Objectifs: Evaluer la frequence des affections thyroidiennes dans le syndrome de Gougerot-Sjogren... more Objectifs: Evaluer la frequence des affections thyroidiennes dans le syndrome de Gougerot-Sjogren primitif (SGS1). Patients et methodes: chez 121 patients consecutifs atteints de SGS1 (criteres de Vitali) et 74 atteints de polyarthrite rhumatoide (PR), nous mesure le taux d'hormones thyroidiennes et recherche les anticorps anti-microsome (ACAM) et anti-thyroglobuline (ACATG) de thyroide, ainsi que les anticorps anti-nucleaires (ANA) et leur specificite anti-ENA. Les ACAM et les ACATG ont ete aussi determines chez 404 sujets temoins. Resultats: les frequences ont ete calculees selon le sexe et l'analyse statistique a ete effectuee dans le sexe feminin. La prevalence des ACAM etait plus haute dans le SGS1 (17,6 %) par rapport aux temoins (9 %) (p <0,05) tandis que les ACATG etaient significativement plus frequents dans le SGS1 (13,4 %) et dans la PR (10,9 %) par rapport aux temoins (1 %) (p <0,0001). L'hypothyroidie etait plus frequente dans le SGS1 (13,4 %) que dans...
We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively... more We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively with systemic lupus erythematosus, systemic sclerosis (scleroderma) and primary Sjögren's syndrome. The typical fibromyalgia findings encountered in these diseases were examined. We enrolled 250 consecutive outpatients: 100 with systemic lupus erythematosus, 50 with systemic sclerosis, 100 with primary Sjögren's syndrome and 2 control groups (30 healthy subjects and 75 patients with primary fibromyalgia). Fibromyalgia features were evaluated by algometry, VAS for pain, Mc Gill Pain Questionnaire and Fibromyalgia Impact Questionnaire. Fibromyalgia has been found in 1 case (1%) with systemic lupus erythematosus, 1 case with systemic sclerosis (2%), 22 cases (22%) with primary Sjögren's syndrome and in 1 (3.3%) of the healthy controls. The number of tender points was significantly higher (p<0.01) in the patients with Sjögren's syndrome in comparison with the other groups...
In spite of all recent years' international meetings, the question of diagnostic criteria of ... more In spite of all recent years' international meetings, the question of diagnostic criteria of primary Sjögren's syndrome (pSS) is still under debate. The aim of our study is to define sensitivity, specificity and diagnostic accuracy of 3 sets of criteria: those of the European Community Study Group (ECSG), those proposed by Fox, and those proposed by Daniels. We considered 219 subjects complaining of dry mouth and/or dry eyes and/or parotid swelling, evaluated for pSS. The following parameters were considered golden standard for the diagnosis of pSS: focus score > or = 2 foci/mm2, double positivity for SSA and SSB antibodies, and a sialographic grade > or = 2. Our study demonstrates that ECSG criteria show a high sensitivity and a good specificity, resulting in a diagnostic accuracy similar, and sometimes higher, than that obtained with Fox and Daniels' criteria.
To evaluate the frequency of thyroid disorders in primary Sjögen's syndrome. 121 consecutive ... more To evaluate the frequency of thyroid disorders in primary Sjögen's syndrome. 121 consecutive patients meeting Vitali's criteria for primary Sjögren's syndrome and 74 with rheumatoid arthritis underwent thyroid hormone assays, tests for antimicrosomal and antithyroglobulin antibodies, tests for antinuclear antibodies and antibodies to extractable nuclear antigens. Antimicrosomal and antithyroglobulin antibodies were also assayed in 404 controls. frequencies were calculated separately in males and females, and data in females were subjected to statistical analysis. As compared with controls, Sjögren's syndrome patients were more likely to have antimicrosomal antibodies (9% versus 17.6%, P < 0.05) and both Sjögren's syndrome and rheumatoid arthritis patients were more likely to have antithyroglobulin antibodies (1% versus 13.4% and 10.9%, respectively, P < 0.0001). Hypothyroidism was more common among Sjögren's syndrome patients (13.4%) than rheumatoid art...
The paper reports the results from the observational retrospective-prospective RUBINO study condu... more The paper reports the results from the observational retrospective-prospective RUBINO study conducted in Italy to assess the safety of rituximab in the treatment of rheumatoid arthritis (RA) in routine clinical practice. The percentage of patients who manifested at least one grade 3 or 4 adverse event (AE) assessed by the Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v.3) during the observation period (primary objective) was evaluated. The percentage of patients manifesting a severe AE (SAE), clinical response to rituximab treatment, clinical remission according to disease activity score for 28 joints (DAS28) criteria, markers of disease and quality of life were also assessed. Fifty-three Italian rheumatology centers took part in the study. Patients with a diagnosis of RA and inadequate response to anti-tumor necrosis factor b (anti-TNFa) drugs were enrolled. Participating patients had previously received at least one cycle of rituximab, and treatment was still o...
Le signe le plus caracteristique du syndrome SAPHO (Synovite, Acne, Pustolose, Hyperostose, Ostei... more Le signe le plus caracteristique du syndrome SAPHO (Synovite, Acne, Pustolose, Hyperostose, Osteite) est une osteite de la paroi thoracique anterieure, qui peut etre suffisamment severe pour provoquer un syndrome du defile thoraco-brachial, une thrombose de la veine sous-claviere ou une compression de la veine cave superieure. Des signes cutanes evocateurs, tels une pustulose palmo-plantaire ou une acne severe, precedent generalement la survenue des lesions osteo-articulaires. Nous decrivons une observation de syndrome SAPHO qui a evolue sans diagnostic pendant de longues annees, provoquant une compression et une thrombose de la veine sous-claviere droite traitee par cleidectomie. Le syndrome SAPHO doit etre systematiquement evoque chez tout patient presentant des lesions inflammatoires de la paroi thoracique anterieure, surtout s'il existe aussi des lesions cutanees.
The frequency of pericardial involvement in Systemic Sclerosis (SSc) is high on autoptic or echoc... more The frequency of pericardial involvement in Systemic Sclerosis (SSc) is high on autoptic or echocardiographic studies, but the clinical recognition of pericarditis with or without effusion is rare. We describe a case of a 71-year-old female with no previous history of heart disease, who presented with a large pericardial effusion and tamponade that required pericardial drain. She had suffered from Raynaud&#39;s phenomenon since 25 years. Six weeks after hospital discharge she complained of skin hardening on left leg. Pericardial tamponade is a very rare manifestation of SSc and occurs both early or late in the course of the disease, but in our case it preceded the recognition of scleroderma. We have only identified two other cases of pericardial effusion preceding cutaneous involvement in scleroderma.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1995
Female patients affected with Sjogren's Syndrome (SS) frequently describe symptoms such as vagina... more Female patients affected with Sjogren's Syndrome (SS) frequently describe symptoms such as vaginal dryness and dyspareunia: however, only a few controlled studies have regarded clinical involvement of the female external genitalia. Objective: The present study was undertaken in order to: (1) Evaluate the involvement of external genitalia in a large number of female patients affected with primary SS (pSS) by semi-quantitative methods covering subjective symptoms and clinical evaluation. (2) Compare pSS patients with a matched healthy control group (pre-and post-menopausal women were separately studied). (3) Correlate the gynaecological involvement with salivary and lacrimal abnormalities in pSS patients. Methods: We evaluated 36 patients with primary SS (18 pre-and 18 post-menopausal women) and 43 healthy controls using a questionnaire regarding vulvar and vaginal dryness and a complete gynaecological examination. Subsequently, three scores related to vulvar and cervical status plus a global score were obtained. In primary SS patients, salivary and lacrimal involvement was also evaluated. Results: Dyspareunia was present in 61% and vaginal dryness in 55% of SS patients versus 39% and 33% of healthy controls. No significant differences regarding gynaecological scores were found between SS patients and controls, in both pre-and post-menopausal women, nor correlation was observed between gynaecological and lacrimal or salivary involvement. Conch~sions: Our data suggest that although SS patients frequently complain of dyspareunia and vaginal dryness they do not greatly differ from healthy subjects in regard to some major gynaecological aspects.
The hallmark of SAPHO Syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is osteitis ... more The hallmark of SAPHO Syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is osteitis of the anterior chest wall, which can be so pronounced as to cause thoracic outlet syndrome, thrombosis of the subclavian vein, and compression of the superior vena cava. ...
Background:Many patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) are in their ... more Background:Many patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) are in their childbearing years. Concerns exist regarding the interplay between the rheumatic diseases and the pregnancy (1).Objectives:Actually, there are contradictory data regarding the pregnancy outcome in patients with RA and SpA (2). Thus, we performed this longitudinal retrospective study to evaluate the effect of RA and SpA on pregnancy outcome.Methods:The data of 78 pregnancies of 60 women followed from April 2017 to December 2020 at pregnancy clinic of Internal Medicine Unit, San Bortolo Hospital, Vicenza and Rheumatology Unit, University of Verona were reviewed. Fifty (64.1%) women were affected by RA and 28 (35.9%) by SpA. Information regarding demographic data, disease activity, drug exposure and maternal/foetal outcomes were collected in an electronic database. Details concerning pregnancy complications and congenital malformation were also collected. We compared pregnancy and foetal/ne...
We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively... more We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively with systemic lupus erythematosus, systemic sclerosis (scleroderma) and primary Sjögren's syndrome. The typical fibromyalgia findings encountered in these diseases were examined. We enrolled 250 consecutive outpatients: 100 with systemic lupus erythematosus, 50 with systemic sclerosis, 100 with primary Sjögren's syndrome and 2 control groups (30 healthy subjects and 75 patients with primary fibromyalgia). Fibromyalgia features were evaluated by algometry, VAS for pain, Mc Gill Pain Questionnaire and Fibromyalgia Impact Questionnaire. Fibromyalgia has been found in 1 case (1%) with systemic lupus erythematosus, 1 case with systemic sclerosis (2%), 22 cases (22%) with primary Sjögren's syndrome and in 1 (3.3%) of the healthy controls. The number of tender points was significantly higher (p<0.01) in the patients with Sjögren's syndrome in comparison with the other groups...
Objectifs: Evaluer la frequence des affections thyroidiennes dans le syndrome de Gougerot-Sjogren... more Objectifs: Evaluer la frequence des affections thyroidiennes dans le syndrome de Gougerot-Sjogren primitif (SGS1). Patients et methodes: chez 121 patients consecutifs atteints de SGS1 (criteres de Vitali) et 74 atteints de polyarthrite rhumatoide (PR), nous mesure le taux d'hormones thyroidiennes et recherche les anticorps anti-microsome (ACAM) et anti-thyroglobuline (ACATG) de thyroide, ainsi que les anticorps anti-nucleaires (ANA) et leur specificite anti-ENA. Les ACAM et les ACATG ont ete aussi determines chez 404 sujets temoins. Resultats: les frequences ont ete calculees selon le sexe et l'analyse statistique a ete effectuee dans le sexe feminin. La prevalence des ACAM etait plus haute dans le SGS1 (17,6 %) par rapport aux temoins (9 %) (p <0,05) tandis que les ACATG etaient significativement plus frequents dans le SGS1 (13,4 %) et dans la PR (10,9 %) par rapport aux temoins (1 %) (p <0,0001). L'hypothyroidie etait plus frequente dans le SGS1 (13,4 %) que dans...
We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively... more We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively with systemic lupus erythematosus, systemic sclerosis (scleroderma) and primary Sjögren's syndrome. The typical fibromyalgia findings encountered in these diseases were examined. We enrolled 250 consecutive outpatients: 100 with systemic lupus erythematosus, 50 with systemic sclerosis, 100 with primary Sjögren's syndrome and 2 control groups (30 healthy subjects and 75 patients with primary fibromyalgia). Fibromyalgia features were evaluated by algometry, VAS for pain, Mc Gill Pain Questionnaire and Fibromyalgia Impact Questionnaire. Fibromyalgia has been found in 1 case (1%) with systemic lupus erythematosus, 1 case with systemic sclerosis (2%), 22 cases (22%) with primary Sjögren's syndrome and in 1 (3.3%) of the healthy controls. The number of tender points was significantly higher (p<0.01) in the patients with Sjögren's syndrome in comparison with the other groups...
In spite of all recent years' international meetings, the question of diagnostic criteria of ... more In spite of all recent years' international meetings, the question of diagnostic criteria of primary Sjögren's syndrome (pSS) is still under debate. The aim of our study is to define sensitivity, specificity and diagnostic accuracy of 3 sets of criteria: those of the European Community Study Group (ECSG), those proposed by Fox, and those proposed by Daniels. We considered 219 subjects complaining of dry mouth and/or dry eyes and/or parotid swelling, evaluated for pSS. The following parameters were considered golden standard for the diagnosis of pSS: focus score > or = 2 foci/mm2, double positivity for SSA and SSB antibodies, and a sialographic grade > or = 2. Our study demonstrates that ECSG criteria show a high sensitivity and a good specificity, resulting in a diagnostic accuracy similar, and sometimes higher, than that obtained with Fox and Daniels' criteria.
To evaluate the frequency of thyroid disorders in primary Sjögen's syndrome. 121 consecutive ... more To evaluate the frequency of thyroid disorders in primary Sjögen's syndrome. 121 consecutive patients meeting Vitali's criteria for primary Sjögren's syndrome and 74 with rheumatoid arthritis underwent thyroid hormone assays, tests for antimicrosomal and antithyroglobulin antibodies, tests for antinuclear antibodies and antibodies to extractable nuclear antigens. Antimicrosomal and antithyroglobulin antibodies were also assayed in 404 controls. frequencies were calculated separately in males and females, and data in females were subjected to statistical analysis. As compared with controls, Sjögren's syndrome patients were more likely to have antimicrosomal antibodies (9% versus 17.6%, P < 0.05) and both Sjögren's syndrome and rheumatoid arthritis patients were more likely to have antithyroglobulin antibodies (1% versus 13.4% and 10.9%, respectively, P < 0.0001). Hypothyroidism was more common among Sjögren's syndrome patients (13.4%) than rheumatoid art...
The paper reports the results from the observational retrospective-prospective RUBINO study condu... more The paper reports the results from the observational retrospective-prospective RUBINO study conducted in Italy to assess the safety of rituximab in the treatment of rheumatoid arthritis (RA) in routine clinical practice. The percentage of patients who manifested at least one grade 3 or 4 adverse event (AE) assessed by the Common Terminology Criteria for Adverse Events version 3.0 (CTCAE v.3) during the observation period (primary objective) was evaluated. The percentage of patients manifesting a severe AE (SAE), clinical response to rituximab treatment, clinical remission according to disease activity score for 28 joints (DAS28) criteria, markers of disease and quality of life were also assessed. Fifty-three Italian rheumatology centers took part in the study. Patients with a diagnosis of RA and inadequate response to anti-tumor necrosis factor b (anti-TNFa) drugs were enrolled. Participating patients had previously received at least one cycle of rituximab, and treatment was still o...
Le signe le plus caracteristique du syndrome SAPHO (Synovite, Acne, Pustolose, Hyperostose, Ostei... more Le signe le plus caracteristique du syndrome SAPHO (Synovite, Acne, Pustolose, Hyperostose, Osteite) est une osteite de la paroi thoracique anterieure, qui peut etre suffisamment severe pour provoquer un syndrome du defile thoraco-brachial, une thrombose de la veine sous-claviere ou une compression de la veine cave superieure. Des signes cutanes evocateurs, tels une pustulose palmo-plantaire ou une acne severe, precedent generalement la survenue des lesions osteo-articulaires. Nous decrivons une observation de syndrome SAPHO qui a evolue sans diagnostic pendant de longues annees, provoquant une compression et une thrombose de la veine sous-claviere droite traitee par cleidectomie. Le syndrome SAPHO doit etre systematiquement evoque chez tout patient presentant des lesions inflammatoires de la paroi thoracique anterieure, surtout s'il existe aussi des lesions cutanees.
The frequency of pericardial involvement in Systemic Sclerosis (SSc) is high on autoptic or echoc... more The frequency of pericardial involvement in Systemic Sclerosis (SSc) is high on autoptic or echocardiographic studies, but the clinical recognition of pericarditis with or without effusion is rare. We describe a case of a 71-year-old female with no previous history of heart disease, who presented with a large pericardial effusion and tamponade that required pericardial drain. She had suffered from Raynaud&#39;s phenomenon since 25 years. Six weeks after hospital discharge she complained of skin hardening on left leg. Pericardial tamponade is a very rare manifestation of SSc and occurs both early or late in the course of the disease, but in our case it preceded the recognition of scleroderma. We have only identified two other cases of pericardial effusion preceding cutaneous involvement in scleroderma.
European Journal of Obstetrics & Gynecology and Reproductive Biology, 1995
Female patients affected with Sjogren's Syndrome (SS) frequently describe symptoms such as vagina... more Female patients affected with Sjogren's Syndrome (SS) frequently describe symptoms such as vaginal dryness and dyspareunia: however, only a few controlled studies have regarded clinical involvement of the female external genitalia. Objective: The present study was undertaken in order to: (1) Evaluate the involvement of external genitalia in a large number of female patients affected with primary SS (pSS) by semi-quantitative methods covering subjective symptoms and clinical evaluation. (2) Compare pSS patients with a matched healthy control group (pre-and post-menopausal women were separately studied). (3) Correlate the gynaecological involvement with salivary and lacrimal abnormalities in pSS patients. Methods: We evaluated 36 patients with primary SS (18 pre-and 18 post-menopausal women) and 43 healthy controls using a questionnaire regarding vulvar and vaginal dryness and a complete gynaecological examination. Subsequently, three scores related to vulvar and cervical status plus a global score were obtained. In primary SS patients, salivary and lacrimal involvement was also evaluated. Results: Dyspareunia was present in 61% and vaginal dryness in 55% of SS patients versus 39% and 33% of healthy controls. No significant differences regarding gynaecological scores were found between SS patients and controls, in both pre-and post-menopausal women, nor correlation was observed between gynaecological and lacrimal or salivary involvement. Conch~sions: Our data suggest that although SS patients frequently complain of dyspareunia and vaginal dryness they do not greatly differ from healthy subjects in regard to some major gynaecological aspects.
The hallmark of SAPHO Syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is osteitis ... more The hallmark of SAPHO Syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis) is osteitis of the anterior chest wall, which can be so pronounced as to cause thoracic outlet syndrome, thrombosis of the subclavian vein, and compression of the superior vena cava. ...
Background:Many patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) are in their ... more Background:Many patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) are in their childbearing years. Concerns exist regarding the interplay between the rheumatic diseases and the pregnancy (1).Objectives:Actually, there are contradictory data regarding the pregnancy outcome in patients with RA and SpA (2). Thus, we performed this longitudinal retrospective study to evaluate the effect of RA and SpA on pregnancy outcome.Methods:The data of 78 pregnancies of 60 women followed from April 2017 to December 2020 at pregnancy clinic of Internal Medicine Unit, San Bortolo Hospital, Vicenza and Rheumatology Unit, University of Verona were reviewed. Fifty (64.1%) women were affected by RA and 28 (35.9%) by SpA. Information regarding demographic data, disease activity, drug exposure and maternal/foetal outcomes were collected in an electronic database. Details concerning pregnancy complications and congenital malformation were also collected. We compared pregnancy and foetal/ne...
We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively... more We studied the prevalence of fibromyalgia in 3 different groups of patients affected respectively with systemic lupus erythematosus, systemic sclerosis (scleroderma) and primary Sjögren's syndrome. The typical fibromyalgia findings encountered in these diseases were examined. We enrolled 250 consecutive outpatients: 100 with systemic lupus erythematosus, 50 with systemic sclerosis, 100 with primary Sjögren's syndrome and 2 control groups (30 healthy subjects and 75 patients with primary fibromyalgia). Fibromyalgia features were evaluated by algometry, VAS for pain, Mc Gill Pain Questionnaire and Fibromyalgia Impact Questionnaire. Fibromyalgia has been found in 1 case (1%) with systemic lupus erythematosus, 1 case with systemic sclerosis (2%), 22 cases (22%) with primary Sjögren's syndrome and in 1 (3.3%) of the healthy controls. The number of tender points was significantly higher (p<0.01) in the patients with Sjögren's syndrome in comparison with the other groups...
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