[Purpose] A butterfly vertebra is a rare congenital anomaly resulting from a symmetric
fusion defect. Only a few cases of butterfly vertebra have been described. This anomaly
may be isolated or associated with Pfeiffer, Jarcho-Levins, Crouzon, or Alagille syndrome.
[Subject and Methods] We herein describe a 38-year-old man who presented with neck and low
back pain and was found to have butterfly vertebrae at the T9 and L3 levels. He also had
Behçet’s disease and psoriasis. [Results] The patient’s symptoms improved with analgesics
and physiotherapy. [Conclusion] To our knowledge, butterfly vertebrae at two levels have
never been reported. Butterfly vertebrae may be confused with vertebral fractures in
lateral radiographs, and awareness of this anomaly is important for a correct
diagnosis.
Orcid :Yaşar Keskin https://orcid.org/: 0000-0003-4457-5917 Kevser Gümüşsu https://orcid.org/0000-0002-5231-2757 Teoman Aydın https://orcid.org/0000-0002-0902-6771 Sevde Özer Poşul https://orcid.org/0000-0001-5830-5438 Esra Başar Gürsoy https://orcid.org/Abstract Objective In this study, we aimed to evaluate autonomic nervous system (ANS) functions by using clinical and electrophysiological tests in patients with ankylosing spondylitis (AS), to investigate the relationship with the disease characteristics and to compare the data with healthy individuals.
Materials and MethodsForty AS patients and 30 healthy controls were included in this case-control study. Clinical measurements including heart rate at rest, systolic blood pressure response to standing were obtained. The electrophysiological assessments of ANS were performed by sympathetic skin response and R-R interval variation measurements. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was used to estimate the disease activity. Patients with AS were also subdivided into two groups; BASDAI≥4 and BASDAI<4. The difference between the groups and correlations between ANS variables and clinical entities were determined.Results Patients expressed feeling of faintness in orthostatic change, abnormal sweating, disturbed bowel function more than control subjects. The patient's heart rate values at rest were higher than control subjects which indicate parasympathetic dysfunction (p=0,001). No significant difference was found on sympathetic skin response (SSR) latencies and amplitudes between patients and control group or patients with low and high disease activity (p>0,05). A correlation was found between SSR latencies and C-Reactif Protein (CRP) levels and disease durations.Conclusion The symptoms of ANS dysfunction were observed more frequently in AS patients than controls but no significant difference of autonomic functions as assessed by R-R interval variation and SSR was found.
ÖzAmaç Bu çalışmada, ankilozan spondilitli (AS) hastalarda klinik ve elektrofizyolojik testler kullanarak otonom sinir sistemi (OSS) fonksiyonlarını değerlendirmeyi, hastalık özellikleriyle ilişkiyi araştırmayı ve verileri sağlıklı bireylerle karşılaştırmayı amaçladık.
Gereç ve YöntemlerBu vaka-kontrol türü çalışmaya, kırk AS hastası ve otuz sağlıklı kontrol grubu dahil edildi. İstirahatte kalp atışı, ayakta durarak sistolik kan basıncı gibi klinik ölçümler alındı. OSS'nin elektrofizyolojik değerlendirmeleri sempatik cilt yanıtı ve R-R aralık varyasyon ölçümleri ile yapıldı. Hastalık aktivitesini tahmin etmek için Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) kullanıldı. AS'li hastalar da iki gruba ayrıldı; BASDAI≥4 ve BASDAI <4. Gruplar arasındaki fark ve OSS değişkenleri ile klinik özellikler arasında korelasyon belirlendi. Bulgular Hastalar ortostatik değişimde solgunluk hissi, anormal terleme, bozulmuş bağırsak fonksiyonlarını kontrol grubundan daha fazla olduğunu ifade etmişlerdir. Hastaların istirahatte kalp atış hızı değerleri parasempatik disfonksiyonu göst...
Leflunomide has been reported to be associated with the development of peripheral neuropathy in patients with rheumatoid arthritis. However, it is possible that this side effect has been underreported and underrecognized. We reported a case of leflunomide-induced peripheral neuropathy with the aim of raising awareness of this side effect. It was reported that cessation of leflunomide within 30 days of the arising symptoms enhances the likelihood of improvement or complete recovery. We should be aware of the possibility of peripheral neuropathy in patients using leflunomide. Early detection of symptoms and drug discontinuation may permit recovery.
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