Sistemik Lupus Eritematozus tanılı hastalarda hipermobilite sıklığı ve bu hastaların demografik, sosyal, klinik özellikleri
Öz
Eklem hipermobilitesi, sık görülen bir fiziksel özelliktir.Benign eklem hipermobilite sendromu (BEHS) tek başına olabileceği gibi, müsküloskeletal ağrı ile birlikte veya kompleks fenotiplerin bir parçası olarak görülebilmektedir. Romatizmal hastalıklarda eklem laksiteleri yıllar içerisinde bazı çalışmalarda araştırılmıştır. Lupus tanılı hastaların vücut yapılarında görülen değişiklikler konusunda literatürde çalışmalar bulunmaktadır. Beighton skoru lupus sürecinde görülen manifestasyonlardan etkilenmez ancak bu skorlama lupus semptomlarını da içermektedir. Bu nedenle skorlama ve lupus arasındaki ilişki kafa karıştırıcı olabilmektedir. Bu çalışmadaki amaç romatoloji polikliniğimizde takipli 40 lupus tanılı hastanın hipermobilite sıklığını ortaya koymaktır. Bu amaçla romatoloji polikliniğine 01.04.2023-01.10.2023 tarihleri arasında başvurmuş sistemik lupus eritematozus (SLE) tanılı hastaların dosyaları retrospektif olarak incelenmiştir. İncelememiz sonucunda hasta grubumuzun 20’sinin (%50) Beighton skorlarının dört ve üzeri olduğunu tespit ettik ve bu hastaları hipermobil olarak sınıflandırdık. Hastaları hipermobil olanlar ve olmayanlar olarak iki gruba ayırıp eklem ağrısı ve artrit yönünden baktığımızda, hipermobil olan yirmi kişinin dokuzunda (%45), hipermobil olmayan yirmi kişinin dördünde (%20) müsküloskeletal şikayet tespit ettik. Sonuç olarak, hipermobilite spektrum bozuklukları, ciddi müsküloskeletal ağrıya neden olabilmektedir. Bu durum ise sistemik lupus eritematozus seyrinde hastalığın oluşturduğu artralji, müsküler ağrı veya artritle karışabilmektedir. Bu durum ise klinisyenlerce hastalığın remisyona girmemesi olarak algılanabilir ve immünsüpresif tedavi verilmesi veya tedavide basamak artırılmasıyla sonuçlanabilir. Bu nedenle lupus seyrinde eşlik edebilen hipermobilitenin ayrıntılı şekilde incelenmesi gerekmektedir.
Anahtar Kelimeler
Etik Beyan
Çalışma protokolü, lokal etik kurula sunulmuş ve 28.11.2023 tarihli toplantı 2023.190.11.04 numaralı karar ile araştırma onayı alınmıştır.
Kaynakça
- Qu Y, Li D, Liu W, Shi D. Molecular consideration relevant to the mechanism of the comorbidity between psoriasis and systemic lupus erythematosus (Review) Exp Ther Med 2023;26:482.
- Pamuk ON, Balci MA, Donmez S, Tsokos GC. The incidence and prevalence of systemic lupus erythematosus in Thrace: A 12-year epidemiological study. Lupus 2016;25:102-9.
- Spinelli FR, Berti R, Farina G, Ceccarelli F, Conti F, Crescioli C. Exercise-induced modulation of Interferon-signature: a therapeutic route toward management of Systemic Lupus Erythematosus. Autoimmun Rev 2023;22:103412.
- Systemic lupus erythematosus. Jama. 1973;224:701-11.
- Morlino S, Castori M. Placing joint hypermobility in context: traits, disorders and syndromes. Br Med Bull 2023;147:90-107.
- Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol. 2000;27:1777-9.
- Uramoto KM, Michet CJ, Jr., Thumboo J, Sunku J, O'Fallon WM, Gabriel SE. Trends in the incidence and mortality of systemic lupus erythematosus. Arthritis Rheum 1999;42:46-50.
- Giffords ED. Understanding and managing systemic lupus erythematosus (SLE). Soc Work Health Care. 2003;37:57-72.
- Chattopadhyay A, Ghosh A. Jaccoud's arthropathy. Rheumatology (Oxford) 2020;59:3117
- Metry AM, Al Salmi I, Al Balushi F, et al. Systemic Lupus Erythematosus: Symptoms and Signs at Initial Presentations. Antiinflamm Antiallergy Agents Med Chem 2019;18:142-50.
- Tanaka Y. State‐of‐the‐art treatment of systemic lupus erythematosus. International Journal of Rheumatic Diseases 2020;23:465-71.
- Merrill JT, Neuwelt CM, Wallace DJ, et al. Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum 2010;62:222-33.
- Johnsson PM, Kohlin C, Rasmusson GR, Bengtsson AA, Sturfelt G, Nived O. Differences in body structure and function between patients with systemic lupus erythematosus and healthy individuals, with particular reference to joint hypermobility. Scand J Rheumatol 2017;46:40-3.
- Gumà M, Olivé A, Roca J, et al. Association of systemic lupus erythematosus and hypermobility. Ann Rheum Dis 2002;61:1024-6.
- Al-Osami MH, Mohammed S, Ali WI, Fawzi HA. The relationship between Hypermobility Syndrome and Systemic Lupus Erythematosus. Indian Journal of Public Health 2018;9:527.
Frequency of hypermobility in patients diagnosed with Systemic Lupus Erythematosus and demographic, social and clinical characteristics of these patients
Öz
Joint hypermobility is a common physical feature. Benign Joint Hypermobility Syndrome (BJHS) can occur alone, with musculoskeletal pain, or as part of complex phenotypes. Detailed studies have been conducted over the years on additional laxities in rheumatic diseases. There are studies in the literature about the changes seen in body structures in patients diagnosed with lupus.The Beighton score is not affected by the manifestations seen during the lupus process, but this scoring also includes the maintenance of lupus. Therefore, the relationship between scoring and lupus can be confusing. The aim of this study is to reveal 40 hypermobile patients diagnosed with lupus who were followed up in our rheumatology outpatient clinic.The files of patients diagnosed with systemic lupus erythematosus (SLE) who were registered at this intended rheumatology outpatient clinic between 01.04.2023 and 01.10.2023 are available retrospectively. As a result of our review, we found that 20 (50%) of our patient group had Beighton scores of four and above, and we classified these individuals as hypermobile.There was a lack of separation of the patients into two groups as hypermobile and non-hypermobile and their arthritis appearance. Musculoskeletal complaints were detected in nine of the twenty hypermobile patients (45%) and in four of the twenty non-hypermobile patients (20%).As a result, hypermobility spectrum disorders can cause severe musculoskeletal pain. This condition may be confused with arthralgia, muscular pain, or arthritis that occurs in the course of systemic lupus erythematosus. This situation may be perceived by clinicians as not entering remission for the country and may result in immunosuppressive treatment or escalation in treatment. For this reason, hypermobility needs to be examined in detail to preserve its features in the course of lupus.
Anahtar Kelimeler
Kaynakça
- Qu Y, Li D, Liu W, Shi D. Molecular consideration relevant to the mechanism of the comorbidity between psoriasis and systemic lupus erythematosus (Review) Exp Ther Med 2023;26:482.
- Pamuk ON, Balci MA, Donmez S, Tsokos GC. The incidence and prevalence of systemic lupus erythematosus in Thrace: A 12-year epidemiological study. Lupus 2016;25:102-9.
- Spinelli FR, Berti R, Farina G, Ceccarelli F, Conti F, Crescioli C. Exercise-induced modulation of Interferon-signature: a therapeutic route toward management of Systemic Lupus Erythematosus. Autoimmun Rev 2023;22:103412.
- Systemic lupus erythematosus. Jama. 1973;224:701-11.
- Morlino S, Castori M. Placing joint hypermobility in context: traits, disorders and syndromes. Br Med Bull 2023;147:90-107.
- Grahame R, Bird HA, Child A. The revised (Brighton 1998) criteria for the diagnosis of benign joint hypermobility syndrome (BJHS). J Rheumatol. 2000;27:1777-9.
- Uramoto KM, Michet CJ, Jr., Thumboo J, Sunku J, O'Fallon WM, Gabriel SE. Trends in the incidence and mortality of systemic lupus erythematosus. Arthritis Rheum 1999;42:46-50.
- Giffords ED. Understanding and managing systemic lupus erythematosus (SLE). Soc Work Health Care. 2003;37:57-72.
- Chattopadhyay A, Ghosh A. Jaccoud's arthropathy. Rheumatology (Oxford) 2020;59:3117
- Metry AM, Al Salmi I, Al Balushi F, et al. Systemic Lupus Erythematosus: Symptoms and Signs at Initial Presentations. Antiinflamm Antiallergy Agents Med Chem 2019;18:142-50.
- Tanaka Y. State‐of‐the‐art treatment of systemic lupus erythematosus. International Journal of Rheumatic Diseases 2020;23:465-71.
- Merrill JT, Neuwelt CM, Wallace DJ, et al. Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum 2010;62:222-33.
- Johnsson PM, Kohlin C, Rasmusson GR, Bengtsson AA, Sturfelt G, Nived O. Differences in body structure and function between patients with systemic lupus erythematosus and healthy individuals, with particular reference to joint hypermobility. Scand J Rheumatol 2017;46:40-3.
- Gumà M, Olivé A, Roca J, et al. Association of systemic lupus erythematosus and hypermobility. Ann Rheum Dis 2002;61:1024-6.
- Al-Osami MH, Mohammed S, Ali WI, Fawzi HA. The relationship between Hypermobility Syndrome and Systemic Lupus Erythematosus. Indian Journal of Public Health 2018;9:527.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Romatoloji ve Artrit |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Erken Görünüm Tarihi | 28 Mart 2024 |
| Yayımlanma Tarihi | 28 Mart 2024 |
| Gönderilme Tarihi | 19 Şubat 2024 |
| Kabul Tarihi | 19 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 5 Sayı: 1 |
Kaynak Göster
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