Thai Journal of Rheumatology https://he04.tci-thaijo.org/index.php/tjr <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> en-US <p>(ใส่ข้อความเดียวกันกับ ก๊อปปี้ไลน์ก็ได้)ดูตัวอย่างได้ที่หน้าบทความ---บทความนี้ตีพิมพ์เป็นลิขสิทธื์ของใคร...</p> secretariat@thairheumatology.org (Assoc.Prof.Ajanee Mahakkanukrauh) laongdow.tra@gmail.com (Laongdow Kabillapat) Fri, 06 Jun 2025 10:48:10 +0700 OJS 3.3.0.8 http://blogs.law.harvard.edu/tech/rss 60 Rheumatology Quiz (Eng) https://he04.tci-thaijo.org/index.php/tjr/article/view/3239 <p>A 34-year-old woman presented with a bruise around the right medial malleolus (Figure 1). She felt mild pain and swelling in her knee for the past ten days and noticed the bruise two days ago.<br /><br /><strong>Questions</strong>:<br />1. What is her clinical sign?<br />2. What is her diagnosis?</p> Anawat Suesuwan Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3239 Fri, 06 Jun 2025 00:00:00 +0700 Cardiovascular Disease Prevalence and Risk in Rheumatoid Arthritis Patients: Insights from a Nationwide Thai Hospital Database (Eng) https://he04.tci-thaijo.org/index.php/tjr/article/view/3234 <p><strong>Background</strong>: Rheumatoid Arthritis (RA) is a chronic inflammatory disease that can lead to cardiovascular system problems and complications. The prevalence of cardiovascular diseases (CVD) in RA patients in Thailand remains unclear.</p> <p><strong>Objectives</strong>: To determine whether patients with RA are at increased risk for cardiovascular disease and to assess the impact of atherosclerosis risk factors in RA.</p> <p><strong>Methods</strong>: A descriptive study used data from a nationwide In-patient healthcare database in Thailand. RA was identified using ICD-10 codes M05-M06. Cardiovascular diseases were defined as angina pectoris, acute myocardial infarction, subsequent myocardial infarction, certain current complications following acute myocardial infarction, and chronic ischemic heart disease. Atherosclerosis risk factors include diabetes mellitus (DM), hypertension (HT), and dyslipidemia (DLD). A total of 4,503 hospitalized RA patients between January 2014 and December 2021 were analyzed.</p> <p><strong>Results</strong>: The mean age of patients was 56 years, and 76% were female. The most prevalent cardiovascular diseases were chronic ischemic heart disease (2.27%) and acute myocardial infarction (0.33%). There was a significant increase in the prevalence of myocardial infarction (MI) in male patients under 65 with HT, DLD, and/or DM (OR 4.19, 95% CI 1.25-14.89), male patients over 65 with HT, DLD, and/or DM (OR 3.04, 95% CI 1.13-8.66), and female patients over 55 with HT, DLD, and/or DM (OR 2.85, 95% CI 1.67-5.02). However, no significant increase was found in female patients under 55 with HT, DLD, and/or DM (OR 3.14, 95% CI 0.72-13.77) compared to those with no risk factors.</p> <p><strong>Conclusions</strong>: Cardiovascular disease and atherosclerosis-related comorbidities are common among patients with rheumatoid arthritis. The presence of hypertension, dyslipidemia, and/or diabetes mellitus significantly increases the risk of cardiovascular disease in most subgroups, except in females under 55 years of age.</p> Natipoom Ketsing, Chingching Foocharoen, Siraphop Suwannaroj, Ajanee Mahakkanukrauh Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3234 Fri, 06 Jun 2025 00:00:00 +0700 Introduction https://he04.tci-thaijo.org/index.php/tjr/article/view/3259 <p>The Thai Journal of Rheumatology proudly presents Volume 2, Issue 2, featuring a collection of diverse and valuable academic articles in the field of rheumatology. This issue aims to disseminate new knowledge and enhance understanding of important medical topics.<br /><br />The content includes an original article, "Cardiovascular Disease Prevalence and Risk in Rheumatoid Arthritis Patients: Insights from a Nationwide Thai Hospital Database," which provides insightful data on cardiovascular complications among rheumatoid arthritis patients in Thailand.<br /><br />Additionally, this issue features a comprehensive literature review titled "Geriatric Rheumatology," highlighting key aspects of rheumatologic care in the elderly population. Two noteworthy case reports, "Vasculitis Mimics Caused by Pythium Infection and Literature Review" and "A Case Report of Adult Type 2 Familial Hemophagocytic Lymphohistiocytosis," offer valuable clinical insights into rare and challenging conditions.<br /><br />To further engage readers, a quiz on the topic of "Crescent Sign" is also included, providing an opportunity for knowledge review and self-assessment.<br /><br />The editorial board sincerely hopes that this issue will be both academically enriching and practically beneficial for all readers. We also extend our heartfelt appreciation to all contributors for their ongoing support in maintaining the quality and relevance of the journal.<br /><br />Editor-in-Chief</p> Editor-in-Chief Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3259 Thu, 12 Jun 2025 00:00:00 +0700 Contents https://he04.tci-thaijo.org/index.php/tjr/article/view/3261 <p><strong>1. Cardiovascular Disease Prevalence and Risk in Rheumatoid Arthritis Patients: Insights from a Nationwide Thai Hospital Database </strong><strong>Abstract<br /></strong>Natipoom Ketsing, Chingching Foocharoen, Siraphop Suwannaroj,<br />Ajanee Mahakkanukrauh<br /><strong>1 - 6</strong><br /><br /><strong>2. Geriatric Rheumatology<br /></strong>Chanikarn Oonjittichai, Pichaya O-charoen<br /><strong>7 - 26<br /><br /></strong><strong>3. Vasculitis mimics caused by Pythium infection and literatures review<br /></strong>Angkana Norasetthada<br /><strong>27 - 36<br /><br /></strong><strong>4. A Case Report of Adult Type 2 Familial Hemophagocytic Lymphohistiocytosis<br /></strong>Supatta Chaiprasert, Phongpon Sumangin<br /><strong>37 – 54</strong><br /><br /><strong>5. Rheumatology Quiz</strong><br />Anawat Suesuwan<br /><strong>55 – 58</strong></p> Editor-in-Chief Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3261 Thu, 12 Jun 2025 00:00:00 +0700 Geriatric Rheumatology (Thai) https://he04.tci-thaijo.org/index.php/tjr/article/view/3235 <p>การเปลี่ยนแปลงของร่างกายเมื่อมีอายุมากขึ้นเป็นกระบวนการทางชีวภาพที่ซับซ้อน มีลักษณะจำเพาะ คือ การทำงานของเซลล์ลดลง ทำให้เสียสภาวะสมดุลของร่างกาย และก่อให้เกิดโรคในผู้สูงอายุ ได้แก่ โรคจากความเสื่อมของระบบประสาท โรคมะเร็ง โรคหัวใจและหลอดเลือด รวมไปถึงโรคข้อและแพ้ภูมิตนเอง การเปลี่ยนแปลงนี้ส่งผลต่อคุณภาพชีวิต และอาจทำให้เสียชีวิต<sup>1</sup><sup> &nbsp;</sup>ในปัจจุบันผู้สูงอายุมีจำนวนมากขึ้น<sup>2</sup> ลักษณะทางคลินิกของโรคข้อและแพ้ภูมิตนเองและแนวทางการรักษาในผู้สูงอายุมีความแตกต่างจากผู้ป่วยทั่วไป บทความนี้กล่าวถึงกระบวนการชราภาพ การเปลี่ยนแปลงของระบบภูมิคุ้มกัน และกลุ่มโรคแพ้ภูมิตนเองที่พบบ่อยในผู้สูงอายุ</p> Chanikarn Oonjittichai, Pichaya O-charoen Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3235 Fri, 06 Jun 2025 00:00:00 +0700 Vasculitis mimics caused by Pythium infection and literatures review (Eng) https://he04.tci-thaijo.org/index.php/tjr/article/view/3237 <p>While early diagnosis of vasculitis is important to induce remission and prevent organ damage, an incorrect diagnosis can result in harmful consequences from missing the underlying condition and exposure to immunosuppressive therapy. Evaluation of vasculitis should include consideration of its mimics. Important mimic categories include infection, vasculopathy, non-inflammatory conditions like atherosclerosis, thrombotic states, calciphylaxis and rare neoplasms.Human pythiosis is a rare life-threatening disease caused by <em>Pythium insidiosum</em>, a fungus-like organism that belongs to the <em>Kingdom</em> <em>Straminiphila</em>.Infected patients were mostly reported from Thailand and usually had an agricultural background. Clinical presentations are documented, cutaneous/subcutaneous, ocular, vascular, and disseminated pythiosis. The majority of the reported patients with vascular pythiosis have lower limb involvement.Known risk factors for vascular pythiosis include thalassemia, hemoglobinopathy, paroxysmal nocturnal hemoglobinuria, aplastic anemia, and leukemia. Furthermore, the rarity of the disease has led to underrecognition, under-diagnosis, and delays in diagnosis, and this has contributed to the occurrence of advanced disease, which affects survival. I, herein, report a case of diabetes mellitus and alcoholism, 31 year-old male presented with ischemic leg ulcers, which skin biopsy revealed leukocytoclastic vasculitis and CT- angiogram suspected vasculitis, and then <em>P. insidiosum </em>has been isolated from vascular sites, and relevant literature reviews.</p> Angkana Norasetthada Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3237 Fri, 06 Jun 2025 00:00:00 +0700 A Case Report of Adult Type 2 Familial Hemophagocytic Lymphohistiocytosis (Thai) https://he04.tci-thaijo.org/index.php/tjr/article/view/3238 <p>โรค Hemophagocytic Lymphohistiocytosis (HLH) เป็นโรคที่ส่งผลต่ออวัยวะหลายระบบ แต่การ<br>วินิจฉัยโรคดังกล่าวทำได้ยาก &nbsp;ในรายงานฉบับนี้นำเสนอกรณีศึกษาของผู้ป่วยชายอายุ 18 ปี ที่มีอาการไข้ <br>1 เดือนก่อนมาโรงพยาบาล และอาการ เห็นภาพหลอน ร่วมกับตรวจพบความผิดปกติที่ปอด ตับม้ามโต ต่อมน้ำเหลืองโต ระดับเม็ดเลือดแดง เม็ดเลือดขาว และเกร็ดเลือดต่ำ ผู้ป่วยได้รับการรักษาด้วยยา azathioprine, hydroxychloroquine และ systemic steroid แต่อาการกลับแย่ลง ภายหลังได้รับการสืบหาโรคเพิ่มเติมโดยทีมผู้เชี่ยวชาญ ไม่พบสาเหตุจากโรคมะเร็ง โรคติดเชื้อ โรคทางระบบภูมิคุ้นกัน และตรวจทางพันธุ์กรรมพบการกลายพันธุ์ของยีน perforin 1 (PRF1) เข้าได้กับโรค Familial HLH ชนิดที่ 2&nbsp;&nbsp;&nbsp;</p> <p>ผู้ป่วยชายไทยโสด อายุ 18 ปี</p> <p><strong>อาการสำคัญ</strong> : ไข้ 1 เดือน ก่อนมาโรงพยาบาล (รพ.)</p> Supatta Chaiprasert, Phongpon Sumangin Copyright (c) 2025 https://creativecommons.org/licenses/by-nc-nd/4.0 https://he04.tci-thaijo.org/index.php/tjr/article/view/3238 Fri, 06 Jun 2025 00:00:00 +0700