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Papers by Elena Grădinaru

Research paper thumbnail of Features of late-onset systemic lupus erythematosus

Revista română de reumatologie, Sep 30, 2021

An 81-year-old female patient with history of inactive hepatitis C presents in the Rheumatology w... more An 81-year-old female patient with history of inactive hepatitis C presents in the Rheumatology ward with fatigue, vesperal fever, significant weight loss in the past six months. She complains of pain affecting small joints of the hands, elbows, shoulders and myalgias. During this time, several RT-PCR tests for SARS-COV2 were performed with negative results.

Research paper thumbnail of Particularities regarding Clinical-biological and Evolutive Parameters of Immune-mediated Rheumatic Diseases in Patients with COVID-19 – systematic literature review

Balneo and PRM Research Journal

Background: Since its outbreak in 2019, Coronavirus disease 2019 (COVID-19)/Severe Acu-te Respira... more Background: Since its outbreak in 2019, Coronavirus disease 2019 (COVID-19)/Severe Acu-te Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was a serious medical threat and was declared Global Pandemic, triggering fear, panic and uncertainty for people around the Globe. Among those individuals, there is a specific category of patients – the ones with immune-mediated rheumatic diseases (IMIDs) – whose mantra from the diagnosis was to avoid infections at all costs because of the additional negative impact on the immune sys-tem and overall reactivity. Objective: Considering the aforementioned, our objective is to understand the in-depth relation of the immune system of patients with IMIDs in the set-ting of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the real bur-den of the disease and vaccination against COVID-19. Materials and Methods: In this res-pect, we have conducted a thoroughly systematic literature review according to the “Prefer-red Reporting Items for Sys...

Research paper thumbnail of Refractory Takayasu’s Arteritis with Severe Coronary Involvement—Case Report and Literature Review

Journal of Clinical Medicine

This report presents the case of a female patient diagnosed with Takayasu arteritis from childhoo... more This report presents the case of a female patient diagnosed with Takayasu arteritis from childhood, with severe, refractory coronary involvement, leading to two acute coronary syndromes and multiple anginous episodes. Consequently, the patient suffered aorto-bicarotid bypass two times, multiple interventional procedures with stent implantation, balloon angioplasty, and up to ten repeated in-stent restenosis that required reinterventions, despite being on maximal immunosuppressive treatment. In recent years, various studies have been reported that aim to best characterize this particular type of vascular damage and to indicate optimal therapeutic options for treatment. The latter should be based on the activity of the underlying disease; however, no reliable markers are available in TA. The management of TA patients with coronary involvement continues to be a challenge and requires both drug and interventional techniques to avoid life-threatening events.

Research paper thumbnail of Myopathic syndrome revealing a rare condition: Sheehan syndrome, a case-based review

Research paper thumbnail of Unraveling the Impact of COVID-19 on Rheumatoid Arthritis: Insights from Two Romanian Hospitals-Preliminary Results

Biomedicines, 2024

Background: Rheumatoid arthritis (RA) patients are at heightened risk of Coronavirus Disease—19 (... more Background: Rheumatoid arthritis (RA) patients are at heightened risk of Coronavirus Disease—19 (COVID-19) complications due to immune dysregulation, chronic inflammation, and treatment with immunosuppressive therapies. This study aims to characterize the clinical and laboratory parameters of RA patients diagnosed with COVID-19, identify predictive risk factors for severe forms of this infection for RA patients, and determine if any RA immunosuppressive therapy
is associated with worse COVID-19 outcomes. Methods: A retrospective observational case-control study included 86 cases (43 diagnosed with RA and 43 cases without any inflammatory or autoimmune disease) that suffered from SARS-CoV-2 in two Romanian hospitals between March 2020 and February 2024. Data on demographics, RA disease characteristics, COVID-19 severity, treatment regimens, and outcomes were analyzed. Results: RA patients exhibited a distinct symptom profile
compared to non-RA controls, with higher incidences of neurological, musculoskeletal, and gastrointestinal symptoms, while the control group showed more respiratory and systemic manifestations. Severe COVID-19 is correlated with age and laboratory markers like erythrocyte sedimentation rate (ESR), leucocytes, neutrophils, neutrophil-to-lymphocyte ratio (NLR), aspartate aminotransferase (AST), serum creatinine, and urea. Additionally, RA treatments, particularly rituximab (RTX), were associated with more severe COVID-19 outcomes (but with no statistical significance), potentially due to the advanced disease stage and comorbidities in these patients. Post-infection, a significant number
of RA patients experienced disease flares, necessitating adjustments in their treatment regimens. Conclusions: This study underscores the complex interplay between RA and COVID-19, highlighting
significant clinical heterogeneity and the need for tailored management strategies. Limitations include sample size constraints, possible selection, and information bias, as well as the lack of adjustments for potential confounding variables that hinder the ability to formulate definitive conclusions. Future research plans to expand the research group size and further elucidate these relationships.

Research paper thumbnail of Features of late-onset systemic lupus erythematosus

Revista română de reumatologie, Sep 30, 2021

An 81-year-old female patient with history of inactive hepatitis C presents in the Rheumatology w... more An 81-year-old female patient with history of inactive hepatitis C presents in the Rheumatology ward with fatigue, vesperal fever, significant weight loss in the past six months. She complains of pain affecting small joints of the hands, elbows, shoulders and myalgias. During this time, several RT-PCR tests for SARS-COV2 were performed with negative results.

Research paper thumbnail of Particularities regarding Clinical-biological and Evolutive Parameters of Immune-mediated Rheumatic Diseases in Patients with COVID-19 – systematic literature review

Balneo and PRM Research Journal

Background: Since its outbreak in 2019, Coronavirus disease 2019 (COVID-19)/Severe Acu-te Respira... more Background: Since its outbreak in 2019, Coronavirus disease 2019 (COVID-19)/Severe Acu-te Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was a serious medical threat and was declared Global Pandemic, triggering fear, panic and uncertainty for people around the Globe. Among those individuals, there is a specific category of patients – the ones with immune-mediated rheumatic diseases (IMIDs) – whose mantra from the diagnosis was to avoid infections at all costs because of the additional negative impact on the immune sys-tem and overall reactivity. Objective: Considering the aforementioned, our objective is to understand the in-depth relation of the immune system of patients with IMIDs in the set-ting of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and the real bur-den of the disease and vaccination against COVID-19. Materials and Methods: In this res-pect, we have conducted a thoroughly systematic literature review according to the “Prefer-red Reporting Items for Sys...

Research paper thumbnail of Refractory Takayasu’s Arteritis with Severe Coronary Involvement—Case Report and Literature Review

Journal of Clinical Medicine

This report presents the case of a female patient diagnosed with Takayasu arteritis from childhoo... more This report presents the case of a female patient diagnosed with Takayasu arteritis from childhood, with severe, refractory coronary involvement, leading to two acute coronary syndromes and multiple anginous episodes. Consequently, the patient suffered aorto-bicarotid bypass two times, multiple interventional procedures with stent implantation, balloon angioplasty, and up to ten repeated in-stent restenosis that required reinterventions, despite being on maximal immunosuppressive treatment. In recent years, various studies have been reported that aim to best characterize this particular type of vascular damage and to indicate optimal therapeutic options for treatment. The latter should be based on the activity of the underlying disease; however, no reliable markers are available in TA. The management of TA patients with coronary involvement continues to be a challenge and requires both drug and interventional techniques to avoid life-threatening events.

Research paper thumbnail of Myopathic syndrome revealing a rare condition: Sheehan syndrome, a case-based review

Research paper thumbnail of Unraveling the Impact of COVID-19 on Rheumatoid Arthritis: Insights from Two Romanian Hospitals-Preliminary Results

Biomedicines, 2024

Background: Rheumatoid arthritis (RA) patients are at heightened risk of Coronavirus Disease—19 (... more Background: Rheumatoid arthritis (RA) patients are at heightened risk of Coronavirus Disease—19 (COVID-19) complications due to immune dysregulation, chronic inflammation, and treatment with immunosuppressive therapies. This study aims to characterize the clinical and laboratory parameters of RA patients diagnosed with COVID-19, identify predictive risk factors for severe forms of this infection for RA patients, and determine if any RA immunosuppressive therapy
is associated with worse COVID-19 outcomes. Methods: A retrospective observational case-control study included 86 cases (43 diagnosed with RA and 43 cases without any inflammatory or autoimmune disease) that suffered from SARS-CoV-2 in two Romanian hospitals between March 2020 and February 2024. Data on demographics, RA disease characteristics, COVID-19 severity, treatment regimens, and outcomes were analyzed. Results: RA patients exhibited a distinct symptom profile
compared to non-RA controls, with higher incidences of neurological, musculoskeletal, and gastrointestinal symptoms, while the control group showed more respiratory and systemic manifestations. Severe COVID-19 is correlated with age and laboratory markers like erythrocyte sedimentation rate (ESR), leucocytes, neutrophils, neutrophil-to-lymphocyte ratio (NLR), aspartate aminotransferase (AST), serum creatinine, and urea. Additionally, RA treatments, particularly rituximab (RTX), were associated with more severe COVID-19 outcomes (but with no statistical significance), potentially due to the advanced disease stage and comorbidities in these patients. Post-infection, a significant number
of RA patients experienced disease flares, necessitating adjustments in their treatment regimens. Conclusions: This study underscores the complex interplay between RA and COVID-19, highlighting
significant clinical heterogeneity and the need for tailored management strategies. Limitations include sample size constraints, possible selection, and information bias, as well as the lack of adjustments for potential confounding variables that hinder the ability to formulate definitive conclusions. Future research plans to expand the research group size and further elucidate these relationships.