First Case of TNF-Receptor-Associated Autoinflammatory Syndrome (TRAPS) in Bulgaria.

TRAPS is a very rare disease with an estimated prevalence of about one per million. We present a 53-year-old patient from Bulgaria. The clinical features of the disease are periodic fever, arthralgia, myalgia, rash, abdominal pain and hepatosplenomegaly.

Adherence to bisphosphonate therapy in postmenopausal osteoporotic women.

Introduction: Osteoporosis is a metabolic bone disease caused by a decrease in the bone mineral density. It is a major public health threat as it weakens bones, especially those in the wrist, spine, or hip, and causes them to break easily.

Aim: The study aimed to find how strictly postmenopausal women with osteoporosis adhere to a long-term therapy with bisphosphonates.

Correlations between arthroscopic findings and synovial membrane histology in patients with rheumatoid synovitis of the knee joint.

Unlabelled: Correlation and agreement between the diagnostic results of arthroscopic and histological examinations of the synovial membrane in rheumatoid synovitis of the knee joint have been discussed in small number of studies with contradictory conclusions.

Aim: The aim of the present study was to determine the correlation between the arthroscopic characteristics and histology of the synovial membrane in patients with rheumatoid arthritis and synovitis of the knee joint.

Methods: Sixty-four arthroscopies of the knee joint with guided multiple synovial biopsies were performed in patients with rheumatoid synovitis.

Minor and major complications of arthroscopic synovectomy of the knee joint performed by rheumatologist.

Unlabelled: The aim of the study was to analyze the type and incidence of major and minor complications resulting from arthroscopy with arthroscopic synovectomy of the knee joint performed by rheumatologist in different rheumatological diseases.

Methods: In a prospective study the incidence of complications in arthroscopic subtotal synovectomy with subsequent tidal flow lavage was analyzed in 201 rheumatic patients. The arthroscopic synovectomies were performed by one team of rheumatologists in the operation room of the University Clinic of Rheumatology in the town of Plovdiv for a period of 8-9 years.

Leflunomide in the treatment of refractory rheumatoid arthritis.

Unlabelled: Leflunomide (LFL) is a modern immunomodulating medication belonging to the group of drugs that favourably affect the course of rheumatoid arthritis (RA). We present in this study the results of an open prospective trial on the effectiveness and side effects of LFL in clinically followed up patients with active RA refractory to other disease modifying anti-rheumatic drugs (DMARDS). At the onset of treatment with LFL the patients had at least 8 swollen and tender joints, the disease severity being assessed by both patients and physicians as over 3 cm VAS.

Serologic markers of early rheumatoid arthritis.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that affects symmetrically multiple joints. Recent therapeutic strategy has been focusing on the symptoms of the disease and the ways to prevent its progression as early as possible. Thus, early diagnosis is crucial since early therapy with disease-modifying anti-rheumatic drugs reduces the severity of joint damage.

Wrist tuberculosis in cladribine--induced remission of hairy cell leukosis.

A 45-year-old man with "hand-shoulder" syndrome developing eight-months after Cladribine-induced remission of an 11-year-old hairy cell leukosis is presented. Wrist bone biopsy was performed because of failure of the algodystrophy treatment and radiographic findings of progressive osteoporosis. Caseating epiteloid granulomas abundant in Langhans cells were found histologically and later Mycobacterium tuberculosis species was isolated in culture specimen.

Differential diagnosis of Kikuchi's disease and systemic lupus erythematosus lymphadenopathy: clinicopathologic algorithm.

The authors have described the first case of Kikuchi's disease in Bulgaria. The present study gives the clinicopathologic algorithm compiled by them to make the correct diagnosis and differentiate Kikuchi's disease from systemic lupus erythematosus lymphadenopathy.

Relevance between arthroscopic pathology and clinical characteristics in knee osteoarthritis.

Unlabelled: Arthroscopy can be used to identify accurately cartilage and synovial changes in knee osteoarthritis (OA). The objective of this study was to find the correlation between arthroscopically established knee chondropathy and synovitis and the corresponding algofunctional characteristics in OA.

Methods: 41 patients with OA in only one knee joint were investigated.

Three month treatment of reactive arthritis with azithromycin: a EULAR double blind, placebo controlled study.

Objective: To determine the efficacy of weekly treatment with oral azithromycin for 13 weeks on the severity and resolution of reactive arthritis (ReA).

Methods: 186 patients from 12 countries were enrolled in a randomised, double blind, placebo controlled trial. Inclusion criteria were inflammatory arthritis of < or =6 swollen joints, and disease duration of < or =2 months.

[Blood serum and synovial fluid proteins in Reiter's syndrome].

Individual proteins (transferrin, ceruloplasmin, alpha 2-macroglobulin, IgG, IgA and IgM) were examined in blood and synovial fluid of 11 patients with Reiter's syndrome. ARA-1981 was used as a diagnostic criteria. The control group included 40 patients with rheumatoid arthritis and 31 with osteoarthrosis of the knee joint.

[Reiter's syndrome: the clinico-histomorphological correlations].

A total of 11 patients with Reiter's syndrome underwent puncture biopsy of the synovial membrane of the knee joint. At the early stage of the disease the patients showed hyperemia, edema, infiltration with neutrophilic leukocytes, lymphocytes and plasmacytes. At the later stage diffuse and focal infiltrates of lymphocytes and plasmacytes and a rise of the fibrocyte count were predominant.

[The sensitivity and specificity of the ARA diagnostic criteria for osteoarthrosis of the knee joint (1986). American Rheumatism Association].

The sensitivity and specificity of the ARA criteria for osteoarthrosis of the knee joint (1986) were studied in 61 clinically ill patients. It was established that the diagnostic sensitivity and specificity for the group of clinical and laboratory criteria is 89.2% and 75% respectively, for the clinical and roentgenologic--91.

[Intravenous pulsed therapy with prednisolone hemisuccinate in severe forms of systemic lupus erythematosus].

The intravenous pulsed treatment with prednisone hemisuccinate of severe forms of systemic lupus erythematosus influences favorably the basic clinical manifestations of the disease--polyarthritis, fever, vasculitis, myocarditis, sialoadenitis. Prednisolone is as efficient as methylprednisolone in the pulsed treatment of patients with systemic lupus erythematosus.

[Circadian rhythm of uric acid levels of the serum in gout].

Uric acid concentration in the serum was investigated 3 times a day using the uricase method in 15 gout inpatients on a hypopurine diet with age- and sex-adjusted caloric content. The highest uric acid concentration was noted at 7 a. m.

[Hamman-Rich syndrome].

The clinical picture and pathologoanatomical changes of one case with Hamman--Rich syndrome are described, with the diagnosis made while still living of a middle aged woman, textile worker with a subchronic course of the disease. The role of the organic textile dust is admitted to be the triggering factor for the development of the disease according to the mechanism of autoallergization.

[Rheumatoid arthritis among the rural population of southern Bulgaria (transitory morbidity established using the Rome and New York diagnostic criteria)].

Examinations of 5021 subjects (2779 females and 2242 males) were carried out with a view to rheumatoid arthritis. En masse examinations of the population over the age of 20 were carried out in eight villages of South Bulgaria. Making use of the Roman diagnostic criteria, rheumatoid arthritis--probable form, was found in 1.