AIM: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that can affect almost all organs of the body. Lupus is a non-curable disease and the treatment is based on symptom control by immunosuppressive and anti-inflammatory treatment. The disease itself as well as treatment-related adverse events have a significant negative impact on life expectancy and quality of life of patients. The aim of this study was to identify the impact of the disease on life of SLE patients. METHODS: Data were collected anonymously using a special questionnaire. The survey involved 76 patients with SLE, results were processed by conventional methods and descriptive statistic methods. RESULTS: The survey has confirmed the impact of SLE on professional activities i.e. up to 63% of patients are registered disabled, of which 46% are granted full disability pension. SLE negatively affects patients' career--up to 39% of SLE patients stated that they had to change a job due to their disease. SLE has a strong impact on everyday life of patients. SLE symptoms are significant even during the period of quiescence--predominantly fatigue, reduced physical activity, pain. The most influenced activities of daily living included sunbathing and more strenuous activities or sport. The fact that limitations in all monitored activities are present in more than 50% of patients is a serious finding. Treatment-related adverse events have negative impact on the quality of life in almost 70% of patients. The most frequent events include gastrointestinal symptoms, visual disturbance and osteoporosis. CONCLUSION: SLE has a significant impact on the quality of life of patients and hinders them from leading everyday life at the level comparable to healthy population.
- MeSH
- dospělí MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- omezení pohyblivosti MeSH
- osobní újma zaviněná nemocí * MeSH
- postižení MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- systémový lupus erythematodes komplikace MeSH
- zaměstnanost MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Autori popisujú prípad 47ročnej ženy s reumatoidnou artritídou, ktorá dlhodobo užívala nesteroidné antireumatiká. Počas kompletnej reumatologickej liečby sa stav komplikoval sideropenickou anémiou s vysokou zápalovou aktivitou. Bola vyšetrená gastroenterológom. Kolonoskopia odhalila závažnú kolitídu, ktorá bola predbežne hodnotená ako Crohnova choroba. Pacientke bola aplikovaná kompletná gastroenterologická liečba, vrátane infliximabu. Pre nezlepšovanie stavu bola realizovaná kontrolná kolonoskopia, ktorá ukázala zhoršenie nálezu so závažnými kontinuálnymi ulceráciami hrubého čreva. Diagnóza bola prehodnotená na kolopatiu indukovanú nesteroidovými antireumatikami. Pôvodná liečba bola ukončená a realizovaná kolektómia s ileosigmoanastomózou. Po operácii bola pacientka bez ťažkostí, krvný obraz sa upravil, klesla zápalová aktivita. Autori podávajú prehľad o kolopatii indukovanej nesteroidovými antireumatikami, ktorá môže imitovať Crohnovu chorobu.
The authors describe the case of a 47-year-old woman with rheumatoid arthritis who took, in the long term, nonsteroidal anti-inflammatory drugs (NSAID). Her state was complicated by sideropenic anaemia with high inflammatory humoral response during complete rheumatological therapy. She was examined by a gastroenterologist. Colonoscopy revealed severe colitis, which was preliminarily evaluated as a Crohn's disease and a complete therapy including infliximab was administered. However, her condition did not improve and repeated colonoscopy was carried out. This investigation revealed a worse finding with severe continuous ulcerationsof the large bowel. The diagnosis was re-evaluated for NSAID induced colopathy. The previous therapy was stopped and colectomy with ileosigmoideostomy was performed. After surgery the patient was feeling well, had no anaemia, and the humoral anti-inflammatory response decreased. The authors present a review of NSAID induced colopathy which can mimic Crohn's disease.
- MeSH
- antiflogistika nesteroidní aplikace a dávkování škodlivé účinky MeSH
- Crohnova nemoc diagnóza MeSH
- lidé středního věku MeSH
- lidé MeSH
- revmatoidní artritida farmakoterapie MeSH
- ulcerózní kolitida farmakoterapie chemicky indukované patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Etiopatogenéza autoimunitných ochorení nebola jednoznačne objasnená. Autoimunitné ochorenia vznikajú u jednotlivcov s genetickou predispozíciou. Z endogénnych faktorov svoju úlohu zohrávajú aj pohlavné hormóny, najmä prolaktín. Cieľom práce bolo vyšetriť bazálne a TRH testom stimulované hodnoty prolaktínu u pacientov so systémovými ochoreniami spojiva: systémový lupus erythematosus (SLE), systémová skleróza, Sjögrenov syndróm, dermatomyozitída. Súbor a metódy: Autori vyšetrili 43 pacientov so systémovými ochoreniami spojiva: 20 pacientov s SLE, 7 pacientov so Sjögrenovým syndrómom, 7 so systémovou sklerózou a 9 s dermatomyozitídou. Priemerný vek pacientov: 39,87 rokov. Ako kontrolu vyšetrili 30 dobrovoľníkov, priemerný vek 35,17 rokov. Výsledky: Hladina prolaktínu u pacientov so systémovými ochoreniami spojiva bola 14,629 ng/ml, čo je viac ako u kontrolnej skupiny (6,952 ng/ml), bez štatistickej významnosti. Po i.v. stimulácii došlo po 20 min k štatisticky významnému vzostupu prolaktínu u pacientov (62,630 ng/ml) v porovnaní s kontrolnou skupinou (30,982 ng/ml). Tento štatisticky významný rozdiel pretrvával aj 60 min po podaní TRH - kontrolná skupina 16,43 ng/ml, pacienti so systémovými ochoreniami spojiva 36,890 ng/ml. Rozdiely v hladinách prolaktínu u jednotlivých systémových ochorení spojiva neboli štatisticky významné. Pozitívna korelácia v skupine chorých bola nájdená medzi stimulovanými hodnotami prolaktínu a hodnotou FW. Celkovo však nebola nájdená jednoznačná korelácia medzi laboratórnou aktivitou a hladinami prolaktínu. Záver: V práci autori zistili, že poststimulované hodnoty prolaktínu u pacientov so systémovými ochoreniami spojiva sú štatisticky významne vyššie v porovnaní s kontrolnou skupinou. Korelačnými analýzami nebola zistená jednoznačná súvislosť medzi zápalovou aktivitou a hladinami prolaktínu, preto autori predpokladajú, že stredne zvýšené hodnoty prolaktínu sú u pacientov so systémovými ochoreniami spojiva skôr rizikový faktor ochorenia ako marker zápalu.
The ethiopathogenesis of auto-immune diseases has not yet been fully explored. Auto-immune diseases develop in individuals with a genetic pre-disposition. Among the endogenous factors, also sexual hormones play a role, especially prolactin. The objective of the study was to use basal exam and TRH test to determine stimulated prolactin values in patients with a systemic connective tissue disease: systemic lupus erythematosus (SLE), systemic sclerosis, Sjögren's syndrome, dermatomyositis. PATIENT GROUP AND METHODS: The authors examined 43 patients with systemic connective tissue diseases: 20 patients with SLE, 7 patients with Sjögren's syndrome, 7 patients with systemic sclerosis and 9 patients with dermatomyositis. The mean age of the patients was 39.87 years. The control group consisted of 30 volunteers with a mean age of 35.17 years. OUTCOME: Prolactin level in the patients with systemic connective tissue diseases was 14.629 ng/ml, which is more than in the control group. A statistically significant increase in prolactin level was recorded 20 minutes after i.v. stimulation as compared with the control group (30.982 ng/ml). This statistically significant difference was still present 60 minutes after the TRH administration, with 16.43 ng/ml in the control group, and 36.890 ng/ml in the systemic connective tissue disorder patient group. The differences between prolactin levels for the different systemic connective tissue diseases were not statistically significant. A positive correlation in the patient group was found between the stimulated prolactin values and the FW value. On the whole, however, there was no clear correlation found between laboratory activity and prolactin levels. CONCLUSION: The authors found out that post-stimulation prolactin levels were statistically significantly higher in patients with systemic connective tissue disease as compared with the control group. Correlation analyses did not show a clear link between inflammatory activity and prolactin levels, and therefore the authors assume that medium increased values of prolactin are rather a risk factor for the disease than an inflammation marker in patients with a systemic connective tissue disease.
- Publikační typ
- abstrakt z konference MeSH
Temporálna arteritída (TA) - M. Horton patří medzi vaskulitídy neznámej etiológie. Postihuje vetvy vonkajšej a vnútornej karotídy, ide však o generalizovanú obrovskobunkovú panarteritídu, ktorá móže zasiahnuť hociktorú veíkú alebo strednú artériu. Polymyalgia rheumatica (PMR) prebieha samostatné alebo spolu s TA. Prejavuje sa bolesťou a stuhnutím ramenného a bedrového pletenca. V článku sú uvedené dve kazuistiky. Prvá demonstruje typický příklad temporálnej arteritídy, druhá kombináciu temporálnej arteritídy s polymyalgia rheumatica. Závěr: Včasná diagnostika a liečba TA je základná podmienka záchrany zraku pacienta.
Temporal arteritis (TA), Horton´ s disease, is vasculitis of unknown etiology affecting branches of the external and internal carotid arteries. However, in question is a generalized gigantocellular panarteritis that can affect any large or medium-size artery. Polymyalgia rheumatica (PMR) either follows an independent course or appears along with TA. It is manifested by pain and stiffening of the shoulder and lumbar regions. Presented are two case reports; one demonstrating a typical example of temporal arteritis, the other a combination of TA and polymyalgia rheumatica. Conclusion: Early diagnostics and treatment of TA is the precondition for preserving the patienťs eyesight.
- MeSH
- artralgie etiologie MeSH
- cévní bolest hlavy etiologie MeSH
- lidé MeSH
- obrovskobuněčná arteritida diagnóza genetika terapie MeSH
- polymyalgia rheumatica diagnóza terapie MeSH
- poruchy zraku etiologie MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
