Background/aim: Systemic sclerosis (SSc) is a chronic systemic disease characterized by vascular damage, autoimmunity, and fibrosis in the skin and internal organs. In this study, we tried to determine the causes of severe infection in patients with SSc and to reveal the factors associated with severe infection. Materials and methods: We retrospectively examined 214 SSc patients between January 2010 and August 2020. Forty-seven patients with at least one severe infection and 167 patients without severe infection were compared. Results: A total of 76 episodes of severe infections were detected in 47 (22%) patients. Common infections included pneumonia, infected digital ulcer, urinary tract infections, and osteomyelitis. Female patients had a higher frequency in the group without severe infection (91.6% vs. 80.9%, p = 0.035). Patients with severe infections had a higher frequency of digital ulcers (p < 0.001), cardiac (p = 0.002), and GIS involvement (p < 0.001). In multivariable analysis, digital ulcer presence (OR: 2.849 [1.356-5.898] (p = 0.006) and cardiac involvement (OR: 2.801 [1.248-6.285]) were associated with severe infection. Of the patients with severe infections, 34% had recurrent severe infections. There was no difference in demographic and clinical characteristics between patients with recurrent and nonrecurrent severe infections. Conclusion: The presence of digital ulcer and cardiac involvement seem to be associated with a severe infection in patients with systemic sclerosis. In patients with cardiac involvement and digital ulcers, more careful attention may be required for the development of severe infections.

Background: Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare au-toimmune disease usually involving small vessels and progressing with necrotizing inflammation. Treatment requires long-term use of immunosuppressive agents to inhibit disease activity. Serious infections (SIs) are a common complication in AAV. Objective: The aim of this study was to identify the risk factors for serious in-fections which required hospitalization in patients with AAV. Methods: In this retrospective cohort study., we included 84 patients admitted to the Ankara University Faculty of Medicine in the last 10 years with a diagno-sis of AAV. Results: In 42 (50%) of 84 patients followed up with the diagnosis of AAV, an infection requiring hospitalization was identified. The patients' total corticosteroid dose, use of pulse steroids, induction regimen, levels of C-reactive protein (CRP) and the presence of pulmonary and renopulmonary involvement were found to be associated with the frequency of infection (p=0.015, p=0.016, p=0.010, p=0.03, p= 0.026 and p=0.029, respectively). In multivariable analysis, it was found that renopulmonary involvement (p=0.002, HR=4.95, 95% CI= 1.804-13.605), age of over 65 (p=0.049, HR=3.37, 95% CI=1.004-11.369) and high CRP levels (p=0.043, HR=1.006, 95% CI=1.000-1.011) constituted independent predictors of serious infection risk. Conclusion: The frequency of infection is known to be increased in ANCA-associated vasculitis. Our study showed that renopul-monary involvement, age and elevated CRP levels on admission are independent risk factors of infection.

OBJECTIVE: The aim of this study was to identify predictive factors associated with pain catastrophizing in women with systemic lupus erythematosus (SLE).METHODS: A total of 104 volunteered women with a diagnosis of systemic lupus erythematosus participated in the study. Pain Catastrophizing Scale, Body Awareness Questionnaire, Tampa Scale of Kinesiophobia, and Beck Depression Inventory were used to assess patients. Correlations between pain catastrophizing (dependent variable) and independent variables (age, body mass index, disease activity, organ damage, depression, kinesiophobia, and body awareness) were analyzed with Pearson's rho correlation analysis. The multiple stepwise linear regression models with R2 were used to compare across the models and explain the total variance. The significance level of a p-value was considered significant if p <= 0.05. RESULTS: There were no correlations between Pain Catastrophizing Scale and age, Beck Depression Inventory, disease activity, and organ damage (p>0.05). Pain Catastrophizing Scale was correlated with Tampa Scale of Kinesiophobia (r=0.585; p<0.001), Beck Depression Inventory (r=0.511; p<0.001), and Body Awareness Questionnaire (r=0.277; p<0.005). The regression analysis showed that the predictor factors of pain catastrophizing in women with systemic lupus erythematosus were TSK (B 0.411; p<0.001), Beck Depression Inventory (B 0.363; p<0.001), Body Awareness Questionnaire (B 0.273; p<0.001), and body mass index (B-0.169; p=0.02) (Nagelkerke R2=0.52).CONCLUSIONS: As a result, the most related factors on pain catastrophizing were kinesiophobia, depression, body awareness, and body mass index in women with systemic lupus erythematosus. We suggest assessing these parameters as predictive of pain catastrophizing throughout systemic lupus erythematosus management.

Background: Systemic sclerosis (SSc) is a systemic autoimmune disease characterized by microangiopathy, inflammation, fibrosis. Interstitial lung disease (ILD) is common among SSc patients. Objective: This study aims to define the clinical, laboratory and serologic characteristics of SSc patients with ILD and to present the frequency of chest computed tomography features. Methods: Two hundred twenty-six SSc patients who applied to the Rheumatology Department between January 2007 and August 2019 were retrospectively examined. A total of 100 SSc patients with ILD (44.2 %) were determined. Clinical, laboratory and serological features of SSc patients with and without ILD were compared. Result: Both groups had similar characteristics in terms of age and sex. The duration of disease (p=0.001) and follow-up time (p=0.001) were longer in SSc patients with ILD. Multivariable logistic regression analysis indicated that the duration of disease (OR: 1.06 [1.01-1.13], p=0.029), presence of gastrointestinal system involvement (OR: 3.29 [1.28-8.46], p=0.013) and anti-SCL70-positivity (OR: 6.04 [2.35-15.49], p<0.001) were associated with ILD. There was an inverse relationship between Anti-CENP-B positivity and the presence of ILD (p=0.001). The assessment regarding the chest computed tomography characteristics of interstitial pneumonia patterns were as follows: 82.5% non-specific interstitial pneumonia, 14.4% usual interstitial pneumonia and 2.1% desquamative interstitial pneumonia. The most frequent abnormal findings included ground glass opacification (88.7%), reticulation (64.9%), traction bronchiectasis (57.7%), septal thickening (52.6%) and honey combing (28.9%). Conclusion: We have shown that there is a relationship between anti-SCL70, disease duration, gastrointestinal system involvement and ILD in SSc patients.

The aim of the study was to compare the hand function (grip strength and grip endurance, manual dexterity, and perceived hand functional disability) of participants with gout, rheumatoid arthritis, and healthy control. Grip strength and grip endurance were assessed using a hand dynamometer, while manual dexterity was evaluated through the Nine-Hole Peg Test. Perceived hand functional disability was measured using the Duruöz Hand Index. The grip strength was similar between gout and healthy control (p>0.05). Dominant and non-dominant grip endurance in gout were lower than healthy control (p=0.008, p=0.001). The dominant placing, removing, and total Nine-Hole Peg Test time of gout compared to healthy control were higher (p=0.001, p<0.001, and p<0.001). The non-dominant placing, removing, and total Nine-Hole Peg Test time of gout were higher than healthy control (p=0.002, p=0.004, and p=0.002). The Duruöz Hand Index in gout was higher than healthy control (p=0.002), but lower than rheumatoid arthritis (p=0.008). Our findings indicate that individuals with gout experience impairments in grip strength, manual dexterity, and perceived hand function. Assessing hand function during clinical examinations of patients with gout should be considered.

Objective: The aims of this study were to compare the frequency of Helicobacter pylori between patients with rheumatoid arthritis (RA) with and without methotrexate (MTX)–related gastrointestinal system (GIS) intolerance, and to demonstrate the associated factors with such intolerance. Methods: The data of 9756 patients with RA who presented between January 2011 and December 2020 were evaluated. Methotrexate-related GIS intolerance was defined as the discontinuation of MTX owing to the dyspeptic symptoms despite supportive measures and was detected in 1742 (31.3%) patients among 5572 MTX users. A total of 390 patients with and without intolerance who had at least 1 gastroscopic evaluation were included in the final analyses. The demographic, clinical, laboratory, and pathologic characteristics of patients with and without MTX-related GIS intolerance were compared. To determine the associated factors with MTX-related GIS intolerance, logistic regression analysis was performed. Results: Of 390 patients, 160 (41.0%) patients had MTX-related GIS intolerance. According to the pathology results, the presence of H. pylori, inflammation, and activity were significantly higher in patients with MTX-related GIS intolerance (p < 0.001 for each comparison). In multivariable logistic regression analysis, the use of biologic disease-modifying antirheumatic drugs (DMARDs) or targeted synthetic DMARDs was found to be an independently associated factor for MTX-related GIS intolerance (odds ratio [OR], 3.03 for model 1; OR, 3.02 for model 2) in addition to H. pylori presence (OR, 9.13 for model 1; OR, 5.71 for model 2). Conclusions: In this study, we found that the presence of H. pylori and the use of biologic or targeted synthetic DMARDs were associated with MTX-related GIS intolerance.