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Papers by burak erer
Clinical Rheumatology
Objective To compare the clinical features, laboratory findings, and prognosis of Behçet’s diseas... more Objective To compare the clinical features, laboratory findings, and prognosis of Behçet’s disease (BD) patients with and without Budd–Chiari syndrome (BCS). Methods This multicenter retrospective study investigated 61 (M/F: 41/20) patients with BD, having coexistent BCS, and 169 (M/F:100/69) BD patients as the control group without BCS from 22 different centers of Turkey diagnosed between 1990 and 2017. Results Of the total 61 BD patients with BCS, the onset of the first symptom and the median age of diagnosis were earlier in contrast to BD patients without BCS ( p = 0.005 and p = 0.007). Lower extremity deep vein and inferior vena cava (IVC) thrombosis were more common in patients with BCS (all; p < 0.01) compared to the control group. Mortality was significantly higher in BD-BCS patients with IVC thrombosis than in the controls ( p = 0.004). Since most of the cases in our cohort had chronic and silent form of BCS, mortality rate was 14.8%, which was on the lower range of mortality rate reported in literature (14–47%). While all BD-BCS patients received immunosuppressive (IS) agents, only half of them received additional anticoagulant treatments. Among IS agents, interferon treatment was more frequently used in this cohort (19%), compared to other series reported in literature (2.3%). Conclusion To our knowledge, this is the largest series of BD patients with BCS. Our patients had earlier disease onset and diagnosis, higher frequency of IVC thrombosis, and higher mortality rate, compared to BD patients without BCS. Mortality was significantly higher in BD-BCS patients with IVC thrombosis compared to controls. Key Points • Mortality rate is higher in BD-associated BCS patients with IVC involvement. • Chronic and silent form of BD-associated BCS has a better prognosis. • The main treatment options are corticosteroids and immunosuppressive agents, whereas anticoagulant treatment remains controversial.
Serum C-reactive protein (CRP) and serum amyloid A (SAA) measurements during the treatment and fo... more Serum C-reactive protein (CRP) and serum amyloid A (SAA) measurements during the treatment and follow-up periods. EOS end of study. (DOCX 61 kb)
Short form-36 (SF-36) physical component summary (PCS) and mental component summary (MCS) scores ... more Short form-36 (SF-36) physical component summary (PCS) and mental component summary (MCS) scores during the treatment and follow-up periods. EOS end of study. (DOCX 53 kb)
Archives of the Turkish Society of Cardiology, 2001
Archives of the Turkish Society of Cardiology, 2001
Archives of the Turkish Society of Cardiology, 2001
Archives of the Turkish Society of Cardiology, 2001
Autoimmunity Reviews, 2016
Clinical Rheumatology, 2016
The association of Takayasu&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more The association of Takayasu&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s arteritis (TAK) and inflammatory bowel disease (IBD) has previously been reported in case series. Microscopic colitis (MC) has IBD-like symptoms with regard to clinical and histopathological feature. We aim to assess the presence of MC in TAK patients in this study. We cross-sectionally assessed TAK patients, between the ages of 18-65 years, who were diagnosed according to the American College of Rheumatology (ACR) criteria. Disease activity was evaluated by Kerr&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s criteria. Age- and sex-matched irritable bowel syndrome (IBS) patients were selected as control group. All patients and controls have been interviewed for IBD and IBS symptoms using the questionnaires of WHO guideline and Rome III criteria, respectively. Lower endoscopic procedure was performed with at least five random biopsies taken from different colonic segments and the terminal ileum. A blinded expert pathologist evaluated the specimens for the features of MC. Thirty TAK patients (29 females and 1 male) with the mean age of 35 ± 11 years (range, 20-59 years) and 15 IBS controls with the mean age of 38 ± 13 years were included in the study. TAK patients all fulfilled the MC criteria (three &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;complete&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and six &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;incomplete&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; cases). MC was found to be significantly higher in active TAK patients in comparison to inactive group (67 vs 14 %, p = 0.03, OR = 7.9). Our results show that there is an increased frequency of MC in TAK patients, and this is the first report on the association of TAK and MC.
Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology, 2005
Pain is one of the cardinal manifestations of rheumatic disorders, which are quite prevalent and ... more Pain is one of the cardinal manifestations of rheumatic disorders, which are quite prevalent and an important cause of morbidity and mortality in the population. In inflammatory rheumatic disorders, synovial inflammation causes peripheral and central sensitization by the nociceptive stimuli. This process is affected by the interaction of cognitive, sociocultural and environmental factors of the individual, which affect the perception and interpretation of pain. Treatment of the underlying cause is the most important goal of the pain management. Treatment strategies only focusing on pain management can not prevent joint damage and disability. Therefore, we have been experiencing very promising results with the new disease-modifying antirheumatic drugs and biological agents, which control the inflammatory process efficiently. Since there is an interaction of the somatic components (nociception and its central transmission) with the cognitive components (belief, mood and behavior), a c...
Annals of the Rheumatic Diseases, 2013
Background Takayasu arteritis (TA) is a chronic vasculitis with an indolent course. Reliable diag... more Background Takayasu arteritis (TA) is a chronic vasculitis with an indolent course. Reliable diagnostic and activity markers have not yet been demonstrated. Objectives We aimed to evaluate the predictivity of conventional acute phase proteins (ESR, CRP) and other non-conventional inflammation and endothelial activity markers such as serum amilod A (SAA) protein, interleukin-6 (IL-6) and von Willebrand factor (vWF) in a TA cohort, prospectively followed-up. Methods Fourty-eight TA patients diagnosed according to ACR 1990 criteria and followed-up ≥ 6 months, 37 patients with granulomatosis with poliangiitis (GPA) diagnosed according to ACR 1990 criteria and 28 healthy controls (HC) were included into the study. Demographic and clinical features of TA, GPA and HCs were recorded into a predefined protocol. ESR, CRP, SAA, IL-6 and vWF levels were analysed initially in all groups and at 3rd, 6th, 12th months visits in TA and GPA groups. Westergreen method for ESR, nephelometric assay for CRP, SAA and ELISA method for IL-6 and vWF were used. Disease activity was evaluated by Kerr criteria for TA and BVAS2003 for GPA. TA and GPA cohorts were stratified to the subgroups according to the activity. Comparisons were performed by Mann Whitney U test in subgroups. ROC curve analysis was used to identify the sensitivity and specificity of laboratory parameters for predicting activity. Results Mean age and disease duration were found as 40±13 yrs, 121±115 mo for TA, 47±13 yrs, 65±42 mo for GPA and mean age was 38±9 for HCs. Females were significantly high in TA cohort (%) when compared to GPA (%) (p<0,001). The percentage of active disease was 40%, 31%, 35%, 29% for TA and 32%, 19%, 11%, 13% for GPA at initial 3rd, 6th and 12th months, respectively. ESR, CRP and SAA levels were significantly high in active TA at the initial, 3rd and 6th months visits (41±20 vs 21±12, p=<0.001 for ESR, 20±20 vs 6±10 p=<0.001 for CRP, 23±23 vs 12±29, p=0.001 for SAA at initial visit, 41±19 vs 24±17, p=0.002 for ESR, 26±28 vs 6±8, p= 0.004 for CRP, 38±59 vs 12±17, p=0.02 for SAA at the 3rd visit, 41±17 vs 24±12, p= <0.001 for ESR, 16±18 vs 4±5, p= 0.01 for CRP, 22±30 vs 10±16, p=0.002 for SAA at the 6th visit). SAA was the only marker that demonstrate the significance between subgroups at the 12th month (12±10 vs 8±11, p= 0.007). In active GPA subgroup, SAA and vWF at the 3rd visit and vWF at the 6th visit were found significantly high compared to inactive patients. Sensitivity and specificity were found as 88-70%, 79-84% for ESR levels of 35 mm/h, 83-65%, 86-84% for CRP levels of 5-8 mg/L 72-50%, 90-80% for SAA levels of 10-11 mg/L at the initial and 6th months visits in TA cohort. At the 12th month visit, SAA levels of 9 mg/L, was the only marker reaching the significant sensitivity (50%) and spesificity (83%) for predicting activity. References In a well established and prospective cohort of TA, SAA has found to be a comparable sensitivity and specificity with ESR and CRP for predicting activity. It’s been observed that sensitivity of ESR, CRP had a trend towards to decrease in time which could be related to the decreasing activity during the follow-up. SAA was the only laboratory parameter which maintained its specificity in contrast to conventional biomarkers. Disclosure of Interest None Declared
Annals of the Rheumatic Diseases, 2013
Angiogenesis and blood vessel stability in Giant Cell Arteritis D. Molloy et al [OP0179] Ann Rheu... more Angiogenesis and blood vessel stability in Giant Cell Arteritis D. Molloy et al [OP0179] Ann Rheum Dis 2012;71(suppl 3):115 • Pathogenesis unknown but involves vascular remodeling, inflammatory infiltrate arterial wall • Aim: assess blood vessel stability and oxidative damage in GCA patients and correlation with disease activity • 20 patients with GCA included (16 positive temporal artery biopsy) • Results: unstable inflamed vessels in GCA, associated with EC/pericyte interaction, expression of Ang2 and oxidative damage markers Retrospective monocentric cohort of orbital masses in granulomatosis
Rheumatology International, 2010
We compared diaphragmatic motion between ankylosing spondylitis (AS) patients and controls, as as... more We compared diaphragmatic motion between ankylosing spondylitis (AS) patients and controls, as assessed by the ultrasonographic method. We included 33 consecutive AS patients (19 males, 14 females) followed up at our center and 14 apparently healthy controls (8 males, 6 females) into our study. AS patients fulfilled the modified New York classification criteria for AS. Patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; demographic and clinical data, functional parameters, and radiographic findings were recorded down. By evaluating the motion of right and left diaphragm during deep expirium and inspirium, the mean diaphragmatic motion was determined by ultrasonography. Diaphragmatic motion in AS patients was less than in controls, but the difference was not significant (68.9 ± 17 mm vs. 77.8 ± 22.4 mm, P = 0.14). Diaphragmatic motion in AS patients who were active according to BASDAI score (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;4) was not different from inactive patients (70.4 ± 20.5 vs. 67.5 ± 13.5, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The mean diaphragmatic motion had a positive correlation with occiput-to-wall distance (r = 0.35, P = 0.048); and negative correlations with cervical rotation (r = -0.45, P = 0.01) and modified Schober test (r = -0.34, P = 0.05) in AS patients. We did not detect any association of mean diaphragmatic motion with thoracic expansion on deep expiration. Diaphragmatic motion in AS does not differ significantly from the control group. Factors like disease activation, chest expansion, and the severity of radiographic findings do not affect diaphragmatic motion. There is no compensatory increase in diaphragmatic motion in AS.
Modern Rheumatology, 2013
Rheumatology International, 2015
Familial Mediterranean fever (FMF) is an autoinflammatory disease, which can be well controlled w... more Familial Mediterranean fever (FMF) is an autoinflammatory disease, which can be well controlled with lifelong use of colchicine. Since studies dealing with the efficacy and safety of colchicine were conducted mainly in the sixties and seventies of the previous century, it seems that this topic needs to be updated. Recently, an international expert panel was undertaken for the establishment of recommendations on how to manage FMF. We aimed to summarize the efficacy and safety of the current treatments available to prevent FMF attacks and to avert the appearance of amyloidosis secondary to FMF. A systematic review was performed. Two reviewers and methodologist established the protocol of the review and the epidemiological questions in PICO terms. MEDLINE through PubMed, Embase, and Cochrane Central Trials Register all up to May 31, 2014, were searched, and only randomized controlled trials or quasicontrolled trials were accepted. For each study, a judgment on risk of bias was then rated as high, moderate, or low. Of 1222 initially captured publications, 153 articles were studied in detail. Finally, only seven studies met all criteria and were included. Among these seven studies, four were randomized crossover clinical trials of colchicine including a total of 57 patients, one RCT of Andrographis paniculata Herba Nees extract employed in 24 patients, one randomized crossover clinical trial of Rilonacept used in 12 patients, and one RCT of interferon treating 34 acute abdominal attacks in 22 patients. The quality of the colchicine trials was low compared with the other drugs trials. Safety was not clearly mentioned in the trials. Colchicine is an effective treatment in FMF.
Aging Clinical and Experimental Research, 2013
Systemic lupus erythematosus (SLE) is a multisystemic disease which potentially involves various ... more Systemic lupus erythematosus (SLE) is a multisystemic disease which potentially involves various organs including the skin, joints, kidneys, liver, hematopoetic system, and serous membranes. It is rarely seen in elderly males. The most common cardiovascular involvement type is pericarditis. Anti-Ro antibodies may be associated with neonatal lupus which causes heart blocks. Recent literature indicates that anti-Ro antibodies may be associated with various rhythm and conduction disturbances in the adulthood. The most common finding associated with anti-Ro antibodies is prolonged corrected QT (QTc) interval. Herein, we present an elderly male patient with anti-Ro-positive SLE associated with prolonged QTc interval and AV blocks that significantly improved after corticosteroid treatment.
Annals of Hepatology, 2008
Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with ob... more Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with obesity and insulin resistance (IR). Leptin plays a key role in the control of energy balance, and insulin sensitivity. In this study, we aimed to examine whether serum leptin levels correlate with insulin resistance, oxidative stress parameters and the severity of histological changes in NAFLD. Methods: Fifty-two patients (M/F: 28/24) with no alcohol intake and biopsy-proven diagnosis of NAFLD were studied. Serum leptin levels were measured by radioimmunoassay. HOMA (homeostasis model assessment) IR index was calculated. Comparisons between the patients with NAFLD and non-alcoholic steatohepatitis (NASH) were performed using the Student's t test. Multivariate regression analysis and the area under the receiver operating characteristic (ROC) curve were used to identify the independent predictors for NASH. Results: We found no association between serum leptin, fasting insulin levels, and oxidative stress parameters. ROC curve and multiple regression analysis revealed no association between the severity of histological changes and serum leptin levels. During six months followed-up period only NASH group with elevated leptin levels had significant reductions of ALT and AST values (p = 0.03, and 0.005, respectively). Conclusion: Our findings show a preventive effect of leptin against progressive liver injury in NAFLD.
The Journal of Rheumatology, 2017
Objective.The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group has been workin... more Objective.The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group has been working toward developing a data-driven core set of outcome measures for use in clinical trials of Behçet’s syndrome [Behçet disease (BD)]. This paper summarizes the group’s work through OMERACT 2016, discussions during the meeting, and the future research agenda.Methods.Qualitative patient interviews were conducted among 20 patients with BD who have different types of organ involvement. A 3-round Delphi among BD experts and patients was initiated to identify domains, subdomains, and outcomes to be assessed in clinical trials of BD. The results of these studies were discussed during OMERACT 2016 and next steps were planned.Results.Patients’ perspectives and priorities were identified through qualitative interviews that identified candidate domains and subdomains for inclusion in the Delphi and characterized some shortcomings of the currently used patient-reported outcomes in BD. The first roun...
Clinical Rheumatology
Objective To compare the clinical features, laboratory findings, and prognosis of Behçet’s diseas... more Objective To compare the clinical features, laboratory findings, and prognosis of Behçet’s disease (BD) patients with and without Budd–Chiari syndrome (BCS). Methods This multicenter retrospective study investigated 61 (M/F: 41/20) patients with BD, having coexistent BCS, and 169 (M/F:100/69) BD patients as the control group without BCS from 22 different centers of Turkey diagnosed between 1990 and 2017. Results Of the total 61 BD patients with BCS, the onset of the first symptom and the median age of diagnosis were earlier in contrast to BD patients without BCS ( p = 0.005 and p = 0.007). Lower extremity deep vein and inferior vena cava (IVC) thrombosis were more common in patients with BCS (all; p < 0.01) compared to the control group. Mortality was significantly higher in BD-BCS patients with IVC thrombosis than in the controls ( p = 0.004). Since most of the cases in our cohort had chronic and silent form of BCS, mortality rate was 14.8%, which was on the lower range of mortality rate reported in literature (14–47%). While all BD-BCS patients received immunosuppressive (IS) agents, only half of them received additional anticoagulant treatments. Among IS agents, interferon treatment was more frequently used in this cohort (19%), compared to other series reported in literature (2.3%). Conclusion To our knowledge, this is the largest series of BD patients with BCS. Our patients had earlier disease onset and diagnosis, higher frequency of IVC thrombosis, and higher mortality rate, compared to BD patients without BCS. Mortality was significantly higher in BD-BCS patients with IVC thrombosis compared to controls. Key Points • Mortality rate is higher in BD-associated BCS patients with IVC involvement. • Chronic and silent form of BD-associated BCS has a better prognosis. • The main treatment options are corticosteroids and immunosuppressive agents, whereas anticoagulant treatment remains controversial.
Serum C-reactive protein (CRP) and serum amyloid A (SAA) measurements during the treatment and fo... more Serum C-reactive protein (CRP) and serum amyloid A (SAA) measurements during the treatment and follow-up periods. EOS end of study. (DOCX 61 kb)
Short form-36 (SF-36) physical component summary (PCS) and mental component summary (MCS) scores ... more Short form-36 (SF-36) physical component summary (PCS) and mental component summary (MCS) scores during the treatment and follow-up periods. EOS end of study. (DOCX 53 kb)
Archives of the Turkish Society of Cardiology, 2001
Archives of the Turkish Society of Cardiology, 2001
Archives of the Turkish Society of Cardiology, 2001
Archives of the Turkish Society of Cardiology, 2001
Autoimmunity Reviews, 2016
Clinical Rheumatology, 2016
The association of Takayasu&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;a... more The association of Takayasu&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s arteritis (TAK) and inflammatory bowel disease (IBD) has previously been reported in case series. Microscopic colitis (MC) has IBD-like symptoms with regard to clinical and histopathological feature. We aim to assess the presence of MC in TAK patients in this study. We cross-sectionally assessed TAK patients, between the ages of 18-65 years, who were diagnosed according to the American College of Rheumatology (ACR) criteria. Disease activity was evaluated by Kerr&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s criteria. Age- and sex-matched irritable bowel syndrome (IBS) patients were selected as control group. All patients and controls have been interviewed for IBD and IBS symptoms using the questionnaires of WHO guideline and Rome III criteria, respectively. Lower endoscopic procedure was performed with at least five random biopsies taken from different colonic segments and the terminal ileum. A blinded expert pathologist evaluated the specimens for the features of MC. Thirty TAK patients (29 females and 1 male) with the mean age of 35 ± 11 years (range, 20-59 years) and 15 IBS controls with the mean age of 38 ± 13 years were included in the study. TAK patients all fulfilled the MC criteria (three &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;complete&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and six &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;incomplete&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; cases). MC was found to be significantly higher in active TAK patients in comparison to inactive group (67 vs 14 %, p = 0.03, OR = 7.9). Our results show that there is an increased frequency of MC in TAK patients, and this is the first report on the association of TAK and MC.
Aǧrı : Ağrı (Algoloji) Derneği'nin Yayın organıdır = The journal of the Turkish Society of Algology, 2005
Pain is one of the cardinal manifestations of rheumatic disorders, which are quite prevalent and ... more Pain is one of the cardinal manifestations of rheumatic disorders, which are quite prevalent and an important cause of morbidity and mortality in the population. In inflammatory rheumatic disorders, synovial inflammation causes peripheral and central sensitization by the nociceptive stimuli. This process is affected by the interaction of cognitive, sociocultural and environmental factors of the individual, which affect the perception and interpretation of pain. Treatment of the underlying cause is the most important goal of the pain management. Treatment strategies only focusing on pain management can not prevent joint damage and disability. Therefore, we have been experiencing very promising results with the new disease-modifying antirheumatic drugs and biological agents, which control the inflammatory process efficiently. Since there is an interaction of the somatic components (nociception and its central transmission) with the cognitive components (belief, mood and behavior), a c...
Annals of the Rheumatic Diseases, 2013
Background Takayasu arteritis (TA) is a chronic vasculitis with an indolent course. Reliable diag... more Background Takayasu arteritis (TA) is a chronic vasculitis with an indolent course. Reliable diagnostic and activity markers have not yet been demonstrated. Objectives We aimed to evaluate the predictivity of conventional acute phase proteins (ESR, CRP) and other non-conventional inflammation and endothelial activity markers such as serum amilod A (SAA) protein, interleukin-6 (IL-6) and von Willebrand factor (vWF) in a TA cohort, prospectively followed-up. Methods Fourty-eight TA patients diagnosed according to ACR 1990 criteria and followed-up ≥ 6 months, 37 patients with granulomatosis with poliangiitis (GPA) diagnosed according to ACR 1990 criteria and 28 healthy controls (HC) were included into the study. Demographic and clinical features of TA, GPA and HCs were recorded into a predefined protocol. ESR, CRP, SAA, IL-6 and vWF levels were analysed initially in all groups and at 3rd, 6th, 12th months visits in TA and GPA groups. Westergreen method for ESR, nephelometric assay for CRP, SAA and ELISA method for IL-6 and vWF were used. Disease activity was evaluated by Kerr criteria for TA and BVAS2003 for GPA. TA and GPA cohorts were stratified to the subgroups according to the activity. Comparisons were performed by Mann Whitney U test in subgroups. ROC curve analysis was used to identify the sensitivity and specificity of laboratory parameters for predicting activity. Results Mean age and disease duration were found as 40±13 yrs, 121±115 mo for TA, 47±13 yrs, 65±42 mo for GPA and mean age was 38±9 for HCs. Females were significantly high in TA cohort (%) when compared to GPA (%) (p<0,001). The percentage of active disease was 40%, 31%, 35%, 29% for TA and 32%, 19%, 11%, 13% for GPA at initial 3rd, 6th and 12th months, respectively. ESR, CRP and SAA levels were significantly high in active TA at the initial, 3rd and 6th months visits (41±20 vs 21±12, p=<0.001 for ESR, 20±20 vs 6±10 p=<0.001 for CRP, 23±23 vs 12±29, p=0.001 for SAA at initial visit, 41±19 vs 24±17, p=0.002 for ESR, 26±28 vs 6±8, p= 0.004 for CRP, 38±59 vs 12±17, p=0.02 for SAA at the 3rd visit, 41±17 vs 24±12, p= <0.001 for ESR, 16±18 vs 4±5, p= 0.01 for CRP, 22±30 vs 10±16, p=0.002 for SAA at the 6th visit). SAA was the only marker that demonstrate the significance between subgroups at the 12th month (12±10 vs 8±11, p= 0.007). In active GPA subgroup, SAA and vWF at the 3rd visit and vWF at the 6th visit were found significantly high compared to inactive patients. Sensitivity and specificity were found as 88-70%, 79-84% for ESR levels of 35 mm/h, 83-65%, 86-84% for CRP levels of 5-8 mg/L 72-50%, 90-80% for SAA levels of 10-11 mg/L at the initial and 6th months visits in TA cohort. At the 12th month visit, SAA levels of 9 mg/L, was the only marker reaching the significant sensitivity (50%) and spesificity (83%) for predicting activity. References In a well established and prospective cohort of TA, SAA has found to be a comparable sensitivity and specificity with ESR and CRP for predicting activity. It’s been observed that sensitivity of ESR, CRP had a trend towards to decrease in time which could be related to the decreasing activity during the follow-up. SAA was the only laboratory parameter which maintained its specificity in contrast to conventional biomarkers. Disclosure of Interest None Declared
Annals of the Rheumatic Diseases, 2013
Angiogenesis and blood vessel stability in Giant Cell Arteritis D. Molloy et al [OP0179] Ann Rheu... more Angiogenesis and blood vessel stability in Giant Cell Arteritis D. Molloy et al [OP0179] Ann Rheum Dis 2012;71(suppl 3):115 • Pathogenesis unknown but involves vascular remodeling, inflammatory infiltrate arterial wall • Aim: assess blood vessel stability and oxidative damage in GCA patients and correlation with disease activity • 20 patients with GCA included (16 positive temporal artery biopsy) • Results: unstable inflamed vessels in GCA, associated with EC/pericyte interaction, expression of Ang2 and oxidative damage markers Retrospective monocentric cohort of orbital masses in granulomatosis
Rheumatology International, 2010
We compared diaphragmatic motion between ankylosing spondylitis (AS) patients and controls, as as... more We compared diaphragmatic motion between ankylosing spondylitis (AS) patients and controls, as assessed by the ultrasonographic method. We included 33 consecutive AS patients (19 males, 14 females) followed up at our center and 14 apparently healthy controls (8 males, 6 females) into our study. AS patients fulfilled the modified New York classification criteria for AS. Patients&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; demographic and clinical data, functional parameters, and radiographic findings were recorded down. By evaluating the motion of right and left diaphragm during deep expirium and inspirium, the mean diaphragmatic motion was determined by ultrasonography. Diaphragmatic motion in AS patients was less than in controls, but the difference was not significant (68.9 ± 17 mm vs. 77.8 ± 22.4 mm, P = 0.14). Diaphragmatic motion in AS patients who were active according to BASDAI score (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;4) was not different from inactive patients (70.4 ± 20.5 vs. 67.5 ± 13.5, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). The mean diaphragmatic motion had a positive correlation with occiput-to-wall distance (r = 0.35, P = 0.048); and negative correlations with cervical rotation (r = -0.45, P = 0.01) and modified Schober test (r = -0.34, P = 0.05) in AS patients. We did not detect any association of mean diaphragmatic motion with thoracic expansion on deep expiration. Diaphragmatic motion in AS does not differ significantly from the control group. Factors like disease activation, chest expansion, and the severity of radiographic findings do not affect diaphragmatic motion. There is no compensatory increase in diaphragmatic motion in AS.
Modern Rheumatology, 2013
Rheumatology International, 2015
Familial Mediterranean fever (FMF) is an autoinflammatory disease, which can be well controlled w... more Familial Mediterranean fever (FMF) is an autoinflammatory disease, which can be well controlled with lifelong use of colchicine. Since studies dealing with the efficacy and safety of colchicine were conducted mainly in the sixties and seventies of the previous century, it seems that this topic needs to be updated. Recently, an international expert panel was undertaken for the establishment of recommendations on how to manage FMF. We aimed to summarize the efficacy and safety of the current treatments available to prevent FMF attacks and to avert the appearance of amyloidosis secondary to FMF. A systematic review was performed. Two reviewers and methodologist established the protocol of the review and the epidemiological questions in PICO terms. MEDLINE through PubMed, Embase, and Cochrane Central Trials Register all up to May 31, 2014, were searched, and only randomized controlled trials or quasicontrolled trials were accepted. For each study, a judgment on risk of bias was then rated as high, moderate, or low. Of 1222 initially captured publications, 153 articles were studied in detail. Finally, only seven studies met all criteria and were included. Among these seven studies, four were randomized crossover clinical trials of colchicine including a total of 57 patients, one RCT of Andrographis paniculata Herba Nees extract employed in 24 patients, one randomized crossover clinical trial of Rilonacept used in 12 patients, and one RCT of interferon treating 34 acute abdominal attacks in 22 patients. The quality of the colchicine trials was low compared with the other drugs trials. Safety was not clearly mentioned in the trials. Colchicine is an effective treatment in FMF.
Aging Clinical and Experimental Research, 2013
Systemic lupus erythematosus (SLE) is a multisystemic disease which potentially involves various ... more Systemic lupus erythematosus (SLE) is a multisystemic disease which potentially involves various organs including the skin, joints, kidneys, liver, hematopoetic system, and serous membranes. It is rarely seen in elderly males. The most common cardiovascular involvement type is pericarditis. Anti-Ro antibodies may be associated with neonatal lupus which causes heart blocks. Recent literature indicates that anti-Ro antibodies may be associated with various rhythm and conduction disturbances in the adulthood. The most common finding associated with anti-Ro antibodies is prolonged corrected QT (QTc) interval. Herein, we present an elderly male patient with anti-Ro-positive SLE associated with prolonged QTc interval and AV blocks that significantly improved after corticosteroid treatment.
Annals of Hepatology, 2008
Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with ob... more Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with obesity and insulin resistance (IR). Leptin plays a key role in the control of energy balance, and insulin sensitivity. In this study, we aimed to examine whether serum leptin levels correlate with insulin resistance, oxidative stress parameters and the severity of histological changes in NAFLD. Methods: Fifty-two patients (M/F: 28/24) with no alcohol intake and biopsy-proven diagnosis of NAFLD were studied. Serum leptin levels were measured by radioimmunoassay. HOMA (homeostasis model assessment) IR index was calculated. Comparisons between the patients with NAFLD and non-alcoholic steatohepatitis (NASH) were performed using the Student's t test. Multivariate regression analysis and the area under the receiver operating characteristic (ROC) curve were used to identify the independent predictors for NASH. Results: We found no association between serum leptin, fasting insulin levels, and oxidative stress parameters. ROC curve and multiple regression analysis revealed no association between the severity of histological changes and serum leptin levels. During six months followed-up period only NASH group with elevated leptin levels had significant reductions of ALT and AST values (p = 0.03, and 0.005, respectively). Conclusion: Our findings show a preventive effect of leptin against progressive liver injury in NAFLD.
The Journal of Rheumatology, 2017
Objective.The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group has been workin... more Objective.The Outcome Measures in Rheumatology (OMERACT) Vasculitis Working Group has been working toward developing a data-driven core set of outcome measures for use in clinical trials of Behçet’s syndrome [Behçet disease (BD)]. This paper summarizes the group’s work through OMERACT 2016, discussions during the meeting, and the future research agenda.Methods.Qualitative patient interviews were conducted among 20 patients with BD who have different types of organ involvement. A 3-round Delphi among BD experts and patients was initiated to identify domains, subdomains, and outcomes to be assessed in clinical trials of BD. The results of these studies were discussed during OMERACT 2016 and next steps were planned.Results.Patients’ perspectives and priorities were identified through qualitative interviews that identified candidate domains and subdomains for inclusion in the Delphi and characterized some shortcomings of the currently used patient-reported outcomes in BD. The first roun...