title: Ultrasound evaluation of the effects of leukocytapheresis on rheumatoid arthritis.
abstract: 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 Doppler (PD) examination. Disease activity of RA was evaluated using the 28-joint Disease Activity Score 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.
authors.affiliation: Department of Internal Medicine (I), Osaka Medical College, Takatsuki-City, Osaka, Japan.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Yoshida
authors.forename: Tohru
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Maeda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kimura
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hata
authors.forename: Yuri
authors.initials: Y
authors.lastname: Hiramatsu
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shoda
authors.forename: Shigeki
authors.initials: S
authors.lastname: Makino
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hanafusa
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Shibahara
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler / Q000379:methods*
chemical_list: D002097:C-Reactive Protein
keywords: Leukocytapheresis; Musculoskeletal Ultrasound; Power Doppler; Rheumatoid Arthritis; Ultrasonography