Nattanicha Chaisrimaneepan

Antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis (AAV) is an autoimmune disorder characterized by inflammation of small blood vessels, leading to progressive tissue damage, fibrosis...

This case represents the first reported instance of adult isopropyl alcohol inhalation intoxication with a rapid onset (2 h) and initially negative serum and urine ketones. It highlights that early isopropyl alcohol intoxication may not exhibit the typical clinical features, such as respiratory depression, altered mental status, and positive ketones.

Juvenile idiopathic arthritis (JIA) encompasses all forms of chronic arthritis of unknown origin that occur before the age of 16.1,2 It is the most common rheumatic disease in childhood, with a med...

Objective: Calcium pyrophosphate deposition disease (CPPD) is a common inflammatory arthritis among older adults. Comorbidities often limit conventional treatment of acute CPPD flare. Anakinra, an interleukin-1 inhibitor, is a promising alternative. We aimed to evaluate the efficacy and safety of anakinra in acute CPPD flares. Methods: We systematically searched studies from MEDLINE, EMBASE, and the Cochrane Database up until August 2024. The primary outcome was a positive treatment response between Day 3 and Day 5 after anakinra initiation. Secondary outcomes included changes in pain ratings assessed by the visual analogue scales (VAS), C-reactive protein (CRP) levels, tender joint counts (TJCs), swollen joint counts (SJCs), and steroid usage. Results: Six studies were included in our meta-analysis: five observational studies and one randomized controlled trial. A total of 84 patients were included in our analysis. Subjective physician assessments of clinical response were reported in all studies with a combined positive treatment response rate of 76% (95% CI: 61–86, I2 = 0%). Our pooled analysis also showed a significant reduction of VAS scores by 48.12 mm (95% CI: 53.21–43.03, I2 = 0%) and CRP levels by 62.09 mg/L (95% CI: 97.74–26.44, I2 = 77%) from baseline. Reductions of TJC and SJC were also demonstrated: 4.86 (95% CI: 5.48–4.23, I2 = 0%) and 3.65 (95% CI: −12.53 to 5.22, I2 = 54%), respectively. Adverse reactions included injection site reaction, rash, bacterial pneumonitis, and neutropenia. Conclusions: Anakinra is a promising alternative treatment for patients with acute CPPD flare as it showed desirable clinical responses and a favourable safety profile.

Anti-carbamylated protein (anti-CarP) antibodies have emerged as novel serologic markers in rheumatoid arthritis (RA). This meta-analysis aimed to assess t

Nattanicha Chaisrimaneepan, M.D., Thunyaporn Khoruamklang, M.D., Tulaton Sodsri, M.D., Natnicha Jakramonpreeya, M.D.. J Rheum Dis -0001;0:. https://doi.org/10.4078/jrd.2025.0035

We report a case of a 59‐year‐old male with a history of hypertension, polycythemia, and optic neuritis, who presented with progressive visual loss, bilateral lower extremity weakness, and new‐onset urinary and fecal incontinence. MRI findings of leptomeningeal enhancements raised suspicion for neurosarcoidosis, leading to initial treatment with intravenous immunoglobulin (IVIG), but with no significant improvement. Six weeks later, the patient developed an acute ischemic stroke, confirmed by MRI, alongside worsening neurological deficits. Further evaluation revealed mediastinal and hilar lymphadenopathy on chest CT, supporting the diagnosis of neurosarcoidosis. Despite a course of high‐dose methylprednisolone and immunosuppressive therapy, including mycophenolate mofetil, the patient showed partial recovery in strength but only minimal improvement in vision. At follow‐up, MRI demonstrated stable disease with new leptomeningeal enhancement, prompting the initiation of TNF‐alpha inhibitors. This case underscores the rare but important association between neurosarcoidosis and ischemic stroke, highlighting the complexity of diagnosis and management, which includes both stroke prevention and sarcoidosis treatment.

Background: The study was conducted to investigate the impact of systemic sclerosis (SSc) on hospitalized COVID-19 patients. Method: This retrospective observational study analyzed data from the National Inpatient Survey (NIS) in 2021. Patients hospitalized with COVID-19 were categorized into SSc and non-SSc groups. Characteristics of patients and comorbidities were compared. The primary outcome was the mortality rate. Secondary outcomes included resource utilization and acute in-hospital complications of SSc. Multivariate logistic regression analyses were conducted, with p -values < 0.05 considered statistically significant. Result: Of all, 1865 patients hospitalized with COVID-19 had SSc. Patients with SSc had a higher mortality risk (aOR = 1.37 [1.03–1.82]; p = 0.032). The average cost of hospitalization was significantly higher in the SSc group ( p = 0.048), with no difference in LOS (9.4 ± 0.65 days vs 8.4 ± 0.03 days; p = 0.260). COVID-19 patients with SSc significantly had a higher risk for DIC (aOR 2.82 [1.06–7.53]; p = 0.038), left-sided HF (aOR 1.76 [1.16–2.67]; p = 0.008), ventricular arrhythmia (aOR 3.17 [1.01–9.89]; p = 0.047), oxygen dependence (aOR 2.41 [1.64–3.55]; p < 0.001), cardiac arrest (aOR 2.61 [1.63–4.18]; p < 0.001), and ileus (aOR 2.61 [1.45–4.69]; p = 0.001). Conclusion: Hospitalized COVID-19 patients with SSc were more likely to develop in-hospital complications and had a higher mortality risk.