Clinical algorithms for the diagnosis and prognosis of interstitial lung disease in systemic sclerosis.

Introduction: Interstitial lung disease (ILD) is currently the primary cause of death in systemic sclerosis (SSc). Thoracic high-resolution computed tomography (HRCT) is considered the gold standard for diagnosis. Recent studies have proposed several clinical algorithms to predict the diagnosis and prognosis of SSc-ILD.

Waist circumference in children and adolescents correlate with metabolic syndrome and fat deposits in young adults.

Background & Aims: To determine the relevance of waist circumference (WC) measurement and monitoring in children and adolescents as an early indicator of overweight, metabolic syndrome (MS) and cardiovascular problems in young adults in comparison with visceral and subcutaneous adiposity.

Methods: A cohort study with 159 subjects (51.6% female) started in 1999 with an average age of 13.

One-year clinical and radiological evolution of a patient with refractory Takayasu's arteritis under treatment with tocilizumab.

A 28-year-old patient with Takayasu's arteritis (TA) failed to respond to high doses of prednisone in combination with methotrexate, pulses of cyclophosphamide and methylprednisolone, azathioprine, mycophenolate mofetil, adalimumab and monthly infusions of infliximab 5 mg/kg. After the beginning of tocilizumab therapy (4-8 mg/kg at monthly infusions), an impressive improvement in clinical and laboratory parameters of disease activity occurred, allowing the reduction of prednisone dose from 30 to 5 mg/day. However, after the 8th dose the patient developed symptoms of vertebrobasilar insufficiency, despite maintaining a good clinical condition and normal values of inflammatory markers.

TCRBV20S1 and TCRBV3S1 gene segment polymorphisms in systemic sclerosis.

Objective: To compare the frequencies of variants of TCRBV20S1 and TCRBV3S1 gene segments in patients with systemic sclerosis (SSc) and in controls. The null allele (allele 2) of TCRBV20S1 is associated with reduced levels of Vbeta20+ T-cells in the peripheral blood, while allele 1 of TCRBV3S1 is related to a low frequency of Vbeta3.1+ T-cells.

Nailfold capillary microscopy can suggest pulmonary disease activity in systemic sclerosis.

Objective: To evaluate the association of capillaroscopic alterations with pulmonary disease activity in systemic sclerosis (SSc).

Methods: Ninety-one patients with SSc were studied by means of interview, physical examination, nailfold capillary microscopy (NCM), serology, pulmonary function tests, esophageal transit scintigraphy, Doppler echocardiography, and pulmonary high resolution computed tomography (HRCT). Pulmonary disease activity was diagnosed by the observation of ground-glass opacities on pulmonary HRCT.