Herpes zoster in patients taking TNFalpha antagonists for chronic inflammatory joint disease.

Objective: To assess the rate of occurrence and outcomes of herpes zoster in patients taking TNFalpha antagonists.

Methods: Retrospective review of the medical records of 300 patients who received TNFalpha antagonists to treat chronic inflammatory joint disease.

Results: We identified 9 (9/300, 3%) patients who experienced herpes zoster, 6 women and 3 men, with rheumatoid arthritis (n=7) or ankylosing spondylitis (n=2).

Pedicle stress fracture: an unusual complication of pycnodysostosis.

Pycnodysostosis is a rare dysplasia characterised by high bone density and susceptibility to long bone fractures caused by cathepsin K deficiency. Spinal abnormalities have rarely been described in this uncommon inherited bone dysplasia. A 28-year-old female, with a past history of pycnodysostosis and spontaneous leg fractures was hospitalized for a 2-month history of spontaneous low back pain.

Adipose tissue, serum adipokines, and ghrelin in patients with ankylosing spondylitis.

Adipokines such as leptin and adiponectin are involved in the regulation of inflammation. Ghrelin, a gastric peptide playing a role in the appetite regulation, possesses anti-inflammatory properties. In this study, we evaluated the circulating levels of adipokines (leptin as potential proinflammatory and adiponectin as anti-inflammatory marker) and ghrelin and the fat mass in patients with ankylosing spondylitis (AS).

The contribution of adipose tissue and adipokines to inflammation in joint diseases.

Adipokines are proteins produced by white adipose tissue, which is an active secretory organ. Regulation of immune and inflammatory responses is among the multiple physiological processes involving adipokines. Leptin, adiponectin and resistin are the most extensively studied adipokines.

Infectious complications with anti-TNFalpha therapy in rheumatic diseases: a review.

TNFalpha plays a pivotal role not only in the inflammatory process but also in the normal response against pathogens and therefore, interfering with this cytokine may increase the risk of infection. TNFalpha antagonists are commonly used in daily clinical practice for the treatment of inflammatory rheumatic diseases including rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and juvenile idiopathic arthritis since the beginning of 2000. The spectrum of pathogens giving infectious disease in patients under anti-TNFalpha therapies ranges from common bacteria to more opportunistic organisms such as Mycobacterium tuberculosis.

Imaging study scores for ankylosing spondylitis.

Scoring systems have been developed for radiographs and magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS). Radiographic scores focus on chronic structural alterations, which occur slowly and show little sensitivity to change in the short-term. Recent clinical studies used the modified Stoke ankylosing spondylitis spine score (mSASSS), which evaluates the cervical and lumbar spine.