Alexis Kitsos

A 3-year old girl presented to the emergency department with high fever, irritability and moderate disturbance of consciousness. Laboratory tests did not show abnormal serum chemistry or inflammatory markers. Analysis of cerebrospinal fluid (CSF) showed a normal cell count and slightly elevated protein. Acute encephalopathy was suspected and a brain-MRI was performed (Fig. 1, 2). Polymerase chain reaction (PCR) test for herpes was negative, while PCR analysis of nasopharyngeal secretions confirmed the presence of influenza-A, H1N1. The child was treated with oseltamivir for 10 days. Her conscious level gradually improved. A follow-up MRI was performed after six months (Fig. 3, 4).

Purpose: White matter (WM) abnormalities may occur in patients with pseudoexfoliation syndrome (PXS). The presence of gray matter (GM) abnormalities in patients with PXS without glaucoma was evaluated, applying histogram and brain surface analysis of MRI data. Material and Methods: Brain MRI was conducted on 20 patients newly diagnosed with PXS without glaucoma, (mean age 68.7 ± 8.6 years) and 14 control subjects (mean age 63.3 ± 6.6 years). The histogram scalars of mean diffusivity (MD) and fractional anisotropy (FA) of GM and WM were evaluated. Brain surface analysis was performed on 3D T1-weighted images. Results: The MD value of the WM showed higher mean, standard deviation, median and 75 th percentile in the patients than in the control subjects. The FA values of GM showed higher mean, standard deviation, median and 75 th percentile, and lower kurtosis and skewness in the patients than in the control subjects. Greater GM volume was observed in the patients in Brodmann areas 25 ...

A 3-year old girl presented to the emergency department with high fever, irritability and moderate disturbance of consciousness. Laboratory tests did not show abnormal serum chemistry or inflammatory markers. Analysis of cerebrospinal fluid (CSF) showed a normal cell count and slightly elevated protein. Acute encephalopathy was suspected and a brain-MRI was performed (Fig. 1, 2). Polymerase chain reaction (PCR) test for herpes was negative, while PCR analysis of nasopharyngeal secretions confirmed the presence of influenza-A, H1N1. The child was treated with oseltamivir for 10 days. Her conscious level gradually improved. A follow-up MRI was performed after six months (Fig. 3, 4).

ABSTRACT Background Chronic arthritis, particularly rheumatoid arthritis (RA), has been associated with accelerated atherosclerosis. Ultrasound-assessed carotid intima-media thickness (IMT) has been suggested as a surrogate marker of atherosclerosis and the risk for future cardiovascular events. An increased IMT has been observed in patients with RA, but also ankylosing spondylitis (AS) and psoriatic arthritis (PsA) as compared to non-arthritis controls in various ethnic groups. Objectives To study subclinical atherosclerosis in Greek patients with spondyloarthritis (SpA). Methods In a case-control study, non-diabetic patients with AS or PsA followed in a single tertiary Rheumatology center were evaluated for potentially modifiable risk factors for atherosclerosis (obesity, smoking, arterial hypertension, serum lipids and lipoproteins), while they all underwent carotid ultrasonography and measurement of carotid IMT. Age- and sex-matched volunteers without arthritis or diabetes served as controls. Results Forty-nine patients were examined (22 with AS, 27 with PsA). They were 35 males and 14 females with a mean age (SD) 45.5 (12.4) years. They were compared to 49 age- and gender-matched controls. The patients’ mean (SD) carotid IMT was 0.071 (0.018) cm, which was significantly greater than the carotid IMT of the controls [mean (SD) 0.063 (0.016) cm, p=0.017]. Comparing the potentially modifiable cardiovascular risk factors, SpA patients were no more obese than controls in terms of body mass index or waist-to-hip ratio, they had a similar prevalence of hypertension, but they were significantly more often smokers than controls (69.4% vs 26.5%, p=0.02). In terms of lipid profile, SpA patients had significantly lower triglyceride levels than controls (103 mg/dL vs 131.1 mg/dL, p=0.012), but the levels of the rest of the lipid parameters [total cholesterol, high and low density lipoprotein cholesterol, Apolipoprotein AI (ApoAI), ApoB, ApoE, Lipoprotein (α)] were similar between patients and controls. Conclusions Patients with spondyloarthritis have enhanced atherosclerosis compared to non-SpA controls. Although differential exposure to cigarette smoking is a significant confounding factor, our results are in line with reports from other ethnic groups suggesting that SpA patients have more advanced atherosclerosis compared to age-and sex-matched non-SpA controls. Disclosure of Interest None Declared