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Timing of onset affects arthritis presentation pattern in antisyntethase syndrome

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79; on behalf of AENEAS (American and European NEtwork of Antisynthetase Syndrome) collaborative group.

  1. Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  2. Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  3. Internal Medicine Department, Vall d'Hebron General Hospital, Barcelona, Spain.
  4. Internal Medicine Department, Vall d'Hebron General Hospital, Barcelona, Spain.
  5. Department of Rheumatology, Oslo University Hospital (OUH), Oslo, Norway.
  6. Department of Rheumatology, Oslo University Hospital (OUH), Oslo, Norway.
  7. Interstitial Lung Disease and Rheumatology Units, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, México City, México.
  8. Interstitial Lung Disease and Rheumatology Units, Instituto Nacional de Enfermedades Respiratorias, Ismael Cosío Villegas, México City, México.
  9. ACURA Centre for Rheumatic Diseases, Baden-Baden, Germany.
  10. ACURA Centre for Rheumatic Diseases, Baden-Baden, Germany.
  11. Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  12. Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Italy.
  13. Department of Internal Medicine V, Division of Rheumatology, University of Heidelberg, Germany.
  14. Division of Rheumatology, Department of Medicine (DIMED), University of Padova, Italy.
  15. Division of Rheumatology, Department of Medicine (DIMED), University of Padova, Italy.
  16. Interdisciplinary Department of Medicine (DIM), Rheumatology Unit, University of Bari, Italy.
  17. Interdisciplinary Department of Medicine (DIM), Rheumatology Unit, University of Bari, Italy.
  18. Rheumatology Unit, University and AO Spedali Civili, Brescia, Italy.
  19. Rheumatology Unit, University and AO Spedali Civili, Brescia, Italy.
  20. ACURA Rheumatology Center, Bad Kreuznach, Germany.
  21. Rheumatology Unit, Azienda Sanitaria di Firenze, S. Giovanni di Dio Hospital, Florence, Italy.
  22. Immunology and Allergy Laboratory, S.Giovanni di Dio Hospital, Florence, Italy.
  23. Immunology and Allergy Laboratory, S.Giovanni di Dio Hospital, Florence, Italy.
  24. Department of Internal Medicine and Medical Specialties-Rheumatology, Sapienza University of Rome, Italy.
  25. Department of Internal Medicine, Rheumatology and Clinical Immunology, University Hospital Johannes-Gutenberg, Mainz, Germany.
  26. U.O.C. Reumatologia, Ospedale San Camillo-Forlanini, Roma, Italy.
  27. U.O.C. Reumatologia, Ospedale San Camillo-Forlanini, Roma, Italy.
  28. Department of Experimental and Clinical Medicine, University of Florence, Italy.
  29. Department of Experimental and Clinical Medicine, University of Florence, Italy.
  30. UOC Reumatologia, Azienda Ospedaliero Universitaria S. Anna, University of Ferrara, Italy.
  31. UOC Reumatologia, Azienda Ospedaliero Universitaria S. Anna, University of Ferrara, Italy.
  32. UOC Reumatologia, Azienda Ospedaliero Universitaria S. Anna, University of Ferrara, Italy.
  33. Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  34. Servicio de Reumatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
  35. Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy.
  36. Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Italy.
  37. Department of Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain.
  38. Department of Rheumatology, University Hospital Ramón y Cajal, Madrid, Spain.
  39. Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Italy.
  40. Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Italy.
  41. ASST Bergamo Ovest, UOC Medicina, Ospedale di Treviglio, Italy.
  42. Lund University, Skane University Hospital, Department of Clinical Sciences, Rheumatology, Lund, Sweden.
  43. Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  44. Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  45. Rheumatology Unit, Santa Chiara Hospital, Trento, Italy.
  46. Division of Rheumatology, Mauriziano Hospital , Turin, Italy.
  47. Tulane University Lung Center Tulane, UMC Scleroderma and Sarcoidosis Patient Care and Research Center New Orleans, LA, USA.
  48. Systemic Autoimmune Diseases Unit, Hospital Clínico San Cecilio, Granada, Spain.
  49. Clinic of Rheumatology, Department of Medical and Biological Sciences (DSMB), Santa Maria della Misericordia Hospital, Udine, Italy.
  50. Rheumatology Unit, Luigi Sacco University Hospital, Milan, Italy.
  51. Rheumatology Unit, Department of Medicine, University of Perugia, Italy.
  52. Rheumatology Unit, Department of Medicine, University of Perugia, Italy.
  53. Department for Rheumatology and Clinical Immunology, St. Josef Krankenhaus, University Clinic, Essen, Germany.
  54. Rheumatology Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy.
  55. Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital, Rozzano, Milano, Italy.
  56. Rheumatology Department, Città Della Salute e della Scienza, Torino, Italy.
  57. Rheumatology Department, Polytechnic University of Marche, C. Urbani Hospital, Jesi, Ancona, Italy.
  58. Pneumology Unit, Cardiothoracic and Vascular Department, University and IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
  59. C. Mondino National Neurological Institute, Pavia, Italy.
  60. School of Medicine and Surgery, University of Milan-Bicocca, Respiratory Unit, ASST Monza, Italy.
  61. School of Medicine and Surgery, University of Milan-Bicocca, Respiratory Unit, ASST Monza, Italy.
  62. Department of Pneumology and Respiratory Intermediate Care Unit, University Hospital of Cattinara, Trieste, Italy.
  63. Azienda Ospedaliero-Universitaria Ospedali Riuniti di Trieste, Italy.
  64. Servicio de Reumatología, Hospital Universitario La Paz, Madrid, Spain.
  65. Interstitial and Rare Lung Disease Unit, Ruhrlandklinik University Hospital, University of Duisburg-Essen, Essen, Germany.
  66. Rheumatology Unit, Department of Internal Medicine, S.Maria Hospital, IRCCS, Reggio Emilia, Italy.
  67. Division of Rheumatology, Instituto de Investigación Sanitaria, Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain.
  68. Division of Rheumatology, Instituto de Investigación Sanitaria, Hospital Clinico Universitario de Santiago, Santiago de Compostela, Spain.
  69. Department of Political and Social Sciences, Social Statistic studies, University of Pavia, Italy.
  70. Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  71. Rheumatology Unit, Centro Hospitalar e Universitário de Coimbra, Portugal.
  72. Rheumatology Unit, Centro Hospitalar e Universitário de Coimbra, Portugal.
  73. Division of Pneumology, Hospital Universitario Marqués de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
  74. Laboratory of Biochemical-Clinical Analyses, IRCCS Policlinico San Matteo Foundation, Pavia, Italy.
  75. Rheumatology Institute of Lucania (IRel), Rheumatology Department of Lucania, San Carlo Hospital of Potenza and Madonna delle Grazie Hospital of Matera, and Basilicata Biomedica (BRB) Foundation, Italy.
  76. Rheumatology Unit, Severo Ochoa Hospital, Madrid, Spain.
  77. Rheumatology Unit, Severo Ochoa Hospital, Madrid, Spain.
  78. Rheumatology Department, Hospital Universitario de la Princesa, IIS-IP, Madrid, Spain.
  79. Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foudation, Pavia, Italy. lorenzo.cavagna@unipv.it

CER10244 Submission on line
2018 Vol.36, N°1 - PI 0044, PF 0049
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Rheumatology Article

 

Abstract

OBJECTIVES:
To evaluate if the timing of appearance with respect to disease onset may influence the arthritis presentation pattern in antisynthetase syndrome (ASSD).
METHODS:
The patients were selected from a retrospective large international cohort of ASSD patients regularly followed-up in centres referring to AENEAS collaborative group. Patients were eligible if they had an antisynthetase antibody testing positive in at least two determinations along with arthritis occurring either at ASSD onset (Group 1) or during the course of the disease (Group 2).
RESULTS:
445 (70%; 334 females, 110 males, 1 transsexual) out of the 636 ASSD we collected had arthritis, in the majority of cases (367, 83%) from disease onset (Group 1). Patients belonging to Group 1 with respect to Group 2 had an arthritis more commonly polyarticular and symmetrical (p=0.015), IgM-Rheumatoid factor positive (p=0.035), erosions at hands and feet plain x-rays (p=0.036) and more commonly satisfying the 1987 revised classification criteria for rheumatoid arthritis (RA) (p=0.004). Features such as Raynaud’s phenomenon, mechanic’s hands and fever (e.g. accompanying findings) were more frequently reported in Group 2 (p=0.005).
CONCLUSIONS:
In ASSD, the timing of appearance with respect to disease onset influences arthritis characteristics. In particular, RA features are more common when arthritis occurs from ASSD onset, suggesting an overlap between RA and ASSD in these patients. When arthritis appears during the follow-up, it is very close to a connective tissue disease-related arthritis. Also, the different prevalence of accompanying features between these two groups is in line with this possibility.

PMID: 28770709 [PubMed]

Received: 08/01/2017 - Accepted : 05/04/2017 - In Press: 26/07/2017 - Published: 05/02/2018