This case study aims to contribute to the literature in order to highlight the importance of this collaboration between medical specialties. A female patient R.N.N. F, age 66, from the city of Manaus, with a previous ...This case study aims to contribute to the literature in order to highlight the importance of this collaboration between medical specialties. A female patient R.N.N. F, age 66, from the city of Manaus, with a previous diagnosis of Sjogren’s syndrome in regular follow-up by the Rheumatology team at the Araujo Lima outpatient clinic and referred to the Ophthalmology sector for complementary evaluation related to visual discomfort. The fundoscopy performed in the patient was within normal limits, but the symptoms experienced by her proved to be an important clinical finding, which has ratified the need for regular and multidisciplinary follow-up. This report unequivocally demonstrates that even in the face of tests considered within the expected limits for a given population, the clinical presentation can be specific and particular for each analyzed individual. Early screening exams should contemplate the patient in a holistic and individualized way whenever possible.展开更多
Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for rheumatological conditions. The evidence for its effects is not formal. The objective was to evaluate the impact of physiotherapy ...Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for rheumatological conditions. The evidence for its effects is not formal. The objective was to evaluate the impact of physiotherapy in the management of rheumatological disorders. Methods: 6-month case-control study (December 15, 2021 to June 20, 2022) at Ignace Deen University Hospital (Conakry). Patients with rheumatological disease who received drug therapy and physiotherapy were included in the case group. Age- and sex-matched controls had rheumatological conditions, treated without physiotherapy. The evaluation questionnaires were used: WOMAC (osteoarthritis), EIFEL (low back pain), NDI (neck pain), SPADI (shoulder). Patients with heart failure, respiratory failure and/or skin infection were not included. Results: We collected 773 patients (389 cases and 384 controls) with a mean age of 53.8 years ± 12.2 with female predominance (56.8%). Patients were mainly followed for osteoarthritis (65.2%). Rheumatological conditions managed were knee-based (119;30.6%), lumbar spine (220;56.6%), shoulders (27;6.9%) and cervical spine (23;5.9%). For an average duration of 53.4 ± 12.2 minutes per session, patients had benefited from a median of 19 physiotherapy sessions. After 3 months, the baseline mean VAS of 6/10 improved to 2.2 ± 1.6 for cases and 5.7 ± 1.2 for controls. Functional capacity was improved (WOMAC: 41.8 ± 22.7 vs. 18.3 ± 7.3). The satisfaction of patients treated with physiotherapy was 20 times higher than in controls. Conclusion: Physiotherapy performed in the management of rheumatological conditions significantly reduced pain and improved functional capacity.展开更多
Introduction: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare disease of uncertain origin proposed to be secondary to viral or autoimmune causes. It presents as unilatera...Introduction: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare disease of uncertain origin proposed to be secondary to viral or autoimmune causes. It presents as unilateral cervical lymphadenopathy and fever, typically resolving within a few months, however, it mimics malignant lymphoma, leading to extensive work-up fearing malignancy. Case History: A 33-year-old female with a history of Sjögren’s syndrome, rheumatoid arthritis (not on immunosuppressive therapy) and recent COVID-19 infection two months ago presented with episodes of flu-like symptoms;fever (101˚F), chills, and myalgias for two months. Upon evaluation, she had leukopenia (WBC 1.8 k/uL), neutropenia (1.0 k/uL), elevated CRP (134 mg/L), and CT neck demonstrated multiple enlarged cervical lymph nodes with necrosis. The patient was started on Cefdinir and doxycycline for a possible atypical infection given neutropenic fevers and the patient continued to have fevers. A biopsy showed focal necrosis with no evidence of malignancy, suggesting KFD that was likely triggered by a recent COVID infection. She was treated with Prednisone and naproxen, which led to an improvement in symptoms and recovery of her pancytopenia. Discussion: This case is unique since the patient’s recent infection with COVID-19 may have triggered the clinical manifestations of KFD. There have been a few case reports of children who were diagnosed with KFD after a COVID-19 infection and adults diagnosed with KFD following COVID vaccinations;however, this is the first case report involving a young adult in her thirties who was diagnosed with KFD two months after COVID-19.展开更多
Sarcopenia("sarx" for muscle,"penia" for loss) is an important problem in the elderly.Although muscle loss is a part of natural aging,excessive loss that limits physical activity is considered path...Sarcopenia("sarx" for muscle,"penia" for loss) is an important problem in the elderly.Although muscle loss is a part of natural aging,excessive loss that limits physical activity is considered pathological.Sarcopenia is associated with age,malnutrition,physical inactivity,inflammatory stress and hormonal changes.Although relationships between sarcopenia and various chronic inflammatory diseases have been shown,the role of rheumatologic disease in sarcopenia development is currently unknown.Our aim in this mini-review was to increase the awareness of clinicians to sarcopenia,and to evaluate studies in which the relationship between sarcopenia and rheumatologic diseases was investigated.We also aimed to determine whether the available literature was sufficient to confirm a strong relationship between these conditions.Although our findings showed that diseases such as rheumatoid arthritis,osteoarthritis and systemic sclerosis may have a role in sarcopenia development and progress,the methodologies and results of the majority of studies were insufficient in determining direct causal relationships.We believe future studies would benefit from focusing on the factors and causes of sarcopenia,with a goal of determining the factors associated with rheumatologic disease that are most effective in sarcopenia development.展开更多
Type 1 or 2 diabetes can be complicated by numerous non-specific joint conditions. Sometimes revealing, these affections are frequent but often remain unrecognized. However, they are the cause of a significant functio...Type 1 or 2 diabetes can be complicated by numerous non-specific joint conditions. Sometimes revealing, these affections are frequent but often remain unrecognized. However, they are the cause of a significant functional handicap. The objective of this work is to describe the osteoarticular rheumatological disorders in diabetics consulting or hospitalized in the rheumatology and internal medicine departments of the National Hospital of Niamey and the Magori Polyclinic. This was a cross-sectional study at the Rheumatology Department in collaboration with the Internal Medicine Department within the National Hospital of Niamey and Polyclinic Magori over a period of 7 months (December 2018 to July 2019). One hundred (100) diabetic patients with osteoarticular diseases were collected, 75% of whom were women with a female/male sex ratio of 0.33. The average age was 56 years with extremes of 21 and 90 years. Forty-three percent (43%) of the patients had diabetes for more than 10 years, with an average age of 13 years. The average BMI was 28.08 ± 5.42 kg/m<sup>2</sup>. Poor glycemic control was found in the majority of patients (92%). Gonarthrosis was the most common disease associated with diabetes (89%). In the context of joint stiffening syndrome, the most frequent problem was a protruding finger, found in 4% of patients, followed by retractile capsulitis in 3% of the 100 cases. Infectious complications were dominated by septic arthritis in 4% of patients. The presence of one or more degenerative complications of diabetes (nephropathy, retinopathy, nephropathy) was the most frequent factor associated with osteoarticular diseases in our diabetic patients. This work underlines the great variety and frequency of osteoarticular affections during diabetes, hence the interest in optimal glycemic control of a close collaboration between rheumatologists and endocrinologists in order to avoid as much as possible the development of these rheumatological affections which are the source of pain and functional handicap, being able to even engage the vital prognosis.展开更多
A possible link is suggested between hepatic diseases and rheumatic disease. Polyarthralgia and polyarthritis may be seen during the prodromal period of acute viral hepatitis, especially in hepatitis B virus (HBV). Th...A possible link is suggested between hepatic diseases and rheumatic disease. Polyarthralgia and polyarthritis may be seen during the prodromal period of acute viral hepatitis, especially in hepatitis B virus (HBV). The symptoms of arthritis, mild, localized or generalized, mostly involve the small joints of hands. Joint symptoms frequently precede the onset of jaundice, no residual joint deformities. Circulating immune complexes are believed to play a causative role in the development of vasculitis and arthritis. Hemochromatosis is an antosomal recessive disorder of iron. About 43%-81% of patients with hemochromatosis have arthritis. The common extrahepatic manifestations of autoimmune hepatitis are arthralgia and skin rash. The reported prevalence of symptomatic inflammatory arthropathy in patients with primary biliary cirrhosis ranges from 4% to 50%. Skeletal involvement with Wilson's disease is common. Such patients may complain of pain and stiffness, mainly in the knee, wrist, or other large joints. Shwachman's syndrome is a disorder of pancreatic exocrine. Symmetric bone lesions have been reported in 10% to 15% of patients. They are involved predominantly at the femoral neck. Rheumatic symptoms are seen in one third of adult patients with cystic fibrosis and arthritis in 2.5% to 12% of patients. The arthritis caused by pancreatic panniculitis is usually symmetrical and involves the small joints of the hand, wrist, and feet, but may involve such larger joints as the elbow, ankle, and knee.展开更多
Dysphagia can be seen in rheumatological diseases. Due to life-threatening complications, early diagnosis and treatment of dysphagia is important. However, sufficient data is not available for the diagnosis and treatm...Dysphagia can be seen in rheumatological diseases. Due to life-threatening complications, early diagnosis and treatment of dysphagia is important. However, sufficient data is not available for the diagnosis and treatment of dysphagia especially in the group of rheumatological diseases. In this paper, the presentation of dysphagia in rheumatological diseases will be reviewed.展开更多
文摘This case study aims to contribute to the literature in order to highlight the importance of this collaboration between medical specialties. A female patient R.N.N. F, age 66, from the city of Manaus, with a previous diagnosis of Sjogren’s syndrome in regular follow-up by the Rheumatology team at the Araujo Lima outpatient clinic and referred to the Ophthalmology sector for complementary evaluation related to visual discomfort. The fundoscopy performed in the patient was within normal limits, but the symptoms experienced by her proved to be an important clinical finding, which has ratified the need for regular and multidisciplinary follow-up. This report unequivocally demonstrates that even in the face of tests considered within the expected limits for a given population, the clinical presentation can be specific and particular for each analyzed individual. Early screening exams should contemplate the patient in a holistic and individualized way whenever possible.
文摘Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for rheumatological conditions. The evidence for its effects is not formal. The objective was to evaluate the impact of physiotherapy in the management of rheumatological disorders. Methods: 6-month case-control study (December 15, 2021 to June 20, 2022) at Ignace Deen University Hospital (Conakry). Patients with rheumatological disease who received drug therapy and physiotherapy were included in the case group. Age- and sex-matched controls had rheumatological conditions, treated without physiotherapy. The evaluation questionnaires were used: WOMAC (osteoarthritis), EIFEL (low back pain), NDI (neck pain), SPADI (shoulder). Patients with heart failure, respiratory failure and/or skin infection were not included. Results: We collected 773 patients (389 cases and 384 controls) with a mean age of 53.8 years ± 12.2 with female predominance (56.8%). Patients were mainly followed for osteoarthritis (65.2%). Rheumatological conditions managed were knee-based (119;30.6%), lumbar spine (220;56.6%), shoulders (27;6.9%) and cervical spine (23;5.9%). For an average duration of 53.4 ± 12.2 minutes per session, patients had benefited from a median of 19 physiotherapy sessions. After 3 months, the baseline mean VAS of 6/10 improved to 2.2 ± 1.6 for cases and 5.7 ± 1.2 for controls. Functional capacity was improved (WOMAC: 41.8 ± 22.7 vs. 18.3 ± 7.3). The satisfaction of patients treated with physiotherapy was 20 times higher than in controls. Conclusion: Physiotherapy performed in the management of rheumatological conditions significantly reduced pain and improved functional capacity.
文摘Introduction: Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare disease of uncertain origin proposed to be secondary to viral or autoimmune causes. It presents as unilateral cervical lymphadenopathy and fever, typically resolving within a few months, however, it mimics malignant lymphoma, leading to extensive work-up fearing malignancy. Case History: A 33-year-old female with a history of Sjögren’s syndrome, rheumatoid arthritis (not on immunosuppressive therapy) and recent COVID-19 infection two months ago presented with episodes of flu-like symptoms;fever (101˚F), chills, and myalgias for two months. Upon evaluation, she had leukopenia (WBC 1.8 k/uL), neutropenia (1.0 k/uL), elevated CRP (134 mg/L), and CT neck demonstrated multiple enlarged cervical lymph nodes with necrosis. The patient was started on Cefdinir and doxycycline for a possible atypical infection given neutropenic fevers and the patient continued to have fevers. A biopsy showed focal necrosis with no evidence of malignancy, suggesting KFD that was likely triggered by a recent COVID infection. She was treated with Prednisone and naproxen, which led to an improvement in symptoms and recovery of her pancytopenia. Discussion: This case is unique since the patient’s recent infection with COVID-19 may have triggered the clinical manifestations of KFD. There have been a few case reports of children who were diagnosed with KFD after a COVID-19 infection and adults diagnosed with KFD following COVID vaccinations;however, this is the first case report involving a young adult in her thirties who was diagnosed with KFD two months after COVID-19.
文摘Sarcopenia("sarx" for muscle,"penia" for loss) is an important problem in the elderly.Although muscle loss is a part of natural aging,excessive loss that limits physical activity is considered pathological.Sarcopenia is associated with age,malnutrition,physical inactivity,inflammatory stress and hormonal changes.Although relationships between sarcopenia and various chronic inflammatory diseases have been shown,the role of rheumatologic disease in sarcopenia development is currently unknown.Our aim in this mini-review was to increase the awareness of clinicians to sarcopenia,and to evaluate studies in which the relationship between sarcopenia and rheumatologic diseases was investigated.We also aimed to determine whether the available literature was sufficient to confirm a strong relationship between these conditions.Although our findings showed that diseases such as rheumatoid arthritis,osteoarthritis and systemic sclerosis may have a role in sarcopenia development and progress,the methodologies and results of the majority of studies were insufficient in determining direct causal relationships.We believe future studies would benefit from focusing on the factors and causes of sarcopenia,with a goal of determining the factors associated with rheumatologic disease that are most effective in sarcopenia development.
文摘Type 1 or 2 diabetes can be complicated by numerous non-specific joint conditions. Sometimes revealing, these affections are frequent but often remain unrecognized. However, they are the cause of a significant functional handicap. The objective of this work is to describe the osteoarticular rheumatological disorders in diabetics consulting or hospitalized in the rheumatology and internal medicine departments of the National Hospital of Niamey and the Magori Polyclinic. This was a cross-sectional study at the Rheumatology Department in collaboration with the Internal Medicine Department within the National Hospital of Niamey and Polyclinic Magori over a period of 7 months (December 2018 to July 2019). One hundred (100) diabetic patients with osteoarticular diseases were collected, 75% of whom were women with a female/male sex ratio of 0.33. The average age was 56 years with extremes of 21 and 90 years. Forty-three percent (43%) of the patients had diabetes for more than 10 years, with an average age of 13 years. The average BMI was 28.08 ± 5.42 kg/m<sup>2</sup>. Poor glycemic control was found in the majority of patients (92%). Gonarthrosis was the most common disease associated with diabetes (89%). In the context of joint stiffening syndrome, the most frequent problem was a protruding finger, found in 4% of patients, followed by retractile capsulitis in 3% of the 100 cases. Infectious complications were dominated by septic arthritis in 4% of patients. The presence of one or more degenerative complications of diabetes (nephropathy, retinopathy, nephropathy) was the most frequent factor associated with osteoarticular diseases in our diabetic patients. This work underlines the great variety and frequency of osteoarticular affections during diabetes, hence the interest in optimal glycemic control of a close collaboration between rheumatologists and endocrinologists in order to avoid as much as possible the development of these rheumatological affections which are the source of pain and functional handicap, being able to even engage the vital prognosis.
文摘A possible link is suggested between hepatic diseases and rheumatic disease. Polyarthralgia and polyarthritis may be seen during the prodromal period of acute viral hepatitis, especially in hepatitis B virus (HBV). The symptoms of arthritis, mild, localized or generalized, mostly involve the small joints of hands. Joint symptoms frequently precede the onset of jaundice, no residual joint deformities. Circulating immune complexes are believed to play a causative role in the development of vasculitis and arthritis. Hemochromatosis is an antosomal recessive disorder of iron. About 43%-81% of patients with hemochromatosis have arthritis. The common extrahepatic manifestations of autoimmune hepatitis are arthralgia and skin rash. The reported prevalence of symptomatic inflammatory arthropathy in patients with primary biliary cirrhosis ranges from 4% to 50%. Skeletal involvement with Wilson's disease is common. Such patients may complain of pain and stiffness, mainly in the knee, wrist, or other large joints. Shwachman's syndrome is a disorder of pancreatic exocrine. Symmetric bone lesions have been reported in 10% to 15% of patients. They are involved predominantly at the femoral neck. Rheumatic symptoms are seen in one third of adult patients with cystic fibrosis and arthritis in 2.5% to 12% of patients. The arthritis caused by pancreatic panniculitis is usually symmetrical and involves the small joints of the hand, wrist, and feet, but may involve such larger joints as the elbow, ankle, and knee.
文摘Dysphagia can be seen in rheumatological diseases. Due to life-threatening complications, early diagnosis and treatment of dysphagia is important. However, sufficient data is not available for the diagnosis and treatment of dysphagia especially in the group of rheumatological diseases. In this paper, the presentation of dysphagia in rheumatological diseases will be reviewed.
