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  • Küçük Resim Yok
    Öğe
    ARE CLINICAL FEATURES IN LOFGREN'S SYNDROME-RELATED ERYTHEMA NODOSUM DIFFERENT FROM IDIOPATHIC ERYTHEMA NODOSUM?
    (Mattioli 1885, 2012) Donmez, S.; Kisacik, B.; Pamuk, O. N.; Pehlivan, Y.; Aydogdu, E.; Yurekli, O. A.; Onat, A. M.
    Background and Objectives: We retrospectively evaluated acute sarcoidosis (Lofgren's syndrome) patients diagnosed at 2 centers and compared the clinical features of Lofgren'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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    Effect of fibromyalgia on bone mineral density in patients with fibromylagia and rheumatoid arthritis
    (Medknow Publications & Media Pvt Ltd, 2013) Buyukbese, M. A.; Pamuk, O. N.; Yurekli, O. A.; Yesil, N.
    Objectives: Fibromyalgia (FM) may t cause a decrease in bone mineral density (BMD) because of decreased mobility. The condition is relatively frequent in rheumatoid arthritis (RA) and RA patients with FM have more disability than those without FM. We evaluated the effect of FM on BMD and investigated the effect of FM on BMD in RA patients. Materials and Methods: We included age-matched 56 FM, 52 RA patients, and 37 healthy females as controls. Twenty three of all RA subjects met 1990 ACR FM criteria. Patients using the antiresorptive drugs, those on hormone replacement therapy, patients with thyroid or parathyroid dysfunction were excluded. Self-reported pain and fatigue severity, functional items of FM impact questionnaire were questioned in FM and RA patients. In all subjects, BMD of the lumbar spine and femur neck were determined by dual X-ray absorptiometry, and T-scores were recorded. Results: Self-reported pain and fatigue scores in FM subjects were significantly higher than in RA patients (P<0.001). The mean lumbar spine and femur neck BMD and their T-scores in RA patients were significantly lower than in FM and control groups (P values<0.01). There was no difference in BMD between FM subjects and the control group. BMD in RA patients with and without FM were similar (P>0.05). There was a significant negative correlation between self-reported pain score and lumbar spine BMD in FM subjects (r=-0.41, P=0.006). Conclusions: In spite of functional disability, FM does not cause a decrease in BMD. The presence of FM in RA patients does not result in a change in BMD.