Browsing by Author "Stupar, Nada Vujasinovic (36549315900)"

Takayasu arteritis (TA) is a rare, chronic large-vessel vasculitis (LVV) characterized by granulomatous inflammation of the vessel wall with an unknown etiopathogenesis. TA predominantly affects young females during the 2nd or 3rd decades of life and mainly involves the aortic arch and its major branches, ascending aorta, thoracic descending aorta and abdominal aorta. A physical examination is the first step for disease assessment. Systemic inflammatory response does not always show a positive correlation with inflammatory activity in the vessel wall. Imaging modalities are very important for establishing the diagnosis of TA. Conventional angiography, the gold standard for initial diagnosis, seems to be replaced with the new imaging modalities such as magnetic resonance angiography, ultrasonography, computerized tomography and, 18Ffluorodeoxyglucose positron emission tomography in recent years. Prognosis is possibly getting better with lower mortality in recent years. The most commonly used agents include corticosteroids and conventional immunosuppressive agents such as methotrexate, azathioprine, micophenolate mofetil and leflunomide. However, in resistant and/or intolerant patients, biologic drugs including anti-TNF agents (mostly infliximab), rituximab and tocilizumab seem to be promising. Antiplatelet treatment may also lower the frequency of ischaemic events in TA. Endovascular interventions (balloon angioplasty or stent graft replacement) or by-pass surgery may be useful for critical arterial occlusions. There is a clear need to develop a validated set of outcome measures in TA, such as measures of disease activity, health-related quality of life and diseaserelated damage. The OMERACT Vasculitis Working Group has taken on this task and aims to develop a core set of outcomes for LVV. © 2015 by Nova Science Publishers, Inc. All rights reserved.

Klippel-Feil syndrome is defined as congenital fusion of two or more cervical vertebrae. In this article, we report a 55-year-old male patient with one-year history of neck pain, headaches, and one episode of syncope after a severe trauma. X-rays and magnetic resonance imaging of cervical spine revealed fused vertebral bodies of C2-C5. The major anomalies associated with Klippel-Feil syndrome (small stature, thoracic kyphoscoliosis, lumbar scoliosis, restricted opening mouth, and bilateral sensorineural hearing loss) as well as multiple minor anomalies (mild face asymmetry, high arched palate, rhinoscoliosis, high nasal bridge, inclined septi nasi, and thin upper lip) were detected. This is a rare case describing the anomalies of the nose in Klippel-Feil syndrome patients. Our patient had no central cord impairment following a severe trauma. ©2016 Turkish League Against Rheumatism. All rights reserved.

Nailfold capillaroscopy is an essential imaging technique and the best method to analyse microvascular abnormalities in autoimmune rheumatic diseases. Capillary microscopy seems to be a useful tool for early selection of those patients who are potentially candidates for developing scleroderma spectrum disorders, especially systemic sclerosis (SSc) and dermatomyositis (DM). In patients with DM, capillaroscopic abnormalities may be similar to those seen in patients with SSc, such as architectural derangement of the nailfold capillary network and prevalent features of marked angiogenesis. Scleroderma pattern was found in 71% of DM patients. Changes in nailfold capillaries reflect disease activity in DM, especially muscle disease activity. Also, loss of capillaries was associated with muscle and global disease activities, and haemorrhage was associated with cutaneous disease activity. Anti-Jo-1 antibody was associated with reduced capillary density. Nailfold capillaroscopy changes such as irregularly enlarged capillaries, haemorrhages and loss of capillaries were improved by disease stabilization in DM. Therefore, monitoring these changes will likely be useful in evaluating disease activity and therapeutic efficacy in patients with DM. © 2017 Nova Science Publishers, Inc. All rights reserved.