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Objective Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease characterized by lymphocytic infiltration of the exocrine glands, affecting many organs. Celiac disease (CD), which causes inflammatory damage to the small intestine, develops as a result of the immunological response to gluten. The incidence of CD has increased in pSS. This research aims to investigate the frequency of CD in pSS. Methods This is a cross-sectional study conducted in a single-center between 2019 and 2020. A total of 90 patients diagnosed with pSS were questioned regarding CD symptoms. Laboratory tests and small bowel biopsies were requested from patients with suspected CD. Anti-gliadin immunoglobulin (Ig)A and IgG, anti-tissue transglutaminase (anti-TTG) IgA and IgG antibodies from celiac antibodies were evaluated using the ELISA method, and anti-endomysium IgA and IgG were evaluated by indirect immunofluorescence. Upper gastrointestinal endoscopy was performed in patients with CD symptoms and autoantibody positivity. The diagnosis of CD was made according to endoscopic biopsy results. Results The pSS patients comprised 98% females, with a mean age of 51.6±11.5 years. The rates of CD symptoms were as follows: 10% loss of appetite, 13.3% abdominal pain, 11.1% diarrhea, 18.9% constipation, 37.8% flatulence, and 2.2% weight loss. Anti-gliadin IgA positivity was determined in 6.7%, anti-gliadin IgG in 6.7%, anti-endomysium IgA in 2.2%, anti-endomysium IgG in 15.6%, and IgA in 1.1%. Gastroscopy was planned for 43 patients with suspected CD based on clinical and laboratory findings. CD was diagnosed in two patients before this study; subsequently, four more patients were diagnosed with CD. Conclusion The findings of this investigation revealed a 6.7% prevalence of CD in pSS. The diagnosis of CD in pSS was supported by histopathology. According to these findings, CD is more prevalent in pSS patients, and the risk of developing CD is higher than that in the general population. Keywords:Sjögren's syndrome, Celiac disease, gluten: [ABSTRACT FROM AUTHOR]

Aim: Animal species and strains exhibit varying degrees of sensitivity to bleomycin-induced dermal fibrosis. This study aimed to establish early (week 2) and late (week 4) changes in bleomycin-induced skin fibrosis in two species (mice and rats) and three strains (BALB/C mice, C57BL/6 mice, Wistar rats) using histopathological and radiological analyses. Material and Methods: Female C57BL/6 and BALB/C mice (n=4 each, 20-25 g, six weeks old) and female Wistar rats (n=4, 200-250 g, six weeks old) were subjected to subcutaneous bleomycin (10 mg/kg/day) or phosphate-buffered saline (PBS) every other day for four weeks. Skin biopsies from the four dorsal quadrants were analyzed for collagen homogenization, eosinophil and basophil counts, inflammatory response, and histological skin thickness (from 3 sections and ten different high-power fields in each biopsy). Results: The collagen homogenization score, eosinophil density, mast cell density, inflammatory response score, and skin thickness were higher in the bleomycin group than in the PBS group across all models. Collagen scores were similar across models, but the inflammatory response and eosinophil and mast cell densities were higher at week 2 than at week 4. The highest inflammatory response scores at week 2 were observed in the BALB/C and Wistar mice. Histological skin thickness was greatest in Wistar rats at weeks 2 and 4. Conclusion: The early inflammatory response was more severe in the BALB/C and Wistar models, although all models showed comparable collagen density and skin thickness. Wistar rats exhibited the most consistent parameters, making them suitable models for bleomycininduced dermal fibrosis. [ABSTRACT FROM AUTHOR]

Baricitinib is an oral Janus kinase (JAK) inhibitor and a member of the targeted synthetic disease-modifying anti-rheumatic drugs. Baricitinib competitively binds to adenosine triphosphate and inhibits the synthesis of cytokines that play prominent roles in arthritis rheumatoid arthritis pathogenesis by selectively inhibiting JAK1 and JAK2 at an effective dose. Its bioavailability is approximately 80%, and 64% is excreted via the kidney. To evaluate the efficacy and safety of baricitinib, 19 clinical pharmacological studies and 3 phase II, 4 phase III, and one extension study were conducted in patients with rheumatoid RA. The effectiveness of baricitinib has been shown in these studies. Clinical research and real-world data suggest that barictinib is a safe drug; however, it has been reported to have some well-known side effects such as neutropenia, anemia, elevation of transaminase levels, hyperlipidemia, and increased risk of infections. In these studies, major cardiovascular events were found to be similar in frequency to placebo, and the incidence of malignancy was found to be similar to that of age-related cancer in the general population. However, as is the case with other JAK inhibitors, it is recommended to be used with caution in patients with risk factors for deep vein thrombosis, such as advanced age, obesity, and inactivity. [ABSTRACT FROM AUTHOR]

This article discusses a case of giant cell arteritis (GCA) with genital system involvement. GCA is a chronic inflammatory condition that primarily affects individuals over the age of 50. While GCA commonly affects the temporal arteries, it can also involve other arteries, including those in the lung, breast, and gynecological system. The article presents a case of a 61-year-old female patient who was diagnosed with GCA based on the analysis of ovarian and uterine pathology specimens. The patient's symptoms and acute phase reactants returned to normal with treatment, and her progress has been monitored for 3 years. The article emphasizes the importance of considering GCA in patients with systemic inflammatory symptoms and genital system problems. [Extracted from the article]

Objective: TURKBIO registry, established in 2011, is the first nationwide biological database in Turkey. This study aimed to provide an overview of TURKBIO data collected by June 2018. Methods: The registry included adult patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), nonradiographic axial spondyloarthritis (nr-AxSpA), and psoriatic arthritis (PsA). Demographic and clinical features, disease activity markers, and other follow-up parameters, current and previous treatments, and adverse events were registered electronically at each visit using open-source software. The registration of patient-reported outcome measures was carried out electronically by the patients using touch screens. Results: TURKBIO registry included a total of 41,145 treatment series with biologicals. There were 2,588 patients with axSpA (2,459 AS and 129 nr-axSpA), 2,036 with RA, and 428 with PsA. The total number of patients, including those with other diagnoses, was 5,718. In the follow-up period, the number of patients and also visits steadily increased by years. The yearly mean number of visits per patient was found to be 2.3. Significant improvements in disease activity and health assessment parameters were observed following the biological treatments. Biologics were often given in combination with a conventional synthetic disease-modifying antirheumatic drug in patients with RA. Infections were the most commonly seen adverse events, followed by allergic reactions. Tuberculosis was observed in 12 patients, malignancy in 18, and treatment-related mortality in 31. Conclusion: TURKBIO provided a valuable real-life experience with the use of biologics in rheumatic diseases in Turkey. [ABSTRACT FROM AUTHOR]

Background: This study aimed to examine fetomaternal outcomes in pregnant women in a large Turkish Takayasu arteritis (TAK) cohort and to evaluate the effects of pregnancy on the disease in those patients. Methods: This is a cohort study involving 296 pregnancies of 112 TAK patients from 8 tertiary rheumatology centers in Turkey. Pregnancies were divided into 2 groups as pre‐d (before disease onset) and post‐d (after disease onset). In addition, post‐d pregnancies were further divided into 2 subgroups according to fetomaternal complications (FMC) development status. Finally, patients were grouped into those with and without a history of pregnancy after disease onset. Results: In post‐d pregnancies, rates of worsening hypertension, new‐onset hypertension, and preeclampsia were higher than in pre‐d pregnancies (0.9% vs 16%, P <.001, 0.5% vs 5.3%, P =.012, and 0% vs 4%, P =.013, respectively). Patients with FMC were more likely to have renal artery involvement (65% vs 21%, P =.003). The patients who had post‐d were younger, had longer disease duration, and had more relapses number than other patients (P <.001, P =.028, P =.016, respectively). Vasculitis Damage Index (VDI) results were similar in patients with or without post‐d pregnancies. Conclusion: Pregnancies after disease onset were found to be associated with HT and preeclampsia/eclampsia. HT‐related FMCs are increased in TAK, and patients with renal artery involvement are at higher risk. The number of relapses increases in patients who become pregnant after disease onset, but pregnancy was not an independent risk factor for relapse. Pregnancy after the onset of disease had no negative effect on VDI. [ABSTRACT FROM AUTHOR]

Amaç: Sistemik sklerozda (SSk) oto-antikorlar hastalığın tanısında, alt tiplerinin ve prognozun belirlenmesinde ve organ tutulumlarının öngörülmesinde kullanılmaktadır. SSk hastalarında hastalığa spesifik oto-antikorlar (anti-sentromer antikor, anti-Scl-70 antikor ve anti-RNA polimeraz II antikor) yanında spesifik olmayan oto-antikorlar da saptanmaktadır. Çalışmamızın, erken SSk hastalarında genişletilmiş bir profilde oto-antikorların sıklığını, erken dönem ve takipte gelişen organ tutulumları ile ilişkisini araştırmaktır. Yöntem: Çalışmaya ACR/EULAR 2013 sınıflama kriterlerini karşılayan ve hastalık süresi <3 yıl olan erken SSk hastaları alındı. Hastaların ANA ölçümleri HEp-20-10/primat karaciğer mozaiği indirekt immünofloresan (IIF) ve geniş panel oto-antikor ölçümü için SSc (Nucleoli) Profile EuroLine (Euroimmun, Lübeck, Almanya) kitleri kullanıldı. Bulgular: Yüz hastadan 93'ü IIF ile ANA için pozitifti. Anti-Scl70 ab en sık saptanan (%41) oto-antikor olurken, bunu %27 ile anti-sentromer ab (ACA) ve %15 sıklıkla RNAPIII izledi. Otuz iki hastada çoklu otoantikor pozitifliği ve 53 hastada tek pozitiflik (26'sı anti-Scl70, 16'sı ACA, 6'sı anti-RNAPIII, 1 anti-Ku ab, 1 anti-PM/Scl100, 2 anti-PM/Scl75 ve 1 anti-Ro52) saptandı. SSk'ye özgü otoantikorlar arasında, anti-Scl70 ve anti-RNAPIII antikorları en yüksek birliktelik gösterdi ve 4 hastada pozitifti. SSk'ye özgü otoantikorlar için tek veya çoklu boyaması olan hastalar arasında majör organ tutulumları açısından fark yoktu (tümü için p>0,05). Hastaların 4 yıllık takibi sonucunda 80 hastanın verilerine ulaşıldı. Hastaların 3'ünün takipten çıktığı ve birinin öldüğü saptandı. Daha önce organ tutulumu saptanmayan hastaların takip sırasında 5'inde İAH, 1'inde PAH ve 3'ünde dijital ülserin yeni geliştiği bulundu. İAH gelişen yaygın deri tutulumlu hastalarda Scl-70 saptanırken, İAH gelişen sınırlı deri tutulumlu hastalarda CENPA/B, Ro52 ve anti-ku antikorlarının ikili pozitiflikleri saptandı. Sonuç: Çalışmamızın sonuçlarına göre SSk'da spesifik otoantikorlar nispeten sık olmasına rağmen, hastaların çoğunluğunda çoklu otoantikor pozitiflikleri görülmüştür. Çoklu oto-antikor pozitiflikleri SSk-spesifik oto-antikorların beklenen organ tutulumlarında farklılığa farklılığa yol açabilir. [ABSTRACT FROM AUTHOR]

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Antiphospholipid syndrome (APS) is characterized by thrombosis and/or pregnancy morbidity with persistently positive antiphospholipid antibodies. However, in APS, there are several non-thrombotic clinical manifestations such as thrombocytopenia, cardiac valve disease, microthrombotic nephropathy, skin ulcer, or cognitive dysfunction. These non-criteria manifestations are relatively common and usually are non-responsive to anticoagulation. Among the non-criteria manifestations, thrombocytopenia, skin ulcers, migraine, and heart valve lesions are the most frequent manifestations described in APS. Limited data are available on the treatment of non-criteria manifestations of APS, and most therapeutic options are based on case reports or retrospective non-randomized studies. Although there is no consensus on the treatment of non-criteria manifestations of APS, anticoagulant therapy and immunomodulatory drugs could be combined in most patients. [ABSTRACT FROM AUTHOR]