ABSTRACT
OBJECTIVES: To evaluate influenza and pneumococcal vaccine coverage in patients taking biological therapy for chronic inflammatory joint disease and to identify factors associated with the decision to administer these two vaccines. METHODS: Retrospective cross-sectional questionnaire study of a cohort of 584 patients taking biological therapy for chronic inflammatory joint disease (rheumatoid arthritis or spondyloarthritis). We studied the influenza and pneumococcal vaccine coverage rates, information about these vaccines given to patients by the primary-care physician and rheumatologist, and reasons for not administering the vaccines. RESULTS: Overall vaccine coverage rates were 44% for influenza and 62% for pneumococcus. Factors associated with being vaccinated were patient age, previous influenza vaccination, and patient information. Concern about adverse effects and absence of patient information by the primary-care physician and rheumatologist were associated with very low coverage rates. CONCLUSION: This study showed insufficient vaccine coverage rates, particularly against influenza, in a population at high risk because of exposure to biological therapy. Patient information by healthcare professionals about influenza and pneumococcal vaccination has a major impact and should be renewed as often as possible.
Subject(s)
Arthritis, Rheumatoid/complications , Biological Therapy/adverse effects , Influenza Vaccines/administration & dosage , Pneumococcal Vaccines/administration & dosage , Spondylarthritis/complications , Adult , Aged , Arthritis, Rheumatoid/drug therapy , Cross-Sectional Studies , Female , Humans , Influenza, Human/etiology , Influenza, Human/prevention & control , Male , Middle Aged , Pneumococcal Infections/etiology , Pneumococcal Infections/prevention & control , Retrospective Studies , Spondylarthritis/drug therapy , Surveys and QuestionnairesABSTRACT
Thromboangiitis obliterans (or Buerger disease) is a rare vascular disease that selectively affects young males who are inveterate smokers. We report a case in a young female smoker who presented with recurrent episodes of polyarthralgia and distal extremity ischemia. The initial diagnosis was connective tissue disease, and the correct diagnosis was established only 7 years after symptom onset. Joint manifestations are common in thromboangiitis obliterans and usually antedate the diagnosis, which should be considered in patients with superficial venous thrombosis, upper limb ischemia, or Raynaud's phenomenon. This is true even in females, as shown by the case described here.
