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03387nam a2200445Ia 4500 |
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10.1002-acr.24530 |
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220510s2022 CNT 000 0 und d |
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|a 2151464X (ISSN)
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245 |
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|a Osteitis in Systemic Sclerosis: A Nationwide Case–Control Retrospective Study
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260 |
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|b John Wiley and Sons Inc
|c 2022
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|z View Fulltext in Publisher
|u https://doi.org/10.1002/acr.24530
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|a Objective: Systemic sclerosis (SSc) is an autoimmune connective tissue disorder characterized by skin fibrosis, vasculopathy, and dysimmunity. Data regarding osteitis in SSc are scarce. Methods: We performed a nationwide multicenter, retrospective, case–control study including patients with SSc, according to the 2013 American College of Rheumatology/European Alliance of Associations for Rheumatology classification, with a diagnosis of osteitis. The objectives of the study were to describe, to characterize, and to identify associated factors for osteitis in patients with SSc. Results: Forty-eight patients were included. Twenty-six patients (54.1%) had osteitis beneath digital tip ulcers. Physical symptoms included pain (36 of 48, 75%), erythema (35 of 48, 73%), and local warmth (35 of 48, 73%). Thirty-one (65%) patients had median (interquartile range) C-reactive protein levels >2 mg/liter of 8 (2.7–44.3) mg/liter. On radiography, computed tomography, or magnetic resonance imaging, osteitis was characterized by swelling or abscess of soft tissues, with acro-osteolysis or lysis in 28 patients (58%). Microbiological sampling was performed in 45 (94%) patients. Most pathogens were Staphylococcus aureus (43.8%), anaerobes and Enterobacteriaceae (29.1%), and Pseudomonas aeruginosa (10.4%). Management comprised antibiotics in 37 (77.1%) patients and/or surgery in 26 (54.2%). Fluoroquinolones were used in 22 (45.8%) patients, and amoxicillin plus β-lactamase inhibitor in 7 (14.6%). Six (12.6%) patients relapsed, 6 (12.6%) patients had osteitis recurrence, 15 (32%) sequelae, and 2 patients had septic shock and died. Conclusion: This study confirmed digital tip ulcers as an associated factor for osteitis and revealed a high rate of functional sequelae. Antimicrobial therapy with oral fluoroquinolone or intravenous amoxicillin and β-lactamase inhibitor are used as first-line antibiotic therapy in SSc patients with osteitis. © 2020 American College of Rheumatology.
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|a Agard, C.
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|a Berthier, S.
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|a Bertolino, J.
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|a Cerles, O.
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|a Chaigne, B.
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|a Cosse, C.
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|a Dion, J.
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|a Diot, E.
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|a Fagedet, D.
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|a Giret, C.
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|a Granel, B.
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|a Jourde, W.
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|a Kernéis, S.
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|a Le Jeunne, C.
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|a Lescoat, A.
|e author
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|a Luque Paz, D.
|e author
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|a Martin, M.
|e author
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|a Maurier, F.
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|a Mouthon, L.
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|a Nguyen, C.
|e author
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|a Priollet, P.
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|a Pugnet, G.
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|a Raffray, L.
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|a Toquet, S.
|e author
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|a Truchetet, M.-E.
|e author
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|a Viallard, J.F.
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|a Watelet, B.
|e author
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773 |
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|t Arthritis Care and Research
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