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Clinical Utility of MBDA Panel in the Management of Adult Onset Still's Disease [Case Report]

Gao, Xuan; Petryna, Olga
BACKGROUND:Adult Onset Still's disease (AOSD) carries an expansive presentation - typically featuring a triad of fevers, myalgia/arthralgia, and a rash - which can be mistaken for infectious or malignant etiology. As such, the role of reliable biomarkers becomes critical in the diagnosis and management of AOSD. The employment of MBDA panel may be of clinical utility in AOSD management, as we describe two cases where its application drives treatment plan. METHODS:We describe two cases where application of MBDA panel - such as Vectra DA -assisted with disease management. RESULTS:Case 1 features a 68-year-old male who presented with recurrent fevers, malaise, and a rash for three weeks. He was found to have an elevated ferritin level (15,599 ng/mL) with elevated acute phase reactants, consistent with AOSD. Vectra DA score was 77 at time of diagnosis. After treatment (see table), repeat Vectra DA at follow-up was 15. Case 2 features a 25-year-old female with history of juvenile idiopathic arthritis (then inactive) who presented with fevers, malaise, and rash. She was found to have an elevated ferritin level (321 ng/mL) with elevated acute phase reactants, also consistent with AOSD. Her Vectra DA score was 80 at peak of symptoms. She underwent appropriate treatment (see table), and repeat Vectra DA at follow-up was 17. CONCLUSION/CONCLUSIONS:A deeper consideration should be placed on the value of MBDA as a monitoring tool in the management of AOSD, specifically when pertaining to patient's responsiveness to therapies.
PMCID:7046059
PMID: 32185275
ISSN: 2529-198x
CID: 4352652

CLINICAL UTILITY OF MBDA PANEL VECTRA-DA IN THE MANAGEMENT OF ADULT ONSET STILL'S DISEASE [Meeting Abstract]

Petryna, O; Gao, X
ISI:000401523106100
ISSN: 1468-2060
CID: 2766572

Screening Optimization of Latent Tuberculosis Infection in Rheumatoid Arthritis Patients

Mehta, Bella; Zapantis, Ekaterini; Petryna, Olga; Efthimiou, Petros
Objective. Rheumatoid arthritis (RA) patients are at increased risk of latent tuberculosis infection (LTBI) but there are no clear guidelines for LTBI screening with Tuberculin Skin Test (TST) or Quantiferon TB Gold testing (QFT-G). Methods. A retrospective study was conducted in a high risk, largely foreign-born, inner city, RA population. After screening 280 RA patients, 134 patients who had both TST and QFT-G testing performed during their initial evaluation were included. Results. Out of 132 RA patients included in our analysis, 50 (37.8%) patients were diagnosed with LTBI with either positive TST 42 (31.8%) or QFT-G 23 (17.4%). 15 (11.4%) were positive and 82 (62.1%) were negative for both tests. The agreement between TST and QFT-G was 73.5% (Kappa 0.305, CI = 95% 0.147-0.463, p = 0.081). Conclusions. There was low-moderate agreement (kappa = 0.305) between TST and QFT-G. In the absence of clearly defined gold standard and limitations associated with both tests, we propose early screening with both tests for patients who need prompt treatment with BRMs. Patients who are not immediate candidates for BRM treatment may be safely and cost effectively screened with a two-step process: initial screening with TST and if negative, IGRA testing. Patients positive for either test should be promptly treated.
PMCID:4532802
PMID: 26294972
ISSN: 2090-1984
CID: 1985762

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

A PROPOSED EFFECTIVE STRATEGY TO SCREENING LATENT TB INFECTION IN RA PATIENTS [Meeting Abstract]

Mehta, B; Zapantis, E; Petryna, O; Efthimiou, P
ISI:000208898500536
ISSN: 1468-2060
CID: 2759902

SUCCESSFUL USE OF CANAKINUMAB IN ADULT-ONSET STILL'S DISEASE REFRACTORY TO SHORT ACTING IL-1 INHIBITORS [Meeting Abstract]

Efthimiou, P; Petryna, O; Mehta, B; Kontzias, A; Cush, J
ISI:000208898501335
ISSN: 1468-2060
CID: 2759942

Posterior reversible encephalopathy syndrome in systemic lupus erythematosus: comment on the article by Efthimiou et al Reply [Letter]

Efthimiou, Petros; Petryna, Olga; Kukar, Manil; Gold, Menachem
ISI:000285934100044
ISSN: 0004-3591
CID: 1986922

Complex Situations in Patients with Adult-Onset Still's Disease

Chapter by: Efthimiou, Petros V; Kukar, Manil; Petryna, Olga
in: AUTOIMMUNE DISEASES: ACUTE AND COMPLEX SITUATIONS by Khamashta, MA; RamosCasals, M [Eds]
BERLIN : SPRINGER-VERLAG BERLIN, 2011
pp. 221-232
ISBN:
CID: 1986912

Headache from cavernous sinus thrombosis in Adamantiades-Behcet disease [Case Report]

Efthimiou, Petros; Petryna, Olga
PMID: 21119387
ISSN: 1536-7355
CID: 1985782

Occupational and Environmental Exposures in Lupus and Systemic Sclerosis: A preventable Risk Factor?

Petryna, Olga; Yavari, N; Efthimiou, P
ORIGINAL:0012307
ISSN: 0899-2517
CID: 2766592