Rheumatoid Arthritis: Arisoy N

Civilibal M, Canpolat N, Yurt A, Kurugoglu S, Erdamar S, Bagci O, Sever L, Kasapcopur O, Caliskan S, Arisoy N. · Department of Pediatric Nephrology, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey. · Clin Pediatr (Phila). · Pubmed #17507575 No free full text.

Abstract: Primary Sjögren syndrome (pSS) is an uncommon disease in childhood. Childhood pSS might have different clinical manifestations than adult pSS. We describe a 13-year-old girl with multiple episodes of bilateral parotid swelling lasting 2 years. Her history included severe arthralgia, local edema, and purpura episodes since 9 years of age. During her 3-week hospitalization, 2 episodes of parotid swelling occurred, which both resolved in 48 hours. Ultrasonography and magnetic resonance images of parotid glands showed parenchymal inhomogeneity related to adipose degeneration and nodular pattern. Investigations showed elevated erythrocyte sedimentation rate, the presence of hypergammaglobulinemia, positive antinuclear antibody, and elevated rheumatoid factor, anti-Sjögren syndrome antigen A, and anti-Sjögren syndrome antigen B. Histopathologic examination of labial minor salivary glands revealed focal periductal lymphocytic infiltrate and sialoduct ectasia. She was diagnosed as having pSS. Recurrent parotid swelling is a more characteristic feature of disease in children, and this finding should alert the clinician to the possible diagnosis of pSS.

Göksel AK, Sever L, Kasapçopur O, Calişkan S, Balci H, Arisoy N. · Department of Pediatric Nephrology and Rheumatology, Cerrahpaşa Medical School, Istanbul University, Turkey. · Pediatr Nephrol. · Pubmed #15599770 No free full text.

Abstract: This study investigates whether renal damage occurs in children with juvenile idiopathic arthritis (JIA) either secondary to the disease per se or due to the side effects of non-steroidal anti-inflammatory drugs (NSAIDs) and slow-acting anti-rheumatic drugs (SAARDs) used in treatment. In this cross-sectional study, albuminuria, N -acetyl glucosaminidase (NAG), beta(2)-microglobulin (beta(2)M), and creatinine (Cr) levels were measured in urine samples of 45 patients (23 female, 22 male, 9.4+/-3.9 years) with JIA and a sex- and age-matched control group of 33 healthy children. The urinary albumin/Cr, NAG/Cr, and beta(2)M/Cr ratios of children with JIA and of the control group did not differ statistically. No difference was noted between patient groups with different types of JIA (12 systemic, 18 polyarticular, and 15 oligoarticular JIA). JIA patients with active disease (n=16) had higher NAG/Cr values than patients with inactive disease (P=0.002). NAG/Cr levels correlated with erythrocyte sedimentation rate (r=0.66, P<0.001) and platelet count (r=0.61, P<0.001) and showed a slight correlation with the number of joints with active arthritis in children with polyarticular JIA (r=0.45, P=0.055). Neither beta(2)M/Cr nor albumin/Cr ratios were associated with disease activity. No difference was noted between patient groups treated with different NSAIDs and SAARDs. In children with JIA tubular enzymuria increases during the active phase of the disease; however, it seems that permanent renal damage does not occur.

Kasapçopur O, Altun S, Aslan M, Karaarslan S, Kamburoglu-Göksel A, Saribas S, Arisoy N, Kocazeybek B. · Department of Paediatric Rheumatology, Cerrahpaşa Medical School, Istanbul, Turkey. · Ann Rheum Dis. · Pubmed #15547097 links to  free full text

Abstract: OBJECTIVE: To correlate serum anti-cyclic citrullinated peptide antibodies (anti-CCP) levels with juvenile idiopathic arthritis (JIA) subtypes and with an erosive disease course. METHODS: The study group comprised 122 children with JIA; 16 were evaluated during both active disease and remission. Nineteen children with systemic lupus erythematosus (SLE), 27 with rheumatoid arthritis (RA), and 15 healthy children were also included in the study. Twelve children with JIA were rheumatoid factor (RF) positive, and 34 patients had persistent erosive joint disease. Anti-CCP antibody levels were determined by ELISA; values above 5 relative units were regarded as positive. RESULTS: Three girls with seropositive polyarticular JIA and erosive joint disease had positive anti-CCP values. Children evaluated during active disease and remission, patients with SLE, and healthy children all had negative anti-CCP antibody levels. However, 19/27 (70%) adult patients with RA had positive anti-CCP antibody values. CONCLUSIONS: In contrast with RA, anti-CCP positivity is only rarely found in patients with JIA. In patients with RF positivity and/or in patients with erosive joint disease, anti-CCP can be detected.

Kasapçopur O, Yologlu N, Ozyazgan Y, Ercan G, Caliskan S, Sever L, Ozdogan H, Arisoy N. · Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. · Indian Pediatr. · Pubmed #15523130 links to  free full text

Abstract: This study was conducted to determine the frequency of antinuclear antibodies (ANA) positivity and uveitis in our newly diagnosed juvenile idiopathic arthritis (JIA) patients classified according to International League Against Rheumatology (ILAR) classification criteria. Ninety-two girls and 106 boys, totally 198 children were enrolled in the study. of them 36 (18.2 percent) were found to be ANA positive. Chronic anterior uveitis was detected in 20 (10.1 percent) patients. ANA positivity was determined in 4 of the systemic JIA patients, in whom no uveitis had been detected. Twenty-five of 37 patients with oligoarticular JIA were ANA positive, in 10 of them uveitis was also diagnosed. ANA were positive in 3 of 34 patients with RF positive polyarticulat JIA, only one patient had positive ANA, and another one had uveitis. Nine patients were extended JIA and in none of them, ANA positivity or uveitis were present. Of 43 patients classified as enthesitis related arthritis (ERA), uveitis was diagnosed in 6 and there was no evidence of ANA positivity, but one had uveitis. We conclude that the incidence of ANA positivity and uveitis is low in Turkish children with JIA.

Metin G, Oztürk L, Kasapçopur O, Apelyan M, Arisoy N. · Department of Physiology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey. · J Rheumatol. · Pubmed #15338509 No free full text.

Abstract: OBJECTIVE: To assess aerobic fitness and exercise capacity in patients with juvenile idiopathic arthritis (JIA) and to determine subgroup differences. METHODS: Thirty-four patients diagnosed with JIA and 21 healthy sedentary volunteers were studied. Aerobic fitness was determined by measuring peak power and peak oxygen uptake (VO2peak) during an incremental cycling test. The patient group consisted of systemic JIA (n = 8), polyarticular JIA (n = 13), oligoarticular JIA (n = 7), and enthesitis-related arthritis (ERA, n = 6). Results from different subgroups of JIA were compared to determine subgroup differences. RESULTS: All subjects tolerated maximal exercise testing well. The JIA group had lower aerobic fitness than controls. In our comparison of JIA subgroups, we found no significant differences in cardiopulmonary measures. The ERA group had higher aerobic capacity than other subgroups. There was no difference in exercise capacity between patients with active disease (n = 10) and those in remission (n = 24). CONCLUSION: We suggest that heterogeneity in VO2peak levels among JIA patients is due to subgroup differences. Exercise programs for improvement of aerobic fitness should be individualized or at least be modified according to different subgroups.

Altun S, Kasapcopur O, Aslan M, Karaarslan S, Koksal V, Saribas S, Ergin S, Arisoy N, Kocazeybek B. · Departments of Microbiology and Clinical Microbiology and Pediatric Rheumatology, Cerrahpaşa Medical School, Istanbul University, Turkey. · J Med Microbiol. · Pubmed #15272067 links to  free full text

Abstract: The role of Chlamydophila pneumoniae in the development and exacerbation of juvenile idiopathic arthritis (JIA) was investigated. Blood samples were taken from 60 JIA patients during an active disease period and for 4 weeks after. Synovial fluid samples were obtained from 20 of the 60 patients. In addition, 22 patients with familial Mediterranean fever (FMF) during the active period and 35 healthy children were included in the study as control groups. Synovial fluid samples were also obtained from three children with FMF. IgG, IgM and IgA levels against C. pneumoniae in serum samples were studied by immunofluorescence and IgG antibody and PCR studies were performed for C. pneumoniae DNA in synovial fluid samples. Twenty-nine (48.3 %) patients with JIA, 18 (81.8 %) patients with FMF and 22 (62.8 %) healthy children were found to be pre-infected with C. pneumoniae. Pre-infection with C. pneumoniae among FMF patients was found to be significantly higher than among those with JIA. We did not find a significant difference between JIA patients and healthy children. Chronic C. pneumoniae infection was observed only in six JIA patients, one FMF patient and two healthy children. Synovial fluid antibodies were found at higher than 1/512-fold dilution in one JIA patient and four times higher than normal serum in three JIA patients. C. pneumoniae DNA was not detected in any synovial fluid sample from FMF or JIA patients by PCR. In conclusion, C. pneumoniae infection does not have a triggering or a progressive effect on the clinical situation in JIA aetiopathogenesis, as a result of a multifactorial aetiology. New, extensive and serial studies (especially PCR studies of synovial tissue) are needed in order to confirm the indirect results.

Ozdogan H, Ruperto N, Kasapçopur O, Bakkaloglu A, Arisoy N, Ozen S, Ugurlu U, Unsal E, Melikoglu M, Anonymous00085. · Cerrahpasa Tip Fakültesi, Iç Hastaliklari ABD, Romatoloji BD, Kasaneler sk. 2/5 Erenköy, 81060 Istanbul, Turkey. · Clin Exp Rheumatol. · Pubmed #11510322 No free full text.

Abstract: We report herein the results of the cross-cultural adaptation and validation into the Turkish language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Turkish CHAQ CHQ were fully validated with 3 forward and 3 backward translations. A total of 145 subjects were enrolled: 85 patients with JIA (35% systemic onset, 41% polyarticular onset, and 24% persistent oligoarticular subtype) and 60 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, and polyarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, and polyarticular onset having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Turkish version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Melikoğlu M, Ozdoğan H, Korkmaz C, Kasapçopur O, Arisoy N, Akkuş S, Fresko Z, Yazici H. · Department of Rheumatology, Cerrahpaşa Medical School, University of Istanbul, Istanbul, Turkey. · Ann Rheum Dis. · Pubmed #11053071 links to  free full text

Abstract: OBJECTIVE: Phenotype II in familial Mediterranean fever (FMF) is the onset of amyloidosis before the onset of FMF with its typical attacks, or as an isolated finding in a member of an FMF family. Its presence was investigated by looking for proteinuria among the asymptomatic relatives of patients with FMF complicated by amyloidosis and among the asymptomatic relatives of patients with juvenile chronic arthritis (JCA) complicated by amyloidosis, used as controls. METHODS: The relatives of the index patients (13 with FMF and amyloidosis) and controls (6 with JCA and amyloidosis) were screened for proteinuria. Rectal biopsies were performed when proteinuria was significant (>/=300 mg/d). RESULTS: 461 relatives were screened in the FMF group and 269 among the controls. Two of the FMF relatives and one JCA relative had no symptoms of FMF but had significant proteinuria. Rectal biopsy for amyloidosis was negative in all instances of significant proteinuria. CONCLUSION: Phenotype II is uncommon among the relatives of patients with FMF and amyloidosis.

Balci S, Aypar E, Kasapçopur O, Tüysüz B, Arisoy N. · No affiliation provided · Clin Exp Rheumatol. · Pubmed #11791657 No free full text.

This publication has no abstract.

Ozdoğan H, Kasapçopur O, Arisoy N. · No affiliation provided · J Rheumatol. · Pubmed #10405960 No free full text.

This publication has no abstract.