Kirsi Paalanen1, Katja Rannio2, Tuomas Rannio3, Juha Asikainen3, Pekka Hannonen3, Tuulikki Sokka3. 1. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland. kirsi.paalanen@ksshp.fi. 2. Department of Radiology, Central Hospital of Central Finland, Jyväskylä, Finland. 3. Department of Rheumatology, Central Hospital of Central Finland, Jyväskylä, Finland.
Abstract
OBJECTIVES: To investigate the 10-year clinical course of patients with seronegative arthritis with the emphasis of reclassification of diagnoses when applicable. METHODS: A total of 1030 patients including 435 seronegative cases were classified as early RA in 1997-2005 at Jyväskylä Rheumatology Centre and prospectively scheduled for a ten-year follow-up. Clinical data from the follow-up visits and the case-reports until and including the 10-year visit or death, whichever happened earlier, were retrospectively collected and reviewed with re-classification of the cases when applicable. Descriptive statistics were used. RESULTS: Among the 435 seronegative cases (69 % women, baseline mean age was 59 years), 13 (13/435 [3%]) could be reclassified as seropositive or erosive RA: 4 turned seropositive (2 for ACPA and 2 for RF [> 2x reference level]) and 9 developed erosions typical for RA. Reclassification revealed 68 (16%) cases of polymyalgia rheumatica, 46 (11%) psoriatic arthritis, 45 (10%) osteoarthritis, 38 (8.7%) spondyloarthritis, 15 (3.4%) plausible reactive arthritis, 10 (2.3%) gout, 17 (3.9%) pseudogout, 6 (1.4%) paraneoplastic arthritis, 6 (1.4%) juvenile arthritis, 2 (0.5%) haemochromatosis, 3 (0.7%) ankylosing spondylitis, 2 (0.5%) giant cell arteritis, and 8 miscellaneous diagnoses. The other 140 patients (32%) could not be reclassified in any clear-cut diagnosis and had features of transient arthritis (n=41), seronegative spondyloarthritis (n=47), while 49 remained unspecified. CONCLUSIONS: Over a 10-year follow-up period, reclassification revealed significant heterogeneity in the diagnosis of seronegative RA. Therefore, seronegative arthritis should not be studied as a homogenous entity.
OBJECTIVES: To investigate the 10-year clinical course of patients with seronegative arthritis with the emphasis of reclassification of diagnoses when applicable. METHODS: A total of 1030 patients including 435 seronegative cases were classified as early RA in 1997-2005 at Jyväskylä Rheumatology Centre and prospectively scheduled for a ten-year follow-up. Clinical data from the follow-up visits and the case-reports until and including the 10-year visit or death, whichever happened earlier, were retrospectively collected and reviewed with re-classification of the cases when applicable. Descriptive statistics were used. RESULTS: Among the 435 seronegative cases (69 % women, baseline mean age was 59 years), 13 (13/435 [3%]) could be reclassified as seropositive or erosive RA: 4 turned seropositive (2 for ACPA and 2 for RF [> 2x reference level]) and 9 developed erosions typical for RA. Reclassification revealed 68 (16%) cases of polymyalgia rheumatica, 46 (11%) psoriatic arthritis, 45 (10%) osteoarthritis, 38 (8.7%) spondyloarthritis, 15 (3.4%) plausible reactive arthritis, 10 (2.3%) gout, 17 (3.9%) pseudogout, 6 (1.4%) paraneoplastic arthritis, 6 (1.4%) juvenile arthritis, 2 (0.5%) haemochromatosis, 3 (0.7%) ankylosing spondylitis, 2 (0.5%) giant cell arteritis, and 8 miscellaneous diagnoses. The other 140 patients (32%) could not be reclassified in any clear-cut diagnosis and had features of transient arthritis (n=41), seronegative spondyloarthritis (n=47), while 49 remained unspecified. CONCLUSIONS: Over a 10-year follow-up period, reclassification revealed significant heterogeneity in the diagnosis of seronegative RA. Therefore, seronegative arthritis should not be studied as a homogenous entity.
Authors: Maltish M Lorenzo; Julia Devlin; Chhavi Saini; Kin-Sang Cho; Eleftherios I Paschalis; Dong Feng Chen; Rafaella Nascimento E Silva; Sherleen H Chen; Milica A Margeta; Courtney Ondeck; David Solá-Del Valle; James Chodosh; Joseph B Ciolino; Roberto Pineda; Louis R Pasquale; Lucy Q Shen Journal: Ophthalmol Glaucoma Date: 2021-08-18
Authors: Khalid Almutairi; Charles Inderjeeth; David B Preen; Helen Keen; Katrina Rogers; Johannes Nossent Journal: Rheumatol Int Date: 2021-02-23 Impact factor: 2.631
Authors: Tiina Kelkka; Paula Savola; Dipabarna Bhattacharya; Jani Huuhtanen; Tapio Lönnberg; Matti Kankainen; Kirsi Paalanen; Mikko Tyster; Maija Lepistö; Pekka Ellonen; Johannes Smolander; Samuli Eldfors; Bhagwan Yadav; Sofia Khan; Riitta Koivuniemi; Christopher Sjöwall; Laura L Elo; Harri Lähdesmäki; Yuka Maeda; Hiroyashi Nishikawa; Marjatta Leirisalo-Repo; Tuulikki Sokka-Isler; Satu Mustjoki Journal: Front Immunol Date: 2020-11-19 Impact factor: 7.561