Rheumatic Manifestations in Autoimmune Liver Disease

Selmi, Carlo; Generali, Elena; Gershwin, M. Eric

doi:10.1016/j.rdc.2017.09.008

Cited by 35 publications

(34 citation statements)

References 125 publications

(93 reference statements)

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“…This option appears to be especially attractive in view of the findings which suggest strongly that – in contrast to standard immunosuppression – phage therapy is safe and relatively free of side effects. ALD and rheumatic diseases co‐exist in approximately 30% of cases, suggesting that they may share pathogenic mechanisms 63. In this context, our recent data showing the efficacy of phage therapy in a mouse model of rheumatoid arthritis provide additional arguments to believe that relevant clinical trials should be on the horizon.…”

Section: Conclusion/perspectivementioning

confidence: 98%

Therapeutic potential of phages in autoimmune liver diseases

Górski

Jończyk‐Matysiak

Łusiak-Szelachowska

et al. 2018

Clinical and Experimental Immunology

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SummaryAutoimmune liver disease (ALD) poses a difficult medical challenge, as there is a significant number of patients in whom current therapy offers questionable or no benefit, yet its side effects may be serious, including the development of malignancy. Bacterial viruses (phages) have been recognized increasingly as immunomodulators contributing to immune homeostasis and curbing inflammation. Accumulating data suggest that phages may be useful in immunotherapy of ALD. Phages have been shown to down‐regulate the expression and/or production and activity of factors associated with hepatic injury [reactive oxygen species, Toll‐like receptor (TLR)‐4 activation, nuclear factor kappa B (NF‐κB) activation, proinflammatory and procoagulant activities of platelets] and up‐regulate the expression and/or production of factors demonstrated as playing a protective role [interleukin (IL)‐10, IL‐1 receptor antagonist].

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Section: Conclusion/perspectivementioning

confidence: 98%

Therapeutic potential of phages in autoimmune liver diseases

Górski

Jończyk‐Matysiak

Łusiak-Szelachowska

et al. 2018

Clinical and Experimental Immunology

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“…Elevation of liver enzymes is more common in AIH and the presence of certain autoantibodies is more specific to AIH (for example, anti-smooth muscle in type 1 AIH or anti-LKM1 and anti-LC1 in type 2 AIH). On the other hand, some clinical manifestations, like Sicca symptoms in SS or Raynaud or inflammatory arthralgia in RA, may help in the differential diagnosis [74].…”

Section: Autoimmune Hepatitis (Aih)mentioning

confidence: 99%

“…Even though ANA positivity (50-70%) is not particularly helpful in the differential diagnosis versus other autoimmune diseases, certain features like AMA positivity (in almost 100% of cases) or cholestatic pattern in liver function tests are important. This distinction is important, since the mainstay of treatment for PBC is ursodesoxycholic acid, quite different from other autoimmune diseases [74].…”

Section: Primary Biliary Cholangitis (Pbc)mentioning

confidence: 99%

Rheumatologic manifestations of hepatic diseases

Fernandes¹,

Dias

Mascarenhas

et al. 2019

aog

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The course of hepatic diseases may be complicated by a multitude of rheumatologic manifestations, which can complicate the diagnostic approach and alter the natural history of primary liver disease, sometimes worsening prognosis due to associated multiple organ dysfunction. These manifestations can occur in association with a multitude of liver diseases, including viral hepatitis, autoimmune hepatitis, alcoholic liver disease, nonalcoholic fatty liver disease, hemochromatosis, or Wilson's disease. It is necessary not only for rheumatologists, but also for other clinicians, to be aware that these atypical manifestations may reflect an undiagnosed hepatic disease. On the other hand, it is crucial that, in a patient with known hepatic disease presenting with rheumatologic symptoms, an accurate distinction be made between the rheumatologic manifestations of hepatic disease and primary rheumatologic disease, since the treatment is often different. This review aims to summarize the current evidence regarding rheumatologic manifestations of hepatic diseases, how to distinguish them from primary rheumatologic disorders, and how to provide adequate management.

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“…Variability in the characteristics of disease as well as severity had been observed by authors both in JOSpA and AOSpA groups. According to some research studies, JOSpA patients may suffer from severe disease and co-morbidities such as psoriasis, inflammatory bowel disease (IBD), uveitis [8][9][10] , fever [11] , and autoimmune liver disease [12][13] . These differences might be more pronounced in refractory SpA patients.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Juvenile and Adult Onset Refractory Spondyloarthritis Patients Attending a Tertiary Rheumatology Clinic

Islam

2020

J. Bangladesh Coll. Phys.

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Objectives: To compare the demographic and clinical characteristics of juvenile onset refractory spondyloarthritis (JOSpA) with a group of adult-onset refractory spondyloarthritis (AOSpA) patients. Methods: In this real-life, cross-sectional study, a total of 215 SpA patients (refractory to two NSAIDs and/or DMARDs) were enrolled following ASAS classification criteria from a rheumatology center in Dhaka, Bangladesh. Based on age, the patients were divided into JOSpA group and AOSpA group for analysis. The patients' demographics, quality of life, laboratory and clinical characteristics were compared and analyzed between the two groups using chisquare and independent sample t-test. Results: Among 215 patients, 57 (53 males, 4 females) were in JOSpA group, and 158 (126 males, 32 females) were in AOSpA group. Most patients were male in both groups (P=0.02). The mean age at diagnosis for JOSpA and AOSpA were 27.68±9.5 and 40.28±10 years respectively (P=0.00), and mean age at onset of disease in JOSpA and AOSpA were 12.33±3.62 and 29.58±96.5 years respectively. The mean disease duration was 15.36±9.3 months in JOSpA compared to 10.70±7.1 months in AOSpA group (P=0.00). Sixteen (28.1%) JOSpA and 9 (5.7%) AOSpA patients were undernourished , (P=0.00). On the contrary, obesity was more prevalent in AOSpA patients (41.1%) than those in JOSpA patients (21.1%) (P=0.00). There were significant differences in mean haemoglobin (11.38±1.7 and 10.94±1.3 g/dl) (P=0.05) and mean serum creatinine (0.94±0.2 and 0.86±0.2 mg/dl) (P=0.03) levels in AOSpA and JOSpA groups respectively. HLA-B27 was done in 20 JOSpA and 61 AOSpA patients. Among them, 19 (95%) were positive in JOSpA and 55 (90.16%) were positive in AOSpA groups. Similarly, hips involvement was higher in JOSpA group 19 (33.3%) compared to the AOSpA group 21 (13.3%) (P=0.004). Significant differences were observed in mean disease activity parameters, patient global assessment (PGA) (7.86±1.2 vs 7.38±1.4, P=0.02), ASDAS-CRP (4.60±0.8 vs 4.33±0.9, P=0.05), and ASDAS-ESR (4.49±0.8 vs 4.17±1.0, P=0.02) in JOSpA and AOSpA groups respectively. The modified Stoke AS Spinal Score (mSASSS) in AOSpA group was higher (24.18±17.22) than that of JOSpA group (17.10±9.6) (P=0.00). Conclusions: In JOSpA patients, under nutrition, hip involvement, longer disease duration, uveitis, PGA, low Hb level and ASDAS-ESR disease activity scores were higher.On the contrary in AOSpA group, male gender, married subjects, obesity, higher creatinine level and mSASSS scores were higher.

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Rheumatic Manifestations in Autoimmune Liver Disease

Cited by 35 publications

References 125 publications

Therapeutic potential of phages in autoimmune liver diseases

Therapeutic potential of phages in autoimmune liver diseases

Rheumatologic manifestations of hepatic diseases

Comparison of Juvenile and Adult Onset Refractory Spondyloarthritis Patients Attending a Tertiary Rheumatology Clinic

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