Ayse Nur Tufan

Comparing female-based contraceptive methods in patients with systemic lupus erythematosus, rheumatoid arthritis and a healthy population

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that is 10 times more prevalent in women, particularly those of reproductive age. The varying effects of pregnancy on SLE and the differences between available SLE treatments make pregnancy timing and contraceptive methods significant. We aimed to determine the contraceptive methods used by SLE patients in the north‐west part of Turkey, and compared them with those used by rheumatoid arthritis (RA) patients and healthy controls.

True Vitamin D Deficiency with Secondary Hyperparathyroidism

To the Editor: We read with interest the article by Koeckhoven, et al 1 suggesting that upper leg strength is associated with 25-hydroxy Vitamin D [25(OH)D] levels in patients with knee osteoarthritis (OA). The association seems to exist when adjustment is made for several confounding factors. However, adjusting for body mass index attenuated this association. One important limitation of their … Address correspondence to Dr. F. Tufan, Istanbul University, Istanbul Faculty of Medicine, Department of Geriatrics, Fatih, P.B. 34093, Istanbul, Turkey. E-mail: drfatiht{at}istanbul.edu.tr

Etanercept in Alzheimer disease: A randomized, placebo-controlled, double-blind, phase 2 trialAuthor Response

Butchart et al.1 investigated the safety and tolerability of subcutaneous etanercept in patients with Alzheimer disease (AD) dementia. Although it was not their primary outcome, the authors hypothesized that etanercept could decrease systemic inflammation and result in cognitive benefits. Butchart et al. previously observed that baseline increased inflammatory marker levels were associated with more rapid decline in cognitive …

Hairy cell leukemia presenting initially with symptoms of Behçet's disease

Vasculitis is relatively uncommon in lymphoproliferative disease and may predate the diagnosis of lymphoproliferative disease. Many vasculitides have been associated with hairy cell leukemia (HCL), including polyarteritis nodosa (PAN) and leukocytoclastic vasculitis. We herein report a case whose initial presentation was like Behçets disease (BD) (arthritis, oral and genital ulcerations, papulopustular skin lesions) in addition to pancytopenia, but turned out to have HCL. Because of the overlap between their symptoms, like oral ulcerations, skin lesions, arthritis and constitutional findings, HCL and BD may mimic each other. We should keep in mind other reasons for vasculitis such as lymphoproliferative disease, especially whose who have hematological abnormalities such as pancytopenia.

THU0329 Budd-chiari syndrome in behÇet's disease: a retrospective multicenter study

Background The aim of this study was to determine the demographic, clinical, laboratory and management characteristics along with the clinical course of Budd-Chiari syndrome (BCS) associated with Behçets disease (BD). Methods Sixty patients with BD with BCS (40 male, 20 female) were identified in 23 rheumatology centers (Group I). A total of 169 consecutive patients (100 male, 69 female) with BD who did not have clinically apparent BCS during the follow-up were evaluated as the control group (Group II). Results Comparison of the demographic and clinical findings between the Group I and the Group II were as follows: The mean age of disease onset was 23.1 +/- 6.7 years vs. 26.8±0.6 years (p=0.013), mean age at diagnosis was 27.2±0.9 vs. 30.4±0.6 years (p=0.008), arthritis was 10% vs. 28.4% (p=0.002), papulopustular skin lesion was 48.3% vs 69.2% (p=0.003), central nervous system (CNS) involvement 10% vs. 3% (p=0.03), cardiac involvement was 16.7% vs. 2.4% (p<0.001), superficial thrombophlebitis was 23.3% vs. 4.7% (p<0.001), and deep vein thrombosis was 58.3% vs. 15.4% (p<0.01). On diagnosis 50% of BD patients with BCS were classified as Child-Pugh A. Inferior vena cava obstruction was observed in 38.3% and portal vein thrombosis was seen in 3.3% of the patients with BCS. Mortality in BCS patients with BD was 18.3%. BCS related treatment after diagnosis in patients with BD were as follows: 71.7% of patients were treated with monthly cyclophosphamide intravenous pulses, 53.3% received intravenous pulse corticosteroids, 55.9% used azathioprine, 54.2% had warfarine treatment, and 50.8% were treated with low molecular weight heparin. Conclusions This study shows a higher frequency of cardiac and CNS involvement, superficial thrombophlebitis, papulopustular skin lesion, deep vein thrombosis in BD patients with BCS. Arthritis was observed less common in BD patients with BCS. The mean age onset was lower in patients with BCS. Medical treatment with immunosuppressive agents and anticoagulation appears to be the treatment of choice in BD patients with BCS. The majority of the patients with BCS were Child–Pugh class A on diagnosis. The inferior vena cava is frequently involved and, often associated with deep vein thrombosis and cardiac involvement. Disclosure of Interest None declared

AB0748 Treatment Satisfaction with Tumour Necrosis Factor-Alpha Inhibitors (ANTI-TNF) in Ankylosing Spondylitis

Background Anti-TNF treatments are currently the only therapeutic option when conventional treatment fails in ankylosing spondylitis (AS) patients. Objectives In this study we aimed to determine the variables associated with treatment satisfaction and change in quality of life (QOL) with anti-TNF treatment in AS. Methods Patients with AS were recruited from two tertiary rheumatology centers in Turkey (Uludag and Trakya universities). The patients who met fulfilling the 1984 modified New York classification criteria were enrolled in a cross-sectional manner. Treatment satisfaction and QOL were assessed using visual analogue scales in which 0 indicated the worst and 10 indicated the best outcomes. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), hospital anxiety and depression scale (HADS), somatic symptom checklist, and Self-Administered Leeds Assessment of Neuropathic Symptoms and Signs (SLANSS) were evaluated. Univariate correlation and multivariate regression analyses were applied to determine the variables associated with treatment satisfaction and QOL. Results A total of the 277 AS patients (202M, 75F, the mean age was, 39.9±11.3 year and the mean disease duration was15.9±9.2 year) were included in the study. HADS-D, LANSS, SOMATIC SS, BASDAI, BASFI were negatively correlated with both treatment satisfaction and QOL. Also, HADS-A was negatively correlated with treatment satisfaction but not in QOL. Multivariate logistic regression analysis revealed that HADS-A, HADS-D, LANSS, SOMATIC SS, BASDAI, BASFI were independent risk factors associated with treatment satisfaction (Table 1) whereas the HADS-D, SOMATIC SS and BASDAI were independent risk factors associated with QOL. Conclusions These findings suggest that psychological status should be examined along with disease activity while assessing patients with AS. References Kilic G, Kilic E, Ozgocmen SMedicine (Baltimore). 2014 Dec;93(29) Giacomelli R, Gorla R, Trotta F, Tirri R, Grassi W, Bazzichi L, Galeazzi M, Matucci-Cerinic M, Scarpa R, Cantini F, Gerli R, Lapadula G, Sinigaglia L, Ferraccioli G, Olivieri I, Ruscitti P, Sarzi-Puttini P. Disclosure of Interest None declared

AB0170 Anti-cyclic citrullinated peptide and rheumatoid factor in patients with chronic hepatitis b and hepatitis b carriers

Background Rheumatoid factor (RF) positivity that may occur in a number of patients with HBV infection poses challenges in terms of differential diagnosis with rheumatoid arthritis (RA). On the other hand, antibodies to cyclic citrullinated peptide (anti-CCP) may prove to be an important marker for differential diagnosis of the two conditions. Objectives This study aimed to assess anti-CCP and RF positivity among patients with hepatitis B and rheumatoid arthritis. Methods Anti-CCP and RF seropositivity was assessed in 61 patients with HBV infection (32 patients with chronic hepatitis, 29 patients with inactive HBV carrier status), and 40 patients with RA as the control group. Results RF positivity was found in 18.7% and 34.4% of the patients with chronic hepatitis B and inactive HBV carrier status, respectively. On the other hand, only one patient with chronic hepatitis B had low positive anti-CCP. RF was positive in 24 (60%) and anti-CCP was positive in 26 (65%) patients among the 40 patients with RA. Conclusions Anti-CCP may be helpful in the differential diagnosis between RA and chronic hepatitis B infection or inactive HBV carrier status. References Inanc N, Dalkilic E, Kamali S, et al. (2007) Anti-CCP antibodies in rheumatoid arthritis and psoriatic arthritis. Clin Rheumatol 26, 17-23. Lee SI, Yoo WH, Yun HJ, et al. (2007) Absence of antibody to cyclic citrullinated peptide in sera of non-arthritic patients with chronic hepatitis B virus infection. Clin Rheumatol 26, 1079-82. Lienesch D, Morris R, Metzger A, Debuys P, Sherman K (2005) Absence of cyclic citrullinated peptide antibody in nonarthritic patients with chronic hepatitis C infection. J Rheumatol 32, 489-93. Disclosure of Interest None Declared