331 results on '"SORIANO, Alessandra"'
Search Results
102. A retrospective analysis of 3156 admissions with fever of unknown origin in a large Italian hospital.
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Nicolotti, N, Cattel, Caterina, Gualano, Mr, Soriano, Alessandra, Manna, Raffaele, Boccia, Stefania, Manna, Raffaele (ORCID:0000-0003-1560-3907), Boccia, Stefania (ORCID:0000-0002-1864-749X), Nicolotti, N, Cattel, Caterina, Gualano, Mr, Soriano, Alessandra, Manna, Raffaele, Boccia, Stefania, Manna, Raffaele (ORCID:0000-0003-1560-3907), and Boccia, Stefania (ORCID:0000-0002-1864-749X)
- Abstract
Background: fever of unknown origin (FUO) is defined as a fever with no etiologic diagnosis after standardized investigations performed during 3 days in hospital or after at least 3 ambulatory visits. Our study aims to describe the epidemiology of classic FUO through the retrospective analysis of 902 861 admissions to a large University Hospital in Italy, to investigate its temporal trend, and to evaluate differences between young and old patients. Methods: we retrieved data records of all the admissions between the 1st January 1988 and 31st December 2007. Proportional admission rate (PAR) of FUO was calculated. Time trends of FUO admissions were analysed by joinpoint regression, with time changes expressed as Expected Annual Percent Change (EA PC). The ICD 9-CM code was used to identify the diagnosis on discharge of FUO cases. Results: in the study period 3 156 patients were admitted with a diagnosis of FUO (PAR=3.50 per 1 000). The time-trend analysis showed two joinpoints, the first in 1995 (EAPC of 307.80, 95% CI: 89.66-776.84, p=0.002), and the second in 1998 (EAPC=-8.57, 95% CI: -10.37-6.73; p<0.001). Around 22% of admissions remained without a definitive diagnosis of FUO, with this percentage being lower in patients ≥65 years compared with subjects aged 21-64. ConclusionS: FUO is a leading cause of admission to hospitals, as well as of morbidity and mortality, thus representing a challenge for diagnostic medicine and hospital care. It is necessary to develop a diagnostic methodology for FUO, so as to reduce costs of preventable hospitalizations.
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- 2013
103. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) 2013: Unveiling the pathogenic, clinical and diagnostic aspects
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Perricone, Carlo, primary, Colafrancesco, Serena, additional, Mazor, Roei D., additional, Soriano, Alessandra, additional, Agmon-Levin, Nancy, additional, and Shoenfeld, Yehuda, additional
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- 2013
- Full Text
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104. Quantifying the efficacy of influenza vaccines
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Soriano, Alessandra, Manna, Raffaele, Manna, Raffaele (ORCID:0000-0003-1560-3907), Soriano, Alessandra, Manna, Raffaele, and Manna, Raffaele (ORCID:0000-0003-1560-3907)
- Abstract
In their meta-analysis of the efficacy and effectiveness of influenza vaccines licensed in the USA, Michael Osterholm and colleagues1 stated that “evidence for protection in adults aged 65 years or older is lacking”, although chronic disorders such as cardiac and pulmonary diseases could require influenza vaccination. The cost-effectiveness of influenza vaccination policy requires consideration of adverse effects such as autoimmune disorders, which are rarely reported. Possible reasons for disregarding these events include the subacute presentation in some cases and the variable latency period (from days to years), which makes ascertainment of the causality link difficult.2 The 1976 national influenza immunisation programme against swine flu subtype A/NJ/76 in the USA was stopped because of the emergence of Guillain-Barré syndrome in some vaccine recipients. The USA, the UK, and Germany have initiated active surveillance studies to detect potential rare adverse events, and “the overall risk–benefit assessments must be interpreted very carefully, since the composition of annual influenza vaccines varies each season“3 and the risk of side-effects might depend on the subtype, or adjuvants, or both. For the past few years, all post-vaccination events have been included in the spectrum of autoimmune or inflammatory syndrome induced by adjuvants, because of previous exposure to immune adjuvants, including those used in vaccines to boost an immune response.4 In our Periodic Fevers Research Centre, which admits patients with fever of unknown origin, over 6 years we identified ten cases of giant cell arteritis or polymyalgia rheumatica, occurring within 3 months of influenza vaccination. A Medline search from 1978 to 2011 showed 11 isolated cases of the same disorders happening after influenza vaccination.5 Such disorders are common in people older than 65 years, who are a major target of influenza vaccination policy. In the Comment accompanying Osterholm and colleagues' me
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- 2012
105. Familial Mediterranean fever: New phenotypes
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Soriano, Alessandra, Manna, Raffaele, Manna, Raffaele (ORCID:0000-0003-1560-3907), Soriano, Alessandra, Manna, Raffaele, and Manna, Raffaele (ORCID:0000-0003-1560-3907)
- Abstract
Familial Mediterranean fever (FMF) is an inherited autosomal recessive disorder, ethnically restricted and commonly found among individuals of Mediterranean descent, caused by MEditerranean FeVer gene (MEFV) mutations on chromosome 16. It is the most frequent periodic febrile syndrome among the autoinflammatory syndromes. Clinically, FMF can be distinguished into three phenotypes: type 1, which is commonly associated with recurrent short episodes of inflammation and serositis, including fever, peritonitis, synovitis, pleuritis, but also pericarditis, orchitis or meningitis episodes; type 2, characterized by the evidence of reactive amyloid-associated (AA) amyloidosis, the most severe complication of FMF, as the first clinical manifestation of the disease in an otherwise asymptomatic individual; type 3, referred to the 'silent' homozygous or compound heterozygote state, in which two MEFV mutations are detected without signs or symptoms of FMF nor of AA amyloidosis. In the recent years it has been observed that also heterozygous mutation carriers can suffer from a mild or incomplete form of FMF, named 'FMF-like' disease. The influence of other modifiers genes and/or environmental factors can contribute to the variable penetrance and to the phenotypic variability of FMF. The insight into complex clinical and genetic cases will provide adjunctive details for the comprehension of the mechanisms of this kaleidoscopic disease.
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- 2012
106. Polymyalgia rheumatica in 2011
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Soriano, Alessandra, Landolfi, Raffaele, Manna, Raffaele, Landolfi, Raffaele (ORCID:0000-0002-7913-8576), Manna, Raffaele (ORCID:0000-0003-1560-3907), Soriano, Alessandra, Landolfi, Raffaele, Manna, Raffaele, Landolfi, Raffaele (ORCID:0000-0002-7913-8576), and Manna, Raffaele (ORCID:0000-0003-1560-3907)
- Abstract
Polymyalgia Rheumatica (PMR) is an inflammatory rheumatic disease that commonly affects individuals over 50 years of age, characterised by pain and morning stiffness of the shoulder and pelvic girdle. PMR can present as 'isolated' form or may be associated with giant cell arteritis. The progress of imaging techniques has helped in understanding different clinical patterns: subclinical vasculitis can occur in at least one-third of PMR patients, causing ischaemic complications. It is considered a polygenic disease and environmental factors may play a role in its pathogenesis, such as viral or bacterial triggers, both in the 'wide' form or assembled with adjuvants in vaccines. The response to steroid therapy is generally dramatic and side effects may occur, as well as the development of glucocorticoid resistance. The optimisation of therapy may require steroid-sparing agents as well as modified-release prednisone as 'nighttime' replacement therapy.
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- 2012
107. Giant cell arteritis and polymyalgia rheumatica after influenza vaccination: report of 10 cases and review of the literature
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Soriano, Alessandra, Verrecchia, Elisa Carla Bianca, Marinaro, Alessia, Giovinale, Maria, Fonnesu, Claudia, Landolfi, Raffaele, Manna, Raffaele, Landolfi, Raffaele (ORCID:0000-0002-7913-8576), Manna, Raffaele (ORCID:0000-0003-1560-3907), Soriano, Alessandra, Verrecchia, Elisa Carla Bianca, Marinaro, Alessia, Giovinale, Maria, Fonnesu, Claudia, Landolfi, Raffaele, Manna, Raffaele, Landolfi, Raffaele (ORCID:0000-0002-7913-8576), and Manna, Raffaele (ORCID:0000-0003-1560-3907)
- Abstract
Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory rheumatic diseases common in people over the age of 50 years. Herein, we report 10 cases of previously healthy subjects who developed GCA/PMR within 3 months of influenza vaccination (Inf-V). A Medline search uncovered additional 11 isolated cases of GCA/PMR occurring after Inf-V. We discuss the role of individual susceptibility, the potential function of immune adjuvants as triggers of autoimmunity post-vaccination, and the correlation of our observation with the 'ASIA' syndrome, i.e. autoimmune/inflammatory syndrome induced by adjuvants and including post-vaccination phenomena.
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- 2012
108. Febbre ed ipertermia
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Gasbarrini, Giovanni, Gricelli, Claudio, S.M.G., GASBARRINI, ANTONIO, Manna, Raffaele, Soriano, Alessandra, Verrecchia, Elena, Manna, Raffaele (ORCID:0000-0003-1560-3907), Gasbarrini, Giovanni, Gricelli, Claudio, S.M.G., GASBARRINI, ANTONIO, Manna, Raffaele, Soriano, Alessandra, Verrecchia, Elena, and Manna, Raffaele (ORCID:0000-0003-1560-3907)
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- 2010
109. Cyclosporine A: good response for patients affected by autoimmune disorders and HCV infection?
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Manna, Raffaele, Verrecchia, Elena, Fonnesu, Claudia, Giovinale, Maria, De Socio, Giuliana, Curigliano, Valentina, Cerquaglia, Claudia, Soriano, Alessandra, Gasbarrini, Giovanni Battista, Manna, Raffaele (ORCID:0000-0003-1560-3907), Manna, Raffaele, Verrecchia, Elena, Fonnesu, Claudia, Giovinale, Maria, De Socio, Giuliana, Curigliano, Valentina, Cerquaglia, Claudia, Soriano, Alessandra, Gasbarrini, Giovanni Battista, and Manna, Raffaele (ORCID:0000-0003-1560-3907)
- Abstract
INTRODUCTION: In autoimmune disorders (ADs), if Hepatitis C Virus (HCV) is present, immunosuppressive treatment could increase virus replication. Cyclosporine A (CsA), in standard therapeutic doses, has been proven able to inhibit HCV cyclophilin in vitro. Therefore CsA could improve the therapy of HCV patients with ADs. AIM: In these patients, we started an open pilot study to evaluate the safety of 3 mg/kg CsA and the ability to reduce steroid therapy. PATIENTS AND METHODS: Five females and 1 male were recruited; mean age 66 +/- 8 years, mean disease duration 13 +/- 5 years. Three patients are affected by Psoriasic Arthritis, 1 by Rheumatoid Arthritis, 1 by Sjogren Syndrome, and 1 by Myasthenia Gravis. None of them had chronic active hepatitis. HCV genotypes were type 2 (in 3 cases) and type 1 (in 3 cases). Patients were treated with 3 mg/kg of CsA for a period of time ranging from 6 to 12 months. The starting mean dose of prednisone was 12.5 mg/day. Liver function tests were checked monthly and serum HCV-RNA load was checked by RT-PCR before and 2 months into the therapy. RESULTS: The prednisone dose was reduced from 12.5 mg/day to 7.5 mg/day. The aminotransferases levels were unchanged after 6 months. In patients with low HCV-RNA levels before treatment, no modifications of viral load were observed, whereas patients with increased levels at onset showed mild reduction 2 months into the treatment. CONCLUSIONS: Immunosuppressive treatment of ADs patients with HCV infection can be safely provided with the integration of CsA.
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- 2009
110. Gastrointestinal amyloidosis: a case of chronic diarrhoea.
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Manna, Raffaele, Fonnesu, Claudia, Giovinale, Maria, Verrecchia, Elena, De Socio, Giuliana, Cerquaglia, Claudia, Curigliano, Valentina, Soriano, Alessandra, Grieco, Antonio, Lauriola, Libero, Gasbarrini, Giovanni Battista, Manna, Raffaele (ORCID:0000-0003-1560-3907), Grieco, Antonio (ORCID:0000-0002-0544-8993), Lauriola, Libero (ORCID:0000-0003-0481-5138), Manna, Raffaele, Fonnesu, Claudia, Giovinale, Maria, Verrecchia, Elena, De Socio, Giuliana, Cerquaglia, Claudia, Curigliano, Valentina, Soriano, Alessandra, Grieco, Antonio, Lauriola, Libero, Gasbarrini, Giovanni Battista, Manna, Raffaele (ORCID:0000-0003-1560-3907), Grieco, Antonio (ORCID:0000-0002-0544-8993), and Lauriola, Libero (ORCID:0000-0003-0481-5138)
- Abstract
Amyloidosis is a rare disease caused by extracellular deposits of insoluble fibrillar proteins in various organs and tissues. There are different forms of amyloidosis distinguished by the type of protein fibrils, by the sites of deposition and by associated conditions. Gastrointestinal involvement is common both in primary and secondary amyloidosis, while isolated gastrointestinal amyloidosis is rare. We describe a case of AL amyloidosis with a gastrointestinal involvement and restrictive cardiomiopathy. A 64 year old woman came to our attention with a history of chronic diarrhoea and weight loss, associated with dysphagia, dry mouth, xerophtalmia, chronic gastritis and depression. Clinical diagnosis has been difficult because of aspecificity of symptoms that mimed other more common diseases, like gastro-paresis, epigastric discomfort, gastric or duodenal ulcers, perforation, malabsorption, intestinal pseudo-obstruction. There is an important risk of misunderstanding and diagnostic delay. Indeed in this patient a diagnosis of irritable colon syndrome was erroneously established two years before admission in our hospital. Therefore gastrointestinal amyloidosis should be considered among differential diagnoses of chronic diarrhoea and weight loss when other more common diseases have been excluded.
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- 2009
111. Atypical sarcoidosis: case reports and review of the literature.
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Giovinale, Maria, Fonnesu, Claudia, Soriano, Alessandra, Cerquaglia, Claudia, Curigliano, Valentina, Verrecchia, Elena, De Socio, Giuliana, Gasbarrini, Giovanni Battista, Manna, Raffaele, Manna, Raffaele (ORCID:0000-0003-1560-3907), Giovinale, Maria, Fonnesu, Claudia, Soriano, Alessandra, Cerquaglia, Claudia, Curigliano, Valentina, Verrecchia, Elena, De Socio, Giuliana, Gasbarrini, Giovanni Battista, Manna, Raffaele, and Manna, Raffaele (ORCID:0000-0003-1560-3907)
- Abstract
Sarcoidosis is a granulomatous disease of unknown origin, with pulmonary findings in more than 90% of patients. Extrapulmonary involvement is common and all organs can be involved (especially lymph nodes, eyes, joints, central nervous system) but it is rare to find an isolated extrapulmonary disease (less than 10% of patients). Granulomatous inflammation of the spleen and the liver is common in patients with systemic sarcoidosis, while hepatosplenic enlargement is unusual and splenic involvement rare. We report two cases of systemic sarcoidosis, that onset with splenic and hepatosplenic disease, and one case with splenic sarcoidosis without pulmonary involvement. In the first case a 53-year-old woman with mild abdominal pain underwent sonography and CT, which revealed one hypoechoic/hypodense splenic lesion. Laboratory tests were normal. In order to exclude a lymphoma, splenectomy was performed: histology revealed a sarcoid granuloma. After surgery the patient was asymptomatic and now, after two years, disease is silent. The second case is a 66-year-old woman with a recent weight loss (8 kg in two months) and alterated liver function tests (AST 61 U/l, ALT 72 U/l, Alkaline phosphatase 748 U/l, g-GT 381 U/l). Since she had a familiar history of colon cancer, abdominal US scan, abdominal CT scan and MRI were performed and showed inter-aorto-caval lymphadenopathies and discreet multiple bilobar hepatic and splenic substitutive lesions, with no signs of primary tumor. Upper and lower GI endoscopy, full gynecological workup, complete set of tumor markers, bone marrow biopsy were performed. All resulted negative for neoplasia. Small pulmonary infiltrations were observed on chest-CT scan but cytology on BAL was normal. Infections were also excluded. An exploratory laparotomy showed whitish peritoneal, hepatic and splenic nodules. The histological exam revealed chronic granulomatous lesions typical for sarcoidosis. During a two-year follow-up after the splenectomy the patie
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- 2009
112. Clinical features of familial Mediterranean fever: an Italian overview.
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Manna, Raffaele, Cerquaglia, Claudia, Curigliano, Valentina, Fonnesu, Claudia, Giovinale, Maria, Verrecchia, Elena, Montalto, Massimo, De Socio, Giuliana, Soriano, Alessandra, La Regina, Micaela, Gasbarrini, Giovanni Battista, Manna, Raffaele (ORCID:0000-0003-1560-3907), Montalto, Massimo (ORCID:0000-0001-8819-3684), Manna, Raffaele, Cerquaglia, Claudia, Curigliano, Valentina, Fonnesu, Claudia, Giovinale, Maria, Verrecchia, Elena, Montalto, Massimo, De Socio, Giuliana, Soriano, Alessandra, La Regina, Micaela, Gasbarrini, Giovanni Battista, Manna, Raffaele (ORCID:0000-0003-1560-3907), and Montalto, Massimo (ORCID:0000-0001-8819-3684)
- Abstract
Familial Mediterranean Fever (FMF) is the most frequent periodic febrile syndrome among the autoinflammatory syndromes (AS), nowadays considered as innate immunity disorders, characterized by absence of autoantibodies and autoreactive T lymphocytes. FMF is a hereditary autosomal recessive disorder, characterized by recurrent, self-limiting episodes of short duration (mean 24e72 h) of fever and serositis. In FMF, periodic attacks show inter- and intra-individual variability in terms of frequency and severity. Usually, they are triggered by apparently innocuous stimuli and may be preceded by a prodromal period. The Mediterranean FeVer gene (MEFV) responsible gene maps on chromosome 16 (16p13) encoding the Pyrine/Marenostrin protein. The precise pathologic mechanism is still to be definitively elucidated; however a new macromolecular complex, called inflammasome, seems to play a major role in the control of inflammation and it might be involved in the pathogenesis of FMF. The most severe long-term complication is type AA amyloidosis, causing chronic renal failure. Two types of risk factors, genetic and non-genetic, have been identified for this complication. Currently, the only effective treatment of FMF is the colchicine. New drugs in a few colchicine resistant patients are under evaluation
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- 2009
113. Lung involvement in connective tissue diseases: A comprehensive review and a focus on rheumatoid arthritis
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Marigliano, Benedetta, primary, Soriano, Alessandra, additional, Margiotta, Domenico, additional, Vadacca, Marta, additional, and Afeltra, Antonella, additional
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- 2013
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114. Vitamin D and Systemic Lupus Erythematosus: Myth or Reality?
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Watad, Abdulla, Neumann, Shana G., Soriano, Alessandra, Amital, Howard, and Shoenfeld, Yehuda
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- 2016
115. Familial Mediterranean fever: New phenotypes
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Soriano, Alessandra, primary and Manna, Raffaele, additional
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- 2012
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116. Quantifying the efficacy of influenza vaccines
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Soriano, Alessandra, primary and Manna, Raffaele, additional
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- 2012
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117. Polymyalgia rheumatica in 2011
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Soriano, Alessandra, primary, Landolfi, Raffaele, additional, and Manna, Raffaele, additional
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- 2012
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118. Comment on "Is the Never-Ending Story Still Unsolved? Beyond the Long Debate About Lateral Pelvic Lymph Node Dissection in Rectal Cancer".
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Maurizio Zizzo, Zanelli, Magda, Sanguedolce, Francesca, Soriano, Alessandra, and Ascani, Stefano
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- 2021
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119. Familial Mediterranean Fever: Genetic Update.
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Soriano, Alessandra and Pras, Elon
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- 2014
120. A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility
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Carmona, F. David, Mackie, Sarah L., Martín, Jose-Ezequiel, Taylor, John C., Vaglio, Augusto, Eyre, Stephen, Bossini-Castillo, Lara, Castañeda, Santos, Cid, Maria C., Hernández-Rodríguez, José, Prieto-González, Sergio, Solans, Roser, Ramentol-Sintas, Marc, González-Escribano, M. Francisca, Ortiz-Fernández, Lourdes, Morado, Inmaculada C., Narváez, Javier, Miranda-Filloy, José A., Beretta, Lorenzo, Lunardi, Claudio, Cimmino, Marco A., Gianfreda, Davide, Santilli, Daniele, Ramirez, Giuseppe A., Soriano, Alessandra, Muratore, Francesco, Pazzola, Giulia, Addimanda, Olga, Wijmenga, Cisca, Witte, Torsten, Schirmer, Jan H., Moosig, Frank, Schönau, Verena, Franke, Andre, Palm, Øyvind, Molberg, Øyvind, Diamantopoulos, Andreas P., Carette, Simon, Cuthbertson, David, Forbess, Lindsy J., Hoffman, Gary S., Khalidi, Nader A., Koening, Curry L., Langford, Carol A., McAlear, Carol A., Moreland, Larry, Monach, Paul A., Pagnoux, Christian, Seo, Philip, Spiera, Robert, Sreih, Antoine G., Warrington, Kenneth J., Ytterberg, Steven R., Gregersen, Peter K., Pease, Colin T., Gough, Andrew, Green, Michael, Hordon, Lesley, Jarrett, Stephen, Watts, Richard, Levy, Sarah, Patel, Yusuf, Kamath, Sanjeet, Dasgupta, Bhaskar, Worthington, Jane, Koeleman, Bobby P.C., de Bakker, Paul I.W., Barrett, Jennifer H., Salvarani, Carlo, Merkel, Peter A., González-Gay, Miguel A., Morgan, Ann W., Martín, Javier, Martínez-Berriochoa, Agustín, Unzurrunzaga, Ainhoa, Hidalgo-Conde, Ana, Madroñero-Vuelta, Ana B., Fernández-Nebro, Antonio, Ordóñez-Cañizares, M. Carmen, Escalante, Begoña, Marí-Alfonso, Begoña, Sopeña, Bernardo, Magro, César, Raya, Enrique, Grau, Elena, Román, José A., de Miguel, Eugenio, López-Longo, F. Javier, Martínez, Lina, Gómez-Vaquero, Carmen, Fernández-Gutiérrez, Benjamín, Rodríguez-Rodríguez, Luis, Díaz-López, J. Bernardino, Caminal-Montero, Luis, Martínez-Zapico, Aleida, Monfort, Jordi, Tío, Laura, Sánchez-Martín, Julio, Alegre-Sancho, Juan J., Sáez-Comet, Luis, Pérez-Conesa, Mercedes, Corbera-Bellalta, Marc, García-Villanueva, M. Jesús, Fernández-Contreras, M. Encarnación, Sanchez-Pernaute, Olga, Blanco, Ricardo, Ortego-Centeno, Norberto, Ríos-Fernández, Raquel, Callejas, José L., Fanlo-Mateo, Patricia, and Martínez-Taboada, Víctor M.
- Abstract
We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10−40, OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1∗04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10−43) and HLA-DQα1 47 (p = 4.02 × 10−46), 56, and 76 (both p = 1.84 × 10−45) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10−6, OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10−6, OR = 1.20), and REL (rs115674477, p = 1.10 × 10−5, OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function.
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121. Rituximab in Patients with Takayasu Arteritis: A Single Center Experience on Five Patients
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Pazzola, Giulia, Muratore, Francesco, Boiardi, Luigi, Catanoso, Mariagazia, Soriano, Alessandra, Macchioni, Pierluigi, Spaggiari, Lucia, Massimiliano Casali, Pipitone, Nicolo, Possemato, Niccolo, and Salvarani, Carlo
122. Higher Frequencies of Lymphocytes Expressing the Natural Killer Group 2D Receptor and Cytotoxic Potential of NK Cells in Patients with Behcet Disease
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Martina Bonacini, Croci, Stefania, Soriano, Alessandra, Cal, Eleonora, Zerbini, Alessandro, Cimino, Luca, Muratore, Francesco, Fontana, Luigi, Parmeggiani, Maria, and Salvarani, Carlo
123. Pre-Clinical Evidences of Immunomodulatory Activities of Tuftsin-Phosphorylcholine on Samples from Patients with Giant Cell Arteritis in Comparison to Corticosteroids
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Croci, Stefania, Martina Bonacini, Muratore, Francesco, Caruso, Andrea, Fontana, Antonio, Boiardi, Luigi, Soriano, Alessandra, Cavazza, Alberto, Cimino, Luca, Belloni, Lucia, Parmeggiani, Maria, Blank, Miri, Shoenfeld, Yehuda, and Salvarani, Carlo
124. Immune Mediated Myopathy following Long-Term Statin Therapy.
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Watad, Abdulla, Soriano, Alessandra, Vaknine, Hananya, Shoenfeld, Yehuda, and Amital, Howard
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- 2015
125. New Therapeutic Approaches to Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitides: Looking at Tomorrow.
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Soriano, Alessandra
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- 2015
126. Bacterial Endocarditis following Lithotripsy: an Unusual Complication Caused by a Non-Invasive Procedure.
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Soriano, Alessandra, Mansour, Ribhi, Horovitz, Yuval, and Amital, Howard
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- 2014
127. Catastrophic Antiphospholipid Syndrome: An Orchestra with Several Musicians.
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Rodríguez-Pintó, Ignasi, Soriano, Alessandra, Espinosa, Gerard, Shoenfeld, Yehuda, and Cervera, Ricard
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- 2014
128. The Paradigm of ASIA (Autoimmune/Inflammatory Syndrome Induced by Adjuvants): A Concept in Evolution.
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Soriano, Alessandra
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- 2014
129. Primary effusion lymphoma occurring in the setting of transplanted patients: a systematic review of a rare, life-threatening post-transplantation occurrence.
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Zanelli, Magda, Sanguedolce, Francesca, Zizzo, Maurizio, Palicelli, Andrea, Bassi, Maria Chiara, Santandrea, Giacomo, Martino, Giovanni, Soriano, Alessandra, Caprera, Cecilia, Corsi, Matteo, Ricci, Stefano, Ricci, Linda, and Ascani, Stefano
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EXUDATES & transudates , *OTITIS media with effusion , *BONE marrow transplantation , *LYMPHOMAS , *OLDER patients , *KAPOSI'S sarcoma - Abstract
Background: Primary effusion lymphoma is a rare, aggressive large B-cell lymphoma strictly linked to infection by Human Herpes virus 8/Kaposi sarcoma-associated herpes virus. In its classic form, it is characterized by body cavities neoplastic effusions without detectable tumor masses. It often occurs in immunocompromised patients, such as HIV-positive individuals. Primary effusion lymphoma may affect HIV-negative elderly patients from Human Herpes virus 8 endemic regions. So far, rare cases have been reported in transplanted patients. The purpose of our systematic review is to improve our understanding of this type of aggressive lymphoma in the setting of transplantation, focusing on epidemiology, clinical presentation, pathological features, differential diagnosis, treatment and outcome. The role of assessing the viral serological status in donors and recipients is also discussed.Methods: We performed a systematic review adhering to the PRISMA guidelines. The literature search was conducted on PubMed/MEDLINE, Web of Science, Scopus, EMBASE and Cochrane Library, using the search terms "primary effusion lymphoma" and "post-transplant".Results: Our search identified 13 cases of post-transplant primary effusion lymphoma, predominantly in solid organ transplant recipients (6 kidney, 3 heart, 2 liver and 1 intestine), with only one case after allogenic bone marrow transplantation. Long-term immunosuppression is important in post-transplant primary effusion lymphoma commonly developing several years after transplantation. Kaposi Sarcoma occurred in association with lymphoma in 4 cases of solid organ recipients. The lymphoma showed the classical presentation with body cavity effusions in absence of tumor masses in 10 cases; 2 cases presented as solid masses, lacking effusions and one case as effusions associated with multiple organ involvement. Primary effusion lymphoma occurring in the setting of transplantation was more often Epstein Barr-virus negative. The prognosis was poor. In addition to chemotherapy, reduction of immunosuppressive treatment, was generally attempted.Conclusions: Primary effusion lymphoma is a rare, but often fatal post-transplant complication. Its rarity and the difficulty in achieving the diagnosis may lead to miss this complication. Clinicians should suspect primary effusion lymphoma in transplanted patients, presenting generally with unexplained body cavity effusions, although rare cases with solid masses are described. [ABSTRACT FROM AUTHOR]- Published
- 2021
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130. Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract: a tricky diagnosis of a gastric case.
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Zanelli, Magda, Zizzo, Maurizio, Sanguedolce, Francesca, Martino, Giovanni, Soriano, Alessandra, Ricci, Stefano, Castro Ruiz, Carolina, Annessi, Valerio, and Ascani, Stefano
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LYMPHOPROLIFERATIVE disorders , *GASTROINTESTINAL system , *SMALL intestine , *CELIAC disease , *COLON (Anatomy) , *CASTLEMAN'S disease , *LACTOSE intolerance - Abstract
Background: Indolent T-cell lymphoproliferative disorder of the gastrointestinal tract is a rare low-grade clonal lymphoid proliferation, included as a provisional entity in the current World Health Organization classification. The disease is generally localized to the gastrointestinal tract, mainly small bowel and colon. Involvement of other organs is infrequently reported. The majority of patients show a protracted clinical course with persistent disease. A prolonged survival, even without treatment, is common.Case Presentation: A 28-year-old woman had a 2-year history of dyspepsia and lactose intolerance. Autoimmune diseases and celiac disease were excluded. No gross lesions were identified by endoscopy. Multiple gastric biopsies showed a small-sized lymphoid infiltrate, expanding the lamina propria, with a non-destructive appearance. The lymphoid cells were positive for CD3, CD4, CD5, CD7 and negative for CD20, CD8, CD56, CD103, PD1, CD30, ALK1, CD10, BCL6, perforin, TIA-1, Granzyme B and Epstein-Barr virus-encoded RNA. KI-67 index was low (5%). Molecular analysis revealed a clonal T-cell receptor γ rearrangement. Bone marrow was microscopically free of disease, but molecular testing identified the same T-cell receptor γ rearrangement present in the gastric biopsies. After the diagnosis of indolent T-cell lymphoproliferative disorder of the gastrointestinal tract, the patient received steroid therapy, only for 2 months. She is alive, with a stable disease restricted to the stomach, at 12 months from diagnosis.Conclusions: Indolent T-cell lymphoproliferative disorder is usually a disease of adulthood (median age: 51 yrs). The small bowel and colon are the sites most commonly involved. Our case occurred in a young woman and affected the stomach, sparing small intestine and colon. Clonality testing identified involvement of bone marrow, a site infrequently affected in this disease. Our aim is focusing on the main diagnostic issues. If appropriate immunostainings and molecular analysis are not performed, the subtle infiltrate may be easily overlooked. The risk of misdiagnosis as more aggressive lymphomas, causing patient overtreatment, needs also to be considered. [ABSTRACT FROM AUTHOR]- Published
- 2020
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131. The right place of interleukin-1 inhibitors in the treatment of Behçet's syndrome: a systematic review.
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Bettiol, Alessandra, Silvestri, Elena, Di Scala, Gerardo, Amedei, Amedeo, Becatti, Matteo, Fiorillo, Claudia, Lopalco, Giuseppe, Salvarani, Carlo, Cantarini, Luca, Soriano, Alessandra, and Emmi, Giacomo
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THERAPEUTICS , *INTERLEUKIN-1 , *META-analysis , *DRUG side effects , *SYNDROMES - Abstract
Behçet's syndrome (BS) is a chronic (auto)-inflammatory disorder characterized by different clusters of symptoms, including mucocutaneous and ocular involvements. Interleukin-1 inhibitors anakinra (ANA), canakinumab (CAN), and gevokizumab (GEV) represent a promising therapeutic alternative in BS. To date, evidence on the use of ANA, CAN, and GEV is mainly based on small isolated studies or case series, and the real place of anti-IL1 agents in the treatment of BS is still unclear. We performed a systematic review of current evidence on the efficacy and safety of anti-IL1 agents in BS. The PubMed search yielded a total of 398 references, from which we retrieved 24 studies for inclusion (4 clinical trials, 6 observational studies, 14 case reports, case series or letters to the editor). Four studies evaluated the overall efficacy of IL-1 inhibitors, 15 studies focused on the specific efficacy of ANA, whereas efficacy of CAN and GEV was evaluated in 8 and 3 studies, respectively. Both ANA and CAN were associated with good control of mucocutaneous and ocular manifestations. ANA resulted effective also for osteoarticular manifestations. GEV was studied only for ocular manifestations, but gave contrasting results. Discordant evidence supports the use of ANA and CAN in pediatric setting and for first-line treatment of general BS manifestations. Most frequent side effects were local or diffuse cutaneous reactions and injection site reactions, particularly for ANA treatment. Blocking the IL-1 pathway could be an effective therapeutic strategy in particular BS involvements. [ABSTRACT FROM AUTHOR]
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- 2019
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132. Safety profile of the interleukin-1 inhibitors anakinra and canakinumab in real-life clinical practice: a nationwide multicenter retrospective observational study.
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Sota, Jurgen, Vitale, Antonio, Insalaco, Antonella, Sfriso, Paolo, Lopalco, Giuseppe, Emmi, Giacomo, Cattalini, Marco, Manna, Raffaele, Cimaz, Rolando, Priori, Roberta, Talarico, Rosaria, de Marchi, Ginevra, Frassi, Micol, Gallizzi, Romina, Soriano, Alessandra, Alessio, Maria, Cammelli, Daniele, Maggio, Maria Cristina, Gentileschi, Stefano, and Marcolongo, Renzo
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CHEMICAL inhibitors , *INTERLEUKIN-1 , *MEDICATION safety , *DRUG side effects , *ADVERSE health care events - Abstract
A few studies have reported the safety profile of interleukin (IL)-1 blockers from real life. The aim of this study is to describe anakinra (ANA) and canakinumab (CAN) safety profile in children and adults, based on data from a real-life setting. Demographic, clinical, and therapeutic data from patients treated with ANA and CAN were retrospectively collected and analyzed. Four hundred and seventy five patients were enrolled; ANA and CAN were prescribed in 421 and 105 treatment courses, respectively. During a mean follow-up of 24.39 ± 27.04 months, 89 adverse events (AE) were recorded; 13 (14.61%) were classified as serious AE (sAE). The overall estimated rate of AE and sAE was 8.4 per 100 patients/year. Safety concerns were more frequent among patients aged ≥ 65 years compared with patients < 16 years (p = 0.002). No differences were detected in the frequency of safety concerns between monotherapy and combination therapy with immunosuppressants (p = 0.055), but a significant difference was observed when injection site reactions were excluded from AE (p = 0.01). No differences were identified in relation to gender (p = 0.462), different lines of biologic therapy (p = 0.775), and different dosages (p = 0.70 ANA; p = 0.39 CAN). The overall drug retention rate was significantly different according to the occurrence of safety concerns (p value < 0.0001); distinguishing between ANA and CAN, significance was maintained only for ANA (p < 0.0001 ANA; p > 0.05 CAN). Treatment duration was the only variable associated with onset of AE (OR = 0.399 [C.I. 0.250-0.638], p = 0.0001). ANA and CAN have shown an excellent safety profile; the risk for AE and sAE tends to decrease over time from the start of IL-1 inhibition. [ABSTRACT FROM AUTHOR]
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- 2018
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133. Efficacy and safety of adalimumab in Behçet's disease-related uveitis: a multicenter retrospective observational study.
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Fabiani, Claudia, Vitale, Antonio, Emmi, Giacomo, Vannozzi, Lorenzo, Lopalco, Giuseppe, Guerriero, Silvana, Orlando, Ida, Franceschini, Rossella, Bacherini, Daniela, Cimino, Luca, Soriano, Alessandra, Frediani, Bruno, Galeazzi, Mauro, Iannone, Florenzo, Tosi, Gian, Salvarani, Carlo, and Cantarini, Luca
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BEHCET'S disease , *ADALIMUMAB , *DRUG efficacy , *MEDICATION safety , *UVEITIS treatment , *RETROSPECTIVE studies , *THERAPEUTICS - Abstract
The study aim was to evaluate the efficacy of adalimumab (ADA) in a large series of Behçet's disease (BD)-related uveitis. We performed a multicenter retrospective observational study including 40 selected patients (66 eyes) receiving ADA. Clinical data were retrospectively analyzed at baseline, at 3 and 12 months of treatment. Primary end point was reduction of ocular inflammatory flares. Secondary end points were improvement of best corrected visual acuity (BCVA), reduction of macular thickness measured by optical coherence tomography (OCT), reduction in the occurrence of vasculitis assessed by fluorescein angiography (FA), and evaluation of statistically significant differences between patients treated with ADA monotherapy and those undergoing ADA plus DMARDs and in patients firstly treated with ADA compared to patients previously administered with other biologics; ADA steroid sparing effect was also evaluated. During the first 12 months of ADA therapy, the number of flares significantly decreased from 200 flares/100 patients/year to 8.5 flares/100 patients/year ( p < 0.0001). Similarly, BCVA improved if compared to baseline (7.4 ± 2.9 versus 8.5 ± 2.1, p = 0.03). OCT findings significantly improved showing a mean reduction of central macular thickness (CMT) of 27.27 ± 42.8 μm at the end of follow-up ( p < 0.006). FA identified retinal vasculitis in 22 cases at baseline (55%), 8 (20%) cases after 3 months, and in only one (2.5%) case at 12-month follow-up. FA improvement was highly significant at 3- and 12-month follow-up if compared to baseline ( p < 0.0001 and p = 0.006, respectively). ADA is highly effective and safe for the treatment of BD-related uveitis, providing a long-term control of ocular inflammation. [ABSTRACT FROM AUTHOR]
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- 2017
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134. Role of Colchicine Treatment in Tumor Necrosis Factor Receptor Associated Periodic Syndrome (TRAPS): Real-Life Data from the AIDA Network
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Bruno Frediani, Laura Obici, Alessandra Renieri, Jurgen Sota, Valeria Caggiano, Francesco Licciardi, José Hernández-Rodríguez, Roberto Giacomelli, Piero Ruscitti, Antonio Vitale, Nicola Ricco, Lorenzo Dagna, Carlo Salvarani, Maria Cristina Maggio, Davide Montin, Giacomo Emmi, Alessandra Soriano, Marco Cattalini, Luca Cantarini, Ombretta Viapiana, Vittoria Lamacchia, Francesco Caso, Raffaele Manna, Antonella Insalaco, Vitale, Antonio, Sota, Jurgen, Obici, Laura, Ricco, Nicola, Maggio, Maria Cristina, Cattalini, Marco, Ruscitti, Piero, Caso, Francesco, Manna, Raffaele, Viapiana, Ombretta, Caggiano, Valeria, Emmi, Giacomo, Insalaco, Antonella, Montin, Davide, Licciardi, Francesco, Soriano, Alessandra, Dagna, Lorenzo, Salvarani, Carlo, Lamacchia, Vittoria, Hernández-Rodríguez, José, Giacomelli, Roberto, Frediani, Bruno, Renieri, Alessandra, Cantarini, Luca, Vitale, A., Sota, J., Obici, L., Ricco, N., Maggio, M. C., Cattalini, M., Ruscitti, P., Caso, F., Manna, R., Viapiana, O., Caggiano, V., Emmi, G., Insalaco, A., Montin, D., Licciardi, F., Soriano, A., Dagna, L., Salvarani, C., Lamacchia, V., Hernandez-Rodriguez, J., Giacomelli, R., Frediani, B., Renieri, A., and Cantarini, L.
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Male ,0301 basic medicine ,Eye Diseases ,TRAPS,Colchicine,AIDA Network ,Gene mutation ,Gastroenterology ,Receptors, Tumor Necrosis Factor ,chemistry.chemical_compound ,Settore MED/38 - Pediatria Generale E Specialistica ,0302 clinical medicine ,Receptors ,Pathology ,RB1-214 ,Colchicine ,Age of Onset ,Young adult ,Child ,Amyloidosis ,Syndrome ,Middle Aged ,Colchicine, tumor necrosis factor, TRAPS ,Inflamació ,Penetrance ,Phenotype ,Child, Preschool ,Female ,Joint Diseases ,Research Article ,Adult ,Risk ,medicine.medical_specialty ,Adolescent ,Fever ,Article Subject ,Immunology ,Exanthema ,Humans ,Mutation ,Myalgia ,Retrospective Studies ,Young Adult ,Lower risk ,03 medical and health sciences ,Internal medicine ,medicine ,Preschool ,Inflammation ,030203 arthritis & rheumatology ,business.industry ,TRAPS ,Retrospective cohort study ,Cell Biology ,medicine.disease ,030104 developmental biology ,chemistry ,Age of onset ,Tumor Necrosis Factor ,business - Abstract
Objective. To analyze the potential role of colchicine monotherapy in patients with tumor necrosis factor receptor associated periodic syndrome (TRAPS) in terms of control of clinical and laboratory manifestations. Methods. Patients with TRAPS treated with colchicine monotherapy were retrospectively enrolled; demographic, clinical and therapeutic data were collected and statistically analysed after having clustered patients according to different times at disease onset, penetrance of mutations, dosage of colchicine, and different disease manifestations. Results. 24 patients (14 males; 15 with pediatric disease onset) treated with colchicine monotherapy were enrolled. Colchicine resulted in a complete response in 3 (12.5%) cases, partial response in 14 (58.3%) patients, and lack of response in 7 (29.2%) patients. There were not significant differences in colchicine response between pediatric and adult disease onset (p=0.42), between low- and high-penetrance mutations (p=0.62), and according to different dosages (p=0.66). No significant differences were identified in the frequency of specific disease manifestations between patients experiencing any response to colchicine and patients with lack of response. Conclusions. Colchicine monotherapy is useful in a low percentage of TRAPS patients; nevertheless, it could be attempted in patients with milder phenotypes and at a lower risk of developing reactive amyloidosis.
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- 2020
135. Outcomes of COVID-19 in 79 patients with IBD in Italy: An IG-IBD study
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Angela Variola, D. Morganti, Laurino Grossi, Marta Ascolani, Arnaldo Amato, Fabiana Zingone, Davide Giuseppe Ribaldone, Gianpiero Manes, V. Casini, Claudio Camillo Cortelezzi, Fabiana Castiglione, M.C. Fantini, Flavio Caprioli, Viviana Gerardi, Silvio Danese, Monica Milla, Alessandro Massari, Luca Pastorelli, Mariangela Allocca, Simone Saibeni, Alessandra Soriano, Cristina Bezzio, Chiara Ricci, Marco Daperno, Alessandro Armuzzi, Marco Vincenzo Lenti, Chiara Viganò, Fabrizio Bossa, Alessandro Sartini, Gionata Fiorino, Bezzio, C, Saibeni, S, Variola, A, Allocca, M, Massari, A, Gerardi, V, Casini, V, Ricci, C, Zingone, F, Amato, A, Caprioli, F, Lenti, Mv, Viganò, C, Ascolani, M, Bossa, F, Castiglione, F, Cortelezzi, C, Grossi, L, Milla, M, Morganti, D, Pastorelli, L, Ribaldone, Dg, Sartini, A, Soriano, A, Manes, G, Danese, S, Fantini, Mc, Armuzzi, A, Daperno, M, Fiorino, G, Bezzio, Cristina, Saibeni, Simone, Variola, Angela, Allocca, Mariangela, Massari, Alessandro, Gerardi, Viviana, Casini, Valentina, Ricci, Chiara, Zingone, Fabiana, Amato, Arnaldo, Caprioli, Flavio, Lenti, Marco Vincenzo, Viganò, Chiara, Ascolani, Marta, Bossa, Fabrizio, Castiglione, Fabiana, Cortelezzi, Claudio, Grossi, Laurino, Milla, Monica, Morganti, Daniela, Pastorelli, Luca, Ribaldone, Davide Giuseppe, Sartini, Alessandro, Soriano, Alessandra, Manes, Gianpiero, Danese, Silvio, Fantini, Massimo Claudio, Armuzzi, Alessandro, Daperno, Marco, and Fiorino, Gionata
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Male ,0301 basic medicine ,medicine.medical_treatment ,Comorbidity ,0302 clinical medicine ,Risk Factors ,Epidemiology ,Prospective Studies ,Viral ,Continuous positive airway pressure ,Prospective cohort study ,epidemiology ,IBD ,Age Factors ,Betacoronavirus ,Female ,Hospitalization ,Humans ,Immunosuppressive Agents ,Italy ,Middle Aged ,Outcome and Process Assessment, Health Care ,Patient Acuity ,Coronavirus Infections ,Inflammatory Bowel Diseases ,Pandemics ,Patient Care Management ,Pneumonia, Viral ,Gastroenterology ,030211 gastroenterology & hepatology ,Cohort study ,medicine.medical_specialty ,Outcome and Process Assessment ,03 medical and health sciences ,Internal medicine ,medicine ,SARS-CoV-2 ,business.industry ,COVID-19 ,Pneumonia ,medicine.disease ,digestive system diseases ,Health Care ,030104 developmental biology ,Concomitant ,business - Abstract
ObjectivesCOVID-19 has rapidly become a major health emergency worldwide. Patients with IBD are at increased risk of infection, especially when they have active disease and are taking immunosuppressive therapy. The characteristics and outcomes of COVID-19 in patients with IBD remain unclear.DesignThis Italian prospective observational cohort study enrolled consecutive patients with an established IBD diagnosis and confirmed COVID-19. Data regarding age, sex, IBD (type, treatments and clinical activity), other comorbidities (Charlson Comorbidity Index (CCI)), signs and symptoms of COVID-19 and therapies were compared with COVID-19 outcomes (pneumonia, hospitalisation, respiratory therapy and death).ResultsBetween 11 and 29 March 2020, 79 patients with IBD with COVID-19 were enrolled at 24 IBD referral units. Thirty-six patients had COVID-19-related pneumonia (46%), 22 (28%) were hospitalised, 7 (9%) required non-mechanical ventilation, 9 (11%) required continuous positive airway pressure therapy, 2 (3%) had endotracheal intubation and 6 (8%) died. Four patients (6%) were diagnosed with COVID-19 while they were being hospitalised for a severe flare of IBD. Age over 65 years (p=0.03), UC diagnosis (p=0.03), IBD activity (p=0.003) and a CCI score >1 (p=0.04) were significantly associated with COVID-19 pneumonia, whereas concomitant IBD treatments were not. Age over 65 years (p=0.002), active IBD (p=0.02) and higher CCI score were significantly associated with COVID-19-related death.ConclusionsActive IBD, old age and comorbidities were associated with a negative COVID-19 outcome, whereas IBD treatments were not. Preventing acute IBD flares may avoid fatal COVID-19 in patients with IBD. Further research is needed.
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- 2020
136. Subcutaneous marginal zone lymphoma: an unusual lipoma-like presentation.
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Zanelli, Magda, Zizzo, Maurizio, Sanguedolce, Francesca, Soriano, Alessandra, Martino, Giovanni, Annessi, Valerio, and Ascani, Stefano
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MUCOSA-associated lymphoid tissue lymphoma , *LYMPHOMAS , *LYMPHOID tissue , *B cell lymphoma , *BIOPSY , *COMBINED modality therapy , *COMPUTED tomography , *DIFFERENTIAL diagnosis , *TUMOR classification , *TREATMENT effectiveness , *LIPOMA , *TUMOR grading - Abstract
Dear Editor, A 50-year-old, hepatitis C virus (HCV)-negative, man developed multiple, palpable, soft subcutaneous nodules underlying a normal appearing skin and clinically resembling lipomas. (Right) Microscopic histological examination: dense and diffuse lymphoid infiltrate restricted to the subcutaneous tissue, sparing dermis, and epidermis MZL is a low-grade non-Hodgkin B cell lymphoma frequently affecting extranodal sites, spleen, and lymph nodes [[1]]. 20174: Lyon; IARC: World Health Organization: 978-9283244943 2 Paulli M, Arcaini L, Lucioni M, Boveri E, Capello D, Passamonti F, Merli M, Rattotti S, Rossi D, Riboni R, Berti E, Magrini U, Bruno R, Gaidano G, Lazzarino M. Subcutaneous "lipoma-like" B-cell lymphoma associated with HCV infection: a new presentation of primary extranodal marginal zone B-cell lymphoma of MALT. [Extracted from the article]
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- 2020
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137. Safety profile of the interleukin-1 inhibitors anakinra and canakinumab in real life clinical practice: a nationwide multicenter retrospective observational study
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Sota, J, Vitale, A, Insalaco, A, Sfriso, P, Lopalco, G, Emmi, G, Cattalini, M, Manna, R, Cimaz, R, Priori, R, Talarico, R, de Marchi, G, Frassi, M, Gallizzi, R, Soriano, A, Alessio, M, Cammelli, D, Maggio, Mc, Gentileschi, S, Marcolongo, R, La Torre, F, Fabiani, C, Colafrancesco, S, Ricci, F, Galozzi, P, Viapiana, O, Verrecchia, E, Pardeo, M, Cerrito, L, Cavallaro, E, Olivieri, An, Paolazzi, G, Vitiello, G, Maier, A, Silvestri, E, Stagnaro, C, Valesini, G, Mosca, M, de Vita, S, Tincani, A, Lapadula, G, Frediani, B, De Benedetti, F, Iannone, F, Punzi, L, Salvarani, C, Galeazzi, M, Angotti, R, Messina, M, Tosi, Gm, Rigante, D, Cantarini, L, 'Working Group' of Systemic Autoinflammatory Diseases of SIR (Italian Society of, Rheumatology)., Sota, J., Vitale, A., Insalaco, A., Sfriso, P., Lopalco, G., Emmi, G., Cattalini, M., Manna, R., Cimaz, R., Priori, R., Talarico, R., de Marchi, G., Frassi, M., Gallizzi, R., Soriano, A., Alessio, M., Cammelli, D., Maggio, M. C., Gentileschi, S., Marcolongo, R., La Torre, F., Fabiani, C., Colafrancesco, S., Ricci, F., Galozzi, P., Viapiana, O., Verrecchia, E., Pardeo, M., Cerrito, L., Cavallaro, E., Olivieri, A. N., Paolazzi, G., Vitiello, G., Maier, A., Silvestri, E., Stagnaro, C., Valesini, G., Mosca, M., de Vita, S., Tincani, A., Lapadula, G., Frediani, B., De Benedetti, F., Iannone, F., Punzi, L., Salvarani, C., Galeazzi, M., Angotti, R., Messina, M., Tosi, G. M., Rigante, D., Cantarini, L., Sota, Jurgen, Vitale, Antonio, Insalaco, Antonella, Sfriso, Paolo, Lopalco, Giuseppe, Emmi, Giacomo, Cattalini, Marco, Manna, Raffaele, Cimaz, Rolando, Priori, Roberta, Talarico, Rosaria, de Marchi, Ginevra, Frassi, Micol, Gallizzi, Romina, Soriano, Alessandra, Alessio, Maria, Cammelli, Daniele, Maggio, Maria Cristina, Gentileschi, Stefano, Marcolongo, Renzo, La Torre, Francesco, Fabiani, Claudia, Colafrancesco, Serena, Ricci, Francesca, Galozzi, Paola, Viapiana, Ombretta, Verrecchia, Elena, Pardeo, Manuela, Cerrito, Lucia, Cavallaro, Elena, Olivieri, Alma Nunzia, Paolazzi, Giuseppe, Vitiello, Gianfranco, Maier, Armin, Silvestri, Elena, Stagnaro, Chiara, Valesini, Guido, Mosca, Marta, de Vita, Salvatore, Tincani, Angela, Lapadula, Giovanni, Frediani, Bruno, De Benedetti, Fabrizio, Iannone, Florenzo, Punzi, Leonardo, Salvarani, Carlo, Galeazzi, Mauro, Angotti, Rossella, Messina, Mario, Tosi, Gian Marco, Rigante, Donato, and Cantarini, Luca
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Anakinra ,Autoinflammatory disorders ,Canakinumab ,Interleukin-1 ,Safety profile ,0301 basic medicine ,Male ,Settore MED/16 - REUMATOLOGIA ,0302 clinical medicine ,Retrospective Studie ,Rheumatology ,Child ,Antibodies, Monoclonal ,General Medicine ,Middle Aged ,Treatment Outcome ,Autoinflammation ,Female ,Cohort study ,medicine.drug ,Human ,Adult ,medicine.medical_specialty ,Adolescent ,Logistic Model ,Neutropenia ,Antibodies, Monoclonal, Humanized ,Autoimmune Disease ,Autoimmune Diseases ,03 medical and health sciences ,Young Adult ,Internal medicine ,Injection site reaction ,medicine ,Humans ,Anakinra, Autoinflammatory disorders, Canakinumab, Interleukin-1, Safety profile, Adolescent, Adult, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Autoimmune Diseases, Child, Female, Humans, Interleukin 1 Receptor Antagonist Protein, Logistic Models, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Young Adult ,Adverse effect ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,Retrospective cohort study ,medicine.disease ,Interleukin 1 Receptor Antagonist Protein ,Logistic Models ,030104 developmental biology ,Autoinflammatory disorder ,Observational study ,business - Abstract
A few studies have reported the safety profile of interleukin (IL)-1 blockers from real life. The aim of this study is to describe anakinra (ANA) and canakinumab (CAN) safety profile in children and adults, based on data from a real-life setting. Demographic, clinical, and therapeutic data from patients treated with ANA and CAN were retrospectively collected and analyzed. Four hundred and seventy five patients were enrolled; ANA and CAN were prescribed in 421 and 105 treatment courses, respectively. During a mean follow-up of 24.39 ± 27.04 months, 89 adverse events (AE) were recorded; 13 (14.61%) were classified as serious AE (sAE). The overall estimated rate of AE and sAE was 8.4 per 100 patients/year. Safety concerns were more frequent among patients aged ≥ 65 years compared with patients < 16 years (p = 0.002). No differences were detected in the frequency of safety concerns between monotherapy and combination therapy with immunosuppressants (p = 0.055), but a significant difference was observed when injection site reactions were excluded from AE (p = 0.01). No differences were identified in relation to gender (p = 0.462), different lines of biologic therapy (p = 0.775), and different dosages (p = 0.70 ANA; p = 0.39 CAN). The overall drug retention rate was significantly different according to the occurrence of safety concerns (p value < 0.0001); distinguishing between ANA and CAN, significance was maintained only for ANA (p < 0.0001 ANA; p > 0.05 CAN). Treatment duration was the only variable associated with onset of AE (OR = 0.399 [C.I. 0.250–0.638], p = 0.0001). ANA and CAN have shown an excellent safety profile; the risk for AE and sAE tends to decrease over time from the start of IL-1 inhibition.
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- 2018
138. A Large-Scale Genetic Analysis Reveals a Strong Contribution of the HLA Class II Region to Giant Cell Arteritis Susceptibility
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David Carmona, F, Mackie, SL, Martin, J-E, Taylor, JC, Vaglio, A, Eyre, S, Bossini-Castillo, L, Castaneda, S, Cid, MC, Hernandez-Rodriguez, J, Prieto-Gonzalez, S, Solans, R, Ramentol-Sintas, M, Francisca Gonzalez-Escribano, M, Ortiz-Fernandez, L, Morado, IC, Narvaez, J, Miranda-Filloy, JA, Beretta, L, Lunardi, C, Cimmino, MA, Gianfreda, D, Santilli, D, Ramirez, GA, Soriano, A, Muratore, F, Pazzola, G, Addimanda, O, Wijmenga, C, Witte, T, Schirmer, JH, Moosig, F, Schoenau, V, Franke, A, Palm, O, Molberg, O, Diamantopoulos, AP, Carette, S, Cuthbertson, D, Forbess, LJ, Hoffman, GS, Khalidi, NA, Koening, CL, Langford, CA, McAlear, CA, Moreland, L, Monach, PA, Pagnoux, C, Seo, P, Spiera, R, Sreih, AG, Warrington, KJ, Ytterberg, SR, Gregersen, PK, Pease, CT, Gough, A, Green, M, Hordon, L, Jarrett, S, Watts, R, Levy, S, Patel, Y, Kamath, S, Dasgupta, B, Worthington, J, Koeleman, BPC, de Bakker, PIW, Barrett, JH, Salvarani, C, Merkel, PA, Gonzalez-Gay, MA, Morgan, AW, Martin, J, Carmona, F. David, Mackie, Sarah L., Martín, Jose-Ezequiel, Taylor, John C., Vaglio, Augusto, Eyre, Stephen, Bossini-Castillo, Lara, Castañeda, Santo, Cid, Maria C., Hernández-Rodríguez, José, Prieto-González, Sergio, Solans, Roser, Ramentol-Sintas, Marc, González-Escribano, M. Francisca, Ortiz-Fernández, Lourde, Morado, Inmaculada C., Narváez, Javier, Miranda-Filloy, José A., Beretta, Lorenzo, Lunardi, Claudio, Cimmino, Marco A., Gianfreda, Davide, Santilli, Daniele, Ramirez, Giuseppe A., Soriano, Alessandra, Muratore, Francesco, Pazzola, Giulia, Addimanda, Olga, Wijmenga, Cisca, Witte, Torsten, Schirmer, Jan H., Moosig, Frank, Schönau, Verena, Franke, Andre, Palm, Oyvind, Molberg, Oyvind, Diamantopoulos, Andreas P., Carette, Simon, Cuthbertson, David, Forbess, Lindsy J., Hoffman, Gary S., Khalidi, Nader A., Koening, Curry L., Langford, Carol A., Mcalear, Carol A., Moreland, Larry, Monach, Paul A., Pagnoux, Christian, Seo, Philip, Spiera, Robert, Sreih, Antoine G., Warrington, Kenneth J., Ytterberg, Steven R., Gregersen, Peter K., Pease, Colin T., Gough, Andrew, Green, Michael, Hordon, Lesley, Jarrett, Stephen, Watts, Richard, Levy, Sarah, Patel, Yusuf, Kamath, Sanjeet, Dasgupta, Bhaskar, Worthington, Jane, Koeleman, Bobby P.C., De Bakker, Paul I.W., Barrett, Jennifer H., Salvarani, Carlo, Merkel, Peter A., González-Gay, Miguel A., Morgan, Ann W., and Martín, Javier
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Multifactorial Inheritance ,Genotype ,European Continental Ancestry Group ,Genes, MHC Class II ,Giant Cell Arteritis ,Genetic Association Studie ,Article ,White People ,MHC Class II ,Cohort Studies ,Genetic ,Genes ,Genetic Association Studies ,Humans ,Multivariate Analysis ,Odds Ratio ,Genetics ,Genetics(clinical) ,Cohort Studie ,Multivariate Analysi ,Giant Cell Arteriti ,Genetics (clinical) ,Human - Abstract
We conducted a large-scale genetic analysis on giant cell arteritis (GCA), a polygenic immune-mediated vasculitis. A case-control cohort, comprising 1,651 case subjects with GCA and 15,306 unrelated control subjects from six different countries of European ancestry, was genotyped by the Immunochip array. We also imputed HLA data with a previously validated imputation method to perform a more comprehensive analysis of this genomic region. The strongest association signals were observed in the HLA region, with rs477515 representing the highest peak (p = 4.05 × 10(-40), OR = 1.73). A multivariate model including class II amino acids of HLA-DRβ1 and HLA-DQα1 and one class I amino acid of HLA-B explained most of the HLA association with GCA, consistent with previously reported associations of classical HLA alleles like HLA-DRB1(∗)04. An omnibus test on polymorphic amino acid positions highlighted DRβ1 13 (p = 4.08 × 10(-43)) and HLA-DQα1 47 (p = 4.02 × 10(-46)), 56, and 76 (both p = 1.84 × 10(-45)) as relevant positions for disease susceptibility. Outside the HLA region, the most significant loci included PTPN22 (rs2476601, p = 1.73 × 10(-6), OR = 1.38), LRRC32 (rs10160518, p = 4.39 × 10(-6), OR = 1.20), and REL (rs115674477, p = 1.10 × 10(-5), OR = 1.63). Our study provides evidence of a strong contribution of HLA class I and II molecules to susceptibility to GCA. In the non-HLA region, we confirmed a key role for the functional PTPN22 rs2476601 variant and proposed other putative risk loci for GCA involved in Th1, Th17, and Treg cell function.
- Published
- 2015
139. ECCO Guidelines on Extraintestinal Manifestations in Inflammatory Bowel Disease.
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Gordon H, Burisch J, Ellul P, Karmiris K, Katsanos K, Allocca M, Bamias G, Barreiro-de Acosta M, Braithwaite T, Greuter T, Harwood C, Juillerat P, Lobaton T, Müller-Ladner U, Noor N, Pellino G, Savarino E, Schramm C, Soriano A, Michael Stein J, Uzzan M, van Rheenen PF, Vavricka SR, Vecchi M, Zuily S, and Kucharzik T
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- Humans, Inflammatory Bowel Diseases complications, Inflammatory Bowel Diseases therapy, Colitis, Ulcerative
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- 2024
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140. Proof-of-Concept Human Organ-on-Chip Study: First Step of Platform to Assess Neuro-Immunological Communication Involved in Inflammatory Bowel Diseases.
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Gabriel-Segard T, Rontard J, Miny L, Dubuisson L, Batut A, Debis D, Gleyzes M, François F, Larramendy F, Soriano A, Honegger T, and Paul S
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- Humans, Neurites, Synapses, Microfluidics, Neurons, Inflammatory Bowel Diseases
- Abstract
Inflammatory bowel diseases (IBD) are complex chronic inflammatory disorders of the gastrointestinal (GI) tract. Recent evidence suggests that the gut-brain axis may be pivotal in gastrointestinal and neurological diseases, especially IBD. Here, we present the first proof of concept for a microfluidic technology to model bilateral neuro-immunological communication. We designed a device composed of three compartments with an asymmetric channel that allows the isolation of soma and neurites thanks to microchannels and creates an in vitro synaptic compartment. Human-induced pluripotent stem cell-derived cortical glutamatergic neurons were maintained in soma compartments for up to 21 days. We performed a localized addition of dendritic cells (MoDCs) to either the soma or synaptic compartment. The microfluidic device was coupled with microelectrode arrays (MEAs) to assess the impact on the electrophysiological activity of neurons while adding dendritic cells. Our data highlight that an electrophysiologic signal is transmitted between two compartments of glutamatergic neurons linked by synapses in a bottom-up way when soma is exposed to primed dendritic cells. In conclusion, our study authenticates communication between dendritic cells and neurons in inflammatory conditions such as IBD. This platform opens the way to complexification with gut components to reach a device for pharmacological compound screening by blocking the gut-brain axis at a mucosal level and may help patients.
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- 2023
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141. Editorial: Uveitis: Insights into pathogenesis and treatment.
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Soriano A, Soriano M, Oliva R, and Smith WM
- Abstract
Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
- Published
- 2022
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142. Management of colovesical fistula: a systematic review.
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Zizzo M, Tumiati D, Bassi MC, Zanelli M, Sanguedolce F, Porpiglia F, Fiori C, Campobasso D, Castro Ruiz C, Bergamaschi FA, Maestroni UV, Carrieri G, Cormio L, Biolchini F, Palicelli A, Soriano A, Sassatelli R, Ascani S, Annessi V, and Giunta A
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- Colon, Sigmoid, Colonoscopy adverse effects, Humans, Male, Diverticulitis, Colonic complications, Diverticulitis, Colonic diagnosis, Diverticulitis, Colonic surgery, Diverticulum complications, Intestinal Fistula diagnosis, Intestinal Fistula surgery, Urinary Bladder Fistula diagnosis, Urinary Bladder Fistula surgery
- Abstract
Introduction: Colovesical fistulas (CVFs) account for approximately 95% enterovesical fistulas (EVFs). About 2/3 CVF cases are diverticular in origin. It mainly presents with urological signs such as pneumaturia and fecaluria. Diagnostic investigations aim at confirming the presence of a fistula. Although conservative management can be chosen for selected individuals, most patients are mainly treated through surgical interventions. CVF represents a challenging condition, which records high rates of morbidity and mortality. Our systematic review aimed at achieving deeper knowledge of both indications, in addition to short- and long-term outcomes related to CVF management., Evidence Acquisition: We performed a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Pubmed/MEDLINE, Embase, Scopus, Cochrane Library and Web of Science databases were used to search all related literature., Evidence Synthesis: The 22 included articles covered an approximately 37 years-study period (1982-2019), with a total 1365 patient population. CVF etiology was colonic diverticulitis in most cases (87.9%). Pneumaturia (50.1%), fecaluria (40.9%) and urinary tract infections (46.6%) were the most common symptoms. Abdomen computed tomography (CT) scan (80.5%), colonoscopy (74.5%) and cystoscopy (55.9%) were the most frequently performed diagnostic methods. Most CVF patients underwent surgery (97.1%) with open approach (63.3%). Almost all patients had colorectal resection with primary anastomosis with or without ostomy and 53.2% patients underwent primary repair or partial/total cystectomy. Four percent anastomotic leak, 1.8% bladder leak and 3.1% reoperations rates were identified. In an average 5-68-month follow-up, overall morbidity, overall mortality and recurrences rates recorded were 8-49%, 0-63% and 1.2%, respectively., Conclusions: CVF mainly affects males and has diverticular origin in almost all cases. Pneumaturia, fecaluria and urinary tract infections are the most characteristic symptoms. Endoscopic tests and imaging are critical tools for diagnostic completion. Management of CVFs depends on the underlying disease. Surgical treatment represents the final approach and consists of resection and reanastomosis of offending intestinal segment, with or without bladder closure. In many cases, a single-stage surgical strategy is selected. Perioperative and long-term outcomes prove good.
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- 2022
- Full Text
- View/download PDF
143. Effectiveness of adalimumab for ulcerative colitis: A multicentre, retrospective study of clinical practice in Italy.
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Vitello A, Grova M, Pugliese D, Rizzello F, Lanzarotto F, Lavagna A, Caccaro R, Cappello M, Viola A, Ribaldone DG, Principi M, Stasi E, Scribano ML, Maida M, Soriano A, Bezzio C, Bodini G, Mocciaro F, Privitera AC, Simondi D, Giuffrida E, D'Incà R, Ricci C, Gionchetti P, Armuzzi A, Orlando A, and Daperno M
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- Adolescent, Adult, Aged, Colectomy statistics & numerical data, Female, Humans, Induction Chemotherapy, Italy, Male, Middle Aged, Retrospective Studies, Treatment Outcome, Young Adult, Adalimumab therapeutic use, Colitis, Ulcerative drug therapy, Tumor Necrosis Factor Inhibitors therapeutic use
- Abstract
Background: Adalimumab is used to treat ulcerative colitis, but additional effectiveness and safety data are needed., Patients and Methods: This retrospective study considered adults with ulcerative colitis treated with adalimumab at 19 hospitals. Clinical data were collected from the start of treatment, after 2, 6 and 12 months, and at the last visit. Outcome measures of effectiveness were treatment duration, reasons for discontinuation and colectomy., Results: We studied 381 patients treated with adalimumab for a median of 12.1 months. Disease activity at the start of treatment was moderate to severe in 262 cases (68.8%) and endoscopic activity was moderate to severe in 339 cases (89.0%). At week 8, clinical responses were observed in 177 cases (46.5%) and clinical remission in 136 cases (35.7%). At 12 months, remission was observed in 128 cases (33.6%). Overall, 44 patients required colectomy, and 170 patients (44.6%) were still taking adalimumab when data were collected. Variables associated with adalimumab discontinuation were concomitant steroid treatment, severe clinical-endoscopic activity at baseline, need for adalimumab intensification and drug-related adverse events. Variables associated with colectomy were concomitant steroid treatment and high baseline C-reactive protein., Conclusion: Adalimumab is safe and effective for the treatment of ulcerative colitis., Competing Interests: Conflict of Interest None declared., (Copyright © 2021. Published by Elsevier Ltd.)
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- 2022
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144. Comment on "Is the Never-Ending Story Still Unsolved? Beyond the Long Debate About Lateral Pelvic Lymph Node Dissection in Rectal Cancer".
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Zizzo M, Zanelli M, Sanguedolce F, Soriano A, and Ascani S
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- Humans, Lymph Node Excision, Rectal Neoplasms surgery
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- 2021
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145. Telemedicine and Remote Screening for COVID-19 in Inflammatory Bowel Disease Patients: Results From the SoCOVID-19 Survey.
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Fantini MC, Biancone L, Dragoni G, Bezzio C, Miranda A, Ribaldone DG, Bertani A, Bossa F, Allocca M, Buda A, Mocci G, Soriano A, Guglielmi FW, Bertani L, Baccini F, Loddo E, Privitera AC, Sartini A, Viscido A, Grossi L, Casini V, Gerardi V, Ascolani M, Di Ruscio M, Casella G, Savarino E, Stradella D, Pumpo R, Cortelezzi CC, Daperno M, Ciardo V, Nardone OM, Caprioli F, Vitale G, Cappello M, Comberlato M, Alvisi P, Festa S, Campigotto M, Bodini G, Balestrieri P, Viola A, Pugliese D, Armuzzi A, Saibeni S, and Fiorino G
- Subjects
- Aftercare methods, Aftercare organization & administration, Betacoronavirus, COVID-19, Hospitalization statistics & numerical data, Humans, Italy epidemiology, Organizational Innovation, Remote Consultation methods, SARS-CoV-2, Surveys and Questionnaires, Coronavirus Infections diagnosis, Coronavirus Infections epidemiology, Coronavirus Infections prevention & control, Hospital Units organization & administration, Hospital Units statistics & numerical data, Hospital Units trends, Infection Control methods, Inflammatory Bowel Diseases diagnosis, Inflammatory Bowel Diseases epidemiology, Inflammatory Bowel Diseases therapy, Mass Screening methods, Pandemics prevention & control, Pneumonia, Viral diagnosis, Pneumonia, Viral epidemiology, Pneumonia, Viral prevention & control, Telemedicine methods, Telemedicine organization & administration
- Published
- 2020
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- View/download PDF
146. The broad landscape of follicular lymphoma: Part II.
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Fratoni S, Zanelli M, Zizzo M, Sanguedolce F, Aimola V, Cerrone G, Ricci L, Filosa A, Martino G, Fara AM, Annessi V, Soriano A, and Ascani S
- Subjects
- Humans, In Situ Hybridization, Fluorescence methods, Lymphoma, Follicular diagnosis, Lymphoma, Follicular genetics, Lymphoma, Large B-Cell, Diffuse surgery, Biomarkers, Tumor analysis, Lymphoma, Follicular pathology, Lymphoma, Large B-Cell, Diffuse pathology, Translocation, Genetic physiology
- Abstract
Follicular lymphoma is a neoplasm derived from follicle center B cells, typically both centrocytes and centroblasts, in variable proportions according to the lymphoma grading. The pattern of growth may be entirely follicular, follicular and diffuse and rarely completely diffuse. It represents the second most common non-Hodgkin lymphoma, after diffuse large B-cell lymphoma and it is the most common low-grade mature B-cell lymphoma in Western countries. In the majority of cases, follicular lymphoma is a nodal tumor, occurring in adults and is frequently associated with the translocation t(14;18)(q32;q21)/IGH-BCL2. However, in recent years the spectrum of follicular lymphoma has expanded and small subsets of follicular lymphoma, which differ from common follicular lymphoma, have been identified and included in the current 2017 WHO classification. The aim of our review is to describe the broad spectrum of follicular lymphoma, pointing out that the identification of distinct clinicopathological variants of follicular lymphoma is relevant for the patient outcomes and treatment., (Copyright © 2020 Società Italiana di Anatomia Patologica e Citopatologia Diagnostica, Divisione Italiana della International Academy of Pathology.)
- Published
- 2020
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147. Colonic perforation due to severe cytomegalovirus disease in granulomatosis with polyangiitis after immunosuppression.
- Author
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Soriano A, Smerieri N, Bonilauri S, De Marco L, Cavazza A, and Salvarani C
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- Aged, Cyclophosphamide therapeutic use, Granulomatosis with Polyangiitis drug therapy, Humans, Immunosuppressive Agents therapeutic use, Male, Colonic Diseases etiology, Cyclophosphamide adverse effects, Cytomegalovirus Infections complications, Granulomatosis with Polyangiitis complications, Immunosuppressive Agents adverse effects
- Abstract
Granulomatosis with polyangiitis (GPA) is a small-vessel necrotizing granulomatous vasculitis typically involving upper airways, lungs, and kidneys, which may lead to end-organ damage and life-threatening complications. Major infections during GPA course represent a considerable concern in the management of the disease. Cytomegalovirus (CMV) infection and disease are rare but significant complications in the course of GPA being associated with high morbidity and mortality rates. Colonic perforation due to CMV colitis is exceedingly rare and has so far almost exclusively been documented in HIV, renal transplant, and systemic lupus erythematosus patients. We reported the case of a patient affected with upper airways-limited GPA who developed acute renal failure from rapidly progressive glomerulonephritis and then experienced colonic perforation due to CMV colitis a few weeks after immunosuppressive treatment with high-dose steroids and cyclophosphamide (CYC) for remission induction of the disease. We also reviewed the literature on CMV-related gastro-intestinal complications in the course of GPA and discussed contributing factors to severe manifestations of CMV infection and its reactivation.
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- 2018
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148. Unmet Needs in the Pathogenesis and Treatment of Vasculitides.
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Muratore F, Pazzola G, Soriano A, Pipitone N, Croci S, Bonacini M, Boiardi L, and Salvarani C
- Subjects
- Antibodies, Antineutrophil Cytoplasmic metabolism, Disease Progression, Glucocorticoids therapeutic use, Humans, Outcome Assessment, Health Care, Risk Factors, Tumor Necrosis Factor-alpha metabolism, Vasculitis drug therapy, Antibodies, Monoclonal, Humanized therapeutic use, Rituximab therapeutic use, Vasculitis diagnosis
- Abstract
Despite the progress in the last years on the field of vasculitides, there are several unmet needs regarding classification, disease activity assessment, predictors of flares and complications, and type of treatment for the different forms. The 1990 American College of Rheumatology (ACR) classification criteria currently used to define giant cell arteritis and Takayasu arteritis were designed to discriminate between different types of vasculitides but not to differentiate vasculitis from other disorders. Recently, efforts have been made to overcome the shortcomings of the ACR criteria. The lack of an accepted definition of disease activity in large-vessel vasculitides presents a major challenge in creating useful and valid outcome tools for the assessment of disease course. Identification of predictors of flares can aid in optimizing therapeutic strategies, minimizing disease flares, and reducing treatment-related side effects. It is furthermore important to recognize and characterize the risk factor that might predict the manifestations associated with poor outcome and prognosis. Two RCTs have evidenced the efficacy of tocilizumab in addition to glucocorticoids (GCs) in the treatment of giant cell arteritis (GCA). However, the role of tocilizumab or other biological agents without GCs needs to be investigated. Recent observational studies have suggested that rituximab is also effective in patients with eosinophilic granulomatosis with polyangiitis and in antineutrophil cytoplasmic antibodies (ANCA)-negative patients with granulomatosis with polyangiitis and microscopic polyangiitis. Rituximab or anti-TNF alfa may represent a possible alternative therapy in case of refractory or difficult to treat polyarteritis nodosa (PAN) patients. The new International Criteria for Behçet's Disease have shown a better sensitivity and a better accuracy compared to the older International Study Group on Behçet's Disease criteria. The EULAR recommendations for the management of Behçet's disease (BD) have been recently updated. However, the treatment of refractory disease is still a real challenge.
- Published
- 2018
- Full Text
- View/download PDF
149. Distribution patterns of 18F-fluorodeoxyglucose in large vessels of Takayasu's and giant cell arteritis using positron emission tomography.
- Author
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Soriano A, Pazzola G, Boiardi L, Casali M, Muratore F, Pipitone N, Catanoso M, Aldigeri R, Cimino L, Versari A, and Salvarani C
- Subjects
- Adult, Aged, Aorta, Abdominal diagnostic imaging, Aorta, Thoracic diagnostic imaging, Aortitis etiology, Axillary Artery diagnostic imaging, Carotid Arteries diagnostic imaging, Carotid Artery Diseases etiology, Cluster Analysis, Female, Femoral Artery diagnostic imaging, Fluorodeoxyglucose F18, Humans, Iliac Artery diagnostic imaging, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Principal Component Analysis, Radiopharmaceuticals, Retrospective Studies, Subclavian Artery diagnostic imaging, Aortitis diagnostic imaging, Carotid Artery Diseases diagnostic imaging, Giant Cell Arteritis diagnostic imaging, Takayasu Arteritis diagnostic imaging
- Abstract
Objectives: To compare patterns of vascular involvement using 18F-fluorodeoxyglucose-positron emission tomography computed tomography (FDG PET/CT) in patients with giant cell arteritis (GCA) and Takayasu's arteritis (TAK)., Methods: A total of 130 consecutive 18F-FDG PET/CT scans performed during the disease course for evaluating disease activity in 15 GCA and 13 TAK patients were retrospectively examined by two nuclear physicians blinded to clinical data. Standardised uptake values (SUVmax) in 14 vascular districts including all the aortic segments and the main tributaries were measured. The average SUVmax value for each vascular district was also calculated. Principal component analysis (PCA) and agglomerative hierarchical cluster analysis (CA) were used to explore distribution patterns of vascular FDG uptake., Results: The aortic segments showed the highest SUV max values among the different districts in both GCA and TAK. SUV max values measured in the different districts were significantly higher in GCA compared to TAK, except for the axillary arteries. Regarding thoracic and abdominal aorta, ascending aorta and aortic arch had the highest correlation in both vasculitis (p<0.0001). CA confirmed that carotid, axillary, subclavian, iliac and femoral arteries clustered with their contralateral counterpart in both vasculitis. The 3 components of thoracic aorta clustered with abdominal aorta in TAK, while aortic arch clustered only with ascending aorta, and descending and abdominal aorta grouped together with iliac and femoral arteries in GCA. PCA analysis identified 3 different components for TAK and GCA explaining 72% and 71% of the total variance respectively in these two vasculitis. Confirming CA, a component including the entire aortic district was identified in TAK, but not in GCA. Similar results in PCA using averaged data were observed., Conclusions: Strong similarities, but also a subtle skewing in terms of distribution patterns of arterial involvement assessed by SUVmax values were observed between GCA and TAK.
- Published
- 2018
150. Sjögren's syndrome presenting with isolated sensory axonal polyneuropathy.
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Di Lazzaro V, Rigon A, Soriano A, Capone F, Corbetto M, Florio L, Afeltra A, Onetti Muda A, and Luigetti M
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- Adult, Biopsy, Female, Humans, Immunosuppressive Agents therapeutic use, Neurologic Examination, Polyneuropathies diagnosis, Polyneuropathies physiopathology, Sjogren's Syndrome diagnosis, Sjogren's Syndrome drug therapy, Polyneuropathies etiology, Sjogren's Syndrome complications
- Published
- 2017
- Full Text
- View/download PDF
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