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Ultrasound Evaluation of the Effects of Leukocytapheresis on Rheumatoid Arthritis
Author(s) -
Yoshida Shuzo,
Takeuchi Tohru,
Maeda Yoichiro,
Kimura Yuko,
Hata Kenichiro,
Hiramatsu Yuri,
Shoda Takeshi,
Makino Shigeki,
Hanafusa Toshiaki,
Shibahara Nobuhisa
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12126
Subject(s) - medicine , erythrocyte sedimentation rate , rheumatoid arthritis , shoulders , ultrasound , surgery , physical examination , nuclear medicine , radiology
Leukocytapheresis ( LCAP ) is effective in treating rheumatoid arthritis ( RA ). Ultrasound ( US ) examination of joints is useful for evaluating disease activity and therapeutic effects in RA , but the clinical assessment of LCAP therapy with US has been little reported. We investigated the usefulness of US for evaluating the effects of LCAP in patients with RA . US examination was performed in six patients (total of seven cases) who underwent LCAP . Twenty‐eight joints (bilateral shoulders, elbows, wrists, 1st to 5th metacarpophalangeal joints, 1st to 5th proximal interphalangeal joints, and knee joints) were evaluated by a systematic multiplanar grey‐scale and power D oppler ( PD ) examination. Disease activity of RA was evaluated using the 28‐joint D isease A ctivity S core with erythrocyte sedimentation rate ( DAS28‐ESR ). Moderate or good responses to LCAP based on the DAS28‐ESR were observed in four of the seven cases although C ‐reactive protein ( CRP ) and ESR did not decrease. LCAP significantly reduced the mean total PD score 17.3 ± 11.6 to 13.0 ± 10.5 ( P = 0.0469). The total PD score decreased in six of the seven cases, and the number of joints with PD score ≥2 decreased in five of the seven cases. The rate of decrease in the number of joints with PD score ≥2 correlated strongly with the DAS28‐ESR and its components, especially swollen joint counts and evaluator's global assessment, but not with the rate of decrease in CRP and ESR . US imaging of joints may be useful for evaluating the therapeutic effects of LCAP on RA compared to other inflammatory parameters.