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Background: Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by microangiopathy, inflammation, fibrosis. Interstitial lung disease (ILD) is common among SSc patients. Objective: This study aims to define the clinical, laboratory, and serologic characteristics of SSc patients with ILD and to present the frequency of chest computed tomography features. Methods: Two hundred twenty-six SSc patients who applied to the Rheumatology Department between January 2007 and August 2019 were retrospectively examined. A total of 100 SSc patients with ILD (44.2%) were determined. Clinical, laboratory, and serological features of SSc patients with and without ILD were compared. Results : Both groups had similar characteristics in terms of age and sex. The duration of disease (p=0.001) and follow-up time (p=0.001) were longer in SSc patients with ILD. Multivariable logistic regression analysis indicated that the duration of disease (OR: 1.06 (1.01-1.13), p=0.029), presence of gastrointestinal system involvement (OR: 3.29 (1.28-8.46), p=0.013) and anti-SCL70-positivity (OR: 6.04 (2.35-15.49), p Conclusion: We have shown a relationship between anti-SCL70, disease duration, gastrointestinal system involvement, and ILD in SSc patients.

Amaç: Mevcut çalışmada 3. Basamak bir sağlık kuruluşuna monoartrit kliniği ile başvurmuş hastaların genel özelliklerini, değerlendirmeler sonucu almış oldukları tanıları, hangi hastaların kronikleştiğini ve oligoartrit ya da poliartrit kliniğine ilerlemiş olduğunu ortaya koymayı amaçladık. Gereç ve Yöntem: Ekim 2019 – Ekim 2020 tarihleri arasında 18 yaşından büyük ve bilinen romatolojik bir hastalığı olmayan ilk kez monoartrit kliniğine sahip olmuş 92 hasta retrospektif olarak incelendi. Tüm hastaların özellikleri, değerlendirmeler sonucu almış oldukları tanıları kaydedildi. Kronik artritli hastalar ile kendini sınırlayan artritli olan hastaların özellikleri karşılaştırıldı.Bulgular: Hastaların %66,3’ ü erkekti. En fazla etkilenen eklemler diz (%38), 1.metatarsofalangeal (MTF) eklem (%31,5) ve ayak bileği eklemleriydi (%20,7). Hastaların %60,9’ unda klinik, tedavi ile ya da spontan olarak kendini sınırlamıştı, %39,1 hastada kronik artrit ortaya çıktı. Kronik artrit gelişen hastaların 7’ sinde monoartrit tablosu oligoartrit ya da poliartrit tablosuna dönmüştü. Hastaların klinik değerlendirme süreci sonunda almış olduğu tanılara bakıldığında gut %37, periferik SPA %15,2, RA %9,8 ve Behçet %4,3 hastada saptandı. Diğer tanılar ise septik artrit, post-streptokoksik artrit, undiferansiye bağ dokusu hastalığı, sjögren hastalığı, malignite ilişkili artrit, travmaya sekonder artrit ve osteoartritti. %19 Hastada ise sınıflandırılamayan artrit tablosu tespit edildi Erkek cinsiyet (p=0.028) ve hiperürisemi (p, Aim: In the current study, we aimed to reveal the general characteristics of the patients who applied to a tertiary health institution with a monoarthritis clinic, the diagnoses they received as a result of the evaluations, which patients became chronic, and progressed to the clinic of oligoarthritis or polyarthritis.Material and Method: Between October 2019 and October 2020, 92 patients who were older than 18 years of age and had no known rheumatologic disease and had a monoarthritis clinic for the first time were analyzed retrospectively. The characteristics of all patients and the diagnoses they received as a result of the evaluations were recorded. The features of patients with chronic arthritis and patients with self-limiting arthritis were compared.Results: 66.3% of the patients were male. The most affected joints were knee (38%), first metatarsophalangeal (MTF) joint (31.5%) and ankle (20.7%). In 60.9% of the patients, the clinic was self-limited with treatment or spontaneously, and chronic arthritis developed in 39.1% of the patients. In 7 of the patients who developed chronic arthritis, the monoarthritis table turned into oligoarthritis or polyarthritis. Considering the diagnoses of the patients at the end of the clinical evaluation process, gout was found in 37%, peripheral SPA in 15.2%, RA in 9.8% and Behçet's syndrome in 4.3%. Other diagnoses were septic arthritis, post-streptococcal arthritis, undifferentiated connective tissue disease, Sjogren's disease, malignancy-associated arthritis, arthritis secondary to trauma, and osteoarthritis. Unclassifiable arthritis was detected in 19% of the patients. While male gender (p=0.028) and hyperuricemia (p

Objective In this study, it was aimed to reveal the hospitalization reasons for patients diagnosed with primary Sjögren syndrome (pSS) and potentially associated factors in a tertiary health center. Method One hundred and sixty-three pSS patients who regularly attended their follow-ups between January 2010 and May 2021 were included in the study. These patients’ reasons for hospitalization, duration of hospitalization, and numbers of presenting to the hospital were recorded. The demographic, clinical and serological characteristics of the hospitalized and non-hospitalized patients were compared. Results Hospitalization occurred in 22.7% of the patients, and the total number of hospitalizations was 79. The hospitalization incidence density rate was 6.21 per 100 patient-years. The most frequently encountered reason for hospitalizations was pSS-related organ involvement (44.3%). Infections (17.7%), malignancy (16.5%), endocrine, and various other reasons were the other indications for hospitalization. While male sex (p = 0.005), the presence of extra-glandular involvement (p

AIM High Mobility Group Box-1 (HMGB-1) is a nuclear protein acting as a proinflammatory molecule. The serum HMGB-1 levels were found elevated in chronic inflammatory diseases. In this cross-sectional study, serum HMGB-1 levels in Behcet's disease (BD) patients and healthy controls (HC) were studied. Also, its association with disease activity scores and clinical findings were evaluated. METHOD Ninety BD patients and 50 age-sex matched HC were included in the study. Disease activity scores were assessed by Behcet Disease Current Activity Form (BDCAF) and Behcet Syndrome Activity Score (BSAS). Serum HMGB-1 levels were measured using a commercial ELISA kit. A p-value of < 0.05 was considered to be statistically significant. RESULTS Serum HMGB-1 levels were significantly higher in BD than in HC (43.26 pg/mL and 16.73 pg/mL; p< 0.001 respectively). Serum HMGB-1 levels were statistically significantly associated with presence of erythema nodosum (EN) and genital ulcers in the last one month prior to recruitment (p= 0.041 and p< 0.001, respectively). BDCAF and BSAS scores were positively correlated with serum HMGB-1 level (p= 0.03 and p= 0.02, respectively). CONCLUSION HMGB-1 may play a role in the development of BD. Also, due to its positive correlation with disease activity indices, it can be used as a novel disease activity parameter in BD.

To describe the clinical characteristics of neuro-Behcet’s syndrome (NBS) and to define the factors associated with relapses and poor outcome. Among 2118 patients with Behcet’s syndrome who fulfilled the international study group criteria, 208 (9.8%) patients had NBS. Retrospective data of 125 NBS patients (55.5% male; mean age 37.2 ± 11.8 years) were analysed. We divided patients into two subgroups, either parenchymal (p-NBS) or non-parenchymal (np-NBS), according to international consensus recommendations for NBS. We assessed the predictor factors associated with relapse and poor outcome—which was defined as a modified Rankin score (mRS) ≥ 3 at last follow-up and/or death—using Cox and logistic regression analyses, respectively. In total, 79 (63.2%) patients presented with p-NBS and 46 (36.8%) presented with np-NBS. Ocular involvement was more common in p-NBS than np-NBS (55.7% vs. 37.0%, p = 0.04), whereas vascular involvement excluding cerebral vein thrombosis was more frequent in patients with np-NBS (19.0% vs. 52.2%, p

Objectives: To evaluate the demographic and clinical characteristics of patients with Behcet's syndrome (BS), and to define their associations with the presence of major organ involvement (MOI).Method: Medical records of 2118 patients (964 males, 1154 females) were analysed retrospectively. MOI was defined as the presence of at least one of vascular, eye, nervous, or gastrointestinal system involvement. Univariable and multivariable binary and ordinal logistic regression analyses were applied to assess the factors that were potentially associated with MOI.Results: The mean ± sd age at diagnosis was 30.5 ± 9.4 years. Genital ulcer and joint involvement were more common in females (both p < 0.001), while MOI was more frequent in males (p < 0.001). Genital ulcer (p < 0.001) and vascular involvement (p = 0.006) were more common in patients with a younger age at diagnosis, while joint involvement was more common in older patients. A total of 1097 patients (51.8%) had at least one MOI, 322 (15.2%) at least two MOIs, and 48 (2.3%) at least three MOIs. Male gender, smoking history, and absence of genital ulcer were significantly associated with MOI in multivariable binary logistic regression. Multivariable ordinal regression analyses confirmed the association between MOI and male gender and smoking, but not the protective effect of genital ulcers. In both regression analyses, we found no significant effects of age, human leucocyte antigen-B51, skin involvement, or joint involvement on MOI.Conclusion: Male gender and positive smoking history have a significant influence on the presence of MOI in patients with BS.

Objectives:The study aimed to reveal the clinical, laboratory and serological features of patients with antiphospholipid syndrome (APS) followed in a referral center and to demonstrate the possible differences of the patients with recurrent thrombosis.Materials and Methods:The data of 43 patients with APS, who applied to our center between January 2010 and January 2019, were scrutinized retrospectively. Clinical, laboratory and serological features of the patients were recorded. The patients with and without recurrent thrombosis were compared. P-value

Objective: Calprotectin is an inflammatory biomarker which assesses disease activity in rheumatoid arthritis (RA). The objective of this study was to test whether serum calprotectin is associated with clinical and ultrasonographic disease activity in patients with RA, and to analyse its predicting value for disease activity evaluation despite normal C-Reactive protein (CRP) levels. Methods: We included 80 patients with RA and 30 healthy subjects. Patients were examined clinically and by ultrasound, (US7 score) along with laboratory parameters (calprotectin, CRP, erythrocyte sedimentation rate [ESR]). Disease activity scores (DAS28) were calculated to assess disease activity. Firstly, patients were divided into four subgroups according to the DAS28-ESR (high, moderate, low disease activity, and remission), then into two subgroups; group-1 (DAS-28≤3.2) and group-2 (DAS28>3.2). The predicting value of calprotectin for disease activity in patients with normal CRP was analysed with univariate and multivariate analysis and receiver operating characteristic curves. Results: Calprotectin levels were higher in RA patients than controls (96.3±45.9 ng/ml, 54.7±50.0 ng/ml, respectively; p

Background Beta-2 microglobulin (β2M) is mainly released from activated lymphocytes. Increased serum β2M levels have been shown in autoimmune diseases. The aim of this study was to analyse the serum levels of β2M in rheumatoid arthritis (RA) patients and to evaluate its relationship with disease activity measures. Material and Methods This cross-sectional study included 137 RA patients, 102 ankylosing spondylitis patients (AS) and 50 healthy controls (HC). To assess the disease activity of RA patients, the 28-joint Disease Activity Score-Erythrocyte Sedimentation Rate (DAS28-ESR), the 28-joint Disease Activity Score-C-Reactive Protein (DAS28-CRP), the Simplified Disease Activity Index (SDAI) and the Clinical Disease Activity Index (CDAI) were used. A p value of Results Serum β2M levels were significantly higher in RA patients (2.95±1.19 mg/L) compared with HC (2.21±0.54 mg/L) and AS patients (2.200.58 mg/L) (p Conclusion Our study revealed that serum β2M levels were higher in RA patients than in healthy controls, and, in contrast to other studies, we found positive correlations between β2M levels and RA disease activity measures.

Objectives:Scleroderma/Systemic Sclerosis (SSc) is characterized by progressive fibrosis. SSc related interstitial lung disease (SSc-ILD) is a major cause of mortality and morbidity among SSc patients. Procalcitonin (PCT) is used for diagnosis and follow up bacterial infections and sepsis. Bacterial pneumonia is an important situation that should be considered in the differential diagnosis of lung diseases. In this study, we aimed to investigate the diagnostic value of serum PCT between in patients with SSc-ILD and bacterial pneumonia.Materials and Methods:One-hundred and fifty-one SSc patients were retrospectively evaluated. Of these, 27 patients with SSc-ILD whose PCT levels checked, and 18 patients diagnosed with bacterial pneumonia were included to the study.Results:Twenty-seven (23 female, four male) patients with a mean age of 49.3±13.5 and a mean duration of disease 9.9±5.9 years were evaluated in the SSK-ILD group. There were 17 (two female, 15 male) patients with a mean age of 75.2±14.6 in pneumonia group. PCT level was higher in pneumonia group than in SSK-ILD group (8.1±15 and 0.1±0.4, p

Objectives:In this study, we aimed to determine the clinical, laboratory and demographic characteristics of patients with rheumatoid arthritis (RA) using tofacitinib, and the drug survival rates.Materials and Methods:A total of 78 RA patients who were prescribed tofacitinib between May 2016 and July 2019 were retrospectively evaluated and included in the study. The clinical, laboratory and demographic features of the patients were recorded. Drug survival rates were analyzed using Kaplan-Meier survival analysis. P

OBJECTIVE Behcet syndrome (BS) is a multisystemic chronic vasculitic disease. Among previous studies, although there are some that showed increased risk of subclinical atherosclerosis in BS, there are also others that showed the opposite. The objective of this study is to evaluate subclinical atherosclerosis in BS by using the cutoff value for intima-media thickness in the 2013 European Society of Cardiology/European Society of Hypertension guideline. METHODS We conducted a cross-sectional analysis of 100 BS patients and 30 healthy volunteers at a single center in a 4-month period. All ultrasound scans were performed in a blind manner to the clinical assessment, and they were carried out by the same researcher by a B-mode ultrasonography. RESULT When we grouped the patients based on the presence of subclinical atherosclerosis, the frequency of subclinical atherosclerosis in the BS patients was found to be higher than that in the healthy controls (32% and 7%, respectively; p = 0.006). When a cutoff is used for carotid intima-media thickness, increased atherosclerosis risk is observed in BS patients with vascular involvement (p = 0.043). CONCLUSIONS Although higher inflammation and increased atherosclerosis in vascular BS patients were expected, this situation was not supported much in previous studies. We think that this may have been caused by mere comparison of numerical data, and usage of a cutoff value could be more significant in distinguishing what is normal and what is abnormal as in several medical parameters.

Objectives The aim of the present study was to evaluate hearing loss in patients diagnosed with systemic sclerosis (SSc) and to investigate the relation between hearing loss, subtypes of the disease, its duration and clinical findings, and antibody positivity. Methods The study included 47 patients with SSc and 44 healthy controls. Audiometric, tympanometric, and otoacoustic emission measurements were applied to both groups. Results The evaluation of the participants medical history showed that among the patients with SSc, 19.1% experienced ear fullness, 27.7% experienced vertigo, and 36.2% experienced tinnitus. Hearing loss was detected in 23.4% of the patients with SSc. The corresponding result was 4.3% in the control group with a statistically significant difference (p = 0.001). Transient-evoked otoacoustic emission amplitude values were significantly lower in the patients’ both ears with SSc than the control group (p Conclusions The present study found that the incidence of hearing loss was significantly higher in the study group than in the healthy control group. In addition to other organ involvements, cochlear involvement occurs in these patients, and further studies are required.

Objectives To describe demographic and clinical characteristics of vascular involvement in patients with Behcet's syndrome (BS) and to evaluate associations with such involvement. Methods We retrospectively evaluated records of 2118 BS patients. In total, 460 patients diagnosed with superficial thrombophlebitis (ST) and/or major vascular events (venous and/or arterial involvements) were included in current analysis. Isolated ST with no accompanying deep venous thrombosis might be accepted as part of skin involvement; therefore, we defined two different outcomes for vascular involvement (“any vascular event” and “major vascular events”) and performed univariable and multivariable logistic regression to assess factors associated with these outcome variables. Results Overall, 68 (14.8%) patients had isolated ST, and 392 (85.2%) had major vascular events. The mean age of vascular BS was 33.8 (SD: 10.5) years and median follow-up was 13.9 (Q1–Q3: 8.3–22.9) years. The primary sites of major vascular events were deep venous thrombosis (n = 358, 77.8%), pulmonary arterial involvement (n = 66, 14.3%), extrapulmonary arterial involvement (n = 52, 11.3%), and intracardiac thrombosis (n = 14, 3.0%), respectively. Male sex was significantly associated with a higher risk for both outcome variables. When it was added to analysis, ST itself was the strongest explanatory variable that was associated with major vascular events in all multivariable models (ORs = 11.9, 12.0, 13.0, and 18.9). While HLA-B51 was significantly associated with any vascular event, there was no similar observation for major vascular events. Conclusion Male sex is a well-known risk factor for major vascular events in BS, but our study established that presence of ST was the strongest risk factor.

To report the clinical characteristics of pulmonary artery involvement (PAI) in patients with Behçet's syndrome (BS) and to define the predictors of relapses.We performed retrospective analysis of BS patients with PAI who fulfilled international study group criteria. Among 460 patients with vascular Behçet's syndrome (VBS), 66 were diagnosed with PAI. For final analyses, 61 patients with PAI were included who had at least 2 follow-up visits (72.1% male, mean age at BS diagnosis 29.34 ± 10.1 years). The patient data were recorded. Relapse was defined as the reoccurrence of vascular event in any vascular structure. Factors associated with relapse were assessed by logistic regression analysis.There were no differences considering demographic and clinical features of the patients with and without PAI in the VBS group, except that intracardiac thrombosis was more common in the patients with PAI (19.7% vs 0.3%). Among 61 patients, 50 (82.0%) had isolated pulmonary artery thrombosis (PAT), whereas 11 (18.0%) had pulmonary artery aneurysm with or without PAT. Twenty-four (39.3%) patients experienced vascular relapse during median follow-up of 65.9 (Q1-Q3: 20.1-109.0) months. To define the factors associated with relapses, patients with isolated PAT were analysed. On multivariable logistic regression analysis, older age at BS diagnosis and anticoagulation usage seemed to be protective (OR: 0.92, 95% CI 0.86-1.02, OR: 0.34, 95% CI 0.09-1.33, respectively).Our results indicate a higher frequency of intracardiac thrombosis in BS patients with PAI and possible efficacy of anticoagulation usage in preventing relapses. Key Points • This study shows that intracardiac and intracranial thromboses are seen more frequently in patients with PAI and the prevalence of pulmonary artery thrombosis has been increasing in the case of PAI. Furthermore, our report indicates that anticoagulation might be effective in preventing further vascular relapses.

Background/aim High mobility group box- 1 (HMGB- 1) is a nuclear protein acting as a proinflammatory molecule. The serum HMGB- 1 levels were found elevated in chronic inflammatory diseases. In this cross-sectional study, serum HMGB- 1 levels in Behcet’s disease (BD) patients and healthy controls (HC) were studied. Also, its association with disease activity scores and clinical findings were evaluated. Materials and methods Ninety BD patients and 50 age-sex matched HC were included in the study. Disease activity scores were assessed by Behcet Disease Current Activity Form (BDCAF) and Behcet Syndrome Activity Score (BSAS). Serum HMGB- 1 levels were measured using a commercial ELISA kit. A p value of < 0.05 was considered to be statistically significant. Results Serum HMGB- 1 levels were significantly higher in BD than in HC (43.26 pg/mL and 16.73 pg/mL; p < 0.001, respectively). Serum HMGB- 1 levels were statistically significantly associated with presence of erythema nodosum (EN) and genital ulcers in the last one month prior to recruitment (p = 0.041 and p < 0.001, respectively). BDCAF and BSAS scores were positively correlated with serum HMGB- 1 level ( p = 0.03 and p = 0.02, respectively). Conclusion HMGB - 1 may play a role in the development of BD. Also, due to its positive correlation with disease activity indices, it can be used as a novel disease activity parameter in BD.

This study was undertaken to evaluate the diagnostic and prognostic values of pentraxin‐3 (PTX‐3) in patients with infected diabetic foot ulcers (IDFU) as well as to assess the association between PTX‐3 levels and IDFU severity. This study included 60 IDFU patients (Group 1), 45 diabetic patients without DFU (Group 2), and 45 healthy controls. Patients with IDFU were divided into mild, moderate, and severe subgroups based on classification of clinical severity. Patients who underwent amputation were also documented. Blood samples were collected to determine PTX‐3 levels. PTX‐3 levels in healthy controls, Group 1, and Group 2 were 5.83 (3.41‐20) ng/mL, 1.47 (0.61‐15.13) ng/mL, and 3.26 (0.67‐20) ng/mL, respectively. A negative correlation between plasma PTX‐3 and glucose levels was found. There were significant differences in terms of procalcitonin (PCT) and PTX‐3 levels in the subgroup analysis of Group 1. The PTX‐3 level in patients who did or did not undergo amputation was 4.1 (0.8‐13.7) and 1 (0.6‐15.1) ng/mL, respectively. Results suggest that PTX‐3 is a particularly effective marker in patients with IDFU, both in terms of predicting disease severity and assisting in the decision to perform amputation.

Background:Behcet’s Syndrome (BS) is a chronic, multisystemic inflammatory disease. High Mobility Group Box-1 (HMGB-1) is a nuclear protein and acts as a proinflammatory molecule. The serum HMGB-1 levels were found high in various chronic inflammatory diseases.Objectives:In this cross-sectional study, serum HMGB-1 levels in patients with BS and healthy controls were studied. Also, its association with disease activity scores and clinical findings in BS were evaluated.Methods:Between March 2018 and March 2019, 90 BS patients and 50 age-sex matched healthy controls were included. Disease activity scores were assessed by using Behcet Disease Current Activity Form (BDCAF) and Behcet Syndrome Activity Score (BSAS). A p-value of Results:The demographic and clinical features were summarized in Table 1. Serum HMGB-1 levels were significantly higher in BS than those in control group.(Table 1) The statistically significant corelation of serum HMGB-1 level with current clinical findings was found only in patients having eryhtema nodosum and genital ulcers in the last 1 month. The eye, central nervous system (CNS), gastrointestinal system (GIS), arterial and venous involvements were classified together as major organ involvement (MOI) (n=47). The serum HMGB-1 level was higher in patients with MOI compared to patients without MOI; however,it was not statistically significant.(40.5pg/mL and 37.2 pg/mL, p=0.560) BDCAF and BSAS scores were positively corelated with serum HMGB-1 level (p=0.022, p=0.026 respectively). (Table 2)Table 1.Demographic features and HMGB-1 levels of study groups with current clinical findings of BS patientsBehcet SyndromeControl GroupP valueAge (years) (±SD)42.1±9.639.5±10.60.128Sex (Women) n(%)51 (56.7)32 (64)0.401Disease Duration (years)10 (1-37)Serum HMGB-1 level (pg/mL)43.26 (0-221.3)16.730-41.9)Oral Ulcers n(%)100 (100.0)Genital Ulcers n(%)68 (75.6)Erythema Nodosum n(%)52 (57.8)Papulopustuler Eruption n(%)59 (65.6)Patergy pozitivity n(%)37 (41.1)Uveitis n(%)27 (30.0)Retinal vasculitis2 (2.2)CNS involvement n(%)7 (7.8)GIS involvement n(%)2 (2.2)Athralgia n(%)75(83.3)Arthritis n(%)15 (16.7)Arterial disease n(%)3 (3.3)Venous disease n(%)25 (27.8)Table 2.Corelation between Serum HMGB-1 level and inflammatory markers in BDHMGB-1rpESR (mm/h)-0,040.68CRP (mg/L)0,120.23Neutrophil/Lymphocyte0,140.20Platelet/Lymphocyte0,020.89BSAS0,240.02BDCAF0,240.03Conclusion:The two studies evaluating the relationship between serum HMGB-1 level and disease activity in BS found higher levels of serum HMGB-1 level in BS than in healthy controls as in our study1,2. This result supports the importance of HMGB-1 in the development of BS through its role in inflammation. De Souza et al. found no association between BDCAF and serum HMGB-1 level; whereas, we found a positive correlation with both BDCAF and BSAS2. This suggests that HMGB-1 can be used as a new disease activity parameter in BS. In conclusion, this study is unique as it involves the largest number of BS patients and uses BDCAF and BSAS together to assess disease activityReferences:[1]Ahn, J.K., et al., Extracellular high-mobility group box 1 is increased in patients with Behcet’s disease with intestinal involvement. Journal of Korean medical science, 2011. 26(5): p. 697-700.[2]de Souza, A.W., et al., High mobility group box 1 serum levels are increased in Behcet’s disease, but not associated with disease activity or disease manifestations. Rheumatology, 2015. 54(12): p. 2151-2155.Disclosure of Interests:None declared

Kalp yetersizligi, insan yasam omrunun uzamasi, kullanilan ilac ve ilac disi tedaviler ve ilerleyen tetkik ve tani yontemleri nedeniyle klinik hayatimizda karsimiza daha fazla cikmaktadir. Bu kitapta kalp yetersizligi tanisini, baska hastaliklar ile iliskisini, tedavisinde kullanilan ilac, cihaz ve cerrahi yontemleri pratik bilgiler de sunarak anlatmaya calistik. Kardiyoloji, Ic Hastaliklari ve Aile Hekimligi uzmanlari basta olmak uzere kalp yetersizligi ile ilgilenen tum hekim arkadaslarin ilgiyle okuyacaklarini dusunmekteyiz.Bu sebeple son yayin ve kilavuzlar isiginda kalp yetersizligi ile iliskili guncel verileri iceren “Kalp Yetersizliginde Pratik Bilgiler” isimli kitabimizi siz okuyucularimiza kazandirmaktan gurur duyuyoruz.Kalp yetersizligi ile ilgilenen hekim arkadaslarimiza faydali olacagini umdugumuz kitabin bolumlerin yazilmasinda emegi gecen tum degerli meslektaslarimiza tesekkur ederiz.

Primary Sjögren syndrome (pSS) is usually encountered between the fourth and sixth decades. It is known that the age of onset in autoimmune diseases may affect the clinical features. In this study, we aimed to investigate the clinical and laboratory characteristics of early onset pSS patients.The data of 352 pSS patients were analyzed retrospectively. The patients were divided into two groups as those with the onset age of 35 or younger (early-onset) and those with the onset age of older than 35. The clinical, laboratory, and serological characteristics of the two groups were compared. p 0.05 was considered statistically significant.Forty patients in the group with an onset age of 35 or younger (11.4%) and 312 patients with an onset age of older than 35 (88.6%) were analyzed. The frequency of skin (22.5% vs 1.9%, p 0.001) and renal involvement (10% vs 2.2%, p = 0.026) was significantly higher in the early-onset group than the late-onset group. There was no significant difference between the two groups in terms of xerostomia, eye dryness, arthritis, and other systemic involvement. Anti-Ro52 positivity (p = 0.04), elevated serum IgG levels (p = 0.004), and low C4 (p = 0.002) presence were more frequent in the early-onset group.Consequently, it is seen that the clinical phenotype of early-onset pSS patients may be different to those with later onset. Especially the more frequent observation of poor prognostic factors at early-onset ages shows the necessity to monitor these patients more regularly.• The clinical and laboratory features of patients with early-onset primary Sjogren syndrome may differ from late-onset patients.

Background To evaluate clinical characteristics according to age and gender in patients with Behcet’s Syndrome (BS). Objectives BS is a systemic vasculitis that affects mucosa, skin, joint, eye, vessels, gastrointestinal system, and central nervous system. The disease characterizes by relapses and remissions, and it is known that prognosis is worse in young males. The aim of this study was to reinvestigate the relationship between the clinical features of BS according to gender and age. Methods The data of 665 patients (282 male, 383 female), diagnosed as BS according to the ISG-1990 Behcet’s Disease classification criteria, were retrospectively evaluated. Results All patients had oral aphthous (OA) ulcers (100%). Eighty-five percent of patients had a genital ulcer (GU), 56.5% had erythema nodosum (EN), 65.9% had papulopustular lesions (PPL), 32.6% had ocular involvement, 49.3% had joint involvement, and 21.7% vascular involvement, and 4.8% had neurobehcet. The incidence rates of PPL, ocular involvement, and vascular involvement were significantly higher in males (p Conclusion Clinical features of BS may vary according to age and gender. Variations can be observed depending on the size of the population, the center where the study is conducted, and the selected-criteria for inclusion. In our study, PPL, ocular involvement and vascular involvement were more frequent in men, whereas GU, joint involvement, headache, and pathergy positivity were more common in women. In addition, GU, EN, and vascular involvement were related to younger ages. Our results were compatible with the BS literature. References None Disclosure of Interests None declared

Background: Scleroderma is a connective tissue disease that is characterized by fibrosis of the skin.The modified Rodnan Skin Score (mRSS) is a measure generally used to assess the skin thickness in patients with scleroderma.Data on the effectiveness of the mRSS training courses differ in the literature. Objectives: The objective of our study was to evaluate the effectiveness of the mRSS training course in rheumatology fellows in the rheumatology departments. Methods: The study included 6 fellows from the departments of rheumatology.Participants were given a 1-hour-long theoretical training, including dermal involvement, and mRSS assessment by 3 rheumatology experts experienced in scleroderma, which was followed by an applied training on 4 patients for one-hour.Participants scored two patients before and after training on a form, which included 17 domains with a total score-range between “0” and “51”. Then using the SPSS15 software program, inter-rater reliability was assessed with intraclass correlation(ICC) analysis for both pre- and post-training mRSS.Fleiss’ kappa was used to measure the degree of agreement according to 12 Rodnan score areas before and after the training. Results: The ICC value for pre-training and post-training total Rodnan scores was 0.867 (95% CI-0.625-1.00, P=0.05), and 0.905(95% CI 0.045-1.00, P=0.02), respectively. Individual analysis of score areas showed that after the training there was an increase in degree of agreement in some of these areas, while there was no difference in one area, and it decreased in others (Table 1). Conclusion: Several studies have demonstrated the applicability, reliability, and validity of mRSS, a measure of dermal involvement, and that evaluation of the score requires experience, and an attentive learning process.In the literature, the inter-rater ICC values during previous training courses are reported to range between 0.378 and 0.92(1). These studies show differences in terms of the number and experience of participants, number of patients, course-length, and repeated courses. Similar to the observation by Ionescu et al(2), the pre-training inter-observer ICC value was very high(0.867), and it increased to 0.905 after the training. Presence of an increase in some areas, and reduction in some others in individual analysis of areas after the training may suggests the need for repeated training. Our limitations were low number of participants and patients. We obtained very good inter-rater ICC values in the mRSS training course given to rheumatology fellows; however we may benefit from new studies for optimization of these conclusions by increasing the numbers of trainees, patients, and the lenght of courses. References [1] Czirjak, L., et al., the EUSTAR model for teaching and implementing the modified Rodnan skin score in systemic sclerosis. Ann Rheum Dis, 2007. [2] Ionescu, R., et al., Repeated teaching courses of the modified Rodnan skin score in systemic sclerosis. Clin Exp Rheumatol, 2010. Disclosure of interests: None declared

Background BehCet’s disease is a chronic, recurrent and systemic vasculitis that may affect veins and arteries at all diameters. Small vessel involvement is responsible for most of its pathological signs. Objectives We aimed to compare the nailfold capillaroscopy findings of patients with BehCet’s disease to a healthy control group and examine the relationships, as well as revealing the relationships with the sub-type, activity and other characteristics of BehCet’s disease. Methods We conducted a cross-sectional analysis of 153 patients with BehCet’s disease and 165 healthy volunteers in a single center. The capillaroscopic findings of the 2nd-5th fingers of both hands of the participants in the BehCet’s patients and control groups were included in the analysis. Capillaroscopic findings were evaluated by two different experts who were experienced in this field by using the scoring at Atlas of Capillaroscopy in Rheumatic diseases by Maurizio Cutolo (1). Results There was no statistically significant difference between the two groups in terms of age or sex (respectively p=0.189 and p=0.585). There was no difference between the BehCet’s patients and healthy volunteers in the qualitative analysis on capillary density, capillary visibility, aneurism, capillary tortuosity, capillary enlargement and presence of avascular areas (p values respectively: 0.610, 0.147, 0.481, 0.057, 0.514 and 0.110). In the BehCet’s patients, bushy capillaries (24.2%, 37/153), capillary dilatation (32%, 49/153) and microhemorrhage (39.2%, (60/153) rates were significantly higher than those in the healthy control group (p Conclusion: the BehCet’s patients had significantly higher total capillaroscopy scores in comparison to those in the healthy control group. Based on these data, we believe that the capillaroscopic changes found in BehCet’s patients, though unspecific, may support clinical diagnosis in uncertain cases where BehCet’s disease is considered as a probability. There is a need for well-planned prospective studies to support this our thought. References [1] Cutolo M. Atlas of Capillaroscopy in Rheumatic Diseases. Elsevier, Milan 2010, 77-86 Keywords BehCet’s disease, nailfold, vasculitis, videocapillaroscopy N, number of patients, *Data were given as median (minimum - maximum) Disclosure of Interests None declared

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide spectrum of clinical manifestations such as organ damage, pain, fatigue, sleep disorders, depression and cognitive deficits. It is known that pain catastrophising may have serious impact in individuals with SLE. Furthermore, catastrophising and maladaptive coping strategies are linked to higher levels of functional impairment and depression in SLE. Objectives: The aim of this study was to identify factors associated with pain catastrophising to detect possible susceptible targets in individuals with systemic lupus erythematosus. Methods: A total of 104 individuals (mean age: 55.54±12.09 years; BMI: 27.17±4.01 kg/m2) with SLE participated to the study. The Pain Catastrophizing Scale (PCS) was used to measure the extent to which people catastrophize in response to pain. The Tampa Scale for Kinesiophobia (TSK) was used to assess pain-related fear of movement. The Beck’s Depression Inventory (BDI) was used to measure characteristic attitudes and symptoms of depression. The Body Awareness Rating Questionnaire (BARQ) was used to reflect on their self-reported body awareness. The multiple stepwise linear regression models with R-square (R2) were used to compare across the models and explain the total variance. Results: Mean PCS was 22.12±12.09; mean TSK was 42.94±7.76; mean BDI was 15.63±11.18 and mean BARS was 88.94±19.85. Linear regression analysis revealed that TSK, BDI, BARS and BMI were independently associated with PCS in predicting pain catastrophising in individuals with SLE (p≤0.001; R2=0.52). There were no correlations between PCS and disease activity (mean SLAM-R:5.39±3.68; r=0.105) and organ damage (mean SLICC-DI:0.58±0.87; r=0.153) (p>0.05). Conclusion: This study increases the understanding of the modifiable predictors to enhance pain coping behavior in accordance with the pharmacological treatment in SLE population. Results demonstrate major importance to explore the main stressors of pain catastrophising such as kinesiophobia, depression level, body awareness and BMI that affect coping behavior. Thus, pain catastrophising may limit the patients’ ability to perform from simple to complex activities. In addition, body image concerns SLE patients as they experience weight gain which negatively impact their self-esteem. The patient reported outcomes could guide health professionals to identify unmet needs of patients at risk to facilitate incorporation of the biopsychosocial model into SLE management. References: [1] Somers, T. J., Kurakula, P. C., Criscione‐Schreiber, L., Keefe, F. J., & Clowse, M. E. (2012). Self‐efficacy and pain catastrophizing in systemic lupus erythematosus: Relationship to pain, stiffness, fatigue, and psychological distress. Arthritis care & research, 64(9), 1334-1340. [2] Fischin, J., Chehab, G., Richter, J. G., Fischer-Betz, R., Winkler-Rohlfing, B., Willers, R., & Schneider, M. (2015). Factors associated with pain coping and catastrophising in patients with systemic lupus erythematosus: a cross-sectional study of the LuLa-cohort. Lupus science & medicine, 2(1), e000113. Disclosure of Interests: None declared

Background:Rheumatoid arthritis-related interstitial lung disease (RA-ILD) is the most common type of lung involvement in rheumatoid arthritis (RA). The existence of RA-ILD is associated with worse survival. There is no mainstay treatment for RA-ILD. However, in recent studies, rituximab (RTX) seems to be effective in RA-ILD.Objectives:To determine the effects of RTX in patients with RA-ILD from a single-centre.Methods:In our biological treatment outpatient clinic, a retrospective study was conducted in patients with RA who were treated with RTX. Among them, patients with RA-ILD were analysed. For lung response to RTX, progression was defined as a decline of 10% ≥ in forced vital capacity (FVC) and/or a decline of 15% ≥ in diffusion capacity of carbon monoxide (DLCO). Computed tomography of the chest (chest-CT) were integrated to lung response so as to constitute missing data of pulmonary function tests (PFTs).Results:A total of 165 patients who are followed-up in our biological treatment outpatient clinic have been using RTX for their RA diagnosis. Among 165 patients, 26 (15.8%) patients with RA-ILD were initiated RTX. Five patients were diagnosed with RA-ILD while using RTX (incidence rate 3%). Patients‘ characteristics were demonstrated in table 1. Of 26 patients, the most commonly used concomitant disease-modifying antirheumatic drugs was leflunomide (46.2%) followed by mycophenolate mofetil (11.5), methotrexate (11.5%) and azathioprine (3.8%). Twenty-four (92.3%) patients used steroids. For the evaluation of lung response, 20 patients who had follow-up PFTs and/or chest-CT were compared. Median DLCO values for pre- and post RTX were 71.0% (60.0-77.0) and 63.0% (47.0-74.0), respectively (p= 0.061). Median pre and post-RTX FVC were 74.0% (61.0-99.0) and 84.0% (63.0-100.0), respectively (p= 0.28). After a median of 2.7 years, 11 (55.0%) patients had stable disease, 2 (10.0%) patients had regression of RA-ILD and 7 (35.0%) patients had progressive disease. Sex, age, seropositivity and radiographic patterns were not associated with progression. In total, 23 adverse events were detected in 11 (42.3%) patients. Five of them were serious infections requiring hospitalization, mostly pneumonia. Other adverse events were simple infections and surgeries such as arthroplasty. RTX was stopped in 4 (15.4%) patients due to infections secondary to hypogammaglobulinemia in 2, malignancy in 1 and allergic reaction in 1.Conclusion:RTX seems to achieve stabilization/improvement of RA-ILD with fewer adverse events. However, given that RA-ILD develops post-RTX, it is not a panacea; therefore, we need more effective treatment modalities in the case of RA-ILD.Table 1.Characteristics of 26 patients with RA-ILD treated with rituximabAge at first RTX infusion, median (IQR), years61.2 (57.1-65.1)RA disease duration at first RTX, median (IQR), years10.1 (4.3-29.7)ILD disease duration at first RTX, median (IQR), years1.9 (0.1-4.5)Age at RA diagnosis, median (IQR), years51.1 (40.0-60.6)Age at ILD diagnosis, median (IQR), years58.3 (53.9-63.3)Male patient, n (%)16 (61.5)RF positivity, n (%)25 (96.2)ACPA positivity, n (%)20 (90.9)CRP levels,mg/L, mean (SD)40.3 (58.9)ESR levels, mean (SD)37.7 (18.2)Smoking status, n (%)16 (64.0)Prior TNF inhibitor treatment, n (%)5 (19.2)DAS28 at first RTX infusion, mean (SD)5.3 (1.5)Radiographic pattern, n (%)UIP7 (26.9)NSIP8 (30.8)OP2 (7.7)Indeterminate8 (30.8)Others1 (3.8)Follow-up duration, median (IQR), years2.5 (1.2-3.7)RA-ILD= Rheumatoid arthritis-related interstitial lung disease, RTX= rituximab, RA= rheumatoid arthritis, RF= rheumatoid factor, ACPA= anti-citrullinated protein antibody, TNF= tumor necrosis factor, CRP= C-reactive protein, ESR= erythrocyte sedimentation rate, UIP= usual interstitial pneumonia, NSIP= non-specific interstitial pneumonia, OP= organizing pneumoniaDisclosure of Interests:None declared

Angiotensin II type 1 receptor autoantibodies (AT1R-AAs) are known to be associated with malignant hypertension, preeclampsia, and vascular rejection in kidney transplantation. They were also suspected to have pathogenetic role in vasculopathic changes in systemic sclerosis (SSc). Clinical data regarding AT1R-AAs in SSc are scarce. In this work, we will examine the relationship between serum levels of AT1R-AAs and disease manifestations. Serum samples from SSc patients and healthy controls were analyzed for AT1R-AAs by using a commercial ELISA kit. We examined the association of serum levels of AT1R-AA with disease duration, systolic pulmonary artery pressure (sPAP) measurements, and disease manifestations like cutaneous, lung and esophageal involvements, and the presence of digital ulcers in a cross-sectional manner. There was no statistically significant difference in levels of AT1R-AAs between SSc (n = 93) patients and healthy controls (n = 66) (p = 0.23). Serum levels of AT1R-AAs were not correlated with disease duration, sPAP measurements, and showed no association with disease manifestations like lung involvement, esophageal involvement, digital ulcers, and cutaneous fibrosis. In our SSc cohort, AT1R-AA serum levels were not different from healthy subjects and higher levels were not associated with any disease manifestation neither.

Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), mean platelet volume (MPV), and red cell distribution width (RDW) may potentially reflect inflammatory status in systemic autoimmune diseases. The aim of this study is to investigate the association between these proposed markers and disease manifestations, activity, and severity in systemic sclerosis (SSc). We conducted a cross-sectional study of 69 systemic sclerosis (SSc) patients and 50 healthy volunteers in a single center. Adult patients with SSc and healthy controls were compared in terms of NLR, MLR, MPV, RDW, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Venous blood samples were drawn after at least 8 h of fasting in the morning. Extension of skin fibrosis was evaluated by using modified Rodnan skin score (mRSS). Disease severity and activity were assessed by Medsger disease severity and European Scleroderma Trials and Research Group (EUSTAR) disease activity scores, respectively. Associations of disease manifestations, clinical, laboratory, and capillaroscopic findings, mRSS, and the disease activity and severity scores with the proposed hematological markers were evaluated. Multiple regression models were generated for significant associations. The neutrophil number was higher (p = 0.004) and lymphocyte number was lower (p

[No abstract available]

BACKGROUND/OBJECTIVE Interleukin (IL) 35 is a member of the IL-12 family. Studies show that IL-35 is an important anti-inflammatory cytokine and suppresses effector T-cell activity. In this study, we aimed to evaluate serum IL-35 levels in systemic sclerosis (SSc) patients and its potential relation with clinical findings. METHODS We conducted a cross-sectional analysis of 70 SSc patients and 29 healthy volunteers in a single center in 5 months' period. Extension of skin fibrosis was evaluated by using modified Rodnan skin score. Disease severity was assessed by Medsger disease severity scores. Serum IL-35 was measured using a commercial enzyme-linked immunosorbent assay (ELISA) kit (Cloud-Clone Corp, Wuhan, China). The relationship between IL-35 levels and clinical and laboratory parameters was investigated. Mann-Whitney U test was used to compare parameters among the groups. Correlation was tested by Spearsman correlation coefficient. RESULTS Serum IL-35 levels was significantly higher in SSc patients (8.69 [interquartile range, 29.33] pg/mL) than in healthy controls (7.11 [interquartile range 7.53] pg/mL; p < 0.001). There was no significant relationship between serum IL-35 levels and organ involvement. There was a negative correlation between serum IL-35 levels and Medsger disease severity score (Rho, -0.333; p = 0.006), modified Rodnan skin score (Rho, -0.307; p = 0.010), and C-reactive protein (Rho, -0.294; p = 0.015). There was no relationship between IL-35 and disease duration and erythrocyte sedimentation rate. CONCLUSIONS Our study revealed that IL-35 levels were higher in SSc patients, and in contrast to previous studies, it was the first study that showed that IL-35 levels did not increase in SSc patients with pulmonary fibrosis.

Background Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are chronic progressive inflammatory diseases, leading to joint damage and reducing the physical fitness of patients. They are among the most common rheumatic diseases. Physical inactivity, fatigue, low health-related quality of life (HRQoL), higher anxiety and depression levels are common problems reported in patients both ankylosing spondylitis (AS) and rheumatoid arthritis (RA) although the clinical manifestations differ in many ways. These low outcomes have been found to be associated with functional limitations in both AS and RA serves as mediators in the link between disease activity and functional limitations in spite of NSAIDs and DMARDs therapies. Although many studies have assessed the outcomes of a single disease state, either RA or AS, few studies have focused on a direct comparison between those both diagnostic groups. Objectives The aim of this study to assess and compare physical activity, fatigue, HRQoL, anxiety and depression levels between AS and RA patients. Methods Twenty-six RA patients and 18 patients with AS were recruited from the outpatient clinic. Physical activity was assessed using the International Physical Activity Questionnaire-Short Form (IPAQ-SF), a validated instrument comprising of four items that estimates the levels of vigorous activity, moderate activity, walking and time spent sitting during the previous 7 days. The Fatigue Severity Scale (FSS) was used to measure the severity of fatigue. Disease-specific instruments to measure (HRQoL) in patients with RA and AS (RAQoL and ASQoL) were used. The Hospital Anxiety and Depression Scale (HADS) were used to assess anxiety and depression. The patient groups were compared using the Kruskal-Wallis test and the Chi-square test. Results Disease durations were similar between RA (mean age=48.92±12.50 years, disease duration=10.81±7.68 years) and AS (mean age=43.44±12.36 years, disease duration=11.39±8.87 years) patients (p=0.867). There was no statistically difference between FSS (RA=45.27±16.95; AS=41.00±12.95; p=0.173), IPAQ-SF (RA=1289.65±839.75; AS=2110.06±1210.86; p=0.062) and HADS scores (RA=18.31±2.93; AS=17.00±2.87; p=0.123) in both patient groups. Conclusions Our results support that physical inactivity due to impaired mobility as well as fatigue, anxiety/depression and low (HRQoL) are common and similar features of both RA and AS. In conclusion, management of disease activity with drug therapies should be targeted not only to improve physical function for RA and AS but also to improve physical activity levels, restore fatigue, anxiety and depression levels and preserve HRQoL. References [1] Lie E, Kristensen LE, Forsblad-d’Elia H, Zverkova-Sandstrom T, Askling J, Jacobsson LT, et al. The effect of comedication with conventional synthetic disease modifying antirheumatic drugs on TNF inhibitor drug survival in patients with ankylosing spondylitis and undifferentiated spondyloarthritis: results from a nationwide prospective study. Ann Rheum Dis2015;74:970–8. [2] Iannone F, Lopalco G, Rigante D, Orlando I, Cantarini LG. LapadulaImpact of obesity on the clinical outcome of rheumatologic patients in biotherapy Autoimmun Rev2016;15:447–450. Disclosure of Interest None declared

Background β−2 microglobulin (β2MG) is produced and secreted from T and B lymphocytes. In autoimmune diseases, due to lymphocyte activation and proliferation, serum β2MG level is expected to be higher than normal. In a few studies, increased serum and synovial fluid β2MG levels in rheumatoid arthritis (RA) were reported. Objectives The aim of this study was to evaluate the concentration of β2MG in peripheral blood in RA patients and to show its relationship with disease activity. Methods In this study, 121 RA patients and 50 sex and age matched healthy controls were enrolled. Patients who had other inflammatory diseases or any kind of malignancy were excluded. Results The mean age of RA patients (97 female and 24 male) were 55 years (±10.9 years) and mean disease duration was 9 years (min: 6 months, max: 42 years). The demographic data of patients and healthy controls are shown in table 1. There was a statistically significant difference between haemoglobin, erythrocyte sedimentation rate and C-reactive protein levels between two groups (p Conclusions Our results show that serum β2MG concentration increase in RA and is higher in active patients. It can be concluded that serum β2MG may be an appropriate parametre to monitor disease activity in rheumatoid arthritis. Disclosure of Interest None declared

Background Interleukin (IL)−35 is a member of the IL-12 family. Studies show that IL-35 is an important anti-inflammatory cytokine and suppresses effector T cell activity. Systemic sclerosis (SSc) is a chronic disease characterised by vascular damage, autoimmunity and fibrosis. Objectives In this study, we aimed to evaluate serum IL-35 level in SSc patients and its potential relation with disease findings. Methods Fifty-five SSc patients and 25 healthy controls were included in the study. All patients were diagnosed according to 2013 ACR/EULAR systemic sclerosis classification criteria. Serum IL-35 was measured using a commercial ELISA kit (Cloud-Clone Corp, Wuhan, China). Results SSc patients and healthy controls had similar ages and genders. The mean of serum IL-35 level was significantly higher in SSc patients (8,2±1,3 pg/ml) than in healthy controls (6,9±0,7 pg/ml) (p Conclusions It has been reported that serum IL-35 level is higher SSc patients than healthy volunteers and is associated with interstitial lung disease. In our study, the level of IL-35 was higher SSc patients than healthy controls. There is no relationship between clinical parameters and IL-35 levels, this may be due to small sample size. Our results suggest that IL-35 may have a role on the pathogenesis of SSc. Further investigations are needed in large sample size of SSc patients. Disclosure of Interest None declared

Background/aim: We aimed to investigate the prevalence of anti-RNA polymerase (RNAP) III and other autoantibodies in a group of Turkish patients with systemic sclerosis (SSc) and their relation with clinical features. Materials and methods: The prevalence of anti-RNAP III and other autoantibodies was analyzed in 93 patients with SSc and control groups including 86 patients with systemic lupus erythematosus (SLE) and 65 healthy subjects, respectively. Their relationship with diseases findings was assessed in a cross-sectional manner. Results: Prevalences of anti-RNAP III were 2/93 (2.2%) in SSc, 1/86 (1.2%) in SLE, and 1/65 (1.5%) in the healthy group and there was no difference among groups (P > 0.999). Anti-Sm was significantly more common in SLE patients (P < 0.001), whereas antitopoisomerase I and anticentromere protein B were significantly more common in SSc patients (P < 0.001). There was a significant association between antitopoisomerase I positivity and interstitial lung disease (P < 0.001), and interestingly there was also a significant association between anti-SS-A 52 positivity and the presence of digital ulcers in patients with SSc. Conclusion: Our data show that anti-RNAP III in SSc patients was low in frequency in a Turkish population.

Objectives The aim of this study was to investigate the association between antiphospholipid antibodies and non-thrombotic and non-gestational manifestations of systemic lupus erythematosus. Methods Systemic lupus erythematosus patients with persistently positive antiphospholipid antibodies or lupus anticoagulant were identified and grouped as systemic lupus erythematosus with antiphospholipid syndrome (SLE-APS), systemic lupus erythematosus with positive antiphospholipid antibodies/lupus anticoagulant without antiphospholipid syndrome (SLE-aPL), and systemic lupus erythematosus with negative aPLs (SLE-No aPL). Groups were compared in terms of non-thrombotic systemic lupus erythematosus manifestations and laboratory features retrospectively. Results A total of 150 systemic lupus erythematosus patients, 26 with SLE-APS, 25 with SLE-aPL, and 99 with SLE-No aPL, were identified. Livedo reticularis, neurologic involvement, and thrombocytopenia were more common in antiphospholipid antibody positive systemic lupus erythematosus cases. Malar rash, arthritis, and pleuritis were more common in the SLE-No aPL, SLE-APS, and SLE-aPL groups, respectively. Positivity rates and titers of specific antiphospholipid antibodies did not differ between the SLE-APS and SLE-aPL groups. Conclusions Presence of antiphospholipid syndrome or persistent antiphospholipid antibodies may be related to non-thrombotic and non-gestational systemic lupus erythematosus manifestations. Patients with systemic lupus erythematosus plus antiphospholipid syndrome and persistent antiphospholipid antibodies without antiphospholipid syndrome also differ in terms of systemic lupus erythematosus manifestations.

Objectives Behcet9s syndrome (BS) is an autoimmune disease characterized by chronic inflammation and endothelial dysfunction. There are only a few studies examining the relationship between neutrophil-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet-lymphocyte ratio (PLR) and BS. The aim of this study was to determine NLR, PLR and MPV levels and their association with disease activation in BS patients with mucocutaneous, ocular and vascular involvement. Methods The study included 259 patients with BS and 41 healthy individuals. Age, sex, total white blood counts, neutrophil, platelet, mean platelet volume and lymphocyte counts of the patients were recorded. Patients with inflammatory bowel, hematological, infectious, cardiovascular diseases, hyperlipidemia, chronic liver, chronic kidney disease, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, malignancy and corticosteroid use were excluded from the study. Of 259 patients, 163 had active disease (75 active mucocutaneous (MC), 40 active ocular, 48 active vascular involvement) and 96 had inactive disease. MPV, NLR and PLR values of the patients were compared between the groups. P value Results Age and sex were similar between the groups. We compared the MPV, NLR and PLR values of patients with active and inactive disease. NLR and PLR were significantly higher while MPV was lower in the active group than the inactive and control groups (Table 1). Statistically significant higher PLR and NLR were found in the active MC and vascular groups, significantly lower MPV was seen only in vascular active group. This significance was not seen in active ocular group (Table 2). We also evaluated the same patient9s active and inactive periods of the disease, lower MPV, higher NLR and PLR values were seen MC and vascular groups (for all groups p Conclusions The low MPV and the high NLR and PLR are found in the active disease, which is especially significant in vascular and mucocutaneous groups. In the light of our findings, NLR and PLR were associated with the activity of BS especially with vascular involvement. The low MPV and the high NLR and PLR. The low MPV and the high NLR and PLR may be useful disease activity markers in behcet9s disease. Disclosure of Interest None declared

Objectives Ultrasonography (US) is a useful method for assessing synovial vascularization and proliferation in rheumatoid arthritis (RA). The aim of the study is to compare the tender joint and swollen joint in patients with rheumatoid arthritis (RA) with gray scale (GS) and power doppler (PD) ultrasonography (US). Methods Thirty RA patients were included. Median disease duration was 53.7 months. Demographic and clinical data, C reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) were recorded for each patient. Disease activity was evaluated using the Disease Activity Score in 28-joints (DAS28) with a median score 3.8.The joint tenderness and swelling were assessed for 10 joints (wrists, second and third proximal interphalangeal and metacarpophalangeal) in each patient.These joints were evaluated by GS and PD by ultrasonography. US joint effusion, synovitis and PD signals were graded from 1 to 3 for each joints. The 10-joint GS and 10-joint PD scores were then calculated. Correlations were tested using the Spearman coefficient. Results GS effusion, synovitis scores (r =0.565, p 0.001) and the PD signal (r=0.069, p>0.001). There was moderate correlation between 10 joints GS, 10 joints PD and DAS28, but it was not statistically significant. Conclusions Evaluating the swollen joints with clinical examination and combining it with US is a sensitive method. As joint tenderness is a more subjective finding than the joint swelling, this may explain the lack of correlation between tender joints and ultrasonography findings. We suggest to use Gray scale US and PD as a complementary method in addition to clinical assessment of joint tenderness in patients with RA. Disclosure of Interest None declared

Angiotensin II type 1 receptor autoantibodies (AT

There are scarce clinical data regarding serum pentraxin 3 (PTX3) and fibroblast growth factor 2 (FGF2) in patients with systemic sclerosis (SSc). Study was conducted to evaluate serum levels in our SSc cohort. Serum PTX3 and FGF2 concentrations were compared among SSc, disease control (systemic lupus erythematosus (SLE)), and healthy control groups. We also examined the association of serum levels of PTX3 and FGF2 with disease manifestations. Serum PTX3 levels were similarly distributed among SSc (n = 93) and healthy groups (n = 66) (p = 1.00) while PTX3 levels were higher in SLE controls (n = 86) compared to both SSc and healthy groups. PTX3 levels were higher in limited SSc cases compared to diffuse cases (p = 0.016). Median PTX3 levels in SSc cases with lung involvement were lower compared to cases with no lung involvement (p = 0.006). Patients with SSc had significantly lower serum levels of FGF2 compared to SLE and healthy groups. Serum FGF2 concentration was undetectable in 61.3% of cases with SSc while 30.2% of SLE and only 4.5% of healthy cases had undetectable FGF2 levels (p

This study aims to investigate ventricular repolarization using T-peak to T-end (Tp-e) intervals and Tp-e/QT ratios in patients with systemic sclerosis (SSc).Totally 65 patients (8 males, 57 females; mean age 49.8 years; range 20 to 77 years) with SSc and 63 control subjects (8 males, 55 females; mean age 49.3 years; range 20 to 77 years) were enrolled. Tp-e intervals, Tp-e/QT, and Tp-e/corrected QT (QTc) ratios were measured from the 12-lead electrocardiogram.Tp-e intervals, QT intervals, QTc intervals, Tp-e/QT, and Tp-e/QTc ratios were significantly higher in patients with SSc than control subjects (all p0.01). There was no difference between patients with diffuse and limited cutaneous SSc in terms of electrocardiogram and echocardiographic findings. Correlation analysis revealed no correlation between Tp-e intervals, Tp-e/QT, and Tp-e/QTc ratios with disease duration and anti-Sjögren's syndrome antigen A antibody levels in patients with SSc (all p0.05).Our study showed that Tp-e intervals, Tp-e/QT, and Tp-e/QTc ratios were increased in patients with SSc than control subjects. The increased frequency of ventricular arrhythmias can be clarified by increased indexes of ventricular repolarization parameters in patients with SSc.