Publications by authors named "Linda Ichchou"

14 Publications

  • Page 1 of 1

Prevalence of latent tuberculosis before biotherapy initiation in rheumatoid arthritis and spondyloarthritis: data from the Moroccan biotherapy registry.

Rheumatol Int 2021 Jun 26. Epub 2021 Jun 26.

Department of Rheumatology A, El Ayachi Hospital, Ibn Sina University Hospital, 11000, Salé, Morocco.

Before the initiation of biotherapy in the treatment of rheumatic diseases, it is highly recommended for the patients to be screened for latent tuberculosis infection (LTBI). The objective of this study is to identify the prevalence of LTBI among patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) before the initiation of biologic therapy in the Moroccan biotherapy registry (RBSMR). A cross sectional study was conducted using the baseline data of the Moroccan biotherapy registry. Tuberculin skin test or IGRA test or both tests were done before starting anti-TNF treatment for screening LTBI. The comparisons between positive and negative LTBI patients according to rheumatic disease were examined using categorical comparisons. 259 patients were included in this study.94 patients had RA and 165 had SpA. The mean age of the RA patients was 50.49 ± 11.82 years with a majority of females (84%). The mean age for the SpA patients was 36 ± 13.7 years with a majority of males (67.3%). The prevalence of LTBI in the RBSMR was 21.6%. This prevalence was at 24.8% in SpA patients, while it was at 15.9% for RA patients. After the comparison between positive and negative LTBI patients according to rheumatic disease, no demographic, clinical, or therapeutic characteristics were statistically associated with LTBI. This study found that in an endemic TB country like Morocco, a high prevalence of patients with SpA and RA had LTBI, and that RA patients had a lower prevalence than SpA patients.
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http://dx.doi.org/10.1007/s00296-021-04929-wDOI Listing
June 2021

Bone Loss and Radiographic Damage Profile in Rheumatoid Arthritis Moroccan Patients.

J Bone Metab 2021 May 31;28(2):151-159. Epub 2021 May 31.

Department of Rheumatology, Mohammed VI University Hospital, Faculty of Medicine, Mohammed I University, Oujda, Morocco.

Background: Rheumatoid arthritis (RA) is a known cause of joint destruction and systemic bone loss. In this study, we aimed to evaluate the bone damage and bone loss profiles of established RA patients.

Methods: We designed a cross-sectional study on a cohort of established RA patients. The bone evaluation was performed by obtaining standard X-ray images of hands and feet combined with bone mineral density (BMD) measurements. Radiographic joint damage was calculated by the modified total Sharp /van der Heijde score (mTSS). BMD was obtained by performing dual energy X-ray absorptiometry of the lumbar spine and femoral neck. Data on age, smoking, alcoholism, steroid prescription, body mass index (BMI), disease duration, disease activity, and functional disability were collected.

Results: A total of 93 RA patients were recruited. Their mean age was 51.59±12.38 years, with a mean disease duration of 12.07±9.19 years. A total of 36.6% of patients had osteoporosis, and the mean mTSS was 70.33±48.93. Both hip (P=0.0005) and lumbar BMD (P=0.0005) were correlated with mTSS. Backward regression analyses determined that bone damage was associated with high titers of rheumatoid factor, low lumbar BMD, and low BMI. General bone loss was associated with gender, steroid dose, steroid duration, menopause, and BMI.

Conclusions: Bone damage was associated with low BMI and axial bone loss in our RA population.
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http://dx.doi.org/10.11005/jbm.2021.28.2.151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8206608PMC
May 2021

The first biological choice in patients with rheumatoid arthritis: data from the Moroccan register of biotherapies.

Pan Afr Med J 2021 17;38:183. Epub 2021 Feb 17.

Rheumatology Department A, El Ayachi Hospital, Ibn Sina University Hospital, Rabat-Sale, Morocco.

Introduction: the aim of our study is to determine, from data of the Moroccan register of biotherapies, the factors influencing the choice of the first prescribed biological treatment.

Methods: cross-sectional multicenter study including rheumatoid arthritis patients who were initiated the first biological treatment either: Rituximab, an anti-TNF, or Tocilizumab. The determinants related to the patient and disease have been gathered. A univariate and then multivariate analysis to determine the factors associated with the choice of the first bDMARDs was realized.

Results: a total of 225 rheumatoid arthritis patients were included in the Moroccan registry. The mean age was 52 ± 11 years, with female predominance 88% (n = 197). The first prescribed biological treatment was Rituximab 74% (n = 166), the second one was Tocilizumab, 13.6% (n = 31) then comes the anti-TNF in 3 position with 12.4% (n = 28). The factors associated with the choice of Rituximab as the first line bDMARDs prescribed in univariate analysis were: the insurance type, the positivity of the rheumatoid factor. In multivariate analysis, only the insurance type that remains associated with the choice of Rituximab as the first biological drugs. The Tocilizumab was associated with shorter disease duration and was more prescribed as mono-therapy compared to non Tocilizumab group. TNFi was associated with the insurance type.

Conclusion: our study suggests that Rituximab and TNFi are associated with the type of insurance and Tocilizumab is the most prescribed biologic mono-therapy in RA patients. Further studies are needed to confirm these results.
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http://dx.doi.org/10.11604/pamj.2021.38.183.27081DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106777PMC
May 2021

One-year direct costs of biological therapy in rheumatoid arthritis and its predictive factors: data from the Moroccan RBSMR registry.

Rheumatol Int 2021 Apr 2;41(4):787-793. Epub 2021 Jan 2.

Department of Rheumatology B, El Ayachi Hospital, Ibn Sina University Hospital, Salé, Morocco.

The aim of the study was to estimate the annual direct costs of biological therapies in rheumatoid arthritis (RA), and to establish possible factors associated with those costs. The main data source was the Moroccan registry of biological therapies in rheumatic diseases (RBSMR Registry). We included patients with available 1-year data. Variables related to socio-economic status, disease and biological therapy were collected. Direct costs included prices of biologics, costs of infusions, and subcutaneous injections. Differences in costs across groups were tested by Mann-Whitney and Kruskal-Wallis tests. Correlations analysis was performed in search of factors associated with high costs. We included 197 rheumatoid arthritis patients. The mean age was 52.3 ± 11 years, with female predominance 86.8%. Receiving one of the following therapies: rituximab (n = 132), tocilizumab (n = 37), or TNF-blockers (n = 28). Median one-year direct costs per patient were €1665 [€1472-€9879]. The total annual direct costs were € 978,494. Rituximab, constituted 25.7% of the total annual budget. TNF-blockers and tocilizumab represented 27.3% and 47% of this overall budget, respectively. Although the costs were not significantly different in terms of gender or level of study, the insurance type significantly affected the cost estimation. A positive correlation was found between the annual direct cost and body mass index (r = 0.15, p = 0.04). In Morocco, a developing country, the annual direct costs of biological therapy are high. Our results may contribute to the development of strategies for better governance of these costs.
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http://dx.doi.org/10.1007/s00296-020-04762-7DOI Listing
April 2021

Seasonal and Weather Effects on Rheumatoid Arthritis: Myth or Reality?

Pain Res Manag 2020 7;2020:5763080. Epub 2020 Sep 7.

Rheumatology Department, Mohammed VI University Hospital, Faculty de Medicine, Mohammed I University, Oriental, Oujda, Morocco.

Introduction: Many of our rheumatic patients report that weather and seasons affect their symptoms.

Objective: The purpose of this study was to examine the effect of meteorological parameters within seasons on rheumatoid arthritis (RA) symptoms.

Methods: A retrospective longitudinal study from July 2017 to August 2018 was conducted. Data from three consultations for three seasons were collected and included a tender and swollen joint count, a disease activity score for 28 joints (DAS28), and patient's pain assessment from their computerized medical record. The weather conditions (minimum and maximum temperature, precipitation, humidity, atmospheric pressure, and wind speed) registered during the same day of consultation for each patient were obtained. Then, the statistical correlation between each meteorological parameter and RA parameters was determined using the multiple linear regression analysis.

Results: The data of 117 patients with a mean age of 50.45 ± 12.17 years were analyzed. The mean DAS28 at baseline was 2.44 ± 0.95. The winter in Oujda is cold (average temperature between 10°C and15°C) compared to summer (24.5°C-32.7°C). The spring is wetter with a 71% average humidity. Overall, the tender joint count was significantly correlated with hygrometry (=0.027) in winter. A similar result was obtained in summer with precipitation (=0.003). The pain intensity in the summer was negatively correlated with minimum temperatures and atmospheric pressure. However, there was no correlation between meteorological parameters and disease objective parameters for all seasons. Multiple linear regression analysis showed that weather parameters appeared to explain the variability in four RA predictors in the summer. No significant associations were observed in the spring.

Conclusion: Our study supported the physicians' assumption regarding the effect of climate on pain in RA patients.
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http://dx.doi.org/10.1155/2020/5763080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492902PMC
January 2021

Spinal Cοrd Compression Secondary to Brοwn Tumοr as First Manifestation of Primary Hyperparathyroidism.

World Neurosurg 2020 05 24;137:384-388. Epub 2020 Feb 24.

Department of Rheumatology, Mohammed VI University Hospital, Mohammed I University, Oujda, Morocco.

Background: Brown tumors (BTs) represent the typical nonmalignant lesions of hyperparathyroidism. Mandibles, ribs, and large bones are the most usual localization of BT. The diagnosis of these tumors requires biological and radiologic assessments. Their treatment is essentially based on parathyroidectomy.

Case Description: The present case report describes a patient with primary hyperparathyroidism who developed a cervical BT revealed by slow spinal compression.

Conclusions: The brown tumor, when localized at the level of the spine, can be life-threatening and must be managed as soon as possible.
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http://dx.doi.org/10.1016/j.wneu.2020.02.076DOI Listing
May 2020

Reversible increase in FGF23 in a hypophosphatemic renal and bone disease linked to antiviral therapy by adefovir.

Joint Bone Spine 2013 Dec 11;80(6):668-9. Epub 2013 Apr 11.

Faculté de médecine et de pharmacie, université Mohamed I, Oujda, Morocco. Electronic address:

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http://dx.doi.org/10.1016/j.jbspin.2013.02.014DOI Listing
December 2013

Relationship between spine osteoarthritis, bone mineral density and bone turn over markers in post menopausal women.

BMC Womens Health 2010 Aug 8;10:25. Epub 2010 Aug 8.

Laboratory of Information and Research on Bone Diseases LIRPOS, Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Morocco.

Background: Several studies have observed an inverse relationship between osteoporosis and spinal osteoarthritis, the latter being considered as possibly delaying the development of osteoporosis. The aim of this study was to determine the association between individual radiographic features of spine degeneration, bone mineral density (BMD) and bone-turn over markers.

Methods: It was a cross sectional study of 277 post menopausal women. BMD of all patients was assessed at the spine and hip using dual-energy X-ray absorptiometry. Lateral spinal radiographs were evaluated for features of disc degeneration. Each vertebral level from L1/2 to L4/5 was assessed for the presence and severity of osteophytes and disc space narrowing (DSN). For Bone turn-over markers, we assessed serum osteocalcin and C-terminal cross-linking telopeptide of type I collagen (CTX). Linear regressions and partial correlation were used respectively to determine the association between each of disc degeneration features, BMD, and both CTX and osteocalcin.

Results: Mean age of patients was 58.7 +/- 7.7 years. Eighty four patients (31.2%) were osteoporotic and 88.44% had spine osteoarthritis. At all measured sites, there was an increase in BMD with increasing severity of disc narrowing while there was no association between severity of osteophytes and BMD. After adjustment for age and BMI, there was a significant negative correlation between CTX and DSN. However, no significant correlation was found between CTX and osteophytes and between osteocalcin and both osteophytes or DSN.

Conclusion: In post menopausal women the severity of disc narrowing, but not osteophytes, is associated with a generalized increase in BMD and a decreased rate of bone resorption. These results are consistent with the hypothesis that osteoarthritis, through DSN, has a protective effect against bone loss, mediated by a lower rate of bone resorption. However, spine BMD is not a relevant surrogate marker for the assessment of osteoporosis in the spine in patients with osteoarthritis and debate as to the relationship between OA and OP is still open because of the contradictory data in the literature.
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http://dx.doi.org/10.1186/1472-6874-10-25DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2924252PMC
August 2010

The effect of past use of oral contraceptive on bone mineral density, bone biochemical markers and muscle strength in healthy pre and post menopausal women.

BMC Womens Health 2009 Nov 3;9:31. Epub 2009 Nov 3.

Department of Rheumatology, El Ayachi University-Hospital, Sale, Morocco.

Background: during adulthood, most studies have reported that oral contraceptive (OC) pills had neutral, or possibly beneficial effect on bone health. We proposed this study of pre and post menopausal women assessing BMD, bone biochemical markers and physical performance among OC past users and comparable women who have never use Ocs.

Methods: A cross-sectional study comparing the bone density, bone biochemical markers (osteocalcin, CTX) and three measures to assess physical performance: timed get-up-and-go test "TGUG", five-times-sit-to-stand test "5 TSTS" and 8-feet speed walk "8 FSW" of users and never users OC. We were recruited 210 women who used OC for at least 2 years with that of 200 nonusers was carried out in pre and postmenopausal women (24-86 years).

Results: when analysing the whole population, BMD and biochemical markers values were similar for Ocs past users and control subjects. However when analysing the subgroup of premenopausal women, there was a statistically significant difference between users and never-users in osteocalcin (15,5 +/- 7 ng/ml vs 21,6 +/- 9 ng/ml; p = 0,003) and CTX (0,30 +/- 0,1 ng/ml vs 0,41 +/- 0,2 ng/ml; p = 0,025). This difference persisted after adjustment for age, BMI, age at menarche and number of pregnancies. In contrast, in post menopausal women, there was no difference in bone biochemical markers between OC users and the control. On the other hand OC past users had a significant greater performance than did the never users group. And when analysing the physical performance tests by quartile OC duration we found a significant negative association between the three tests and the use of OC more than 10 years.

Conclusion: the funding show no evidence of a significant difference in BMD between Ocs users and never user control groups, a decrease in bone turn over in OC pre menopausal users and a greater physical performances in patients who used OC up than 10 years.
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http://dx.doi.org/10.1186/1472-6874-9-31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2776575PMC
November 2009

Low bone mineral density is related to atherosclerosis in postmenopausal Moroccan women.

BMC Public Health 2009 Oct 14;9:388. Epub 2009 Oct 14.

Laboratory of Information and Research on Bone Diseases (LIRPOS), Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Morocco.

Background: Some studies have implicated several possible metabolic linkages between osteoporosis and vascular calcification, including estrogen deficiency, vitamin D excess, vitamin K deficiency and lipid oxidation products. Nevertheless, it remains unclear whether osteoporosis and atherosclerosis are related to each other or are independent processes, both related to aging. The aim of this cross-sectional study was to evaluate the correlation between arterial thickening and bone status in a sample of apparently healthy Moroccan women.

Methods: Seventy-two postmenopausal women were studied. All patients were without secondary causes that might affect bone density. Bone status was assessed by bone mineral density (BMD) in lumbar spine and all femoral sites. Arterial wall thickening was assessed by intima-media thickness (IMT) in carotid artery (CA) and femoral artery (FA). Prevalent plaques were categorized into four groups ranging from low echogenicity to high echogenicity.

Results: The mean age was 59.2 +/- 8.3 years. 84.7% had at least one plaque. By Spearman Rank correlation, CA IMT was negatively correlated to Femoral total BMD (r = -0.33), Femoral neck BMD (r = -0.23), Ward triangle BMD (r = -0.30) and Trochanter BMD (r = -0.28) while there was no association with lumbar BMD. In multiple regression analysis, CA IMT emerged as an independent factor significantly associated with all femoral sites BMD after adjusting of confounding factors. FA IMT failed to be significantly associated with both Femoral and Lumbar BMD. No significant differences between echogenic, predominantly echogenic, predominantly echolucent and echolucent plaques groups were found concerning lumbar BMD and all femoral sites BMD CONCLUSION: Our results demonstrate a negative correlation between bone mineral density (BMD) qnd carotid intima-media thickness (IMT) in postmenopausal women, independently of confounding factors. We suggest that bone status should be evaluated in patients with vascular disease to assess whether preventive or therapeutic intervention is necessarry.
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http://dx.doi.org/10.1186/1471-2458-9-388DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2768707PMC
October 2009

The relationship between physical performance measures, bone mineral density, falls, and the risk of peripheral fracture: a cross-sectional analysis.

BMC Public Health 2009 Aug 18;9:297. Epub 2009 Aug 18.

Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Sale, Morocco.

Background: Several factors, in addition to low bone mineral density (BMD), have been identified as risks for fractures, including reduced levels of physical activity, poor balance and low physical performance. The aim of this study was to evaluate the relationship between physical performance measures, BMD, falls, and the risk of peripheral fracture in a population sample of Moroccan women.

Methods: 484 healthy women were included. Three measures were used to assess physical performance: timed get-up-and-go test 'TGUGT', five-times-sit-to-stand test '5 TSTS' and 8-feet timed walk '8 FTW'. The association between physical performance measures and BMD, peripheral fracture and falls was performed by univariate and multivariate analysis.

Results: The mean age was 55.1 years. Higher 'TGUGT', '5 TSTS', '8 FTW' test scores were associated with lower BMD measured at different sites (p range from < 0.001 to 0.005). The relationship between the three tests and BMD in all measured sites remained significant after multiple linear regression (p range from <0.001 to 0.026). In the group of post-menopausal patients, the scores of 'TGUGT' and '8 FTW' were significantly higher in fractured patients compared with patients without. After logistic regression, a score of 'TGUGT' > 14.2 sec, a score of '5 TSTS' > 12.9 sec and a score of '8 FTW' > 4.6 sec respectively, increased the probability of anterior peripheral fracture by 2.7, 2.2 and 2.3 (OR = 2.7; 95% CI = 1.2-6.4, OR = 2.2; 95% CI = 1.1-5.2; and OR = 2.3; 95% CI = 1.1-5.1). There was a significant positive correlation between the number of fall/year and the 3 tests. This correlation persisted after poisson regression.

Conclusion: This study suggested that low physical performance is associated with low BMD, and a high risk of history of falls and fractures.
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http://dx.doi.org/10.1186/1471-2458-9-297DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746809PMC
August 2009

Relationship between historical height loss and vertebral fractures in postmenopausal women.

Clin Rheumatol 2009 Nov 14;28(11):1283-9. Epub 2009 Aug 14.

Laboratory of Information and Research on Bone Diseases, Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Rabat, Morocco.

The aim of this study was to evaluate the relationship between historical height loss (HHL) and prevalent vertebral fractures (VF) in postmenopausal Moroccan women and to estimate its accuracy as a clinical test for detecting VF. Two hundred eighty-eight postmenopausal women were studied. All subjects had bone density measurements and spinal radiographs. Vertebral bodies (T4-L4) were graded using the semi-quantitative method of Genant. HHL was calculated as the difference between a patient's tallest recalled height and the current measured height. The mean age was 58.4 +/- 7.8 years. Thirty-one percent of patients were osteoporotic, and 46.5% had VF. Patients with VF had lost more height than those without VF (median, 2.0 cm (0.26-3.3) vs 0.96 cm (0.33-2.4), p < 0.05). In univariate analysis, HHL was positively correlated to both number and grade of prevalent VF (p < 0.05). The area under the receiver operating characteristics curve for the ability of HHL to detect VF was 0.60 (95% confidence interval (CI), 0.52, 0.69). Our HHL threshold for detecting VF was >1.5 cm, its sensitivity was 58%, and its specificity was 61%. The positive predictive value was 53%, and the negative predictive value was 65%. With HHL >1.5 cm, positive likelihood ratio was 1.49 with 95% CI, 1.07, 2.06. Our results demonstrate significant positive associations between HHL, VF, number of VF, and grade of VF. However, this relationship is not clinically pertinent. Consequently, HHL cannot be used as a reliable clinical test for detecting VF in postmenopausal Moroccan women.
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http://dx.doi.org/10.1007/s10067-009-1236-6DOI Listing
November 2009

Factors influencing quality of life in Moroccan postmenopausal women with osteoporotic vertebral fracture assessed by ECOS 16 questionnaire.

Health Qual Life Outcomes 2009 Mar 13;7:23. Epub 2009 Mar 13.

Department of Rheumatology, El Ayachi hospital, University Hospital of Rabat-Sale, Rabat, Morocco.

Objective: The aim of the study was to evaluate factors influencing quality of life (QOL) in Moroccan postmenopausal women with osteoporotic vertebral fracture assessed by the Arabic version of ECOS 16 questionnaire.

Methods: 357 postmenopausal women were included in this study. The participants underwent bone mineral density (BMD) measurements by DXA of the lumbar spine and the total hip as well as X-ray examination of the thoraco-lumbar spine to identify subclinical vertebral fractures. Patients were asked to complete a questionnaire on clinical and sociodemographic parameters, and osteoporosis risk factors. The Arabic version of the ECOS16 (Assessment of health related quality of life in osteoporosis questionnaire) was used to assess quality of life.

Results: The mean age was 58 +/- 7.8 years, and the mean BMI was 28.3 +/- 4.8 kg/m2. One hundred and eight women (30.1%) were osteoporotic and 46.7% had vertebral fractures. Most were categorized as Grade1 (75%). Three independent factors were associated with a poor quality of life: low educational level (p = 0,01), vertebral fracture (p = 0,03), and history of peripheral fracture (p = 0,006). Worse QOL was observed in the group with vertebral fracture in all domains except "pain": Physical functioning (p = 0,002); Fear of illness (p = 0,001); and Psychosocial functioning (p = 0,007). The number of fractures was a determinant of a low QOL, as indicated by an increased score in physical functioning (p = 0,01), fear of illness (p = 0,007), and total score (p = 0,01) after adjusting on age and educational level. Patients with higher Genant score had low QOL in these two domains too (p = 0,002; p = 0,001 respectively), and in the total score (p = 0,01) after adjusting on age and educational level.

Conclusion: Our current data showed that the quality of life assessed by the Arabic version of the ECOS 16 questionnaire is decreased in post menopausal women with prevalent vertebral fractures, with the increasing number and the severity of vertebral fractures.
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http://dx.doi.org/10.1186/1477-7525-7-23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663551PMC
March 2009

Progressive pseudorheumatoid dysplasia: three cases in one family.

Joint Bone Spine 2007 Jul 25;74(4):393-5. Epub 2007 May 25.

Rheumatology Department, El-Ayachi Hospital, Rabat-Salé Teaching Hospital, Rabat-Salé, Morocco.

Unlabelled: Progressive pseudorheumatoid dysplasia is an inherited skeletal dysplasia with autosomal recessive transmission. Radiographs of the spine show abnormalities similar to those seen in spondyloepiphyseal dysplasia tarda. The clinical presentation, but not the imaging study findings, suggest juvenile idiopathic arthritis. We report 3 cases of progressive pseudorheumatoid dysplasia in the same family.

Case-reports: A 4-year-old girl had been receiving follow-up for 3 years for seronegative, polyarticular juvenile idiopathic arthritis progressing by flares and remissions. The disease was unresponsive to anti-inflammatory medications. Findings at admission included inflammatory joint pain, joint swelling, range-of-motion limitation, and joint deformities in the hands, wrists, ankles, and knees. The hips were normal. Normal values were found for the erythrocyte sedimentation rate and C-reactive protein level. Synovial fluid removed from one of the knees exhibited mechanical properties. Plain radiographs of the hands and forefeet showed no evidence of joint destruction. Bilateral hip dysplasia was noted on a radiograph of the pelvis. The diagnosis of juvenile idiopathic arthritis was reconsidered. A study of the family identified two similar cases, in a brother and paternal uncle. The brother, who was 14 years old, had similar manifestations without laboratory evidence of inflammation; radiographs disclosed dysplasia of the hips and metacarpophalangeal epiphyses. Manifestations in a paternal uncle consisted of spinal stiffness, thoracic kyphosis, and motion-range limitation at the hips; radiographs showed normal sacroiliac joints and bilateral hip dysplasia. A diagnosis of progressive pseudorheumatoid dysplasia with polyarticular involvement was given.

Discussion: Progressive pseudorheumatoid dysplasia is an autosomal recessive disease characterized by abnormal cartilage homeostasis. It should be included among the differential diagnoses of juvenile idiopathic arthritis.
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http://dx.doi.org/10.1016/j.jbspin.2006.11.014DOI Listing
July 2007
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