Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease
OBJECTIVE Although the influence of age on clinical and laboratory features has been widely demonstrated in many arthropathies, studies on elderly onset (> 60 years) psoriatic arthritis (EOPsA) are rare. This study compares manifestations at onset and two year outcome of EOPsA with those of young...
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| Veröffentlicht in: | Annals of the rheumatic diseases 1999-04, Vol.58 (4), p.226-229 |
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| creator | Punzi, Leonardo Pianon, Margherita Rossini, Paola Schiavon, Franco Gambari, Pier Franca |
| description | OBJECTIVE Although the influence of age on clinical and laboratory features has been widely demonstrated in many arthropathies, studies on elderly onset (> 60 years) psoriatic arthritis (EOPsA) are rare. This study compares manifestations at onset and two year outcome of EOPsA with those of younger onset PsA (YOPsA). PATIENTS AND METHODS Sixty six consecutive PsA patients with disease duration < 1 year, 16 EOPsA (>60 years) and 50 YOPsA (⩽60 years) were admitted to a prospective study. Clinical, laboratory, and radiographic assessment were carried out at admission and after two years. HLA class I and bone scintigraphy were also recorded. In 10 patients with EOPsA and 24 with YOPsA it was possible to obtain synovial fluid, which was subsequently analysed for local inflammatory indices, including interleukin (IL) 1β, IL6, and IL8. RESULTS Presenting manifestations of EOPsA differed from YOPsA in number of active joints (mean (SD)) (12.2 (6.3) v 6.7 (4.6), p |
| doi_str_mv | 10.1136/ard.58.4.226 |
| format | Article |
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This study compares manifestations at onset and two year outcome of EOPsA with those of younger onset PsA (YOPsA). PATIENTS AND METHODS Sixty six consecutive PsA patients with disease duration < 1 year, 16 EOPsA (>60 years) and 50 YOPsA (⩽60 years) were admitted to a prospective study. Clinical, laboratory, and radiographic assessment were carried out at admission and after two years. HLA class I and bone scintigraphy were also recorded. In 10 patients with EOPsA and 24 with YOPsA it was possible to obtain synovial fluid, which was subsequently analysed for local inflammatory indices, including interleukin (IL) 1β, IL6, and IL8. RESULTS Presenting manifestations of EOPsA differed from YOPsA in number of active joints (mean (SD)) (12.2 (6.3) v 6.7 (4.6), p<0.001), foot bone erosions (2.7 (1.2) v1.1 (1.1), p<0.001), erythrocyte sedimentation rate (64.2 (35.3)v 30.5 (30.0) mm 1st h, p<0.001), C reactive protein (3.9 (2.0) v 1.3 (1.3) mg/dl, p<0.001) and synovial fluid IL1β (8.0 (4.7)v 3.0 (3.0) pg/ml, p<0.001) and IL6 (828.2 (492.6) v 469.3 (201.4) pg/ml, p<0.005). No differences were found in the number of subjects with dactylitis, pitting oedema, HLA-B27, or signs of sacroiliac and sternoclavicular joint involvement at bone scintigraphy. After two years, progression was more evident in EOPsA than in YOPsA, as the number of new erosions in the hands and also the C reactive protein were higher in EOPsA patients. CONCLUSION PsA has a more severe onset and a more destructive outcome in elderly people (onset >60 years) than in younger subjects. This behaviour may be influenced by immune changes associated with aging, as suggested by the higher concentrations of IL1β and IL6 found in the synovial fluid of EOPsA than in YOPsA.]]></description><identifier>ISSN: 0003-4967</identifier><identifier>EISSN: 1468-2060</identifier><identifier>DOI: 10.1136/ard.58.4.226</identifier><identifier>PMID: 10364901</identifier><identifier>CODEN: ARDIAO</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and European League Against Rheumatism</publisher><subject>Adult ; Age ; Age of Onset ; Aged ; Arthritis, Psoriatic - complications ; Arthritis, Psoriatic - immunology ; Biological and medical sciences ; Blood Sedimentation ; C-Reactive Protein - analysis ; Cytokines ; Dermatology ; Disease ; Disease Progression ; elderly onset arthritis ; Extended Reports ; Female ; Gene expression ; Humans ; Hypotheses ; Interleukin-1 - analysis ; Interleukin-6 - analysis ; Interleukin-8 - analysis ; interleukins ; Joints - pathology ; Laboratories ; Male ; Medical sciences ; Middle Aged ; Older people ; Prospective Studies ; Psoriasis. Parapsoriasis. Lichen ; psoriatic arthritis ; Rheumatic diseases ; synovial fluid ; Synovial Fluid - immunology ; Tumor necrosis factor-TNF</subject><ispartof>Annals of the rheumatic diseases, 1999-04, Vol.58 (4), p.226-229</ispartof><rights>Annals of the Rheumatic Diseases</rights><rights>1999 INIST-CNRS</rights><rights>Copyright: 1999 Annals of the Rheumatic Diseases</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b507t-1b74c35a63677e45abba807904e37487110f065df9ffb4eca167375b41ad229d3</citedby><cites>FETCH-LOGICAL-b507t-1b74c35a63677e45abba807904e37487110f065df9ffb4eca167375b41ad229d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1752862/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1752862/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1770260$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10364901$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Punzi, Leonardo</creatorcontrib><creatorcontrib>Pianon, Margherita</creatorcontrib><creatorcontrib>Rossini, Paola</creatorcontrib><creatorcontrib>Schiavon, Franco</creatorcontrib><creatorcontrib>Gambari, Pier Franca</creatorcontrib><title>Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease</title><title>Annals of the rheumatic diseases</title><addtitle>Ann Rheum Dis</addtitle><description><![CDATA[OBJECTIVE Although the influence of age on clinical and laboratory features has been widely demonstrated in many arthropathies, studies on elderly onset (> 60 years) psoriatic arthritis (EOPsA) are rare. This study compares manifestations at onset and two year outcome of EOPsA with those of younger onset PsA (YOPsA). PATIENTS AND METHODS Sixty six consecutive PsA patients with disease duration < 1 year, 16 EOPsA (>60 years) and 50 YOPsA (⩽60 years) were admitted to a prospective study. Clinical, laboratory, and radiographic assessment were carried out at admission and after two years. HLA class I and bone scintigraphy were also recorded. In 10 patients with EOPsA and 24 with YOPsA it was possible to obtain synovial fluid, which was subsequently analysed for local inflammatory indices, including interleukin (IL) 1β, IL6, and IL8. RESULTS Presenting manifestations of EOPsA differed from YOPsA in number of active joints (mean (SD)) (12.2 (6.3) v 6.7 (4.6), p<0.001), foot bone erosions (2.7 (1.2) v1.1 (1.1), p<0.001), erythrocyte sedimentation rate (64.2 (35.3)v 30.5 (30.0) mm 1st h, p<0.001), C reactive protein (3.9 (2.0) v 1.3 (1.3) mg/dl, p<0.001) and synovial fluid IL1β (8.0 (4.7)v 3.0 (3.0) pg/ml, p<0.001) and IL6 (828.2 (492.6) v 469.3 (201.4) pg/ml, p<0.005). No differences were found in the number of subjects with dactylitis, pitting oedema, HLA-B27, or signs of sacroiliac and sternoclavicular joint involvement at bone scintigraphy. After two years, progression was more evident in EOPsA than in YOPsA, as the number of new erosions in the hands and also the C reactive protein were higher in EOPsA patients. CONCLUSION PsA has a more severe onset and a more destructive outcome in elderly people (onset >60 years) than in younger subjects. This behaviour may be influenced by immune changes associated with aging, as suggested by the higher concentrations of IL1β and IL6 found in the synovial fluid of EOPsA than in YOPsA.]]></description><subject>Adult</subject><subject>Age</subject><subject>Age of Onset</subject><subject>Aged</subject><subject>Arthritis, Psoriatic - complications</subject><subject>Arthritis, Psoriatic - immunology</subject><subject>Biological and medical sciences</subject><subject>Blood Sedimentation</subject><subject>C-Reactive Protein - analysis</subject><subject>Cytokines</subject><subject>Dermatology</subject><subject>Disease</subject><subject>Disease Progression</subject><subject>elderly onset arthritis</subject><subject>Extended Reports</subject><subject>Female</subject><subject>Gene expression</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Interleukin-1 - analysis</subject><subject>Interleukin-6 - analysis</subject><subject>Interleukin-8 - analysis</subject><subject>interleukins</subject><subject>Joints - pathology</subject><subject>Laboratories</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Older people</subject><subject>Prospective Studies</subject><subject>Psoriasis. Parapsoriasis. Lichen</subject><subject>psoriatic arthritis</subject><subject>Rheumatic diseases</subject><subject>synovial fluid</subject><subject>Synovial Fluid - immunology</subject><subject>Tumor necrosis factor-TNF</subject><issn>0003-4967</issn><issn>1468-2060</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1999</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kUFv1DAQhS1ERZfCjTOyBIJLs9iOYzsckNCKFqoVXApXa5I4XS-JvbUdYP89brMqhQMnazSfn968h9AzSpaUluINhG5ZqSVfMiYeoAXlQhWMCPIQLQghZcFrIY_R4xi3eSSKqkfomJJS8JrQBUqrwTrbwoDBdXiAxgdIPuzxCM72JiZI1ruIfY_N0Jkw7HEeTcK76IPNyxZDSJtgk41vMeDWjzsINnqHf9q0wXs_uSsTDp86Gw1E8wQd9TBE8_TwnqCvZx8uVx-L9ZfzT6v366KpiEwFbSRvywpEKaQ0vIKmAUVkTbgpJVeSUtITUXV93fcNNy1QIUtZNZxCx1jdlSfo3ay7m5rRdK1xKcCgd8GOEPbag9V_b5zd6Cv_Q1NZMSVYFnh1EAj-espp6NHG1gwDOOOnqEWtWJmzzuCLf8Ctn4LLx2UtqYhgNakzdTpTbfAxBtPfWaFE35Spc5m6UprrXGbGn9-3fw-e28vAywMAMVfYB3CtjX84KQm7NVfMmI3J_LpbQ_iubwPTn7-t9PpCXVRnl1KrzL-e-Wbc_t_hbyp7xY8</recordid><startdate>19990401</startdate><enddate>19990401</enddate><creator>Punzi, Leonardo</creator><creator>Pianon, Margherita</creator><creator>Rossini, Paola</creator><creator>Schiavon, Franco</creator><creator>Gambari, Pier Franca</creator><general>BMJ Publishing Group Ltd and European League Against Rheumatism</general><general>BMJ</general><general>Elsevier Limited</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19990401</creationdate><title>Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease</title><author>Punzi, Leonardo ; Pianon, Margherita ; Rossini, Paola ; Schiavon, Franco ; Gambari, Pier Franca</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b507t-1b74c35a63677e45abba807904e37487110f065df9ffb4eca167375b41ad229d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1999</creationdate><topic>Adult</topic><topic>Age</topic><topic>Age of Onset</topic><topic>Aged</topic><topic>Arthritis, Psoriatic - complications</topic><topic>Arthritis, Psoriatic - immunology</topic><topic>Biological and medical sciences</topic><topic>Blood Sedimentation</topic><topic>C-Reactive Protein - analysis</topic><topic>Cytokines</topic><topic>Dermatology</topic><topic>Disease</topic><topic>Disease Progression</topic><topic>elderly onset arthritis</topic><topic>Extended Reports</topic><topic>Female</topic><topic>Gene expression</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Interleukin-1 - analysis</topic><topic>Interleukin-6 - analysis</topic><topic>Interleukin-8 - analysis</topic><topic>interleukins</topic><topic>Joints - pathology</topic><topic>Laboratories</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Older people</topic><topic>Prospective Studies</topic><topic>Psoriasis. Parapsoriasis. Lichen</topic><topic>psoriatic arthritis</topic><topic>Rheumatic diseases</topic><topic>synovial fluid</topic><topic>Synovial Fluid - immunology</topic><topic>Tumor necrosis factor-TNF</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Punzi, Leonardo</creatorcontrib><creatorcontrib>Pianon, Margherita</creatorcontrib><creatorcontrib>Rossini, Paola</creatorcontrib><creatorcontrib>Schiavon, Franco</creatorcontrib><creatorcontrib>Gambari, Pier Franca</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of the rheumatic diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Punzi, Leonardo</au><au>Pianon, Margherita</au><au>Rossini, Paola</au><au>Schiavon, Franco</au><au>Gambari, Pier Franca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease</atitle><jtitle>Annals of the rheumatic diseases</jtitle><addtitle>Ann Rheum Dis</addtitle><date>1999-04-01</date><risdate>1999</risdate><volume>58</volume><issue>4</issue><spage>226</spage><epage>229</epage><pages>226-229</pages><issn>0003-4967</issn><eissn>1468-2060</eissn><coden>ARDIAO</coden><abstract><![CDATA[OBJECTIVE Although the influence of age on clinical and laboratory features has been widely demonstrated in many arthropathies, studies on elderly onset (> 60 years) psoriatic arthritis (EOPsA) are rare. This study compares manifestations at onset and two year outcome of EOPsA with those of younger onset PsA (YOPsA). PATIENTS AND METHODS Sixty six consecutive PsA patients with disease duration < 1 year, 16 EOPsA (>60 years) and 50 YOPsA (⩽60 years) were admitted to a prospective study. Clinical, laboratory, and radiographic assessment were carried out at admission and after two years. HLA class I and bone scintigraphy were also recorded. In 10 patients with EOPsA and 24 with YOPsA it was possible to obtain synovial fluid, which was subsequently analysed for local inflammatory indices, including interleukin (IL) 1β, IL6, and IL8. RESULTS Presenting manifestations of EOPsA differed from YOPsA in number of active joints (mean (SD)) (12.2 (6.3) v 6.7 (4.6), p<0.001), foot bone erosions (2.7 (1.2) v1.1 (1.1), p<0.001), erythrocyte sedimentation rate (64.2 (35.3)v 30.5 (30.0) mm 1st h, p<0.001), C reactive protein (3.9 (2.0) v 1.3 (1.3) mg/dl, p<0.001) and synovial fluid IL1β (8.0 (4.7)v 3.0 (3.0) pg/ml, p<0.001) and IL6 (828.2 (492.6) v 469.3 (201.4) pg/ml, p<0.005). No differences were found in the number of subjects with dactylitis, pitting oedema, HLA-B27, or signs of sacroiliac and sternoclavicular joint involvement at bone scintigraphy. After two years, progression was more evident in EOPsA than in YOPsA, as the number of new erosions in the hands and also the C reactive protein were higher in EOPsA patients. CONCLUSION PsA has a more severe onset and a more destructive outcome in elderly people (onset >60 years) than in younger subjects. This behaviour may be influenced by immune changes associated with aging, as suggested by the higher concentrations of IL1β and IL6 found in the synovial fluid of EOPsA than in YOPsA.]]></abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and European League Against Rheumatism</pub><pmid>10364901</pmid><doi>10.1136/ard.58.4.226</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of the rheumatic diseases, 1999-04, Vol.58 (4), p.226-229 |
| issn | 0003-4967 1468-2060 |
| language | eng |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Adult Age Age of Onset Aged Arthritis, Psoriatic - complications Arthritis, Psoriatic - immunology Biological and medical sciences Blood Sedimentation C-Reactive Protein - analysis Cytokines Dermatology Disease Disease Progression elderly onset arthritis Extended Reports Female Gene expression Humans Hypotheses Interleukin-1 - analysis Interleukin-6 - analysis Interleukin-8 - analysis interleukins Joints - pathology Laboratories Male Medical sciences Middle Aged Older people Prospective Studies Psoriasis. Parapsoriasis. Lichen psoriatic arthritis Rheumatic diseases synovial fluid Synovial Fluid - immunology Tumor necrosis factor-TNF |
| title | Clinical and laboratory manifestations of elderly onset psoriatic arthritis: a comparison with younger onset disease |
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