ABSTRACT
INTRODUCTION: The aim of the research was the study of the adherence to treatment in patients with systemic lupus erythematosus. METHODS: Cross-sectional study including 132 consecutive patients with systemic lupus erythematosus (SLICC, 2012 classification criteria). We collected clinical and socio-demographic data, socio-economic status; we assessed SLEDAI-2k disease activity, and estimated the adherence to treatment by Morisky questionnaire. RESULTS: Our results demonstrated that low adherence to treatment in patients with systemic lupus erythematosus was in only 11.36% of patients, while 43.18% and 45.46% of the patients were scored as moderate and high adherence, respectively. A moderate/high adherence to treatment was associated to a high level of education (r = -0.51, p < 0.05, 95% CI = -0.25 to -0.66), low disease activity (r = 0.38, p < 0.05, 95% CI = 0.25 to 0.53) and low indices of physician global assessment (r = -0.31, p<0.05, 95% CI = -0.23 to -0.71). The sub-analysis of the adherence to each drug demonstrated that the highest adherence was to treatment with glucocorticosteroids - 92.85%, followed by hydroxychloroquine and aspirin - 92.15% and 89.79%, respectively. CONCLUSION: In our cohort, the adherence to treatment was high in 45.46%, moderate in 43.18% and low in only 11.36% cases. High adherence to treatment was associated to low disease activity. The adherence was positively influenced by the age at the onset of the disease and a high educational level.
Subject(s)
Lupus Erythematosus, Systemic/drug therapy , Medication Adherence , Adolescent , Adult , Age of Onset , Aged , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Aspirin/therapeutic use , Cross-Sectional Studies , Educational Status , Employment , Female , Glucocorticoids/therapeutic use , Humans , Hydroxychloroquine/therapeutic use , Immunosuppressive Agents/therapeutic use , Income , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/psychology , Male , Middle Aged , Surveys and Questionnaires , Young AdultABSTRACT
This case report describes an unusual form of gout, called miliarial gout, in association with carpal tunnel syndrome in a 54-year-old woman. Miliarial gout was first described in 2007 and is a very rare presentation of chronic tophaceous gout. The latter condition can cause carpal tunnel syndrome, but this association has not previously been described in association with miliarial gout. In addition, the authors discuss the use of the parsimony principle in internal medicine whereby a single cause is first sought for different symptoms presenting at the same time. LEARNING POINTS: Miliarial gout, a form of chronic tophaceous gout, is a very rare clinical presentation of the disease.Patients with miliarial gout, despite subcutaneous nodules, may present with other organ involvement.Carpal tunnel syndrome in patients with gout may be caused by monosodium urate crystal deposition.
