ABSTRACT
Background: Behçet's disease (BD) is an systemic infammatory vasculitis characterized by recurrent oral aphthae and genital ulcers. In the course of the disease, skin, eye, musculoskeletal, nervous system and gastrointestinal system involvements can be detected. Objectives: To evaluate the clinical, laboratory and radiological fndings of pedi-atric cases diagnosed with BD. Methods: Fifty patients (0-20 years old) who were followed up with the diagnosis of BD at the Pediatric Rheumatology outpatient clinic of Uludag University Faculty of Medicine between January 2011 and July 2021 were included in our study. The patients were diagnosed according to the diagnostic criteria of the International BD Study Group. Results: Twenty-four (48%) of the patients were male and 26 (52%) were female. The mean age at the diagnosis of patients was 9 ±4.55 years (10.75±4.55 years in boys, 12.35±3.65 years in girls). Twenty patients (36.3%) had a family history of Behçet's Disease. Oral aphthae were present in 96% (n=48) patients, while genital ulcers were in 32% (n=16) (Table 1). Of the nine patients with uveitis, 6 had panu-veitis, 2 had anterior uveitis and 1 had posterior uveitis. There was no difference in the distribution of symptoms according to the gender of the patients. HLA-B51 allel was found in 39 (78%) and ANA was positive in 14 patients (28%). Immunological tests showed that serum immunoglobulins were low in 11 (32.3%) of 34 patients. Low IgG levels were detected in 6 patients, low IgM levels were in 3, and low IgA levels were in 2. Thrombus was presented in three cases (thrombus in the right ventricle in one case, in the intracranial transverse sigmoid sinus and left jugular vein in two cases). The most commonly used drug for aphthae was colchicine (n=45, 82%). The use of biological agents according to patient manifestations is shown in Table 2. In the follow-up, clinical fndings improved in 35 patients (70%) Complete improvement was detected only with biological agents in 8 patients with uveitis. One patient was operated due to the development of complicated cataracts secondary to uveitis. Three patients were diagnosed with Covid-19, one of them was followed without treatment, while two of them were treated with favipiravir at home. Three patients with Covid-19 infection were using only colchicine treatment. Conclusion: Behçet's disease is rare in childhood. Although it is not common, life-threatening complications can be observed. To reduce morbidity and complications, physicians should be aware of manifestations and rare clinical pictures of the BD.
ABSTRACT
Objective: The aim of this study is to examine and compare the anxiety level and stress perception of acromegaly patients with controlled and active disease in the coronavirus disease 2019 pandemic. Methods: A total of 49 (23 females/26 males) patients applied to the outpatient clinic during the month after the first lockdown of the pandemic period were recruited in this cross-sectional study. State-Trait Anxiety Inventory (S-Anxiety for state scale, T-Anxiety for trait scale) and Perceived Stress Scale-14 were used to evaluate the event-related current state anxiety, the general tendency to anxiety, and perceived stressful situations. Patients were divided into 2 groups as active (n = 14) and well controlled (n = 35) patient groups and compared. Results: The active acromegaly group had significantly higher scores than well-controlled patients on all the S-Anxiety (P = .011), T-Anxiety (P = .002), and Perceived Stress Scale-14 (P = .007) scores after controlling for age, gender, body mass index, education years, marital and occupation status, disease duration, and disease-specific medical treatment status covariates. S-Anxiety (P = .021), T-Anxiety (P = .004), and Perceived Stress Scale-14 (P = .009) scores were found significantly higher in single patients than in married ones. Conclusion: This study showed significantly increased anxiety and perceived stress levels after the first lockdown of the coronavirus disease 2019 pandemic, especially in the active and single acromegaly patients compared to the well-controlled and married ones. Psychiatric symptoms should be carefully evaluated in the follow-up of acromegaly patients. The necessary psychological support should be provided to patients by focusing on these symptoms to improve patient management, particularly in a health-related stressful situation such as the coronavirus disease 2019 pandemic.