Background: Calprotectin is an important molecule in the initiation and progression of the inflammatory process. Systemic and local intraperitoneal inflammation are distinct processes and consequences in peritoneal dialysis (PD). We aimed to evaluate dialysate calprotectin levels and its associations with peritonitis and dialysis adequacy in PD patients.Methods: Forty-four PD patients were included in this prospective study. Calprotectin concentration was evaluated in 24-h peritoneal drainage fluid. Patients were followed-up for 1 year, and peritonitis episodes were recorded. Dialysate calprotectin levels were compared to dialysis adequacy parameters and peritonitis frequency.Results: The mean age of patients was 54.9±12.7 years. Median PD duration was 54 (23-76) months. Seventeen patients (38.6%) had previous peritonitis episodes.During follow-up, 15 of 44 patients (34.1%) had peritonitis. The median calprotectin concentration was 79.5 (75.2-86.3) ng/ml. The patients were divided into low and high calprotectin groups according to median value. In the high calprotectin group, BMI was found higher (p = 0.04). There was no significant relationship between calprotectin concentration and peritonitis during follow-up (p = 0.29). However, the patients that have had previous peritonitis had higher calprotectin concentrations (p = 0.02). The patients who had higher erythrocyte sedimentation rate (ESR) levels also had higher calprotectin concentrations (p = 0.01). Conclusion:Peritoneal calprotectin concentrations were correlated with higher BMI and ESR, and it was higher in patients with previous peritonitis episodes. To our knowledge, this is the first study to examine the peritoneal calprotectin levels in PD patients. Further studies are needed to determine the use of peritoneal calprotectin as an inflammatory marker in PD. | INTRODUCTIONPeritoneal dialysis (PD) is one of the treatment modalities for endstage renal disease (ESRD) patients. Continuous exposure to bioincompatible PD solutions causes structural and functional alterations in the peritoneal membrane during PD. Increased peritoneal solute transport rate (PSTR) is the most common functional alteration, leading to impaired ultrafiltration, inadequate dialysis, and PD treatment discontinuation. 1 Since adequate dialysis provides more prolonged PD treatment and improves quality of life, higher PSTR is an accepted risk factor for technique failure and mortality in PD patients. 2 Peritonitis is a frequent complication of PD which impairs dialysis adequacy and increases morbidity and mortality in PD patients, and it is the leading cause of technique failure. 3,4 It is essential to determine the patients who are at high risk for peritonitis to prevent peritonitis and adverse outcomes in PD patients.Calprotectin is a 36.5 kD weight, heterocomplex, calcium, and zinc-binding protein secreted from neutrophils, monocytes, epithelial
Recent studies have evaluated the severity of COVID-19 in patients with iRMD, and it has been reported that glucocorticoid use is associated with severe disease (3)(4)(5). Also, the risk factors for severe COVID-19 in patients with iRMD were identified as risk factors in the general population, such as male gender, older age, hypertension, and obesity (6). Strangfeld et al. (7) reported Aim: Aim: Coronavirus disease-2019 (COVID-19) has affected more than three hundred million individuals, and many risk factors for increased mortality and morbidity in COVID-19 have been defined. There are many studies evaluating the course of COVID-19 in inflammatory rheumatic diseases, however, fewer data are available for patients with Takayasu arteritis (TAK). This study assessed the characteristics and outcomes of TAK patients with COVID-19. Material and Methods:Material and Methods: A phone survey was conducted among TAK patients that are followed up in our clinic between February 2021 and March 2021. All patients were asked whether they were diagnosed with COVID-19 during the pandemic. The patients who had a history of COVID-19 were asked about the symptoms, hospitalization status, and treatment received for COVID-19. Information about their chronic diseases was obtained from the patient files.Results: Results: Among 118 TAK patients, 15 had COVID-19 during the first year of the pandemic; 13 were female, and the mean age was 42.5±12.04 years. Nine of the patients were taking prednisone therapy, 12 were taking conventionally synthetic disease-modifying antirheumatic drugs (csDMARDs), 7 patients were taking biological disease-modifying antirheumatic drugs (bDMARDs), and 5 patients were taking a combination of csDMARD and bDMARD therapy when they were diagnosed with COVID-19. Two patients were hospitalized, and one of them was admitted to the intensive care unit for 5 days. All the patients fully recovered, and there was no mortality related to COVID-19. Conclusion: Conclusion:Our data suggest that there is no increased risk for morbidity or mortality related to COVID-19 in TAK patients.
BackgroundIn vascular involvement of Behçet’s disease (BD), inflammatory cells infiltrate mainly the adventitia and media, but only a few inflammatory cells were shown in the intima layer during active arteritis.[1]We recently showed that increased common femoral vein (CFV) thickness is a distinctive feature of BD with a specificity higher than 80% for the cut-off value of ≥0.5 mm.[2]ObjectivesIn this study, we aim to investigate the localization of inflammation in vein wall in BD patients by measuring both whole wall thickness and the intima-media thickness (IMT) of CFV.MethodsPatients with BD (n=42, 27M/15F) and age- and sex-matched healthy controls (HC) (n=35, 21M/14F) were included in the study. IMT and venous wall thickness of CFV were measured with Doppler ultrasonography.ResultsThe mean age was 39.8±10.0 years in BD patients and 36.8±7.9 years in HC. The median disease duration of BD patients was 72 (28.5-162.0) months and 61.9% of them had major organ involvement. The most common major organ involvement was vascular (57.7%) followed by ocular (34.6%), and neurological (7.7%) involvement. Most (66.7%) BD patients were using immunosuppressive treatment.Both IMT-R and IMT-L were significantly higher in BD patients than HC (p<0.0001). The measurements of IMT and venous wall thickness of CFV were shown in Table 1.There was a significant positive correlation between IMT-R and CFV-R, IMT-L and CFV-L measurements (p<0.0001,r=0.918 and p<0.0001, r=0.907, respectively).There was no significant difference between IMT-R and IMT-L measurements in BD patients with and without major organ involvement (p>0.05 for both).ConclusionIMT of CFV, as well as CFV wall thickness, is significantly increased in BD patients than HC. Our results suggest that there is a full layer venous wall inflammation including intima-media layer in BD independent of vascular involvement.References[1]Kobayashi M, et al. Histopathology, 2000.[2]Alibaz-Oner F., et al. Rheumatology (Oxford), 2021.Table 1.The measurements of intima-media and venous wall thickness of common femoral veinBehçet’s diseaseHealthy controlspRight CFV wall thickness, mm, (mean±sd)0.74 ± 0.180.18 ± 0.04<0.0001Left CFV wall thickness, mm, (mean±sd)0.74 ± 0.190.19 ± 0.05<0.0001Right IMT of CFV, mm, (mean±sd)0.32 ± 0.170.10 ± 0.01<0.0001Left IMT of CFV, mm, (mean±sd)0.34 ± 0.170.10 ± 0.01<0.0001CFV, common femoral vein; IMT, intima-media thickness, SD, standard deviationAcknowledgements:NIL.Disclosure of InterestsNone Declared.
BackgroundSecondary Sjögren’s syndrome (sSS) accompanies many systemic rheumatic diseases at certain rates, including axial spondyloarthritis (axSpA).[1]There are some case reports in which psoriasis or psoriatic arthritis (PsA) with sSS co-existence.[2]However, the prevalence of sSS in psoriasis (PsO) and PsA is not fully addressed. Additionally, clinical and laboratory features that may be associated with sSS, and whether arthritis and sSS are related are not known.ObjectivesThis study aims to assess the prevalence of sSS in patients with non-arthritic psoriasis and PsA and illuminate disease features associated with sSS.MethodsPsoriasis patients diagnosed by a dermatologist and patients classified as PsA who fulfilled the CASPAR criteria were questioned for sicca symptoms consistent with the 2002 American-European Sjogren’s Syndrome Consensus Criteria (AECG). The salivary gland scintigraphy of the patients with oral dryness was performed and the unstimulated salivary flow rate (SFR) was measured. Schirmer’s test was performed on patients with dry eyes. Anti-Ro antibodies were measured and minor salivary gland biopsies were performed in patients with sicca detected by objective measurements. After the evaluation of the patients, the sSS was classified according to the 2002 AECG. The frequency of sSS in non-arthritic psoriasis and PsA patients were compared. In addition, PsA patients were divided into two groups according to the presence and absence of sSS. PsA-specific characteristics in these two groups were compared.ResultsOf the 184 psoriasis patients who participated in the study, 112 had PsA, and 72 had psoriasis without arthritis. There was no significant age difference between non-arthritic psoriasis and PsA patients (48.3±11.9 and 49.4±13.5, respectively; p=0.59) Similarly, female to male ratio (rates (%): non-arthritic psoriasis: 43/29 (59.7/40.3) PsA: 82/30 (73/27), respectively; p= 0.08) and age of onset of psoriatic skin changes (mean (SD) of non-arthritic psoriasis: 30.3 ±10.9, PsA: 29.4 ±13.2, respectively; p=0.68) did not differ between non-arthritic psoriasis and PsA patients. sSS was more prevalent in PsA patients when compared with the non-arthritic psoriasis group (PsA: 20 (%17.9), non-arthritic psoriasis: 1 (%1.3), p<0.001). None of the patients had a previous diagnosis of sSS. Of the patients with sSS (n=20), 18 had salivary gland involvement detected in salivary gland scintigraphy, four Anti-Ro positivity, and three low unstimulated SFR. All PsA patients with sSS (sSS/PsA) had a positive Schirmer test.sSS/PsA patients were significantly more positive for ANA and had plantar fasciitis more frequently than PsA patients without sSS (Table 1). Although not statistically significant, the age of onset of joint involvement in sSS/PsA patients was higher and was treated less with biological therapy (Table 1).ConclusionSecondary Sjögren’s syndrome is part of the clinical picture in a substantial proportion of PsA patients and its absence in non-arthritic PsO implies that sSS is arthritis associated. Whether the type of arthritis in sSS/PsA patients has a pattern necessitates larger patient numbers. A higher rate of ANA positivity may suggest the role of B lymphocytes in the progression from PsO to PsA.References[1]Brandt et al, 1998[2]Yamamoto T and Yokoyama A,1996.Table 1- Comparison of PsA patients with and without sSSPresence of sSSn=20Absence of sSSn=92pAge mean (SD)53.948.40.09Female/Male ratio18/261/270.08Age of onset of skin involvements mean (SD)30.629.40.74Age of onset of joint involvements mean (SD)42.637.40.09Axial Involvement n (%)6 (35.3)25 (29.4)0.77Polyarthritis n (%)4 (22.2)11 (14.9)0.29Heel Enthesitis n (%)5 (31.3)12 (21.4)0.19Plantar Fasciitis n (%)5 (31.3)6 (9)0.03RF positivity n (%)1 (7.7)1 (1.9)0.36ANA positivity n (%)10 (55.6)12 (27.2)0.04Biological therapy ever n (%)10 (50)63 (72.4)0.06sSS: Secondary Sjögren’s syndrome, SD: Standard deviation, RF: Rheumatoid Factor, ANA: Anti-Nuclear Antibody, PsA: Psoriatic ArthritisAcknowledgements:NIL.Disclosure of InterestsNone Declared.
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