Hematological Manifestations among Patients with Rheumatic Diseases

Klein, Alina; Molad, Yair

doi:10.1159/000511759

Cited by 34 publications

(43 citation statements)

References 76 publications

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“…Shanmugam et al demonstrated anti-phospholipid antibodies and genetic prothrombotic conditions in a high percentage of patients with lower extremity ulcers [34]. According to Klein and colleagues, patients may also develop a hypercoagulable state with a predisposition to thromboembolic events related to underlying neutropenia and leukopenia [35]. At the same time, certain antirheumatic drugs can cause leukopenia [36].…”

Section: Discussionmentioning

confidence: 99%

Microangiopathy in Inflammatory Diseases—Strategies in Surgery of the Lower Extremity

Biehl

Tarner

et al. 2022

Life

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Background: Patients with an inflammatory disease frequently develop chronic angiopathy of the capillaries. Due to this pathology, there is an increased rate of complications in lower extremity surgical procedures. It is not uncommon for microangiopathic wound healing disorders to cause deep infections and fistulas, which lead to prolonged courses and hospitalizations. In addition, adhesions and ossifications of the contractile elements occur regularly. This sometimes results in serious limitations of the mobility of the patients. The study aims to present the results of a combination of vacuum and physical therapy. Patient and methods: A retrospective study of six patients with systemic sclerosis undergoing joint-related procedures of the lower extremity between 2015 and 2020 was performed. In addition to characterization of the patients and therapy, special attention was paid to cutaneous wound healing, affection of the fascia and displacement layers, and sclerosis of the muscle and tendon insertion. Results: The characterized structures (skin, tendon, fascia) show pathological changes at the microangiopathic level, which are associated with delayed healing and less physical capacity. Early suture removal regularly results in secondary scar dehiscence. With a stage-adapted vacuum therapy with sanitation of the deep structures and later on a dermal vacuum system, healing with simultaneous mobilization of the patients could be achieved in our patient cohort. Conclusion: In the case of necessary interventions on the lower extremity, such as trauma surgery, additional decongestive measures in the sense of regular and sustained lymphatic therapy and adapted physiotherapy are indispensable.

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Section: Discussionmentioning

confidence: 99%

Microangiopathy in Inflammatory Diseases—Strategies in Surgery of the Lower Extremity

Biehl

Tarner

et al. 2022

Life

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“…Jenis infeksi yang paling umum yakni infeksi bakteri pada kulit dan saluran pernapasan oleh Staphylococcus aureus, Streptococcus, Herpes zoster, bakteri gram negatif, dan jamur. 7,8 Gejala sistemik seperti demam dan berat badan turun juga dapat ditemukan. Pasien dapat mengeluh nyeri kuadran kiri atas abdomen karena infark limpa atau distensi kapsular kalenjar limpa.…”

Section: Diagnosis Tanda Dan Gejalaunclassified

“…Laju endap darah (LED) dan C-Reactive Protein (CRP) juga ditemukan meningkat. 3,6,7,9 Temuan laboratorium dari artritis reumatoid, seperti FR positif dan anti-CCP, hampir selalu ada pada kasus sindrom Felty. Anti-CCP memiliki spesifisitas yang sangat tinggi untuk artritis reumatoid.…”

Section: Diagnosis Tanda Dan Gejalaunclassified

“…Sebuah studi melaporkan 18 pasien dari 19 kasus sindrom Felty mengalami hiperplasia mieloid dan maturation arrest pada pemeriksaan aspirasi sumsum tulang. 2,7 Sampai saat ini, tidak ada tes diagnostik khusus untuk sindrom Felty. Diagnosis klinis artritis reumatoid dengan adanya neutropenia dan splenomegali yang tidak dapat dijelaskan mendukung penegakkan diagnosis sindrom Felty.…”

Section: Diagnosis Tanda Dan Gejalaunclassified

“…Namun, laporan klinis terkait penggunaan agen-agen tersebut dalam penatalaksanaan sindrom Felty masih sangat terbatas. 2,3,[5][6][7] Cyclophosphamide dosis tinggi dilaporkan memberikan respons pada beberapa kasus sindrom Felty refrakter. Namun, para klinisi menemukan cyclophosphamide lebih merespons baik saat digunakan pada vaskulitis reumatoid dan manifestasi ekstraartikular artritis reumatoid serius lainnya daripada untuk sindrom Felty.…”

Section: Diagnosis Bandingunclassified

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Sindrom Felty – Diagnosis dan Tata Laksana

Hardika¹

2022

CDK

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Sindrom Felty merupakan kondisi medis dengan karakteristik trias yaitu artritis reumatoid, neutropenia, dan splenomegali; terjadi pada beberapa kasus artritis reumatoid erosif yang sudah berlangsung lama. Hanya 1 – 3% pasien artritis reumatoid akan berkembang menjadi Sindrom Felty. Genetik (HLA-DR4) dan faktor lingkungan berperan dalam terjadinya kondisi ini. Neutropenia persisten dengan hitung neutrofil absolut umumnya kurang dari 1500/mm3 merupakan ciri khas diagnosis Sindrom Felty. Kondisi medis ini biasanya asimtomatik, infeksi lokal serius atau sistemik bisa menjadi petunjuk awal. Terapi farmakologi menggunakan disease-modifying anti-rheumatic drugs (DMARDs); methotrexate oral dosis rendah menjadi modalitas terapi lini pertama. Splenektomi merupakan upaya terakhir dalam algoritma penatalaksanaan Sindrom Felty.

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