1. Department of General Internal Medicine, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
2. Department of Rheumatology, Sasebo City General Hospital, Sasebo, Japan;
3. Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
4. Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
5. Rheumatic and Collagen Disease Center, Sasebo Chuo Hospital, Sasebo, Japan;
6. Department of Surgery, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
7. Department of Hematology, National Hospital Organization Nagasaki Medical Center, Omura, Japan;
8. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan