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Öğe CPPD-related pseudoneuroarthropathy in a patient with myelodysplastic syndrome(2022) Pekdiker, Mete; Kimyon, GezmişThe calcium pyrophosphate deposition (CPPD) disease is a common form of crystal arthropathy. It usually affects elderly patients. The clinical and radiological features of CPPD vary widely, so CPPD is a great mimicker of other musculoskeletal conditions. Asymptomatic and destructive forms can present at the same time in the same patients. Several diseases have been proposed to be related to CPPD, but hematologic disorders have not been reported to occur concurrently. Charcot arthropathy (CA) is associated with neuropathy and is characterized by erosive joint disease. Here, we report an interesting CPPD case presenting as pseudo-CA in a patient with myelodysplastic syndrome.Öğe CPPD-related pseudoneuroarthropathy in a patient with myelodysplastic syndrome(Galenos Publishing House, 2022) Pekdiker, Mete; Kimyon, GezmişThe calcium pyrophosphate deposition (CPPD) disease is a common form of crystal arthropathy. It usually affects elderly patients. The clinical and radiological features of CPPD vary widely, so CPPD is a great mimicker of other musculoskeletal conditions. Asymptomatic and destructive forms can present at the same time in the same patients. Several diseases have been proposed to be related to CPPD, but hematologic disorders have not been reported to occur concurrently. Charcot arthropathy (CA) is associated with neuropathy and is characterized by erosive joint disease. Here, we report an interesting CPPD case presenting as pseudo-CA in a patient with myelodysplastic syndrome. © 2022 by the Turkish Society for Rheumatology / Journal of Turkish Society for Rheumatology published by Galenos Publishing House.Öğe Factors associated with frequency and severity of COVID-19 in patients with axial spondyloarthritis(2023) Pekdiker, Mete; Kara, Mete; Koç, Emrah; Kimyon, GezmişPurpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in managing rheumatic diseases during the pandemic; therefore, we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials and methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa-associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% of them had ankylosing spondylitis, 35.5% had non-radiographic axSpa, and 59.4% of patients were treated with a biologic agent. The frequency of COVID-19 was 23% (n:192); only five patients (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high-resolution computed tomography (HRCT) (p:0.02, p:0.01, and p<0.001). In hospitalized individuals, female gender, HT, DM, and disease lasting longer than 10 years were significantly higher (p:0.03, p:0.011, p<0.001, and p:0.014). Only DM was found as an independent risk factor for both pulmonary involvement in HRCT (p:0.029) and hospitalization (p:0.001). Conclusion: We conducted our study with a homogenous study population and our results suggested that biological agents did not affect poor COVID-19 outcomes; only DM was associated with a more severe COVID-19 course in patients with axSpa.Öğe Factors associated with frequency and severity of COVID-19 in patients with axial spondyloarthritis(Pamukkale University, 2023) Pekdiker, Mete; Kara, Mete; Koç, Emrah; Kimyon, GezmişPurpose: The severe course of COVID-19 in individuals with chronic diseases has led to concerns in managing rheumatic diseases during the pandemic; therefore, we aimed to define the factors associated with the frequency and severity of COVID-19 in patients with axial spondyloarthritis (axSpa) in this study. Materials and methods: Patients with axSpa who were followed up in three tertiary hospitals and used their treatment regularly for at least six months were included. We assessed the relationship between axSpa-associated variables such as disease duration time, radiological severity, treatment and COVID-19 outcomes. Results: A total of 833 patients with a mean disease duration of 109 months were analyzed; 64.5% of them had ankylosing spondylitis, 35.5% had non-radiographic axSpa, and 59.4% of patients were treated with a biologic agent. The frequency of COVID-19 was 23% (n:192); only five patients (0.5%) had a history of intensive care unit. Advanced age, hypertension (HT), and diabetes mellitus (DM) were found to be significantly more common in those with involvement in high-resolution computed tomography (HRCT) (p:0.02, p:0.01, and p<0.001). In hospitalized individuals, female gender, HT, DM, and disease lasting longer than 10 years were significantly higher (p:0.03, p:0.011, p<0.001, and p:0.014). Only DM was found as an independent risk factor for both pulmonary involvement in HRCT (p:0.029) and hospitalization (p:0.001). Conclusion: We conducted our study with a homogenous study population and our results suggested that biological agents did not affect poor COVID-19 outcomes; only DM was associated with a more severe COVID-19 course in patients with axSpa. © 2023, Pamukkale University. All rights reserved.Öğe The first involved joints and associated factors in patients with rheumatoid arthritis(Turkish League Against Rheumatism, 2024) Pekdiker, Mete; Oguzman, HamdiObjectives: This study aimed to investigate the first involved joints and associated factors in Turkish patients with rheumatoid arthritis (RA). Patients and methods: This retrospective cross-sectional study included 300 newly diagnosed and disease-modifying antirheumatic drug-na & iuml;ve RA patients (240 females, 60 males; mean age: 54 +/- 1.2 years; range, 18 to 82 years). Baseline demographic, clinical, and laboratory data were evaluated between January 2022 and December 2022. The patients were divided into four groups according to autoantibody profile: antibody-negative patients (Group 1; both RF and anti-CCP were negative in this group of patients), RF-positive patients (Group 2), anti-CCP-positive patients (Group 3), and patients with dual seropositivity with RF and antiCCP (Group 4). The patients were also divided into two groups according to the size of the first affected joint: patients with SJI at diagnosis and patients without SJI involvement at diagnosis. Results: Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody positivity rates were 40.3% and 35.6%, respectively. The mean lag time to diagnosis was 25 +/- 36 months. At the disease onset, 20% of patients did not have small joint involvement (SJI). Seronegative patients tended to be female (p=0.001), had longer lag time (p=0.001), and had lower levels of C-reactive protein (p=0.025), white blood count (p=0.005), and neutrophil/lymphocyte ratio (p=0.001) compared to the dual seropositive group. Patients presenting with SJI had a younger age (p=0.002), tended to be female (p=0.001), and had lower RF (p=0.034) and anti-CCP (p=0.031) positivity. Only age (p=0.005) and dual seronegativity (RF and anti-CCP; p=0.035) were the independent predictors of SJI in multivariate analysis. Conclusion: The decreasing age and seronegative status were defined as independent risk factors of SJI at the onset of RA. Population-based, prospective studies are needed for earlier diagnosis.Öğe The frequency and associated factors of infusion-related reactions to rituximab for patients with rheumatoid arthritis(2023) Pekdiker, MeteObjectives: Rituximab is an effective biological agent for treating patients with rheumatoid arthritis (RA). Rheumatologists can avoid rituximab therapy because of infusion-related reactions (IRR). There is a lack of data about rituximab-related IRR, especially in rituximab-naïve patients with RA; therefore, we aimed to determine the frequency and associated factors of rituximab-related IRR in these patients. Methods: Baseline demographic, laboratory, and treatment data were noted. One course of rituximab was used in two infusions to 95 rituximab-naïve patients with RA. Standardized premedication was administered before infusions. Rates, severity, and management of IRR were recorded. Efficacy and infections were also noted if there were. Results: Ninety-four of 95 patients completed the rituximab course successfully. We observed a total of 23 IRRs in 20 patients. The frequency of IRR was 12.1%, and serious IRR was 0.52%. Grade 1-2-3 IRRs had a rate of 52.2%, 30.4%, and 17.4%, respectively; grade 4 or 5 IRR wasn’t detected. Age <60 years, anti-CCP <200U/ml and absence of biologic agent use before rituximab was significantly higher in patients with IRR than without IRR (p=0.01, p=0.002, p=0.01 respectively). We found out that if only the disease age is above 60 months, it is protective against IRR as per the results of multivariate model analysis. Conclusion: Results supported that rituximab is a safe biological agent option for patients with RA at secondary central hospitals. Identified risk factors of IRR need to be corroborated in larger studies for safer rituximab therapy.Öğe Persistent undifferentiated arthritis: Evaluation of 60 cases(2023) Pekdiker, MeteObjective: Undifferentiated arthritis (UA) is diagnosed after excluding other arthritis-related diseases. Current data generally focuses on the early forms of UA, and knowledge about persistent UA (pUA) is insufficient. Therefore, we investigated the general characteristics of patients with pUA in this study. Methods: The study included patients with persistent peripheral arthritis of undetermined etiology lasting longer than six months. Medical records were reviewed retrospectively. Patients having an arthritis-associated diagnosis were excluded. Arthritis was verified by magnetic resonance imaging. The disease activity was evaluated with a visual analog scale. Results: We totally analyzed 60 patients with a mean age of 49.7 years and 76.7% of them were female. The mean disease duration was 78 months, and 21.6% of them had a family history of rheumatic diseases. The most common clinical pattern was knee monoarthritis (56.6%), the number of affected joints was two at most, and the frequency of erosive arthritis was 35%. Among all variables, only metatarsophalangeal joint involvement was significantly higher in patients with erosive arthritis (p=0.046). 98% of patients achieved remission with disease-modifying anti-rheumatic drugs (DMARDs). Conclusion: Our research shows that pUA shares several characteristics with other rheumatic diseases such as the family history of rheumatic disease, good response to DMARDs, and chronic course. We found that the cases with pUA show mono/oligoarticular involvement as spondyloarthritis; female gender predominance, and (sometimes) erosive course as rheumatoid arthritis. A long lag time is a major problem, and the prognosis of pUA is generally benign. Further studies are needed for a better definition of this clinical entity.Öğe Persistent undifferentiated arthritis: Evaluation of 60 cases(Galenos Publishing House, 2023) Pekdiker, MeteObjective: Undifferentiated arthritis (UA) is diagnosed after excluding other arthritis-related diseases. Current data generally focuses on the early forms of UA, and knowledge about persistent UA (pUA) is insufficient. Therefore, we investigated the general characteristics of patients with pUA in this study. Methods: The study included patients with persistent peripheral arthritis of undetermined etiology lasting longer than six months. Medical records were reviewed retrospectively. Patients having an arthritis-associated diagnosis were excluded. Arthritis was verified by magnetic resonance imaging. The disease activity was evaluated with a visual analog scale. Results: We totally analyzed 60 patients with a mean age of 49.7 years and 76.7% of them were female. The mean disease duration was 78 months, and 21.6% of them had a family history of rheumatic diseases. The most common clinical pattern was knee monoarthritis (56.6%), the number of affected joints was two at most, and the frequency of erosive arthritis was 35%. Among all variables, only metatarsophalangeal joint involvement was significantly higher in patients with erosive arthritis (p=0.046). 98% of patients achieved remission with disease-modifying anti-rheumatic drugs (DMARDs). Conclusion: Our research shows that pUA shares several characteristics with other rheumatic diseases such as the family history of rheumatic disease, good response to DMARDs, and chronic course. We found that the cases with pUA show mono/oligoarticular involvement as spondyloarthritis; female gender predominance, and (sometimes) erosive course as rheumatoid arthritis. A long lag time is a major problem, and the prognosis of pUA is generally benign. Further studies are needed for a better definition of this clinical entity. © 2023 by the Turkish Society for Rheumatology/Journal of Turkish Society for Rheumatology published by Galenos Publishing House.
