Try a new search

Format these results:

Searched for:

person:efthip01

in-biosketch:true

Total Results:

82


CHARACTERIZATION OF PHENOTYPE AND IMMUNOGLOBULIN GENES OF AUTOREACTIVE B CELLS IN SJOGREN'S SYNDROME [Meeting Abstract]

Efthimiou, P; Kadavath, S; Bhatta, A; Charles, E; Dustin, L
ISI:000346919802038
ISSN: 1468-2060
CID: 2760062

LOW BACK PAIN ASSOCIATED HOSPITAL CARE COSTS INCREASED DESPITE A STEADY DECLINE IN HOSPITALIZATIONS: 10 YEAR TRENDS FROM A US NATIONAL STUDY [Meeting Abstract]

Mujib, NA; Mazumder, NK; Mujib, M; Mehta, B; Rahman, A-AZ; Aronow, WS; Efthimiou, P
ISI:000346919801362
ISSN: 1468-2060
CID: 2760072

PREVALENCE OF LATENT TUBERCULOSIS INFECTION IN RHEUMATOID ARTHRITIS PATIENTS: FINDINGS FROM A UNITED NATIONS NATIONAL STUDY [Meeting Abstract]

Mehta, B; Shi, Q; Sule, S; Efthimiou, P
ISI:000346919806321
ISSN: 1468-2060
CID: 2760082

Can traumatic injury trigger psoriatic arthritis? A review of the literature

Hsieh, Jane; Kadavath, Sabeeda; Efthimiou, Petros
Traumatic injury as a trigger for the subsequent development of psoriatic arthritis (PsA) has been implicated by several case reports and case series. However, it is still unclear whether trauma is the inciting event or just an incidental finding. It is thought that the interplay of genetic, immunologic, and environmental factors, such as trauma, may trigger the development of PsA. At least two hypotheses of how trauma may be linked to the development of PsA have surfaced and involve a "deep Koebner effect," the concept of a synovio-entheseal complex and activation of the innate immune system by biomechanical factors. The role of neuropeptides such as substance P and vasoactive intestinal peptide has been highlighted in the synovium after trauma. Better understanding of this phenomenon would shed light into the pathophysiology of Psa and help the development of preventive and therapeutic strategies.
PMID: 24249146
ISSN: 1434-9949
CID: 2759102

Life-threatening complications of adult-onset Still's disease

Efthimiou, Petros; Kadavath, Sabeeda; Mehta, Bella
Adult-onset Still's Disease (AOSD) since its description in 1971 has proven to be a very complex and challenging disease entity. This rare auto-inflammatory disease is classically described by the "Still's triad" of fever, rash, and arthritis, although the atypical cases frequently outnumber the typical ones. The exact pathogenesis and etiologic factors responsible for the clinical features remain largely obscure, despite recent suggestive cytokine biology findings. Diagnosis is made on clinical grounds, following the exclusion of mimickers of infectious, autoimmune or neoplastic etiology, with the additional consideration of non-specific laboratory abnormalities such as peripheral leukocytosis and elevation of serum ferritin and other acute phase reactants. The disease manifestations are protean and can include diverse complications, affecting multiple organ systems. Moreover, the severity of the organ involvement can vary considerably, representing a wide spectrum from the self-limited to severe. The mainstay of therapy has evolved from the traditional use of corticosteroids and oral immunosupressants to the newer targeted treatments with biologic agents. The scope of this review is to alert the clinician to the existence of life-threatening AOSD complications, namely the macrophage activation syndrome, disseminated intravascular coagulopathy, thrombotic thrombocytopenic purpura, diffuse alveolar hemorrhage, and pulmonary arterial hypertension. Such knowledge may lead in earlier recognition, prompt treatment, and, ideally, improved patient outcomes.
PMID: 24435354
ISSN: 1434-9949
CID: 2759092

A novel therapeutic approach in pulmonary arterial hypertension as a complication of adult-onset Still's disease: targeting IL-6 [Case Report]

Kadavath, Sabeeda; Zapantis, Ekaterini; Zolty, Ronald; Efthimiou, Petros
Adult-onset Still's Disease (AOSD), often though as the adult variant of systemic juvenile idiopathic arthritis (JIA), has an incidence of 1-3 cases per 1 million. Cardinal manifestations include fever, arthritis, skin rash, sore throat, hepatosplenomegaly and lymphadenopathy. Prolongation in diagnosing this disease results from its similarity to infectious, malignant and rheumatic diseases and lack of biomarkers. Pulmonary arterial hypertension (PAH) is a rare pulmonary complication of AOSD, and we are aware of only six cases reported in literature to date. Here we present a patient with AOSD who has developed pulmonary hypertension as a complication. We report a case of AOSD complicated by PAH treated successfully with tocilizumab, a humanized monoclonal antibody to human interleukin (IL)-6 receptor. A Pubmed and Medline search for evidence of pulmonary hypertension in AOSD and use of IL-6 inhibition in management was performed. Data for this study was collected from the patient's chart records. No infectious or neoplastic cause of her disease was identified and after extensive diagnostic workup, the patient was diagnosed with AOSD fulfilling Yamaguchi criteria. After initiation of IL-6 therapy the patient was followed over time to monitor the hemodynamic changes in pulmonary vasculature. Following treatment with Tocilizumab, the patient showed dramatic improvement in her clinical symptoms and remains in remission, through combination of tocilizumab (8 mg/kg), methotrexate and prednisone. Improvement of systemic symptoms, right heart catheterization (RHC) findings and the VECTRA-DA score served as a measure of treatment response. Tocilizumab has been effective in demonstrating marked improvement in both the clinical and laboratory parameters. Tocilizumab is an effective novel treatment for AOSD with PAH. This is the first documented report of successful use of tocilizumab in AOSD patients presenting with PAH. Prospective comparative studies could help validate its efficacy and safety.
PMID: 24581387
ISSN: 1756-185x
CID: 2759082

Raynaud's Phenomenon and African American Race Are Independently Associated With Non-Hodgkin's Lymphoma In Sjogrens Syndrome Patients: Findings From a United States National Study [Meeting Abstract]

Mehta, Bella; Jadeja, Neville; Mujib, Marjan; Efthimiou, Petros V
ISI:000325359202017
ISSN: 1529-0131
CID: 2760032

Use Of B Lymphocyte Stimulator Inhibitor Belimumab May Be Associated With a Decrease In the Serum Concentration Of Endothelial Growth Factor In Patients With Primary Sjogren's Syndrome [Meeting Abstract]

Bobic, Slavica; Kadavath, Sabeeda; Gerber, Linda; Zapantis, Ekaterini; Efthimiou, Petros V
ISI:000325359203477
ISSN: 1529-0131
CID: 2760042

IL-1 Trap rilonacept in refractory adult onset Still's disease [Letter]

Petryna, Olga; Cush, J Jack; Efthimiou, Petros
PMID: 22679302
ISSN: 1468-2060
CID: 1985772

The use of Canakinumab, a novel IL-1beta long-acting inhibitor, in refractory adult-onset Still's disease [Case Report]

Kontzias, Apostolos; Efthimiou, Petros
OBJECTIVES: We describe the successful treatment of adult-onset Still's disease (AOSD) with canakinumab, a novel anti-interleukin (IL)-1beta, long-acting, monoclonal antibody, on patients refractory to anakinra and rilonacept. In many cases the expected positive therapeutic effect of short-acting IL-1 inhibitors is transient or completely absent, leading to our hypothesis that their short half-life may be associated with incomplete IL-1 blockade, given the cyclic nature of the disease. METHODS: We report 2 cases of AOSD resistant to short-acting IL-1 blockade, which were subsequently treated with canakinumab. A retrospective chart review was conducted of patients diagnosed with AOSD in our regional referral center. RESULTS: Response to treatment was assessed by its effect on the systemic symptoms (resolution of fever and rash), polyarthritis (using the disease activity score 28--C-reactive protein score), and the levels of serum ferritin. Canakinumab demonstrated sustained efficacy in both patients as evidenced by clinical and laboratory parameters with minimal adverse reactions. CONCLUSIONS: This is the first documented report of successful use of canakinumab, a novel IL-1beta inhibitor, in AOSD patients refractory to traditional disease-modifying antirheumatic drugs and short- to moderate-acting IL-1 blockade. Prospective comparative studies are needed to validate canakinumab's efficacy and safety.
PMID: 22512815
ISSN: 1532-866x
CID: 2759132