nach oben

Current Rheumatology Reports

Erschienen in:

01.12.2017 | Orphan Diseases (B Manger, Section Editor)

Eosinophilic Fasciitis: an Updated Review on Diagnosis and Treatment

verfasst von: Daniel R. Mazori, Alisa N. Femia, Ruth Ann Vleugels

Erschienen in: Current Rheumatology Reports | Ausgabe 12/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

First recognized in 1974, eosinophilic fasciitis (EF) is a fibrosing disorder of the fascia with characteristic cutaneous and hematologic manifestations. This review discusses recent trends in the diagnosis and treatment of EF.

Recent Findings

Although fascial biopsy has classically been considered the gold standard for making a diagnosis of EF, radiologic imaging, particularly magnetic resonance imaging, has been increasingly used for both diagnosis and monitoring of treatment response. Systemic corticosteroids remain the first-line treatment for EF; however, their often prolonged use in the treatment of EF has prompted a search for adjunctive therapies. Methotrexate has emerged as the leading corticosteroid-sparing agent for EF.

Summary

Since EF was initially described over 40 years ago, important diagnostic and therapeutic progress has been made. Future efforts should be directed at the pursuit of prospective studies including clinical trials and evidence-based guidelines.

Shulman LE. Diffuse fasciitis with hypergammaglobulinemia and eosinophilia: a new syndrome? J Rheumatol. 1974;1(1):46.

Fruchter R, Mazori DR, Femia AN. Groove sign of eosinophilic fasciitis. J Clin Rheumatol. 2017;23(3):169. https://doi.org/10.1097/rhu.0000000000000524.CrossRefPubMed

Lakhanpal S, Ginsburg WW, Michet CJ, Doyle JA, Moore SB. Eosinophilic fasciitis: clinical spectrum and therapeutic response in 52 cases. Semin Arthritis Rheum. 1988;17(4):221–31.CrossRefPubMed

•• Wright NA, Mazori DR, Patel M, Merola JF, Femia AN, Vleugels RA. Epidemiology and treatment of eosinophilic fasciitis: an analysis of 63 patients from 3 tertiary care centers. JAMA Dermatol. 2016;152(1):97–9. https://doi.org/10.1001/jamadermatol.2015.3648. This study represents the largest EF cohort to date and found that treatment with the combination of systemic corticosteroids and methotrexate led to the best outcomes.CrossRefPubMed

Lebeaux D, Frances C, Barete S, Wechsler B, Dubourg O, Renoux J, et al. Eosinophilic fasciitis (Shulman disease): new insights into the therapeutic management from a series of 34 patients. Rheumatology (Oxford). 2012;51(3):557–61. https://doi.org/10.1093/rheumatology/ker366.CrossRef

•• Pinal-Fernandez I, Selva-O’ Callaghan A, Grau JM. Diagnosis and classification of eosinophilic fasciitis. Autoimmun Rev. 2014;13(4–5):379–82. https://doi.org/10.1016/j.autrev.2014.01.019. This review is the first to propose diagnostic criteria for EF.CrossRefPubMed

Endo Y, Tamura A, Matsushima Y, Iwasaki T, Hasegawa M, Nagai Y, et al. Eosinophilic fasciitis: report of two cases and a systematic review of the literature dealing with clinical variables that predict outcome. Clin Rheumatol. 2007;26(9):1445–51. https://doi.org/10.1007/s10067-006-0525-6.CrossRefPubMed

Peterson LS, Nelson AM, Su WP. Classification of morphea (localized scleroderma). Mayo Clin Proc. 1995;70(11):1068–76. https://doi.org/10.1016/s0025-6196(11)64442-x. CrossRefPubMed

Chung L, Lin J, Furst DE, Fiorentino D. Systemic and localized scleroderma. Clin Dermatol. 2006;24(5):374–92. https://doi.org/10.1016/j.clindermatol.2006.07.004.CrossRefPubMed

10.

Bielsa Marsol I. Update on the classification and treatment of localized scleroderma. Actas Dermosifiliogr. 2013;104(8):654–66. https://doi.org/10.1016/j.adengl.2012.10.012.CrossRefPubMed

11.

Guillevin L, Berezne A, Seror R, Teixeira L, Pourrat J, Mahr A, et al. Scleroderma renal crisis: a retrospective multicentre study on 91 patients and 427 controls. Rheumatology (Oxford). 2012;51(3):460–7. https://doi.org/10.1093/rheumatology/ker271.CrossRef

12.

Heidary N, Cheung W, Wang N, Kamino H, Franks AG Jr. Eosinophilic fasciitis/generalized morphea overlap. Dermatol Online J. 2009;15(8):2.PubMed

13.

• Gorcey L, Femia AN, Eastham AB, Gaviola G, Vleugels RA. The role of magnetic resonance imaging in the diagnosis of early eosinophilic fasciitis prior to the development of cutaneous findings. J Invest Dermatol. 2014;134(Supplement 1):S15. This case report describes the ability of MRI to contribute to the diagnosis of EF before the onset of cutaneous manifestations.

14.

Ergun T, Seckin D, Salman A, Ocak ES, Yucelten AD, Direskeneli H, et al. Atypical presentations of eosinophilic fasciitis. Indian J Dermatol Venereol Leprol. 2016;82(1):47–52. https://doi.org/10.4103/0378-6323.171010.CrossRefPubMed

15.

•• Kirchgesner T, Dallaudiere B, Omoumi P, Malghem J, Vande Berg B, Lecouvet F, et al. Eosinophilic fasciitis: typical abnormalities, variants and differential diagnosis of fasciae abnormalities using MR imaging. Diagn Interv Imaging. 2015;96(4):341–8. https://doi.org/10.1016/j.diii.2014.06.018. This review summarizes the MRI features of EF and outlines the differential diagnosis of EF on MRI.CrossRefPubMed

16.

De Clerck LS, Degryse HR, Wouters E, Van Offel JF, De Schepper AM, Martin JJ, et al. Magnetic resonance imaging in the evaluation of patients with eosinophilic fasciitis. J Rheumatol. 1989;16(9):1270–3.PubMed

17.

Baumann F, Bruhlmann P, Andreisek G, Michel BA, Marincek B, Weishaupt D. MRI for diagnosis and monitoring of patients with eosinophilic fasciitis. AJR Am J Roentgenol. 2005;184(1):169–74. https://doi.org/10.2214/ajr.184.1.01840169.CrossRefPubMed

18.

al-Shaikh A, Freeman C, Avruch L, McKendry RJ. Use of magnetic resonance imaging in diagnosing eosinophilic fasciitis. Report of two cases. Arthritis Rheum. 1994;37(11):1602–8.CrossRefPubMed

19.

Moulton SJ, Kransdorf MJ, Ginsburg WW, Abril A, Persellin S. Eosinophilic fasciitis: spectrum of MRI findings. AJR Am J Roentgenol. 2005;184(3):975–8. https://doi.org/10.2214/ajr.184.3.01840975.CrossRefPubMed

20.

Grados D, Martinez-Morillo M, Tejera B, Olive A. A comment on “from diagnosis to remission: place of MRI in eosinophilic fasciitis”. Clin Rheumatol. 2011;30(3):441–2. https://doi.org/10.1007/s10067-010-1670-5.CrossRefPubMed

21.

Chan V, Soans B, Mathers D. Ultrasound and magnetic resonance imaging features in a patient with eosinophilic fasciitis. Australas Radiol. 2004;48(3):414–7. https://doi.org/10.1111/j.0004-8461.2004.01331.x.CrossRefPubMed

22.

Desvignes-Engelbert A, Sauliere N, Loeuille D, Blum A, Chary-Valckenaere I. Polymyalgia revealing eosinophilic fasciitis in a young male: contribution of magnetic resonance imaging. Joint Bone Spine. 2010;77(4):367–8. https://doi.org/10.1016/j.jbspin.2010.04.008.CrossRefPubMed

23.

Ronneberger M, Janka R, Schett G, Manger B. Can MRI substitute for biopsy in eosinophilic fasciitis? Ann Rheum Dis. 2009;68(10):1651–2. https://doi.org/10.1136/ard.2008.103903.CrossRefPubMed

24.

• Kissin EY, Garg A, Grayson PC, Dubreuil M, Vradii D, York M, et al. Ultrasound assessment of subcutaneous compressibility: a potential adjunctive diagnostic tool in eosinophilic fasciitis. J Clin Rheumatol. 2013;19(7):382–5. https://doi.org/10.1097/rhu.0000000000000020. In the only ultrasound study on EF to date, ultrasound-measured tissue compressibility was found to be lowest in EF compared with other fibrosing and sclerosing disorders.CrossRefPubMed

25.

Mondal S, Goswami RP, Sinha D, Ghosh A. Ultrasound is a useful adjunct in diagnosis of eosinophilic fasciitis. Rheumatology (Oxford). 2015;54(11):2041. https://doi.org/10.1093/rheumatology/kev290. CrossRef

26.

Cheriet S, Chastan M, Levesque H, Marie I. Positron emission tomography in the diagnosis of eosinophilic fasciitis. QJM. 2011;104(11):987–8. https://doi.org/10.1093/qjmed/hcq218.CrossRefPubMed

27.

Kim HJ, Lee SW, Kim GJ, Lee JH. Usefulness of FDG PET/CT in the diagnosis of eosinophilic fasciitis. Clin Nucl Med. 2014;39(9):801–2. https://doi.org/10.1097/rlu.0000000000000260.CrossRefPubMed

28.

Marie I, Sauvetre G. Fluorodeoxyglucose positron emission tomography in eosinophilic fasciitis. Joint Bone Spine. 2014;81(6):541. https://doi.org/10.1016/j.jbspin.2014.07.001.CrossRefPubMed

29.

• Kurimoto R, Ikeda K, Nakagomi D, Nakajima H. Eosinophilic fasciitis illustrated by [(18)F] FDG-PET/CT. Intern Med. 2016;55(16):2321–2. https://doi.org/10.2169/internalmedicine.55.6937. In this case report, PET-CT facilitated the diagnosis of EF prior to the development of skin findings.CrossRefPubMed

30.

Farrington ML, Haas JE, Nazar-Stewart V, Mellins ED. Eosinophilic fasciitis in children frequently progresses to scleroderma-like cutaneous fibrosis. J Rheumatol. 1993;20(1):128–32.PubMed

31.

de Masson A, Bouaziz JD, Peffault de Latour R, Benhamou Y, Molucon-Chabrot C, Bay JO, et al. Severe aplastic anemia associated with eosinophilic fasciitis: report of 4 cases and review of the literature. Medicine (Baltimore). 2013;92(2):69–81. https://doi.org/10.1097/MD.0b013e3182899e78.CrossRef

32.

Naschitz JE, Misselevich I, Rosner I, Yeshurun D, Weiner P, Amar M, et al. Lymph-node-based malignant lymphoma and reactive lymphadenopathy in eosinophilic fasciitis. Am J Med Sci. 1999;318(5):343–9.PubMed

33.

Fleming CJ, Clarke P, Kemmett D. Eosinophilic fasciitis with myelodysplasia responsive to treatment with cyclosporin. Br J Dermatol. 1997;136(2):297–8.CrossRefPubMed

34.

Haddad H, Sundaram S, Magro C, Gergis U. Eosinophilic fasciitis as a paraneoplastic syndrome, a case report and review of the literature. Hematol Oncol Stem Cell Ther. 2014;7(2):90–2. https://doi.org/10.1016/j.hemonc.2013.12.003.CrossRefPubMed

35.

Laneuville P, Cyclosporin A. Induced remission of CD4+ T-CLL associated with eosinophilia and fasciitis. Br J Haematol. 1992;80(2):252–4.CrossRefPubMed

36.

Khanna D, Verity A, Grossman JM. Eosinophilic fasciitis with multiple myeloma: a new haematological association. Ann Rheum Dis. 2002;61(12):1111–2.CrossRefPubMedPubMedCentral

37.

Philpott H, Hissaria P, Warrren L, Singhal N, Brown M, Proudman S, et al. Eosinophilic fasciitis as a paraneoplastic phenomenon associated with metastatic colorectal carcinoma. Australas J Dermatol. 2008;49(1):27–9. https://doi.org/10.1111/j.1440-0960.2007.00415.x.CrossRefPubMed

38.

Frumholtz L, Sebert M, de Masson A, Attias P, Ades L, Roux J, et al. Efficacy of eculizumab against eosinophilic fasciitis associated with paroxysmal nocturnal haemoglobinuria. J Eur Acad Dermatol Venereol. 2016; https://doi.org/10.1111/jdv.13819.

39.

Sasaki K, Popat U, Jain P, Kadia T, Patel K, Patel K, et al. Successful treatment of aplastic anemia-paroxysmal nocturnal hemoglobinuria associated with eosinophilic fasciitis with matched unrelated donor allogeneic peripheral blood stem cell transplantation. Clin Case Rep. 2016;4(8):765–7. https://doi.org/10.1002/ccr3.613.CrossRefPubMedPubMedCentral

40.

Agnew KL, Blunt D, Francis ND, Bunker CB. Magnetic resonance imaging in eosinophilic fasciitis. Clin Exp Dermatol. 2005;30(4):435–6. https://doi.org/10.1111/j.1365-2230.2005.01753.x.CrossRefPubMed

41.

Liou CH, Huang GS, Taylor JA, Juan CJ, Gao HW, Chen CY. Eosinophilic fasciitis in a military recruit: MRI evaluation with clinical correlation. Skelet Radiol. 2003;32(1):52–7. https://doi.org/10.1007/s00256-002-0596-7.CrossRef

42.

Desvignes-Engelbert A, Sauliere N, Loeuille D, Blum A, Chary-Valckenaere I. From diagnosis to remission: place of MRI in eosinophilic fasciitis. Clin Rheumatol. 2010;29(12):1461–4. https://doi.org/10.1007/s10067-010-1508-1.CrossRefPubMed

43.

Nakajima H, Fujiwara S, Shinoda K, Ohsawa N. Magnetic resonance imaging and serum aldolase concentration in eosinophilic fasciitis. Intern Med. 1997;36(9):654–6.CrossRefPubMed

44.

Sugimoto T, Nitta N, Kashiwagi A. Usefulness of magnetic resonance imaging in eosinophilic fasciitis. Rheumatol Int. 2007;27(8):791–2. https://doi.org/10.1007/s00296-006-0302-5.CrossRefPubMed

45.

Silny W, Osmola-Mankowska A, Czarnecka-Operacz M, Zaba R, Danczak-Pazdrowska A, Marciniak A. Eosinophilic fascitis: a report of two cases treated with ultraviolet A1 phototherapy. Photodermatol Photoimmunol Photomed. 2009;25(6):325–7. https://doi.org/10.1111/j.1600-0781.2009.00463.x.CrossRefPubMed

46.

Janzen L, Jeffery JR, Gough J, Chalmers IM. Response to methotrexate in a patient with idiopathic eosinophilic fasciitis, morphea, IgM hypergammaglobulinemia, and renal involvement. J Rheumatol. 1995;22(10):1967–70.PubMed

47.

Pouplin S, Daragon A, Le Loet X. Treatment of eosinophilic fasciitis with methotrexate. J Rheumatol. 1998;25(3):606–7.PubMed

48.

•• Berianu F, Cohen MD, Abril A, Ginsburg WW. Eosinophilic fasciitis: clinical characteristics and response to methotrexate. Int J Rheum Dis. 2015;18(1):91–8. https://doi.org/10.1111/1756-185x.12499. This retrospective study demonstrated that methotrexate has corticosteroid-sparing and remittive effects in the treatment of EF.CrossRefPubMed

49.

•• Mertens JS, Zweers MC, Kievit W, Knaapen HK, Gerritsen M, Radstake TR, et al. High-dose intravenous pulse methotrexate in patients with eosinophilic fasciitis. JAMA Dermatol. 2016; https://doi.org/10.1001/jamadermatol.2016.2873. One of the few prospective studies on EF, this trial of intravenous pulse methotrexate showed a response in the majority of patients, with generally manageable adverse effects.

50.

Loupasakis K, Derk CT. Eosinophilic fasciitis in a pediatric patient. J Clin Rheumatol. 2010;16(3):129–31. https://doi.org/10.1097/RHU.0b013e3181d56f73.CrossRefPubMed

51.

Weber HO, Schaller M, Metzler G, Rocken M, Berneburg M. Eosinophilic fasciitis and combined UVA1—retinoid—corticosteroid treatment: two case reports. Acta Derm Venereol. 2008;88(3):304–6. https://doi.org/10.2340/00015555-0417. PubMed

52.

Schiener R, Behrens-Williams SC, Gottlober P, Pillekamp H, Peter RU, Kerscher M. Eosinophilic fasciitis treated with psoralen-ultraviolet A bath photochemotherapy. Br J Dermatol. 2000;142(4):804–7.CrossRefPubMed

53.

Horacek E, Sator PG, Gschnait F. Venous furrowing’: a clue to the diagnosis of eosinophilic fasciitis. A case of eosinophilic fasciitis ultimately treated with oral PUVA therapy. Dermatology. 2007;215(1):89–90. https://doi.org/10.1159/000102041. CrossRefPubMed

54.

Romano C, Rubegni P, De Aloe G, Stanghellini E, D'Ascenzo G, Andreassi L, et al. Extracorporeal photochemotherapy in the treatment of eosinophilic fasciitis. J Eur Acad Dermatol Venereol. 2003;17(1):10–3.CrossRefPubMed

55.

Minciullo PL, Morabito F, Mandaglio R, Iacopino P, Gangemi S. Eosinophilic fasciitis associated with autoimmune phenomena after bone marrow transplantation: report of two cases. Clin Rheumatol. 2006;25(1):80–2. https://doi.org/10.1007/s10067-005-1138-1.CrossRefPubMed

56.

Pileri A, Odorici G, Giudice V, Patrizi A, Bardazzi F. Bosentan and extracorporeal photochemotherapy in eosinophilic fasciitis: synergistic action or fortuitous coincidence? Int J Low Extrem Wounds. 2014;13(2):160–1. https://doi.org/10.1177/1534734614529651.CrossRefPubMed

57.

Pimenta S, Bernardes M, Bernardo A, Brito I, Castro L, Simoes-Ventura F. Intravenous immune globulins to treat eosinophilic fasciitis: a case report. Joint Bone Spine. 2009;76(5):572–4. https://doi.org/10.1016/j.jbspin.2009.06.001.CrossRefPubMed

58.

Bukiej A, Dropinski J, Dyduch G, Szczeklik A. Eosinophilic fasciitis successfully treated with cyclosporine. Clin Rheumatol. 2005;24(6):634–6. https://doi.org/10.1007/s10067-005-1099-4.CrossRefPubMed

59.

Hayashi N, Igarashi A, Matsuyama T, Harada S. Eosinophilic fasciitis following exposure to trichloroethylene: successful treatment with cyclosporin. Br J Dermatol. 2000;142(4):830–2.CrossRefPubMed

60.

Tahara K, Yukawa S, Shoji A, Hayashi H, Tsuboi N. Long-term remission by cyclosporine in a patient with eosinophilic fasciitis associated with primary biliary cirrhosis. Clin Rheumatol. 2008;27(9):1199–201. https://doi.org/10.1007/s10067-008-0912-2.CrossRefPubMed

61.

Valencia IC, Chang A, Kirsner RS, Kerdel FA. Eosinophilic fasciitis responsive to treatment with pulsed steroids and cyclosporine. Int J Dermatol. 1999;38(5):369–72.CrossRefPubMed

62.

Smith LC, Cox NH. Dapsone treatment for eosinophilic fasciitis. Arch Dermatol. 2008;144(7):845–7. https://doi.org/10.1001/archderm.144.7.845.CrossRefPubMed

63.

Alonso-Castro L, de las Heras E, Moreno C, Fleta-Asin B, Munoz-Zato E, Carrillo R, et al. Eosinophilic fasciitis/generalized morphea overlap successfully treated with azathioprine. Int J Dermatol. 2014;53(11):1386–8. https://doi.org/10.1111/j.1365-4632.2012.05741.x.CrossRefPubMed

64.

Caspi D, Fishel R, Varon M, Yona E, Baratz M, Yaron M. Multisystem presentation of eosinophilic fasciitis. Rheumatol Rehabil. 1982;21(4):218–21.CrossRefPubMed

65.

Drosou A, Kirsner RS, Welsh E, Sullivan TP, Kerdel FA. Use of infliximab, an anti-tumor necrosis alpha antibody, for inflammatory dermatoses. J Cutan Med Surg. 2003;7(5):382–6. https://doi.org/10.1007/s10227-002-0134-1.CrossRefPubMed

66.

Khanna D, Agrawal H, Clements PJ. Infliximab may be effective in the treatment of steroid-resistant eosinophilic fasciitis: report of three cases. Rheumatology (Oxford). 2010;49(6):1184–8. https://doi.org/10.1093/rheumatology/keq062.CrossRef

67.

Tzaribachev N, Holzer U, Schedel J, Maier V, Klein R, Kuemmerle-Deschner J. Infliximab effective in steroid-dependent juvenile eosinophilic fasciitis. Rheumatology (Oxford). 2008;47(6):930–2. https://doi.org/10.1093/rheumatology/ken142.CrossRef

68.

Poliak N, Orange JS, Pawel BR, Weiss PF. Eosinophilic fasciitis mimicking angioedema and treatment response to infliximab in a pediatric patient. Ann Allergy Asthma Immunol. 2011;106(5):444–5. https://doi.org/10.1016/j.anai.2011.01.021.CrossRefPubMed

69.

Scheinberg M, Hamerschlak N, Kutner JM, Ribeiro AA, Ferreira E, Goldenberg J, et al. Rituximab in refractory autoimmune diseases: Brazilian experience with 29 patients (2002-2004). Clin Exp Rheumatol. 2006;24(1):65–9.PubMed

70.

Oza VS, Walsh R, North J, Berger TG, Murase JE. Treatment of eosinophilic fasciitis with sirolimus. JAMA Dermatol. 2016;152(4):488–90. https://doi.org/10.1001/jamadermatol.2016.0048.CrossRefPubMed

71.

Espinoza F, Jorgensen C, Pers YM. Efficacy of tocilizumab in the treatment of eosinophilic fasciitis: report of one case. Joint Bone Spine. 2015;82(6):460–1. https://doi.org/10.1016/j.jbspin.2015.02.008.CrossRefPubMed

72.

• Mendoza FA, Bai R, Kebede AG, Jimenez SA. Severe eosinophilic fasciitis: comparison of treatment with D-penicillamine plus corticosteroids vs. corticosteroids alone. Scand J Rheumatol. 2016;45(2):129–34. https://doi.org/10.3109/03009742.2015.1067713. This double-arm trial reported improved outcomes, but greater adverse effects, with prednisone and d-penicillamine compared with prednisone alone.CrossRefPubMed

73.

Manzini CU, Sebastiani M, Giuggioli D, Manfredi A, Colaci M, Cesinaro AM, et al. D-penicillamine in the treatment of eosinophilic fasciitis: case reports and review of the literature. Clin Rheumatol. 2012;31(1):183–7. https://doi.org/10.1007/s10067-011-1866-3.CrossRefPubMed

Titel: Eosinophilic Fasciitis: an Updated Review on Diagnosis and Treatment
verfasst von: Daniel R. Mazori
Alisa N. Femia
Ruth Ann Vleugels
Publikationsdatum: 01.12.2017
Verlag: Springer US
Erschienen in: Current Rheumatology Reports / Ausgabe 12/2017
Print ISSN: 1523-3774
Elektronische ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-017-0700-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Eosinophilic Fasciitis: an Updated Review on Diagnosis and Treatment

Abstract

Purpose of Review

Recent Findings

Summary

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Costims – das nächste heiße Ding in der Krebstherapie?

Perioperative Checkpointhemmer-Therapie verbessert NSCLC-Prognose

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

Update Innere Medizin

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2017

Clinical Outcome and Long-term Remission in JIA

Can positive affect attenuate (persistent) pain? State of the art and clinical implications

The Microbiome and Bone and Joint Disease

Rheumatoid Arthritis-Associated Interstitial Lung Disease: Current Concepts

B Cell-Based Treatments in SLE: Past Experience and Current Directions

Renal Macrophages and Dendritic Cells in SLE Nephritis

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Costims – das nächste heiße Ding in der Krebstherapie?

Perioperative Checkpointhemmer-Therapie verbessert NSCLC-Prognose

Positiver FIT: Die Ursache liegt nicht immer im Dickdarm

GLP-1-Agonisten können Fortschreiten diabetischer Retinopathie begünstigen

Update Innere Medizin