ABSTRACT
Objective: To determine the frequency and predictors of pulmonary hypertension in patients with Systemic Lupus Erythematosus in a Pakistani population, presenting at a tertiary care hospital
Methods: This cross-sectional study was conducted at the Department of Rheumatology, Shiekh Zayed Hospital, Lahore from March to June 2018. A total of 97 patients, who fulfilled the Systemic Lupus Erythematosus [SLE] criteria of American College of Rheumatology [ACR] 1992 were enrolled. Pulmonary Arterial Hypertension [PAH] was measured by calculating pulmonary arterial systolic pressure through echocardiography by a single consultant cardiologist. Disease characteristics and demography was collected in a self-administered proforma. PAH was defined as mean pulmonary arterial pressure of 25mmHg or above by calculating with a formula. SPSS version 20 was used for analysis of data
Results: Out of 97 patients, 89.7% [n=87] were females and 10.3% [n=10] were males, with mean age of 31.29+/-8.824 years. The mean disease duration was 24.21+/-30.46 months. PAH was found in 23.3% [n=23] patients, including 19 females and 4 males. On further analysis of data, Raynaud phenomenon, rheumatoid factor and nephritis were assessed as predictors of PAH and all of these showed statistical significance for presence of PAH as per Chi-square test [p<0.05]
Conclusion: In this study, 23.3% SLE patients showed evidence of PAH and positive statistical significance was found between predictors like Raynaud phenomenon, rheumatoid factor, nephritis and presence of PAH. So it is imperative to detect PAH early and start prompt treatment to achieve better quality of life
ABSTRACT
Objective: To determine the frequency of fibromyalgia American college of rheumatology [ACR] 2010/2011 criteria] in patients with rheumatoid arthritis and its impact on disease activity score [DAS-28]
Study Design: Cross-sectional study
Place and Duration of study: Department of Rheumatology and Immunology, Sheikh Zayed Hospital Lahore from Jun 2016 to Feb 2017
Patients and Methods: Total 140 diagnosed patients of rheumatoid arthritis by criteria ACR 2010 were included in this study. ACR modified 2010/2011 criterion of fibromyalgia was used to diagnose co existing fibromyalgia in these patients. Clinically disease activity status was assessed by standardized and validated DAS-28 calculator; 2ml of blood was drawn and sent to laboratory for estimation of erythrocyte sedimentation rate for all study participants
Results: The mean age, duration of disease, DAS-28 of sampled population was 49.12 +/- 8.5 years, 7.36 +/- 3.8 years, 4.08 +/- 1.1 respectively. Out of 140 patients, 127 patients [90.7percent] were females. Fibromyalgia was diagnosed in 41 patients [29.1percent]. The mean DAS-28 score in patients of rheumatoid arthritis with fibromyalgia was 5.39 +/- .58 while for patients of without fibromyalgia it was 3.54 +/- 0.69 [p-value<0.001]
Conclusion: Secondary fibromyalgia is common in patients with rheumatoid arthritis and needs to be screened out in all patients diagnosed as rheumatoid arthritis and on subsequent follow up visits, coexisting fibromyalgia affects the disease activity status and this may result into inappropriate and unnecessary changes in treatment plans