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Hereditary angioedema (HAE) is a rare, debilitating and potentially life-threatening disease characterized by recurrent attacks of oedema. With the development of new therapies and better availability of diagnostic tools, important advances have been made. However, the disease still remains frequently misdiagnosed and inadequately treated. Familial Mediterranean fever (FMF) is an autoinflammatory syndrome comprised of serositis, fever, arthritis and skin involvement. Both diseases can cause severe abdominal pain resembling that of acute abdomen. We report a case of three family members that presented with various symptoms that could fit in a clinical picture of both diseases, only to confirm a diagnosis of HAE type II after a diagnostic delay of many years.

Contains fulltext : 172407.pdf (Publisher’s version ) (Closed access) IMPORTANCE: Digital ulcers in patients with systemic sclerosis are associated with pain and poor quality of life. Endothelin-1 promotes vasculopathy in systemic sclerosis after macitentan, an endothelin-1 blocker. OBJECTIVE: To evaluate the efficacy of macitentan in reducing the number of new digital ulcers in patients with systemic sclerosis. DESIGN, SETTING, AND PARTICIPANTS: Two international, randomized, double-blind, placebo-controlled trials (DUAL-1, DUAL-2) were conducted between January 2012 and February 2014. Participants were patients with systemic sclerosis and active digital ulcers at baseline. Target enrollment for each study was 285 patients. INTERVENTIONS: Patients were randomized (1:1:1) to receive oral doses of 3 mg of macitentan, 10 mg of macitentan, or placebo once daily and stratified according to number of digital ulcers at baseline (3). MAIN OUTCOMES AND MEASURES: The primary outcome for each trial was the cumulative number of new digital ulcers from baseline to week 16. Treatment effect was expressed as the ratio between treatment groups. RESULTS: In DUAL-1, among 289 randomized patients (mean age 51.2 years; 85.8% women), 226 completed the study. The adjusted mean number of new digital ulcers per patient over 16 weeks was 0.94 in the 3-mg macitentan group (n = 95) and 1.08 in the 10-mg macitentan group (n = 97) compared with 0.85 in the placebo group (n = 97) (absolute difference, 0.09 [95% CI, -0.37 to 0.54] for 3 mg of macitentan vs placebo and 0.23 [-0.27 to 0.72] for 10 mg of macitentan vs placebo). Among 265 patients randomized in DUAL-2 (mean age 49.6 years; 81.9% women), 216 completed the study. In DUAL-2, the adjusted mean number of new digital ulcers was 1.44 in the 3-mg macitentan group (n = 88) and 1.46 in the 10-mg macitentan group (n = 88) compared with 1.21 in the placebo group (n = 89) (absolute difference, 0.23 [95% CI, -0.35 to 0.82] for 3 mg of macitentan vs placebo and 0.25 [95% CI, -0.34 to 0.84] for 10 mg of macitentan vs placebo). Adverse events more frequently associated with macitentan than with placebo were headache, peripheral edema, skin ulcer, anemia, upper respiratory tract infection, diarrhea, and nasopharyngitis. CONCLUSIONS AND RELEVANCE: Among patients with systemic sclerosis and active ischemic digital ulcers, treatment with macitentan did not reduce new digital ulcers over 16 weeks. These results do not support the use of macitentan for the treatment of digital ulcers in this patient population. TRIAL REGISTRATION: clinicaltrials.gov Identifiers: NCT01474109, NCT01474122.

Visceral leishmaniasis triggering (mimicking) macrophage activation syndrome in a patient with adult onset Still disease

Polymyositis (PM) is a chronic autoimmune disease characterised by symmetrical and bilateral inflammation of proximal muscles. Course of the disease is diverse with symptoms varying from painless muscle weakness to myalgias and constitutional symptoms, but also affection of pharyngeal and respiratory muscles in severe cases (1). Interstitial lung disease (ILD) is found in 60–70% of patients at the time of diagnosis. Pulmonary complications are a major factor causing mortality and a marker of poor prognosis (2)

Background: Although the number of fulfilled ACR criteria is not a feature of disease severity in patients with systemic lupus erythematosus (SLE), renal and neurologic involvement are associated with a severe disease course (1, 2). Objectives: Comparison of the number of fulfilled ACR criteria between SLE patients (a) deceased early and late during the disease course and (b) identified and not identified as deceased in the period from 2006 to 2011. Methods: Data were retrieved from our hospital- based registry of SLE patients. Patients with a clinical diagnosis of SLE and at least one visit to the Centre in the 2006-2011 period or death in the same period were analyzed. Deceased patients were identified using the registry and death certificates. The number of fulfilled ACR criteria was counted for each patient. The χ2 test and Fisher exact test, as well as the Student t-test were used to evaluate differences between categorical and continuous variables, respectively. The study was approved by the hospital ethics committee. Results: The total number of SLE patients with at least one visit to the Centre between 2006 and 2011 identified from the registry was 702. The frequency of ACR criteria was available for 693/702 patients. We identified 48 deceased patients (31 females and 17 males): 28 using the registry and 20 using death certificates - the latter were lost to follow-up before 2006. Data on the year of diagnosis and fulfillment of ACR criteria were not available for 4 deceased patients. The length of follow-up in the observed group of deceased patients was 12.09±7.38 years. Only 9/44 patients died within the first 5 years following diagnosis (early death). The rest of observed patients (35/44) died later during the disease course. The number of fulfilled criteria in the early and late death group was 4.11±1.05 and 4.71±1.56, respectively (difference not statistically significant). No difference was observed between the fulfillment of each of the criteria, except for the malar rash (19/35 in the late death group vs. 1/9 in the early death group, p=0.027). The frequency of renal disorder and discoid rash was significantly higher in the deceased patient group compared to patients not identified as deceased (21/44 vs. 167/665, χ2=9.702, p=0.002 and 20/44 vs. 128/665, χ2=15.610, p

Retrospektivna analiza podataka o liječenju golimumabom bolesnika s upalnim reumatskim bolestima u Hrvatskoj

Bolesnici koji razviju totalnu spinalnu ankilozu (TSA) podložniji su funkcionalnoj onesposobljenosti, ali i većem riziku ozbiljnijih komplikacija bolesti (npr. osteoporotski prijelomi, deformacije kralježnice). Osim toga, mogu imati znakove i simptome aktivnog ankilozantnog spondilitisa. Cilj rada bio je ocijeniti učinkovitost i sigurnost primjene svih TNF-α blokatora kod bolesnika sa AS i TSA. Primarni ishod: dostizanje ASAS 20 (the Assessment in AS International Working Group criteria for 20% improvement) u 12. i 52. tjednu primjene lijeka. Vrsta istraživanja: opservacijsko, multicentrično. Trideset bolesnika (26 muškaraca, 4 žene, prosječne životne dobi 49, 2 ± 11, 6 godina) s ankilozantnim spondilitisom dijagnosticiranim na temelju modifi ciranih NY kriterija iz 1987. godine i aktivnom bolesti (BASDAI ≥ 4) uključeno je u ovo istraživanje. Svi bolesnici s dijagnozom AS i TSA su regrutirani iz kliničkih baza podataka sedam različitih reumatoloških odjela u Hrvatskoj. Lije- čenje TNF-α inhibitorima indicirano je na temelju smjernica Hrvatskog reumatološkog društva iz 2007. godine i odobreno je od strane Povjerenstva za lijekove nadlež- nih zdravstvenih ustanova. Devetnaest je ispitanika bilo Sažetak Abstract2013. 60(2) Reumatizam 115 na terapiji adalimumabom, devet ispitanika etanerceptom, a po jedan ispitanik na terapiji golimumabom odnosno infl iximabom. U istraživanju je korišten strukturirani upitnik koji sadržava demografske i kliničke podatke. Srednje vrijednosti slijedećih varijabli su evaluirane u na početku liječenja, u 12. i 52. tjednu praćenja: funkcija (BASFI), aktivnost bolesti (BASDAI), bolesnikova i liječnikova globalna procjena aktivnosti bolesti na vizualnoj analognoj skali, te ukupni intenzitet križobolje i umora na (na 10 cm vizualnoj analognoj skali - VAS). Rezultati učinkovitosti i sigurnosti primjene lijekova deskriptivno su prikazani. Prosječna dužina trajanja bolesti je 18, 7± 12, 4 godine. Dvadeset osam bolesnika je HLA-B27 pozitivno. Nakon 3 mjeseca liječenja, ASAS20 je postiglo 29/30 bolesnika, a nakon 12 mjeseci liječenja 23/30 bolesnika. Prosječne vrijednosti pojedinačnih analiziranih varijabli na početku liječenja su bile slijedeće: BASFI 6, 79±1, 18, BASDAI 6, 42±1, 15, ukupni intenzitet boli 7, 23±1, 36, bolesnikova globalna procjena aktivnosti bolesti 7, 33±1, 63, liječnikova globalna procjena aktivnosti bolesti 7, 45±1, 26, intenzitet umora 6, 67±1, 65. U usporedbi sa inicijalnim vrijednostima, uočeno je statistički je značajno poboljšanje u domeni funkcije (BASFI) i aktivnosti bolesti (BASDAI) nakon 12, odnosno 52 tjedna primjene TNF-α antagonista: BASFI (3, 4±1, 53 odnosno 2, 85±1, 57) i BASDAI (2, 96±1, 67 odnosno 2, 01±1, 41). Statistički značajno poboljšanje uočeno je na nakon 12. odnosno 52. tjedna liječenja i u ostalim promatranim domenama: ukupna bol (3, 53±1, 91 odnosno 1, 78±1, 11), bolesnikova globalna procjena aktivnosti bolesti (3, 27±1, 78 odnosno 2, 50±1, 84), liječ- nikova globalna procjena aktivnosti bolesti (3, 5±1, 87 odnosno 2, 31±1, 72) i intenzitet umora (2, 97±2, 1 odnosno 1, 71±1, 19). Eritem na mjestu injiciranja lijeka imalo je 4 bolesnika, i to na početku liječenja. Ozbiljnih sistemskih neželjenih nuspojava nije bilo tijekom prvih 12 mjeseci primjene lijekova. Inhibitori TNF-α su se u bolesnika s AS i TSA pokazali djelotvornim: značajno poboljšanje funkcije i smanjenje aktivnosti bolesti. U kohorti naših ispitanika nisu registrirane ozbiljnije sistemske nuspojave.

Croatian Society for Rheumatology of Croatian Medical Association updated the proposal for the application of TNF-alpha inhibitors in adult patients with spondyloartritides (SpA) in accordance with the new classification of SpA and european recommendations for the treatment of SpA with biologic agents. In this way a standardized method of diagnosis, targeted treatment, monitoring and evaluating outcomes are proposed.

Program MAXIMA (Management of Axial SpA) je međunarodni, multicentrični program koji za cilj ima poboljšanje općeg znanja o aksijalnom spondiloartritisu (Axial SpA), ranom prepoznavanju, klasifi ciranju i odgovarajućem liječenju. Kao svojevrsna početna točka programa provedena je međunarodna anketa kako bi se dobio trenutni i činjenični uvid u regionalni i lokalni pristup dijagnostici i liječenju aksijalnog spondiloartritisa. Upitnik se sastojao od 35 pitanja podijeljenih u 7 kategorija, a evaluirani su dijagnostika, značajke bolesti i terapijska praksa. U Hrvatskoj je upitnik ispunilo 8 reumatologa, od kojih je dvoje bilo “čistih” praktičara, dok su ostali istovremeno angažirani na fakultetu. Prema rezultatima bolesnika s kroničnom križoboljom koja traje tri mjeseca, dobi

Reumatoidni artritis je kronična upalna reumatska bolest s prevalencijom od oko 1 %, karakterizirana sinovitisom, erozivnim promjenama zglobova, bolovima i oštećenjem funkcije. Etiologija bolesti nije poznata ali nastajanje takve autoimune bolesti je, zasigurno, posljedica genetskih i okolišnih čimbenika. Većina bolesnika s reumatoidnim artritisom liječi se standardnim lijekovima koji mogu modificirati bolest. Bolje razumijevanje bolesti dovelo je do razvoja bioloških lijekova s kojima želimo postići remisiju bolesti umjesto simptomatskog poboljšanja. Biološki lijekovi imaju brz i kontinuiran učinak, uz prihvatljiv sigurnosni profil. U ime Hrvatskog reumatološkog društva iznosimo prijedlog primjene bioloških lijekova u reumatoidnom artritisu., Rheumatoid arthritis is a chronic, inflammatory disease with the prevalence about 1 %. Rheumatoid arthritis is characterized with synovitis, often evolve erosions of the joints, pain and functional deficit. Etiology is unknown, but the development of such autoimmune disease is due to genetic and environmental factors. Most of the patients with diagnosis of rheumatoid arthritis use nonbiologic disease modifying antirheumatic drugs. Advances in the undersstanding of the disease process have led to the development of biological agents to treat rheumatoid arthritis. With the use of biologic agents we wish to evolve the goal of therapy from that of symptomatiic relief to clinical remission. Biologic drugs have documented, fast and continuous efficacy with generaly well accepted safety profile. On behalf of Croatian Society for Rheumatology we propose recommendations for the biologic therapy in rheumatoid arthritis.

This paper is on biological drugs in spondyloarthropaties.

Rad govori o značaju vitamina D na koštani metabolizam

Rad govori o liječenju postmenopauzalne osteoporoze kombinacijom alendronata i Vitamina D

Proposal of Croatian society for rheumatology for anti-TNF therapy in adult patients with spondyloarthritides.

Spondyloarthritides (SpA) as a group are one of the most common rheumatic disorders with a predominant affection of the spine. Conventinal disease modifying antirheumatic drugs which are effective in rheumatoid arthritis have poor effect on spinal inflammation. Today there is confirmed efficacy ofbiologics in spondylitis. This therapy is expensive and potentially hazaradous. Croatian Society for Rheumatology set up recommendations for the use of TNF-alpha blockers in SpA. There are several important points to be considered before their use: diagnosis of Spa, duration and disease activity, previous therapy and it's efficacy, application and efficacy ofbiologics, contraindications and safety preacutions and finally a decision for continuous tretament with biologics.

Reumatoidni artritis je kronična upalna reumatska bolest s prevalencijom od oko 1%, karakterizirana sa sinovitisom, erozivnim promjenama zglobova, bolovima i oštećenjem funkcije. Etiologija bolesti nije poznata, a u patogenezi reumatoidnog artritisa ključnu ulogu imaju proupalni citokini, poglavito, čimbenik nekroze tumora (TNFα). Lijekovi, antagonisti TNFα imaju brz i kontinuiran učinak, uz prihvatljiv sigurnosni profil pa su, danas, etablirani lijekovi u ranoj i kasnoj fazi reumatoidnog artritisa. Propisuju se s kontroliranim ograničenjima prema lokalnim preporukama s obzirom na visoku cijenu liječenja. Ispred Hrvatskog reumatološkog društva iznosimo prijedlog primjene antagonista TNFα u liječenju bolesnika s reumatoidnim artritisom.

Sažetak slijedi naknadno.

Posljednjih su godina brojne studije pokazale potrebu primjene D vitamina u liječenju osteoporoze. Nedostatak D vitamina dokazan je u postmenopauzalnih žena s osteoporozom. Učinci primjene D vitamina očitovali su se u smanjenju rizika za prijelome i padove te u poboljšanju neuromuskularnih performansi. Alendronat je, uz više od deset godina kliničke primjene, pokazao učinke i u brojnim dugoročnim i kratkoročnim studijama - smanjio je rizike vertebralnih i ekstravertebralnih prijeloma, povećao je BMD svih mjerenih lokalizacija u postmenopauzalnih žena i muškaraca s osteoporozom. Pozitivni učinci alendronata pokazani su u različitim entitetima kao što su osobe različite dobi i stupnja smanjenja mineralne gustoće kosti ili bolesnici s osteoporozom uzrokovanom glukokortikoidima. Kombiniranje D vitamina s antiresorptivnim lijekom dokazane djelotvornosti - alendronatom, rezultiralo je dobrim kliničkim učinkom. Kombinacija alendronata i D vitamina je zadržala farmakološke osobine i dokazane kliničke učinke pripravka alendronata namijenjenog tjednoj primjeni, a uz to uklonila potrebu cjelokupnog nadomještanja D vitamina.

The analysis of the highly aggregated national hospitalisations registry danathe primary source for epidemiological research of SLE using stratification methods and pareto charts.

Kliničko značenje pojave autoantitijela u bolesnika s reumatoidnim artritisom.(RA) liječenih infliksimabom.

Pojava autoantijela u bolesnika s rezistentnim reumatoidnim artritisom liječenih infliksimabom

Neuropsihijatrijska oštećenja u sustavnom eritemskom lupusu.

Background: In intestinal inflammation, the inflammatory cells accounting within mucosa and submucosa express various functional surface molecules including the receptor for IL-2 (CD 25). The aim of this study was to investigate the effect of cyclosporine (CsA), given intreperitonealy i.p.) or in a form of enema (i.r.) on number of CD25 plus inflammatory cells within colonic mucosa and submucosa, in haptene- induced murine model of experimental colitis. Methods: Experimental colitis was induced in NMRI mice (Pliva Research Institute), using the enema of 0.2 percent solution od Dinitrofluorobenzen (DNFB) (Sigma, Saint Luois, USA) in 4:1 acetone to olive solution, and combined with previous skin sensitisation. Two experimental groups of animals (N equal 6-8) were treated with 3/mg/kg/ day) of CsA diluted with phosponate buffered saline (PBS), and given i.p. or i.r., 6 hours after induction of colitis and for consecutive 5 days. One control group was treated with PBS i.r., in the same manner, after induction of colitis. Second control group consisted of untreated healthy animals. On day 5, all animals were killed and entire colon of each animal was longitudinally dissected in two halves that were taken for histology (HE) and immunohystochemical analysis for CD25 (anti mouse IL-2R/CD25, Boehringer Biochemica Mannheim, Germany), respectively. Colonic lesions were assessed using histopathologic score ranging 0-30, and mean number of CD25 plus cells in 20 HPF (light microscopy) from each specimen was expressed as mean plus (min SD for each group of animals). Results: CsA was effective in diminishing the histologic extent of provoked colonic inflammation in experimental groups treated with dose of 3 mg/kg/day i.p. or i.r. (p less 0.05, Kruskal-Wallkis, ANOVA). There was no difference between experimental groups in regard to way of application of CsA. Induction of experimental colitis significantly increased the number of CD25 plus inflammatory cells, when compared to mucosa of healthy animals (p less 0.05, Mann- Whitney). CsA , applied i.p. or i.r. significantly decreased the number of CD25 plus inflammatory cells, when compared to control group with experimental colitis, treated with PBS i.r. (p less 0.05, Mann-Whitney). There was no difference between experimental groups in regard to way of application of CsA (i.p. or i.r.). Conclusion: CsA in dose 3 mg/kg/day is capable of diminishing the extent of haptene induced colonic inflammation when applied i.p. or i.r.. This effect is in part expressed in decreasing the number of CD25 plus cells within colonic mucosa and submucosa.

Polymorphism in the gene for angiotensin converting enzyme (ACE), especially the DD genotype as a genetic candidate for atherosclerosis, has been implicated in the pathogenesis of a variety of cardiovascular disorders, hypertension, diabetic and IgA nephropathy, carotid artery thickening, and lacunar cerebral stroke. Systemic lupus erythematosus (SLE) is a multifactorial disease characterized by renal dysfunction, arthritis, and CNS involvement. We examined ACE polymorphism, as a possible marker in glomerulosclerosis leading to loss of kidney function in 50 SLE patients with kidney involvement, treated with corticosteroid therapy. The deletion/insertion (I/D) screening of intron 16 of the ACE gene was performed by polymerase chain reaction. The DD, ID and II genotypes were found in 60%, 24%, and 11% of patients, compared with 24%, 52%, 24% in the control group respectively. The results also show different response to the corticosterid treatment depending on the ACE genotypes studied. The percentages of patients with DD, ID and II genotype who had good response to treatment are 66.7%, 75%, 62, 5%, respectively, while 33.3%, 25% and 37.5% patients had a bad course and poor response to treatment. The findings suggest firstly that SLE are partially determined by genetic disposition. and secondly increased proportion of ACE ID genotype with good response to corticosteroids therapy might be of prognostic significance, predicting therapeutic efficiency. The molecular mechanisms involved in these response differences need to be investigated in further studies.

Background: In intestinal inflammation, the inflammatory cells accounting within mucosa and submucosa express various functional surface molecules including the receptor for IL-2 (CD 25). The aim of this study was to investigate the effect of cyclosporine (CsA), given intreperitonealy i.p.) or in a form of enema (i.r.) on number of CD25 plus inflammatory cells within colonic mucosa and submucosa, in haptene- induced murine model of experimental colitis. Methods: Experimental colitis was induced in NMRI mice (Pliva Research Institute), using the enema of 0.2 percent solution od Dinitrofluorobenzen (DNFB) (Sigma, Saint Luois, USA) in 4:1 acetone to olive solution, and combined with previous skin sensitisation. Two experimental groups of animals (N equal 6-8) were treated with 3/mg/kg/ day) of CsA diluted with phosponate buffered saline (PBS), and given i.p. or i.r., 6 hours after induction of colitis and for consecutive 5 days. One control group was treated with PBS i.r., in the same manner, after induction of colitis. Second control group consisted of untreated healthy animals. On day 5, all animals were killed and entire colon of each animal was longitudinally dissected in two halves that were taken for histology (HE) and immunohystochemical analysis for CD25 (anti mouse IL-2R/CD25, Boehringer Biochemica Mannheim, Germany), respectively. Colonic lesions were assessed using histopathologic score ranging 0-30, and mean number of CD25 plus cells in 20 HPF (light microscopy) from each specimen was expressed as mean plus (min SD for each group of animals). Results: CsA was effective in diminishing the histologic extent of provoked colonic inflammation in experimental groups treated with dose of 3 mg/kg/day i.p. or i.r. (p less 0.05, Kruskal-Wallkis, ANOVA). There was no difference between experimental groups in regard to way of application of CsA. Induction of experimental colitis significantly increased the number of CD25 plus inflammatory cells, when compared to mucosa of healthy animals (p less 0.05, Mann- Whitney). CsA , applied i.p. or i.r. significantly decreased the number of CD25 plus inflammatory cells, when compared to control group with experimental colitis, treated with PBS i.r. (p less 0.05, Mann-Whitney). There was no difference between experimental groups in regard to way of application of CsA (i.p. or i.r.). Conclusion: CsA in dose 3 mg/kg/day is capable of diminishing the extent of haptene induced colonic inflammation when applied i.p. or i.r.. This effect is in part expressed in decreasing the number of CD25 plus cells within colonic mucosa and submucosa. Background: anaerobic bacteria especially Bacteroides spp have been incriminated in the pathogenesis of experimental colitis in several animal models. The anti-inflammatory activity of azalides (as a subgroup of macrolide antibiotics) is recognised and documented in studies of in vivo models, and immunomodulation by antibiotic may anerge as an interesting aspect of therapy of intestinal inflammation. The aim of this study was to investigate the effect of azithromycin (as an azalide antibiotic) on inflammatory lesions in hapten-induced murine model for experimental colitis. Methods: Experimental colitis was induced in CD1 mice (Pliva research institute) using the enema of 0.2 percent solution of dinitroflourobenzene (DFNB) (Sigma, Saint Louis, USA) in 4:1 acetone to olive oil solution, and combined with previous skin sensitisation. Two experimental groups of animals (N=6-8 per group) were pre-treated with azithromycin 50 mg/kg/day (Sigma, Saint Louis, USA), respectively; starting 24 hours before induction of colitis with challenge enema of DNFB, and thereafter treated for consecutive 5 days. Other two experimental groups were also treated with same dose (50 mg/kg/day) of azithromycin or metronidazole, starting 6 hours after induction of colitis, and for 5 consecutive days. Substances were administratived after diluting with an equvivolume of phosphate buffered saline (PBS) and by means of oral lavage. One control group was treated with PBS only, i the same manner, starting 6 hours after induction of colitis. Second control group was treated with methylpredonisolone 10 mg/kg/day interperionealy, starting 6 hours after induction of colitis, and for 5 consecutive days. On day 5, all the animals were killed and entire colon of each animal was taken for histology (HE). Colonic lesions were assessed using histopathologic score ranging 0-30. Results: Azithromycin was effective in diminishing the histologic extent of provoked colonic inflammation in both, pre-treated group and in group which the treatment was started 6 hours after induction of colitis (p less then 0.05; Kruskal-Wallis ANOVA). The effect in both experimental group treated with azithromycin did not differ significantly when compared to anti-inflammatory effect in control group treated with metylprednisole. On the contrary, we observed no significant anti-inflammatory effect in groups treated with metronidazole when compared to maximal observed lesion in control group treated with PBS after induction of colitis. Conclusion: Azithromycin, applied with oral lavage in dose of 50 mg/kg/day, starting the treatment 24 hours before or 6 hours after induction of colitis, was shown to have significant anti-inflammatory effect in the range of methylpredonisolone. It seems unlikely that the effect of azithromycin in this particular model of experimental colitis could be attributed to its antimicrobial effect on intestinal flora.

The role of wide-field nailfols capillaroscopy and hand X-rays in the investigation of patients with undifferentiated connective tissue disease.

Neurološka i psihijatrijska očitovanja bolesti u sistemskom eritemskom lupusu.

Neurologic manifestations of antiphospholipid syndrome.

Neurološka očitovanja sistemskog eritemskog lupusa.

The aim of this article was to reveal the major biologic features of intestine that predispose the intestinal mucosa to numerous inflammatory conditions, especially in regard to experimental models of inflammatory bowel disease.

Thyroid autoimmunity with systemic lupus erythematosus.Summary.

Neurološki poremećaji u sistemskom eritemskom lupusu.

Cardiac lesions in patients with systemic lupus erythematosus and antiphospholipid syndrome.

Heart involvement in patients with antiphospholipid syndrome in connective tissue diseases.