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Blom A, van den Bosch M, Cats H, van den Hoogen F, Lafeber F, van den Berg W, van Lent P, van der Kraan P. OP0028 Association of Differential Synovial Expression Patterns in Early Osteoarthritis with Pain and Progression of Joint Damage. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Lesuis N, van Vliet J, Boers N, den Broeder N, Cats H, Hulscher MEJL, Verrips A, den Broeder AA. The value of routine creatine kinase and thyroid stimulating hormone testing in patients with suspected fibromyalgia: a cross-sectional study. Rheumatology (Oxford) 2016; 55:1273-6. [PMID: 27032423 DOI: 10.1093/rheumatology/kew046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The aim was to examine the prevalence of abnormal creatine kinase (CK) and thyroid stimulating hormone (TSH) values and previously unknown myopathy or thyroid disease in patients with suspected FM syndrome (FMS). METHODS All adult patients with suspected FMS referred to the study hospital between November 2011 and April 2014 could participate. Patients with a history of myopathy or a previous diagnosis of thyroid disorder were excluded. Outcome measures were the percentages of abnormal CK and TSH values and the final diagnosis in those patients. RESULTS Three hundred and seventy-three patients were included in this study (94% female, mean age 42 years). Of these patients, 7.5% (95% CI: 5.2, 10.6%) had an abnormal CK according to the local reference values. Applying the European Federation of the Neurological Societies guideline, this changed to 0.5% (95% CI: 0.2, 1.9%). In none of these patients was hyperCKaemia-related myopathy diagnosed, and the final diagnosis was FMS in 89% of the patients. Of the total number of patients, 3.5% (95% CI: 2.1, 5.9%) had an elevated TSH and 1.4% (95 CI: 0.6, 3.1%) a lowered TSH, with one patient having a somewhat lowered free thyroid hormone level. The final diagnosis was FMS in all these patients. CONCLUSION Abnormal CK and TSH values are rare in patients with suspected FMS and do not result in an alternative diagnosis. Therefore, it seems that routine testing of CK and TSH levels in patients with suspected FMS referred to secondary care does not contribute to the diagnostic process.
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Affiliation(s)
| | | | - Nadine Boers
- Department of Rheumatology, Sint Maartenskliniek
| | | | - Hans Cats
- Department of Rheumatology, Sint Maartenskliniek
| | - Marlies E J L Hulscher
- Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Aad Verrips
- Department of Neurology, Canisius Wilhelmina Ziekenhuis and
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Blom A, van den Bosch M, Cats H, van den Hoogen F, Lafeber F, van den Berg W, van Lent P, van der Kraan P. THU0011 Early Osteoarthritis Patients with Progression of Cartilage Damage or Osteophyte Formation Show Different Synovial Expression Patterns. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Blom A, van Lent P, van den Bosch M, Cats H, van den Hoogen F, Lafeber F, van der Kraan P, van den Berg W. THU0455 Transcriptomics to Identify Synovial Genes and Pathways Associated with Disease Progression in A Cohort of Early Osteoarthritis Patients (CHECK). Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Blom A, van Lent P, van den Bosch M, Cats H, van der Kraan P, van den Berg W. SAT0003 Microarray studies of synovial tissue of early human (CHECK) and experimental OA identify pathways and processes associated with cartilage damage. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Vriezekolk JE, Geenen R, van den Venne SA, Peters A, Cats H, van den Ende CH. THU0588 Health Care Visits in Fibromyalgia are Associated with Partner and Family Responses. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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van Lent PLEM, Blom AB, Schelbergen RFP, Slöetjes A, Lafeber FPJG, Lems WF, Cats H, Vogl T, Roth J, van den Berg WB. Active involvement of alarmins S100A8 and S100A9 in the regulation of synovial activation and joint destruction during mouse and human osteoarthritis. ACTA ACUST UNITED AC 2012; 64:1466-76. [PMID: 22143922 DOI: 10.1002/art.34315] [Citation(s) in RCA: 152] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE To investigate whether alarmins S100A8 and S100A9 are involved in mediating cartilage destruction during murine and human osteoarthritis (OA). METHODS Two different murine models of OA that differed in terms of synovial activation were compared. Cartilage destruction was measured histologically. Synovial biopsy and serum samples from OA patients were derived from the Cohort Hip and Cohort Knee (CHECK) patients with symptomatic early OA. Expression of mediators in the synovium was measured by reverse transcription-polymerase chain reaction analysis and immunolocalization. RESULTS In collagenase-induced OA, which showed marked synovial activation, interleukin-1β was expressed at significant levels only during the early stages of disease, whereas S100A8 and S100A9 expression remained high for a prolonged period of time (up to day 21 after induction). In S100A9-knockout mice, we found a major impact of S100A8 and S100A9 on synovial activation (62% inhibition) and OA cartilage destruction (45-73% inhibition) as compared to wild-type controls. In contrast, in the surgically induced destabilized medial meniscus model, in which synovial involvement is scant, we found no role of S100A8 and S100A9 in the focal OA cartilage destruction. Examination of arthroscopic synovial biopsy samples from patients in the early symptomatic OA CHECK cohort revealed substantial levels of S100A8 and S100A9 messenger RNA and protein, which correlated significantly with synovial lining thickness, cellularity in the subintima, and joint destruction. Levels of S100A8/A9 serum protein were significantly enhanced (19%) at baseline in patients who had pronounced progression of joint destruction after 2 years. CONCLUSION Our data suggest that the S100A8 and S100A9 proteins are crucially involved in synovial activation and cartilage destruction during OA and that high levels may predict joint destruction in humans with OA.
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Stukstette MJPM, Hoogeboom TJ, de Ruiter R, Koelmans P, Veerman E, den Broeder AA, Cats H, Bijlsma JW, Dekker J, van den Ende CHM. A multidisciplinary and multidimensional intervention for patients with hand osteoarthritis. Clin Rehabil 2012; 26:99-110. [DOI: 10.1177/0269215511417739] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Although several guidelines recommend that treatment programmes in patients with hand osteoarthritis should be both multidisciplinary and multidimensional, currently no such treatment programme for hand osteoarthritis has been described. Therefore the aim of this study was to systematically develop a multidisciplinary and multidimensional non-pharmacological treatment programme and to give a detailed description on the content of this treatment programme. Development of the treatment programme: The programme was developed in phases. In a preclinical theoretical phase, disease-specific problems, current evidence and the influence of patient characteristics on the benefit of interventions were explored. In a modelling phase, the treatment programme was designed. Treatment programme: The programme contains an individual intake, four weekly nurse and occupational therapist-led group sessions and a booster session after six months. Treatment components of the programme are self-management, daily home exercises to enhance joint mobility and grip strength and education about ergonomic principles. The treatment programme is tailored to the needs of individual patients with hand osteoarthritis. Conclusions: A non-pharmacological multidisciplinary and multidimensional treatment programme for patients with hand osteoarthritis was developed. Further research is necessary to investigate the effectiveness of this treatment programme. Currently, the programme is being evaluated in an ongoing randomized clinical trial.
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Affiliation(s)
- MJPM Stukstette
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - TJ Hoogeboom
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - R de Ruiter
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - P Koelmans
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - E Veerman
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - AA den Broeder
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - H Cats
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - JW Bijlsma
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - J Dekker
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - CHM van den Ende
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands
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van Koulil S, van Lankveld W, Kraaimaat FW, van Helmond T, Vedder A, van Hoorn H, Donders ART, Wirken L, Cats H, van Riel PLCM, Evers AWM. Tailored cognitive-behavioural therapy and exercise training improves the physical fitness of patients with fibromyalgia. Ann Rheum Dis 2011; 70:2131-3. [DOI: 10.1136/ard.2010.148577] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van Koulil S, Kraaimaat FW, van Lankveld W, van Helmond T, Vedder A, van Hoorn H, Donders ART, Thieme K, Cats H, van Riel PLCM, Evers AWM. Cognitive-behavioral mechanisms in a pain-avoidance and a pain-persistence treatment for high-risk fibromyalgia patients. Arthritis Care Res (Hoboken) 2011; 63:800-7. [PMID: 21312345 DOI: 10.1002/acr.20445] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The heterogeneity of cognitive-behavioral patterns in patients with fibromyalgia (FM) has been proposed to underlie the variability in treatment outcomes. It has previously been shown that pain-avoidance and pain-persistence treatments tailored to the patient's pattern are effective in improving physical and psychological functioning and overall impact in high-risk patients with heightened psychological distress. In the present study, the cognitive-behavioral effects of these treatments were evaluated to provide insight into the main proposed mechanisms, specifically pain-avoidance behaviors and activity pacing in the pain-avoidance and pain-persistence treatments, respectively. METHODS High-risk FM patients were classified into 2 groups, pain avoidance and pain persistence, and randomized in groups to the relevant treatment or waiting-list control condition. The pain-avoidance and pain-persistence treatments both comprised 16 twice-weekly sessions of cognitive-behavioral therapy and exercise training. Cognitive--behavioral factors assessed at pre- and posttreatment and 6 months of followup were evaluated using linear mixed models. RESULTS A significant treatment effect was found for pain-avoidance behavior in the pain-avoidance treatment and for activity pacing in the pain-persistence treatment, showing improvements in the treatment condition relative to the controls. Furthermore, the effect on functioning was mediated by changes in pain-avoidance behavior in the pain-avoidance treatment and by changes in activity pacing in the pain-persistence treatment. Both treatments also showed significant improvements in other relevant cognitive-behavioral factors. CONCLUSION Both the pain-avoidance and pain-persistence treatments are effective in improving cognitive-behavioral factors in high-risk FM patients. Pain-avoidance behavior and activity pacing might be important mediating mechanisms for beneficial outcomes in pain-avoidance and pain-persistence treatments, respectively.
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Affiliation(s)
- S van Koulil
- Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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van Koulil S, Kraaimaat FW, van Lankveld W, van Helmond T, Vedder A, van Hoorn H, Cats H, van Riel PLCM, Evers AWM. Screening for pain-persistence and pain-avoidance patterns in fibromyalgia. Int J Behav Med 2008; 15:211-20. [PMID: 18696315 DOI: 10.1080/10705500802222964] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The heterogeneity of patients regarding pain-related cognitive-behavioral mechanisms, such as pain-avoidance and pain-persistence patterns, has been proposed to underlie varying treatment outcomes in patients with fibromyalgia (FM). PURPOSE To investigate the validity of a screening instrument to discriminate between pain-persistence and pain-avoidance patterns in FM. METHOD In a three-part study, a self-reported screening instrument that assesses pain-avoidance behavior was used to distinguish patients with pain-persistence and pain-avoidance patterns. The resultant groups were compared with regard to several pain-related cognitive-behavioral factors, performance on a physical fitness test, and with regard to the judgments of trained therapists based on a semi-structured interview. RESULTS The validity of the screening instrument to distinguish between pain-avoidance and pain-persistence patterns was supported by other validated self-report questionnaires for pain-related cognitive-behavioral factors, physical exercise tests, as well as by a high correspondence with blinded therapist judgment after intake assessments. CONCLUSION These findings suggest that a short self-report screening instrument can be used to distinguish between pain-avoidance and pain-persistence patterns within the heterogeneous population of FM patients, which offers promising possibilities to improve treatment efficacy by tailoring treatment to specific patient patterns.
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Affiliation(s)
- S van Koulil
- Department of Medical Psychology, Nijmegen Medical Center, Radboud University, Nijmegen, The Netherlands.
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van Koulil S, van Lankveld W, Kraaimaat FW, van Helmond T, Vedder A, van Hoorn H, Cats H, van Riel PLCM, Evers AWM. Tailored cognitive-behavioral therapy for fibromyalgia: two case studies. Patient Educ Couns 2008; 71:308-314. [PMID: 18187283 DOI: 10.1016/j.pec.2007.11.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2007] [Revised: 11/19/2007] [Accepted: 11/25/2007] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To illustrate a multidisciplinary group treatment for patients with fibromyalgia (FM) tailored to the patient's cognitive-behavioral pattern. METHOD In a case-study design the tailored treatment approaches of two FM patients were described. One patient characterized by avoidance behavior (pain-avoidance pattern) participated in a group treatment aimed at changing pain-avoidance mechanisms and one patient characterized by continuing with activities in spite of pain (pain-persistence pattern) participated in a group treatment aimed at changing pain-persistence mechanisms. Assessments were made at baseline, post-treatment and at 6-months follow-up. RESULTS Comparison of the pretest, post-test and follow-up scores on pain, functional disability, fatigue and psychological distress showed clinically significant improvements for both patients. CONCLUSION The heterogeneity of patients regarding pain-related cognitive-behavioral mechanisms has been proposed to underlie varying treatment outcomes in FM patients. These results demonstrate that a group treatment tailored to pain-avoidance and pain-persistence patterns is feasible and can result in clinically significant changes for FM patients. PRACTICE IMPLICATIONS FM offers a great challenge for clinicians due to the lack of effective treatment options. These case studies suggests that tailored CBT and exercise training directed at specific patient patterns can contribute to the improvement of the care of FM patients.
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Affiliation(s)
- S van Koulil
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
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van Laarhoven AIM, Kraaimaat FW, Wilder-Smith OH, van de Kerkhof PCM, Cats H, van Riel PLCM, Evers AWM. Generalized and symptom-specific sensitization of chronic itch and pain. J Eur Acad Dermatol Venereol 2008; 21:1187-92. [PMID: 17894703 DOI: 10.1111/j.1468-3083.2007.02215.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Physicians are frequently confronted with patients reporting severe itch and pain. Particularly in patients suffering from persistent itch and pain, central and peripheral sensitization processes are assumed to be involved in the long-term maintenance and aggravation of the symptoms. The present study explores generalized and symptom-specific sensitization processes in patients suffering from persistent itch and pain. Specifically, it examines whether patients with chronic itch and pain are more sensitive to somatosensory stimuli (generalized sensitization) and simultaneously perceive somatosensory stimuli as a symptom of their main physical complaint, e.g. pain in chronic pain patients (symptom-specific sensitization). METHODS Thresholds for different mechanical and electrical sensory stimuli of Quantitative Sensory Testing were determined in 15 female patients suffering from chronic itch associated with atopic dermatitis, 15 female chronic pain patients diagnosed with fibromyalgia, and 19 female healthy controls. Intensities of itch and pain sensations were rated on a visual analogue scale. RESULTS As expected, the patient groups had significantly lower tolerance thresholds for the somatosensory stimuli applied than the healthy controls, supporting generalized sensitization. Moreover, patients with chronic itch consistently reported more itch, while patients with chronic pain partly reported more pain in response to analogous somatosensory stimuli than the healthy controls and the other patient group, indicating symptom-specific sensitization. CONCLUSION The present study provides preliminary support that both generalized and symptom-specific sensitization processes play a role in the regulation and processing of somatosensory stimulation of patients with chronic itch and pain.
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Affiliation(s)
- A I M van Laarhoven
- Department of Medical Psychology, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands
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van Koulil S, Effting M, Kraaimaat FW, van Lankveld W, van Helmond T, Cats H, van Riel PLCM, de Jong AJL, Haverman JF, Evers AWM. Cognitive-behavioural therapies and exercise programmes for patients with fibromyalgia: state of the art and future directions. Ann Rheum Dis 2007; 66:571-81. [PMID: 16916856 PMCID: PMC1954607 DOI: 10.1136/ard.2006.054692] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2006] [Indexed: 12/21/2022]
Abstract
This review provides an overview of the effects of non-pharmacological treatments for patients with fibromyalgia (FM), including cognitive-behavioural therapy, exercise training programmes, or a combination of the two. After summarising and discussing preliminary evidence of the rationale of non-pharmacological treatment in patients with FM, we reviewed randomised, controlled trials for possible predictors of the success of treatment such as patient and treatment characteristics. In spite of support for their suitability in FM, the effects of non-pharmacological interventions are limited and positive outcomes largely disappear in the long term. However, within the various populations with FM, treatment outcomes showed considerable individual variations. In particular, specific subgroups of patients characterised by relatively high levels of psychological distress seem to benefit most from non-pharmacological interventions. Preliminary evidence of retrospective treatment analyses suggests that the efficacy may be enhanced by offering tailored treatment approaches at an early stage to patients who are at risk of developing chronic physical and psychological impairments.
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Affiliation(s)
- S van Koulil
- Department of Medical Psychology, Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands.
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Nauta JM, Timmenga NM, Cats H. [Peripheral facial nerve palsy]. Ned Tijdschr Tandheelkd 1993; 100:183-4. [PMID: 11908448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
There are different etiological factors concerning the acute peripheral facial nerve palsy. In the majority of the cases, however, no etiological factor can be found. These cases are called idiopathic facial palsy or Bells palsy. Perhaps local anaesthetics could play a role as an etiological factor. By means of a case-report this form of facial nerve palsy will be discussed.
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Affiliation(s)
- J M Nauta
- Kliniek voor Mondziekten, Kaakchirurgie en Bizondere Tandheelkunde en Academisch Ziekenhuis te Groningen
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Veldhuizen JA, de Wolf JT, Buiter CT, Cats H. [Epistaxis caused by an acquired thrombocytopathy]. Ned Tijdschr Geneeskd 1989; 133:622-4. [PMID: 2716879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Epistaxis may be the sole manifestation of a platelet aggregation dysfunction. Bleeding time according to Ivy within normal ranges does not exclude a severe disturbance of primary haemostasis. In two women (aged 53 and 76 yr, respectively) persistent epistaxis could not be stopped by local therapy. The bleeding time according to Ivy was within normal ranges in both cases. In one patient a bleeding disorder was not recognized as laboratory screening tests were normal and her situation became life-threatening. Anamnesis, clinical history and platelet aggregation tests led to the correct diagnosis; in one patient the relation with acetylsalicylic acid treatment was clear. After administration of platelet concentrate the bleeding stopped within a few hours in both cases and did not recur.
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Abstract
A 58-year-old woman developed Gradenigo's syndrome. The clinical signs and symptoms of the otitis were rather atypical and there was a considerable delay before the correct diagnosis was made. The pathophysiology, therapy and differential diagnosis of this syndrome, which has become rare since the introduction of antibiotics, are discussed.
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Affiliation(s)
- J de Graaf
- Department of Neurology, University Hospital Groningen, The Netherlands
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