Žiga Rotar - Academia.edu (original) (raw)

Papers by Žiga Rotar

Research paper thumbnail of Dysregulated Expression of Arterial MicroRNAs and Their Target Gene Networks in Temporal Arteries of Treatment-Naïve Patients with Giant Cell Arteritis

International Journal of Molecular Sciences

In this study, we explored expression of microRNA (miR), miR-target genes and matrix remodelling ... more In this study, we explored expression of microRNA (miR), miR-target genes and matrix remodelling molecules in temporal artery biopsies (TABs) from treatment-naïve patients with giant cell arteritis (GCA, n = 41) and integrated these analyses with clinical, laboratory, ultrasound and histological manifestations of GCA. NonGCA patients (n = 4) served as controls. GCA TABs exhibited deregulated expression of several miRs (miR-21-5p, -145-5p, -146a-5p, -146b-5p, -155-5p, 424-3p, -424-5p, -503-5p), putative miR-target genes (YAP1, PELI1, FGF2, VEGFA, KLF4) and matrix remodelling factors (MMP2, MMP9, TIMP1, TIPM2) with key roles in Toll-like receptor signaling, mechanotransduction and extracellular matrix biology. MiR-424-3p, -503-5p, KLF4, PELI1 and YAP1 were identified as new deregulated molecular factors in GCA TABs. Quantities of miR-146a-5p, YAP1, PELI1, FGF2, TIMP2 and MMP9 were particularly high in histologically positive GCA TABs with occluded temporal artery lumen. MiR-424-5p exp...

Research paper thumbnail of The Role of Statins on the Outcomes on the Cholesterol Embolism Syndrome with Secondary Vasculitis-A Case Report and Review of the Literature

The cholesterol embolization syndrome (CES) is a potentially severe complication of atheroscleros... more The cholesterol embolization syndrome (CES) is a potentially severe complication of atherosclerosis, caused by embolization of atherosclerotic plaques, most frequently after vascular surgery or endovascular procedures. The clinical presentation closely mimics that of systemic vasculitides hence it should be considered in the differential diagnosis in patients with suspected vasculitis. Skin lesions (e.g. acrocyanosis, blue toe syndrome, livedo reticularis, purpura, nodules, ulcerations, gangrene) are almost invariably present and usually an early sing of CES. Rare reports of CES presenting as secondary necrotizing vasculitis emphasize the need for careful pathohistological examination of affected tissue to obtain the correct diagnosis, and choose the optimal treatment strategy. We report a case of a patient with spontaneous CES with clinical features of necrotizing small vessel vasculitis suggestive of polyarteritis nodosa, and present a thorough literature review of the nine cases ...

Research paper thumbnail of Incidence of scleroderma spectrum disorders in Slovenia

OBJECTIVES This paper aims to investigate the incidence of scleroderma spectrum disorders (SDS) i... more OBJECTIVES This paper aims to investigate the incidence of scleroderma spectrum disorders (SDS) in Slovenia. METHODS From 01.01.2007 to 31.12.2009 we prospectively examined all patients over 18 years of age suspected of suffering from SDS who were referred to our department, which is the only Rheumatology referral centre in the Ljubljana region serving a population of 518.921 Caucasians over 18. Patient work-up consisted of clinical assessment, laboratory and imaging studies, and functional tests. The working classification of SDS proposed by Maricq and Valter was used to classify patients as having CREST syndrome, digital scleroderma disease (SD), intermediate SD, diffuse SD, undifferentiated connective tissue disease with SD features, and SD sine scleroderma. Patients with certain features of SDS who did not fit any specific class were classified as having prescleroderma using LeRoy's classification of early systemic sclerosis. RESULTS We examined 100 patients. Forty-one new c...

Research paper thumbnail of The Predictive Value of the aCL and Anti-β2GPI at the Time of Acute Deep Vein Thrombosis—A Two-Year Prospective Study

Biomedicines

Antiphospholipid syndrome (APS) is an important cause of deep vein thrombosis (DVT). According to... more Antiphospholipid syndrome (APS) is an important cause of deep vein thrombosis (DVT). According to current APS classification criteria, APS cannot be confirmed until 24 weeks after DVT. This time frame results in frequent discontinuation of anticoagulant treatment before APS is diagnosed. Therefore, the aim of our study was to evaluate the potential predictive value of anticardiolipin (aCL) and anti-β2glycoprotein I (anti-β2GPI) before discontinuation of anticoagulation therapy. Patients with newly diagnosed DVT were included into a 24-month prospective study. All patients received anticoagulant therapy. aCL and anti-β2GPI were determined at inclusion and every four weeks for the first 24 weeks and then one and two years after inclusion. APS was confirmed in 24/221 (10.9%) patients. At the time of acute DVT 20/24 (83.3%), APS patients had positive aCL and/or anti-β2GPI. Two patients had low aCL levels and two were negative at the time of acute DVT but later met APS criteria due to lu...

Research paper thumbnail of Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration

Annals of the Rheumatic Diseases

BackgroundComedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARD... more BackgroundComedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy.MethodsPatients with PsA from 13 European countries who initiated a first TNFi in 2006–2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not sig...

Research paper thumbnail of Secukinumab for the maintenance of glucocorticoid-free remission in a patient with giant cell arteritis and psoriatic arthritis

Research paper thumbnail of COVID-19 in Association With Development, Course, and Treatment of Systemic Autoimmune Rheumatic Diseases

Frontiers in Immunology

Autoimmune diseases and infections are often closely intertwined. Patients with autoimmune diseas... more Autoimmune diseases and infections are often closely intertwined. Patients with autoimmune diseases are more susceptible to infections due to either active autoimmune disease or the medications used to treat them. Based on infections as environmental triggers of autoimmunity, an autoimmune response would also be expected in COVID-19. Although some studies have shown the occurance of autoantibodies and the possible development of autoimmune diseases after SARS-CoV-2 infection, current data suggest that the levels of autoantibodies following SARS-CoV-2 infection is comparable to that of some other known infections and that the autoantibodies might only be transient. The risk of SARS-CoV-2 infection in patients with a systemic autoimmune rheumatic disease (SARD) appears slightly higher compared to the general population and the course of COVID-19 disease does not seem to be very different, however, specific therapies such as glucocorticoids and anti-TNF might modulate the risk of hospi...

Research paper thumbnail of Eosinophilic granulomatosis with polyangiitis evolution during severe eosinophilic asthma treatment with benralizumab

The Journal of Allergy and Clinical Immunology: In Practice

Research paper thumbnail of Risk factors for severe cranial ischaemic complications in giant cell arteritis

Rheumatology

Objectives Vision complications and a stroke represent severe cranial ischaemic complications (sC... more Objectives Vision complications and a stroke represent severe cranial ischaemic complications (sCIC) associated with increased morbidity and mortality in GCA. We aimed to determine the risk factors for sCIC in GCA. Methods We analysed the medical records of prospectively enrolled GCA patients diagnosed between September 2011 and August 2019, and compared the clinical and laboratory characteristics of patients with and without sCIC defined as either severe vision complications (diplopia, transient vision loss, permanent partial vision field/acuity defect and permanent visual loss) or stroke. Results During the 96-month observation period, we identified 295 new GCA patients [65.4% female, median (interquartile range) age 74.7 (67.3–80.0) years]. Sixty-one (20.7%) patients developed sCIC (52 isolated severe vision complications, 5 isolated ischaemic strokes and 4 patients with both complications). In a multivariable logistic regression model jaw claudication [odds ratio (OR) 3.43 (95% ...

Research paper thumbnail of Determination of red blood cells in urinary sediment: Do pH and specific gravity of urine matter?

Clinical Nephrology

INTRODUCTION It has been postulated that erythrocyte cell lysis in urine is common in the case of... more INTRODUCTION It has been postulated that erythrocyte cell lysis in urine is common in the case of low urine specific gravity and high urine pH. We aimed to verify the influence of urine dipstick pH and specific gravity on erythrocyturia in the urine sediment in the case of positive dipstick hemoglobinuria. METHODS We retrospectively collected data on dipstick specific gravity, pH, and urine sediment analysis done by nephrologists in the clinical and research urine laboratory at the Department of Nephrology, University Medical Center Ljubljana. RESULTS During the 6-year observation period, we analyzed 843 second morning midstream urine samples with positive dipstick hemoglobinuria. Erythrocyturia in urinary sediment was detected significantly less often in urine samples with concomitant hemoglobinuria 1+ and pH < 6.0, (odds ratio (OR) 0.40; 95% confidence interval (CI) 0.21 - 0.76, p = 0.005). The difference was maintained in multivariate analysis including patient age, gender, and specific gravity (OR 0.32; 95% CI 0.15 - 0.65, p = 0.002). In samples with higher grade of hemoglobinuria (≥ 2+), the impact of cell lysis in the case of low pH was negligible. Specific gravity did not have any influence on erythrocyte detection in urinary sediment. CONCLUSIONS Urinary pH < 6.0 impaired the detection of erythrocytes in urinary sediment, while the dipstick measured urine specific gravity did not have any impact on it. Urine samples with low-grade hemoglobinuria and low pH without erythrocyte detection in urinary sediment should be evaluated again to avoid false-negative results. .

Research paper thumbnail of An Immune-Mediated Adverse Event Potentially Related to Rituximab

JCR: Journal of Clinical Rheumatology

Image A 68-year-old man with seropositive rheumatoid arthritis since 2010 complicated by intersti... more Image A 68-year-old man with seropositive rheumatoid arthritis since 2010 complicated by interstitial lung disease started treatment with rituximab in combination with a 4-month methylprednisolone taper in December 2017. In July 2018, a month after he completed a second rituximab cycle, he complained of malaise, diffuse abdominal pain, and weight loss (16 kg). In October 2018, when admitted, he appeared ill andwas intermittently subfebrile, confused, vitally stable, and without arthritis, meningeal signs, or skin changes. Laboratory results were consistent with chronic inflammation (erythrocyte sedimentation rate 90 mm/h [reference value, <15 mm/h], CRP 68 mg/L [reference value, <5 mg/L], hemoglobin 107 g/L [reference range, 130–170 g/L], platelets 460 10/L [reference range, 150–410 10/L], albumin 26 g/L [reference range, 36–54 g/L]) and hyponatremia (122 mmol/L [reference range, 135–145 mmol/L]). Diagnostic workup included the head, thoracic, and contrast-enhanced abdominal computed tomography scans; brain magnetic resonance imaging (chronic ischemic changes); echocardiography; endoscopic examination of the upper gastrointestinal tract (chronic gastritis) and the colon and terminal ileum (chronic colitis); positron emission tomography– computed tomography; immunoserological tests; tumor markers; paraneoplastic antibodies; and broad microbiological testing,

Research paper thumbnail of Predicting gastrointestinal and renal involvement in adult IgA vasculitis

Arthritis Research & Therapy

Background Immunoglobulin A vasculitis (IgAV) is still poorly defined in the adult population. We... more Background Immunoglobulin A vasculitis (IgAV) is still poorly defined in the adult population. We aimed to determine the predictors of gastrointestinal (GI) or renal involvement in adult IgAV. Methods The prospective study included histologically proven adult IgAV cases diagnosed between January 2013 and July 2019 at our secondary/tertiary rheumatology center. We evaluated the role of clinical and the laboratory parameters as markers predicting the GI or renal involvement in IgAV, using the multiple logistic regression analysis. Results During the 79-month observation period, we identified 214 new adult IgAV cases (59.3% males, median (interquartile range) age 64.6 (57.2–76.7) years). The GI tract and renal involvement developed in 58 (27.1%) and 83 (38.8%) cases, respectively (concurrently in 26 (12.1%) cases). In the multivariate logistic regression analysis, generalized purpura (OR 6.74 (95%CI 3.18–14.31)), the pre-treatment neutrophil to lymphocyte ratio (NLR) > 3.5 (OR 2.78 ...

Research paper thumbnail of The cut-off values for the intima–media complex thickness assessed by colour Doppler sonography in seven cranial and aortic arch arteries

Rheumatology

Objectives Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GC... more Objectives Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GCA. Data on cut-off values for intima–media complex thickness (IMT) that can be used in clinical practice to distinguish between normal and inflamed arteries are limited. We aimed to derive potential cut-off values for IMT of seven preselected arteries by comparing IMT between GCA patients and a control group. Methods We performed CDS of the preselected temporal, facial, occipital, carotid, vertebral, subclavian and axillary arteries in consecutive newly diagnosed GCA patients between October 2013 and September 2019. A ‘halo’ with positive compression sign was considered a positive finding. We measured the maximum IMT in the preselected arteries and compared it with the maximum IMT of the control group. Results We were able to demonstrate a halo sign in at least one of the examined arteries of 244/248 (98.4%) GCA patients. Temporal arteries were the most commonly affected vessels, involve...

Research paper thumbnail of IgA vasculitis in adults: few certainties and many uncertainties

Annals of the Rheumatic Diseases

Research paper thumbnail of The incidence of spondyloarthritis in Slovenia

Medicine

Epidemiological studies of spondyloarthritides (SpA) are rare and data for our country are lackin... more Epidemiological studies of spondyloarthritides (SpA) are rare and data for our country are lacking. We aimed to determine the incidence of SpA in a well-defined region in Slovenia. We performed a retrospective chart review of adults diagnosed with SpA between January 2014 and December 2016 at an integrated secondary/tertiary medical center, which provides rheumatology services to almost a half of the adult national population, that is, 700,000 adults. Potential cases were ascertained by searching the electronic medical records for ICD-10 codes M02

Research paper thumbnail of The persistence of golimumab compared to other tumour necrosis factor-α inhibitors in daily clinical practice for the treatment of rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: observations from the Slovenian nation-wide longitudinal registry of patients treated with biolo...

Research paper thumbnail of Added value of non-criteria antiphospholipid antibodies for antiphospholipid syndrome: lessons learned from year-long routine measurements

Research paper thumbnail of The incidence rate and the early management of rheumatoid arthritis in Slovenia

Research paper thumbnail of The incidence of idiopathic inflammatory myopathies in the adult Slovenian population

Research paper thumbnail of Giant Cell Arteritis and Malignancy—More Than Just a Coincidence?

JCR: Journal of Clinical Rheumatology

Research paper thumbnail of Dysregulated Expression of Arterial MicroRNAs and Their Target Gene Networks in Temporal Arteries of Treatment-Naïve Patients with Giant Cell Arteritis

International Journal of Molecular Sciences

In this study, we explored expression of microRNA (miR), miR-target genes and matrix remodelling ... more In this study, we explored expression of microRNA (miR), miR-target genes and matrix remodelling molecules in temporal artery biopsies (TABs) from treatment-naïve patients with giant cell arteritis (GCA, n = 41) and integrated these analyses with clinical, laboratory, ultrasound and histological manifestations of GCA. NonGCA patients (n = 4) served as controls. GCA TABs exhibited deregulated expression of several miRs (miR-21-5p, -145-5p, -146a-5p, -146b-5p, -155-5p, 424-3p, -424-5p, -503-5p), putative miR-target genes (YAP1, PELI1, FGF2, VEGFA, KLF4) and matrix remodelling factors (MMP2, MMP9, TIMP1, TIPM2) with key roles in Toll-like receptor signaling, mechanotransduction and extracellular matrix biology. MiR-424-3p, -503-5p, KLF4, PELI1 and YAP1 were identified as new deregulated molecular factors in GCA TABs. Quantities of miR-146a-5p, YAP1, PELI1, FGF2, TIMP2 and MMP9 were particularly high in histologically positive GCA TABs with occluded temporal artery lumen. MiR-424-5p exp...

Research paper thumbnail of The Role of Statins on the Outcomes on the Cholesterol Embolism Syndrome with Secondary Vasculitis-A Case Report and Review of the Literature

The cholesterol embolization syndrome (CES) is a potentially severe complication of atheroscleros... more The cholesterol embolization syndrome (CES) is a potentially severe complication of atherosclerosis, caused by embolization of atherosclerotic plaques, most frequently after vascular surgery or endovascular procedures. The clinical presentation closely mimics that of systemic vasculitides hence it should be considered in the differential diagnosis in patients with suspected vasculitis. Skin lesions (e.g. acrocyanosis, blue toe syndrome, livedo reticularis, purpura, nodules, ulcerations, gangrene) are almost invariably present and usually an early sing of CES. Rare reports of CES presenting as secondary necrotizing vasculitis emphasize the need for careful pathohistological examination of affected tissue to obtain the correct diagnosis, and choose the optimal treatment strategy. We report a case of a patient with spontaneous CES with clinical features of necrotizing small vessel vasculitis suggestive of polyarteritis nodosa, and present a thorough literature review of the nine cases ...

Research paper thumbnail of Incidence of scleroderma spectrum disorders in Slovenia

OBJECTIVES This paper aims to investigate the incidence of scleroderma spectrum disorders (SDS) i... more OBJECTIVES This paper aims to investigate the incidence of scleroderma spectrum disorders (SDS) in Slovenia. METHODS From 01.01.2007 to 31.12.2009 we prospectively examined all patients over 18 years of age suspected of suffering from SDS who were referred to our department, which is the only Rheumatology referral centre in the Ljubljana region serving a population of 518.921 Caucasians over 18. Patient work-up consisted of clinical assessment, laboratory and imaging studies, and functional tests. The working classification of SDS proposed by Maricq and Valter was used to classify patients as having CREST syndrome, digital scleroderma disease (SD), intermediate SD, diffuse SD, undifferentiated connective tissue disease with SD features, and SD sine scleroderma. Patients with certain features of SDS who did not fit any specific class were classified as having prescleroderma using LeRoy's classification of early systemic sclerosis. RESULTS We examined 100 patients. Forty-one new c...

Research paper thumbnail of The Predictive Value of the aCL and Anti-β2GPI at the Time of Acute Deep Vein Thrombosis—A Two-Year Prospective Study

Biomedicines

Antiphospholipid syndrome (APS) is an important cause of deep vein thrombosis (DVT). According to... more Antiphospholipid syndrome (APS) is an important cause of deep vein thrombosis (DVT). According to current APS classification criteria, APS cannot be confirmed until 24 weeks after DVT. This time frame results in frequent discontinuation of anticoagulant treatment before APS is diagnosed. Therefore, the aim of our study was to evaluate the potential predictive value of anticardiolipin (aCL) and anti-β2glycoprotein I (anti-β2GPI) before discontinuation of anticoagulation therapy. Patients with newly diagnosed DVT were included into a 24-month prospective study. All patients received anticoagulant therapy. aCL and anti-β2GPI were determined at inclusion and every four weeks for the first 24 weeks and then one and two years after inclusion. APS was confirmed in 24/221 (10.9%) patients. At the time of acute DVT 20/24 (83.3%), APS patients had positive aCL and/or anti-β2GPI. Two patients had low aCL levels and two were negative at the time of acute DVT but later met APS criteria due to lu...

Research paper thumbnail of Effectiveness and treatment retention of TNF inhibitors when used as monotherapy versus comedication with csDMARDs in 15 332 patients with psoriatic arthritis. Data from the EuroSpA collaboration

Annals of the Rheumatic Diseases

BackgroundComedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARD... more BackgroundComedication with conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) during treatment with tumour necrosis factor inhibitors (TNFi) is extensively used in psoriatic arthritis (PsA), although the additive benefit remains unclear. We aimed to compare treatment outcomes in patients with PsA treated with TNFi and csDMARD comedication versus TNFi monotherapy.MethodsPatients with PsA from 13 European countries who initiated a first TNFi in 2006–2017 were included. Country-specific comparisons of 1 year TNFi retention were performed by csDMARD comedication status, together with HRs for TNFi discontinuation (comedication vs monotherapy), adjusted for age, sex, calendar year, disease duration and Disease Activity Score with 28 joints (DAS28). Adjusted ORs of clinical remission (based on DAS28) at 12 months were calculated. Between-country heterogeneity was assessed using random-effect meta-analyses, combined results were presented when heterogeneity was not sig...

Research paper thumbnail of Secukinumab for the maintenance of glucocorticoid-free remission in a patient with giant cell arteritis and psoriatic arthritis

Research paper thumbnail of COVID-19 in Association With Development, Course, and Treatment of Systemic Autoimmune Rheumatic Diseases

Frontiers in Immunology

Autoimmune diseases and infections are often closely intertwined. Patients with autoimmune diseas... more Autoimmune diseases and infections are often closely intertwined. Patients with autoimmune diseases are more susceptible to infections due to either active autoimmune disease or the medications used to treat them. Based on infections as environmental triggers of autoimmunity, an autoimmune response would also be expected in COVID-19. Although some studies have shown the occurance of autoantibodies and the possible development of autoimmune diseases after SARS-CoV-2 infection, current data suggest that the levels of autoantibodies following SARS-CoV-2 infection is comparable to that of some other known infections and that the autoantibodies might only be transient. The risk of SARS-CoV-2 infection in patients with a systemic autoimmune rheumatic disease (SARD) appears slightly higher compared to the general population and the course of COVID-19 disease does not seem to be very different, however, specific therapies such as glucocorticoids and anti-TNF might modulate the risk of hospi...

Research paper thumbnail of Eosinophilic granulomatosis with polyangiitis evolution during severe eosinophilic asthma treatment with benralizumab

The Journal of Allergy and Clinical Immunology: In Practice

Research paper thumbnail of Risk factors for severe cranial ischaemic complications in giant cell arteritis

Rheumatology

Objectives Vision complications and a stroke represent severe cranial ischaemic complications (sC... more Objectives Vision complications and a stroke represent severe cranial ischaemic complications (sCIC) associated with increased morbidity and mortality in GCA. We aimed to determine the risk factors for sCIC in GCA. Methods We analysed the medical records of prospectively enrolled GCA patients diagnosed between September 2011 and August 2019, and compared the clinical and laboratory characteristics of patients with and without sCIC defined as either severe vision complications (diplopia, transient vision loss, permanent partial vision field/acuity defect and permanent visual loss) or stroke. Results During the 96-month observation period, we identified 295 new GCA patients [65.4% female, median (interquartile range) age 74.7 (67.3–80.0) years]. Sixty-one (20.7%) patients developed sCIC (52 isolated severe vision complications, 5 isolated ischaemic strokes and 4 patients with both complications). In a multivariable logistic regression model jaw claudication [odds ratio (OR) 3.43 (95% ...

Research paper thumbnail of Determination of red blood cells in urinary sediment: Do pH and specific gravity of urine matter?

Clinical Nephrology

INTRODUCTION It has been postulated that erythrocyte cell lysis in urine is common in the case of... more INTRODUCTION It has been postulated that erythrocyte cell lysis in urine is common in the case of low urine specific gravity and high urine pH. We aimed to verify the influence of urine dipstick pH and specific gravity on erythrocyturia in the urine sediment in the case of positive dipstick hemoglobinuria. METHODS We retrospectively collected data on dipstick specific gravity, pH, and urine sediment analysis done by nephrologists in the clinical and research urine laboratory at the Department of Nephrology, University Medical Center Ljubljana. RESULTS During the 6-year observation period, we analyzed 843 second morning midstream urine samples with positive dipstick hemoglobinuria. Erythrocyturia in urinary sediment was detected significantly less often in urine samples with concomitant hemoglobinuria 1+ and pH < 6.0, (odds ratio (OR) 0.40; 95% confidence interval (CI) 0.21 - 0.76, p = 0.005). The difference was maintained in multivariate analysis including patient age, gender, and specific gravity (OR 0.32; 95% CI 0.15 - 0.65, p = 0.002). In samples with higher grade of hemoglobinuria (≥ 2+), the impact of cell lysis in the case of low pH was negligible. Specific gravity did not have any influence on erythrocyte detection in urinary sediment. CONCLUSIONS Urinary pH < 6.0 impaired the detection of erythrocytes in urinary sediment, while the dipstick measured urine specific gravity did not have any impact on it. Urine samples with low-grade hemoglobinuria and low pH without erythrocyte detection in urinary sediment should be evaluated again to avoid false-negative results. .

Research paper thumbnail of An Immune-Mediated Adverse Event Potentially Related to Rituximab

JCR: Journal of Clinical Rheumatology

Image A 68-year-old man with seropositive rheumatoid arthritis since 2010 complicated by intersti... more Image A 68-year-old man with seropositive rheumatoid arthritis since 2010 complicated by interstitial lung disease started treatment with rituximab in combination with a 4-month methylprednisolone taper in December 2017. In July 2018, a month after he completed a second rituximab cycle, he complained of malaise, diffuse abdominal pain, and weight loss (16 kg). In October 2018, when admitted, he appeared ill andwas intermittently subfebrile, confused, vitally stable, and without arthritis, meningeal signs, or skin changes. Laboratory results were consistent with chronic inflammation (erythrocyte sedimentation rate 90 mm/h [reference value, <15 mm/h], CRP 68 mg/L [reference value, <5 mg/L], hemoglobin 107 g/L [reference range, 130–170 g/L], platelets 460 10/L [reference range, 150–410 10/L], albumin 26 g/L [reference range, 36–54 g/L]) and hyponatremia (122 mmol/L [reference range, 135–145 mmol/L]). Diagnostic workup included the head, thoracic, and contrast-enhanced abdominal computed tomography scans; brain magnetic resonance imaging (chronic ischemic changes); echocardiography; endoscopic examination of the upper gastrointestinal tract (chronic gastritis) and the colon and terminal ileum (chronic colitis); positron emission tomography– computed tomography; immunoserological tests; tumor markers; paraneoplastic antibodies; and broad microbiological testing,

Research paper thumbnail of Predicting gastrointestinal and renal involvement in adult IgA vasculitis

Arthritis Research & Therapy

Background Immunoglobulin A vasculitis (IgAV) is still poorly defined in the adult population. We... more Background Immunoglobulin A vasculitis (IgAV) is still poorly defined in the adult population. We aimed to determine the predictors of gastrointestinal (GI) or renal involvement in adult IgAV. Methods The prospective study included histologically proven adult IgAV cases diagnosed between January 2013 and July 2019 at our secondary/tertiary rheumatology center. We evaluated the role of clinical and the laboratory parameters as markers predicting the GI or renal involvement in IgAV, using the multiple logistic regression analysis. Results During the 79-month observation period, we identified 214 new adult IgAV cases (59.3% males, median (interquartile range) age 64.6 (57.2–76.7) years). The GI tract and renal involvement developed in 58 (27.1%) and 83 (38.8%) cases, respectively (concurrently in 26 (12.1%) cases). In the multivariate logistic regression analysis, generalized purpura (OR 6.74 (95%CI 3.18–14.31)), the pre-treatment neutrophil to lymphocyte ratio (NLR) > 3.5 (OR 2.78 ...

Research paper thumbnail of The cut-off values for the intima–media complex thickness assessed by colour Doppler sonography in seven cranial and aortic arch arteries

Rheumatology

Objectives Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GC... more Objectives Colour Doppler sonography (CDS) is becoming ever more important in the diagnosis of GCA. Data on cut-off values for intima–media complex thickness (IMT) that can be used in clinical practice to distinguish between normal and inflamed arteries are limited. We aimed to derive potential cut-off values for IMT of seven preselected arteries by comparing IMT between GCA patients and a control group. Methods We performed CDS of the preselected temporal, facial, occipital, carotid, vertebral, subclavian and axillary arteries in consecutive newly diagnosed GCA patients between October 2013 and September 2019. A ‘halo’ with positive compression sign was considered a positive finding. We measured the maximum IMT in the preselected arteries and compared it with the maximum IMT of the control group. Results We were able to demonstrate a halo sign in at least one of the examined arteries of 244/248 (98.4%) GCA patients. Temporal arteries were the most commonly affected vessels, involve...

Research paper thumbnail of IgA vasculitis in adults: few certainties and many uncertainties

Annals of the Rheumatic Diseases

Research paper thumbnail of The incidence of spondyloarthritis in Slovenia

Medicine

Epidemiological studies of spondyloarthritides (SpA) are rare and data for our country are lackin... more Epidemiological studies of spondyloarthritides (SpA) are rare and data for our country are lacking. We aimed to determine the incidence of SpA in a well-defined region in Slovenia. We performed a retrospective chart review of adults diagnosed with SpA between January 2014 and December 2016 at an integrated secondary/tertiary medical center, which provides rheumatology services to almost a half of the adult national population, that is, 700,000 adults. Potential cases were ascertained by searching the electronic medical records for ICD-10 codes M02

Research paper thumbnail of The persistence of golimumab compared to other tumour necrosis factor-α inhibitors in daily clinical practice for the treatment of rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: observations from the Slovenian nation-wide longitudinal registry of patients treated with biolo...

Research paper thumbnail of Added value of non-criteria antiphospholipid antibodies for antiphospholipid syndrome: lessons learned from year-long routine measurements

Research paper thumbnail of The incidence rate and the early management of rheumatoid arthritis in Slovenia

Research paper thumbnail of The incidence of idiopathic inflammatory myopathies in the adult Slovenian population

Research paper thumbnail of Giant Cell Arteritis and Malignancy—More Than Just a Coincidence?

JCR: Journal of Clinical Rheumatology