Rheumatology ResearchRheumatology Research2476-58565220200401A rare association of Graves' disease and sarcoidosis394212192310.22631/rr.2020.69997.1089ENILYAS EL KASSIMIInternal Medicine Department, Mohammed V Military Teaching Hospital, Mohammed V University, Rabat, Morocco.0000-0001-5015-9659Adil RkiouakInternal Medicine Department, Mohammed V Military Teaching Hospital, Mohammed V University, Rabat, Morocco.0000-0003-0261-5044Nawal SahelInternal Medicine Department, Mohammed V Military Teaching Hospital, Mohammed V University, Rabat, Morocco.Meryem ZaizaaInternal Medicine Department, Mohammed V Military Teaching Hospital, Mohammed V University, Rabat, Morocco.Youssef SekkachInternal Medicine Department, Mohammed V Military Teaching Hospital, Mohammed V University, Rabat, Morocco.Journal Article20191130<span class="fontstyle0">Graves' disease is the most common autoimmune disease in hyperthyroidism. Sarcoidosis is an inflammatory granulomatous<br />disease of unknown cause. The association of the two diseases has rarely been reported in the literature. We report a new case<br />of newly diagnosed sarcoidosis in a patient followed for Graves' disease. This is an original case of Graves' disease, the course<br />of which was marked by the onset of active sarcoidosis presented as Löfgren's syndrome complicated by hypercalcemia. Given<br />its rarity and the lack of a causal link, the association between Graves' disease and sarcoidosis may be a mere coincidence. More<br />studies could allow us to understand more common etiopathogenic mechanisms since both are chronic inflammatory diseases.</span>https://www.rheumres.org/article_121923_9c3e90c199bfc385ca2b5e6c2bb7d1e4.pdfRheumatology ResearchRheumatology Research2476-58565220200401Non-contrast MRI Findings of Adhesive Capsulitis: A review434812507010.22631/rr.2020.69997.1090ENAida KaramiDepartment of Radiology, School of Medicine, ZanjanUniversity of Medical Sciences, Zanjan, Iran.Parviz GhezelbashDepartment of Radiology, School of Medicine, ZanjanUniversity of Medical Sciences, Zanjan, Iran.Mohammad QorbanisaniDepartment of Radiology, School of Medicine, ZanjanUniversity of Medical Sciences, Zanjan, Iran.Zahra GhezelbashDepartment of Radiology, School of Medicine, ZanjanUniversity of Medical Sciences, Zanjan, Iran.Amir HosseinNorooznezhadMedical Biology Research Center, Technology Health Research Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.0000-0002-9987-7093Parisa KaramiDepartment of Radiology, School of Medicine, ZanjanUniversity of Medical Sciences, Zanjan, Iran.Journal Article20191203<span class="fontstyle0">Adhesive Capsulitis (AC) is a self-limiting disease of the shoulder joint characterized by progressive painful restriction of the<br />shoulder’s motion. This study aimed to search the findings on AC in non-contrast MRI. Although AC is a clinical diagnosis,<br />imaging can provide helpful data for earlier diagnosis and treatment. It seems that some findings are specific and sensitive for<br />accurate diagnosis and staging of AC such as coracohumeral ligament thickening, joint capsule edema, and rotator interval<br />infiltration. Non-contrast MRI can provide an abundance of information on AC and help clinicians make a more definitive<br />diagnosis, stage the disease, and choose better treatment plans.</span>https://www.rheumres.org/article_125070_c31f4101084b385849f5cdcf0f37179c.pdfRheumatology ResearchRheumatology Research2476-58565220200401Reduced gene expression of Survivin in PBMCs from patients with limited systemic sclerosis495612241210.22631/rr.2020.69997.1091ENElham FarhadiRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Inflammation Research Center,
Tehran University of Medical Sciences, Tehran, Iran.Mobina JalalvandRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Shiva PoursaniRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Leila Nejatbakhsh SamimiRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Shayan MostafaeeDepartment of Biostatistics, School of Health,
Kermanshah University of Medical Sciences, Kermanshah, Iran.Nooshin AhmadzadehRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Farhad GharibdoostRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Ahmadreza JamshidiRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Mahdi MahmoudiRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Inflammation Research Center,
Tehran University of Medical Sciences, Tehran, Iran.0000-0002-8164-8831Hoda KavosiRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran. Inflammation Research Center,
Tehran University of Medical Sciences, Tehran, Iran.0000-0003-4762-6943Journal Article20191102<span class="fontstyle0">Systemic sclerosis (SSc) is a rheumatologic disease, and fibroblasts are the main cells responsible for SSc pathogenesis. The<br /></span><span class="fontstyle2">BIRC5 </span><span class="fontstyle0">gene encodes survivin, an inhibitor of apoptosis protein. Studies have suggested a role for survivin overexpression in<br />leading to decreased apoptosis of fibroblasts in SSc patients. This study explored the frequencies of two single nucleotide<br />polymorphisms (SNPs) in the </span><span class="fontstyle2">BIRC5 </span><span class="fontstyle0">gene (rs9904341 [G>C] and rs17878467 [C>T]) in SSc patients and evaluated survivin<br />gene expression in the peripheral blood mononuclear cells (PBMC) of patients and compared it with that of healthy individuals.<br />The allelic and genotypic frequencies of rs9904341 in 459 SSc patients and 487 healthy controls were assessed. For the<br />rs17878467 SNP, the survivin gene in 214 SSc patients and 246 controls was analyzed. Genomic analyses were carried out on<br />DNA samples isolated from whole blood by the phenol-chloroform method. TaqMan rt-PCR was used to investigate the survivin<br />gene alleles. Survivin gene expression was also investigated in 53 patients (lSSc = 25, dSSc = 28) and 55 controls by specific<br />primers for the survivin gene (SYBR Green Real-time PCR method). The allelic and genotypic frequencies of both SNPs showed<br />no significant difference in patients and controls; however, survivin expression level was significantly lower in limited SSc<br />(lSSc) and total SSc patients than in controls. The results suggest that survivin might have a role in the pathogenesis of SSc;<br />however, more research is needed to confirm the relationship.</span>https://www.rheumres.org/article_122412_da5ff5123b1eca0e0dddd30e82ce0f9c.pdfRheumatology ResearchRheumatology Research2476-58565220200401Measuring of knee cartilage thickness: A comparison between ultrasound and magnetic resonance imaging methods576412165010.22631/rr.2020.69997.1092ENLida ShashaaniHzrat e Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran.Armin AsiachiAlborz University of Medical Sciences, Karaj, Iran.Omid MotamediHzrat e Rasool Hospital, Iran University of Medical Sciences, Tehran, Iran.Journal Article20190801<span class="fontstyle0">Cartilage diameter evaluation is critical for cartilage assessment. Magnetic resonance imaging (MRI) is the gold standard tool<br />in cartilage evaluation. This observational and analytical study was designed to answer the question of whether there is a<br />relationship between MRI and ultrasound in measuring cartilage thickness in the medial femoral condyle. The current study was<br />conducted at the Radiology Department of Rasole-Akram Hospital, Tehran, Iran, between March and May 2020. The sample<br />size was 18 people. The mean cartilage thickness of the left medial femoral cartilage was measured by T1 weighted MRI and<br />ultrasound from transverse, anterior, middle, and posterior medial femoral regions in nine healthy females with a mean ± std<br />deviation as indicated below: thickness = 1.6 ± 0.04 m, weight = 55.3 ± 4.3 kg, age = 21.7 ± 0.8 years.<br />Additionally, nine healthy males with thickness = 1.80 ± 0.02 m, weight = 78.6 ± 11.1 kg, age = 22.4 ± 0.7 years were also<br />included. Pearson and Bland–Altman plots were used for correlations and agreements. Anterior longitudinal ultrasound<br />thickness measures were significantly positively correlated with MRI anterior (r = 0.93, </span><span class="fontstyle2">p </span><span class="fontstyle0">= 0.00001), transverse ultrasound<br />with MRI anterior (r = 0.87 </span><span class="fontstyle2">p </span><span class="fontstyle0">= 0.0369), middle longitudinal ultrasound with MRI anterior (r = 0.87 </span><span class="fontstyle2">p </span><span class="fontstyle0">= 0.00002), and transverse<br />ultrasound and MRI middle (r = 0.87 </span><span class="fontstyle2">p </span><span class="fontstyle0">= 0.00001).<br />Agreement in all aspects was good except between the anterior longitudinal ultrasound and MRI posterior. There was a good<br />absolute agreement between corresponding measurements done by ultrasound and MRI. The results suggest that ultrasound may<br />be a good clinical tool for assessing relative cartilage thickness in medial femoral regions.</span>https://www.rheumres.org/article_121650_526c712f9af238ce4fd7fb735d879270.pdfRheumatology ResearchRheumatology Research2476-58565220200401Altered Expression of Unfolded Protein Response Genes in Macrophages from Behcet’s Disease657212282410.22631/rr.2020.69997.1093ENMaliheh HeshmatpanahDepartmentofBiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.Nakisa Zarrabi AhrabiDepartmentofBiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.Farhad ShahramRheumatology Research Center, Tehran University of Medical Sciences, Tehran Iran.Maassoumeh AkhlaghiRheumatology Research Center, Tehran University of Medical Sciences, Tehran Iran.Maryam AkhtariRheumatology Research Center, Tehran University of Medical Sciences, Tehran Iran.
Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-5342-3440Elmira ShamsianRheumatology Research Center, Tehran University of Medical Sciences, Tehran Iran.Shayan MostafaeeDepartment of Biostatistics, School ofHealth, Kermanshah University of Medical Sciences, Kermanshah, Iran.Mahdi MahmoudiRheumatology Research Center, Tehran University of Medical Sciences, Tehran Iran.
Inflammation Research Center, Tehran University of Medical Sciences, Tehran, Iran.0000-0002-8164-8831Journal Article20191116<span class="fontstyle0">Endoplasmic reticulum (ER) stress triggers the unfolded protein response (UPR), which has been correlated with enhanced<br />production of inflammatory cytokines. Given the important pathogenic roles of macrophages and inflammatory responses in the<br />etiopathogenesis of Behcet’s disease (BD), this study aimed to assess the mRNA expression pattern of genes involved in the<br />UPR pathway in macrophages from smoker and non-smoker BD patients. This case-control study was conducted between 2015<br />and 2016 in Shariati Hospital, Tehran, Iran. Monocytes were enriched from obtained whole blood samples of 10 smokers and 10<br />non-smoker BD patients as well as 10 healthy individuals. Using macrophage-colony stimulating factor (M-CSF), separated<br />monocytes were differentiated into macrophages. After total RNA purification and cDNA synthesis, quantification analysis of<br />UPR genes, including </span><span class="fontstyle2">activating transcription factor </span><span class="fontstyle0">(</span><span class="fontstyle2">ATF) 4, ATF6</span><span class="fontstyle0">, X-box binding protein 1 (</span><span class="fontstyle2">XBP1</span><span class="fontstyle0">), </span><span class="fontstyle2">binding immunoglobulin<br />protein (BIP)</span><span class="fontstyle0">, </span><span class="fontstyle2">C/EBP homologous protein </span><span class="fontstyle0">(</span><span class="fontstyle2">CHOP)</span><span class="fontstyle0">, </span><span class="fontstyle2">homocysteine-inducible, endoplasmic reticulum stress-inducible, ubiquitin-like domain member 1 </span><span class="fontstyle0">(</span><span class="fontstyle2">HERP), and growth arrest and DNA damage-inducible protein (GADD34)</span><span class="fontstyle0">, was performed using SYBR<br />green master mix and real-time PCR. Among the measured genes, </span><span class="fontstyle2">HERP </span><span class="fontstyle0">mRNA was overexpressed in macrophages from BD<br />patients in comparison with healthy macrophages. </span><span class="fontstyle2">HERP </span><span class="fontstyle0">and </span><span class="fontstyle2">GADD34 </span><span class="fontstyle0">genes were upregulated in smoker BD patients compared<br />with non-smoker BD patients as well as healthy subjects. Cigarette smoke can induce UPR gene expression in BD patients. The<br />altered UPR gene expression in BD macrophages may contribute to BD pathogenesis.</span>https://www.rheumres.org/article_122824_7c11677daf223c66de886da50ca0aa92.pdfRheumatology ResearchRheumatology Research2476-58565220200401Assessment of serum vitamin D level and its relationship with disease activity in adult patients with Systemic Lupus Erythematosus (SLE)738011956610.22631/rr.2020.69997.1094ENZahra Bagheri-HosseinabadiMolecular Medicine Research Center, Research Institute of Basic Medical Sciences, Rafsanjan University of Medical Sciences,
Rafsanjan, Iran.Fatemeh MoadabStudent Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.Zahra KamiabStudent Research Committee, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.Amir RahnamaNon-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.Mitra AbbasifardNon-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
Department of Internal Medicine, Ali-Ibn AbiTalib hospital, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.0000-0003-4670-7127Journal Article20191212<span class="fontstyle0">Vitamin D level varies according to the geographic location. This study was conducted to evaluate Vitamin D level in the serum<br />samples of Systemic lupus erythematosus (SLE) patients from the Iranian population and determine its association with SLE disease<br />activity index (SLEDAI), sun exposure, smoking, photosensitivity, sun protector cream use, and drug regimen. In this crosssectional study, 200 patients were included. The patient’s data were obtained using a questionnaire. The enzyme-linked<br />immunosorbent assay (ELISA) technique was used to determine Vitamin D level in the serum samples of the patients. The study<br />population was comprised of 27 (13.5%) males and 173 (86.5%) females, with a mean age of 38.46 ± 13.24 years. The serum<br />level of Vitamin D was 13.62 ± 3.22 ng/ml in the patients. Vitamin D deficiency was observed in 104 (52%) patients. There was<br />a statistically positive correlation between vitamin D level and duration of sun exposure (CC = 0.57, </span><span class="fontstyle2">P </span><span class="fontstyle0">= 0.004). A statistically<br />significant negative correlation was seen between vitamin D level and SLEDAI (CC = -0.41, </span><span class="fontstyle2">P </span><span class="fontstyle0">= 0.013).<br />Vitamin D level was significantly (</span><span class="fontstyle2">P </span><span class="fontstyle0">= 0.030) lower in the SLE patients with photosensitivity. SLE patients using sun<br />protector cream had significantly (</span><span class="fontstyle2">P </span><span class="fontstyle0">= 0.002) lower level of Vitamin D. Patients receiving glucocorticoid drugs had<br />significantly (</span><span class="fontstyle2">P </span><span class="fontstyle0">= 0.001) lower levels of Vitamin D in comparison to the patients not receiving glucocorticoids. Vitamin D is<br />involved in the disease activity of SLE patients. It is important to include vitamin D supplementation in the drug regimen of SLE<br />patients, especially when it includes glucocorticoids.</span>https://www.rheumres.org/article_119566_82187e1d715154527f090a1cfd5afdee.pdfRheumatology ResearchRheumatology Research2476-58565220200401New Onset Systemic Lupus Erythematosus Presenting with Massive Pericardial Effusion: A Case Report818612552710.22631/rr.2020.69997.1095ENDorsa KavandiSchool of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.Majid AlikhaniRheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.Sepideh Tahsini TekantapehTabriz University of Medical Sciences, Tabriz, Iran.Journal Article20191225<span class="fontstyle0">Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disorder with multiple system involvements which<br />commonly affects the cardiovascular system. Although pericarditis and pericardial effusion are prevalent cardiac manifestations<br />in SLE, massive pericardial effusion as an initial presentation is unusual. We describe a 47-year-old woman who presented to<br />the hospital with a headache, dry cough, shortness of breath, and fatigue. According to the clinical, radiologic, echocardiographic<br />and laboratory rheumatologic test findings, SLE was diagnosed and treatment with prednisolone, hydroxychloroquine, and<br />mycophenolate mofetil was initiated. The patient improved clinically, and follow-up echocardiography showed a reduction in<br />the effusion volume compared with previous tests within the preceding 6 months. In patients with cardiopulmonary symptoms,<br />especially when other organ involvement is seen, screening for autoimmune systemic diseases such as SLE should be<br />considered. To achieve rapid recovery and prevent life-threatening complications, early diagnosis and treatment are essential.</span>https://www.rheumres.org/article_125527_5b17874c3301fc1b9e1c10203cbf2d2b.pdf