https://he04.tci-thaijo.org/index.php/tjr/issue/feed Thai Journal of Rheumatology 2024-08-16T13:40:59+07:00 Assoc.Prof.Ajanee Mahakkanukrauh secretariat@thairheumatology.org Open Journal Systems <p>Thai Journal of Rheumatology has the commencement of the First Compilation in 1989. In the past, we disseminated cutting-edge insights in the field of rheumatology through literature reviews, incorporating case reports, intriguing cases, and quizzes. However, in the current era, we are introducing a new element by featuring research contributions in each publication dedicated to rheumatology. This initiative aims to motivate our members to contribute more research articles, both in our local context and on an international scale. Therefore, there has been a development to create a journal in an electronic format, available in both Thai and English languages. The journal is scheduled to be released every 3 months and comprises four main sections: Original Articles, Journal Reviews, Patient Case Reports, and Interesting Clinical Symptoms, and others.</p> https://he04.tci-thaijo.org/index.php/tjr/article/view/1471 Introduction 2024-08-05T08:09:20+07:00 Editor-in-Chief ajamah@kku.ac.th <p>Welcome to the second issue of the Thai Journal of Rheumatology. This journal aims to disseminate important information and research in the field of rheumatology, focusing on providing knowledge to doctors and medical personnel involved in the care and treatment of patients with rheumatic diseases.</p> <p>In this issue, we have an intriguing original article on the nutritional status of patients with systemic sclerosis, and a literature review on practical approaches to managing autoimmune disease-related interstitial lung disease. Additionally, there is a case report on antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in tuberculosis patients, and clinical images testing medical knowledge about physical examinations. We also feature a significant case study on scleroderma renal crisis.</p> <p>We hope this issue will be beneficial and serve as a valuable resource for everyone interested and working in the field of rheumatology.</p> 2024-08-08T00:00:00+07:00 Copyright (c) 2024 https://he04.tci-thaijo.org/index.php/tjr/article/view/1472 Contents 2024-08-05T09:19:33+07:00 Editor-in-Chief ajamah@kku.ac.th <p>1. Nutritional Status in Patients with Systemic Sclerosis at Scleroderma Clinic, Srinagarind University Hospital, Thailand<br />Patapong Towiwat <br />1 - 7</p> <p>2. A practical approach to the autoimmune disease-related interstitial lung disease <br />Chayawee Muangchan<br />8 - 15</p> <p>3. Antineutrophil Cytoplasmic Antibodies associated vasculitis in Patients with Tuberculosis<br />Chutipan SaeJung, Parichat Uea-areewongsa (Advisor)<br />16 – 21</p> <p>4. Scleroderma renal crisis with secondary membranous nephropathy<br />Pinyada Narawong, Nantakarn Pongtarakulpanit, Pintip Ngamjanyaporn (Advisor)<br />22 - 32</p> <p>5. Rheumatology Quiz<br />Anawat Suesuwan<br />33 - 34</p> 2024-08-08T00:00:00+07:00 Copyright (c) 2024 https://he04.tci-thaijo.org/index.php/tjr/article/view/1451 Nutritional Status in Patients with Systemic Sclerosis at Scleroderma Clinic, Srinagarind University Hospital, Thailand 2024-07-31T11:34:58+07:00 Patapong Towiwat puidulian@gmail.com Pranithi Hongsprabhas secretariat@thairheumatology.org Ratanavadee Nanagara Ratanava@kku.ac.th <p><strong>Objectives</strong>: Systemic sclerosis (SSc) is a connective tissue disease that involves multiple organs. Recently, there has been a lack of Thailand data on the prevalence, severity, nutritional status and risk factors of malnutrition in SSc. Therefore, we designed this research to study prevalence, severity, nutritional status and malnutrition risk factors in SSc at Srinakarin University Hospital, Thailand.</p> <p><strong>Method</strong>: This study was a non-randomized cross-sectional study conducted in the scleroderma clinic at Srinakarin University Hospital between 2011-2012. After obtaining informed consent, the patient was followed up in the next two months for a venous blood sample and evaluation of nutritional status by asking for a history and performing a physical exam.</p> <p><strong>Results</strong>: Regarding nutritional status, SSc patients who were malnourished were 34 (46.58%). In the malnutrition group, we found that severe malnutrition was 13 (17.81%). However, multivariate analysis was insignificant regarding risk factors in the malnutrition group; the severe malnutrition group showed that difficulty chewing and dental carries were statistically significant.</p> <p><strong>Conclusions</strong>: In the scleroderma clinic at Srinakarin University Hospital, SSc patients have malnutrition, and some have severe malnutrition. We suggest that difficult chewing and dental carries were risk factors in the severe malnutrition group. Perhaps good oral hygiene may protect against severe malnutrition in SSc patients.</p> 2024-08-08T00:00:00+07:00 Copyright (c) 2024 https://he04.tci-thaijo.org/index.php/tjr/article/view/1453 Antineutrophil Cytoplasmic Antibodies associated vasculitis in Patients with Tuberculosis 2024-07-31T14:23:40+07:00 Chutipan SaeJung little_popeye@hotmail.com Parichat Uea-areewongsa pueareewongsa@yahoo.com <p>A sixty-five-year-old female was diagnosed disseminated tuberculosis (TB) infection. Two weeks after initiating TB treatment, she developed rapid progressive glomerulonephritis, polyneuropathy, active alveolitis, peripheral ulcerative keratitis (PUK), and episcleritis. Positivity of a high level of anti-Myeloperoxidase (MPO) Antibody, which is compatible with antineutrophil cytoplasmic antibodies-associated vasculitis. After receiving monthly intravenous immunoglobulin (IVIG) treatment and concurrent steroid therapy alongside anti-tuberculosis drugs, her clinical condition improved.</p> 2024-08-08T00:00:00+07:00 Copyright (c) 2024 https://he04.tci-thaijo.org/index.php/tjr/article/view/1454 Scleroderma renal crisis with secondary membranous nephropathy 2024-07-31T14:29:22+07:00 Pinyada Narawong pinyada.nar@gmail.com Nantakarn Pongtarakulpanit nantakarnpong@gmail.com Pintip Ngamjanyaporn pintiptip@yahoo.com <p>ภาวะวิกฤติทางไต (scleroderma renal crisis, SRC) เป็นภาวะแทรกซ้อนทางระบบไตที่สำคัญในโรคหนังแข็ง (systemic sclerosis) มีลักษณะเด่นคือ ความดันโลหิตสูง, ไตบาดเจ็บเฉียบพลัน (acute kidney injury) และเลือดจางจากการแตกของเม็ดเลือดแดงในหลอดเลือด (microangiopathic hemolytic anemia, MAHA) การรักษาที่ล่าช้าอาจทำให้ผู้ป่วยจำเป็นต้องเข้ารับการรักษาทดแทนไตในระยะยาว และอัตราการเสียชีวิตเพิ่มขึ้นได้ SRC ต้องแยกจากความผิดปกติทางระบบไตอื่น ๆ โดยภาวะที่สำคัญ ได้แก่ ภาวะหลอดเลือดขนาดเล็กอุดตัน (thrombotic microangiopathy) และภาวะไตอักเสบ (glomerulonephritis) ที่สัมพันธ์กับโรคหลอดเลือดอักเสบ ANCA (ANCA-associated vasculitis) &nbsp;ลักษณะปัสสาวะของ SRC มักปกติ อาจพบเม็ดเลือดแดงได้บ้าง และพบโปรตีนปริมาณเพียงเล็กน้อย หากตรวจพบโปรตีนในปัสสาวะปริมาณมากควรคำนึงถึงภาวะอื่น ๆ ด้วย ส่วน membranous nephropathy เป็นภาวะทางระบบไตที่พบได้น้อยในผู้ป่วยโรคหนังแข็ง สำหรับในผู้ป่วยรายนี้ เป็นผู้ป่วยโรคหนังแข็งชนิดหนังแข็งกระจาย (diffuse cutaneous systemic sclerosis, dcSSc) ที่แสดงอาการกลุ่มเนโฟรติก (nephrotic syndrome) มา 1 เดือนและเกิดไตบาดเจ็บเฉียบพลันขึ้น ผู้ป่วยได้รับการตัดชิ้นเนื้อไต ผลพยาธิสภาพเข้าได้กับ SRC ร่วมกับ membranous nephropathy ซึ่งก่อนหน้านี้มีรายงานผู้ป่วยหนังแข็งเพียงไม่กี่รายที่มีผลพยาธิสภาพทางไตเป็น membranous nephropathy และผู้ป่วยรายนี้เป็นรายแรกที่พบ SRC ร่วมกับภาวะ membranous nephropathy หลังจากได้รับการรักษาด้วยยา ACE inhibitor, cyclophosphamide, และ prednisolone ผู้ป่วยมีการทำงานของไตดีขึ้นกลับไปเท่าค่าตั้งต้น โดยที่ไม่ต้องได้รับการรักษาทดแทนไต และมีระดับโปรตีนในปัสสาวะลดลง</p> 2024-08-08T00:00:00+07:00 Copyright (c) 2024 https://he04.tci-thaijo.org/index.php/tjr/article/view/1573 Rheumatologic Quiz 2024-08-16T13:37:06+07:00 Anawat Suesuwan anawatsuesuwan@gmail.com <p>A 40-year-old woman with a history of rheumatoid arthritis presented with pain and swelling on the dorsal side of both wrists for one week. (Figure 1)</p> 2024-08-16T00:00:00+07:00 Copyright (c) 2024 https://he04.tci-thaijo.org/index.php/tjr/article/view/1455 A practical approach to the autoimmune disease-related interstitial lung disease 2024-07-31T14:42:48+07:00 Chayawee Muangchan sichayawee@gmail.com <p>Autoimmune diseases are heterogeneous groups of immune-mediated inflammatory diseases. However, they have multi-organ involvement, and patterns of organ complication usually present as the phenotypic trademark for each disease caused by different antibodies that recognize different sets of antigens. Pulmonary parenchyma is sometimes a target and complicated as interstitial lung disease. Autoimmune disease-related interstitial lung disease could occur at acute onset and progress rapidly or at chronic onset and insidiously progress. Host characteristics, clinical features suggesting autoimmune diseases, and serological tests help delineate the cause of ILD in the differential diagnosis.</p> 2024-08-08T00:00:00+07:00 Copyright (c) 2024