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Abstract Background/Aim To investigate the frequency and clinical relevance of an extended autoantibody profile in patients with systemic sclerosis (SSc). Materials and Methods In this cross‐sectional study, serum from 100 consecutive patients was subjected to indirect immunofluorescence (IIF) (HEp‐20‐10/primate liver mosaic) and Systemic Sclerosis Profile by EUROIMMUN to evaluate anti‐nuclear antibodies (ANA) and autoantibodies against 13 different autoantibodies in patients with SSc less than 3 years. Results Ninety‐three of 100 patients were positive for ANA by IIF. Fifty‐three patients showed single positivity, 26 anti‐topoisomerase antibodies (anti‐Scl70 ab), 16 anticentromere antibodies (ACAs), six anti‐RNA polymerase III antibodies (anti‐RNAPIII ab), one anti‐Ku antibody, one anti‐PM/Scl100 antibody, two anti‐PM/Scl75 antibodies, one anti‐Ro52 antibody, whereas 32 patients had multiple autoantibody positivities. Among classic SSc‐specific autoantibodies, anti‐Scl70 and anti‐RNAPIII abs showed the highest cooccurrence (n = 4). One patient was simultaneously positive for anti‐RNAPIII ab and ACA, and one was positive for ACA and anti‐Scl70 ab. The clinical features were not statistically different between single and multiple autoantibody‐positivity for classic SSc‐specific autoantibodies (ACA, anti‐Scl70 ab, and anti‐RNAPIII ab), except for digital ulcer in the multiantibody positive ACA group (p = .019). Conclusion Based on our results, coexpression of autoantibodies is not uncommon in SSc patients. Although autoantibodies specific to SSc in early disease show generally known clinical features, it remains to be investigated how the coexpression of autoantibodies will affect clinical presentation.

Introduction In this study, we aimed to determine the frequency of MEFV mutations in Behçet’s disease (BD) and to investigate the relationship between clinical findings of the disease and the MEFV mutations. Material and methods A total of 66 participants (30 BD patients, 36 healthy subjects) were included in this study. The MEFV gene was analyzed by using DNA sequence analysis. Results The distribution of MEFV mutations was not significantly different between the patients and the control group (p = 0.373). However, individuals with R202Q mutation had a risk of OR 4 times (95% CI: 1.1–14.5) higher than those without the mutation (p = 0.035). The rate of vascular involvement was statistically significantly higher in patients with the mutation than in patients without the mutation (p = 0.005). Conclusions MEFV mutation was associated with vascular involvement in patients with BD. This is also the first study to indicate that the R202Q mutation may have a role in BD. However large series from different regions are required to compare these results.

Şiddetli akut solunum yolu sendromu koronavirüsü 2 (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) solunum sistemini en çok etkileyen ve akciğerdeki çok sayıda ACE2 reseptörü nedeniyle hızla yayılan bulaşıcı bir ajandır. Artralji ve miyalji en sık görülen romatolojik bulgulardır, ancak artrit nadirdir. Sitokin fırtınası adı verilen hiperinflamatuar durum, akut solunum sıkıntısı sendromu (acute respiratory distress syndrome, ARDS)’na neden olarak ölüme neden olur. Koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) çoğu durumda hafif veya asemptomatik olmasına rağmen, özellikle ileri yaş ve komorbiditeleri olan hastalarda pnömoni ve ARDS'ye ilerleyebilir. Enflamatuar yanıtı baskılayan ve sitokin fırtınasını azaltan tosiluzumab gibi ilaçlar, COVID-19 pnömonisinin tedavisinde etkili olabilir. Nedeni tam olarak anlaşılamayan ve bağışıklık sistemindeki birçok yapının birbiriyle etkileşime girdiği sitokin fırtınası oldukça karmaşıktır ve buna katkıda bulunan farklı mekanizmalara sahiptir. Tedavide hidroksiklorokin gibi antimalaryal ilaçlar kullanılsa da etkili olduklarına dair kesin bir kanıt yoktur. Romatizmal hastalıklarda COVID-19 sıklığının ve seyrinin genel popülasyona benzer olduğu, artan yaş ve ek komorbid durumların mortalite riskini artırdığı gösterilmiştir. Romatizmal hastalıkların tedavisinde kullanılan anti-romatizmal ilaçların, hasta COVID-19 ile enfekte olmadıkça kesilmemesi önerilmektedir.

BackgroundThe course of novel coronavirus disease 2019 (COVID-19) has been of special concern in patients with inflammatory rheumatic diseases (IRDs) due to the immune dysregulation that may be associated with these diseases and the medications used for IRDs, that may affect innate immune responses.ObjectiveIn this cohort study, we aimed to report the disease characteristics and variables associated with COVID-19 outcome among Turkish patients with IRDs.MethodsBetween April and June, 2020, 167 adult IRD patients with COVID-19 were registered from 31 centers in 14 cities in Turkey. Disease outcome was classified in 4 categories; (i) outpatient management, (ii) hospitalization without oxygen requirement, (iii) hospitalization with oxygen requirement, and (iv) intensive care unit (ICU) admission or death. Multivariable ordinal logistic regression analysis was conducted to determine variables associated with a worse outcome.Results165 patients (mean age: 50 ± 15.6 years, 58.2% female) were included. Twenty-four patients (14.5%) recovered under outpatient management, 141 (85.5%) were hospitalized, 49 (30%) required inpatient oxygen support, 22 (13%) were treated in the ICU (17 received invasive mechanic ventilation) and 16 (10%) died. Glucocorticoid use (OR: 4.53, 95%CI 1.65-12.76), chronic kidney disease (OR: 12.8, 95%CI 2.25-103.5), pulmonary disease (OR: 2.66, 95%CI 1.08-6.61) and obesity (OR: 3.7, 95%CI 1.01-13.87) were associated with a worse outcome. Biologic disease-modifying antirheumatic drugs (DMARDs) do not seem to affect COVID-19 outcome while conventional synthetic DMARDs may have a protective effect (OR: 0.36, 95%CI 0.17-0.75). Estimates for the associations between IRD diagnoses and outcome were inconclusive.ConclusionsAmong IRD patients with COVID-19, comorbidities and glucocorticoid use were associated with a worse outcome, while biologic DMARDs do not seem to be associated with a worse outcome.

Introduction: Immunosuppressive drug use is common in the treatment of systemic lupus erythematosus (SLE). In cases receiving immunosuppressive therapy, screening for hepatitis B reactivation risk is also recommended. In this study, we aimed to investigate the frequency of hepatitis B screening in cases diagnosed as having SLE, who were followed up in the Rheumatology Clinic of Hatay Mustafa Kemal University. Materials and Methods: We included 93 patients who were followed-up in the Rheumatology Clinic of Hatay Mustafa Kemal University with the diagnosis of SLE between July 2017-December 2019 in our study. The screening rates of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core protein antibody (anti-HBc IgG) of the cases and the immunosuppressive drugs used by them were analyzed retrospectively. Results: The mean age of the cases was 38 years (minimum-maximum: 18-79), and 91.4% were women. Of the cases, 43 (46.2%) were determined to be never screened for hepatitis B, 34 (36.6%) screened inadequately, and only 16 (17.2%) screened fully. In 22 cases receiving high-risk immunosuppressive therapy, the rate of full screening of hepatitis B was 27.3%. Conclusion: In patients with SLE, even those who used high-risk immunosuppressive therapy, screening rates were found low. We think that awareness should be increased in this regard by performing joint training with clinics that start immunosuppressive therapy, a periodic repetition of these trainings should be done, and also multi-center studies should be conducted.

Introdução: Colchicina é a viga-mestra para o tratamento de FFM, que é uma doença autoinflamatória com polisserosite recidivante como principal manifestação. Apesar de doses diárias de 2 mg ou mais/dia, aproximadamente 5%-10% dos pacientes continuam a sofrer de seus ataques. Neste estudo, objetivamos investigar os aspectos da depressão e dos ataques em pacientes com FFM apresentando resistência à colchicina (RC). Pacientes e Métodos: Em pacientes com FFM, RC foi definida como dois ou mais ataques nos últimos seis meses, quando em medicação com colchicina 2 mg/dia. Dezoito pacientes (nove mulheres e nove homens) foram recrutados no grupo RC e 41 pacientes no grupo de controle (29 mulheres/12 homens). Foram avaliados os achados demográficos, clínicos e laboratoriais, a fidelidade ao tratamento e os escores do Beck Depression Inventory (BDI). Resultados: A idade de surgimento da FFM foi significativamente menor no grupo RC (12,3 anos vs. 16,9 anos, P = 0,03). A duração da doença foi maior no grupo RC (p = 0,01). Dores abdominais e nas pernas em decorrência do exercício foram significativamente mais frequentes no grupo RC versus controles (83% vs. 51%; p = 0,02 e 88% vs. 60%; p = 0,04, respectivamente). Pacientes com escores BDI > 17 pontos foram mais frequentes no grupo RC versus controles (50% vs. 34,1%; p < 0,001). Discussão: Verificamos que: (1) a idade do surgimento da doença foi mais baixa e (2) a duração da doença foi maior no grupo RC. Ataques pleuríticos, hematúria e proteinúria foram mais frequentes em pacientes com RC. Propomos que a depressão é fator importante a ser levado em consideração na sensibilidade à RC.

Abstract Anti-tumor necrosis factor drugs are frequently preferred in the treatment of rheumatologic diseases and other inflammatory diseases. The development of myositis after using anti-tumor necrosis factor drugs is a rare clinical condition. Here we aimed to report cases who developed myositis after using anti-tumor necrosis factor drugs and review the current literature. We report two cases of rheumatoid arthritis and a case of ankylosing spondylitis developed idiopathic inflammatory myopathy following anti-tumor necrosis factor therapy. In conclusion, myositis could develop during anti-tumor necrosis factor therapy, so these patients should be evaluated carefully initially for myositis and should be closely monitored due to the potential for developing myositis in treatment process.