Classification Criteria For Rheumatic Diseases Research Articles

Do we need distinct paediatric classification criteria for rheumatic diseases that affect both children and adults?

Do we need distinct paediatric classification criteria for rheumatic diseases that affect both children and adults?

High risk of misclassification of acute Parvovirus B19 infection into a systemic rheumatic disease.

Parvovirus B19 most frequently causes epidemics of erythema infectiosum in children but also affects adults often leading to rheumatologic manifestations. While the serum profile allows the diagnosis, manifestations may mimic autoimmune conditions. The aim was to evaluate the proportion of patients with acute Parvovirus B19 infection fulfilling classification criteria for rheumatic diseases (RA and SLE). We evaluated the clinical and serological features of 54 patients diagnosed with acute Parvovirus B19 infection seeking rheumatological attention between March and June 2024. The majority of patients were females (78%), with a mean (s.d.) age of 45 (13) years and 54% could not recall any known exposure. Fifty-one/54 (94%) had arthralgia, 27 (50%) arthritis (oligoarthritis in 67% of them), 24 (44%) fever, 19 (35%) skin rash and 7 (13%) purpura. Symptoms resolution generally occurred within 6 weeks. Complement levels were low in 14/33 (42%) tested patients, while the presence of serum ANA, anti-dsDNA, anti-phospholipids and rheumatoid factor was detected in 21/38 (55%), 10/26 (38%), 6/12 (50%) and 5/37 (13%) patients, respectively. Classification criteria for SLE were fulfilled in 93% of ANA-positive patients and RA criteria in 38% of patients with arthritis. Parvovirus B19 infection manifestations may vary and nearly all patients with positive serum ANA fulfil the classification criteria for SLE. The risk of misclassification in patients with viral infection should not be overlooked.

Association between sinusitis and incident rheumatic diseases: a population-based study

ObjectivesTo determine whether antecedent sinusitis is associated with incident rheumatic disease.MethodsThis population-based case–control study included all individuals meeting classification criteria for rheumatic diseases between 1995 and 2014. We matched three...

Prevalence of rheumatic diseases in Russia

Aim : To estimate the prevalence of the rheumatic diseases in an epidemiological study. Materials and methods: During a questionnaire survey among 76 162 adult individuals in 12 regions of the Russian Federation, those with complaints of joint pain and swelling were selected and a group (n = 4894) was formed at random for subsequent clinical assessment by rheumatologists to identify main rheumatic diseases. In all regions, the study was conducted according to the unified protocol, with the unified strategy of the population selection and the use of unified questionnaires. Diagnoses were made based on widely adopted classification criteria for rheumatic diseases. Results: For the first time in Russia it was found that among adult Russian population, the life-time prevalence of joint pain (mostly knee and hip) was 39.5%, whereas that of joint swelling amounted to 26%. From those, arthralgias eventually disappear in 8% and arthritis, in 7%. Among all rheumatic clinical entities, knee and/or hip osteoarthritis ranks the first, with its prevalence calculated to all adult population of Russia above 18 years of age being 13%. The prevalence of rheumatoid arthritis was 0.61%, of ankylosing spondylitis, 0.1%, psoriatic arthritis, 0.37%, reactive arthritis, 0.42%, gout, 0.3%, and of systemic connective tissue disorders (systemic lupus erythematosus, systemic sclerosis, dermatomyositis/polymyositis, Sjogren's syndrome, systemic vasculitis, etc), 0.11%. Conclusion: The true prevalence of the rheumatic diseases found in the epidemiological study was higher than the data of the official statistics as follows: 2.5-fold for rheumatoid arthritis, 5-fold for osteoarthritis, 3.5-fold for spondyloarthritis and 3-fold for systemic connective tissue disorders. The results obtained showed an underestimation of the rheumatic diseases and incomplete data in the country statistics. This might be related to low referral levels for medical care due to significant distances of the vast regional areas from the specialized centers, as well as with insufficient qualification of primary care physicians in the field of rheumatology. All together, this leads to inevitable and serious misdiagnoses and low registration of the rheumatic diseases.

Immunsystem und rheumatische Erkrankungen im Alter

Impairments of the immune system play an important role in all immun-mediated rheumatic diseases. Recently, the following news were reported: · Early aging of the immune system with thymus insufficiency has now been reported for both patients with rheumatoid arthritis and axial spondyloarthritis, without prethymic lack of progenitors at least in rheumatoid arthritis.. · For giant cell arteritis, the most frequent vasculitis in the elderly, an increased expression of IL-17A in temporal artery biopsies coincides with good prognosis and reponse to glucocorticoids.. · Concerning immunosenescence in systemic lupus erythematosus, BAFF appears to have an important role for relapses after B-cell depletion.. For the future it can be anticipated that the use of unified classification criteria for rheumatic diseases (as with the new 2012 EULAR / ACR classification criteria for polymyalgia rheumatica) will ensure better comparability of immunological studies also in the elderly.

Classification criteria for rheumatic diseases: Why and how?

, Johnsonet al report the results of a systematic literature research onthe main psychometric properties of classification criteriafor rheumatic diseases (1). A previous editorial (2), writtenby members of the American College of Rheumatology(ACR) Classification and Response Criteria Subcommitteeof the Committee on Quality Measures, emphasized themain steps to follow when proposing classification and/orresponder criteria, and in their article, Johnson et al giveuseful additional information on this topic.The main scientific societies in rheumatology, such asthe ACR and the European League Against Rheumatism(EULAR), strongly support research in the field of classi-fication or responder criteria and have promoted appropri-ate standing committees for this purpose. Within EULAR,there are 2 committees dealing with criteria: the StandingCommittee of Epidemiology, and the Standing Committeefor International Studies Including Clinical Trials. Withinthe ACR, the Committee on Quality Measures is in chargeof this aspect.The role of the ACR and EULAR in defining criteria is topromote procedures that are useful for optimizing the col-laboration between experts in a rheumatologic field ofinterest (e.g., rheumatoid arthritis, ankylosing spondylitis,gout, osteoarthritis, etc.) and experts in the field of clinicalepidemiology (3). Most experts in a specific field of rheu-matology are not also experts in the field of clinical epi-demiology and, therefore, might not be the appropriatepeople to plan, conduct, and analyze studies in order topropose criteria for rheumatic diseases. Similarly, mostexperts in clinical epidemiology are not also experts inspecific topics of rheumatic disorders. There is a need tocombine their expertise. Therefore, the role of the appro-priate EULAR and ACR committee is to help colleagueswho are experts in a specific field and are planning topropose criteria by providing them with expertise in thefield of clinical epidemiology.Such expertise can be provided by obtaining a criticalreview of applications by the appropriate committee, or byproposing a clinical epidemiologist to be part of the taskforce aimed at proposing criteria. In the latter case, whichis the current EULAR procedure for the elaboration ofrecommendations (3), it is mandatory for each task force topropose both a convener, who is usually the expert in thefield of research, and a clinical epidemiologist, who maybe inexperienced in the specific disease. For example,Bernard Combe and Robert Landewe´ acted as the convenerand clinical epidemiologist, respectively, for the EULARrecommendations for management of early arthritis (4).A basis for recommendations and procedures proposedby the ACR Classification and Response Criteria Subcom-mittee of the Committee on Quality Measures with regardto the elaboration and validation steps of criteria for rheu-matic diseases has been explicitly described in the articleby Johnson et al (1). It should be emphasized that due tothescreeningtechniqueJohnsonetalusedinselectingsetsof criteria to assess, their review is not exhaustive of allexisting sets of criteria, but rather is aimed at raisingawareness of methodologic issues regarding diagnosticand classification criteria. This article is a basis for furtherresearch in the field of criteria (i.e., it can be used as afuture work agenda). We strongly recommend readingtheir Methods section carefully, as we feel that it reflectsthe suggestions of the ACR Quality Measures Committee,which were presented in an earlier editorial in