The rheumatic diseases share many features. Clinically, they are often systemic diseases affecting multiple organs. Pathologically, these diseases share in common a diffuse vasculitis with an inflammatory process. Involvement of myocardium is also pathologically a common finding in rheumatic diseases, especially systemic sclerosis and dermatopolymyositis. Although clinical symptoms are often silent, potentially life-threatening manifestations are well known. Non invasive techniques such as nuclear imaging and echocardiography are useful to detect occult cardiac lesions. Clinically overt cardiac involvement portends an unfavorable prognosis. Early detection of subclinical involvement of myocardium is essential to improve prognosis.
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Curr Treatm Opt Rheumatol
December 2024
Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA USA.
Purpose Of Review: To summarize the current treatment landscape of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) in the context of the recent 2023 American College of Rheumatology/American College of Chest Physicians guideline for ILD treatment in systemic autoimmune rheumatic diseases.
Recent Findings: The guideline conditionally recommends mycophenolate, azathioprine, and rituximab for first-line RA-ILD therapy, with cyclophosphamide and short-term glucocorticoids as additional options. For RA-ILD progression after first line, mycophenolate, rituximab, nintedanib, tocilizumab, cyclophosphamide, and pirfenidone are conditionally recommended, while long-term glucocorticoids are conditionally recommended against.
Front Immunol
January 2025
Department of Intensive Care Unit, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.
Background: For severe systemic rheumatic diseases (SRDs), therapeutic plasma exchange (TPE) may be applied as a rescue therapy; it usually combined with intravenous immunoglobulin (IVIG) or intravenous methylprednisolone pulse (IVMP) in severe SRDs. However, the necessity of this combination treatment strategy in SRDs remains uncertain.
Objective: This retrospective study aimed to evaluate the effectiveness of TPE alone versus TPE combined with IVIG/IVMP in treating severe SRDs.
Rheumatol Int
January 2025
Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Mental health has been shown to impact rheumatoid arthritis (RA) outcomes and is associated with self-management behaviors. The extent to which mental health impacts outcomes via different self-management behaviours has not been thoroughly investigated. Adult RA patients who were starting a new medication or dosage were recruited to a prospective cohort with follow-ups at 3 and 12-months covering clinical and patient-reported outcomes.
View Article and Find Full Text PDFEur J Immunol
January 2025
Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Many human autoimmune diseases (AIDs) are hallmarked by the presence and persistence of autoreactive B-cells. While autoreactive B-cells may frequently encounter antigens, the signals required to balance and maintain their activation and survival are mostly unknown. Understanding such signals may be important for strategies aimed at eliminating human B-cell autoreactivity.
View Article and Find Full Text PDFClin Cardiol
January 2025
Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Background: The association between rheumatoid arthritis (RA) and the risk of developing atrial fibrillation (AF) is well-established. However, data on the impact of RA on AF recurrence postcatheter ablation (CA) remain unclear. This current study aimed to assess the impact of RA on AF recurrence after catheter-based pulmonary vein isolation.
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