Arvind Ganapati

All India Institute of Medical Sciences Mangalagiri · Rheumatology and Clinical Immunology

Background Conventional synthetic disease-modifying anti-rheumatic drugs (cs-DMARDs) remained the mainstay of treatment of Rheumatoid Arthritis for decades. However, their use in day-to-day practice has come down in the last few years due to the advent of Biologic DMARDs and Targeted Synthetic DMARDs(JAK Inhibitors). B-DAMRDs are inaccessible to mo...

Determine domain-based-outcomes and steroid-sparing efficacy of generic tofacitinib in IIM. This is a multicenter retrospective study wherein clinical phenotype, autoantibody profile, prior immunosuppressives, and outcomes at 3, 6, and 12 months were retrieved for IIM patients prescribed tofacitinib. Overall clinical response was assessed as comple...

Introduction: Tofacitinib has emerged as a therapeutic option for axial spondyloarthritis (axSpA) following successful clinical trials. The evidence on the efficacy of tofacitinib generics in the management of axSpA is limited. In India, the usage of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) is commonplace in the mana...

Evidence on agreement of point-of-care (POC) INR testing with laboratory testing in APS patients on oral anticoagulation (OAC), is scarce. This study assessed agreement of paired PT INR testing by a POC device vs. conventional platform-based laboratory test, in APS patients on OAC using a pre-determined definition of agreement. Simultaneous paired...

Introduction: Safety of rituximab (RTX) in autoimmune rheumatic diseases (AIRDs) has been a concern during this ongoing coronavirus (COVID-19) pandemic. Delayed worsening of COVID symptoms, increased hospital stays, and mortality has been reported among those infected post-RTX. This study describes the occurrence and course of COVID-19 infection am...

We report a series of 3 Adult-onset Still's disease (AOSD)-like presentations in previously healthy females following vaccination with the ChAdOx1 nCoV-19 vaccine, and also compare them with similar cases reported in literature through a PubMed database search. Our first patient had a high spiking bi-quotidian type of fever with myalgia, sore throa...

Immunoglobulin G4-related disease (IgG4-RD) is a systemic autoimmune disorder with a variety of manifestations. Association with other systemic autoimmune diseases is uncommonly reported in the literature. Hence, we intended to understand better the uniqueness of the overlapping associations of IgG4RD with other systemic autoimmune diseases. Retros...

Deficiency of adenosine deaminase 2 (DADA2) is a newly described entity of monogenic vasculitis with multisystem involvement and prominent neurological features. With this report, we are adding to the growing spectrum of cases of DADA2 with two adult cases of early-onset recurrent cerebrovascular events with multisystem involvement. These cases hig...

Background This study aimed to compare inflammation at the interphalangeal (IP) joint of thumb in patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), undifferentiated inflammatory arthritis (UIA), and in psoriasis patients without clinical arthritis (PsO) using low-field magnetic resonance imaging (MRI). Methods Age-matched and dis...

Background Consensus on treatment of idiopathic inflammatory myositis (IIM), particularly with regard to flares and interstitial lung disease (ILD), does not exist. We studied the long-term outcome and treatment response in our large, retrospective cohort of adult South-Asian patients exclusively with IIM.MethodologyElectronic records of IIM patien...

Objective Evaluation of response to combination conventional synthetic DMARD (csDMARD) therapy with methotrexate (MTX) and sulfasalazine (SSZ) in active axial spondyloarthritis (axSpA) patients without peripheral arthritis (group 1) as compared to active axSpA with peripheral arthritis (group 2), who are economically constrained for biologicals.Met...

Hyper-IgD syndrome (HIDS, OMIM #260920) is a rare autosomal recessive autoinflammatory disorder caused by pathogenic variants in the mevalonate kinase (MVK) gene. HIDS has an incidence of 1:50,000 to 1:5,000, and is thought to be prevalent mainly in northern Europe. Here, we report a case series of HIDS from India, which includes ten patients from...

Background Idiopathic inflammatory myositis (IIM) are a heterogeneous group of immune-mediated disorders with varied presentations and multiple organ involvement. Data on long term outcome among South Asian patients with IIM is sparse. Objectives To study the long term clinical outcome, treatment responses and factors predicting outcome among adul...

Background Anti-phospholipid syndrome (APS) is an important cause for recurrent pregnancy losses (RPL). Conventional APS antibodies (aPLs) like lupus anti-coagulant (LA), anti-cardiolipin(ACL) and anti-beta 2 glycoprotein I (anti-β2 GP I) are not present in significant number of obstetric APS(OAPS) patients, leading to a state described as “ sero-n...

Background: Impact of COVID-19 pandemic and consequential lockdown in India, on patients with chronic rheumatic diseases (CRD) pertaining these components of interest: (a) physical health, (b) mental health, (c) facets of social well-being, (d) health-care accessibility, and (e) COVID-19 related knowledge, attitude, and practices (KAP) was assessed...

Background: Reports signifying the utility of myeloid-related proteins (MRP) 8/14 in axial spondyloarthritis (AxSpA) as a theragnostic biomarker are scarce. Objectives: Evaluating the utility of serum MRP 8/14 (baseline levels and change from baseline to 3 months) in AxSpA as a predictor of Assessment of SpondyloArthritis International Society (ASA...

Systemic lupus erythematosus (SLE) and other autoimmune rheumatic diseases (AIRD) tend to co-aggregate in families, making positive familial history a risk factor. We aimed to estimate familial aggregation of AIRD in SLE patients and to compare between ones having a positive and negative family history of autoimmunity in our cohort. We included fam...

Antiphospholipid syndrome (APS) is the most common acquired pro-thrombotic disorder, also associated with obstetric complications. Phosphatidylserine/Prothrombin complex antibody (aPSPT) though associated with various APS manifestations, is not included in the revised Sapporo Criteria. To study the prevalence of aPSPT in Asian-Indian patients with...

Background: Deflazacort (DFZ), an oxazoline derivative of prednisolone (PDN), has a dose equivalence of 1.2:1 (mg) to PDN. No study to date has compared adverse effects and efficacy of high doses of DFZ as against high-dose PDN in systemic lupus erythematosus (SLE). Objectives: To compare adverse effects of high dose DFZ and PDN in SLE patients,...

Mycophenolate mofetil (MMF) is an effective therapeutic agent with high safety profile in the management of lupus nephritis. This retrospective study was conducted to assess the efficacy and side effect profile of MMF as induction as well as maintenance therapeutic agent along with tapering steroids in neuropsychiatric lupus (NPSLE). Hospital elect...

Background Rheumatoid vasculitis (RV) is a severe extra-articular manifestation of rheumatoid arthritis (RA), with high morbidity and mortality reported in literature Objectives To describe the Asian Indian perspective on RV patients, their clinico-laboratory features and their outcome along with the factors affecting them Methods A retrospective...

Background: To estimate the prevalence of rheumatic manifestations in HIV patients and to correlate with factors such as age, sex, duration of HIV infection, highly active antiretroviral therapy (HAART) regimen, duration of HAART, Hb%, ESR, CRP and CD4 cell count. Methods: The study involved 382 HIV patients attending a tertiary healthcare and ref...

The advent of biologic therapies has brought in significant improvement in the outcome of patients suffering from chronic inflammatory arthritis. High costs and unavailability have however, limited their utility in some parts of the world. These limitations have been overcome to a good extent by the introduction of biosimilar versions of original p...

Background and aims Deflazacort (DFZ), oxazoline prednisolone (PDN) derivative, has dose equivalence of 1.2:1 (mg) to PDN. No study has compared adverse effects and efficacy of high doses of DFZ and PDN, in SLE. Aims-To compare adverse effects of high dose DFZ and PDN in SLE patients concerning cushingoid features and body weight changes, 3 and 6 m...

Background and aims SLE and other auto-immune diseases (AID) tend to co-aggregate in families, making positive family history a risk factor for SLE. We aimed to calculate familial aggregation of rheumatic AIDs including SLE, in lupus pro-bands and to compare familial and sporadic lupus pro-bands in our cohort. Methods We studied families of 157 co...

Background and aims To explore utility of Antibodies to Phosphatidylserine/Prothrombin Complex (aPSPT), in Indian Anti phospholipid Syndrome (APS) patients. Methods Data of 372 subjects whose sera was tested for aPSPT by ELISA (AESUKU,GERMANY), was retrospectively analysed. Performance of various APLs was compared using non-parametric tests. To as...

Background: Association of myositis-specific (MSA) and myositis-associated (MAA) autoantibodies with clinical outcome is well known in idiopathic inflammatory myositis (IIM). Data on these autoantibodies in Indian patients are scarce. This retrospective study aims to establish the association between clinical disease manifestations and autoanti-bod...

Background: Association of myositis-specific (MSA) and myositis-associated (MAA) autoantibodies with clinical outcome is well known in idiopathic inflammatory myositis (IIM). Data on these autoantibodies in Indian patients are scarce. This retrospective study aims to establish the association between clinical disease manifestations and autoanti-bod...

Objective: To describe the nature of human immunodeficiency virus (HIV) associated stroke and further establish its etiopathogenesis Methods: A retrospective study of 19 patients of HIV associated stroke, admitted in Regional Institute of Medical Sciences, Imphal between November 2010 and November 2011. History was taken stressing importance on...

Systemic lupus erythematosus (SLE) is known for long to cause intracranial calcifications usually in the basal ganglia region. Fahr's disease is idiopathic striatopallidodentate nuclei calcification presenting with neuropsychiatric manifestations. We present a case of central nervous system(CNS) lupus with brain imaging mimicking Fahr's disease alo...

Objective: To study QTc interval prolongation as an independent predictor of cardiac mortality in patients with Type 2 Diabetes Mellitus (DM). Methods: A prospective study of 100 patients of Type 2 DM, comprising of 74 males and 26 females, age ranging from 30-75 years,were randomly selected and their 12 lead resting ECG was recorded and the QTc in...