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.
Objective The purpose of this study was to determine hepatitis B virus (HBV) screening rates in patients receiving anti‐tumor necrosis factor (TNF)‐α therapy and the frequency of HBV reactivation in patients with resolved hepatitis B virus infection (hepatitis B surface antigen [HBsAg] negative, hepatitis B core antibody [Anti‐HBc] positive). Patients and methods Data from 1834 patients who underwent anti‐TNF‐α therapy in the Rheumatology, Gastroenterology and Dermatology Departments of our hospital between 2010 and 2020 were retrospectively analyzed. Within 6 months before the initial anti‐TNF‐α therapy, performing a HBsAg and/or anti‐HBc test is defined as HBV screening. HBV reactivation is defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive. Results The overall HBV screening rate was 82.3% before starting anti‐TNF‐α therapy. There was an increasing trend in HBV screening rates during the years analyzed (64% in 2010, 87.4% in 2019) (P < .001). Before anti‐TNF‐α therapy was initiated, 272 patients were HBsAg negative and anti‐HBc positive. Among these patients, HBV reactivation did not occur in 31 patients who received antiviral prophylaxis, whereas HBV reactivation occurred in only 1 (0.4%) of the 241 patients who did not receive antiviral prophylaxis. Conclusion Hepatitis B virus screening rates prior to starting anti‐TNF‐α therapy were relatively high, and its trend was increased by year. HBV reactivation because of anti‐TNF‐α use rarely occurred in patients with resolved HBV infection. Further studies are needed on whether routine anti‐HBc screening and/or HBV DNA follow‐up are necessary in these patients aside from HBsAg.
Objective: Behçet 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.
ObjectivesBehcet's 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.MethodsThe 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 <0.05 was considered significant.ResultsAge 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 patient's active and inactive periods of the disease, lower MPV, higher NLR and PLR values were seen MC and vascular groups (for all groups p<0,05). When the active 3 groups were compared within themselves, the MPV value was significantly lower and NLR and PLR values were significantly higher in vascular group than active ocular and active mucocutaneous groups (p=0.033, <0.001, 0.001, respectively).Table 1.Demografic and laboratoary, characteristicsBaseline characteristicsActive BDInactive BDControlp n=163n=96n=41 Age, y (IQR)35,7 (16,2)31,3 (13,2)38,4 (11,8)0,143Male, n (%)69 (%42,3)36 (%37,5)10 (%24,4)0,105CRP, mg/L (IQR)4,8 (20,9)2,7 (5,1)1 (2,9) <0,001 ESR, mm/h (IQR)24 (30)12 (16)11,5 (9) <0,001 MPV (f/L)8,5±1,18,9±18,8±0,9 0,011 NLR (IQR)2,4 (1,7)1,9 (1,0)1,8 (0,8) <0,001 PLR (IQR)134 (63)116 (44)130 (65) 0,012 Table 2.MPV, NLR and PLR valuesMPVNLRPLR Mucocutaneous Involvementactive (n=75)8,6±1,02,4 (1,4)134 (54)inactive (n=96)8,8±1,11,9 (0,9)118 (51)P0,168 0,009 0,006 Ocular Involvementactive (n=40)8,8±1,51,9 (1,3)117 (43)inactive (n=96)8,8±1,11,9 (0,9)118 (51)P0,8070,7160,386Vascular Involvementactive (n=48)8,1±0,93,2 (2)161 (98)inactive (n=96)8,9±1,11,9 (1,0)116 (44)P <0,001 <0,001 <0,001 ConclusionsThe low MPV and the high NLR and PLR are found in the active disease, which is especially significant in...
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