Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Data Collection
2.3. Treatment and Outcomes
2.4. Data Analysis
3. Results
3.1. Patient Characteristics
3.1.1. General Description of the Study Lot
3.1.2. Anatomic Distribution of Calcinosis
3.2. Correlation Analyses between Different IMRD and Subcutaneous Calcinosis
3.3. Treatment Strategies and Outcomes in Patients with IMRD—Related Calcinosis
3.3.1. Treatment of Calcinosis Cutis
3.3.2. Outcomes and Survival
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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dcSSc (n = 39) | lcSSc (n = 25) | Overlap CTD a (n = 8) | SLE (n = 6) | PM (n = 5) | DM (n = 4) | pSS (n = 2) | MCTD (n = 1) | p | |
---|---|---|---|---|---|---|---|---|---|
Demographics | |||||||||
Female | 37 (49) | 19 (79) | 8 (100) | 6 (100) | 5 (100) | 4 (100) | 2 (100) | 1 (100) | 0.58 |
Age, (IQR), years | 50 (36–60) | 54 (28–73) | 39 (24–55) | 29 (20–48) | 39 (24–55) | 44 (37–68) | 46 (35–67) | 39 | 0.18 |
Time to onset of calcinosis, (IQR), months | 13 (2–43) | 90 (0–372) | 128 (2–312) | 24 (1–55) | 108 (18–546) | 48 (11–109) | 258 (228–742) | 75 | <0.001 |
Total observation period, (IQR), years | 0.09 | ||||||||
Raynaud’s | 31 (79) | 23 (92) | 8 (100) | 1 (16) | - | - | - | 1 (100) | 0.54 |
Telangiectasias | 18 (46) | 23 (92) | 7 (88) | - | - | - | - | 1 (100) | 0.49 |
Digital ulcers | 20 (51) | 16 (64) | 5 (62) | - | - | - | - | - | 0.03 |
Articular involvement | 22 (56) | 24 (96) | 6 (75) | 3 (50) | 2 (40) | 1 (25) | 1 (50) | 1 (100) | 0.06 |
Muscle involvement | 14 (36) | 16 (64) | 7 (88) | 2 (33) | 5 (100) | 4 (100) | 2 (100) | - | 0.10 |
GIT involvement | 18 (46) | 21 (84) | 4 (50) | 1 (16) | 1 (20) | 1 (25) | - | 1 (100) | 0.003 |
Severe GIT disease | 14 (35) | 4 (16) | 2 (25) | - | - | - | - | 1 (100) | <0.001 |
Peripheric arterial disease | 25 (64) | 20 (80) | 3 (37) | - | - | - | - | - | 0.01 |
Severe peripheral arterial disease | 19 (48) | 9 (36) | 3 (37) | - | - | - | - | - | 0.02 |
ILD | 26 (66) | 15 (60) | 5 (63) | - | 2 (40) | - | - | 1 (100) | 0.28 |
PAH | 13 (33) | 11 (44) | 2 (25) | - | - | - | - | 1 (100) | 0.17 |
Myocardial disease | 14 (36) | 6 (24) | 1 (12) | - | - | - | - | 1 (100) | 0.21 |
Chronic kidney disease | 4 (10) | 2 (8) | 1 (12) | 1 (17) | - | - | 1 (50) | - | 0.15 |
Osteoporosis | 12 (31) | 9 (36) | 2 (25) | 1 (17) | 2 (40) | - | - | - | 0.81 |
Arterial hypertension | 12 (31) | 13 (52) | 1 (12) | - | 1 (20) | 1 (25) | 1 (50) | - | 0.25 |
Diabetes | 3 (8) | 2 (8) | - | - | - | 1 (25) | - | - | 0.10 |
Dyslipidemia | 8 (20) | 8 (32) | 3 (37) | - | - | 1 (25) | 1 (50) | - | 0.11 |
Malignancy | 4 (10) | 1 (4) | 1 (12) | - | 1 (20) | - | - | - | 0.35 |
Multivariate Analysis | ||
---|---|---|
Variable | OR (95% CI) | p-Value |
Age | 0.99 (0.97–1.01) | 0.88 |
Female | 1.83 (1.12–2.95) | 0.02 |
Disease duration | 1.04 (1.00–1.08) | 0.001 |
ATA | 1.00 (0.59–1.68) | 0.98 |
ACA | 1.42 (0.84–2.40) | 0.18 |
Anti-Pm/Scl | 7.58 (1.13–9.17) | 0.004 |
mRSS | 1.01 (0.97–1.05) | 0.56 |
Tendon friction rubs | 0.60 (0.22–1.66) | 0.33 |
Synovitis | 0.82 (0.42–1.60) | 0.56 |
Muscle weakness | 0.81 (0.45–1.47) | 0.50 |
Upper GI symptoms | 0.90 (0.52–1.56) | 0.71 |
Lower GI symptoms | 1.44 (0.81–2.53) | 0.20 |
Severe GI disease | 1.27 (1.02–14.76) | 0.001 |
PAH | 1.96 (0.93–4.41) | 0.07 |
DU | 1.36 (1.06–3.03) | 0.004 |
EScSG AI | 1.09 (1.01–1.46) | 0.05 |
Subcutaneous Lesions Size | ||||
---|---|---|---|---|
Variable | ≤1 cm | ≥4 cm | ||
OR (95% CI) | p-Value | OR (95% CI) | p-Value | |
ATA | 1.90 (1.06–5.57) | 0.04 | 1.42 (0.50–4.01) | 0.50 |
ACA | 0.41 (0.14–1.19) | 0.10 | 0.66 (0.22–1.98) | 0.46 |
Anti-Pm/Scl | 0.42 (0.13–1.28) | 0.12 | 2.15 (1.70–6.57) | 0.01 |
mRSS | 1.02 (0.94–1.11) | 0.51 | 0.98 (0.91–1.06) | 0.72 |
Tendon friction rubs | 1.06 (0.36–3.11) | 0.91 | 2.05 (0.53–7.97) | 0.29 |
Synovitis | 1.45 (1.05–3.40) | 0.02 | 1.00 (0.31–3.23) | 0.99 |
Muscle weakness | 0.65 (0.22–1.89) | 0.43 | 3.12 (1.04–9.31) | 0.04 |
Upper GI symptoms | 0.89 (0.25–3.13) | 0.86 | 0.83 (0.25–2.72) | 0.76 |
Lower GI symptoms | 1.72 (0.34–8.61) | 0.50 | 1.54 (0.41–5.71) | 0.51 |
Severe GI disease | 1.43 (0.41–4.94) | 0.57 | 0.92 (0.28–2.96) | 0.89 |
Peripheral arterial disease | 2.38 (0.61–9.17) | 0.20 | 1.48 (0.43–5.11) | 0.53 |
Severe peripheral arterial disease | 0.55 (0.09–3.28) | 0.51 | 1.48 (1.03–5.11) | 0.007 |
Systemic arterial hypertension | 1.60 (0.62–4.11) | 0.32 | 1.83 (1.29–2.37) | <0.001 |
PAH | 1.06 (0.36–3.11) | 0.91 | 1.01 (0.98–1.04) | 0.46 |
ILD | 2.13 (1.77–6.92) | 0.01 | 0.39 (0.13–1.17) | 0.09 |
DU | 2.44 (1.83–7.10) | 0.02 | 0.83 (0.29–2.37) | 0.73 |
Malignancy | 1.02 (0.97–1.09) | 0.34 | 1.01 (1.00–3.23) | 0.01 |
EScSG AI | 1.37 (0.46–4.04) | 0.56 | 2.06 (1.68–6.24) | 0.02 |
Multivariate Analysis | ||
---|---|---|
Variable | OR (95% CI) | p Value |
Raynaud’s phenomenon | 6.79 (2.63–9.31) | 0.06 |
DU | 3.68 (1.39–9.74) | 0.009 |
Severe GI disease | 2.95 (1.88–9.86) | 0.01 |
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Nita, C.; Groseanu, L.; Opris, D.; Predeteanu, D.; Bojinca, V.; Berghea, F.; Vlad, V.; Abobului, M.; Constantinescu, C.; Negru, M.; et al. Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study. Diagnostics 2024, 14, 637. https://doi.org/10.3390/diagnostics14060637
Nita C, Groseanu L, Opris D, Predeteanu D, Bojinca V, Berghea F, Vlad V, Abobului M, Constantinescu C, Negru M, et al. Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study. Diagnostics. 2024; 14(6):637. https://doi.org/10.3390/diagnostics14060637
Chicago/Turabian StyleNita, Cristina, Laura Groseanu, Daniela Opris, Denisa Predeteanu, Violeta Bojinca, Florian Berghea, Violeta Vlad, Mihai Abobului, Cosmin Constantinescu, Magdalena Negru, and et al. 2024. "Calcinosis in Rheumatic Disease Is Still an Unmet Need: A Retrospective Single-Center Study" Diagnostics 14, no. 6: 637. https://doi.org/10.3390/diagnostics14060637