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1.
Introduction
Interleukin-34 (IL-34) is a newly discovered cytokine essential for skin homoeostasis. It is involved in macrophage differentiation, osteoclastogenesis and inflammation. This could suggest a potential role in the pathogenesis of psoriasis and psoriatic arthritis (PsA).Aim of the work
To assess serum IL-34 level in psoriatic patients with and without arthritis and to correlate it with disease activity and severity.Patients and methods
Serum IL-34 level was measured in 45 psoriasis patients (21 had PsA) and 20 healthy controls. Patients were clinically assessed using psoriasis skin area severity index (PASI), composite psoriasis disease activity index (CPDAI) and peripheral joint score (PJS). Radiological assessment of hands and feet was done using modified Sharp-van der Heijde (mSvH) scoring method for PsA.Results
The mean age of the PsA patients (47.4 ± 10.2 years) was comparable with the psoriasis only patients (42.5 ± 7.5 years) and control (43.4 ± 7 years). Serum IL-34 was significantly higher among PsA patients compared to those without arthritis and controls (median = 2500 ng/L, 512 ng/L and 325 ng/L, respectively). CPDAI was significantly higher in PsA compared to patients without arthritis. PASI scores were comparable between patients. Serum IL-34 level correlated significantly with each of PASI, CPDAI and PJS but not with the mSvH score. Receiver operator characteristic curve analysis revealed that serum IL-34 testing showed excellent diagnostic performance for PsA in psoriasis patients.Conclusion
The markedly elevated IL-34 serum level in PsA patients compared to non-arthritic ones and its remarkable correlation with PsA disease activity, suggest its importance as a marker for arthritis in psoriasis patients. 相似文献2.
Shahira El Fedawy Hala Ghareeb Neama Lotfy Noran Osama El-Azizi Asmaa Mahmoud 《The Egyptian Rheumatologist》2017,39(3):175-178
Aim of the work
To determine the frequency of anti-mutated citrullinated vimentin (anti-MCV) antibodies in chronic hepatitis C virus (HCV) patients and its relation to HCV associated arthritis.Patients and methods
The study included 60 HCV patients and 30 age and sex matched control. Patients were subgrouped according to the presence and absence of associated arthritis. Laboratory investigations were performed and anti-MCV antibodies were measured.Results
The age of the patients ranged between 29 and 75 years (mean 57.65 ± 8.49 years) and they were 38 males (63.3%) and 22 females (36.7%) M:F 1.7:1. 32 (53.3%) patients had arthritis while the remaining 28 (46.7%) did not. There was a significantly higher anti-MCV antibody level in the patients (median 250 ug/L; range 175–375 ug/L) compared to the control (p < 0.001). There was no significant difference in the anti-MCV antibodies between HCV patients with and without arthritis (p = 0.15). The HCV patients without arthritis had a significantly higher level of anti-MCV antibody (median 200 ug/L, range 175–375 ug/L) than the control (median 30 ug/L, range 5–15 ug/L) (p < 0.001) and the area under the curve (AUC) was 0.85 (95% CI 0.69–1, p = 0.004). When the cut-off value for anti-MCV antibody was set at 57.5 ug/L, clinical sensitivity was 80% and specificity was 80% between those without arthritis and the control. There was no significant correlation between anti-MCV antibody with various studied parameters in the HCV patients.Conclusion
Anti-MCV antibody is significantly increased in HCV patient and has no role in diagnosing HCV-associated arthritis. 相似文献3.
Nabila Abd EI-Hamid Gohar Mayada Ali Abdalla Marwa Khairy Mehasseb Walaa Abd El-Rahman Saleh 《The Egyptian Rheumatologist》2018,40(2):79-83
Background
Hepatitis C virus (HCV) infection is one of the most frequently encountered public health problems in Egypt. It is associated with many autoimmune diseases such as rheumatoid arthritis.Aim of the work
To assess the impact of HCV infection in rheumatoid arthritis (RA) Egyptian patients; its relation to disease activity, functional status and ultrasonography findings.Patients and methods
The study included 155 RA patients further classified according to the presence of concomitant HCV infection into 2 groups; rheumatoid arthritis (RA) and rheumatoid arthritis/hepatitis C virus (RA/HCV) groups. All patients were subjected to full history taking, thorough clinical examination, laboratory investigations, assessment of disease activity using the disease activity score 28 (DAS28) and assessment of functional status using the modified health assessment questionnaire (MHAQ). Ultrasonography (US) assessment was done using the German US7 score.Results
Both DAS28 and MHAQ scores showed significant differences between both the RA and the RA/HCV groups (p < 0.001), with higher mean values observed in the RA/HCV group (5.4 ± 1.1 and 1.05 ± 0.79 respectively). Significantly higher US7 synovitis scores were found in the RA/HCV group compared to the RA group (p = 0.03). US7 synovitis tenosynovitis scores revealed significant correlations with DAS28 and US7 synovitis scores correlated with MHAQ in both groups.Conclusion
Concomitant HCV infection in RA patients had an impact on disease activity. RA patients with concomitant HCV infection (RA/HCV) had higher DAS28 and MHAQ scores, with higher US7 synovitis scores compared to RA patients. US7 score is a valuable objective tool for the assessment of RA disease activity. 相似文献4.
Adel Abdelsalam Samar Tharwat Marwa Abo Almauty Amira F. Barakat Asmaa Farouk Enein Noha Abdelsalam Mahmoud Awad Dina Shahin 《The Egyptian Rheumatologist》2017,39(2):109-114
Introduction
Seronegative spondyloarthritis (SpA) is a group of chronic potentially disabling diseases that affect mainly axial joints in addition to extra-articular manifestations such as enthesitis, dactylitis and uveitis.Aim of the work
To assess the demographic features, clinical manifestations and radiological findings of SpA in Egyptian patients.Patients and methods
Fifty-three SpA patients were recruited from the Rheumatology and Immunology Unit of Mansoura University Hospital. Demographic, clinical and therapeutic data were collected. Skin was carefully assessed for psoriasis. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured. All patients were evaluated by conventional radiographs of hands, knees, ankles, sacroiliac joints (SIJ) and lumbosacral spines in addition to magnetic resonance imaging (MRI) of the SIJs.Results
Ankylosing spondylitis (AS) was the most prevalent (55%) followed by psoriatic arthritis (PsA) (38%) and 2 patients had enteropathic arthritis, one had reactive arthritis and another had undifferentiated SpA. The mean age of the patients was 39 ± 10.8 years; disease duration was 10 ± 3.5 years with a male predominance (58%). Inflammatory low back pain was present in all the patients and 77.4% had both axial and peripheral arthritis. Extra-articular manifestations as enthesitis, bursitis and dactylitis were detected in only 9.4% of patients. Sacroiliitis was detected in 81.1% of patients using conventional radiographs. MRI detected bone marrow edema in 9.4%, narrowing in 11.3%, sclerosis in 17% and ankylosis in 52.8%.Conclusion
The demographic, clinical and radiological characteristics of Egyptian SpA patients are comparable to those from other countries except for the lower prevalence of extra-articular manifestations. 相似文献5.
Soha Eldessouki Ibrahim Nashwa Aly Morshedy Naglaa Farouk Amir Louis Louka 《The Egyptian Rheumatologist》2018,40(1):17-21
Background
Anticarbamylated proteins (anti-CarP) are a novel family of antibodies recently identified in patients with inflammatory arthritis.Aim of the work
To investigate the anti-CarP serum levels in psoriatic arthritis (PsA) patients. The relation of anti-CarP to disease activity and severity as well as to the ultrasonographic findings and scores were well thought-out.Patients and methods
Forty-five PsA patients diagnosed according to the classification of psoriatic arthritis (CASPAR) criteria. 45 matched controls were included. The erythrocyte sedimentation rate (ESR), C-reactive protein and serum anti-CarP antibody were measured. PsA disease activity was recorded according to the modified disease activity score (DAS28). The severity and extent of psoriasis was assessed by the psoriasis area severity index (PASI). Musculoskeletal ultrasound (US) of the small hand joints was performed using grey scale (GS) and power Doppler (PD) to derive composite scores based on abnormal counts and severity.Results
The mean age of the patients was 44.58 ± 6.76 years, 40 females and 5 males (F:M 8:1), disease duration 4.93 ± 3.17 years. Serum levels of anti-CarP antibody were increased in PsA patients (33.48 ± 14.05) compared to controls (12.21 ± 4.71 ng/ml) (p < 0.001). The mean DAS28 was 4.61 ± 1.59 There was a significant correlation between anti-CarP antibody and each of DAS28, ESR, CRP, PASI, the GS and PD joint counts (r = 0.97, r = 0.97, r = 0.97, r = 0.97, r = 0.96, r = 0.9 respectively) as well as with the US joint scores; GSJS and PDJS (r = 0.98, r = 0.97 respectively) denoting severity.Conclusions
Anti-CarP antibody might represent a promising marker to predict joint damage and disease activity in PsA patients. 相似文献6.
7.
Background
Gout is the most common form of crystal arthropathy. Monoarthritis affecting the first metatarsophalangeal joint is the common initial presentation. Bilateral olecranon bursitis is a rare presentation of gout.Aim of the work
To describe the clinical features of bilateral olecranon bursitis as an initial presentation of gout.Case report
A 62-year old male patient presented to the rheumatology clinic , Adnan Menderes University with sudden bilateral elbow pain and swelling for three months . Swellings gradually increased to the size of a golf ball with minimal restriction in the elbow extension (170°). He didn’t have arthritis in the elbows. The patient had medical history of heart failure and chronic obstructive pulmonary disease and medications received included acetylsalicylic acid and diuretics. Blood tests revealed elevated serum uric acid (12.6 mg/dL), with normal renal function tests, erythrocyte sedimentation rate (ESR) 43 mm/h and C-reactive protein (CRP) 8.8 mg/L. Rheumatoid factor and hepatitis markers were negative. Diagnostic bursal aspiration excluded septic bursitis and under polarized microscopy monosodium urate (MSU) crystals were identified with typical negative birefringence. A diagnosis of gout was established. ESR and CRP were normalized after diclofenac potassium (100 mg) and colchicine (1.5 mg). Allopurinol 300 mg was added when his joint pain was relieved.Conclusion
This is the first gout case initially presenting with bilateral olecranon bursitis. Bursal fluid analysis is important in such atypical presentation to look for MSU crystals and establish a diagnosis. 相似文献8.
Alexey Tsyganov Erik Wissner Andreas Metzner Sergey Mironovich Maria Chaykovskaya Vitaly Kalinin Mikhail Chmelevsky Christine Lemes Karl-Heinz Kuck 《Journal of electrocardiology》2018,51(1):92-98
Introduction
The aim of this study was to assess the use of a novel noninvasive epicardial and endocardial electrophysiology system (NEEES) for mapping of ventricular arrhythmias.Methods
Eight patients (2 females, mean age 50 ± 17 years) with ischemic (n = 3) and nonischemic (n = 5) cardiomyopathy and inducible ventricular arrhythmias during electrophysiology study were enrolled. Noninvasive mapping of ventricular arrhythmias was performed using the NEEES based on body-surface electrocardiograms and computed tomography imaging data. Arrhythmia patterns were analyzed using noninvasive phase mapping.Results
Macro-reentrant VT circuits were observed in 3 ischemic and 1 nonischemic cardiomyopathy patient, respectively. In the remaining 4 patients, phase mapping revealed relatively stable rotor activity and multiple wavelets.Conclusions
Noninvasive cardiac mapping was able to visualize the macro-reentrant circuits in patients with scar-related VT. In patients without myocardial scar only polymorphic VT or VF was inducible, and rotor activity and multiple wavelets were observed. 相似文献9.
Raja Alaya Imen Zouche Dhia Kaffel Hend Riahi Wafa Hamdi Mohamed Montacer Kchir 《The Egyptian Rheumatologist》2017,39(4):255-258
Introduction
The association of silicosis and RA is rare compared to pulmonary manifestations of rheumatoid arthritis (RA). A history of lung disease or a long exposure at work to silica and typical radiographic lesions on chest X-ray suggest the diagnosis of Caplan’s syndrome. We describe the case of an elderly Tunisian male RA patient with the Caplan’s syndrome diagnosed after prolonged exposure to silica.Case report
A 62-year old patient was referred for exploration of a chronic symmetrical polyarthritis for 2 years involving the hands, elbows, forefeet, and knees and accompanied by prolonged morning stiffness. He had no history of lung disease but had worked in a ceramic plant for 20 years. He presented with arthritis of the wrists and knees with a rheumatoid nodule of the left elbow. Joint destruction was present in both hands and feet. Rheumatoid factor and anti-cyclic citrullinated peptide antibodies were highly positive (135 UI/L and 363 UI/L respectively). The patient was diagnosed as RA and the disease activity score (DAS-28) was up for 6.87. His breathing was normal, pulmonary auscultation and spirometry were normal. Chest X-rays revealed a multiple micro-nodules distributed throughout the lungs but predominantly in the upper and middle zones. Bronchoalveolar lavage showed a pauci-cellular liquid and chest CT scan showed bilateral, round, well-delimited small centri-lobular nodules which predominate the upper lobes. There was infra-centimetrical adenopathy with mediastinal calcification.Conclusion
Prolonged exposure to silica dust has a remarkable influence on the development of RA with a suggested intricacy in to its pathogenesis. 相似文献10.
11.
Jamila Es-Souiri Amina Mounir Irene Kona Fatima Ezzahra Abourazzak Taoufik Harzy 《The Egyptian Rheumatologist》2017,39(3):183-185
Background
Poncet’s disease is a reactive polyarthritis associated to active tuberculosis with excluded presence of mycobacterium in the joints and bones affected; it is an infrequent form of tuberculosis and challenging diagnosis condition with unknown pathogenesis. We report a case of Poncet’s disease in Moroccan patient to contribute data which could result in a consensus of clinical criteria.Case report
A 38-year-old female was admitted to the Rheumatology Department, Hassan II University Hospital as she presented with morning stiffness, arthralgias, symmetric arthritis of the wrists, ankles, bilateral sacroiliitis, enthesitis and inflammatory back pain. The patient had cervical lymphadenopathy with fever and erythema nodosum. Laboratory results were as follows: ESR 25 mm/h and C-reactive protein 13 mg/L while anti-nuclear antibodies, rheumatoid factor, human immunodeficiency virus and angiotensin converting enzyme were negative. The intradermal skin test for tuberculosis reading was 20 mm which is considered strongly positive. Histological report of cervical node tissue revealed granulomatous lesions compatible with tuberculosis. No alteration was observed in the radiographies of chest and the affected joints. MRI of sacroiliac joint and spine was normal. Spondyloarthritis and rheumatoid arthritis were ruled out. Therapy with pyrazinamide, isoniazide and rifampicin was started after which the arthritis resolved in a few days. The diagnosis of Poncet’s disease was confirmed.Conclusion
The differential diagnosis between Poncet’s disease and autoimmune inflammatory joint diseases is a clinical challenge. However, Poncet’s disease should be considered as a differential diagnosis for patients with fever and arthritis of unknown cause, particularly if active tuberculosis is suspected. 相似文献12.
Introduction
Eosinophilia is reported in several rheumatic diseases including rheumatoid arthritis (RA) and considered an indicator of high disease activity and a factor of poor prognosis.Aim of the work
To detect the frequency of eosinophilia in a cohort of RA patients from Kashmir, India and to study its relation to disease activity.Patients and methods
This study was conducted on 134 RA patients attending the Rheumatology outpatient clinic, Sher-i-Kashmir Institute of Medical Sciences (SKIMS) Medical Institute. Patients with known cause associated with eosinophilia such as drug reaction, allergies or helminthic infection were excluded. The eosinophilic count was recorded and the disease activity score (DAS-28) was calculated.Results
The patients had a mean age of 36.6 ± 11.5 years and disease duration of 6.8 ± 5.3 years. They were 103(76.9%) females and 31(23.1%) males (F:M 3.32:1). All the patients were rheumatoid factor positive. The mean DAS28 was 4.53 ± 0.96 (range: 2.9–7.1). 42(31.3%) had high disease activity. The mean eosinophilic count was 4.53 ± 3.12% (range 1.1–16.4%) and eosinophilia (>6%) was found in 29(21.6%) patients with a mean count of 9.4 ± 2.6% (range 6.3–16.4%). The rest of the 105 patients had normal eosinophilic count. The mean eosinophil count was lower in RA patients with high disease activity (4.14 ± 2.62%). Those RA patients with eosinophilia had a mean DAS28 of 4.4 ± 0.74. A non-significant negative correlation was present between the eosinophilic count and the DAS28 (r = ?0.038, p = 0.66). None of the eosinophilic patients had any associated pneumonia.Conclusion
Eosinophilia is quite common in RA patients but does not have any relation with disease activity. 相似文献13.
Amina B. Eldin Samah A. ElBakry Caroline S. Morad Aly M. Abd-El-Samie 《The Egyptian Rheumatologist》2018,40(1):7-10
Aim of the work
To assess the impact of metabolic syndrome (MetS) on the pattern and clinical presentation of rheumatoid arthritis (RA), and its relation to disease activity and functional status of the patients.Patients and Methods
Sixty RA patients were equally grouped into those with MetS (group A) and those without (group B). The disease activity score (DAS-28) was assessed and functional status was measured using health assessment questionnaire (HAQ).Results
The 30 patients with MetS had a mean age of 46.3 ± 9.9 years (27–66 years), disease duration of 5 (3–10) years and the 30 without were of matched age and sex. Joint deformities were detected in 8 patients (26.7%) in group A and in 10 patients (33.3%) in group B. While bone erosions were in 6 (20%) in group A, and 7 (23.3%) in group B. As regards the functional capacity; it was found to be more impaired in patients with MetS shown by the significantly higher HAQ in group A than group B (p = 0.007). While no significant differences were detected regarding the DAS28 and visual analogue scale (VAS)(p = 0.26 and 0.13 respectively). In patients with MetS (group A), body weight and waist circumference were significantly increased in those with an increased frequency of joint deformities (p = 0.047 and p = 0.018 respectively). A significant correlation was found between fasting blood glucose and both joint deformities and erosions (p = 0.016 and p = 0.004 respectively).Conclusion
MetS might have a negative impact on RA disease activity and functional status. Regular screening for MetS in RA patients is recommended. 相似文献14.
Nihal Fathi Samar H. Goma Nadia M. Ismail Abeer M. Ghandour Sally S. Youssef Nisreen A. Mohammed Eman Mosad 《The Egyptian Rheumatologist》2018,40(1):45-49
Background
Systemic sclerosis (SSc) is an autoimmune connective tissue disease with vascular, fibrotic and immune changes of skin and some internal organs. Anti-heterogeneous nuclear ribonucleoproteins (anti-hnRNP) were found in SSc patients.Aim of the work
To assess anti-hnRNP A1 and A2 autoantibodies in limited SSc patients and to find their relation to clinical and hand radiographic characteristics.Patients and methods
26 limited SSc patients and 16 matched control were studied. Skin thickness was scored according to the modified Rodnan skin score method (mRss) and radiologic examination by plain X-ray of the hand and wrist was performed anti-hnRNP A1 and A2 were measured in patients and control.Results
All patients were females with a mean age of 37.5 ± 11.24 years and mean disease duration of 7.84 ± 1.19 years. 96.2% of cases showed juxta-articular osteoporosis, 38.5% with marginal erosions, 73.1% with surface erosions, 42.3% with subchondral cyst, 42.3% with metacarpophalangeal subluxation, 11.5% with marginal sclerosis, 80.8% with resorption of distal phalanges, 38.5% with resorption of distal ulna and 34.6% with calcinosis. Anti-hnRNPA1 was positive in all the patients but the anti-hnRNPA2 was positive in 21 (80.8%). Anti-hnRNP A1 and A2 showed significant difference between patients and control (5.66 ± 4.18 ng/ml vs 2.88 ± 0.82; p < 0.01 and 1.82 ± 0.36 vs 0.73 ± 0.08; p < 0.02, respectively). There was no significant correlation between the markers with the mRss or radiographic changes.Conclusion
Joint affection in SSc is more frequent than expected. Anti-hnRNP A1 and anti hnRNP A2 antigens may be useful markers for SSc patient although no significant relation was found with radiologic findings. 相似文献15.
Murillo de Oliveira Antunes Nelson Samesima Horacio Gomes Pereira Filho Afonso Yoshikiro Matsumoto Richard L. Verrier Carlos Alberto Pastore Edmundo Arteaga-Fernández Charles Mady 《Journal of electrocardiology》2017,50(2):184-190
Background/Purpose
Patients with hypertrophic cardiomyopathy (HCM) have elevated risk for sudden cardiac death (SCD). Our study aimed to quantitatively characterize microvolt T-wave alternans (TWA), a potential arrhythmia risk stratification tool, in this HCM patient population.Methods
TWA was analyzed with the quantitative modified moving average (MMA) in 132 HCM patients undergoing treadmill exercise testing, grouped according to Maron score risk factors as high-risk (H-Risk, n = 67,), or low-risk (L-Risk, n = 65, without these risk factors).Results
TWA levels were much higher for the H-Risk than for the L-Risk group (101.40 ± 75.61 vs. 54.35 ± 46.26 μV; p < 0.0001). A 53 μV cut point, set by receiver operator characteristic (ROC), identified H-Risk patients (82% sensitivity, 69% specificity).Conclusions
High TWA levels were found for hypertrophic cardiomyopathy patients. Abnormal TWA associated with major risk factors for SCD: non-sustained ventricular tachycardia on Holter (p = 0.001), family history of SCD (p = 0.006), septal thickness ≥30 mm (p < 0.001); and inadequate blood pressure response to effort (p = 0.04). 相似文献16.
Fiaz Alam Abdo Qaid Lutf Nabeel Abdulla Eman Hassan Satti Elsayed Mohammed Hammoudeh 《The Egyptian Rheumatologist》2017,39(2):103-108
Aim of the work
To study the clinical, laboratory and radiographic characteristics of ankylosing spondylitis (AS) patients living in Qatar.Patients and methods
Sixty-two consecutive AS patients including 4 Qataris were enrolled. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and AS quality of life (ASQoL) scores were calculated. Inflammatory markers, human leukocytic antigen-B27 (HLA-B27), plain x-rays and magnetic resonance imaging of the sacroiliac joint and spine were considered.Results
Mean age at symptom onset was 25.9 ± 7.3 years and at diagnosis 32.3 ± 8.4 years with an average delay in the diagnosis of 6.4 years. The male-to-female ratio was 5.2:1. Arabs comprised 40.3% while 59.7% were non-Arabs. HLA-B27 was positive in 80.7%. Family history of spondyloarthritis was present in 16 (25.8%) patients. All patients had inflammatory low back pain. Peripheral arthritis was observed in 46.8%, heel enthesitis in 37.1% and tenosynovitis in 14.5% patients. Anterior uveitis occurred in 14.5% patients. Radiological evidence of bilateral sacroiliitis and spine involvement was observed in 83.3% and 59.7% patients respectively. Mean erythrocyte sedimentation rate and C-reactive protein were 20.3 ± 14.2 mm/hr and 11.4 ± 11.8 mg/L respectively. Mean BASDAI, BASFI and ASQoL were 3.3 ± 1.8, 2.9 ± 2.1 and 6.5 ± 5.2 respectively. Twenty-eight patients (45.2%) were maintained on NSAIDs monotherapy, 14.5% were receiving DMARDs and 40.3% were on biologics.Conclusion
The characteristics of AS patients in Qatar are revealed. Similar to others, there is male predominance. Disease activity and functional status were found to be low which may be due to high frequency of patients receiving biologics. 相似文献17.
Multifocal osteoarticular tuberculosis and pleuropulmonary involvement in an immunocompetent patient
Jamila Es-Souiri Nassira Aradoini Fatima Ezzahra Abourazzak Taoufik Harzy 《The Egyptian Rheumatologist》2017,39(3):199-201
Introduction
Multifocal tuberculosis is an uncommon presentation in immune-competent patients; it’s associated more with an immune-depression like HIV (Human Immunodeficiency Virus) infection. Here, we are presenting unusual multifocal osteoarticular localizations including the wrist and tarsal joint which are rare and pleura-pulmonary tuberculosis.Case presentation
Wrist, ankle, tarsal joint, hip and lung involvement was detected in a 30 year-old male patient. Mycobacterium tuberculosis was isolated from both synovial and pleural biopsy specimen cultures. The treatment was based on 9 months of antituberculosis drugs: rifampin (RMP), isoniazid (INH), pyrazinamide (Z) and ethambutol (EMB). INH (300 mg/day), RMP (600 mg/day), PZA (3gr/day) and EMB (1200 mg/day) were given for treatment 6 days/7. In the 4th week the patient’s condition improved and was discharged. After two months, the therapy was continued with INH and RMP up to 9 months. A hip replacement surgery and wrist Arthrodesis will be discussed after the patient’s total healing.Conclusion
Tuberculous osteoarthritis is a frequently missed diagnosis, especially in different clinical patterns. A high level of suspicion is required particularly in high-risk populations and endemic areas. Well conducted treatment improves the prognosis. 相似文献18.
Shereen R. Kamel Hanaa A. Sadek Fatma A. Mohamed Haidy M. Osman 《The Egyptian Rheumatologist》2018,40(1):1-5
Aim of the work
To evaluate role of ultrasound disease activity score (DAS) in assessing joint inflammation in rheumatoid arthritis (RA), and its correlation with disease parameters.Patients and methods
Fifty RA were included. All patients were assessed for DAS-28, health assessment questionnaire disability index (HAQ-DI) and X-ray simple erosion narrowing score (SENS). Power Doppler (PD) and grey-scale (GS) US examination were done for all patients. PDUS score for synovitis in 22 joints and GS score for effusion/hypertrophy in 28 joints were included in US DAS calculation.Results
The mean age of the patients was 43.9 ± 10.8 years; 46 females and 4 males and the mean disease duration was 8.7 ± 6.1 years. The mean DAS28 was 5.04 ± 1.2 and HAQ-DI was 1.2 ± 0.7. The mean US DAS was 5.2 ± 1.3 (2.11–7.21). According to the US DAS, patients with high activity had significantly prolonged morning stiffness, higher swollen and tender joint counts, patient and physician global assessment, DAS-28, HAQ-DI, and SENS compared to those with moderate activity or low activity/remission. The mean US erosion count (USEC) was 8.9 ± 6.6 (0–18) and it was higher in patients with high disease activity (p = 0.04). A significant correlation was found between USDAS with DAS28 and HAQ-DI. US DAS showed moderate correlation (r = 0.5, p = 0.001), while USEC showed a strong correlation (r = 0.8, p < 0.001) with SENS.Conclusion
US DAS is a feasible scoring system for use in daily rheumatologic practice. US DAS may reflect disease activity and disability. The association between US DAS and USEC with radiologic scoring reflects their ability to detect structural joint damage. 相似文献19.
Daniel Karlsson Jan Engvall Agota Alfoldine Ando Meriam Åström Aneq 《Journal of electrocardiology》2017,50(2):176-183
Objectives
We investigated arrhythmia, electrocardiography and physical work capacity (PWC) in the follow-up of ARVC.Design
Twenty-three patients (13 men; age 41 ± 12 years) fulfilling diagnostic criteria were re-investigated after at least five years.Results
Ventricular arrhythmia during exercise testing (ET) was present in 14 patients (61%) and showed variation between examinations. In eleven (48%), complex ventricular ectopic activity was observed at peak exercise or immediately thereafter. Mutations known to be pathogenic in ARVC were present in 13 patients (57%) of which 11 developed complex ventricular arrhythmia at ET. PWC at baseline was 190 ± 66 W (104 ± 26%) decreasing to 151 ± 61 W (91 ± 23%, p = 0.008) after 10.7 years.Conclusion
The appearance of ventricular arrhythmia during exercise testing showed temporal variation but was frequent in patients with relevant genetic mutation. Physical exercise capacity decreased over time in patients with ARVC in excess to the age-related deterioration and regardless of medication. 相似文献20.
Asma Bachali Hana Sahli Raoudha Tekaya Ines Mahmoud Soumaya Hedhili Leila Abdelmoula 《The Egyptian Rheumatologist》2017,39(3):179-182
