Samy Metyas

Center for Rheumatology

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Daniel G. Arkfeld

University of Southern California

Francisco P. Quismorio

University of Southern California

Manjunath S. Vadmal

University of Southern California

M. Kokhab

LAC+USC Medical Center

Karina D. Torralba

Loma Linda University

D. Gale Johnson

Mayo Clinic Hospital

Deborah M. Forrester

University of Southern California

Andrew M. Ballester

Center for Rheumatology

Viktor Roschke

Crystal Pharmatech (United States)

Caroline Metyas

University of Southern California

Cooperative Institutions

University of Southern California

Center for Rheumatology

Los Angeles Medical Center

LAC+USC Medical Center

Keck Hospital of USC

Human Genome Sciences (United States)

National Institutes of Health

American Graduate University

Southern California University for Professional Studies

Loma Linda University

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Diet and Lifestyle Modifications for Fibromyalgia

Current Rheumatology Reviews (2024)

Caroline Metyas Tun Tun Aung Jennifer R. Cheung Marina Joseph Andrew M. Ballester

Abstract: Fibromyalgia (FM) is a complex, widespread pain disorder characterized by symptoms such as fatigue, sleep deprivation, mental fog, mood swings, and headaches. Currently, there are only three FDA-approved medications for FM patients: duloxetine, milnacipran, and pregabalin, with outcomes frequently being inadequate. This research team aims to investigate the effects of diet and lifestyle modifications on FM, with emphasis on anti-inflammatory diet, antioxidants, and gluten-free diets, as well as supplementation with Magnesium, CQ10, and Vitamin D, microbiome, sleep, exercise, and cognitive behavioral therapy. We reviewed the pathophysiology of certain foods that can be proinflammatory with the release of cytokines leading to activation of pain, fatigue and aggravation of the majority of Fibromyalgia symptoms. A literature review was performed by identifying FM articles published between 1994 and 2022 via PubMed and EMBASE databases, with particular emphasis on randomized controlled trials, meta-analysis, and evidence-based treatment guidelines. This review article was completed by a comprehensive narrative review process, in which our team systematically examined relevant scientific literature to provide a comprehensive overview of the significant role that diet and other lifestyle modifications play in mediating symptoms of Fibromyalgia. We propose that diet modifications and lifestyle changes, such as sleep, exercise, and weight loss, can be important steps in managing FM.

Pregabalin

Milnacipran

10.2174/0115733971274700231226075717

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Citations (9)

Inflammatory arthritis secondary to metastatic gastric cancer.

PubMed (2003)

Samy Metyas Christopher Lum Anwar Raza Marina Vaysburd Deborah M. Forrester

Metastatic spread of malignancy to the joints is rare and only a few cases of solid tumors have been reported. We describe a patient with inflammatory arthritis of the knee and ankle secondary to metastatic gastric adenocarcinoma to the joints and bone diagnosed by synovianalysis. Arthritis secondary to metastatic cancer is a poor prognostic sign. The diagnosis is based on a strong clinical suspicion, magnetic resonance imaging, and joint fluid cytology or synovial biopsy.

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271 CUTANEOUS REACTION PATTERNS ASSOCIATED WITH INFLIXIMAB THERAPY.

Journal of Investigative Medicine (2004)

M. Kokhab Karina D. Torralba Samy Metyas Manjunath S. Vadmal D. Gale Johnson

10.1136/jim-52-suppl1-271

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Infliximab Treatment of Familial Mediterranean Fever and Its Effect on Secondary AA Amyloidosis

JCR Journal of Clinical Rheumatology (2004)

Samy Metyas Daniel G. Arkfeld Deborah M. Forrester Glenn R. Ehresmann

We describe a patient with a long history of familial Mediterranean fever who developed proteinuria as a result of secondary AA amyloidosis. In this patient, the inflammatory process, including recurrent attacks of arthritis, abdominal pain, nephrotic syndrome secondary to amyloidosis, and high sedimentation rate, was rapidly suppressed by treatment with infliximab and there was remarkable improvement of the proteinuria.Because TNF-alpha is a proinflammatory cytokine that plays a major role in FMF and secondary amyloid, it is an appropriate target for therapy. Our case is the first case of reactive systemic amyloidosis secondary to familial Mediterranean fever, which responded favorably to infliximab.

AA amyloidosis

Erythrocyte sedimentation rate

10.1097/01.rhu.0000128856.13595.eb

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Citations (49)

B lymphocyte stimulator overexpression in patients with systemic lupus erythematosus: Longitudinal observations

Arthritis & Rheumatism (2003)

William Stohl Samy Metyas Soon‐Min Tan Gurtej S. Cheema Bonifacia Oamar

Abstract Objective To assess the overexpression of B lymphocyte stimulator (BLyS) over time in patients with systemic lupus erythematosus (SLE). Methods Sixty‐eight SLE patients were followed up longitudinally for a median 369 days. At each physician encounter, disease activity was assessed by the Systemic Lupus Erythematosus Disease Activity Index, and blood was collected for determination of the serum BLyS level, blood BLyS messenger RNA (mRNA) level, and cell surface BLyS expression. Twenty normal control subjects underwent similar laboratory evaluations. Results In contrast to the uniformly normal serum BLyS and blood BLyS mRNA phenotypes in control subjects, SLE patients displayed marked heterogeneity, with 50% and 61% of patients manifesting persistently or intermittently elevated serum BLyS and blood BLyS mRNA phenotypes, respectively. Surface BLyS expression by SLE peripheral blood mononuclear cells was also often increased. Treatment of patients who had elevated serum BLyS levels with intensive courses of high‐dose corticosteroids resulted in marked reductions in serum BLyS levels, and tapering of the corticosteroid dosage often resulted in increases in serum BLyS levels. Serum BLyS levels generally correlated with anti–double‐stranded DNA (anti‐dsDNA) titers (in those with detectable anti‐dsDNA titers), but changes in serum BLyS levels did not correlate with changes in disease activity in individual patients. Serum BLyS phenotype did not associate with specific organ system involvement. Conclusion Dysregulation of BLyS over extended periods of time is common in patients with SLE. Neutralization of BLyS activity with an appropriate BLyS antagonist may be therapeutically beneficial.

Belimumab

10.1002/art.11354

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Citations (482)

CUTANEOUS REACTION PATTERNS ASSOCIATED WITH INFLIXIMAB THERAPY.

Journal of Investigative Medicine (2004)

M. Kokhab Karina D. Torralba Samy Metyas Manjunath S. Vadmal D. Gale Johnson

10.1097/00042871-200401001-00271

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Citations (0)

Hip Arthroplasty in a 101-Year-Old Patient

JCR Journal of Clinical Rheumatology (2005)

Stephanie M. Lacson Samy Metyas Daniel G. Arkfeld

Division of Rheumatology; Department of Medicine; Keck School of Medicine of the University of Southern California; Los Angeles, California

Hip Arthroplasty

10.1097/01.rhu.0000165282.60312.04

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Anakinra prevents symptoms of familial cold autoinflammatory syndrome and Raynaud's disease.

PubMed (2006)

Samy Metyas Hal M. Hoffman

Familial cold autoinflammatory syndrome (FCAS) is a rare, hereditary disorder characterized by cold-induced inflammation. We describe the successful longterm treatment of a patient with FCAS with anakinra, an interleukin 1 receptor antagonist (IL-1Ra). The remarkable response of FCAS and associated Raynaud's disease in this patient suggests that IL-1 is an important mediator of these inflammatory diseases. Our report supports increasing evidence that anakinra plays an important role in the treatment of select chronic inflammatory diseases.

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Cutaneous Reaction Patterns Associated with Infliximab Therapy

Journal of Investigative Medicine (2001)

M. Kokhab Karina D. Torralba Samy Metyas Manjunath S. Vadmal D. Gale Johnson

10.1177/108155890105201s271

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Rheumatologic Manifestations of Post SARS-CoV-2 Infection: A Case Series

Current Rheumatology Reviews (2022)

Samy Metyas Christina Chen Tun Aung Andrew M. Ballester Sovanndy Cheav

Background: It has been over a year since the first documented case of the COVID-19 virus was recorded. Since then, our understanding of this virus has continually evolved, however, its wide-ranging effects are still unfolding. Similar to previously studied viral infections, severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has been shown to lead to a degree of autoimmunity in patients who are recovering from its effects. Due to its effects on the innate im-mune system, such as the toll-like receptors and complement system, a varying degree of pro-inflammatory markers can become widespread in those who continue to recover from the virus. This case series offers a unique perspective on how COVID-19 has had dramatic effects on those already suffering from inflammatory rheumatic conditions, such as rheumatoid arthritis, systemic lupus erythematosus, or fibromyalgia. As the ever-lasting effects of COVID-19 are still unfolding, this case series is one of few to discuss the development and changes of patients with rheumatic conditions. This study hopes to encourage larger studies to be conducted on the effects of COVID-19 on autoimmune conditions. Case presentation: Seven patients were identified with new manifestations of rheumatic conditions, which included 3 cases of rheumatoid arthritis, 2 cases of polymyalgia rheumatica, 1 case of reac-tive arthritis, and 1 case of cutaneous lupus. Post-COVID syndrome was also diagnosed in 7 other patients. Patients with rheumatoid arthritis presented with symptoms 4-5 weeks after being diagnosed with COVID-19. Symptoms of polyarticular joint pain, swelling, and morning stiffness were reported in this group. These patients were treated with disease-modifying anti-rheumatic drugs and experi-enced an improvement in symptoms on follow-up. Two cases of polymyalgia rheumatica were identified in patients that were previously diagnosed with COVID-19 six weeks prior. One patient had no significant past medical history and the other patient had a history of rheumatoid arthritis, which was well controlled. These patients experienced weakness and tenderness in the proximal joints with elevated levels of ESR and CRP. They were treated with prednisone and showed improvement. Reactive arthritis was diagnosed in 1 patient who presented with swelling in both hands and wrists 2 days after being diagnosed with COVID-19. This patient began to experience symptoms of reac-tive arthritis 2 days after resolution of initial COVID-19 symptoms and this persisted for 3 months. The patient was managed with methylprednisolone injections and NSAIDs, which improved her symptoms. Post-COVID syndrome was identified in 7 patients. All patients were female and had a history of well-controlled fibromyalgia. Patients generally experienced fatigue, headaches, and memory fog, which had variable onset from a few days and up to 4 weeks after being diagnosed with COVID-19. One patient had a complete recovery of her symptoms at follow-up 3 months after the initial presen-tation. The other 6 patients continued to report symptoms of post-COVID syndrome at follow-up. Patients were managed with lifestyle modifications and their previous fibromyalgia treatment. Conclusion: While cases of COVID-19 continue to rise, complications of this disease are still being discovered. Those who initially recover from COVID-19 may experience new-onset rheumatic con-ditions, worsening of previously diagnosed rheumatic conditions, or post-COVID syndrome. As we continue to learn more about the effects of COVID-19, the awareness of these manifestations will play a key role in the appropriate management of these patients.

Reactive arthritis

Polymyalgia rheumatica

Proinflammatory cytokine

10.2174/1573397118666220211155716

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Citations (22)