Publications by authors named "Merete Engelhart"

3 Publications

  • Page 1 of 1

Trends in incidence, mortality, and causes of death associated with systemic sclerosis in Denmark between 1995 and 2015: a nationwide cohort study.

BMC Rheumatol 2018 7;2:36. Epub 2018 Dec 7.

5Department of Cardiology, Herlev and Gentofte Hospital, Gentofte, Kildegårdsvej 28, 2900 Hellerup, Denmark.

Background: To investigate the incidence and the mortality-rates of systemic sclerosis (SSc), its primary causes of death, and the temporal trends in events in Denmark during the last decades.

Methods: Using the Danish National Patient Registry, we identified all persons aged ≥18 years with a first-time diagnosis of SSc (ICD-10 code M34, excluding M34.2) between 1995 and 2015.

Results: A total of 2778 incident SSc cases were identified. The mean age at time of SSc diagnosis was 56 (standard deviation 15) years and 76% were women. The overall incidence rate (per 1,000,000 person-years) of diagnosed SSc was 24.4 (95% confidence interval 23.6-25.4), with a slight increase over the study period, age- and sex-adjusted incidence rate ratio 1.02 (95% confidence interval 1.01-1.02) per 1-year increase. The 1-year all-cause mortality rate per 100 person-years decreased from 6.1 (3.1-12.2) in 1995 to 5.3 (2.5-11.1) in 2015, sex- and age-adjusted hazard ratio 0.96 (95% CI 0.94-0.98) per 1-year increase. Over the period, the average age at SSc diagnosis increased and the proportion of women decreased, whereas the burden of comorbidities increased. One fifth of all deaths were attributable to cardiovascular causes, a fourth to pulmonary diseases, and 15% were due to cancer.

Conclusions: Within the last few decades, the incidence of SSc has increased and the 1-year mortality rate has decreased slightly in Denmark. Almost half of all deaths were attributable to cardiopulmonary causes.
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http://dx.doi.org/10.1186/s41927-018-0043-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390621PMC
December 2018

Infection Mimicking Progression of Scleroderma.

Case Rep Rheumatol 2017 27;2017:4029271. Epub 2017 Sep 27.

Center for Rheumatology and Spine Diseases, Rigshospitalet, 2100 Copenhagen, Denmark.

This case report describes a patient with scleroderma who developed infection, which for more than a year mimicked worsening of her connective tissue disorder. The patient was diagnosed with scleroderma based on puffy fingers that developed into sclerodactyly, abnormal nail fold capillaries, interstitial lung disease, Raynaud's phenomenon, esophageal dysmotility, and positivity for rheumatoid factor and anti-SSA antibodies. She developed massive inflammatory changes of the cutis, the subcutis, and the muscle fasciae of the right leg, that after several failed attempts of immunosuppressive treatments were found to be caused by . While she was receiving high-dose prednisolone, as worsening of her connective tissue disease was suspected to be the cause of the inflammatory changes, she had meningitis and was hospitalized for several weeks, but she recovered from this without sequelae. After infection was diagnosed, she was treated with clarithromycin and rifampicin. Her skin manifestations, arthralgias, and fatigue improved considerably, and the wounds of the right leg healed, unfortunately with significant scarring. Immunodeficiency testing was unremarkable. In summary, an infection with was mistaken for an unusually severe progression of scleroderma.
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http://dx.doi.org/10.1155/2017/4029271DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5635288PMC
September 2017

A comparison of anti-nuclear antibody quantification using automated enzyme immunoassays and immunofluorescence assays.

Autoimmune Dis 2014 28;2014:534759. Epub 2014 Jan 28.

Department of Clinical Biochemistry, Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark.

Anti-nuclear antibodies (ANA) have traditionally been evaluated using indirect fluorescence assays (IFA) with HEp-2 cells. Quantitative immunoassays (EIA) have replaced the use of HEp-2 cells in some laboratories. Here, we evaluated ANA in 400 consecutive and unselected routinely referred patients using IFA and automated EIA techniques. The IFA results generated by two independent laboratories were compared with the EIA results from antibodies against double-stranded DNA (dsDNA), from ANA screening, and from tests of the seven included subantigens. The final IFA and EIA results for 386 unique patients were compared. The majority of the results were the same between the two methods (n = 325, 84%); however, 8% (n = 30) yielded equivocal results (equivocal-negative and equivocal-positive) and 8% (n = 31) yielded divergent results (positive-negative). The results showed fairly good agreement, with Cohen's kappa value of 0.30 (95% confidence interval (CI) = 0.14-0.46), which decreased to 0.23 (95% CI = 0.06-0.40) when the results for dsDNA were omitted. The EIA method was less reliable for assessing nuclear and speckled reactivity patterns, whereas the IFA method presented difficulties detecting dsDNA and Ro activity. The automated EIA method was performed in a similar way to the conventional IFA method using HEp-2 cells; thus, automated EIA may be used as a screening test.
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http://dx.doi.org/10.1155/2014/534759DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3926329PMC
March 2014
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