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Low relapse rate in patients with giant cell arteritis in a multi-centre retrospective Turkish Registry. Clin Exp Rheumatol 2024; 42:816-821. [PMID: 37976117 DOI: 10.55563/clinexprheumatol/zr7s0g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/21/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Glucocorticoids (GC) are widely accepted as the standard first-line treatment for giant cell arteritis (GCA). However, relapse rates are reported up to 80% on GC-only protocol arms in controlled trials of tocilizumab and abatacept in 12-24 months. Herein, we aimed to assess the real-life relapse rates retrospectively in patients with GCA from Turkey. METHODS We assembled a retrospective cohort of patients with GCA diagnosed according to ACR 1990 criteria from tertiary rheumatology centres in Turkey. All clinical data were abstracted from medical records. Relapse was defined as any new manifestation or increased acutephase response leading to the change of the GC dose or use of a new therapeutic agent by the treating physician. RESULTS The study included 330 (F/M: 196/134) patients with GCA. The mean age at disease onset was 68.9±9 years. The most frequent symptom was headache. Polymyalgia rheumatica was also present in 81 (24.5%) patients. Elevation of acute phase reactants (ESR>50 mm/h or CRP>5 mg/l) was absent in 25 (7.6%) patients at diagnosis. Temporal artery biopsy was available in 241 (73%) patients, and 180 of them had positive histopathological findings for GCA. For remission induction, GC pulses (250-1000 methylprednisolone mg/3-7 days) were given to 69 (20.9%) patients, with further 0.5-1 mg/kg/day prednisolone continued in the whole group. Immunosuppressives as GC-sparing agents were used in 252 (76.4%) patients. During a follow-up of a median 26.5 (6-190) months, relapses occurred in 49 (18.8%) patients. No confounding factor was observed in relapse rates. GC treatment could be stopped in only 62 (23.8%) patients. Additionally, GC-related side effects developed in 64 (24.6%) patients, and 141 (66.2%) had at least one Vasculitis Damage Index (VDI) damage item present during follow-up. CONCLUSIONS In this first multi-centre series of GCA from Turkey, we observed that only one-fifth of patients had relapses during a mean follow-up of 26 months, with 76.4% given a GC-sparing IS agent at diagnosis. At the end of follow-up, GC-related side effects developed in one-fourth of patients. Our results suggest that patients with GCA had a low relapse rate in real-life experience of a multi-centre retrospective Turkish registry, however with a significant presence of GC-associated side effects during follow-up.
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FRI0476 Comorbidities in Psoriatic Arthritis: Patient Education Counts. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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THU0586 Agreement of Patient and Physician Global Assessment of Disease Activity in Adult Onset Still's Disease. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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AB0747 Psoriatic Arthritis Registry of Turkey (PSART): Results of A Multicenter Registry on 1081 Patients:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Systemic vasculitis in a patient with rhupus syndrome. Reumatismo 2016; 67:161-4. [DOI: 10.4081/reumatismo.2015.858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 04/15/2016] [Accepted: 04/20/2016] [Indexed: 11/23/2022] Open
Abstract
Rhupus is a rare syndrome characterized by overlap of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Previous reports mentioned that rhupus patients have prominent RA associated clinical manifestations and only mild organic damage related to SLE. Progressive or life-threatening manifestations are rare in rhupus patients. Our patient diagnosed as rhupus was a young women, presented with multi-organ involvement of systemic vasculitis. Rheumatologists should be aware of possibility that rhupus may be accompanied by progressive or life-threatening conditions such as vasculitis.
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Validity and reliability of medication adherence scale in FMF. Pediatr Rheumatol Online J 2015. [PMCID: PMC4599380 DOI: 10.1186/1546-0096-13-s1-p112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Evaluation of Superoxide Dismutase and Glutathione Peroxidase Enzyme Polymorphisms in Familial
Mediterranean Fever Patients. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2015. [DOI: 10.15197/ejgm.01463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Association between red blood cell distribution width and disease activity in patients with Behçet's disease. J Int Med Res 2015; 43:765-73. [PMID: 26359293 DOI: 10.1177/0300060515591063] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/21/2015] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To examine associations between red blood cell distribution width (RDW) and organ involvement and disease activity in patients with Behçet's disease. METHODS Haematological and inflammatory parameters including RDW, high-sensitivity C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) were examined in patients with Behçet's disease and in healthy controls. Patients were divided into those with active or inactive disease. RESULTS Data from 236 patients with Behçet's disease (77 with active and 159 with inactive disease) and 72 controls were analysed. RDW, ESR and hsCRP were significantly higher in patients with Behçet's disease than in controls, and in those with active disease compared with inactive disease or controls. In addition, ESR and hsCRP were significantly higher in those with inactive disease than controls. No correlations were found between hsCRP, ESR and RDW. No differences were observed in RDW, ESR or hsCRP between patients with or without ocular or vascular involvement. Multivariate logistic regression analysis revealed that RDW was significantly higher in active disease compared with inactive disease. CONCLUSIONS RDW was increased in active disease compared with inactive disease. No relationships were found between organ involvement and RDW. RDW may be a cost-effective, novel potential parameter to evaluate disease activity in Behçet's disease.
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AB0670 The Survival and Prognostic Factors of Patients with Systemic Sclerosis: Experience of Two Centers. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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AB1118 Validity and Reliability of Medication Adherence Scale in FMF (Adult Version). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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AB0432 Dose Escalation and Switching Patterns of Anti-TNF Drugs in Rheumatoid Arthritis: A Retrospective Chart – Review Study in Turkey: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.6029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND/AIM To define the frequency of familial Mediterranean fever gene (MEFV) mutations in ankylosing spondylitis (AS) and describe different clinical aspects of MEFV mutation carrier and noncarrier AS patients. MATERIALS AND METHODS In 112 AS patients, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores were calculated. The frequencies of 12 different MEFV mutations were studied by multiplex polymerase chain reaction/reverse hybridization method and were compared to those of previously studied healthy controls for 5 common MEFV mutations. RESULTS MEFV mutations were identified in 46 of 224 (20%) alleles and in 39 (35%) of AS patients. The distribution of mutations was: M694V, 30% (14); E148Q, 30% (14); P369S, 17% (8); V726A, 13% (6); A744S, 8% (4); and K695R, 2% (1). There were no significant differences between MEFV mutation carriers and noncarriers with respect to sex, age of symptom onset, disease duration, peripheral joint involvement, acute phase reactant levels, and BASDAI and BASFI scores (P > 0.05 all). MEFV mutation allelic frequency was not different between AS patients and healthy controls after adjusting for mutations studied (34/224 versus 22/200; P > 0.05). CONCLUSION Although we did not find significant clinical and laboratory differences between MEFV mutation carrier and noncarrier AS patients, further investigations are needed to define the impact of MEFV mutations on AS disease course.
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Validity and reliability of the Lupus QoL index in Turkish systemic lupus erythematosus patients. Lupus 2014; 24:816-21. [PMID: 25542903 DOI: 10.1177/0961203314565412] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 11/26/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) patients have seriously impaired quality of life (QoL). In addition to activity and damage indices used in the past, tools to evaluate QoL in SLE have been developed in recent years. In this study, we test the validity of the Turkish version of the Lupus-QoL (LupusQoL-TR) score, and investigate its association with clinical findings and activity indices. METHODS A total of 132 patients diagnosed with SLE according to ACR 1997 criteria were included. The clinical and demographic features, and biochemical data were retrieved from hospital records. SLE Disease Activity Index (SLEDAI) and damage score (SLICC-ACR) were determined at the time of administration of Lupus-QoL questionnaire. The Lupus-QoL includes 34 questions divided into eight domains. We reevaluated the LupusQoL-TR and pretested its understandability. SLE patients were concomitantly administered the LupusQoL-TR and generic SF-36. Internal consistency, test-retest reliability, convergent and discriminant validity were calculated. RESULTS The mean age of our SLE patients was 37.9 ± 12.8 years. Internal consistency reliability ranged from 0.88 to 0.93, and test-retest reliability from 0.84 to 0.94. LupusQoL-related domains in SF-36 were correlated (from 0.66 to 0.74). Most LupusQoL-TR domains, except planning, were able to discriminate between active and inactive SLE groups. Scores in all domains of the LupusQoL-TR were found to be discriminative for patients with and without damage according to SLICC-ACR score. CONCLUSION The LupusQoL-TR was found to be a valid patient-reported outcome measure method when evaluating QoL in Turkish SLE patients.
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THU0072 Comparison of Characteristics of Ankylosing Spondylitis in Association with Familial Mediterranean Fever with Those of Typical Ankylosing Spondylitis: Table 1. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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OP0234 Effects of Anticoagulant Treatment on the Incidence of New Vascular Events in Patients with Behcet's Disease with Vascular Involvement. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.3394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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The relationship between disease activity and depression and sleep quality in Behçet’s disease patients. Clin Rheumatol 2014; 34:1259-63. [DOI: 10.1007/s10067-014-2632-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 04/04/2014] [Accepted: 04/04/2014] [Indexed: 12/01/2022]
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Amyloidosis and its related factors in Turkish patients with familial Mediterranean fever: a multicentre study. Rheumatology (Oxford) 2013; 53:741-5. [DOI: 10.1093/rheumatology/ket400] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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PReS-FINAL-2213: Validation of inadequate drug response and definition of colchicum resistance in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC4044079 DOI: 10.1186/1546-0096-11-s2-p203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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PW01-025 – Definition of colchicine resistance in FMF. Pediatr Rheumatol Online J 2013. [PMCID: PMC3952434 DOI: 10.1186/1546-0096-11-s1-a78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Subclinical cardiovascular target organ damage manifestations of ankylosing spondylitis in young adult patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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SAT0222 Investigating the Association Between Rho-Kinase 1 (Rock1) Gene Polymorphisms and Systemic Sclerosis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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THU0366 Does being a hepatitis B virus carrier decrease applying to hospital in patients with rheumatoid arthritis and ankylosing spondylitis?:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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AB0008 Familial mediterranean fever (FMF) gene mutations (MEFV): are they a risk factor for coronary artery disease? Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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THU0487 Palosuran Treatment, Effective as Bosentan in the Treatment of Pulmonary Arterial Hypertension (PAH) Model. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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AB1223 Evaluation of the factors affecting colchicum resistance, treatment adherence and accuracy of diagnosis in colchicum resistant familial mediterranean fever (FMF) patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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THU0491 Delay of Diagnosis in Still’s Disease is Associated with a Chronic/Relapsing Pattern: National, Multicenter Study of 356 Patients. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Association between Rho-kinase (ROCK2) gene polymorphisms and Behçet's disease. Transl Res 2012; 160:428-34. [PMID: 22939913 DOI: 10.1016/j.trsl.2012.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Revised: 08/07/2012] [Accepted: 08/09/2012] [Indexed: 12/14/2022]
Abstract
Behçet's disease (BD) is a multi-systemic vasculitis. The aim of this study was to investigate the association between Rho-kinase (ROCK2) gene polymorphisms and patients with BD in a Turkish population. A total of 194 BD patients and 276 healthy controls with similar age and sex were included to this study. Polymorphisms were analyzed in genomic DNA using a BioMark 96.96 dynamic array system. mRNA from blood samples was extracted, and real-time polymerase chain reaction was performed for ROCK2 gene expression. There were marked changes in both genotype (TT, 41.8%; TA, 30.3%) and allele (T, 57%; A, 43%) frequencies for the rs35768389 (Asp601Val) polymorphism in patients compared with controls (TT, 64.6%; TA, 9.4%, P < 0.0001; T, 69.3%; A, 30.7%, P = 0.0004). Although CC genotype (52.0%) of rs1515219 polymorphism were more frequent, CT genotype (27.7%) were less frequent among the patients than controls (CC, 31.7%, CT, 44.6%, P = 0.0001). There was an increase in C allele (65.8% vs 54.0%) and decrease in T allele frequencies (34.2% vs 46.0%, P = 0.001) in patients. However, no associations were found with rs726843, rs2290156, rs965665, rs10178332, rs2230774, rs6755196, rs10929732, and rs34945852 polymorphisms. There was an increase in peripheral blood mRNA ROCK2 expressions in patients. This is the first study to examine the involvement of ROCK2 gene variation in the risk of incident BD. The results strongly suggest that ROCK2 gene polymorphisms may modify individual susceptibility to BD in the Turkish population.
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Are clinical features in Löfgren's syndrome-related erythema nodosum different from idiopathic erythema nodosum? SARCOIDOSIS, VASCULITIS, AND DIFFUSE LUNG DISEASES : OFFICIAL JOURNAL OF WASOG 2012; 29:128-131. [PMID: 23461075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND AND OBJECTIVES We retrospectively evaluated acute sarcoidosis (Löfgren's syndrome) patients diagnosed at 2 centers and compared the clinical features of Löfgren's syndrome (LS) related erythema nodosum (EN) to patients with idiopathic IEN who were diagnosed within the same time frame. METHODS Thirty patients (10 males, 20 females) who were diagnosed with LS and were being followed up for the last 8 years at 2 centers were included. Thirty patients (4 males, 26 females) who were admitted to the rheumatology outpatient clinics for IEN during that time period were taken as controls. The clinical and laboratory features at the initial admission, treatment modalities and response were recorded. RESULTS Twentyfour (80%) patients with LS related EN had arthritis and/or arthralgia. Fifteen of them had only findings of periarticular ankle inflammation and 4 had polyarthritis. When LS related EN patients were compared to IEN patients, the former group had more arthritis and/or arthralgia (p < 0.001), leucocytosis (p = 0.02), lymphopenia (p = 0.005) and thrombocytosis (p = 0.05), and higher ESR (p = 0.02). Twentyfive (83.3%) patients with LS related EN were administered oral corticosteroids. In 21 patients, hilar lymphadenopathy disappeared on control chest x-ray and CT; in 3 patients, minimal residual lymph node enlargement was persistent. During a median follow-up of 54 months (range: 10-84 months), none of the LS related EN patients had clinical relapse. CONCLUSIONS Apart from BHL, arthritis and/or arthralgia especially periarticular ankle inflammation is the feature which could be used to differentiate LS related EN from IEN. There is more need for steroids in LS patients and the symptoms quickly resolve with steroids.
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Effects of periodontal therapy on disease activity and systemic inflammation in rheumatoid arthritis patients. Oral Dis 2012; 19:394-400. [PMID: 22998534 DOI: 10.1111/odi.12017] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Revised: 07/24/2012] [Accepted: 08/24/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVE This observational prospective cohort study aimed to evaluate the effects of non-surgical periodontal treatment on clinical periodontal measurements and systemic inflammatory mediator levels in low or moderate to highly active rheumatoid arthritis (RA) patients with chronic periodontitis. SUBJECTS AND METHODS Rheumatoid arthritis activity was assessed with disease activity score test (DAS28). Thirty patients with RA with moderate to high disease activity (DAS28 ≥ 3.2) and chronic periodontitis (MHDA group) and thirty patients with RA with low disease activity (DAS28 < 3.2) and chronic periodontitis (LDA group) were enrolled in the study. The patients were monitored at the beginning and 3 months after undergoing periodontal therapy. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), tumour necrosis factor-alpha (TNF-α) levels in serum, DAS28 and periodontal parameters were evaluated. RESULTS Erythrocyte sedimentation rate, CRP, TNF-α levels in serum, DAS28 and periodontal parameters exhibited similar and significant reduction 3 months after the non-surgical periodontal treatment. CONCLUSION Non-surgical periodontal treatment may prove beneficial in reducing RA severity as measured by ESR, CRP, TNF-α levels in serum and DAS28 in low or moderate to highly active RA patients with chronic periodontitis.
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Ischemic skin necrosis following terlipressin therapy: report of two cases and review of the literature. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2012; 23:788-791. [PMID: 23864457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Terlipressin is a synthetic vasopressin analogue that is used in the treatment of bleeding esophageal varices and hepatorenal syndrome in patients with cirrhosis. Hepatorenal syndrome is a form of renal failure seen in patients with cirrhosis, with fatal outcomes. Ischemic adverse effects related to terlipressin are rarely observed. Herein, two cases who developed ischemic skin necrosis due to terlipressin usage are presented. Terlipressin therapy was started in two cirrhotic patients with presumptive hepatorenal syndrome. During the therapy, ecchymotic and necrotic changes were observed on the scrotal regions of both patients. Skin lesions were relieved after terlipressin therapy. Biopsy results were consistent with ischemia. Even if seen rarely, possible emergence of ischemic complications must be considered.
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Thematic stream: inflammatory arthritis (PP01-PP31): PP01. Autoinflammatory Synovitis in Familial Mediterranean Fever is Characterized by Numerous Neutrophils Lacking Myeloperoxidase and Lysozyme, Macrophages, Mast Cells and B Cells, Up-Regulation of Galectin-1, P65 (REL A)/NF-KB and Inos, but not COX-2. Rheumatology (Oxford) 2011. [DOI: 10.1093/rheumatology/ker097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Successful treatment of primary Sjögren's syndrome complicated with primary biliary cirrhosis and lung involvement. THE TURKISH JOURNAL OF GASTROENTEROLOGY : THE OFFICIAL JOURNAL OF TURKISH SOCIETY OF GASTROENTEROLOGY 2010; 21:60-62. [PMID: 20533116 DOI: 10.4318/tjg.2010.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A patient with primary Sjögren's syndrome complicated with primary biliary cirrhosis and lymphocytic interstitial pneumonia is presented. She was 38 years old and was admitted to our hospital for generalized pruritus, xerostomia, xerophthalmia, fatigue, and reticulonodular changes on her chest X-ray. With the findings of ground-glass attenuation and centrilobular nodules in high resolution computerized tomography, the diagnosis of lymphocytic interstitial pneumonia was made. Oral methylprednisolone 1 mg/kg/day and ursodeoxycholic acid 15 mg/kg/day were started. At the 6th month follow-up, she had no complaints, and pulmonary function tests and high resolution computerized tomography were normal. This is the first case of Sjögren's syndrome, primary biliary cirrhosis and lymphocytic interstitial pneumonia in the English literature.
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Two successive pregnancies after ursodeoxycholic acid therapy in a previously infertile woman with antimitochondrial antibody-negative primary biliary cirrhosis. Fertil Steril 2005; 83:761-3. [PMID: 15749512 DOI: 10.1016/j.fertnstert.2004.11.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2004] [Revised: 11/08/2004] [Accepted: 11/08/2004] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the benefit of ursodeoxycholic acid (UDCA) for the initiation and completion of a successful pregnancy in a previously infertile woman with primary biliary cirrhosis. DESIGN Case report. SETTING A university hospital with relevant departments. PATIENT(S) A 29-year-old woman with primary biliary cirrhosis and failure to conceive for 6 years. INTERVENTION(S) Establishment of diagnosis with a liver biopsy, pretreatment of patient with UDCA before conception, and continuation of UDCA after first trimester until term. UDCA was used in the second pregnancy again after the first trimester. MAIN OUTCOME MEASURE(S) Achievement of a safe conception and full-term pregnancy. RESULT(S) Two consecutive successful pregnancies, a healthy 3,250-g male infant and a healthy 3,000-g female infant. The second conception occurred in a period without the use of UDCA, implicating a latent beneficial effect of either UDCA or the previous pregnancy via some possible immune mechanism. CONCLUSION(S) Ursodeoxycholic acid could help achieve conception in infertile women with primary biliary cirrhosis. The use of UDCA after the first trimester is shown to be safe in two consecutive pregnancies. Although it cannot be conclusive, the unintentional use of UDCA in the first 20 days after conception did not result in any teratogenicity in the first child.
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