ABSTRACT
Thromboangiitis obliterans [TAO], or Buerger's disease, is a vascular occlusive disease associated with cigarette smoking. It typically affects medium sized vessels of extremities. Basic pathology of TAO is described to be endothelial activation with highly inflammatory intraluminal thrombosis preserving internal elastic membrane. Cryoglobulins are immunoglobulins that precipitate in the cold and dissolve on re-warming. Cryoglobulinemic vasculitis is a typical small vessel disease associated with cryoglobulinemia commonly bearing typical purpuric skin lesions. An association of TAO with cryoglobulinemia is not reported yet. We report a 34-year-old male heavy cigarette smoker seen for extremity pain and cyanosis of left little finger along with skin rashes characteristic of small vessel disease. Initial presentation of his symptoms at winter and unusual purpuric skin lesions led to search for cold-agglutinating globulins in his plasma. He had severe cryoglobulinemia while the other laboratory tests were normal. TAO associated with cryoglobulinemia merges as a possibility
ABSTRACT
Objective: To determine the markers of systemic inflammation in soft tissue rheumatic disorders [STRDs]. Study Design: Case series. Place and Duration of Study: Rheumatology Clinic, Yazd, Iran, from November 2010 to December 2011
Methodology: Patients aged 20 years or above with known diagnosis of STRD according to clinical criteria and/ or paraclinical investigations for at least 3 weeks duration were longitudinally followed. Patients with diagnosis of rheumatoid arthritis, hypothyroidism, or any other known systemic conditions [other than diabetes mellitus] were excluded. After careful and detailed history taking, laboratory tests indicating systemic inflammation including erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], and routine screening rheumatologic tests were assessed
Results: Of the 90 patients, 75% were female and 25% were male and 28 [31.1%] of patients had diabetes mellitus. Fifty six [62%] and 49 [54%] of all studies cases had some degrees of morning stiffness and remarkable fatigue respectively. Twenty two [24%] had elevated CRP and 5 [5.5%] had abnormal ESR. Rheumatoid factor [RF] and anti-CCP was positive in 5 [5.5%] and 12 [13.3%] of patients accordingly. Three [3.3%] patients suffered from anemia of chronic disease. Mean ESR was 48 +/- 7.34 [hl] and mean CRP was 10.06 +/- 1.96 mg/dl. Mean RF was 10.8 +/- 1.64 U/ml and mean antiCCP was 18.5 +/- 2.71 U/ml. Mean hemoglobin was between 10.4 +/- 1.01 g/dl
Conclusion: Features of subtle systemic inflammation are positive in some cases of soft tissue rheumatism
ABSTRACT
Background: Rheumatic diseases are among the most prevalent diseases recognized in the world. Musculoskeletal disorders are one of the main causes of disability around the world and expend a large amount of health care and social resources and have a substantial impact on the quality of life of those affected. To identify preventable risk factors and to gain insights into the burden of the diseases, it is important to know the prevalence and demographics of them. Herein we are to describe the pattern of different rheumatic disorders and characteristics of the patients attending in rheumatology clinics in Yazd, Iran, with addressing some different points of views in this regards. Materials and Methods:In this retrospective study, medical records of all patients referred to two main referral rheumatology clinics in Yazd from March 2009 to February 2010 were reviewed. A questionnaire including sex, age, chief complaint, diagnoses, and co-morbid diseases was used for gathering the data. Results:All medical records were reviewed, of whom 5187 patients had specific diagnoses. The mean age of the patients was 38.57 year ± 19.4 SD. 70.81% were females and 29.19% were males. The most common diagnoses were: degenerative joint disease (58.33%), autoimmune disorders (17.88%), and soft tissue rheumatism (12.47%). The most frequent complaints were knee pain (32%). 55.6% of the patients were overweight (BMI >29) and 923 (17.8 %) of the patients had diabetes mellitus. Conclusion: Our findings were similar to other studies from Iran and the other countries in most features. The prevalence of autoimmune disorders was rather higher than the other studies; this is perhaps due to our belief that some of periarthritis conditions were part of systemic autoimmune diseases by careful history taking and using pertinent laboratory investigations.