RESUMO
Leukocytapheresis (LCAP) is effective in treating rheumatoid arthritis (RA). Ultrasound (US) examination of joints is useful for evaluating disease activity and therapeutic effects in RA, but the clinical assessment of LCAP therapy with US has been little reported. We investigated the usefulness of US for evaluating the effects of LCAP in patients with RA. US examination was performed in six patients (total of seven cases) who underwent LCAP. Twenty-eight joints (bilateral shoulders, elbows, wrists, 1st to 5th metacarpophalangeal joints, 1st to 5th proximal interphalangeal joints, and knee joints) were evaluated by a systematic multiplanar grey-scale and power Doppler (PD) examination. Disease activity of RA was evaluated using the 28-joint Disease Activity Score with erythrocyte sedimentation rate (DAS28-ESR). Moderate or good responses to LCAP based on the DAS28-ESR were observed in four of the seven cases although C-reactive protein (CRP) and ESR did not decrease. LCAP significantly reduced the mean total PD score 17.3 ± 11.6 to 13.0 ± 10.5 (P = 0.0469). The total PD score decreased in six of the seven cases, and the number of joints with PD score ≥ 2 decreased in five of the seven cases. The rate of decrease in the number of joints with PD score ≥ 2 correlated strongly with the DAS28-ESR and its components, especially swollen joint counts and evaluator's global assessment, but not with the rate of decrease in CRP and ESR. US imaging of joints may be useful for evaluating the therapeutic effects of LCAP on RA compared to other inflammatory parameters.
Assuntos
Artrite Reumatoide/terapia , Proteína C-Reativa/metabolismo , Leucaférese/métodos , Ultrassonografia Doppler/métodos , Idoso , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/fisiopatologia , Sedimentação Sanguínea , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Subcapsral prostatectomy was performed in a 75-year-old male, with the diagnosis of benign prostatic hyperplasia. Total prostate volume was 105 ml by transrectal ultrasonography (TRUS) and the excised prostate weighed in 90 g. After the surgery, he recovered from urinary disturbance once, but, he again complained of severe dysuria 12 days after the surgery. With the aim of non-invasive examination, we performed TRUS at voiding. Urethral stricture was definitely diagnosed using TRUS during micturition. Thus voiding TRUS was very effective in diagnosing urethral stricture.
