Clinical patterns of psoriatic arthritis in Jordanian patients with psoriasis in a single center from Jordan

Objective: To investigate the clinical patterns of psoriatic arthritis in Jordanian patients presented to our Rheumatology clinic

Methods: This is a descriptive study which included 50 well characterized patients with psoriatic arthritis, of both sexes and aged 18-75 years. Patients with psoriatic arthritis were diagnosed according to [CASPAR] classification during six years time period from Aug 2008 to Aug 2013 at our rheumatology clinic in King Hussein medical center, Amman, Jordan. Written informed consent from all participants and approval from the ethics board review committee were obtained. Demographics and psoriatic arthritis frameworks were registered

Results: 42 patients [42/50=84%] were newly diagnosed at our clinic and eight patients [8/50=16%] were diagnosed previously as psoriatic arthritis. The most frequent significant type was polyarticular symmetrical arthritis [20/50=40%], then in decreasing order comes oligoarticular arthritis [10/50=20%] affecting mainly the knees, spondyloarthritis [9/50=18%], enthesitis and dactylitis [6/50=12%], distal interphalangeal arthritis [4/50=8%] and arthritis mutilans [1/50=2%]

Conclusions: Polyarticular pattern was the most significant frequent clinical pattern of psoriatic arthritis presentation in psoriatic Jordanian patients

Eosinophilic leukemia presenting with behcet-like symptoms

We report on a 28 year old female who was diagnosed as a case of Behcet's syndrome and referred to our rheumatology clinic for further evaluation regarding unexplained fever and leukocytosis. Blood film revealed anemia and persistent eosinophilia. Bone marrow examination showed eosinophilic leukemia which is a rare condition especially in the female gender. Although Behcet syndrome can be associated with eosinophilia, the clinical picture was suggestive of myeloid neoplasm

Thyroid dysfunctions among Jordanian patients with rheumatoid arthritis and systemic lupus erythematosus: a hospital-based study

To determine the frequency of thyroid dysfunction among Jordanian patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis. This study was conducted in collaboration between Rheumatology and Endocrine clinics at King Hussein Medical Center in the period between January 2010 and July 2010. One hundred and twenty-two patients were studied; 80 patients with Systemic Lupus Erythematosus and 42 patients with Rheumatoid Arthritis were screened for thyroid diseases [clinical or subclinical hyper/hypothyroidism] regardless of their symptoms. The results were compared with 304 apparently healthy controls. A total number of 122 patients, female to male ratio 7.7:1 and a mean age [SD] of 37.1 +/- 13.5 years, were included in the study. Twenty-six patients were found to have thyroid function abnormalities. The frequency of thyroid disease was 21.3%. The mean age in the control group was 49.4 years. The frequency of thyroid dysfunction in the control was 6.6%. Subclinical hypothyroidism was seen in 5% of healthy controls, 13.7% of Systemic Lupus Erythematosus and 7.1% of Rheumatoid Arthritis patients. The majority of cases of subclinical hypothyroidism with Systemic Lupus Erythematosus and all cases with Rheumatoid Arthritis were females. Overt hypothyroidism was seen in 0.9% of controls, 8.7% of Systemic Lupus Erythematosus and 4.7% of Rheumatoid Arthritis patients. Biochemical hyperthyroidism was seen in 0.3% of controls, 2.5% of Systemic Lupus Erythematosus and 2.3% of Rheumatoid Arthritis patients, all of whom were female. Patients with rheumatologic disorders have high frequency rate of thyroid dysfunction. These dysfunctions are often subclinical in nature with female predominance. Screening should be regularly conducted in all patients with rheumatologic diseases for proper early detection and management

Spectrum of micro-organisms and anti-microbial resistance of gram negative micro-organisms in the intensive care unit at King Hussein Hospital

To determine the spectrum of micro-organisms and anti-microbial resistance of gram negative micro-organisms. A retrospective review was conducted at the Intensive Care Unit at King Hussein Medical Hospital between Jan 2007 and Jan 2008. Blood was withdrawn from every Intensive Care Unit patient suspected infection 48 hours post admission. Gram negative micro-organisms and antimicrobial resistance were determined by using the standard method at Prince Iman and Research Laboratory Center. A total of 610 blood culture specimens were obtained from 400 patients. Bacteria were isolated from 213 of these specimens. The different types of bacteria isolated were as follows: 47% were coagulase negative staphylococcus epidermidis, 35% were gram negative bacteria and 5% were Candida. Among the gram negative isolate the most common was Acinetobacter baumannii 31% while the least common was Citrobacter and Morganella 1.4% each. Rates of anti-microbial susceptibility for Acinetobacter were 45% for Ciprofloxacillin, 39% for Amikacin and 30% for Imipenem and Piperacillin while 48% of the Acinetobacter isolate were multi-resistant. This study provides information on spectrum of micro-organisms and antibiotic resistance of blood isolates. It may be a useful and baseline guide for physicians initiating empiric therapy and may help in providing antibiotic therapy policy in our hospital

Synovial cysts and compression neuropathies: a case report

Synovial cysts may arise from any joint affected with an inflammatory arthropathy and can cause compression of adjacent structures. The commonest joint affected is the knee. Synovial cysts arising from other joints are uncommon and those arising from the elbow joint are a rarity. Here we describe a patient with rheumatoid arthritis who presented with right ulnar nerve palsy due to a large synovial cyst arising from the elbow joint and extended into the forearm. In addition to the description of the case a literature review of compression neuropathies secondary to synovial cysts has been performed