Clinical Characteristics of Arthritis in Behcet's Disease / 대한류마티스학회지

OBJECTIVE: To investigate the clinical, laboratory and radiologic characteristics of arthritis presented as initial manifestation in patients with Behcet's disease. METHODS: We retrospectively reviewed medical protocols, laboratory and radiologic findings in 33 patients with Behcet's disease. Evaluation was made out at diagnosis and included age, sex, duration and onset pattern of arthritis, involved joint, and laboratory findings included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-nuclear antibody (ANA), rheumatoid factor (RF), and HLA type. RESULTS: In 33 patients (7 males and 26 females), mean age was 34.4+/-9.4 years, and duration of arthritis was 34.1+/-37.9 months. The frequency of involved joint was as follows ; 58% in knee, 33% in proximal interphalangeal joints, 27% in wrist, and 24% in ankle. The pattern of involvement was oligoarticular in 18 patients (55%), polyarticular in 9 patients (27%), and monoarticular in 6 patients (18%). Monoarticular pattern was more frequent in younger patients (< or =35 year-old) than older patients. ESR and CRP were elevated in 17 (53%) and 8 patients (24%), respectively. Radiologic examination of the involved joint was normal in 93% of patients. CONCLUSION: In patients with Behcet's disease diagnosed by arthritis as initial manifestation, the most commonly involved joint was knee and the most common pattern of involvement was oligoarticular.

A Case of Polyarteritis Nodosa Associated with Central Retinal Artery Occlusion / 대한류마티스학회지

Polyarteritis nodosa is a necrotizing vasculitis affecting medium and small-sized arteries throughout the body. Eye involvement is present in about 10% to 20% of patients, including chemosis, iritis, episcleritis, corneal ulcers, keratitiis, choroiditis, retinal detachment, extraocular muscle palsies, and hypertensive retinopathy. Rarely there have been reports of optic neuropathies and occasional central retinal artery occlusions. We experienced a patient with central retinal artery occlusion who had been diagnosed polyarteritis nodosa with mononeuritis multiplex.

The Clinical Study of Hematoimmunologic Features and Opportunistic Infections of Patients with AIDS / 대한내과학회지

The number of persons with HIV infection in Korea have increased steadily, total number of HIV infection in Korea were 478 on August, 1995. To investigate the clinicoimmunologic manifestation of AIDS in Korea, we reviewed complete blood counts (CBC), CD4 counts, serum beta2-microglobulin level, opportunistic infections and cause of death for 19 AIDS patients who had been admitted or visited at Pusan national university hospital during the period of January, 1990 to August, 1995. 1) The predominant mode of HIV transmission was heterosexual contact(18), other modes of transmission were homosexual contact(1). Clues of diagnosis of HIV infection were routine occupational health examination(14), and opportunistic infection symptoms such as fever, coughing(4). 2) Mean CD4 cell counts(/mm3) were 53 +/- 72 totally, 22 +/- 27 for 8 dead patients at mean 2 month before, 91 +/- 87 for 7 living patients. There were not significant difference(p>0.05). 3) Serum beta2-microglobulin(MG;ug/ml) was measured at 12 patients, mean serum beta2-MG level was4.8 +/- 7.3 totally, 7.1 +/- 10.3 for 6 dead patients at mean 1.3 month before, 2.5 +/- 0.4 for 6 living patients. There were not significant(p>0.05). 4) At CBC examination, WBC(/mm3) was 5,932 +/- 2,899 totally, 5,452 +/- 3,436 for 10 dead patients, 6,500 +/- 2,221 for 9 living patients(p>0.05). Hb(g/dl) was 11,4 +/- 2.8 totally, 9.4 +/- 1.8 for dead patients, 13.6 +/- 1.8 for living patients(p<0.05). Lymphocyte count(/mm) was 1,255 +/- 800 totally, 731 +/- 424 for dead patients, 1,838716 for living patients(p<0.05). ESR(mm/h) was 72 +/- 47 totally, 97 +/- 33 for dead patients, 47 +/- 47 for living patients(p<0.05). 5) Opportunistic infections had developed at 14 patients, candidiasis 7, pneumocystis carinii pneumonia 5, tuberculosis 3, cytomegalovirus infection 2, herpes zoster 3, toxoplasmosis 1, cryptococcal infection 2, bacterial pneumonia 5, and herpes simplex l. Malignant lymphoma had developed in 1 patient. 6) Mean survival interval from diagnosis of HIV infection to death was 32.8 +/- 19.1 months, and the most common cause of death was pneumocystis carinii pneumonia, and other causes of death were meningitis, bacterial pneumonia and AIDS-wasting syndrome. Based on these results, We concluded that CD4 counts, serum beta2-microglobulin level, Hb, total lymphocyte count and ESR in AIDS patients are specific laboratory markers of progression and prognosis of AIDS, the most common opportunistic infection was candidiasis, and the most common cause of death in AIDS patients was pneumocystis carinii pneumonia.