Reumatologia最新文献

{"title":"Peculiarities of clinical signs, course and treatment of musculoskeletal system lesions in post-COVID syndrome.","authors":"Larysa Voloshyna, Svitlana Smiyan, Oleksandr Voloshyn, Inna Buzdugan, Olga Bukach, Natalia Voloshynovych, Oleksandra Doholich","doi":"10.5114/reum/172575","DOIUrl":"10.5114/reum/172575","url":null,"abstract":"<p><strong>Introduction: </strong>Post-COVID syndrome (PCS) is a frequent phenomenon of patients who have suffered from an acute attack of COVID-19 infection, and it is characterized by a wide range of symptoms from different organs and systems including the musculoskeletal system (MSS). However, peculiarities of MSS lesions have not been sufficiently studied to date, in particular, in the aspect of the therapeutic process. We aimed to investigate peculiarities of MSS lesions in patients with PCS.</p><p><strong>Material and methods: </strong>Observations were carried out in 142 patients with PCS and MSS lesions. The age of patients was 36-67 years. Up-to-date methods of disease verification were used. An acute period of COVID-19 in all the patients was of moderate severity without oxygen support.</p><p><strong>Results: </strong>Musculoskeletal system lesions in patients with PCS were found to appear 1-4 weeks after the experienced acute period of COVID-19 infection. Against the background of significant arthralgia (100%) in 93 (65.5%) patients manifestations of acute arthritis were detected, the frequency of which increased with age. Musculoskeletal system lesions were found against the background of dominating PCS manifestations from the cardiovascular and digestive systems. Deterioration of the course and results of treatment of diseases caused by an age-related polymorbid background was determined. Certain difficulties in the treatment of MSS lesions by means of non-steroidal anti-inflammatory drugs and limitation in the use of glucocorticosteroids are caused by severe gastroduodenopathy and arterial hypertension. Long-term, up to 6 months, administration of L-arginine, L-carnitine and quercetin in the rehabilitation complex improved the overall results of treatment of PCS manifestations including arthropathy.</p><p><strong>Conclusions: </strong>Musculoskeletal system lesions in patients with PCS are not the main constituent of this syndrome. Difficulties in the treatment of arthropathy are due to the signs of gastroduodenopathy and arterial hypertension. Additional administration of L-arginine, L-carnitine and quercetin is reasonable.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 5","pages":"339-344"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The significance of prolactin in systemic connective tissue diseases.","authors":"Michał Piotr Jakubaszek","doi":"10.5114/reum/170319","DOIUrl":"https://doi.org/10.5114/reum/170319","url":null,"abstract":"<p><strong>Objectives: </strong>Does prolactin (PRL) level testing in the diagnosis of systemic connective tissue diseases make sense and should we test it in everyday practice?</p><p><strong>Material and methods: </strong>Connective tissue diseases (CTDs) are a group of heterogeneous disorders, involving multiple body systems. Rheumatoid arthritis (RA) is one of the most common connective tissue diseases with a global prevalence of 0.3-1% and can be inherited. Less common are systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), systemic sclerosis (SSc), primary Sjögren's syndrome (pSS) and inflammatory myositis. Prolactin is responsible for lactation, breast growth and many other bodily processes, and is elevated in blood of woman who are pregnant or breastfeeding. Hyperprolactinemia is relatively common in women, so some rheumatic diseases may be caused by high prolactin levels, and it should be detected during diagnosis.</p><p><strong>Results: </strong>Prolactin signals are found in arthritic joint tissues (chondrocytes and synovial fibroblasts) to inhibit cartilage degradation, synovitis and osteoclastogenesis. On the other hand, hyperprolactinemia also promotes the conversion of PRL to vasoinhibin, a fragment of PRL that directly stimulates and indirectly inhibits arthritis in a cell type-dependent manner. The role of the PRL/vasoinhibin axis in inflammatory arthritis should still be monitored and further research is needed to help elucidate the role of PRL in rheumatic diseases in order to ultimately develop new therapeutic interventions that can be tested in patients.</p><p><strong>Conclusions: </strong>Nowadays, there are no clear indications for prolactin testing in the diagnosis of systemic connective tissue diseases. In the case of suspicion or confirmation of some systemic connective tissue diseases, such as rheumatoid arthritis or systemic lupus erythematosus, testing the prolactin level makes sense when severity of disease symptoms is observed.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 4","pages":"264-270"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e8/2a/RU-61-170319.PMC10515120.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41134767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoimmune polyendocrine syndromes associated with autoimmune rheumatic diseases.","authors":"Katarzyna Jankowska,&nbsp;Piotr Dudek,&nbsp;Małgorzata Stasiek,&nbsp;Katarzyna Suchta","doi":"10.5114/reum/170266","DOIUrl":"https://doi.org/10.5114/reum/170266","url":null,"abstract":"<p><p>Autoimmune polyendocrine syndromes (APSs), also called autoimmune polyglandular syndromes, are a group of autoimmune diseases characterized by the co-occurrence of dysfunctions of several (at least two) endocrine glands. They develop under the influence of environmental factors in genetically predisposed people. Autoimmune polyendocrine syndromes may accompany autoimmune rheumatic diseases and worsen their course - APS-2 and APS-3 are the most common. The APS-2 includes the coexistence of, e.g. Hashimoto's disease, celiac disease and rheumatoid arthritis (RA). In APS-3, rheumatic diseases such as RA, systemic lupus erythematosus, and Sjögren's syndrome may coexist with Hashimoto's disease, type 1 diabetes and hypogonadism or other endocrinopathies. Undiagnosed endocrine diseases may be the reason for the intensification of metabolic disorders observed in the course of rheumatic diseases, cause the ineffectiveness of rheumatological treatment and also increase the frequency of bone fractures due to osteoporosis, cardiovascular complications and even miscarriages when coexistent, e.g. Hashimoto's disease with hypothyroiditis, which increases the risk of pregnancy loss. It is important to be able to conduct an extensive interview, paying attention to the symptoms of possible endocrinopathy as well as the features of other autoimmune disorders in the physical examination (e.g. vitiligo or darkening of the skin in Addison's disease). Depending on the history and physical examination, screening for various APSs is advised.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 4","pages":"225-238"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/b3/RU-61-170266.PMC10515125.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy- and lactation-related osteoporosis: an important topic also for rheumatologists.","authors":"Waldemar Misiorowski","doi":"10.5114/reum/171597","DOIUrl":"https://doi.org/10.5114/reum/171597","url":null,"abstract":"<b>Objectives</b>\u0000\u0000\u0000<b>Material and methods</b>\u0000\u0000\u0000<b>Results</b>\u0000\u0000\u0000<b>Conclusions</b>\u0000\u0000\u0000<b></b>\u0000\u0000\u0000<b></b>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 4","pages":"223-224"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/e8/RU-61-171597.PMC10515126.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41146055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiosynovectomy of the hip joint - preliminary experience.","authors":"Marek Marcin Chojnowski,&nbsp;Danuta Owczarczak,&nbsp;Maria Teresa Płazińska,&nbsp;Marek Dedecjus,&nbsp;Leszek Królicki","doi":"10.5114/reum/166608","DOIUrl":"https://doi.org/10.5114/reum/166608","url":null,"abstract":"<p><strong>Introduction: </strong>Radiosynovectomy (RSV) is a minimally invasive method of treating and controlling joint inflammation refractory to conventional pharmacotherapy. It consist in intraarticular injection of radioactive colloids which irradiate the inflamed synovial membrane to cause its subsequent involution. Despite the fact that hip joint involvement is quite common in systemic inflammatory arthropathies, hip joint RSVs are rarely performed. The aim of this paper is to assess to safety and efficacy of hip joint radioisotope treatment.</p><p><strong>Material and methods: </strong>We retrospectively analyzed the effects of 21 hip joint RSVs performed in 14 patients (10 female, 4 male; aged 8 to 79; mean age 48 years). Before the RSV, all the patients underwent clinical and ultrasound examination. The radiosynovectomies were performed using rhenium-186 sulfide under ultrasound guidance. Each patient underwent post-therapeutic scintigraphy to assess intraarticular distribution of the radiopharmaceutical. The effects of the treatment were assessed clinically and ultrasonographically during at least 2 follow-up visits 3 and 6 months after the RSV.</p><p><strong>Results: </strong>In 9 cases, we observed complete resolution of symptoms 3 and 6 months after the RSV. Four patients had only a partial response and required repeated treatment, and all responded well to the second RSV. In 4 patients the treatment had no significant effect, and no repeated treatment attempt was made. All the responders suffered from inflammatory arthropathies; the non-responders had osteoarthritis, with no history of systemic diseases. In all the patients, no significant adverse effects were observed; in particular there were no radiation burns or infections. All post-therapeutic scintigrams showed proper, intraarticular distribution of the radiopharmaceutical.</p><p><strong>Conclusions: </strong>Radiosynovectomy of the hip joint in systemic joint diseases, especially performed using ultrasound-guidance, is a safe and effective treatment modality.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 3","pages":"186-190"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/65/RU-61-166608.PMC10373165.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful use of tadalafil in oligohydramnios associated with lupus pregnancy.","authors":"Kushagra Gupta,&nbsp;Meenakshi Bansal,&nbsp;Kamal Kishore,&nbsp;Divya Goyal","doi":"10.5114/reum/167432","DOIUrl":"https://doi.org/10.5114/reum/167432","url":null,"abstract":", We present the case of a 26-year-old female patient, who came to us with complaints of generalized swelling in the legs and a malar rash on her face, during the 17 th week of gestation. The patient’s complaints had begun only 1 month before prior to which she was fine. On general examination mild pallor and pedal edema were observed. The initial vital state was stable. Investigation showed mild anemia with a hemoglobin level of 7.4 mg/ dl. Initial investigations are presented in Table I. Serum albumin levels were low (2.5 g/dl) and urine examination showed presence of proteinuria. 24-hour urine protein estimation was 8 g/day. Other significant results: ANA positivity (1 : 2560, homogenous) and raised anti-dsDNA levels (450 IU/ml) as well as positive direct Coombs test. The ENA was positive for anti-Sm, anti-SSA and anti-SSB antibodies and C3 (31 mg/dl) and C4 levels (8 mg/dl) were also low, suggestive of lupus flare. Echocardiography showed mild pericardial effusion. The patient was diagnosed with lupus nephritis with autoimmune hemolytic anemia and serositis. Ultra-sound abdomen assessment done at baseline showed a normal healthy fetus appropriate for gestational age","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 3","pages":"219-220"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/99/dd/RU-61-167432.PMC10373169.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9913643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The frequency and factors affecting anxiety and depression in patients with rheumatoid arthritis.","authors":"Ayşe Unal Enginar,&nbsp;Hakan Nur","doi":"10.5114/reum/161282","DOIUrl":"https://doi.org/10.5114/reum/161282","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid arthritis (RA) is a chronic inflammatory disease. Anxiety and depression are important problems in patients with RA. The aim of this study was to determine the frequency and the factors affecting depression and anxiety in patients with RA.</p><p><strong>Material and methods: </strong>One hundred and eighty-two patients with RA, aged 18-85 years, were included in this study. The diagnosis of RA was established according to ACR/EULAR RA classification criteria from 2010. Psychosis, pregnancy, breastfeeding and malignancy were exclusion criteria. The demographic data as well as disease duration, educational status, Disease Activity Score with 28-joint counts (DAS28), Health Assessment Questionnaire (HAQ) score and the Hospital Anxiety and Depression Scale (HADS) were the parameters used in the analysis.</p><p><strong>Results: </strong>Depression symptoms were present in 50.3%, anxiety in 25.3% of the studied patients. In patients with depression and/or anxiety HAQ and DAS28 scores were higher than other studied RA patients. Depression was determined at significantly higher rates in females, housewives and those with a low education level. Anxiety was determined significantly more often in blue-collar workers.</p><p><strong>Conclusions: </strong>In the present study, depression and anxiety were observed at high rates in patients with RA. These results confirm the real problem in RA patients in comparison to the general population. This points to the relationship between inflammation and depression and anxiety. Psychiatric evaluations and mental status assessment should not be forgotten together with physical examinations of RA patients.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 1","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/42/RU-61-161282.PMC10044030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9225980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Depression, anxiety, and quality of life in patients with systemic lupus erythematosus.","authors":"Ali Dehghan, Hamidreza Soltani, Seyedeh Tahereh Faezi, Azarakhsh Baghdadi, Hossein Soleymani Salehabadi, Hamidreza Bashiri, Roya Hemayati, Mehrdad Mansouri, Mohammad Motaghi, Mohammad Nejadhosseinian","doi":"10.5114/reum/168396","DOIUrl":"https://doi.org/10.5114/reum/168396","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a multisystem disorder that can affect multiple organs; psychiatric manifestations including depression and anxiety are commonly seen in SLE. The aim of this study is to explore the prevalence of depression, anxiety, and stress, and assess the quality of life (QOL) in patients with SLE and also evaluate associated risk factors.</p><p><strong>Material and methods: </strong>In this cross-sectional study, adult patients with SLE were identified through our institution's SLE data registry. Participants were evaluated with three questionnaires: Depression, Anxiety, and Stress Scale (DASS-42), General Health Ouestionnaire-28 (GHQ-28), and World Health Organization quality of life instrument short form (WHO-QOL BREF).</p><p><strong>Results: </strong>A total of 222 patients were included in the study, 203 (91%) of whom were female and 19 were male (9%). Participants had a mean age of 35.6 ±9.5 years. According to DASS-42 questionnaire, 22.1%, 28.7% and 20.3% of patients had varying degrees of depression, anxiety, and stress, respectively. Based on GHQ-28 questionnaire, 137 (62%) of patients reported some degree of distress. Quality of life score was 12.8, 13, 14.3, and 13.9 in physical health, psychological health, social relationships, and environmental health, respectively.</p><p><strong>Conclusions: </strong>We found that depression, anxiety, and stress are common in patients with SLE, and quality of life is significantly affected. A high percentage of patients with SLE deal with some degree of distress. Routine evaluation of the quality of life and psychological disturbances is recommended in patients with SLE. Non-pharmacological interventions as well as specialist referral should be considered in patients with anxiety, depression, or stress.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 5","pages":"368-374"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epstein-Barr virus and autoimmunity: effective preventive and therapeutic strategies are urgently needed.","authors":"Piotr Rzymski, Agnieszka Szuster-Ciesielska","doi":"10.5114/reum/171506","DOIUrl":"https://doi.org/10.5114/reum/171506","url":null,"abstract":"Epstein-Barr virus (EBV), belonging to the family Orthoherpesviridae (subfamily Gammaherpesvirinae, genus Lymphocryptovirus), is a ubiquitous human pathogen with a 170 kilobase double-stranded DNA genome closed within an icosahedral capsid surrounded by a protein layer called the tegument and enclosed by a lipid envelope containing glycoproteins with high expression of gp350 and gp220 [1]. The tegument helps the virus replication and evasion of the cell’s immune response. Epstein-Barr virus is well-adapted to humans, its only known host, and primarily targets B cells due to their expression of CD21, the principal entry receptor for the virus. However, it can also infect epithelial cells by utilizing the ephrin receptor A2. Following acute infection, EBV persists in a latent state, causing life-long infection. Developing latency requires evasion of the immune response, which EBV achieves through blocking the expression of interferon genes, inhibiting complement activation, inactivating the cytotoxic functions of CD8+ lymphocytes, and inhibiting the host MHC class I antigen processing and presentation pathway [2]. During latency, the EBV genome usually persists in cell nuclei in the form of the multicopy, circular episome that associates with chromosomes during mitosis and is replicated by host DNA polymerase during the S phase. Different latent forms of EBV, varying in the transcriptional profile of non-coding RNAs and protein-coding mRNAs, have been identified (Fig. 1). Under conditions of altered cell-mediated immunity (induced by, e.g., stress, infections, immunosuppression), EBV reactivation can occur and not only lead to the onset of clinical symptoms and the virus becoming contagious but may also play a role in the pathogenesis of various diseases [3]. Epstein-Barr virus, which spreads most commonly by saliva, infects 90–95% of the world’s human population, but such a high prevalence does not justify disregarding it as a significant pathogen. Firstly, EBV is a causative agent of infectious mononucleosis, most commonly affecting children, adolescents, and young adults [4]. Secondly, it is the leading cause of post-transplant lymphoproliferative disease [4]. Thirdly, it has been classified as a group 1 carcinogen, implicated in the etiology of Burkitt’s lymphoma, Hodgkin’s disease, nasopharyngeal carcinoma, some T cell lymphomas, and selected cancers of the stomach and smooth muscle (Fig. 1), and is responsible for 240,000– 358,000 new cancer cases and 138,000–209,000 cancer-related deaths annually [5]. Epstein-Barr virus infection, particularly its reactivations, has also been implied in the autoimmune processes, acting as a trigger and/or a driver of selected autoimmune diseases (Table I). Further research is pivotal to elucidate genetic and environmental factors contributing to EBV-associated autoimmune effects [6]. The links between EBV infection and autoimmunity are continuously being explored, as evidenced by the increasing number of pee","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 5","pages":"327-330"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10634406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oculomotor nerve palsy, an unusual onset of polyarteritis nodosa.","authors":"Ana Martins,&nbsp;Filipe Oliveira Pinheiro,&nbsp;Sofia Vedor,&nbsp;Daniela Oliveira,&nbsp;Maria Seabra Rato,&nbsp;Diogo Fonseca,&nbsp;Pedro Madureira,&nbsp;Luís Braz,&nbsp;Sofia Pimenta,&nbsp;Lúcia Costa","doi":"10.5114/reum/161085","DOIUrl":"https://doi.org/10.5114/reum/161085","url":null,"abstract":"<p><strong>Introduction: </strong>Cranial nerve involvement in polyarteritis nodosa(PAN) is underrecognized and rarely reported. The aim of this article is to review the available literature and present an example of oculomotor nerve palsy in the course of PAN.</p><p><strong>Material and methods: </strong>Evaluation of texts describing the analyzed problem using the terms \"polyarteritis nodosa\", \"nerve\", \"oculomotor\", \"cranial nerve\" and \"cranial neuropathy\" for searching the PubMed database was done. Only full-text articles in English language with titles and abstracts were included in the analysis. As a guideline for the analysis of articles, the methodology described in the Principles of Individual Patient Data systematic reviews (PRISMA-IPD) was used.</p><p><strong>Results: </strong>After screening articles only 16 reported cases of PAN with cranial neuropathy were included in the analysis. In 10 the cranial neuropathy was reported as the initial manifestation of PAN with optic nerve involvement as the most frequent (62.5%); among these cases the oculomotor nerve was involved in 3 cases. Treatment with glucocorticosteroids and cyclophosphamide was the most common.</p><p><strong>Conclusions: </strong>Although cranial neuropathy, especially oculomotor nerve palsy is a rare first neurological manifestation of PAN, this clinical problem should be considered in the differential diagnosis.Especially patients with peripheral neuropathy, general symptoms, skin lesions and hepatitis B virus infection should be evaluated for cranial nerve involvement in the course of vasculitis.In the case of unclear involvement of the cranial nerves, PAN should also be considered in the differential diagnosis as the cause of symptoms and the first manifestation of the disease.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"61 1","pages":"71-77"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a8/5a/RU-61-161085.PMC10044037.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9230521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}