HLA B-27 Subtypes in Turkish Patients with Spondyloarthropathy and Healthy Controls

The frequency and the distribution of HLA-B27 subtypes in spondylarthropathy (SpA) patients and controls were investigated in a sample Turkish population. B27 subtyping was performed by PCR-SSP method in two groups: 49 unrelated HLA-B27 positive Turkish patients with the diagnosis of SpA according to the European Spondyloarthropathy Study Group Criteria, and 55 HLA-B27 positive healthy controls. The frequency of HLA-B(∗)27 was 2.6% in the Turkish population, and B(∗)2705 was the predominant allele among patients with SpA. The difference was mainly between male patients and male controls The proportion of B(∗)2705 among B27-positive patients and controls was significantly different (P = 0.02). Our study supports other reports from different populations which showed that B(∗)2705 and B(∗)2702 were more frequent in Caucasian patients with SpA

Coagulation factor V gene mutation increases the risk of venous thrombosis in Behcet's disease

We investigated the prevalence of the coagulation factor V gene G1691A mutation in 64 patients with Behcet's disease (BD) and in 107 apparently healthy individuals. The mutation was present in the heterozygous state in 37.5% of the patients with a history of deep vein thrombosis (12/32) and in 9.4% of the patients without any thrombotic event (3/32). Eleven healthy individuals were also heterozygous for the mutation (10.3%). The prevalence of the mutation in BD patients with and without thrombosis was significantly different (P = 0.0079). We conclude that the factor V gene mutation may play a major role in the development of venous thrombosis in BD

Cytomegalovirus retinitis in a patient with Wegener's granulomatosis

Cytomegalovirus retinitis (CMVR) is a rare complication of systemic immunosuppressive therapy in patients with rheumatic disorders, We describe a 44-year-old man with Wegener's granulomatosis who was treated with cyclophosphamide and methylprednisolone and who subsequently developed bilateral CMVR, In spite of dis continuation of immunosuppressive therapy and administration of systemic ganciclovir, retinitis recurred and maintenance therapy was needed, In conclusion, increased awareness of this potentially serious complication of immunosuppressive therapy is critical, If immune recovery is slow after discontinuation of immunosuppressive agents, prolonged antiviral therapy is required in order to prevent recurrences of CMVR. Copyright (C) 2000 S. Karger AG, Basel

Primary antiphospholipid syndrome associated with mesenteric inflammatory veno-occlusive disease

We describe a 24-year old Caucasian man with gangrene of small bowels and intestinal resection due to mesenteric inflammatory veno-occlusive disease (MIVOD) who later developed deep vein thrombosis in his left leg. He had no clinical evidence of an underlying symptomatic connective tissue disease or Behcet's disease. An IgG anticardiolipin antibody titre above 60 GPL unit/mL and thrombocytopenia confirmed the diagnosis of primary antiphospholipid syndrome (APS). This is the first known case of APS associated with MNOD

The use of two different Health Assessment Questionnaires in Turkish rheumatoid arthritis population and assessment of the associations with disability

The aim of this study was to compare and evaluate the Health Assessment Questionnaire (HAQ) and Arthritis Impact Measurement Scale (AIMS) in our patient population with rheumatoid arthritis (RA) and also to find some associations with clinical assessment of disability. One hundred and twenty-three consecutive adult patients with RA were included in the study. Pain, and global assessments by patients and physicians were recorded using a 10 cm visual analogue scale. Each patient completed the HAQ and AIMS questionnaires. Correlations among tender and swollen joint counts, erythrocyte sedimentation rate, pain, and AIMS anxiety and depression scores were all investigated. Pearson correlation was used to assess the possible correlations between each questionnaire and clinical variables. Pain and the AIMS subscales of mobility, dexterity, social activity and activities of daily living correlated with global assessments by patients and physicians, and tender joint counts. Depression correlated with pain and disability (HAQ). It was also of note that we observed high intercorrelation between the global assessments of physicians and patients. It was concluded that a measure of functional status, patient global assessment and pain score should be considered as important in the evaluation of RA patients. Measuring psychological well-being also provides further information. The HAQ, with the addition of the anxiety and depression sections of AIMS (CLINHAQ), provides the advantage of a global evaluation of these chronically ill patients

Clinical evaluation and comparison of different criteria for classification in Turkish patients with psoriatic arthritis

Several criteria are being used for the classification of psoriatic arthritis (PsA) and there is a lack of consensus about PsA as a separate entity. Our aim is to investigate the clinical features of our patients with a clinical diagnosis of PsA, compare the sensitivities of different classification criteria and agreement between the criteria. In this study 86 PsA patients were investigated (48 female, mean age 44). Moll and Wright criteria were fulfilled by 91%, Vasey and Espinoza criteria by 94% and modified European SpA study group criteria by 59%, classification of PsA study group criteria by 86%, modified McGonagle criteria by 96%, Fournie et al. criteria by 84%, and Gladman criteria by 95%. Significant agreement was present between criteria but generally kappa values were less than 0.5. The pattern of PsA can differ with time and the implementation of the available classification criteria showed considerable differences