Abstract:
BACKGROUND:The predominant forms of adult large vessel vasculitis (LVV) are giant cell arteritis (GCA) and Takayasu arteritis (TA). Cardiac involvement in LVV is a cause of morbidity and mortality, particularly in TA. Cardiac failure is most commonly secondary to uncontrolled arterial hypertension or myocardial ischaemia. Pulmonary hypertension and aortic valve incompetence following ascending aortic dilatation represent other serious cardiovascular complications. However, cardiac failure as a consequence of myocarditis is rarely reported, principally in single case reports or in autopsy studies. METHODS:The Imperial College LVV database was, retrospectively, reviewed to identify patients with cardiac involvement at presentation. Patients with evidence for myocarditis were identified. The cardiac presentation, imaging studies and subsequent medical and surgical management were reviewed in detail. RESULTS:The cohort included 139 patients with TA and 24 with GCA. Sixteen presented with cardiac failure without a history of ischaemic coronary heart disease, 14 (10%) with TA and 2 (8.3%) with GCA. Cardiovascular disease identified at presentation included aortic regurgitation (n = 11), myocarditis (n = 4) and hypertensive cardiomyopathy secondary to renal artery stenosis (n = 1). Those patients with evidence of myocarditis at presentation (2.8%) underwent transthoracic echocardiography and cardiac magnetic resonance imaging (CMR). These non-invasive techniques were sufficient for diagnosis of clinically significant myocarditis. Furthermore, they were subsequently used to monitor response to treatment, with serial improvement in left ventricular ejection fraction (LVEF) observed in all 4 patients (p < 0.05). Prednisolone plus cyclophosphamide (CyC) therapy was associated with significant improvement in heart failure symptoms and LVEF in 3 cases. In one case where CyC was contraindicated, tocilizumab treatment led to marked improvement in cardiac symptoms. CONCLUSION:Clinically significant myocarditis in LVV remains a rare but serious presentation. Non-invasive imaging techniques offer an alternative to the gold-standard myocardial biopsy. Initial aggressive immunosuppressive therapy is recommended and led to significant improvements in LVEF and cardiac status.
journal_name
Semin Arthritis Rheumjournal_title
Seminars in arthritis and rheumatismauthors
Bechman K,Gopalan D,Nihoyannopoulos P,Mason JCdoi
10.1016/j.semarthrit.2017.03.023subject
Has Abstractpub_date
2017-10-01 00:00:00pages
241-246issue
2eissn
0049-0172issn
1532-866Xpii
S0049-0172(16)30438-3journal_volume
47pub_type
杂志文章abstract:OBJECTIVE:Behcet's disease (BD) is a systemic inflammatory disorder characterized by recurrent mucocutaneous ulcerations, ocular inflammation, and numerous severe systemic inflammatory manifestations. While most patients respond to standard immunosuppressive therapies, a subset will develop refractory disease. In this ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2010.12.002
更新日期:2011-10-01 00:00:00
abstract::Of an inception cohort of 87 patients with lupus nephritis who underwent a renal biopsy, 42 underwent second biopsies a median of 25 months later. From first to second biopsy, focal and diffuse proliferative nephritis (World Health Organization classes III and IV) became less frequent, and mesangial hypercellularity (...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/s0049-0172(05)80019-8
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVES:Posterior interosseous nerve (PIN) palsy is a very rare complication of rheumatoid arthritis affecting the elbow joint. It results in weakness of extension of the fingers and may be confused with extensor tendon rupture and wrist drop due to radial nerve damage. METHODS:We present a case of PIN palsy second...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2010.07.011
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:To analyze the effectiveness of immunosuppressants and biological therapies in autoimmune posterior uveitis, chronic anterior uveitis associated with juvenile idiopathic arthritis, and macular edema. METHODS:Systematic review. We conducted a sensitive literature search in Medline (from 1961) and EMBASE (fro...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2010.05.008
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:18F-FDG PET/CT has proved to be of potential value for early diagnosis of large-vessel vasculitis (LVV), which frequently involves the aorta. However, its role in the follow-up of these patients has not been well established. Our aim was to evaluate the contribution of 18F-FDG PET/CT in this clinical situatio...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2017.08.009
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Familial arthropathy comprises a heterogeneous group of arthropathies. It can be either an inflammatory or a noninflammatory condition. The worldwide frequency of these disorders is unknown. OBJECTIVE:To study the demographic, clinical and biochemical features, and survival of a large series of children wit...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2006.08.008
更新日期:2007-02-01 00:00:00
abstract::A variety of neurological complications may occur in the various connective tissue and "collagen-vascular" diseases. Most of these complications are due to vasculitis affecting various sites in the central or peripheral nervous system. While the evidence for definitive vasculitis in SLE is not strong, small vessel dam...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(81)90100-1
更新日期:1981-08-01 00:00:00
abstract:OBJECTIVES:The purpose of our study was to detect early clinical and laboratory signs that help to discriminate macrophage activation syndrome (MAS) from active systemic juvenile idiopathic arthritis (SJIA) without MAS. METHODS:Our retrospective study was based on reviewing the medical charts of the children admitted ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2014.09.004
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:Glucocorticoids (GC) are the mainstay of treatment of polymyalgia rheumatica (PMR). However GC-related adverse events occur frequently, particularly in patients with relapsing disease. Several studies have demonstrated that IL-6 is a key player in the pathogenesis of PMR. OBJECTIVES:To report 2 patients wit...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2013.01.003
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:It has been well known that TNF-α inhibitor (TNFi) treatment for patients with rheumatoid arthritis (RA) is associated with anti-nuclear antibody (ANA) development. We previously reported that ANA development was associated with poor outcomes of infliximab (IFX) treatment (1). However, no replication studies...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2019.02.003
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:To better understand why immunosuppressed individuals with systemic lupus erythematosus (SLE) fail to receive influenza and pneumococcal vaccines. METHODS:These cross-sectional data were derived from the 2009 cycle of the Lupus Outcomes Study (LOS), an annual longitudinal telephone survey of individuals with...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2015.01.002
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Chondroitin sulfates (CS) are involved in articular metabolism and could be used as therapeutic agents in degenerative articular diseases. OBJECTIVES:To review the published reports describing both the metabolism of glycosaminoglycans (GAG) and their involvement in osteoarticular pathophysiology. METHODS:M...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1053/sarh.2000.24874
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVES:To identify and describe measures that can be used to assess the impact of psoriatic arthritis (PsA) on patient functioning and health-related quality of life (HRQOL). METHODS:A literature search of the PubMed database to identify papers describing assessment tools for quality of life and function in rheuma...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2008.01.003
更新日期:2009-02-01 00:00:00
abstract::Concentrations of serum lipids and serum very low-density lipoproteins and low-density lipoproteins (VLDL+LDL, originally called beta lipoproteins) were measured and agarose gel electrophoresis of serum lipoproteins was performed in 69 patients with active rheumatoid arthritis (RA), 40 patients with psoriatic arthriti...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/0049-0172(92)90017-8
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVES:To assess the interaction between the sympathetic and parasympathetic systems in patients with fibromyalgia syndrome (FM), using power spectrum analysis (PSA) of heart rate variability (HRV). In addition, we explored the association between HRV, measures of tenderness, FM symptoms, physical function, psychol...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/s0049-0172(00)80010-4
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:Arthralgia is among the most frequent musculoskeletal symptoms occurring in patients with chronic lymphocytic thyroiditis (CLT), often causing pain and physical impairment over extended periods of time. Our study aims to characterize arthralgia and, in particular, polyarthralgia (PA) associated with CLT and ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1053/sarh.2002.33722
更新日期:2002-08-01 00:00:00
abstract::The treatment of hand disease in patients with rheumatoid arthritis (RA), with focus on rehabilitation and splinting, is discussed. A review of the data on splinting of hands in RA is included, as is a review of methods for evaluating hand function and staging RA. Recommendations are made for splinting early in the di...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(91)90039-3
更新日期:1991-10-01 00:00:00
abstract::The shoulder, a very common site of pain syndromes in medical practice, lends itself well to precise clinical analysis and identification of the pain-sensitive structure or structures. Once identified, rational and effective management can be applied, associated with predictably good prognosis. Early identification o...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/s0049-0172(77)80003-6
更新日期:1977-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Intra-articular (IA) hyaluronans (HAs) are indicated for pain relief of osteoarthritis (OA) of the knee. Hyalgan (sodium hyaluronate), Supartz (sodium hyaluronate), and Synvisc (hylan G-F 20) are Food and Drug Administration-approved HA products. They are derived from rooster combs; Hyalgan an...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1053/sarh.2002.50008
更新日期:2003-04-01 00:00:00
abstract::Reproduction capacity and long-term preserved hormonal function are important aspects with big impacts on patients' quality of life. Updated information on the interaction between drug therapy and reproductive function is essential when discussing family planning with patients. Currently, limited data is published reg...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2018.01.006
更新日期:2018-10-01 00:00:00
abstract::Gout is currently the most frequent cause of inflammatory arthritis worldwide. It results from elevated serum urate and subsequent deposition of monosodium urate crystals in joints and other tissues. While many patients with gout can be managed with conventional agents (e.g., allopurinol, febuxostat), those with chron...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2020.04.011
更新日期:2020-06-01 00:00:00
abstract::Inequality of leg lengths is associated with low back pain, greater trochanteric bursitis, and degenerative hip disease. The pelvic obliquity that results from a discrepancy of leg lengths may contribute to degenerative changes in the lumbar spine. The diagnosis of leg length inequality may be overlooked. If this occu...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/0049-0172(88)90020-0
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVES:Discuss issues regarding clinical trial design for the development of biosimilars in the European Union and the United States, with special focus on monoclonal antibodies used in the treatment of inflammatory diseases. METHODS:A search of the Internet as well as PubMed was conducted through June 2014 for in...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2015.04.002
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVES:To investigate early vertical growth patterns and factors associated with poor growth in a modern inception cohort of UK children with juvenile idiopathic arthritis (JIA) using data from the Childhood Arthritis Prospective Study (CAPS). METHODS:A study period of 3 years was chosen. Children included in this...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2017.11.002
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:The EULAR Outcome Measures Library (OML) is a freely available database of validated patient-reported outcomes (PROs). The aim of this study was to provide a comprehensive review of validated PROs specifically developed for systemic sclerosis (SSc) to feed the EULAR OML. METHODS:A sensitive search was devel...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2016.10.002
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:Aortic disease is a known complication of HLA-B27-associated spondyloarthritis. We present the case of a 52-year-old HLA-B27-positive woman with aortitis of the abdominal aorta and spondyloarthritis. METHODS:In addition to the case reported, a literature search (MEDLINE) for articles published between 1946 ...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2014.05.012
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Acute gout is a common arthritis that may eventually develop into chronic tophaceous gout (CTG). CTG usually is manifested by recurrent gout attacks. The diagnosis and treatment of CTG is challenging. Although the emergence of CTG without previous gout attacks is uncommon, it is important to recognize this u...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章,评审
doi:10.1016/j.semarthrit.2017.11.006
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:To describe the clinical and microbiological characteristics and outcomes after antibiotic treatment of a national cohort of patients with Lyme arthritis confirmed by PCR testing on synovial fluid and by serology, when available. METHODS:Using the French National Reference Center for Borrelia database, pati...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/j.semarthrit.2018.09.007
更新日期:2019-06-01 00:00:00
abstract:OBJECTIVE:To examine immunogenetic and clinical features in a series of patients with the idiopathic tubulointerstitial nephritis and uveitis (TINU) syndrome diagnosed at the single referral hospital for a defined population in Southern Spain. PATIENTS AND METHODS:Retrospective study of the case records of all patient...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1053/sarh.2002.33718
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:To study the prevalence and characteristics of retinal vascular disease in patients with systemic lupus erythematosus (SLE) and to analyze their relationship with antiphospholipid antibodies (aPL) and other serological markers. PATIENTS AND METHODS:Eighty-two consecutive patients (77 women and 5 men; mean a...
journal_title:Seminars in arthritis and rheumatism
pub_type: 杂志文章
doi:10.1016/s0049-0172(99)80017-1
更新日期:1999-04-01 00:00:00