ABSTRACT
Respiratory disorders in systemic sclerosis (SSc) are common. They are also a leading cause of morbidity and mortality in this group of patients. Currently, there are no good clinical or serological parameters that would predict respiratory disorders in SSc. The aims of this study are to review the different patterns of respiratory disorder in Thai SSc and to identify the clinical and serological parameters that may be associated with those respiratory disorders. A retrospective medical records review was performed. Out of 137 scleroderma patients seen by the division of rheumatology at Siriraj Hospital Mahidol University from January 1986 to December 2006, sixty-six (48.2%) had respiratory disorders. The most common respiratory disorder was interstitial lung disease (ILD) (81.8%), followed by secondary pulmonary hypertension (PHT) (24%). A few cases of isolated PHT were found (3%). There were no statistically significant differences in the clinical manifestations, disease subtypes or serological parameters between SSc patients who had ILD with or without secondary PHT. Raynaud’s phenomenon was very commonly seen in the SSc patients with PHT.
ABSTRACT
OBJECTIVE: To describe symptoms, signs, laboratory findings and to compare sensitivity of several classification criteria in Thai patients who were diagnosed with Behcet's disease. MATERIAL AND METHOD: Using medical records from the rheumatology unit, Siriraj hospital, all cases diagnosed with Behcet's disease by our rheumatology staff were identified and reviewed. Demographic data, clinical presentations, and laboratory data were collected. All cases were also reviewed if they had fulfilled any of the following criteria: Iran classification tree, Japanese, Korean, ISG and O'Duffy's criteria. The sensitivity of each criterion was calculated. RESULTS: Twenty three cases were identified during a 24 year interval (1980-2003). Our population had a mean age of 30.83 years. Common clinical presentations were recurrent oral ulcers 100% (23/23), genital ulcers 69.6% (16/23), eye involvement 52.2% (12/23), skin involvement 60.9% (14/23), GI ulcers 8.7% (2/23), epididymitis 4.3% (1/23), vascular lesions 8.7% (2/23), CNS involvement 8.7% (2/23), fever 60.9% (14/23), and positivity of the pathergy test 33.3% (3/9). The sensitivity of criteria used for diagnosis of our patients with Behcet's disease varied widely. We found that the Iran classification tree criteria had the highest sensitivity followed by those from Japan (82.6%), O'Duffy's (73.9%), ISG (52.2%), and Korean (39.1%o) criteria respectively. CONCLUSION: Behcet's disease is heterogeneous in its manifestations and clinical constellation of the disease varies widely among different parts of the world. This is the first epidemiologic study describing Thai Behcet's patients. We also found the Iran classification tree criteria had the highest sensitivity for diagnosis of Thai patients.