Löfgren Sendromunda kas-iskelet sistemi bulgularının değerlendirildiği klinik araştırma
Loading...
Date
2020-10-01
Authors
Ayar, Koray
Ermurat, Selime
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Biz bu çalışmada Löfgren sendromu ile takipli olan hastaların başlangıç eklem bulgularını ve seyrini, eklem bulgularına eşlik eden bulguları tespit etmeyi, kronik ve akut artrit ile seyreden olguların eklem ve laboratuvar bulguları ile kullandıkları ilaçları karşılaştırarak hangi değişkenlerin kronikleşmeyi etkilemiş olabileceğini araştırmayı amaçladık. Çalışmada 3071 hastanın dosyası retrospektif olarak incelenmiş olup 12 Löfgren sendromlu hasta çalışmaya dahil edilmiştir. Hastaların başlangıç klinik ve laboratuvar bulguları hasta dosyalarından, başlangıç görüntüleme tetkikleri "PACS" sisteminden, kas iskelet sistemi bulguları da telefonla veya yüz yüze görüşülerek elde edilmiştir. Katılımcılar akut artrit (<6 hafta) ve kronik artrit (≥6 hafta) olarak 2 gruba ayrılarak eklem tutulum paternleri ve laboratuvar bulguları gruplar arasında karşılaştırılmıştır. Kullanılan ilaçların sıklığına göre eklem tutulum paternleri de incelenmiştir. Katılımcıların başlangıç klinik bulguları sıklık sırasına göre artrit (%58,3) eritema nodozum (%58,3), göğüs ağrısı (%16,6), bel ağrısı (%8,4), nefes darlığı (%8,4) ve öksürüktür (%8,4). Ayak bileği ödemi, akut artrit ve oligoartrit sıklıkları sırasıyla %75,0, %58,3 ve %75,0'dır. El bileği ve proksimal interfalangial eklemlerin tutulumlarının sıklıkları kronik artrit seyri olanlarda sırasıyla %40 ve %20 iken akut artrit seyri olanlarda sırasıyla %14,7 ve %0 oranında tespit edilmiştir. Sülfasalazin, hidroksiklorokin ve kolşisin kullananlarda kronik artrit seyri sırasıyla %20, %75 ve %100 oranındaydı. Löfgren sendromunda el bileği, proksimal interfalangial eklem ve dirsek tutulumu kronik artrit seyrinde daha sıktır, anjiyotensin dönüştürücü enzim akut artritte daha yüksek görülme eğilimindedir; bunun dışında hastalığın seyrinde ayırt ettirici olabilecek karakteristik klinik ve laboratuvar özellik yoktur. Sülfasalazin gibi potensi yüksek hastalığı modifiye edici ilaçlar hastalığın eklem bulgularının daha kısa sürede kontrol altına alınmasında etkili olabilirler.
In this study, we aimed to determine the initial joint findings in Löfgren's syndrome and investigate which variables might have affected chronicity in patients with the drugs they used. Charts of 3071 patients were analyzed retrospectively and 12 patients were included in the study. The initial clinical and laboratory findings of the patients were obtained from the patients charts, the initial imaging with Löfgren syndrome examinations were obtained from the PACS system, and the musculoskeletal system findings were obtained by telephone or faceto-face interview. Participants were divided into 2 groups as acute (<6 weeks) and chronic arthritis (6 weeks) and joint patterns and laboratory findings were compared between groups. Joint patterns were also analyzed according to the frequency of the drugs used. Initial clinical findings were arthritis (58.3%), the erythema nodosum (58.3%), chest pain (16.6%), low back pain (8.4%), shortness of breath (8.4%) and cough (8.4%). The frequencies of ankle edema, acute arthritis and oligoarthritis were 75.0%, 58.3% and 75.0%, respectively. While the frequency of and proximal interphalangial joint involvement was 40% and 20% in chronic arthritis, it was 14.7% and 0%, respectively, in acute arthritis. The course of chronic arthritis in sulfasalazine, hydroxychloroquine and colchicine users was 20%, 75% and 100%, respectively. Wrist, proximal interphalangial joint and elbow involvement are more common in chronic arthritis, angiotensin converting enzyme tends to be higher in acute arthritis; apart from this, there are no characteristic features that can be distinguished in the course of the disease. High potency disease-modifying drugs such as sulfasalazine may be effective in controlling joint symptoms of the disease in a shorter time.
In this study, we aimed to determine the initial joint findings in Löfgren's syndrome and investigate which variables might have affected chronicity in patients with the drugs they used. Charts of 3071 patients were analyzed retrospectively and 12 patients were included in the study. The initial clinical and laboratory findings of the patients were obtained from the patients charts, the initial imaging with Löfgren syndrome examinations were obtained from the PACS system, and the musculoskeletal system findings were obtained by telephone or faceto-face interview. Participants were divided into 2 groups as acute (<6 weeks) and chronic arthritis (6 weeks) and joint patterns and laboratory findings were compared between groups. Joint patterns were also analyzed according to the frequency of the drugs used. Initial clinical findings were arthritis (58.3%), the erythema nodosum (58.3%), chest pain (16.6%), low back pain (8.4%), shortness of breath (8.4%) and cough (8.4%). The frequencies of ankle edema, acute arthritis and oligoarthritis were 75.0%, 58.3% and 75.0%, respectively. While the frequency of and proximal interphalangial joint involvement was 40% and 20% in chronic arthritis, it was 14.7% and 0%, respectively, in acute arthritis. The course of chronic arthritis in sulfasalazine, hydroxychloroquine and colchicine users was 20%, 75% and 100%, respectively. Wrist, proximal interphalangial joint and elbow involvement are more common in chronic arthritis, angiotensin converting enzyme tends to be higher in acute arthritis; apart from this, there are no characteristic features that can be distinguished in the course of the disease. High potency disease-modifying drugs such as sulfasalazine may be effective in controlling joint symptoms of the disease in a shorter time.
Description
Keywords
Eritema nodozum, Löfgren sendromu, Erythema nodosum, Sarkoidoz, Sarcoidosis, Löfgren's syndrome
Citation
Ayar, K. ve Ermurat, S. (2020). ''Löfgren Sendromunda kas-iskelet sistemi bulgularının değerlendirildiği klinik araştırma''. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 46(3), 291-297.