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Transient perivascular inflammation of the carotid artery (TIPIC) is a rare vascular disease characterized by inflammation of the carotid artery, leading to thickening of the carotid wall and unilateral carotidynia. This case report presents a 48-year-old woman who was diagnosed with TIPIC syndrome in a rheumatology outpatient clinic. The patient experienced right neck pain and numbness in the right hand, accompanied by local tenderness and increased arterial pulse. Laboratory tests showed no abnormalities, and imaging studies revealed inflammatory processes in the carotid artery. TIPIC syndrome is a self-limiting condition with a good prognosis and can be treated with nonsteroidal anti-inflammatory drugs. It is important for healthcare providers to be aware of this syndrome to prevent unnecessary treatment and to differentiate it from systemic vasculitis. [Extracted from the article]

Aim: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) infection may have a more severe course in patients with underlying disease or who have had immunosuppression. In this study, it was aimed to determine the frequency of coronavirus disease 2019 (COVID‐19) and the mortality rates related to COVID‐19 among patients with rheumatic disease. Methods: The patients who were followed up with rheumatic disease in the rheumatology outpatient clinic in a tertiary hospital were retrospectively assessed if they had COVID‐19 infection or not between March 2020 and January 2022. Results: A total of 10 682 patients were evaluated. There were 2928 (27.4%) COVID‐19‐positive and 7754 (72.6%) COVID‐19‐negative patients. The mean age of COVID‐19‐positive patients was 46.2 ± 14.6 years, and 65.8% were female. Forty‐two (1.4%) patients died due to COVID‐19. Among COVID‐19‐negative patients, 192 patients died. The most common rheumatic disease among patients with COVID‐19 was spondyloarthritis (SpA) (30.4%). Corticosteroids were the most common treatment agent in COVID‐19‐positive patients regardless of mortality. Thirty‐one (73.8%) patients were receiving corticosteroids, and 35 (83.3%) patients were receiving immunosuppressive agents among patients with mortality. According to the logistic regression analysis, older age, male gender, and receiving corticosteroid, hydroxychloroquine, mycophenolate mofetil, tofacitinib, rituximab, and cyclophosphamide were found to be related to increased mortality. Conclusion: COVID‐19 is a serious infection and the current study emphasized that patients with rheumatic diseases had increased mortality rates, particularly in patients who were old, male, and on immunosuppressive treatments. [ABSTRACT FROM AUTHOR]

Background/aim: The objective of this study is to evaluate the clinical presentations and adverse outcomes of Coronavirus Disease 2019 (COVID-19) in patients with systemic sclerosis (SSc) and assess the impact of SSc features on the clinical course of COVID-19. Materials and methods: In this multicenter, retrospective study, SSc patients with COVID-19 were included. Clinical features of SSc, along with detailed COVID-19 data, were extracted from medical records and patient interviews. Results: The study included 112 patients (mean age 51.4 ± 12.8 years; 90.2% female). SSc-associated interstitial lung disease (ILD) was evident in 57.1% of the patients. The findings revealed hospitalization in 25.5%, respiratory support in 16.3%, intensive care unit admission in 3.6%, and a mortality rate of 2.7% among SSc patients with COVID-19. Risk factors for respiratory failure, identified through univariate analysis, included ILD (OR: 7.49, 95% CI: 1.63-34.46), =1 comorbidity (OR: 4.55, 95% CI: 1.39-14.88), a higher physician global assessment score at the last outpatient visit (OR 2.73, 95% CI: 1.22-6.10), and the use of mycophenolate at the time of infection (OR: 5.16, 95 %CI: 1.79-14.99). Notably, =1 comorbidity emerged as the sole significant predictor of the need for respiratory support in COVID-19 (OR: 5.78, 95% CI: 1.14-29.23). In the early post-COVID-19 period, 17% of patients reported the progression of the Raynaud phenomenon, and 10.6% developed new digital ulcers. Furthermore, progression or new onset of dyspnea and cough were detected in 28.3% and 11.4% of patients, respectively. Conclusion: This study suggests a potential association between adverse outcomes of COVID-19 and SSc-related ILD, severe disease activity, and the use of mycophenolate. Additionally, it highlights that having comorbidities is an independent risk factor for the need for respiratory support in COVID-19 cases. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to investigate Behçet's syndrome (BS) patients' regarding anthropometric measurements, daily energy and nutrient intake, and the MD adherence of patients. METHODS: 100 consecutive patients with BS were prospectively enrolled in two rheumatology outpatient clinics. Mid Upper Arm circumference (MUAC), Triceps skinfold thickness (TST), Mid Upper Arm Muscle Circumference (MUAMC), and Mid Upper Arm Muscle Area (MUAMA) measurements of patients were compared with Turkish reference values. Participants' daily energy and nutrient intake were categorized by the 'MD Adherence Score.' RESULTS: Thirty patients (30%) had only mucocutaneous involvement. According to reference values, 47%, 36%, 14%, and 27% of the participants had low percentile values (<50. percentile) for MUAC, TST, MUAMC, and MUAMA, respectively. Walnuts (35%), eggplant (35%), and tomatoes (13%) were reported as the most prominent foods for symptom exacerbations. The mean MD adherence score was 23.5±6.5 (male: 23.2±6.9; female: 24.2±5.9) points and the adherence status was average (60%) and poor (35%) in the majority of the patients. CONCLUSIONS: Food consumption is important regarding symptom occurrence and multidisciplinary management of BS. Some participants had poor adherence to the MD. Increased waist/hip ratio, BMI, and decreased TST and MUAMA may indicate body muscle mass and unhealthy eating patterns. Patients with BS need encouragement for healthy eating habits. [ABSTRACT FROM AUTHOR]

Objectives: Behçet's disease (BD) is a multisystem disease and frequently occurs during the second–fourth decades of life, although disease onset may be seen at any age. This study aimed to analyze the influence of the age of onset on clinical manifestations of BD. Materials and methods: This retrospective study analyzed two cohorts (paediatric and adult) to determine the association between the age of onset and clinical features in BD. Patients were classified into four groups to analyze the clinical characteristics according to the age of fulfilling the BD diagnostic criteria as follows: childhood onset (<12 years), adolescent onset (13–17 years), adult onset (18–39 years), and late onset (>40 years). Results: The study included 801 patients with BD. Male predominance, pathergy test positivity, aphthosis (oral or genital), and skin and ocular involvements were higher among adult patients than paediatric patients. The presence of positive family history for BD, neuro-BD, and epididymitis were observed significantly common in the paediatric group. Conclusion: There may be differences in clinical manifestations with regard to the age of disease onset. Disease presentations may differ from adult patients, and clinicians should be aware of the high familial aggregation rate of BD, especially in countries where the disease is endemic. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate the hepatitis B (HBV) and C (HCV) frequency and clinical characteristics among patients with rheumatoid arthritis (RA) or spondyloarthritis (SpA) who receive biological treatments. Patients and methods: The observational study was conducted with patients from the TReasure database, a web-based prospective observational registry collecting data from 17 centers across Türkiye, between December 2017 and June 2021. From this database, 3,147 RA patients (2,502 males, 645 females; median age 56 years; range, 44 to 64 years) and 6,071 SpA patients (2,709 males, 3,362 females; median age 43 years; range, 36 to 52 years) were analyzed in terms of viral hepatitis, patient characteristics, and treatments used. Results: The screening rate for HBV was 97% in RA and 94.2% in SpA patients. Hepatitis B surface antigen (HBsAg) positivity rates were 2.6% and 2%, hepatitis B surface antibody positivity rates were 32.3% and 34%, hepatitis B core antibody positivity rates were 20.3% and 12.5%, HBV DNA (deoxyribonucleic acid) positivity rates were 3.5% and 12.5%, and antibody against HCV positivity rates were 0.8% and 0.3% in RA and SpA patients, respectively. The HBsAg-positive patients were older and had more comorbidities, including hypertension, diabetes, and coronary artery disease. In addition, rheumatoid factor (RF) positivity was more common in HBsAg-positive cases. The most frequently prescribed biologic disease-modifying antirheumatic drugs were adalimumab (28.5%), etanercept (27%), tofacitinib (23.4%), and tocilizumab (21.5%) in the RA group and adalimumab (48.1%), etanercept (31.4%), infliximab (22.6%), and certolizumab (21.1%) in the SpA group. Hepatitis B reactivation was observed in one RA patient during treatment, who received rituximab and prophylaxis with tenofovir. Conclusion: The epidemiological characteristics of patients with rheumatic diseases and viral hepatitis are essential for effective patient management. This study provided the most recent epidemiological characteristics from the prospective TReasure database, one of the comprehensive registries in rheumatology practice. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to assess the demographic and clinical characteristics of patients with adult-onset Still's disease (AOSD) under biological treatment. Patients and methods: This retrospective cohort study included a total of 19 AOSD patients (13 males, 6 females; median age: 37 years; range, 28 to 52 years) who received biological drugs due to refractory disease between January 2008 and January 2020. The data of the patients were obtained from the patient files. The response to the treatment was evaluated based on clinical and laboratory assessments at third and sixth follow-up visits. Results: Interleukin (IL)-1 inhibitor was prescribed for 13 (68.4%) patients and IL-6 inhibitor prescribed for six (31.6%) patients. Seventeen (89.5%) patients experienced clinical remission. Conclusion: Biological drugs seem to be effective for AOSD patients who are resistant to conventional therapies. Due to the administration methods and the high costs of these drugs, however, tapering the treatment should be considered, after remission is achieved. [ABSTRACT FROM AUTHOR]

Objective: The etiopathogenesis of spondyloarthropathies (SpA) is still unclear. Recently, anti-CD74 antibody has been suspected to play a role in SpA etiopathogenesis. This study aimed to examine the levels of anti-CD74 antibody in patients with SpA and investigate their association with disease activity. Methods: This study was conducted using data from patients who were treated at the departments of rheumatology and gastroenterology between June 2013 and November 2013. The demographic and clinical characteristics of the participants and their serum IgG-type antibodies against anti-CD74 were analyzed. Results: We analyzed 111 patients with ankylosing spondylitis (AS), 108 patients with inflammatory bowel disease (IBD), and 101 healthy controls. The rate of human leukocyte antigen--B27 positivity was 86.5% in patients with AS and 21.3% in patients with IBD. The mean levels of anti-CD74 antibodies in the AS, IBD, and control groups were 6.99±3.24 ng/mL, 6.25±3.34 ng/mL, and 7.83±4.72 ng/mL, respectively. Anti-CD74 levels were higher in healthy controls than in patients with IBD (P = .009). There was no significant difference in anti-CD74 levels between the AS and IBD groups and the AS and control groups. In addition, there was no correlation between anti-CD74 levels and disease activity. Conclusion: This study could not find an association between anti-CD74 levels and SpA in Turkish patients. [ABSTRACT FROM AUTHOR]

Background/aim: Familial Mediterranean fever (FMF) is a hereditary autoinflammatory disease that requires lifelong colchicine treatment. Colchicine is the mainstay of the treatment, which decreases the frequency and the severity of recurrent FMF attacks and prevents the development of amyloidosis. This study aimed to investigate the rates of colchicine treatment adherence in patients with FMF and the factors related to treatment non-adherence. Materials and methods: This observational study was conducted with 179 patients with FMF between November 2018 and April 2019 in a tertiary rheumatology outpatient clinic. The sociodemographic and clinical data were recorded. Compliance Questionnaire on Rheumatology (CQR) was used to assess the treatment adherence and the Beliefs About Medicines Questionnaire (BMQ-T) was used to assess a patient’s beliefs about colchicine. The factors associated with adherence to the treatment were evaluated. Results: The study included 113 male (63.1%) and 66 (36.9%) female patients with a mean age of 30 (25–44) years. The rate of the patients who declared regular colchicine usage was 66.5%. The frequency of non-adherent patients was 83.8% according to CQR. Treatment adherence was better in patients with comorbid diseases than those without (41.4% vs. 22%, respectively, p = 0.028). The frequency of married patients in the adherent group (72.4%) was higher than the non-adherent group (47.3%) (p = 0.013). The colchicine dose used in the adherent group was 1.5 (1.3–1.8) mg/day, whereas it was 1.5 (1.0–1.5) mg/day in the non-adherent group (p = 0.033). The adherence rate was rising with increasing scores of BMQ-T Specific Necessity. As the scores of BMQ-T General Overuse and General Harm increased, non-adherence to colchicine increased. Conclusion: Evaluating adherence to colchicine treatment with objective methods is crucial to ensure sufficient treatment and prevent amyloidosis. Determining beliefs about colchicine may increase patients’ adherence to treatment. [ABSTRACT FROM AUTHOR]

Objective: Central Physician Appointment System (CPAS) is being used for creating appointments to be examined in hospitals, oral and dental health centers or by general practitioners since 2010. This study aimed to evaluate the frequency and the causes of non-attendance to appointments in a tertiary rheumatology outpatient clinic. Methods: One hundred and ninety-seven patients, who created but did not attend an appointment between June 2019 and January 2020 in the rheumatology outpatient clinic of Gülhane Training and Research Hospital, were included in the study. Demographical characteristics and the reasons for non-attendance to the appointments were learned by phone call. Results: There were 148 (75.1%) female and 49 (24.9%) male patients, whose mean age was 51.1±16.2 years. We could not contact 74 (37.6%) patients due to the wrong phone number or not answering the phone call. The reasons for non-attendance were workrelated in 55 (44.7%) patients, feeling too sick in 18 (14.6%) patients, caring for a child in 9 (7.3%) patients, forgetting the appointment in 7 (5.7%) patients, feeling better in 4 (3.3%) patients, a problem about transportation in 1 (0.8%) patient and having another health problem in 1 (0.8%) patient. Conclusion: The ratio of non-attendance to appointments in the rheumatology outpatient clinic is lower than other departments. The most frequent reasons were neglect of employer and limitation due to the activation of disease. Applications of information systems added to CPAS or an informing message for employers about the appointments of their employees may be useful for preventing non-attendance to appointments. [ABSTRACT FROM AUTHOR]

Amaç: Erkek sistemik lupus eritematozus (SLE) hastalarında hastalık özelliklerinin farklı olduğu, daha fazla renal ve kardiyak tutulum nedeni ile daha şiddetli hastalığa sahip olabildikleri bildirilmektedir. Kadın baskınlığı nedeniyle erkek hastalara ilişkin klinik bulguların daha iyi belirlenmesine ihtiyaç vardır. Bu çalışmada, SLE'li erkek hastaların klinik özelliklerini değerlendirmek amaçlandı. Yöntem: Bu retrospektif çalışmaya, Ekim 2016 ile Aralık 2021 arasında Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi Romatoloji Polikliniği'nde takip edilen erkek SLE hastaları dahil edildi. 2012 SLE Uluslararası İş Birliği Klinikleri (SLICC) kriterlerini karşılayanlar dahil edildi. Hastaların verileri ve SLE Hastalık Aktivite İndeksi-2000 (SLEDAI-2K) değerleri dosyalardan elde edildi. Bulgular: Çalışmaya alınan 40 hastanın ortalama yaşları 42,7±17,3 yıl idi. Medyan tanı yaşı 30 (89-19) yıl, medyan hastalık süresi 63,5 (5-444) ay ve ortalama SLICC skoru 4,7±0,8 idi. En sık görülen ilk klinik belirtiler her biri 8 (%9,6) hastada görülen trombositopeni ve fotosensitivite idi (Tablo 1). Altı (%15) hastada sekonder antifosfolipid antikor sendromu vardı. Otuz beş (%87,5) hastada başlangıç tedavisi ile remisyon sağlanırken, takip döneminde on dört (%35) hastada en az bir relaps görüldü. Nüks sonrası en sık bulgu, tanı anında böbrek tutulumu olmayan dokuz (%22,5) hastada lupus nefriti idi. Bunların medyan SLEDAI skoru 2 (0-12) idi. Tedavi için en sık tercih edilen ilaç hidroksiklorokin ve kortikosteroidlerdi (her biri için %92,5). On dokuz (%47,5) hastaya pulse steroid verildi. Ayrıca en sık reçete edilen immünosüpresif ilaç mikofenolat mofetil (%37,5) idi. Azatioprin, siklofosfamid, metotreksat, siklosporin A, rituksimab, intravenöz immünoglobulin ve leflunomid kullanım oranları sırasıyla %30, %27,5, %17,5, %10, %7,5, %7,5, %5 idi. Sonuç: Bu çalışmada seropozitiflik oranının literatürdekinden daha az olması erkek hastaların dikkatle değerlendirilmesi gerektiğini göstermektedir. Morbiditeyi ve mortaliteyi önemli derecede etkileyebilen böbrek tutulumu ilk tutulumda daha az görülse de takip esnasında ortaya çıkabilir. [ABSTRACT FROM AUTHOR]

Amaç: COVID-19 patogenezinde, interlökin-6'nın (IL-6) önemli rolü nedeniyle, IL-6 reseptör antikoru olan tocilizumabın etkin bir tedavi seçeneği olacağı düşünülmüştür. Ancak, COVID-19'lu hastalarda tocilizumabın etkinliğinin değerlendirildiği randomize kontrollü klinik çalışmalarının sonuçları tutarlı değildir. Bu çalışmanın amacı, COVID-19 sebebi ile hospitalize edilen ve standart tedaviye yanıtsızlık sebebi ile tocilizumab uygulanan hastalarda, tedavi öncesi prognostik nutrisyon indeksi (PNİ), C-reaktif protein/albümin oranı (CAR), sistemik immünenflamatuvar indeks (Sİİ), IL-6 ve laktat dehidrojenaz (LDH) düzeylerinin tedavi yanıtını öngörmedeki yerini araştırmaktır. Yöntem: Tocilizumab uygulanan 133 COVID-19 hastası dahil edildi. Primer sonlanım noktası, 28. gündeki ölüm oranı ve yeni gelişen mekanik ventilasyon ihtiyacı olarak belirlendi. Bulgular: Tocilizumab tedavisi sonrası 34 (%25,56) hasta öldü. Tocilizumab sonrası iyileşen hastalar, ölen hastalardan daha gençti ve daha düşük IL-6, LDH, Sİİ, CAR düzeyi ve daha yüksek PBİ düzeyine sahipti (Tablo 1). Tek değişkenli lojistik regresyon analizinde, yaş, IL-6, LDH, PBİ, Sİİ, CAR ve CRP mortalitenin bağımsız prediktörü olarak saptandı. Ancak, çok değişkenli lojistik regresyon analizinde sadece yaş ve LDH, tocilizumab sonrası mortalitenin bağımsız prediktörleri olarak saptandı (Tablo 2). COVID-19 hastalarında tocilizumab yanıtını belirlemek için, IL-6 en yüksek eğri altında kalan alan (EAA) değerine sahipti (EAA: 0,782, %95 GA: 0,694-0,870), ardından LDH (EAA: 0,761, %95 GA: 0,661-0,861), PBİ (EAA: 0,696, %95 GA: 0,584-807), Sİİ (EAA: 0,671, %95 GA: 0,551-0,790), CAR (EAA: 0,682, %95 GA: 0,578-0,786) ve CRP (EAA: 0,643, %95 GA: 0,535-0,751) geliyordu. Sonuç: Düşük IL-6, LDH, Sİİ, CAR ve yüksek PBİ düzeyleri olan hastalarda tocilizumab tedavisi sonrası düzelme olmasına rağmen, sadece serum LDH düzeyi ve yaş mortalitenin bağımsız prediktörleridir. [ABSTRACT FROM AUTHOR]

Bone destruction, which has an unknown etiology, can be seen in the course of systemic sclerosis. On the other hand, osteolysis may not always be acro-osteolysis. In this case report, a patient with systemic sclerosis and osteolysis in bilateral distal ulna is reported to emphasize the importance of being careful about the presence of osteolysis in tubular bones in patients with systemic sclerosis. Osteolysis in systemic sclerosis may be associated with disease severity. [ABSTRACT FROM AUTHOR]

Amaç: SARS-CoV-2 enfeksiyonu (COVID-19), altta yatan hastalığı olan veya immünosüprese hastalarda daha ağır seyredebilmektedir. Bu çalışmada romatizmal hastalık ile takip edilen hastalarda COVID-19 sıklığı ve ölüm oranının belirlenmesi amaçlanmıştır. Yöntem: Bu tanımlayıcı çalışmada Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi, Romatoloji Polikliniği'ne 01.09.2016-01.01.2022 tarihleri arasında başvuran ve romatizmal hastalık tanısı olan 18 yaş üstü hasta kayıtları retrospektif olarak tarandı. Hastaların demografik verileri, COVID-19 pozitifliği ve mortalite olup olmadığı, COVID-19 pozitif olan hastaların da aldığı tedaviler hasta dosyalarından kaydedildi. Bulgular: Toplam 10.702 hasta (yaş 47,13±15,97, %62,1 kadın) değerlendirildi. Hastaların 2.935'inin (%27,4) COVID-19 pozitifliği saptandı. COVID-19 pozitif olan hastaların 1.930'u (%65,8) kadındı, ortalama yaş 46,2±14,6 idi. En sık spondiloartropati (SpA) tanısı mevcuttu (%30,3). COVID-19 pozitif olanların diğer tanı verileri Tablo 1'de özetlenmiştir. COVID-19 pozitif olan hastalarda olmayanlara göre kadın oranı daha fazla (p<0,001), yaş ortalaması daha düşüktü (p<0,001). COVID-19 ilişkili mortalite 42 (%1,4) hastada görüldü (medyan yaş 67,5, %52,4 kadın). Mortalite gözlenen hastalarda en sık saptanan romatizmal hastalık Romatoid artrit (RA) idi (%42,9) (Tablo 1). Otuz bir (%73,8) hasta kortikosteroid, 35 (%83,3) hasta immünosüpresif ajan almaktaydı (Tablo 2). COVID-19'a bağlı ölen hastalar yaşayan hastalar ile karşılaştırıldığında, ölen hastaların daha ileri yaşta oldukları saptandı (p<0,001). Ayrıca ölen hasta grubunda SpA (p<0,001), RA (p=0,001) ve polimiyaljiya romatika (PMR) (p=0,012) daha fazla saptandı. Sonuç: Çalışmamızda COVID-19 ilişkili mortalite kortikosteroid ve immünosüpresif tedavi kullanan ileri yaştaki hastalar ile RA, SpA ve PMR tanısı olan hastalarda yüksek bulunmuştur. Biyolojik kullanan hasta sayısı az olsa da özellikle rituksimab kullanan hastalara COVID-19'un fatal sonuçları açısından dikkat edilmelidir. [ABSTRACT FROM AUTHOR]

Amaç: Sigaranın ankilozan spondilit (AS) hastalarının prognozu ve tedavisi üzerinde olumsuz etkisi olduğu iyi bilinmektedir. Bu çalışmada AS hastalarında sigara bırakma oranlarının ve sigarayı bırakmada etkili faktörlerin değerlendirilmesi amaçlanmıştır. Yöntem: Bu kesitsel çalışma Mart-Haziran 2022 tarihleri arasında Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi'nde yapılmıştır. Romatoloji polikliniğinde takipli AS hastaları çalışmaya alındı. Hastaların demografik verilerinin yanı sıra sigara içme durumları, sigara içme süresi, günlük ortalama sigara sayısı, bırakan hastaların sigarayı bırakma nedenleri ve sigarayı bırakma yöntemleri sorgulandı. Bulgular: Çalışma 158 (%51,3) erkek ve 150 (%48,7) kadın olmak üzere 308 hasta üzerinden gerçekleştirildi. Yüz on dokuz (%38,6) hasta halen sigara içiyor, 121 (%39,3) hasta sigarayı bırakmış ve 68 (%22,1) hasta sigara kullanmamıştı (Tablo 1). Sigarayı bırakanların 41'i (%33,9) romatolog tavsiyesi ile ve 32'sinde (%26,4) AS hastalığı nedeniyle sigarayı bıraktıklarını bildirdi. Ayrıca 61 hastada (%19,8) ise, sigara içip içmedikleri hakkında daha önce sorgulanmadıkları tespit edildi. Sigarayı bırakmada en sık kullanılan yöntemler ise bitkisel tedaviler 48 (%39,7) ve sigara bırakma ilaçları 47 (%38,8) olarak saptandı (Tablo 2). Sonuç: Hastalık prognozu üzerinde önemli ve değiştirilebilir bir etken olan sigaranın, hastaların yaklaşık beşte birinde değerlendirilmediği tespit edilmiştir. Diğer yandan sigarayı bırakanlar üzerinde etkisi en fazla olan faktörün de takip eden romatolog olduğu gözlenmiştir. Romatologların tüm AS hastalarının sigara alışkanlıklarını sorgulaması ve bırakma konusunda yönlendirici olmalarının, daha olumlu sonuçlar getireceği öngörülebilir. [ABSTRACT FROM AUTHOR]

Amaç: Hiperferritinemi enflamasyon, enfeksiyon veya malignite gibi çeşitli nedenlere bağlı olarak gelişebilir. çalıŞmamızda, serum ferritin düzeyi =1,000 µg/L olan hastaların Koronavirüs hastalığı-2019 (COVID-19) pandemisi öncesinde ve sonrasında kliniklerine ve tanılarına göre dagılımını araŞtırmayı ve karşılaştırmayı amaçlamaktayız. Yöntem: Serum ferritin düzeyleri =1,000 µg/L olan 18 yaş üstü ve 85 yaş altı tüm hastalar çalışmaya dahil edildi. Hastaların demografik özellikleri, tanıları ve takip oldukları servisler tıbbi kayıtlardan elde edilerek retrospektif olarak kaydedildi. Birden fazla ferritin ölçümü yapılan hastalarda en yüksek değer alındı. Hastaların kliniklerine ve tanılarına göre dağılımları, COVID-19 pandemisi öncesindeki 18 ay ve sonrasındaki 18 ayı kapsayacak şekilde belirlendi. Bulgular: Çalışmamıza toplamda 2,022 hasta dahil edildi. COVID-19 pandemisi öncesindeki 554 hastanın ve COVID-19 pandemisi sonrasındaki 1,468 hastanın ferritin düzeyi 1000 µg/L ve üzerindeydi. Pandemi öncesinde hastaların yaş ortancası 57 (39-69), pandemi sonrasında ise hastaların yaş ortancası 63 (52-72) idi. Pandemi öncesine göre pandemi sonrasında hiperferritineminin nedenleri erkek hastalarda anlamlı şekilde artmıştı (p<0,001). Pandemi öncesinde en sık hiperferritinemi nedeni olarak hematolojik maligniteler yer alır iken pandemi sonrasında en sık olarak COVID-19 enfeksiyonu yer almaktaydı (Tablo 1). Takip oldukları servislere göre dağılımına bakıldığında ise pandemi öncesinde hematoloji bölümü, pandemi sonrasında ise COVID-19 klinikleri hiperferritineminin en sık saptandığı bölümlerdi. Sonuç: Serum ferritin değerleri sıklıkla enfeksiyöz, enflamatuvar ve malign durumlarda bir akut faz reaktanı olarak yükselebilmektedir. Özellikle =1,000 µg/L üzerinde ki değerler hastanın klinik durumuna göre klinisyenleri daha spesifik tanılara yönlendirebilmektedir. COVID-19 pandemisi ile birlikte enfeksiyonun hiperenflamatuvar sendroma yol açabilmesi sebebi ile özellikle klinik durumu destekleyeci laboratuvar testi olarak sıklıkla serum ferritin ölçü mü istenmiş ve yüksek saptanmıştır. Bu sebeple aŞırı yüksek ferritin degerleri tespit edildiginde birçok önemli klinik durumları akılda tutmak gerekse de ilk olarak hastanın klinik durumu ile uyumlu olabilecek en yaygın tabloları düŞü nmemiz gerektigi kanaatindeyiz. [ABSTRACT FROM AUTHOR]