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Drynda A, Padjas A, Wójcik K, Dziedzic R, Biedroń G, Wawrzycka-Adamczyk K, Włudarczyk A, Wilańska J, Musiał J, Zdrojewski Z, Czuszyńska Z, Masiak A, Majdan M, Jeleniewicz R, Augustyniak-Bartosik H, Jakuszko K, Krajewska M, Dębska-Ślizień A, Storoniak H, Bułło-Piontecka B, Tłustochowicz W, Kur-Zalewska J, Wisłowska M, Głuszko P, Madej M, Jassem E, Damps-Konstańska I, Kucharz E, Brzosko M, Milchert M, Hawrot-Kawecka A, Miłkowska-Dymanowska J, Górski P, Lewandowska-Polak A, Makowska J, Zalewska J, Zaręba L, Bazan-Socha S. Clinical Characteristics of EGPA Patients in Comparison to GPA Subgroup with Increased Blood Eosinophilia from POLVAS Registry. J Immunol Res 2024; 2024:4283928. [PMID: 38699219 PMCID: PMC11065486 DOI: 10.1155/2024/4283928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/26/2024] [Accepted: 04/06/2024] [Indexed: 05/05/2024] Open
Abstract
Objective To characterize the eosinophilic granulomatosis with polyangiitis (EGPA) population from the POLVAS registry depending on ANCA status and diagnosis onset, including their comparison with the granulomatosis with polyangiitis (GPA) subset with elevated blood eosinophilia (min. 400/μl) (GPA HE) to develop a differentiating strategy. Methods A retrospective analysis of the POLVAS registry. Results The EGPA group comprised 111 patients. The ANCA-positive subset (n = 45 [40.54%]) did not differ from the ANCA-negative one in clinics. Nevertheless, cardiovascular manifestations were more common in ANCA-negative patients than in those with anti-myeloperoxidase (MPO) antibodies (46.97% vs. 26.92%, p = 0.045). Patients diagnosed before 2012 (n = 70 [63.06%]) were younger (median 41 vs. 49 years, p < 0.01), had higher blood eosinophilia at diagnosis (median 4,946 vs. 3,200/μl, p < 0.01), and more often ear/nose/throat (ENT) and cardiovascular involvement. GPA HE comprised 42 (13.00%) out of 323 GPA cases with reported blood eosinophil count. Both GPA subsets had a lower prevalence of respiratory, cardiovascular, and neurologic manifestations but more often renal and ocular involvement than EGPA. EGPA also had cutaneous and gastrointestinal signs more often than GPA with normal blood eosinophilia (GPA NE) but not GPA HE. The model differentiating EGPA from GPA HE, using ANCA status and clinical manifestations, had an AUC of 0.92, sensitivity of 96%, and specificity of 95%. Conclusion Cardiovascular symptoms were more prevalent in the ANCA-negative subset than in the MPO-ANCA-positive one. Since EGPA and GPE HE share similarities in clinics, diagnostic misleading may result in an inappropriate therapeutic approach. Further studies are needed to optimize their differentiation and tailored therapy, including biologics.
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Affiliation(s)
- Anna Drynda
- Students' Scientific Group of Immune Diseases and Hypercoagulation, Jagiellonian University Medical College, Cracow, Poland
| | - Agnieszka Padjas
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Krzysztof Wójcik
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Radosław Dziedzic
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Grzegorz Biedroń
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | | | - Anna Włudarczyk
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Joanna Wilańska
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Jacek Musiał
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Maria Majdan
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland
| | - Radosław Jeleniewicz
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Lublin, Poland
| | | | - Katarzyna Jakuszko
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Hanna Storoniak
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Barbara Bułło-Piontecka
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Witold Tłustochowicz
- Department of Internal Medicine and Rheumatology, Military Medical Institute, Warsaw, Poland
| | - Joanna Kur-Zalewska
- Department of Internal Medicine and Rheumatology, Military Medical Institute, Warsaw, Poland
| | - Małgorzata Wisłowska
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Piotr Głuszko
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa Jassem
- Department of Allergology, Medical University of Gdansk, Gdansk, Poland
| | | | - Eugeniusz Kucharz
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
| | - Marek Brzosko
- Department of Rheumatology, Internal Medicine, Diabetology, Geriatrics and Clinical Immunology with the Gastroenterology Unit, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Marcin Milchert
- Department of Rheumatology, Internal Medicine, Diabetology, Geriatrics and Clinical Immunology with the Gastroenterology Unit, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Anna Hawrot-Kawecka
- Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland
| | | | - Paweł Górski
- Department of Pneumology, Chair of Internal Medicine, Medical University of Lodz, Lodz, Poland
| | | | - Joanna Makowska
- Department of Rheumatology, Medical University of Lodz, Lodz, Poland
| | - Joanna Zalewska
- Department of Rheumatology and Connective Tissue Diseases, Ludwik Rydygier Collegium Medicum in Bydgoszcz of the Nicolaus Copernicus University in Torun, Bydgoszcz, Poland
| | - Lech Zaręba
- Institute of Computer Science, College of Natural Sciences, University of Rzeszow, Rzeszow, Poland
| | - Stanisława Bazan-Socha
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Cracow, Poland
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Filipowicz G, Wajda A, Stypińska B, Kmiołek T, Felis-Giemza A, Stańczyk S, Czuszyńska Z, Walczyk M, Olesińska M, Paradowska-Gorycka A. Mixed Connective Tissue Disease as Different Entity: Global Methylation Aspect. Int J Mol Sci 2023; 24:15495. [PMID: 37895173 PMCID: PMC10607312 DOI: 10.3390/ijms242015495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023] Open
Abstract
Mixed connective tissue disease (MCTD) is a very rare disorder that belongs in the rare and clinically multifactorial groups of diseases. The pathogenesis of MCTD is still unclear. The best understood epigenetic alteration is DNA methylation whose role is to regulate gene expression. In the literature, there are ever-increasing assumptions that DNA methylation can be one of the possible reasons for the development of Autoimmune Connective Tissue Diseases (ACTDs) such as systemic sclerosis (SSc) and systemic lupus erythematosus (SLE). The aim of this study was to define the global DNA methylation changes between MCTD and other ACTDs patients in whole blood samples. The study included 54 MCTD patients, 43 SSc patients, 45 SLE patients, and 43 healthy donors (HC). The global DNA methylation level was measured by ELISA. Although the global DNA methylation was not significantly different between MCTD and control, we observed that hypomethylation distinguishes the MCTD patients from the SSc and SLE patients. The present analysis revealed a statistically significant difference of global methylation between SLE and MCTD (p < 0.001), SLE and HC (p = 0.008), SSc and MCTD (p ≤ 0.001), and SSc and HC (p < 0.001), but neither between MCTD and HC (p = 0.09) nor SSc and SLE (p = 0.08). The highest % of global methylation (median, IQR) has been observed in the group of patients with SLE [0.73 (0.43, 1.22] and SSc [0,91 (0.59, 1.50)], whereas in the MCTD [0.29 (0.20, 0.54)], patients and healthy subjects [0.51 (0.24, 0.70)] were comparable. In addition, our study provided evidence of different levels of global DNA methylation between the SSc subtypes (p = 0.01). Our study showed that patients with limited SSc had a significantly higher global methylation level when compared to diffuse SSc. Our data has shown that the level of global DNA methylation may not be a good diagnostic marker to distinguish MCTD from other ACTDs. Our research provides the groundwork for a more detailed examination of the significance of global DNA methylation as a distinguishing factor in patients with MCTD compared to other ACTDs patients.
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Affiliation(s)
- Gabriela Filipowicz
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland; (G.F.)
| | - Anna Wajda
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland; (G.F.)
| | - Barbara Stypińska
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland; (G.F.)
| | - Tomasz Kmiołek
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland; (G.F.)
| | - Anna Felis-Giemza
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland (S.S.)
| | - Sandra Stańczyk
- Biologic Therapy Center, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland (S.S.)
| | - Zenobia Czuszyńska
- Department of Rheumatology, Clinical Immunology, Geriatrics and Internal Medicine, Medical University of Gdansk, Smulochowskiego 17, 80-214 Gdansk, Poland
| | - Marcela Walczyk
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Marzena Olesińska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland
| | - Agnieszka Paradowska-Gorycka
- Department of Molecular Biology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Spartanska 1, 02-637 Warsaw, Poland; (G.F.)
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Saletra A, Meenakshi J, Fronczyk K, Czuszyńska Z, Sierakowska M, Szmyrka M, Olesińska M. AB1490 THE POLISH VALIDATION OF A DISEASE SPECIFIC PATIENT REPORTED OUTCOME MEASURE OF SYSTEMIC LUPUS ERYTHEMATOSUS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.5335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundSystemic Lupus Erythematosus (SLE) is a chronic multisystemic autoimmune disease with a very broad clinical picture. Due to its generalized nature, it affects all aspects of the patient’s life, such as physical, psychological and social well-being. As a result, the quality of life in patients with SLE is substantially decreased. Therefore, it is recommended to introduce evaluation of quality of life in clinical trials and in the daily practice.LupusPRO is a disease-targeted, patient reported outcome measure developed for assessment of quality of life in patients with Systemic Lupus Erythematosus. Originally, the questionnaire was validated among US patients of varied ethnic background and both genders.What differs LupusPRO from previous disease-specific quality of life questionnaire used in SLE is its comprehensiveness. It comprises two constructs: health- related quality of life domains (HRQOL) and non- health - related quality of life domains.ObjectivesThe aim of this study is to carry out a cross-cultural adaptation and validation of the Polish-translated version of LupusPRO.MethodsThe Polish version of LupusPRO was administrated along with the 36-Item Short Form Health Survey (SF-36) and EQ-5D-5L questionnaire and Hospital Anxiety and Depression Scale (HADS). At the same time, demographics and clinical characteristics were collected. Disease activity, damage and exacerbation were assessed using SELENA-SLEDAI, SLICC/ACR DI and LFA Flare. Internal consistency reliability, test-retest reliability, convergent validity (against corresponding domains of SF-36) and criterion validity (against disease activity and damage) and known group validity were tested.ResultsA total of 199 (91% females) patients with SLE with a mean age of 42.6 ⊥12.62 years participated in the study. The mean SELENA-SLEDAI reached 5.3(⊥ 5.9) points and SLICC/ACR DI was observed at 1.3(⊥ 2.0) points. The internal consistency reliability of LupusPRO domains ranged between 0.737-0.925 (except for Lupus Symptoms, Social Support, Coping and Satisfaction with care). For all domains, except Social Support, test-retest reliability exceeded 0.7. Convergent validity with corresponding domains of the SF-36 was good (r>0,5). All health-related quality of life domains performed well against disease activity and damage measure, establishing its criterion validity. Known group validity against disease activity was observed. Confirmatory factor analysis showed a good fit.ConclusionThe Polish version of LupusPRO has proved to have fair psychometric properties among Polish patients with SLE. It is the first disease-specific quality of life questionnaire in Polish, validated among Polish patients with Systemic Lupus Erythematosus.References[1]Jolly M, Pickard AS, Block JA et al. Disease-specific patient reported outcome tools for systemic lupus erythematosus. Semin Arthritis Rheum. 2012: 42(1): 56-65. doi:10.1016/j.semarthrit.2011.12.005.Disclosure of InterestsNone declared
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Felis-Giemza A, Ornowska S, Haładyj E, Czuszyńska Z, Olesińska M. Relationship between type of skin lesions and nailfold capillaroscopy pattern in mixed connective tissue disease. Clin Rheumatol 2022; 41:281-288. [PMID: 34370129 PMCID: PMC8724086 DOI: 10.1007/s10067-021-05717-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/20/2021] [Accepted: 03/23/2021] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Mixed connective tissue disease (MCTD) is a rare disease with clinical picture consisted of multiple organ manifestations, including skin changes resembling systemic lupus erythematosus (SLE), systemic sclerosis (SSc), or dermatomyositis (DM). On the background of these manifestations are microvascular changes - alteration of endothelial function and impairment of endothelial progenitor cell. Nailfold capillaroscopy (NFC) is a simple, non-invasive technique for investigating microvascular involvement in rheumatic diseases. OBJECTIVES To describe the relationship between type of skin lesions and NFC pattern in MCTD patients. METHODS We analyzed the clinical picture and NFC patterns in 79 patients with MCTD. The NFC changes were classified into Normal, "Early," "Active," and "Late" scleroderma-like patterns (SD-like pattern) based on Cutolo classification. In all patients, subjective and physical examinations were carried out, specifically the occurrence of skin lesions in the course of MCTD was assessed (systemic sclerosis-like (Ssc-like), systemic lupus erythematosus-like (SLE-like), dermatomysitis-like (DM-like)). RESULTS Skin changes were present in 64 (81%) patients, involving 43 (54%) SLE-like, 48 (61%) SSc-like, and 4 (5.1%) DM-like. NFC changes were observed in a total of 55 (69.6 %) patients with predominance of the "Early" pattern - 41 (51.9 %) patients. According to skin change phenotypes, NFC changes were observed in 31 (72%) patients with SLE-like and in 32 (66.7%) patients with SSc-like skin phenotypes. The "early" pattern predominated in both group. CONCLUSIONS We did not find any correlation between NFC pattern and the type skin changes. Key Points • The study did not show a correlation between the presence and absence of skin lesions and NFC pattern. • Scleroderma-like patterns were found in over 60% of patients with mixed connective tissue disease. • The "early" pattern is dominant regardless of the occurrence or absence of skin lesions in patients with MCTD. • Skin lesions, regardless of their type (SLE or SSc), do not correlate with type of lesion found in the NFC examination.
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Affiliation(s)
- Anna Felis-Giemza
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Sylwia Ornowska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Ewa Haładyj
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Marzena Olesińska
- Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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Wójcik K, Biedroń G, Wawrzycka-Adamczyk K, Bazan-Socha S, Ćmiel A, Zdrojewski Z, Masiak A, Czuszyńska Z, Majdan M, Jeleniewicz R, Klinger M, Krajewska M, Kusztal M, Brzosko M, Iwona B, Dębska-Ślizień A, Storoniak H, Bułło-Piontecka B, Tłustochowicz W, Kur-Zalewska J, Wisłowska M, Madej M, Hawrot-Kawecka A, Głuszko P, Stasiek M, Kucharz E, Musiał J. Subphenotypes of ANCA-associated vasculitis identified by latent class analysis. Clin Exp Rheumatol 2021; 39 Suppl 129:62-68. [DOI: 10.55563/clinexprheumatol/d01o72] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/08/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Krzysztof Wójcik
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Biedroń
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Stanisława Bazan-Socha
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Ćmiel
- Department of Applied Mathematics, AGH University of Science and Technology, Kraków, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
| | - Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
| | - Maria Majdan
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Poland
| | - Radosław Jeleniewicz
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Poland
| | - Marian Klinger
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland
| | - Mariusz Kusztal
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Poland
| | - Marek Brzosko
- Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Poland
| | - Brzosko Iwona
- Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Poland
| | - Hanna Storoniak
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Poland
| | - Barbara Bułło-Piontecka
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Poland
| | - Witold Tłustochowicz
- Department of Internal Medicine and Rheumatology, Military Medicine Institute, Warsaw, Poland
| | - Joanna Kur-Zalewska
- Department of Internal Medicine and Rheumatology, Military Medicine Institute, Warsaw, Poland
| | - Małgorzata Wisłowska
- Department of Internal Diseases and Rheumatology, Central Clinical Hospital of the Ministry of the Interior and
Administration, Warsaw, Poland
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Anna Hawrot-Kawecka
- Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland
| | - Piotr Głuszko
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Małgorzata Stasiek
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Eugeniusz Kucharz
- Department of Internal Medicine and Rheumatology, Medical University of Silesia, Katowice, Poland
| | - Jacek Musiał
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland.
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Biedroń G, Włudarczyk A, Wawrzycka-Adamczyk K, Wójcik K, Musiał J, Bazan-Socha S, Zdrojewski Z, Masiak A, Czuszyńska Z, Majdan M, Jeleniewicz R, Klinger M, Krajewska M, Augustyniak-Bartosik H, Jakuszko K, Brzosko M, Brzosko I, Dębska-Ślizień A, Storoniak H, Bułło-Piontecka B, Tłustochowicz W, Kur-Zalewska J, Wisłowska M, Madej M, Hawrot-Kawecka A, Głuszko P, Kucharz EJ, Szczeklik W. Respiratory involvement in antineutrophil cytoplasmic antibody-associated vasculitides: a retrospective study based on POLVAS registry. Clin Exp Rheumatol 2021; 40:720-726. [DOI: 10.55563/clinexprheumatol/tvtyen] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Grzegorz Biedroń
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anna Włudarczyk
- Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Krzysztof Wójcik
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jacek Musiał
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Stanisława Bazan-Socha
- 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
| | - Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Poland
| | - Maria Majdan
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Poland
| | - Radosław Jeleniewicz
- Department of Rheumatology and Connective Tissue Diseases, Medical University of Lublin, Poland
| | - Marian Klinger
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, and Department of Nephrology and Internal Medicine, University of Opole, Poland
| | - Magdalena Krajewska
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | | | - Katarzyna Jakuszko
- Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Marek Brzosko
- Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Poland
| | - Iwona Brzosko
- Department of Rheumatology and Internal Diseases, Pomeranian Medical University in Szczecin, Poland
| | - Alicja Dębska-Ślizień
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Poland
| | - Hanna Storoniak
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Poland
| | - Barbara Bułło-Piontecka
- Department of Nephrology, Transplantology and Internal Diseases, Medical University of Gdańsk, Poland
| | - Witold Tłustochowicz
- Department of Internal Medicine and Rheumatology, Military Institute of Medicine, Warszawa, Poland
| | - Joanna Kur-Zalewska
- Department of Internal Medicine and Rheumatology, Military Institute of Medicine, Warszawa, and Clinical Research Support Centre, Military Institute of Medicine, Warszawa, Poland
| | - Małgorzata Wisłowska
- Department of Internal Diseases and Rheumatology, Central Clinical Hospital of the Ministry of the Interior and Administration, Warszawa, Poland
| | - Marta Madej
- Department of Rheumatology and Internal Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Anna Hawrot-Kawecka
- Department of Internal Medicine and Metabolic Diseases, Medical University of Silesia, Katowice, Poland
| | - Piotr Głuszko
- Department of Rheumatology, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warszawa, Poland
| | - Eugeniusz J. Kucharz
- Department of Internal Medicine, Rheumatology and Clinical Immunology, Medical University of Silesia, Katowice, Poland
| | - Wojciech Szczeklik
- Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland.
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Jaskólska M, Chylińska M, Masiak A, Siemiński M, Ziętkiewicz M, Czuszyńska Z, Smoleńska Ż, Zdrojewski Z. Neuro-Sjögren: Uncommon or underestimated problem? Brain Behav 2020; 10:e01665. [PMID: 32583978 PMCID: PMC7428478 DOI: 10.1002/brb3.1665] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Sjögren's syndrome (SS) is a chronic inflammatory disease with an autoimmune background with possible complications from peripheral (PNS) and central nervous system (CNS). The aim of this study was to assess the prevalence and to describe the phenotype of peripheral neuropathies in patients with SS. MATERIALS & METHODS We studied fifty patients with primary Sjögren's syndrome for peripheral nervous system involvement. All patients underwent neurological and rheumatological examination followed by nerve conduction studies (NCS) of nine peripheral nerves. RESULTS Thirty-six patients (72%) fulfilled the criteria for the diagnosis of neuropathy. Carpal tunnel syndrome (54%) and axonal sensorimotor neuropathy (22%) were the most common. Neurological symptoms preceded the diagnosis of SS in eight patients. CONCLUSIONS Peripheral neuropathies are frequent in SS patients. Neurologists should be aware of possible autoimmune causes of neuropathies because clinical manifestations of neuropathy may precede the development of other symptoms of the autoimmune disease.
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Affiliation(s)
- Marta Jaskólska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | | | - Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Mariusz Siemiński
- Department of Adult Neurology, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Ziętkiewicz
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Żaneta Smoleńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdansk, Poland
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Gałąska R, Masiak A, Kulawiak-Gałąska D, Czuszyńska Z, Dorniak K, Fijałkowski M. Reactive arthritis-associated aortitis followed by Yersinia Enterocolitica infection: Multimodal imaging. Cardiol J 2020; 26:298-299. [PMID: 31246268 DOI: 10.5603/cj.2019.0060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/25/2022] Open
Affiliation(s)
- Rafał Gałąska
- 1st Department of Cardiology, Medical University of Gdansk, Poland.
| | - Anna Masiak
- Chair and Department of Internal Diseases, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Poland
| | | | - Zenobia Czuszyńska
- Chair and Department of Internal Diseases, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Poland
| | - Karolina Dorniak
- Department of Noninvasive Cardiac Diagnostics, Medical University of Gdansk, Poland
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Jaskólska M, Chylińska M, Masiak A, Nowicka-Sauer K, Siemiński M, Ziętkiewicz M, Czuszyńska Z, Zdrojewski Z. Peripheral neuropathy and health-related quality of life in patients with primary Sjögren's syndrome: a preliminary report. Rheumatol Int 2020; 40:1267-1274. [PMID: 32172462 PMCID: PMC7316843 DOI: 10.1007/s00296-020-04543-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/27/2020] [Indexed: 12/20/2022]
Abstract
Sjögren's syndrome (SS) is a chronic autoimmune disease with a wide spectrum of possible organ involvement. Peripheral (PNS) and central nervous system (CNS)-related symptoms may occur in the course of the disease. The aim of this study was to compare the health-related quality of life (HR-QOL) in SS patients with and without peripheral neuropathy. The study involved 50 patients with primary Sjögren's syndrome (pSS). All patients underwent neurological clinical examination followed by nerve conduction studies (NCS) and rheumatological examination. Thirty-six-item Short Form Health Survey (SF-36) was used for evaluating HR-QOL. To assess pSS activity, the EULAR Sjögren's Syndrome Disease Activity Index (ESSDAI) and EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) were used. For the assessment of clinical disability due to peripheral neuropathy, the Overall Disability Sum Score scale (ODSS) was used. Additional evaluation of pain was performed with the use of the Visual Analogue Scale (VAS) and a semistructured interview. Twenty-three (46%) patients were diagnosed with peripheral neuropathy. The most common PNS manifestation was sensorimotor neuropathy (47%). Neurological symptoms preceded the diagnosis of pSS in eight patients. The following domains of the SF-36 form were significantly lower scored by patients with peripheral nervous system involvement: role-physical [0 (0-100) vs. 75 (0-100)], role-emotional [67 (0-100) vs. 100 (0-100)], vitality [40 (10-70) vs. 50 (20-75)], bodily pain [45 (10-75) vs. 55 (0-100)], and general health [20 (5-50) vs. 30 (0-50)] (p ≤ 0.05). Our study showed that peripheral neuropathy was a common organ-specific complication in SS patients. In pSS patients, coexisting neurological involvement with symptoms such as pain and physical disability may be responsible for diminished HR-QOL.
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Affiliation(s)
- Marta Jaskólska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland.
| | | | - Anna Masiak
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
| | | | - Mariusz Siemiński
- Department of Adult Neurology, Medical University of Gdansk, Gdańsk, Poland
| | - Marcin Ziętkiewicz
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
| | - Zenobia Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
| | - Zbigniew Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdansk, Gdańsk, Poland
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10
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Nowicka-Sauer K, Hajduk A, Kujawska-Danecka H, Banaszkiewicz D, Smoleńska Ż, Czuszyńska Z, Siebert J. Illness perception is significantly determined by depression and anxiety in systemic lupus erythematosus. Lupus 2018; 27:454-460. [PMID: 29325492 DOI: 10.1177/0961203317751858] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objectives Illness perception is a cognitive representation influencing physical and psychological functioning and adherence in patients with rheumatic disease. Studies exploring illness perception in systemic lupus erythematosus (SLE) are still scarce and none of them have investigated factors determining illness perception. We aimed to assess illness perception and to identify psychological, clinical and sociodemographic factors that might influence illness perception in SLE. Methods The study involved 80 patients with SLE (87.5% women, mean age 41.56 years). The Brief Illness Perception Questionnaire, State Trait Anxiety Inventory, Beck Depression Inventory, Pittsburgh Sleep Quality Index, Visual Analogue Scale-Pain and Fatigue Severity Scale were used. Clinical and sociodemographic data were collected via structured interview and medical files review. Results Illness perception was significantly positively correlated with anxiety, depression, sleep quality, fatigue and pain while it was not related to age, education, steroid treatment, disease duration and activity (SLEDAI) or organ damage (SLICC/ACR). Regression analysis revealed that state anxiety and depression explained 43% of illness perception variance. Cluster analysis identified three patient groups among which the middle-aged group had the most negative illness perception, the highest levels of anxiety, depression, pain and fatigue, and the poorest sleep quality. Conclusions The study has proved a significant relationship between negative illness perception and anxiety and depression. Patients reporting fatigue, poor sleep and pain might have special needs in terms of psychological intervention focused on negative illness perception and distress symptoms. Multidisciplinary care in managing SLE seems to be of great importance.
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Affiliation(s)
- K Nowicka-Sauer
- 1 Department of Family Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - A Hajduk
- 2 Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, University Clinical Centre, Medical University of Gdańsk, Gdańsk, Poland
| | - H Kujawska-Danecka
- 2 Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, University Clinical Centre, Medical University of Gdańsk, Gdańsk, Poland
| | - D Banaszkiewicz
- 3 Department of Statistics, Faculty of Management, Gdańsk University, Gdańsk, Poland
| | - Ż Smoleńska
- 2 Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, University Clinical Centre, Medical University of Gdańsk, Gdańsk, Poland
| | - Z Czuszyńska
- 2 Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, University Clinical Centre, Medical University of Gdańsk, Gdańsk, Poland
| | - J Siebert
- 1 Department of Family Medicine, Medical University of Gdańsk, Gdańsk, Poland
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11
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Gałąska R, Kulawiak‑Gałąska D, Czuszyńska Z, Masiak A, Zdrojewski Z, Gruchała M. A rare case of complex cardiac involvement in granulomatosis with polyangiitis. Pol Arch Intern Med 2017; 127:63-65. [DOI: 10.20452/pamw.3914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Felis-Giemza A, Kontny E, Haładyj E, Nałęcz-Janik J, Walkiewicz-Pielaszek K, Czuszyńska Z, Zdrojewski Z, Paradowska-Gorycka A, Olesińska M. SAT0195 Early Nailfold Capillaroscopic Pattern Predominates in Patients with Mixed Connective Tissue Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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13
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Felis-Giemza A, Kontny E, Haładyj E, Walkiewicz-Pielaszek K, Czuszyńska Z, Zdrojewski Z, Paradowska-Gorycka A, Olesińska M. AB0586 Predictors of Interstitial Lung Disease in 79 Patients with Mixed Connective Tissue Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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14
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Nowicka-Sauer K, Pietrzykowska M, Banaszkiewicz D, Hajduk A, Czuszyńska Z, Smoleńska Ż. How do patients and doctors-to-be perceive systemic lupus erythematosus? Rheumatol Int 2016; 36:725-9. [DOI: 10.1007/s00296-016-3431-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/26/2016] [Indexed: 12/01/2022]
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15
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Hajduk A, Nowicka-Sauer K, Smoleńska Ż, Czuszyńska Z, Zdrojewski Z. Prevalence and correlates of suicidal thoughts in patients with neuropsychiatric lupus. Lupus 2015; 25:185-92. [PMID: 26359173 DOI: 10.1177/0961203315603136] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 08/05/2015] [Indexed: 02/02/2023]
Abstract
BACKGROUND Suicidal ideation is observed in patients with systemic lupus erythematosus (SLE). No study on this notable phenomenon in neuropsychiatric SLE (NPSLE) is available so far. METHODS Participants were 53 consecutive outpatients with NPSLE (48 women; mean age 43.8 years) diagnosed according to the American College of Rheumatology nomenclature for SLE neuropsychiatric syndromes. A Neuropsychiatric Questionnaire (NP-Q) concerning 45 neurological, cognitive and psychiatric symptoms was used to assess the prevalence of self-perceived neuropsychiatric symptoms. The Modified Hospital Anxiety and Depression Scale (HADS-M) was used to assess the level of anxiety, depression and irritability. Formal neuropsychological examination was performed. Clinical data were collected by means of medical charts review and structured interview. RESULTS Suicidal thoughts were present in 25% of patients with NPSLE, irrespective of sex, age, education, work status, disease duration and steroid treatment. Suicidal ideation was connected with elevated levels of depression, anxiety and irritability. In patients with suicidal ideation the prevalence of cognitive, psychiatric and neurological self-perceived problems was significantly higher. CONCLUSIONS Suicidal thoughts are common in patients with NPSLE. Neuropsychiatric manifestation per se, depression, anxiety and patients' subjective complaints can be risk factors for suicidal ideation. Screening for suicidal thoughts is vital in routine care of SLE patients.
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Affiliation(s)
- A Hajduk
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Gdańsk, Poland
| | - K Nowicka-Sauer
- Department of Family Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Ż Smoleńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Z Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Gdańsk, Poland
| | - Z Zdrojewski
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics, Medical University of Gdańsk, Gdańsk, Poland
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16
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Olesińska M, Felis-Giemza A, Rowińska-Osuch A, Haładyj E, Czuszyńska Z, Zdrojewski Z, Walkiewicz-Pielaszek K, Paradowska-Gorycka A, Jędryka-Gόral A. SAT0468 Disease Activity and Damage in Patients with Mixed Connective Tissue Disease (MCTD). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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17
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Nowicka-Sauer K, Banaszkiewicz D, Staśkiewicz I, Kopczyński P, Hajduk A, Czuszyńska Z, Ejdys M, Szostakiewicz M, Sablińska A, Kałużna A, Tomaszewska M, Siebert J. Illness perception in Polish patients with chronic diseases: Psychometric properties of the Brief Illness Perception Questionnaire. J Health Psychol 2015; 21:1739-49. [PMID: 25589086 DOI: 10.1177/1359105314565826] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study evaluates the psychometric properties of a Polish translation of the Brief Illness Perception Questionnaire. A total of 276 patients with chronic conditions (58.7% women) completed the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. The internal consistency of the Polish Brief Illness Perception Questionnaire measured with Cronbach's alpha was satisfactory (α = 0.74). Structural validity was demonstrated by significant inter-correlations between the Brief Illness Perception Questionnaire components. Discriminant validity was supported by the fact that the Brief Illness Perception Questionnaire enables patients with various conditions to be differentiated. Significant correlations were found between Brief Illness Perception Questionnaire and depression and anxiety levels. The Polish Brief Illness Perception Questionnaire thus evaluated is a reliable and valid tool.
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Affiliation(s)
| | | | | | | | | | | | - Mariola Ejdys
- University of Warmia and Mazury in Olsztyn, Poland Municipal Hospital in Olsztyn, Poland
| | | | | | - Anna Kałużna
- Independent Public Specialist Health Care Centre in Lebork, Poland
| | - Magda Tomaszewska
- Wojewódzki Szpital Specjalistyczny im. Janusza Korczaka, Słupsk, Poland
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18
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Nowicka-Sauer K, Czuszyńska Z, Majkowicz M, Smoleńska Ż, Jarmoszewicz K, Olesińska M, Siebert J. Neuropsychological assessment in mixed connective tissue disease: comparison with systemic lupus erythematosus. Lupus 2012; 21:927-33. [DOI: 10.1177/0961203312441511] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: The aims of the study were to assess cognitive functions (CF) in patients with mixed connective tissue disease (MCTD) and to compare MCTD patients with systemic lupus erythematosus patients with and without neuropsychiatric manifestations (NP-SLE and non-NP-SLE, respectively) in terms of CF. Methods: Neuropsychological examination was performed in 141 patients: 30 with MCTD (24 women, 6 men), mean age: 48.07 years, 37 with non-NP-SLE (36 women, 1 man), mean age: 40.76 years and 74 with NP-SLE (68 women, 6 men), mean age: 41.97 years. Neuropsychological tests and structured interview were used. Emotional state was assessed by Hospital Anxiety and Depression Scale and clinical review. Results: We observed cognitive impairment in six MCTD patients (20%); in one (3%) the impairment was severe. MCTD patients achieved significantly higher results in seven out of 11 tests compared with patients with NP-SLE. MCTD and non-NP-SLE patients did not differ significantly. The differences were irrespective of premorbid IQ, education, disease duration and steroid treatment. Conclusions: In the majority of MCTD patients, CF were not impaired and severe impairment was unusual. Cognitive functioning was most disturbed in NP-SLE. The cognitive deficits observed in connective tissue diseases can be connected with nervous system involvement.
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Affiliation(s)
- K Nowicka-Sauer
- Department of Family Medicine, Medical University of Gdańsk, Poland
| | - Z Czuszyńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics; Rheumatology, Internal Medicine, and Connective Tissue Diseases Outpatient Clinic of University Clinical Centre, Medical University of Gdańsk, Poland
| | - M Majkowicz
- Department of Psychology; Department of Quality of Life Research, Medical University of Gdańsk, Poland
| | - Ż Smoleńska
- Department of Internal Medicine, Connective Tissue Diseases and Geriatrics; Rheumatology, Internal Medicine, and Connective Tissue Diseases Outpatient Clinic of University Clinical Centre, Medical University of Gdańsk, Poland
| | - K Jarmoszewicz
- Department of Cardiac Surgery, Medical University of Gdańsk, Poland
| | - M Olesińska
- Department of Systemic Connective Tissue Diseases, Institute of Rheumatology, Poland
| | - J Siebert
- Department of Family Medicine, Medical University of Gdańsk, Poland
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Zietkiewicz M, Hajduk A, Wojteczek A, Smoleńska Z, Czuszyńska Z, Zdrojewski Z. [Macrophage activation syndrome: report on three cases]. Ann Acad Med Stetin 2012; 58:55-61. [PMID: 23547396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The macrophage activation syndrome (MAS) is a rare and potentially fatal disease. This syndrome is founded on congenital or acquired dysfunction of NK cells resulting in secondary activation and proliferation of macrophages with excessive cytokine production and organ infiltration. Causes of acquired MAS include viral infections (chiefly EBV and CMV), malignancies, and autoimmune diseases. The macrophage activation syndrome is usually associated with juvenile idiopathic arthritis and adult-onset Still's disease and rarely with rheumatoid arthritis, systemic lupus erythematosus, dermatomyositis, and systemic sclerosis. Fever, hepatosplenomegaly, lymphadenopathy, and bi- or pancytopenia in peripheral blood represent typical symptoms of MAS. Hyperferritinemia, hypertriglyceridemia, hypertransaminasemia, and hypofibrinogenemia are among the common laboratory findings. The macrophage activation syndrome is a life-threatening condition requiring aggressive therapy due to multiple organ dysfunction. Treatment also includes elimination of the triggering infection and high-dose glucocorticosteroids. Second-line therapy is based on cyclosporin, intravenous immunoglobulins, and etoposide. The present work focuses on diagnostic and therapeutic difficulties in three patients with the macrophage activation syndrome.
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Affiliation(s)
- Marcin Zietkiewicz
- Katedra i Klinika Chorób Wewnetrznych, Chorób Tkanki Łacznej i Geriatrii Gdańskiego Uniwersytetu Medycznego, ul. Debinki 7, 80-952 Gdańsk
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20
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Markiewicz J, Strzelecki A, Lakomy EA, Czuszyńska Z, Zdrojewski Z. [Still's disease or systemic lupus erythematosus in a young adult patient--diagnostic doubts]. Przegl Lek 2011; 68:239-241. [PMID: 21853681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Systemic lupus erythematosus and Still's disease are chronic autoimmune disorders of unknown etiology. Symptomatology of these diseases may be similar causing diagnostic difficulties. Long-term observation and immunological studies are essential to identify the definite disorder. We present a case of a 24-year-old patient with high fever, sore throat and arthritis. During hospitalization rash accompanying fever, nodular erythema, pulmonary changes, liver damage and splenomegaly were observed. Although initially adult-onset Still's disease was diagnosed according to the Yamaguchi criteria, the diagnosis of systemic lupus erythematosus was made after re-analysis of the clinical course and immunological tests.
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Affiliation(s)
- Joanna Markiewicz
- Oddział XI Pomorskiego Centrum Chorób Zakaźnych i Gruźlicy w Gdańsku.
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21
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Czuszyńska Z, Zdrojewski Z. [Clinical manifestations of Takayasu's arteritis seen at the University Medical Center in Gdańsk]. Ann Acad Med Stetin 2010; 56 Suppl 1:95-98. [PMID: 21365952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Takayasu's arteritis (TA) is a granulomatous inflammation of the aorta and its major branches, usually occurring in young women. The disease is rare in Europe. The aim of this study was to describe clinical manifestations of TA among patients at the Department of Connective Tissue Diseases, University Medical Center in Gdańsk. MATERIAL AND METHODS We conducted a retrospective data analysis and performed a clinical examination of the patients. All patients met ACR criteria for TA. The mean age at disease onset was 26 years and the mean diagnostic delay was 19 months. Four out of 12 patients had a history of extensive stroke. Bypass surgery or balloon angioplasty was done in four patients. One patient underwent aortic valve replacement. CONCLUSION Early diagnosis and pharmacologic treatment may significantly improve the prognosis in TA.
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Affiliation(s)
- Zenobia Czuszyńska
- Katedra i Klinika Chorób Wewnetrznych, Chorób Tkanki Łacznej i Geriatrii Gdańskiego Uniwersytetu Medycznego ul. Debinki 7, 80-952 Gdańsk
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22
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Krajka-Lauer J, Mazurkiewicz-Bełdzińska M, Lauer W, Kokot W, Lass P, Czuszyńska Z, Luksza L, Iwaszkiewicz-Bilikiewicz B. [Frequency of appearance systemic complications of autoimmunological diseases: primary and secondary Sjögren syndrome]. Klin Oczna 2004; 106:466-8. [PMID: 15636238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
PURPOSE As Sjögren syndrome is regarded by ophthalmologists as a synonim of dry eye syndrome, we decided to evaluate how often these patients demonstrate other than ocular symptoms, especially systemic complications. MATERIAL AND METHODS We examined 30 patients with primary (PZS) and 45 patients with secondary Sjögren syndrome (WZS). RESULTS Pathological findings in course of Sjogren syndrome concerned predominantly eyes (94%) and mucous membrane of the mouth (91%), salivary glands (65%) and skin. The most frequent complaint was fatigue (91%). CONCLUSIONS Sjogren syndrome is a chronic systemic disease, in which predominant symptoms are: dryness of mucous membranes, chronic fatigue, painful joints and stomach disturbances.
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23
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Czuszyńska Z, Romanowicz G. Myocardial perfusion in women with systemic lupus erythomatosus and no symptoms of coronary artery disease. Nucl Med Rev Cent East Eur 2004; 7:171-4. [PMID: 15968605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND The aim of the study was to assess myocardial perfusion in women with systemic lupus erythomatosus (SLE) and no symptoms of coronary artery disease (CAD). MATERIAL AND METHODS Twenty two women with SLE of mean age 40.5 +/- 7.2 were enrolled in the study. The average duration time of the disease was from 2 to 19 years, mean 8 +/- 4.6 years. The inclusion criterion was the absence of stenocardial symptoms. The myocardial perfusion was studied by using Single Photon Emission Computerized Tomography (SPECT) utilising (99m)Tc-MIBI and a triple-head gamma-camera. We also analyzed risk factors of heart ischemic disease in our group. RESULTS Myocardial perfusion stress scanning showed abnormal perfusion in 12 patients, 54.5% of the whole group, mostly in the anterior wall. At rest hypoperfusion abnormalities were found in 7 individuals. In patients with positive myocardial perfusion, out scanning, risk factors of CAD were more pronounced than in a sub-group with a negative result of myocardial perfusion scanning. CONCLUSIONS In young women with SLE and no symptoms of coronary artery disease, myocardial perfusion defects may be detected by means of myocardial perfusion scintigraphy. Exercise and resting electrocardiography tests could be not sufficient for CAD diagnosis in women with SLE. The presence of coronary artery disease risk factors in women with SLE could be an indication to perform myocardial perfusion SPECT scanning.
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Affiliation(s)
- Zenobia Czuszyńska
- Department of Family Medicine, Connective Tissue Diseases Outpatients, Medical University, Gdańsk, Poland
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Czuszyńska Z, Debski J, Szurowska E, Hebanowski M, Łuszczyńska-Nitka G. [Clinical symptoms variety as a cause of late diagnosed Takayasu's arteritis]. Pol Merkur Lekarski 2002; 13:503-5. [PMID: 12666452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Takayasu's arteritis (TA) is a chronic inflammatory arteritis, preferentially affecting the major arteries such as the aorta and its main branches. Its course may be biphasic, with an early systemic phase characterised by non-specific inflammatory features and a later stage with occlusive lesion of the affected vessels. We reported 3 patients with TA, who presented very varied symptoms. These cases emphasise the importance of ultrasound image, which can help to establish the diagnosis at very early stage of vasculitis and improve prognosis.
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Affiliation(s)
- Z Czuszyńska
- Katedra Medycyny Rodzinnej AMG i Poradnia Układowych Chorób Tkanki Łacznej SPSK 1, Gdańsku
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Narozny W, Stankiewicz C, Przewoźny T, Bakowska A, Czuszyńska Z. A case of multisymptomatic relapsing polychondritis in a 22-year-old woman. ACTA OTO-RHINO-LARYNGOLOGICA BELGICA 2002; 55:227-33. [PMID: 11685960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
A case of multisymptomatic relapsing polychondritis in a 22-year-old woman. We report a case of a 22-year-old woman with relapsing polychondritis (RP)--a rare and little known systemic autoimmune disease characterised by episodic inflammation of cartilaginous structures (ear, nose, bronchi, trachea, larynx, ribs, cardiovascular system). This patient presents with a seven-year history, initiated by the saddle nose. The patient developed a multitude of symptoms: auricular chondritis, ocular symptoms, recurrent arthritis, respiratory complications (laryngotracheomalacia, bilateral vocal cord palsy), sensorineural hearing loss and enchondroma of the humeral bone. The examination of an auricle biopsy by an immunofluorescent method and a positive serum reaction from the patient to normal cartilage supported the immunological nature of relapsing polychondritis. Treatment consisted of orally administered prednisone and diaminodiphenylsulfone (Dapsone).
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Affiliation(s)
- W Narozny
- ENT Department, Medical University of Gdańsk, Poland
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