1. Department of General Internal Medicine, National Hospital Organization Nagasaki Medical Center, Japan
2. Department of Rheumatology, National Hospital Organization Nagasaki Medical Center, Japan
3. Clinical Research Center, National Hospital Organization Nagasaki Medical Center, Japan
4. Department of Rheumatology, Sasebo City General Hospital, Japan
5. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan