Browsing by Author "Pavlov-Dolijanović, Slavica (8452470400)"

Statins might cause and/or aggravate the immune-mediated myositis in patients on long-term, stable treatment. We provide a case of polymyositis with an immunological background and gastrointestinal and urinary manifestations in patient on long-term, stable atorvastatin treatment for the past six years. The diagnose of polymyositis was established based on clinical symptoms and signs, electromyography and laboratory test results (elevated aspartate aminotransferase 279 U/L, reference range 0-40 U/L; alanine aminotransferase 198 U/L, 0-33 U/L; lactate dehydrogenase 2200 U/L, 103-227 U/L; creatine kinase 7820 U/L, 15-84 U/L; and positive antinuclear antibodies test, titer of 1:160, with suspect antisynthetase antibodies). Polymyositis was probably related to atorvastatin treatment (Naranjo score, 5). Other probable causes of the myositis were rejected. Coricosteroid therapy, methotrexate and supplementation with vitamin D did not improve the condition. The patient remained bedridden and died two months after the hospital discharge due to the acute myocardial infarction. © 2014 Versita and Springer-Verlag.

Introduction Adult-onset Still’s disease (AOSD), a systemic inflammatory disorder, often represents a heterogeneous entity and diagnosis requires the exclusion of mimicking disorders, including autoinflammatory diseases. We present a patient who meets the diagnostic criteria for AOSD and Muckle–Wells syndrome (MWS). Case outline A 35-year-old male presented with lymphadenopathy and a chronic nonspecific rash, fever spikes, widespread arthralgia, and joint effusions. Laboratory results showed increased inflammation, leukocytosis, neutrophilia, thrombocytosis, and elevated liver enzymes, accompanied by negative immunoserological tests. Patient was diagnosed with AOSD and prednisone (15 mg/d), methotrexate (10 mg/w) and chloroquine (250 mg/d) are introduced in therapy. Due to refractory course, patient was introduced with anti IL-6 biological agent tocilizumab in 2014 (8 mg/kg monthly). However, after three doses, the drug is stopped due to disease exacerbation. In 2015, there was suspicion that there was another underlying disease from the autoinflammatory spectrum, but DNA analysis of the most common mutations in the NLRP3 gene was negative. In 2017, an ear, nose, and throat specialist confirmed bilateral sensorineural hearing loss, and in 2019, amyloidosis was confirmed after biopsy of the duodenum. Patient fulfilled a new-proposed diagnostic criteria for MWS and confirmation of mutation in NLRP3 gene is not obligatory according to Eurofever registry. Conclusion The symptoms of AOSD and MWS partly overlap, as well as their diagnostic criteria. In chronic refractory cases of AOSD, evaluation of diagnosis should be performed and autoinflammatory syndromes must be kept in mind. © 2024, Serbia Medical Society. All rights reserved.

[No abstract available]

SUMMARY Introduction Pfeifer–Weber–Christian disease (PWCD) is a rare inflammatory disorder of the subcutaneous fatty tissue. Angiolipoma, is a benign adipocytic soft tissue tumor composed of mature adipose tissue and small vascular proliferations. Treatment with corticosteroids could lead to proliferation of fat tissue but the stimulation of angiolipoma growth during corticosteroid therapy is extremely rare. Case outline We describe a case of a 46-year-old female patient with histopathological confirmation two rare diseases: PWCD and benign multiple subcutaneous non-infiltrative angiolipomas. Angiolipo-mas were treated conservatively. Treatment for PWCD was prednisone 20 mg/day. Due to poor control of PWCD and rapid angiolipomas growth on forearms, corticosteroids were discontinued after two months of use. Administration of oral cyclosporine A led to a rapid remission of the PWCD, and with no new growth of angiolipomas. Conclusion The successful therapy with the Cyclosporine A supports the hypothesis that PWCD is a T cell mediated autoinflammatory condition. Rapid growth of angiolipoma during corticosteroid therapy is an extremely rare condition. © 2023, Serbia Medical Society. All rights reserved.

Background/Aim. Osteoporosis mainly affects women in the early years following menopause. The aim of this study was to determine the level of knowledge about osteoporosis and osteoporosis related risk factors in postmenopausal women in Serbia. Methods. The study included postmenopausal women regardless if suffering from osteoporosis or not. Assessment of knowledge was carried out by using the Osteoporosis Knowledge Assessment Tool-Shorter Version (OKAT-S) questionnaire that was validated for Serbian population. Answers to the 9 questions were coded as 1-true, or 0-false or “do not know”. Also, the following risk factors data for osteoporosis were collected: age, the onset and duration of menopause, body mass index (BMI), data on fractures, the incidence of falls, smoking, lifestyle (active, sedentary), regular sunbathing, calcium and vitamin D supplementation, intake of milk and dairy products. Results. A total of 132 postmenopausal women responded to the questionnaire with the response rate of 90.41%. Their knowledge varied from 27.94% to 74.26% of the correct answers, with the average OKAT-S score of 4.5 (SD = 2.55), which was 50% of the maximum possible score. Only 2 participants (1.47%) filled the all OKAT-S items correctly, while 11 (8.09%) of them did not have the proper answer to any question. A reduced bone density (T-score below-1) was registered in 40.91% of the women, previous fractures in 49 (34.51%), and more or less 3 falls registered in 9.59% or 4.79%, respectively. Conclusion. The Serbian version of the questionnaire OKAT-S revealed generally poor knowledge on osteoporosis among postmenopausal women in Serbia. Developing effective interventions and public health programms could be helpful in general education towards understanding osteoporosis and risk factors. Promotion of preventive measures and healthy behaviour may prevent or at least slow down the accelerated bone loss in postmenopausal women. © 2017, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved.

Introduction: The classification of antiphospholipid syndrome (APS) comprises clinical criteria (vascular thrombosis or obstetric complications throughout life) and laboratory criteria (antiphospholipid antibodies (aPLs) positivity, confirmed at least twice at 12-week interval). Methods: In 100 patients admitted to the hospital with COVID-19 pneumonia, thrombosis and pregnancy complications were recorded during the hospital stay and in personal medical history. They were tested for nine types of aPLs at four time points (admission, deterioration, discharge, and 3-month follow-up): anticardiolipin (aCL), anti-β2-glycoproteinI (anti-β2GPI), and antiphosphatidylserine/prothrombin (aPS/PT) isotypes IgM/IgG/IgA. Results: During hospitalization, aPLs were detected at least once in 51% of patients. All 7% of deceased patients tested negative for aPLs upon admission, and only one patient became aCL IgG positive as his condition worsened. In 83.3% of patients, intrahospital thrombosis was not related to aPLs. One patient with pulmonary artery and cerebral artery thrombosis was given an APS diagnosis (triple aPLs positivity on admission, double on follow-up). Personal anamnesis (PA) for thromboembolism was verified in 10 patients, all of whom tested negative for aPLs at admission; however, transition to aPLs positivity at discharge (as the disease subsided) was seen in 60% of patients: three of six with arterial thrombosis (at follow-up, two did not appear, and one was negativized) and three of four with deep vein thrombosis (one was confirmed at follow-up and diagnosed with APS, one was negativized, and one did not appear). At admission, the majority of the aPLs were of the aCL IgG class (58.8%). Unexpectedly, as the COVID-19 disease decreased, anti-β2GPI IgG antibodies (linked with thromboses) became newly positive at discharge (14.9%), as confirmed at follow-up (20.8%). Conclusion: The incidence of APS in our cohort was 2.0%, whereas in the general population, it ranges from 0.001% to 0.002%. The incidence might have increased even more if the four aPLs-positive patients with intrahospital thrombosis/history of thrombosis had attended follow-up. Recommendation: All patients with severe COVID-19 or post-COVID syndrome should be evaluated for current/previous thrombosis and tested for aPLs at least twice: at admission to the hospital and at discharge, then retested 3 months later in positive cases in order to be given the appropriate therapy. © 2025 by the authors.

Introduction: The classification of antiphospholipid syndrome (APS) comprises clinical criteria (vascular thrombosis or obstetric complications throughout life) and laboratory criteria (antiphospholipid antibodies (aPLs) positivity, confirmed at least twice at 12-week interval). Methods: In 100 patients admitted to the hospital with COVID-19 pneumonia, thrombosis and pregnancy complications were recorded during the hospital stay and in personal medical history. They were tested for nine types of aPLs at four time points (admission, deterioration, discharge, and 3-month follow-up): anticardiolipin (aCL), anti-β2-glycoproteinI (anti-β2GPI), and antiphosphatidylserine/prothrombin (aPS/PT) isotypes IgM/IgG/IgA. Results: During hospitalization, aPLs were detected at least once in 51% of patients. All 7% of deceased patients tested negative for aPLs upon admission, and only one patient became aCL IgG positive as his condition worsened. In 83.3% of patients, intrahospital thrombosis was not related to aPLs. One patient with pulmonary artery and cerebral artery thrombosis was given an APS diagnosis (triple aPLs positivity on admission, double on follow-up). Personal anamnesis (PA) for thromboembolism was verified in 10 patients, all of whom tested negative for aPLs at admission; however, transition to aPLs positivity at discharge (as the disease subsided) was seen in 60% of patients: three of six with arterial thrombosis (at follow-up, two did not appear, and one was negativized) and three of four with deep vein thrombosis (one was confirmed at follow-up and diagnosed with APS, one was negativized, and one did not appear). At admission, the majority of the aPLs were of the aCL IgG class (58.8%). Unexpectedly, as the COVID-19 disease decreased, anti-β2GPI IgG antibodies (linked with thromboses) became newly positive at discharge (14.9%), as confirmed at follow-up (20.8%). Conclusion: The incidence of APS in our cohort was 2.0%, whereas in the general population, it ranges from 0.001% to 0.002%. The incidence might have increased even more if the four aPLs-positive patients with intrahospital thrombosis/history of thrombosis had attended follow-up. Recommendation: All patients with severe COVID-19 or post-COVID syndrome should be evaluated for current/previous thrombosis and tested for aPLs at least twice: at admission to the hospital and at discharge, then retested 3 months later in positive cases in order to be given the appropriate therapy. © 2025 by the authors.