New concepts in systemic rheumatic diseases that are registered as rare diseases in Korea

Lee, Jennifer Jooha,Park, Sung-Hwan Korean Medical Association (KAMJE) 2012 대한의사협회지 Vol.55 No.3

Korean guidelines for the management of gout

( Jennifer Jooha Lee ),( Ji Soo Lee ),( Min Kyung Chung ),( Joong Kyong Ahn ),( Hyo-jin Choi ),( Seung-jae Hong ),( Chong-hyeon Yoon ),( Su-hyun Kim ),( Kyung-hwan Jeong ),( Jong-woo Kim ),( Bo-yeon K 대한내과학회 2023 The Korean Journal of Internal Medicine Vol.38 No.5

Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.

The Risk of Osteoporotic Fractures According to the FRAX Model in Korean Patients with Rheumatoid Arthritis

Lee, Jae Ho,Suh, Young Sun,Koh, Jung Hee,Jung, Seung-Min,Lee, Jennifer Jooha,Kwok, Seung-Ki,Ju, Ji Hyeon,Park, Kyung-Su,Park, Sung-Hwan The Korean Academy of Medical Sciences 2014 JOURNAL OF KOREAN MEDICAL SCIENCE Vol.29 No.8

<P>The aim of the current study is to identify patients without osteoporosis who met the criteria of the fracture risk assessment tool (FRAX) of the National Osteoporosis Foundation (NOF) only. The incidence of fractures was investigated in patients who met only the FRAX criteria of the NOF and patients who presented osteoporosis. Five hundred and forty five patients with rheumatoid arthritis who visited a single center were recruited in Korea. In the follow-up period of median 30 months, the new onset of fractures was investigated. Of 223 patients who have no osteoporosis, 39 (17.4%) satisfied the FRAX criteria for pharmacological intervention. During the follow-up period, 2 new onset fractures occurred in patients who met only the FRAX criteria and 22 new onset fractures did in patients with osteoporosis by bone mineral density. The incidence rate for new onset fractures of patients who met only the FRAX criteria was with 295.93 per 10,000 person-years higher than in the general population with 114.99 per 10,000 person-years. Patients who met the FRAX criteria of the NOF only need pharmacological intervention because their numbers of incidence for new onset fractures are similar to those of patients with osteoporosis by BMD.</P><P><B>Graphical Abstract</B></P><P/>

Case Reports : Diagnosis and Symptomatic Treatment of Early Reactive Cardiac Amyloidosis in Systemic Sclerosis

( Rae Seok Lee ),( Hyun Jin Sung ),( Jung Im Jung ),( Hea Ok Jung ),( Seung Min Jung ),( Jennifer Jooha Lee ),( Seung Ki Kwok ),( Ji Hyeon Ju ),( Sung Hwan Park ) 대한류마티스학회 2015 대한류마티스학회지 Vol.22 No.2

Systemic sclerosis as a connective tissue disease could affect all internal organs of the body and could also manifest as a cutaneous lesion. Cardiac involvement leading to cardiac manifestations in systemic sclerosis patients is not rare. However, cardiac amyloidosis combined with systemic sclerosis is extremely rare. Although there were no definite treatment options in this case, symptomatic treatment is the cornerstone of the management plan. In this case report, we described a correct diagnosis and symptomatic medical care of early reactive cardiac amyloidosis with systemic sclerosis and summarize the current state of the relevant literature. (J Rheum Dis 2015;22:132-136)

Transient Systemic Lupus Erythematosus-like Syndrome Associated With Parvovirus B19 Infection: A Case Report

( Moon Young Kim ),( Jennifer Jooha Lee ) 대한류마티스학회 2021 대한류마티스학회지 Vol.28 No.1

Human parvovirus B19 (HPV-B19) usually infects children. We report a case of an adult with HPV-B19 infection mimicking systemic lupus erythematosus (SLE). A previously healthy 46-year-old woman presented with an acute illness of cough, fever, chilling, polyarthritis, and skin rash. Laboratory findings showed pancytopenia, increased creatinine level, proteinuria and hypocomplementemia. Anti-double stranded DNA antibody (anti-dsDNA Ab) and antinuclear antibody were positive. Highly suspected of SLE based on clinical and laboratory findings, the patient was initially treated with corticosteroids. Meanwhile, the result of HPV-B19 polymerase chain reaction, which was done initially with other viral tests to exclude infection, turned out to be positive. Steroid was tapered, and pancytopenia, proteinuria, hypocomplementemia gradually improved. On the seventh day, anti-dsDNA Ab was found to be negatively converted. HPV-B19 infections are mostly self-limited and occur rarely in adults, but if a patient presents lupus-like syndrome with transient autoantibody positivity, lupus mimickers including HPV-B19 should be considered. (J Rheum Dis 2021;28:45-49)

Characteristics of patients with psoriatic arthritis in Korea: focusing on axial involvement

Hanna Park,Ji Hyun Lee,Seung-Ki Kwok,Ji Hyeon Ju,Wan-Uk Kim,Sung-Hwan Park,Jennifer Jooha Lee 대한내과학회 2024 The Korean Journal of Internal Medicine Vol.39 No.1

Background/Aims: We aimed to clarify the clinical characteristics of psoriatic arthritis (PsA) in Korean patients focusing on PsA with axial involvement. Methods: A retrospective medical chart review was performed to identify PsA patients at a single tertiary center. Cases of AS patients with psoriasis were recruited from a prospective AS registry of the same center. Demographics, laboratory findings, and radiologic characteristics were assessed. Results: A total of 69 PsA patients were identified. In PsA patients, spondylitis (46.4%) was the most common form. Compared to AS patients with psoriasis, PsA patients with radiographic axial involvement were older (50.9 vs. 32.4 years; p < 0.001) and showed greater peripheral disease activity (peripheral arthritis 78.1 vs. 12.5%, p < 0.001; enthesitis 50.0 vs. 6.3%, p = 0.003). AS patients with psoriasis presented a higher rate of HLA-B*27 positivity (81.3 vs. 17.2%; p < 0.001) and a more frequent history of inflammatory back pain (100.0 vs. 75.0%; p = 0.039) than PsA patients with radiographic axial involvement. Significant proportions of PsA patients with radiographic axial involvement had cervical spine involvement (10/18, 55.6%) reacand spondylitis without sacroiliitis (10/23, 43.5%). Conclusions: We demonstrate that axial involvement is common in Korean PsA patients, and its characteristics can be distinct from those of AS.

Reliability and Validity of the Korean Version of the Gout Impact Scale

Kim Min Jung,Kim Ju Yeon,Lee Jennifer Jooha,Moon Ki Won,Shin Kichul 대한의학회 2023 Journal of Korean medical science Vol.38 No.35

Background: The Gout Impact Scale (GIS), part of the Gout Assessment Questionnaire 2.0, measures gout-specific health-related quality of life (HRQOL). This study aimed to translate the GIS into Korean and validate the Korean version (K-GIS) using generic HRQOL measures. Methods: The GIS was translated into Korean and back-translated into English. We asked patients aged 18 years or older who met the 2015 gout classification criteria to fill out the questionnaires (from January 2022 to June 2022); the K-GIS (5 scales [0–100 scores each]), along with the Korean version of Health Assessment Questionnaire (HAQ) and EuroQol-5 dimension (EQ-5D). We investigated the internal consistency, construct validity, and discriminative validity for gout characteristics of K-GIS. The K-GIS form was administrated to patients 4 weeks later to assess the test-retest reliability using the intraclass correlation coefficient (ICC). Results: One hundred patients completed the questionnaire. The mean ± standard deviation age of the patients was 53.0 ± 15.1 years, and 99.0% of the patients were men. All scales had high degree of internal consistency (Cronbach’s α = 0.59 to 0.96) and test-retest reliability (n = 18, ICC = 0.83 to 0.94, all P < 0.001), except for unmet gout treatment needs. Weak-tomoderate correlations were observed between the K-GIS scales and HAQ or EQ-5D (r = 0.21 to 0.46). The K-GIS scores were significantly higher in the presence of bone erosion, absence of urate-lowering therapy, serum urate levels > 6 mg/dL, frequent gout flares in the past year, and fewer comorbidities. In contrast, neither the HAQ nor the EQ-5D could discern these subsets of patients. Conclusion: The K-GIS is a reliable and valid HRQOL measure for patients with gout. Higher K-GIS scores were associated with clinical characteristics leading to unfavorable outcomes, which were not demonstrated by the HAQ and EQ-5D.

Autonomic Dysfunction in Primary Sjogren’s Syndrome: A Prospective Cohort Analysi s

( Jung Hee Koh ),( Seung-ki Kwok ),( Jennifer Jooha Lee ),( Sung-hwan Park ) 대한내과학회 2015 대한내과학회 추계학술대회 Vol.2015 No.1

Background/Aims: To determine the prevalence of autonomic dysfunction among Korean patients with primary Sjogren’s syndrome (pSS) and its associations with the clinical features of pSS. Methods: We analyzed 154 participants from the Korean Initiative of primary Sjigren’s Syndrome (KISS) as a prospective pSS cohort and 154 age- and sex-matched healthy controls. A standardized 5-min, supine, resting heart rate variability (HRV) test was performed, and autonomic dysfunction was defined as standard deviation of normal-to-normal RR intervals (SDNN) <30 ms in patients <50 years old and SDNN <20 ms in patients ≥ 50 years old. The associations between autonomic dysfunction and various clinical features of pSS were analyzed. Results: The overall autonomic activity in patients with pSS was significantly lower than that in controls. Autonomic dysfunction with the HRV test was observed in 35.7% of the KISS participants and was associated with a higher European League Against Rheumatism Sjogren’s Syndrome Patient Reported Index fatigue score (p=0.024). Raynaud’s phenomenon was a more frequent clinical presentation in pSS patients with autonomic dysfunction than in those without autonomic dysfunction (29.4% and 14.4%, respectively; p=0.048). Decreased parasympathetic activity was observed in 41.6% of pSS patients. No differences were found in the oral and ocular signs of pSS according to the decreased parasympathetic activity. Conclusions: In Koreanpatients with pSS, decreased and imbalanced autonomic activity is prevalent and is associated with fatigue. However, an association between autonomic dysfunction and glandular manifestations was not detected.