Psöriatik artritli hastalarda eklem tutulum tipleri ve klinik özellikler
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Dosyalar
Tarih
2012
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Psöriatik artrit eklem destrüksiyonu ile giden, genellikle romatoid faktörün negatif olduğu, psöriazis ile ilişkili inflamatuvar bir artrittir. Klinikte distal interfalangal eklem tutulumu, asimetrik oligoartrit, daktilit, entezit ve spondilartrit şeklinde tutulum görülebilir. Psöriatik artrit bu özelliklerinden dolayı seronegatif spondilartritler içerisinde sınıflandırılmaktadır. Psöriatik artrit prevalansı %0,04-0,1 arasında değişmektedir. Hastalığın nedeni tam olarak bilinmemekle beraber genetik, immünolojik ve çevresel faktörlerin hastalık patogenezinde rol oynadığı düşünülmektedir. Psöriatik artrite özgül bir laboratuvar testi yoktur.Tedavide nonsteroidler, hastalık modifiye edici ilaçlar, kortikosteroidler ve biyolojik ajanlar kullanılmaktadır. Çalışmamızda merkezimizde psöriatik artrit tanısıyla izlenen hastaların eklem tutulum tipleri ve klinik özellikleri değerlendirilecek ve eklem hasarının ilişkili olduğu faktörler belirlenmeye çalışılacaktır. Çalışmamız Trakya Üniversitesi Tıp Fakültesi, Romatoloji Bilim Dalı Polikliniğine 2000-2011 tarihleri arasında başvuran ve psöriatik artrit kriterlerini dolduran 172 hasta ile Dermatoloji polikliniğinden 61 ardışık psöriazis hastası alındı. Hasta dosyalarından demografik özellikler, psöriazis tipi ve süresi, psöriatik artrit tipi ve süresi, hassas ve şiş eklem sayısı, tedavi için kullanılan ilaçlar, grafilerden eklem hasarı, laboratuvar değerleri kaydedildi. Hastalar kadın ve erkek ile eklem tutulum tiplerine göre ayrılarak klinik özellikler, laboratuvar bulguları ve kullanılan tedaviler açısından karşılaştırıldı. Çalışmamızda psöriartik artritli olgularımız arasında poliartiküler eklem tutulumunu en sık olarak saptadık. Aynı zamanda poliartiküler grupta; yaş, psöriazis ve psöriartik artrit hastalık süresi, eklem tutulum sayısı, erozif hastalık daha fazla saptandı. Önemli oranda poliartiküler psöriartik artritli hastada antisitrüline siklik peptit pozitifiliği görüldü. Kullanılan ilaçlar açısından gruplar arasında belirgin fark saptanmadı. Tırnak değişiklikleri distal interfalangeal grubunun üveit ise spondilit grubunun özelliği olarak görülmektedir. Psöriartik artrit tanısı ile izlenen hastalarda eklem tutulum tipinin bilinmesi hastalığın prognozunu belirleme ve tedavi kararı vermede önem taşımaktadır. Özellikle uzun dönem hastalığı olanlarda poliartrit görülme sıklığı artmaktadır ve bu grup aynı zamanda en sık eroziv hastalık, kemik ve eklem hasarının görüldüğü gruptur.Anahtar kelimeler: Psöriatik artrit, psöriazis, poliartiküler, oligoartiküler, spondilartrit.
Abstract
Psoriatic arthritis is an inflammatory arthritis associated with psoriasis, which is characterized with joint destruction, and generally a negative rheumatoid factor. Clinically, there might be distal interphalangeal joint involvement, asymmetric oligoarthritis, dactylitis, enthesitis and spondyloarthritis. Psoriatic arthritis is classified within the sernegative spondyloarthritides because of these features. The prevalence of psoriatic arthritis varies between 0.04-0.1%. Although the cause of the disease is not known exactly, it is speculated that genetic, immunologic and environmental factors play a role in disease pathogenesis. There is no laboratory test specific for psoriatic arthritis. Nonsteroids, disease-modifying drugs, corticosteroids and biologic agents are used in therapy. In our study, we aim to evaluate types of joint involvement in psoriatic arthritis patients followed up at our center, assess their clinical features and determine factors which are associated with joint damage. In our study, we included 172 patients who were admitted to Trakya University Medical Faculty, Rheumatology Outpatient Clinic between 2000-2011 and who fulfilled criteria for psoriatic arthritis, and 61 psoriasis patients being followed up at Dermatology Outpatient Clinic. The demographic features, type and duration of psoriasis, type and duration of psoriatic arthritis, number of tender and swollen joints, drugs used for therapy, extent of joint damage in X-rays, laboratory values were obtained from hospital files. The patients were divided as males and females and according to types of joint involvement; and their clinical features, laboratory findings, and therapies were compared. In our study, polyarticular joint involvement was the most frequent type in our psoriatic arthritis patients. In addition, the polyarticular group was older, durations of psoriasis and psoriatic arthritis were longer, they had more involved joints, and more frequent erosive disease. A significant ratio of polyarticular psoriatic arthritis patients had anticitrullinated cyclic peptide positivity. The groups were not different in the drugs they were using. Nail changes seem to be a feature of distal interphalangeal group, uveitis seem to be a feature of spondylitis group. Knowledge about the type of joint involvement in psoriatic arthritis is important to determine prognosis and to give treatment decisions. The frequency of polyarthritis is higher in patients with long-term disease and this is the group with most common erosive disease, bone and joint damage.Key words: Psoriatic arthritis, psoriasis, polyarthritis, oligoarthritis, spondyloarthritis.
Abstract
Psoriatic arthritis is an inflammatory arthritis associated with psoriasis, which is characterized with joint destruction, and generally a negative rheumatoid factor. Clinically, there might be distal interphalangeal joint involvement, asymmetric oligoarthritis, dactylitis, enthesitis and spondyloarthritis. Psoriatic arthritis is classified within the sernegative spondyloarthritides because of these features. The prevalence of psoriatic arthritis varies between 0.04-0.1%. Although the cause of the disease is not known exactly, it is speculated that genetic, immunologic and environmental factors play a role in disease pathogenesis. There is no laboratory test specific for psoriatic arthritis. Nonsteroids, disease-modifying drugs, corticosteroids and biologic agents are used in therapy. In our study, we aim to evaluate types of joint involvement in psoriatic arthritis patients followed up at our center, assess their clinical features and determine factors which are associated with joint damage. In our study, we included 172 patients who were admitted to Trakya University Medical Faculty, Rheumatology Outpatient Clinic between 2000-2011 and who fulfilled criteria for psoriatic arthritis, and 61 psoriasis patients being followed up at Dermatology Outpatient Clinic. The demographic features, type and duration of psoriasis, type and duration of psoriatic arthritis, number of tender and swollen joints, drugs used for therapy, extent of joint damage in X-rays, laboratory values were obtained from hospital files. The patients were divided as males and females and according to types of joint involvement; and their clinical features, laboratory findings, and therapies were compared. In our study, polyarticular joint involvement was the most frequent type in our psoriatic arthritis patients. In addition, the polyarticular group was older, durations of psoriasis and psoriatic arthritis were longer, they had more involved joints, and more frequent erosive disease. A significant ratio of polyarticular psoriatic arthritis patients had anticitrullinated cyclic peptide positivity. The groups were not different in the drugs they were using. Nail changes seem to be a feature of distal interphalangeal group, uveitis seem to be a feature of spondylitis group. Knowledge about the type of joint involvement in psoriatic arthritis is important to determine prognosis and to give treatment decisions. The frequency of polyarthritis is higher in patients with long-term disease and this is the group with most common erosive disease, bone and joint damage.Key words: Psoriatic arthritis, psoriasis, polyarthritis, oligoarthritis, spondyloarthritis.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Psöriatik Artrit, Psöriazis, Poliartiküler, Oligoartiküler, Spondilartrit, Psoriatic Arthritis, Psoriasis, Polyarthritis, Oligoarthritis, Spondyloarthritis
