has been proposed as a useful tool for diagnosis and follow-up. It may identify muscle inflammation (edema) and fatty infiltration for evaluation of disease activity and damage. Little information is available on the role of MRI in assessment of large cohorts of adult patients with IIM. METHODS Fifty-one patients underwent MRI of the thigh muscles, laboratory tests, and clinical evaluation, including Physician Global Assessment (PGA) of myositis activity and the Manual Muscle Test 8 (MMT8). RESULTS Muscle edema correlated significantly with creatine kinase values (P = 0.017) and PGA (P < 0.001). A significant correlation between edema and MMT8 values (P = 0.025) was observed when patients with muscle fatty infiltration were excluded. With respect to clinical diagnosis, the sensitivity of MRI was 92.3%, and specificity was 83.3%. CONCLUSIONS MRI appears to provide additional information that complements clinical and biochemical examinations. Muscle Nerve 54: 666-672, 2016.
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Affiliation(s)
- Simone Barsotti
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy. .,Genetic, Oncology and Clinical Medicine doctorate, University of Siena, Siena, Italy.
| | - Virna Zampa
- Department of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Rosaria Talarico
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabrizio Minichilli
- Unit of Environmental Epidemiology, Institute of Clinical Physiology, National Council of Research, Pisa, Italy
| | - Simona Ortori
- Department of Diagnostic and Interventional Radiology, University of Pisa, Via Roma 67, 56126, Pisa, Italy
| | - Valentina Iacopetti
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Anna D'ascanio
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Stefano Bombardieri
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marta Mosca
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rossella Neri
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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9
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Giannese D, Moriconi D, Capecchi R, Egidi MF, Tavoni AG. MP084RETROPERITONEAL FIBROSIS: A SINGLE CENTER EXPERIENCE WITH MULTIDISCIPLINARY APPROACH. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw183.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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10
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Carli L, Tani C, Querci F, Della Rossa A, Vagnani S, Baldini C, Talarico R, d'Ascanio A, Neri R, Tavoni AG, Bombardieri S, Mosca M. Analysis of the prevalence of cataracts and glaucoma in systemic lupus erythematosus and evaluation of the rheumatologists' practice for the monitoring of glucocorticoid eye toxicity. Clin Rheumatol 2013; 32:1071-3. [PMID: 23456414 DOI: 10.1007/s10067-013-2214-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 01/31/2013] [Accepted: 02/03/2013] [Indexed: 10/27/2022]
Abstract
Chronic glucocorticoid (GC) therapy is associated with an increased risk of developing cataracts and glaucoma, and recommendations have been developed for monitoring these side effects in patients with rheumatic diseases. The aim of this study was to assess the prevalence of cataracts and glaucoma and the adherence to the existing recommendations for monitoring eye toxicity of chronic GC therapy among systemic lupus erythematosus (SLE) patients in routine clinical practice. Clinical charts of 170 patients were examined, and 34 (20%) of them never underwent an eye assessment. The remaining 136 underwent an eye assessment with an interval of 75 ± 61.7 months. Only 45 (33%) had received an evaluation during the previous 12 months. All these 170 patients were taking chronic CG therapy at a mean daily dose of 5.4 ± 2.4 mg prednisone and a mean cumulative dose of 27.6 ± 20.5 g. Out of the 136 patients with at least one eye assessment, cataracts were observed in 39 patients (29%) and glaucoma in 4 patients (3%). Cataracts were diagnosed at a mean age of 46.5 ± 10 years; the development of cataracts was associated with age, disease duration, and cumulative GC dose. Glaucoma was diagnosed at a mean age of 40.5 ± 16 years; due to the small number of patients, no correlations were made. The prevalence of cataracts and glaucoma is higher than in the general population, and these conditions occur early in the life of SLE patients. An association between GC and cataracts is confirmed. The adherence to recommendations is suboptimal as only 33% of patients underwent an eye assessment over the previous 12 months. These data reinforce the need to improve adherence to recommendations for eye monitoring among SLE patients under chronic therapy with GC.
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Affiliation(s)
- L Carli
- Rheumatology Unit, University of Pisa, Via Roma, 67, 56126 Pisa, Italy
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11
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Baldini C, Mosca M, Della Rossa A, Pepe P, Notarstefano C, Ferro F, Luciano N, Talarico R, Tani C, Tavoni AG, Bombardieri S. Overlap of ACA-positive systemic sclerosis and Sjögren's syndrome: a distinct clinical entity with mild organ involvement but at high risk of lymphoma. Clin Exp Rheumatol 2013; 31:272-280. [PMID: 23343785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Accepted: 11/05/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES We aimed to assess the prevalence of patients with either primary Sjögren's syndrome (pSS) and positive anticentromere antibodies (ACA) and secondary Sjögren's syndrome (sSS) and limited cutaneous ACA positive-systemic sclerosis (SSc) in two large cohorts of patients with pSS and SSc¸ and also to compare the clinical features of these two subsets with those of patients affected by 'ACA-positive SSc without sicca symptoms' and 'pSS'. METHODS In this retrospective monocentric study, the case records of 'overlap' patients fulfilling both the classification criteria for SS and the LeRoy criteria for early SSc were identified from two datasets of patients with limited cutaneous ACA positive SSc (209 subjects) and with pSS (402 subjects) who attended our Rheumatology Unit in the years between 1989 and 2011. Control groups were represented by SSc subjects without sicca symptoms ('SSc group') and ACA negative Pss patients ('pSS group'). SSc patients with sicca symptoms ('Sicca-SSc group') who did not complete the diagnostic algorithm for SS were excluded from the analysis. Demographic, clinical and immunological data of the patients enrolled were collected cumulatively over the entire follow up period. Statistical analysis was performed using SPSS 13 (SPSS Inc., Chicago IL, USA). RESULTS Out of the two datasets 41 'overlap' patients were selected. The control groups were represented by 102/209 SSc subjects without sicca symptoms ('SSc group') and 387/402 pSS patients ('pSS group'). Eighty-one 'sicca-SSc' with an incomplete work-up for SS were excluded from the analysis. The prevalence of ACA positive pSS patients among pSS was 3.7% (15/402), while the frequency of patients with definite sSS in the SSc cohort was 20% (26/128). No differences were detected between 'overlap' patients and control groups, relatively to demographic characteristics. 'Overlap patients' were characterised by a milder SSc disease (i.e. lower frequency of sclerodactily, negative evolution of the capillaroscopy pattern or absence of severe systemic involvement) whereas, as far as the SS-related manifestations were concerned, although often lacking in specific autoantibodies (i.e. rheumatoid factor, anti-Ro/SSA, anti-La/SSB), the 'overlap patients' displayed a full blown SS phenotype with recurrent salivary gland enlargement, purpura, fatigue, arthralgias, and leukocytopenia. It is noteworthy that the prevalence of non-Hodgkin's lymphoma in the 'overlap patients' was higher than in pSS. CONCLUSIONS Taken together, the results of our work emphasise the existence of a novel distinct clinical entity which might tentatively be called 'ACA-positive limited scleroderma/SS overlap syndrome' characterised by a benign SSc clinical course but at a high risk of non-Hodgkin's lymphoma.
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Quartuccio L, Schiavon F, Zuliani F, Carraro V, Catarsi E, Tavoni AG, Bombardieri S, Punzi L, De Vita S. Long-term efficacy and improvement of health-related quality of life in patients with Takayasu's arteritis treated with infliximab. Clin Exp Rheumatol 2012; 30:922-928. [PMID: 23044074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 09/14/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To explore the efficacy in the long-term and the impact on Health Related Quality of Life (HRQOL) of infliximab in patients suffering from Takayasu's arteritis (TA). METHODS Clinical data were retrospectively collected in 15 patients with TA. Evaluation of Medical Outcomes Study Short Form 36 (SF-36) questionnaires was made at baseline and at the last follow-up in 10 patients continuing infliximab at the last follow-up. RESULTS Follow-up after initiation of infliximab was 71±44 months (range 10-162). Remission at the last follow-up was noted in 11/15 (73.3%). Significant reduction in BVAS score was noted at the last follow-up [from 4.0 (1-16) to 3.0 (0-9), p=0.003]. Significant steroid dose reduction was recorded [from 10 mg/day (0-50) to 2.5 mg/day (0-15), p=0.005)]. Steroid suspension occurred in 5/11 responder patients. Inflammatory markers were normalised in about two thirds of the patients. Radiological disease activity was assessed in 13/15 during infliximab therapy, with evidence of improvement in 2/13, stable disease activity in 9/13, and worsening in 2/13. No relevant side effects or severe infections were recorded during the whole follow-up under infliximab. One patient stopped infliximab at the third infusion for acute reaction. HRQOL in patients with TA was impaired, with major involvement of physical domains [(body pain (BP) and global health (GH)]. Infliximab significantly improved HRQOL, in particular BP (40.0±32.3 vs. 67.2±27.6, p=0.035), GH (31.2±21.5 vs. 54.9±21.1, p=0.007) and Vitality (VT) (47.0±28.7 vs. 67.0±20.3, p=0.01) domains. CONCLUSIONS Infliximab determined a sustained clinical improvement in the long-term in TA, with significant benefits on HRQOL.
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Affiliation(s)
- Luca Quartuccio
- Clinic of Rheumatology, Department of Medical and Biological Sciences (DSMB), University of Udine, Italy.
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Tavoni AG, Baldini C, Bencivelli W, Cavazzini L, Covelli M, De Vita S, Caporali R, Gerli R, Giansanti M, Govoni M, Donati V, Montecucco CM, Morbini P, Pilato FP, Resta L, Scott CA, Mosca M, Vitali C, Bombardieri S. Minor salivary gland biopsy and Sjögren's syndrome: comparative analysis of biopsies among different Italian rheumatologic centers. Clin Exp Rheumatol 2012; 30:929-933. [PMID: 23069002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 10/02/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES The minor salivary gland biopsy (MSGB) is widely considered an important component of the diagnostic algorithm of primary Sjögren's syndrome (pSS) and is mentioned in all the classification criteria sets for the disease. The aim of this study, coordinated by the Italian Society of Rheumatology, was to verify the inter-observer agreement on the evaluation of MSGB among different experienced Italian rheumatologic centres, in order to better standardise the diagnostic methodology. METHODS Seven centres participated in the study, providing a total of 50 MSGB samples. Each center blindly classified all the samples according to the Chisholm and Mason (CM) grading. The results were collected and analysed. RESULTS The inter-observer agreement was satisfactory when the samples were stratified as consistent and non-consistent with the final diagnosis of pSS (median κ =0.75; mean κ =0.70). Nonetheless, significant discrepancies in the histopathologic evaluation of MSGB emerged when the agreement was assessed on the single scores. Considering the modal CM grading for each sample as the correct grading, upon re-examination, a potential bias in the final clinical diagnosis was detected in 7 out of 50 samples. CONCLUSIONS This study has shown significant discrepancies in the evaluation of MSGB among different rheumatologic centres in the same country. Greater standardisation of the procedure is clearly necessary, both to improve the diagnostic performance and scientific communication.
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Affiliation(s)
- Antonio Gaetano Tavoni
- Clinical Immunology Unit, Department of Internal Medicine, University of Pisa, Pisa, Italy.
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Vergaro G, Catarsi E, Dascanio A, Fontana M, Aquaro GD, Pastormerlo LE, Valleggi A, Passino C, Emdin M, Tavoni AG. [Cardiomyopathy and hypereosinophilia: a post-partum case]. Recenti Prog Med 2009; 100:541-546. [PMID: 20178306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Cardiomiopathy and hypereosinophilia: a post-partum case. A case of cardiomyopathy and hyperoesinophilia observed soon after delivery is reported. A wide spectrum of different clinical entities characterized by peripheral hyperoesinophilia, tissue infiltration and eosinophil-mediated organ damage is referred to as hypereosinophilic syndrome and their distinction is often challenging. Cardiac involvement is frequent in such these syndromes and worsens prognosis. A prompt recognition and therapy of the underlying disease and of its peripheral expression, as in the following case, may improve patients' outcome.
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Affiliation(s)
- Giuseppe Vergaro
- U.O.C. Medicina Cardiovascolare, Fondazione Gabriele Monasterio, Pisa.
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