Could CGRP mAbs for migraine trigger rheumatoid arthritis? Insights from a case report.

Background: Case reports suggest that calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) may trigger inflammatory flares in patients with autoimmune diseases.

Case Description: A 56-year-old woman with a history of severe migraines, experienced improvement in migraine frequency and intensity after starting fremanezumab 225 mg monthly. However, three months into treatment, she developed symmetric inflammatory polyarthralgias.

Drugs and ANCA - an atypical association.

Eosinophilic vasculitis is a rare condition due to vascular damage and infiltration of eosinophils into tissues. Antineutrophil cytoplasmic antibody (ANCA), like perinuclear ANCA (p-ANCA), is common in the context of systemic vasculitis, but its association with illicit drug use is unusual. This case report showcases a distinctive scenario featuring a positive pANCA, prompting a meticulous examination of the interplay between vasculitic manifestations and drug abuse.

Sex and body mass index impact on digit circumference for Leeds Dactylitis Index calculation.

Objectives: To estimate digit circumference and the impact of sex and body mass index (BMI) for the calculation of the Leeds Dactylitis Index (LDI) in psoriatic arthritis (PsA) patients with bilateral dactylitis.

Methods: Digit circumference of the hands and the foot were measured with a dactylometer and were studied according to sex and BMI (divided in 4 weight categories) in healthy Portuguese subjects, using Student's t-test and One-way ANOVA, respectively. The effect size of sex and BMI were calculated using Cohen's d test and Eta squared, respectively.

Concomitant ischemic stroke and myocarditis as the initial clinical presentation of Takayasu arteritis.

Tayakasu arteritis (TA) is a chronic large-vessel systemic vasculitis more frequent in women. The pathogenesis of TA is not fully understood. Due to its silent and heterogenous nature, it is a challenging diagnosis, with no specific diagnostic tests.

A Rare Cause of Low Back Pain: A Challenging Diagnosis.

One of the rarest causes of low back pain is septic arthritis of a lumbar facet joint. We report the case of a 92-year-old diabetic woman with a history of four days of back pain, dysuria, and fever. Due to a sudden worsening of lumbar pain, she went to the emergency department.

Infective endocarditis - why should rheumatologists be aware?

Infective endocarditis has a wide range of clinical manifestations, making the diagnosis complex. Musculoskeletal symptoms whose prevalence is not negligible are often underestimated. This clinical case is about a 44-year-old female patient with previous aortic and mitral valvuloplasty for rheumatic fever valve disease referred to the outpatient Rheumatology department for the migratory onset of pain and swelling of the left lateral malleolus, right wrist, right first finger and left fifth distal phalanx associated with painful punctate lesions of the digital pulps and lateral edge of the feet and migratory and painful erythematous papules lasting for three months.

Is Botulinum Toxin Useful in Systemic Sclerosis Related Peripheral Vasculopathy? A Literature Review.

Introduction: In systemic sclerosis (SSc), peripheral vasculopathy presents typically as Raynaud Phenomenon (RP) and Digital Ulceration (DU). Over the last decade, botulinum toxin (BT) has been reported effective in this scenario. Our goal was to review existing literature evaluating the efficacy of BT on RP/DU in SSc.

GO-DACT: a phase 3b randomised, double-blind, placebo-controlled trial of GOlimumab plus methotrexate (MTX) versus placebo plus MTX in improving DACTylitis in MTX-naive patients with psoriatic arthritis.

Objectives: To assess the efficacy of golimumab in combination with methotrexate (MTX) versus MTX monotherapy in psoriatic arthritis (PsA) dactylitis.

Methods: Multicentre, investigator-initiated, randomised, double-blind, placebo-controlled, parallel-design phase 3b trial in 11 Portuguese rheumatology centres. Patients with PsA along with active dactylitis and naive to MTX and biologic disease-modifying antirheumatic drugs (bDMARDs) were randomly assigned to golimumab or placebo, both in combination with MTX.

First steps to understand productivity loss in Portuguese patients with rheumatoid arthritis.

Rheumatoid Arthritis (RA), in consequence of joint inflammation and damage, is known to lead to productivity loss. Developments during the 21st century, such as biologic treatments, allowed remission/low disease activity to be achieved in more RA patients. Despite this, evidence is equivocal concerning work outcomes improvement.

The GO-DACT protocol: a multicentre, randomized, double-blind, parallel-group study to compare the efficacy of golimumab in combination with methotrexate (MTX) versus MTX monotherapy.

The GO-DACT is an investigator-initiated, national, multicentric randomized placebo-controlled double-blinded trial, that assesses dactylitis as primary endpoint. Psoriatic arthritis patients naïve to methotrexate and biologic disease modifying anti-rheumatic drugs, with at least one active dactylitis, were assigned to golimumab in combination with methotrexate or placebo in combination with methotrexate, for 24 weeks. Both clinical (dactylitis severity score and the Leeds dactylitis index) and imaging (high resolution magnetic resonance imaging), among others, were assessed as outcomes.

Effectiveness of a Referral Program for rheumatoid arthritis and axial spondyloarthritis Diagnosis at Primary Care Centers in Portugal - SIARA STUDY.

Objectives: Early diagnosis and treatment of Rheumatoid Arthritis (RA) and axial Spondylarthritis (axial SpA) can limit the impact of disease outcomes. This study evaluated the effectiveness of a referral program on the identification of patients with RA and axial SpA.

Methods: This was an observational, prospective, randomized (by clusters) study conducted in Portugal to evaluate the impact of the implementation of a set of referral support actions (RSA).

[Hip arthritis in an young adult - a diagnosis to consider].

Osteoarthritis is the most common articular degenerative disease and can be classified as primary or secondary. The last one must be excluded in the context of a young adult. Optimal management requires early diagnosis and awareness of the risk factors (more importantly «modifiable» ones) that can affect the prognosis.

[Hospitalization of patients with systemic sclerosis: characteristics of a population].

Objectives: The authors propose to characterize a population in the area of reference of the Hospital de São João (HSJ) in Oporto, with severe manifestations of Systemic Sclerosis (SS), and need of hospitalization in this institution. Given the lack of data referring to SS in inpatient set (and its inexistence in Portugal), this elements may obviate a parallelism with populations described in other countries, or even identify specificities of this population, that in the future, can be important to study measures directed to optimizing their care, in Portugal.

Methods: The cases were collected from a computerized database containing all discharge registers of the Rheumatology Department of HSJ from 1/1/2003 to 31/12/2008 (6 years), diagnosed of SS (ICD9-CM code of 710,1).