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11. Increased Serum Levels of soluble ST2 as a Predictor of Disease Progression in Systemic Sclerosis.

Author

Günther, F, Straub, RH, Hartung, W, Luchner, A, Fleck, M, and Ehrenstein, B

Subjects
SYSTEMIC scleroderma, DISEASE progression, RECEIVER operating characteristic curves, LOGISTIC regression analysis, C-reactive protein
Abstract

Interleukin-33 (IL-33) has been investigated as a mediator in the pathogenesis of fibrosis in lung, liver, and heart. There is accumulating evidence for the involvement of the IL-33/IL-33 receptor ST2L signalling pathway in systemic sclerosis (SSc). Little is known about the role of serum sST2 in SSc, which is the subject of the present investigation. Serum levels of sST2 were measured in 49 patients with SSc, recruited prospectively between November 2017 and March 2019. Patients were divided into those with progressive and those with stable disease. Receiver operating characteristics (ROC) curve analysis was applied to study sST2 as a marker for identifying patients with progressive disease. We used multivariate logistic regression analysis to evaluate the predictive value of sST2 for progressive disease after adjustment for potential confounding factors. Serum sST2 levels in patients with progressive disease were significantly elevated compared with patients with stable disease (mean ± sem: 50.4 ± 4.7 ng/mL vs 29.2 ± 2.97 ng/mL, p < 0.001). ROC curve analysis identified an sST2 cut-off value of 37.8 ng/mL as optimal for discriminating patients with progressive disease from those with stable disease (sensitivity 80.0%, specificity 79.3%, area under the curve 0.80). After controlling for potential confounding factors (age, gender, C-reactive protein, pro-brain natriuretic peptide, and sum of internal medicine comorbidities), sST2 remained predictive of progressive disease (odds ratio 1.070, 95% confidence interval 1.017–1.126, p < 0.009). In the present study, sST2 serum levels were predictive of disease progression in patients with SSc. [ABSTRACT FROM AUTHOR]

Published
2022
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21. Unklare Polyarthralgien, was nun?

Author

Krammer, OB, Ehrenstein, B, Hartung, W, and Fleck, M

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Vorgeschichte: Eine 53-jährige Patientin stellte sich im Februar 2019 erstmals rheumatologisch in unserer Klinik vor. Die Patientin beschrieb bei Aufnahme Polyarthralgien der Hände, Füße und Kniegelenke beidseits, die ca. 2018 erstmalig aufgetreten seien. Zudem wurde eine Dysurie,[zum vollständigen Text gelangen Sie über die oben angegebene URL], Deutscher Rheumatologiekongress 2020, 48. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 34. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh)

Published
2020
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31. Verdacht auf seronegative RA – eine diagnostische Herausforderung

Author

Diller, M, Ehrenstein, B, Hartung, W, and Fleck, M

Subjects
ddc: 610, Rheumatoide Arthritis, Seronegativ, 610 Medical sciences, Medicine, M. Whipple
Abstract

Vorgeschichte: Ein 53-jähriger Patient mit einer 2005 erstdiagnostizierten RF und ACPA negativen Rheumatoiden Arthritis wurde vom Hausarzt zur Therapieoptimierung in unsere Klinik eingewiesen. Trotz verschiedenster Therapieversuche mit DMARDs, Biologika (TNF-α-Inhibitoren, IL-1- und IL-6-Blockade,[zum vollständigen Text gelangen Sie über die oben angegebene URL], 44. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 30. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 26. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

Published
2016
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32. Depression moderates the association between beliefs about medicines and medication adherence in patients with rheumatoid arthritis

Author

Brandstetter, S, Bartsch, N, Riedelbeck, G, Steinmann, M, Loss, J, Ehrenstein, B, and Apfelbacher, C

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Introduction: Adherence to medication is crucial to achieve treatment control in chronic disease. The necessity-concerns framework postulates that patients’ adherence behaviour is influenced by beliefs about the necessity of prescribed medicines and the concerns patients might have regarding [for full text, please go to the a.m. URL], 14. Deutscher Kongress für Versorgungsforschung

Published
2015
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33. An 84-year old patient with refractory arthritis of the knee joint

Author

Jantsch, V, Diller, M, Pongratz, G, Ehrenstein, B, and Fleck, M

Subjects
musculoskeletal diseases, ddc: 610, 610 Medical sciences, Medicine, skin and connective tissue diseases
Abstract

Background: An 84-year old female patient was admitted to our tertiary Rheumatology center due to refractory arthritis of the left knee joint since 14 months. During the disease course, the diagnosis of seronegative rheumatoid arthritis had been established and DMARD treatment with MTX in combination[for full text, please go to the a.m. URL], 43. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 29. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 25. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

Published
2015
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34. Interleukin-3 Expression durch T-Zellen von Patienten mit Rheumatoider Arthritis

Author

Brühl, H, Fleck, M, Ehrenstein, B, Renner, K, Hermann, F, Metzger, A, and Mack, M

Subjects
ddc: 610, T-Zellen, IL-3, 610 Medical sciences, Medicine, RA
Abstract

Einleitung: In Voruntersuchungen haben wir gezeigt, dass die Blockade von IL-3 mit einem monoklonalen Antikörper in der Kollagen-induzierten Arthritis zu einer deutlichen Abschwächung der Gelenkentzündung führt, während durch rekombinantes IL-3 die Erkrankung verstärkt [for full text, please go to the a.m. URL], 42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

Published
2014
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35. High resolution- and colour Doppler ultrasound of the ankle joint in patients with Rheumatoid Arthritis. What may we learn from Sonography?

Author

Al Suwaidi, M, Ehrenstein, B, Fleck, M, and Hartung, W

Subjects
musculoskeletal diseases, ddc: 610, ultrasound, ankle Joint, Rheumatoid Arthritis, Colour Doppler, 610 Medical sciences, Medicine
Abstract

Background: As weight bearing joints the ankle joints play a substantial role for patients mobility, nevertheless they are historically neglected by the DAS 28 scoring system. However only few studies have assessed US detected pathologies of the ankle in symptomatic RA patients [ref:1]. Therefore[for full text, please go to the a.m. URL], 42. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh); 28. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh); 24. wissenschaftliche Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR)

Published
2014
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37. THU0414 Inter SPA: Sensitivity and Specifity of Autoantibodies against CD74 in Early Axial Spondyloarthritis

Author

Riechers, E., primary, Baerlecken, N.T., additional, Baraliakos, X., additional, Achilles-Mehr Bakhsh, K., additional, Aries, P.M., additional, Bannert, B., additional, Becker, K., additional, Brandt-Jürgens, J.F., additional, Braun, J., additional, Ehrenstein, B., additional, Euler, H., additional, Fleck, M., additional, Hein, R., additional, Karberg, K., additional, Köhler, L., additional, Matthias, T., additional, Max, R., additional, Melzer, A., additional, Meyer-Olson, D., additional, Rech, J., additional, Rockwitz, K., additional, Rudwaleit, M., additional, Schweikhard, E., additional, Sieper, J., additional, Stille, C., additional, von Hinüber, U., additional, Wagener, P., additional, Weidemann, H., additional, Zinke, S., additional, and Witte, T., additional

Published
2016
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39. Admissions with nH1N1 infection at the University Hospital Regensburg - high rate of complications in a collective of mostly younger patients

Author

Bauernfeind, S., Ehrenstein, B., Müller, T., Werner, S., and Salzberger, B.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Zielsetzung: Infektionen mit dem neuen H1N1-Influenzavirus traten 2009 erstmals auf. Ziel dieser Arbeit war die Beschreibung der stationären Fälle an einem Universitätsklinikum hinsichtlich Komorbiditäten, Verlauf und Outcome. Methoden: In einer retrospektiven Studie werden alle[for full text, please go to the a.m. URL], 10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Published
2010

41. The role of domestic hygiene in inflammatory bowel diseases: hepatitis A and worm infestations

Author

Hafner, S, Timmer, A, Herfarth, H, Rogler, G, Schölmerich, J, Schäffler, A, Ehrenstein, B, Jilg, W, Ott, C, Strauch, U G, Obermeier, F, University of Zurich, and Obermeier, F

Subjects
10219 Clinic for Gastroenterology and Hepatology, 10076 Center for Integrative Human Physiology, 570 Life sciences, biology, 610 Medicine & health, 2721 Hepatology, 2715 Gastroenterology
Published
2008

42. PCR analysis is superior to histology for diagnosis of Whipple's disease mimicking seronegative rheumatic diseases.

Author

Lehmann, P, Ehrenstein, B, Hartung, W, Dragonas, C, Reischl, U, and Fleck, M

Subjects
*WHIPPLE'S disease diagnosis, *POLYMERASE chain reaction, *LIPODYSTROPHY, *MALABSORPTION syndromes, *NUCLEIC acid amplification techniques, *DIAGNOSIS
Abstract

Objectives: The diagnosis of Whipple's disease (WD) is commonly confirmed by histology demonstrating Periodic Acid Schiff (PAS)-positive macrophages in the duodenal mucosa. Analysis of intestinal tissue or other specimens using polymerase chain reaction (PCR) is a more sensitive method. However, the relevance of positive PCR findings is still controversial. Therefore, we evaluated the relevance of histology and PCR findings to establishing the diagnosis of WD in a series of WD patients initially presenting with suspected rheumatic diseases.Method: Between 2006 and 2014, 20 patients with seronegative rheumatic diseases tested positive for Tropheryma whipplei (Tw) by PCR and/or histology and were enrolled in a retrospective analysis of the diagnostic value of both procedures.Results: Seven of the 20 cases (35%) were diagnosed with 'classic' WD as indicated by PAS-positive macrophages. In the remaining 13 patients, the presence of Tw was detected by intestinal (n = 10) or synovial PCR analysis (n = 3). Two of the 20 patients (10%) with evidence of Tw did not respond to antibiotic therapy. They were not considered to suffer from WD. Therefore, relying only on histological findings of intestinal biopsies would have missed 11 (61%) of the 18 patients with WD in our cohort. In comparison, PCR of intestinal biopsies detected Tw-DNA in 14 (93%) of the 15 WD patients evaluated. Patients with a positive histology did not differ from PCR-positive patients with regard to sex, age, or duration of disease, but more often presented with gastrointestinal symptoms.Conclusions: A substantial number of WD patients present without typical intestinal histology findings. Additional PCR analysis of intestinal tissue or synovial fluid increased the sensitivity of the diagnostic evaluation and should be considered particularly in patients presenting with atypical seronegative rheumatic diseases and a high-risk profile for WD. [ABSTRACT FROM AUTHOR]

Published
2017
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50. Quantitative assessment of synovitis in patients with rheumatoid arthritis using fluorescence optical imaging

Author

Schäfer, Valentin S., Hartung, Wolfgang, Hofstetter, Patrick, Berger, Jörn, Stroszczynski, Christian, Müller, Martina, Fleck, Martin, and Ehrenstein, B.

Subjects
Male, ddc:610, Synovitis, Carpal Joints, Hand Joints, Immunology, Optical Imaging, 610 Medizin, Reproducibility of Results, Middle Aged, Magnetic Resonance Imaging, Sensitivity and Specificity, Arthritis, Rheumatoid, Metacarpophalangeal Joint, Radiography, Rheumatology, Finger Joint, Immunology and Allergy, Humans, Female, Prospective Studies, Ultrasonography, Doppler, Color, Research Article, Aged
Abstract

Introduction To prospectively evaluate quantitative assessment of fluorescence optical imaging (FOI) for differentiation of synovitic from non-synovitic joints in patients suffering from rheumatoid arthritis (RA). Methods FOI of the hands was performed in patients with active RA, and a stratified quantitative fluorescence readout (FLRO) of 3 phases (1-120 s; 121-240 s; 241-360 s) was generated for 5 individual joints of the clinical predominant hand (carpal joint, metacarpophalangeal and proximal interphalangeal joints of digits II & III). To dissect the effect of the overall perfusion of the hand from the perfusion due to synovitis, a fluorescence ratio (FLRA) was additionally calculated, dividing each FLRO by the readout of the eponychium of digit II. The mean FLRO and FLRA were compared between joints with absent vs. present synovitis determined by clinical examination, grayscale, color Doppler ultrasonography, or magnetic resonance imaging (MRI). Results The analysis for 90 individual joints from 18 patients yielded FLRO ranging from 4.4 to 49.0 × 103, and FLRAs ranging from 0.37 to 2.27. Overall, the analyses based on the FLRA revealed a higher discrimination than the analyses related to the FLRO, demonstrating most significant differences in phases 2 and 3. A sensitivity of 26/39 (67%) and a specificity of 31/40 (77%) were calculated for FLRA of phase 3 using a cut-off value of more than 1.2 to detect MRI-confirmed synovitis with FOI. Conclusions FOI has a potential for visualizing synovitis in subjects with RA. For adequate FOI interpretation, quantitative analysis should be based on the novel FLRA calculated for phases 2 and 3.

Published
2013

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