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Objectives: This study aimed to assess the clinical outcomes and risk factors for severe coronavirus disease 2019 (COVID-19) in patients with inflammatory rheumatic disease (IRD) of a national cohort. Patients and methods: The multicenter cross-sectional study was carried out between July 15, 2020, and February 28, 2021. Data collection was provided from a national network database system, and 3,532 IRD patients (2,359 males, 1,173 females; mean age: 48.7±13.9 years; range; 18 to 90 years) were analyzed. Demographics, clinics about rheumatic disease, comorbidities, smoking status, being infected with COVID-19, and the course of the infection were questioned by rheumatology specialists. Results: One hundred seventeen patients were infected with COVID-19, the hospitalization rate due to COVID-19 was 58.9%, and the mortality rate was 1.7%. There was no difference between the COVID-19 positive and negative groups in terms of rheumatic disease activities and receiving drugs. It was observed that patients with COVID-19 had worse compliance with isolation rules, and bacillus Calmette-Guérin (BCG) vaccination was less common. The mean age and the rate of smoking of hospitalized COVID-19 patients were higher than those without hospitalization. Conclusion: In this cohort, in which real-life data were analyzed, COVID-19 rates in IRD patients were similar to the general population for the same period. Compliance with the isolation rules and BCG vaccination attracted attention as components that reduce the risk of COVID-19 infection. The risk factors for hospitalization were older age and smoking. [ABSTRACT FROM AUTHOR]

Objective: The C-reactive protein/albumin ratio (CAR) has recently emerged as a novel inflammatory biomarker, indicating its potential role in determining inflammation in various disorders. This study aims to investigate the role of CAO in determining disease activity in axial spondyloarthritis (axSpA). Material and Method: This study is a retrospective case-control study. A total of 128 patients with axSpA and 111 age-gender-matched healthy controls were included in the study. Serum albumin, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were recorded. CAR was calculated as serum CRP/Albumin. The Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Ankylosing Spondylitis Disease Activity Score-CRP (ASDAS-CRP) scores were used to determine disease activity. Patients were divided into two subgroups based on the BASDAI score: =4 was considered active disease, and <4 was considered an inactive disease. Additionally, axSpA patients were also subdivided into radiographic and non-radiographic disease groups. Results: CAR was significantly higher in axSpA patients compared to healthy controls (1.42 (0.91-4.49) and 0.46 (0.25-0.95), p<0.001, respectively). Similarly, CAO was found to be significantly higher in patients with active disease compared to those with inactive disease (4.61 (2.04-6.87) and 0.977 (0.75-1.52), p<0.001, respectively). CAR showed a significant correlation with CRP, ESR, BASDAI, and ASDAS-CRP (r=0.996, p<0.001; r=0.471, p<0.001; r=0.779, p<0.001, r=0.842, p<0.001, respectively). The area under the curve (AUC) for distinguishing active from inactive disease using CAR was 0.795 (95% confidence interval (CI) 0.714-0.861; p<0.001). Conclusion: CAR correlates highly with disease activity in axSpA. It can potentially be a useful biomarker for determining and monitoring inflammation in axSpA. [ABSTRACT FROM AUTHOR]

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Granulomatosis with polyangiitis (GPA) is a primary systemic vasculitis characterized by granulomatous inflammation. Arthritis in GPA is most commonly associated with large joints, particularly the knees and ankles; however, symmetrical polyarthritis of small joints has been rarely reported in literature. Here, we describe retrospective analysis of six patients with GPA showing initial symptom of symmetrical polyarthritis who were followed-up by three different rheumatology departments. Male sex, anti-cyclic citrulinated peptide negativity, and early arthritis period are important clues for GPA. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Sistemik lupus eritematozus (SLE) sıklıkla yüksek doz ste-roid ve immunsupresif tedavi gerektiren otoimmun sistemik birhastalıktır. Doğal immunitedeki primer defekder aynı zamanda enfeksiyonlara yatkınlıkta artışa katkıda bulunur. Bunların arasında özellikle tüberküloz (TB) enfeksiyonusıklıkla SLE'yi klinik olarak taklit edebilmekte veayırıcı tamda zorluğa yol açmaktadır. Burada eş zamank olarak hem TB hem de SLE tanısı olan olgu sunulmaktadır. Olgu: 19 yaşında bayan hasta polikliniğe halsizlik, ldlo kaybı, el ve dirsek eklemlerinde ağrı ve hareket kısıtlılığı şikayetleri ile başvurdu. Öyküsünde son 4 ayda 10 ldlo kaybı mevcuttu. Ro-matolojik sorgusunda ağız kuruluğu ve saç dökülmesi vardı. Fizik muayenede el bileklerinde şişlik, hassasiyet, sağ dirsekte ısı artışı ve ekstansiyon sonunda kısıtlılık mevcuttu. Aksiller bölgeden başlayan, göğüs yan duvarına kadar men yaklaşık 9×4 cm boyutlarında yumuşak ağrısız kitle palpe edildi. Tetkiklerinde WBC: 2990, lenfosit: 630, Hb: 8.6 g/dL, ESR: 71 mm/saat, CRP: 51 mg/L, ANA: 2+ benekli saptandı. ANA profilde; anti-ribozomal P, anti-Sm, nukleozom pozitifti. Direk Coombs 3+, C3 düşüktü. İdrarda protein +l'ti. Kemik iliği biyopsisinde nor-mosellüler saptandı. Yüzeyel doku US; sağ aksillayı belirgin derecede dolduran 9.5×4 cm boyutunda, düzgün sınırlı, lobüle ve belirgin vaskülaritesi bulunan heterojen hipoekoik kitle lezyonu izlenmiş olup, lenfadenopati ile uyumluydu. Toraks BT'de me-diasten ve hiluslarda çok sayıda kalsifikasyon içeren LAP'lar, sol akciğer apikal lobda multifokal konsolidasyon alanları saptandı (Şekil 1 ve 2 PS-247). Balgamda ARB görülmedi. Eksizyonel olarak çıkarılan kitlenin patolojisinde nekroze granülomatöz lenfadenit olarak raporlandı. Göğüs hastalıklarma tarafından TB tanısıyla anti-tüberküloz tedavi başlandı. Aynı zamanda hastaya SLICC kritelerine göre SLE tanısı da konularak hid-roksikloroldn 200 mg başlandı. Sonuç: SLE ve TB arasındaki ilişki komplex olup, biri diğerinin gelişmesi için risk faktörü gibi görünmektedir. Mikobakte-riyel enfeksiyonlar otoimmun fenomen ile yalandan ilişkilidir ve SLE gelişimini tetikleyebilir. SLE'li hastalarda da immuni-tedeki anormalliklere bağlı olarak enfeksiyonlara yatkınlık görülmekte veya tedaviye bağlı da gelişebilmektedir.TB tedavisi de (özellikle INH) lupus benzeri hastalığa ve alevlenmelere neden olabilmektedir. Gecikmiş taıu, immunsupresif ilaçlar ve eşlik eden SLE'nin alevlenmesi nedeniyle mortaliteyle sonuçlanabileceğinden TB enfeksiyonu pek çok açıdan farlandalık gerektirmektedir. [ABSTRACT FROM AUTHOR]