UVEITIS RELATED FACTORS IN PATIENTS WITH SPONDYLOARTHRITIS

Annual European Congress of Rheumatology (EULAR) -- JUN 12-15, 2019 -- Madrid, SPAIN[No Abstract Available]European League Against Rheumatis

Smoking May Be Related to Sacroiliitis in Enteropathic Arthritis Patients: Treasure Real-Life Preliminary Data

Annual European Congress of Rheumatology (EULAR) -- JUN 12-15, 2019 -- Madrid, SPAIN[No Abstract Available]European League Against Rheumatis

Koronavirüs Hastalığı-2019 Hastalarının Tırnak Dibi Kapilleroskopisi ile Değerlendirilmesi

Amaç: Mikrovaskülopati, Koronavirüs hastalığı-2019 (COVID-19) hastalığı komplikasyonlarında rol alan mekanizmalardan biridir. Tırnak dibi kapilleroskopisi (TDK) mikrovasküleriteyi değerlendirmede kullanılan non-invaziv bir yöntemdir. COVID-19 hastalarında endotel disfonksiyonu ve mikrovaskülopatinin saptanmasında yol gösterici olabilir. Gereç ve Yöntem: Şiddetli akut solunum yolu sendromu-CoV-2 testi pozitif çıkmış 54 hastaya TDK yapıldı ve hastalar kapiller yoğunluk, mimari ve morfoloji açısından değerlendirildi. Anormal ve normal kapilleroskopi bulguları olan hastalar COVID-19 klinik semptomları açısından karşılaştırıldı. Bulgular: Çalışmaya alınan hastaların %72’si erkek, yaş ortalaması ise 35,6±11,6 idi. Toplamda 22 hastada (%41) anormal kapilleroskopik değişikliklerden en az 1 tanesi vardı. Kapilleroskopik yaygın anormallikler ise sırasıyla, perikapiller ödem (%43), genişlemiş ve dilate kapil (%24), tortiyozite kapiller (%22) oldu. Hastaların %17’sinde hiperenflamatuvar yanıt görüldü ve 1 hastada yoğun bakım ihtiyacı oldu. Anormal kapilleroskopik değişliği olan hastalarda hiperenflamatuvar yanıt, antisitokin kullanımı ve tromboz sıklığı artmıştı. Sonuç: COVID-19 hastalarında anormal kapilleroskopik bulgular sıklıkla gözlenmiştir. Anormal kapilleroskopik bulguları olan hastalarda hiperenflamatuvar yanıt ve antisitokin ilaç kullanımı sıklığının artması hiperenflamasyon ile mikrovaskülopati arasında bir ilişki olabileceğini düşündürmektedir. TDK’nın, COVID-19 hastalığı klinik tutulumları ile ilişkisini değerlendirmek için daha fazla çalışmaya ihtiyaç vardır

The Possible Relation of Demodex and Facial Erythema in Connective Tissue Diseases

Background: We aimed to investigate the frequency of Demodex infestation and clinical implications in connective tissue disease patients with facial erythema. Methods: Patients diagnosed with a connective tissue disease and had facial erythema were consecutively enrolled in the study from 2019-2020. An age and gender matched control group was formed from healthy volunteers. Presence of Demodex was investigated by standardized skin surface biopsy. Number of Demodex mites over 5 per centimeter square was considered meaningful for infestation. Topical or systemic metronidazole treatment was given to the connective tissue disease patients with Demodex infestation. Facial erythema visual analog scale was questioned in patients at treatment onset and one month after. Results: A total of 31 connective tissue disease patients with facial erythema were enrolled. Control group included 31 healthy volunteers. Demographics and comorbidities were similar between groups. Demodex infestation was present in 58.1% of the disease group and in 25.8% of the control group (P=0.01). Pruritus was the most common symptom in patients with infestation. Median (IQR) facial erythema visual analog scale score was 6 (3) at treatment onset and was 2 (2.5) one month later (P<0.001). Conclusion: When evaluating facial cutaneous lesions, Demodex infestation should not be overlooked in a patient group like connective tissue diseases with dysfunctional immune system

Bosentan for digital ulcers in patients with systemic sclerosis : single center experience

Objectives: This study aims to investigate the effects of bosentan on the prevention and treatment of digital ulcers in systemic sclerosis (SSc) patients.Patients and methods: The study included 30 patients (4 males, 26 females; mean age 49.6&plusmn;15.4 years; range 23 to 71 years) diagnosed with SSc and treated with bosentan for digital ulcers. Bosentan was administered to all patients for a mean of 14&plusmn;10.3 months. All SSc cases were refractory to calcium channel antagonists or angiotensin II inhibitors. The diagnosis of SSc was based on the American College of Rheumatology criteria and patients were classified as limited or diffuse cutaneous SSc according to the LeRoy classification.Results: Mean disease duration was 8.8&plusmn;8.0 years and mean duration of digital ulcers was 29.4&plusmn;6.6 months. Under the bosentan treatment, eight patients (26.7%) developed new digital ulcers; all of these patients had diffuse cutaneous SSc. Health Assessment Questionnaire scores improved after 12 months and 24 months of treatment (p&lt;0.001). Three patients (10%) developed pulmonary arterial hypertension under bosentan treatment [two patients (6.6%) had SSc-associated pulmonary arterial hypertension and one patient (3.3%) had interstitial fibrosis-associated pulmonary arterial hypertension]. The anti-centromere antibody positive patients were predominantly classified as limited cutaneous SSc. Of the patients positive for anti-topoisomerase-1 antibodies, a high proportion was classified as diffuse cutaneous SSc. Pulmonary fibrosis was most frequent in the anti-topoisomerase-1 antibody subset. New digital ulcers developed mainly in the anti-topoisomerase-1 antibody positive patients.Conclusion: Bosentan may be used either alone or in combination with other treatments when digital ulcers worsen and may be expected to suppress the development of new ulcers and severe pain. Further preclinical studies are required shedding light on the etiopathogenesis of SSc and larger clinical trials are needed for more definitive treatment strategiesObjectives: This study aims to investigate the effects of bosentan on the prevention and treatment of digital ulcers in systemic sclerosis (SSc) patients.Patients and methods: The study included 30 patients (4 males, 26 females; mean age 49.6&plusmn;15.4 years; range 23 to 71 years) diagnosed with SSc and treated with bosentan for digital ulcers. Bosentan was administered to all patients for a mean of 14&plusmn;10.3 months. All SSc cases were refractory to calcium channel antagonists or angiotensin II inhibitors. The diagnosis of SSc was based on the American College of Rheumatology criteria and patients were classified as limited or diffuse cutaneous SSc according to the LeRoy classification.Results: Mean disease duration was 8.8&plusmn;8.0 years and mean duration of digital ulcers was 29.4&plusmn;6.6 months. Under the bosentan treatment, eight patients (26.7%) developed new digital ulcers; all of these patients had diffuse cutaneous SSc. Health Assessment Questionnaire scores improved after 12 months and 24 months of treatment (p&lt;0.001). Three patients (10%) developed pulmonary arterial hypertension under bosentan treatment [two patients (6.6%) had SSc-associated pulmonary arterial hypertension and one patient (3.3%) had interstitial fibrosis-associated pulmonary arterial hypertension]. The anti-centromere antibody positive patients were predominantly classified as limited cutaneous SSc. Of the patients positive for anti-topoisomerase-1 antibodies, a high proportion was classified as diffuse cutaneous SSc. Pulmonary fibrosis was most frequent in the anti-topoisomerase-1 antibody subset. New digital ulcers developed mainly in the anti-topoisomerase-1 antibody positive patients.Conclusion: Bosentan may be used either alone or in combination with other treatments when digital ulcers worsen and may be expected to suppress the development of new ulcers and severe pain. Further preclinical studies are required shedding light on the etiopathogenesis of SSc and larger clinical trials are needed for more definitive treatment strategie

Response to Rituximab in a Case of Lupus Associated Digital Ischemia

We report the case of a 38-year-old female patient with systemic lupus erythematosus (SLE) and Jaccoud arthritis (JA) that sequentially developed digital ischemic lesions of the hands. In spite of follow-up treatment with glucocorticoids, immunosuppressant, antiaggregant, and potent vasodilatator agents, a serious progression to digital gangrene over a one-month period was observed. Surprisingly, her nonhealing digital lesions improved after two cycles of rituximab (RTX) administration

A Case of Amyopathic Dermatomyositis with Pneumomediastinum and Subcutaneous Emphysema

A 34-year-old man was admitted with dyspnea, cough, and fever. Thorax computed tomography revealed ground glass opacities and pneumomediastinum. The patient was diagnosed as amyopathic dermatomyositis due to skin lesions and radiological findings. Despite immunosuppressive treatment clinical deterioration and radiological progression were observed and the patient died because of severe hypoxemic respiratory failure. The patient presented with extremely rare occurrence of pneumomediastinum and subcutaneous emphysema in amyopathic dermatomyositis with a poor prognosis

Treatment Resistant Severe Digital Ischemia Associated with Antiphospholipid Syndrome in a Male Patient with Systemic Sclerosis

We report the case of a male patient with limited cutaneous systemic sclerosis (SSc) that was complicated with severe digital ischemia, resistant to medical treatment. Due to the lack of treatment response, further laboratory and imaging studies were conducted. Findings were compatible with antiphospholipid syndrome and oral warfarin was added to the treatment regimen. After successful anticoagulation no further recurrences of digital ischemia were seen. An underlying etiology in SSc patients with treatment resistant digital ischemic necrosis should be suspected for accompanying antiphospholipid syndrome (APS)

Are There Any Clues to Predict Bamboo Spine in Axial Spondyloarthritis?

[No Abstract Available

Physicians' Biological Drug Preference in Patients With Rheumatoid Arthritis and Spondyloarthritis With a History of Malignancy: Perspectives From the Treasure Database

OBJECTIVE: Because of concerns about malignancy risks, using biological disease-modifying antirheumatic drugs (bDMARDs) in patients with a history of malignancy remains a challenging issue in rheumatology practice. This study aimed to investigate bDMARD preferences of physicians when treating of rheumatoid arthritis (RA) and spondyloarthritis (SpA) patients with a history of malignancy. METHODS: The data for this cross-sectional study were gathered from the TReasure database using a date range of December 2017 and January 2020. Biological disease-modifying antirheumatic drug preferences were analyzed for 40 RA patients and 25 SpA patients with a history of malignancy. RESULTS: The most frequently prescribed bDMARD was rituximab, which was given to 28 RA patients (70%). For 25 patients (62.5%), the time between the diagnosis of malignancy and starting on a bDMARD regimen was less than 60 months, with a median interval of 43.5 months. Among SpA patients, the preferred bDMARDs were secukinumab and etanercept, which were each administered to 7 patients (28%). For 13 SpA patients (52%), the time between the diagnosis of malignancy and starting on bDMARDs was less than 60 months, with a median interval of 97 months. CONCLUSIONS: The observed bDMARD preferences may be related to the therapeutic effects of rituximab on lymphoproliferative malignancies, the protective effects of secukinumab on tumor progression, and the short half-life of etanercept. Biological disease-modifying antirheumatic drugs should be used in RA and SpA patients with malignancy in case of high inflammatory activity. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved