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10.1097/MD.0000000000000011

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suck abstract from ncbi


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pmid24378738
      Medicine+(Baltimore) 2014 ; 93 (1 ): 1-10
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  • Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases #MMPMID24378738
  • Mekinian A ; Braun T ; Decaux O ; Falgarone G ; Toussirot E ; Raffray L ; Omouri M ; Gombert B ; De Wazieres B ; Buchdaul AL ; Ziza JM ; Launay D ; Denis G ; Madaule S ; Rose C ; Grignano E ; Fenaux P ; Fain O
  • Medicine (Baltimore) 2014[Jan]; 93 (1 ): 1-10 PMID24378738 show ga
  • We describe the characteristics and outcome of inflammatory arthritis in patients with myelodysplastic syndrome (MDS) in a French multicenter retrospective study. Twenty-two patients with MDS (median age, 77.5 yr [interquartile range, 69-81]; 10 women) were included. Inflammatory arthritis presented as polyarthritis in 17 cases (77%) and with symmetric involvement in 15 cases (68%). At diagnosis, the median disease activity score 28 based on C-reactive protein (DAS28-CRP) was 4.5 [2-6.5]. Two patients had anti-citrullinated protein antibodies (ACPAs), and 1 had radiologic erosions. The median time between the diagnoses of arthritis and MDS was 10 months [6-42], with a median articular symptom duration of 3 months [2-8]. The diagnosis of both diseases was concomitant in 6 cases (27%); arthritis preceded MDS in 12 cases (55%), and occurred after MDS in 4 (18%). While the number of swollen and tender joints significantly decreased during follow-up, as did the median DAS28-CRP (from 4.3 [3.8-4.6] at baseline to 2.9 [1.75-3.3]; p < 0.05), CRP remained elevated (CRP >20 mg/L) in 8 patients (42%). Nevertheless, radiographic progression and new ACPA positivity were not observed during a median follow-up of 29 months [9-76]. While most of the patients were treated with steroids (n = 16) for arthritis, additional treatment was administered in only 4 patients (hydroxychloroquine, n = 2; sulfasalazine [Salazopyrin] and etanercept, n = 1, respectively). Eleven patients died during follow-up from acute myeloid leukemia (n = 5); infections (n = 3); or cerebral bleeding, cardiorespiratory failure, or undetermined cause (n = 1, respectively). Inflammatory arthritis associated with MDS can have various presentations and is often seronegative and nonerosive. Steroids alone are the most common treatment in MDS-associated arthritis, but that treatment is insufficient to control arthritis. Steroid-sparing strategies need to be identified.
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Arthritis/*complications/drug therapy/epidemiology [MESH]
  • |Female [MESH]
  • |France/epidemiology [MESH]
  • |Glucocorticoids/therapeutic use [MESH]
  • |Humans [MESH]
  • |Male [MESH]
  • |Myelodysplastic Syndromes/*complications/epidemiology [MESH]
  • |Polymyalgia Rheumatica/epidemiology [MESH]
  • |Retrospective Studies [MESH]


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