Hungarian Immunology

[Functional measurements of the hand’s circulation in Raynaud’s patients]

CSIKI Zoltán, GALUSKA László, GARAI Ildikó, SZABÓ Nóra, GALAJDA Zoltán, VARGA József, ZEHER Margit

FEBRUARY 20, 2005

Hungarian Immunology - 2005;4(01)

[INTRODUCTION - In patients presenting with isolated tissue perfusion disturbance without large vessel involvement the examination of hand microcirculation is of major importance. In our study we present the results of three examination methods used for hand perfusion monitoring which measure the tissue microcirculation in different depths. PATIENTS AND METHODS - We examined 58 primary Raynaud's patients using capillary microscopy, laser doppler perfusion imaging and hand perfusion scintigraphy with Tc-99m-DTPA. From our patients 38 were smokers, 42 patients frequently suffered from headache. For the validation of our laser Doppler results we involved into the study also 16 non-smoker healthy volunteers. For the standardisation of the results the studies were performed in a climatised room. During the laser examination we performed and analysed also the post-occlusion hyperaemia test. RESULTS - In the majority of our patients no morphological alterations were found with capillary microscopy. In primary Raynaud’s patients the perfusion values measured with laser-Doppler scanner in basic condition were significantly lower both in fingers’ and palm’s regions compared to healthy controls. In the primary Raynaud’s group the smokers had significantly lower hyperaemic response than the non-smokers and we measured also significantly lower FPR (finger-to-palm ratio) values with hand perfusion scintigraphy. Both with laser doppler imaging and hand perfusion scintigraphy there was no difference between the values measured in patients with or without headache. CONCLUSIONS - We consider of benefit the functional examination of hand circulation in all diseases involving the hand microcirculation.]



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Hungarian Immunology

[Hand perfusion scintigraphy in primary and secondary Raynaud's syndrome]

GARAI Ildikó, GALUSKA László, VARGA József, SZŰCS Gabriella, CSIKI Zoltán

[INTRODUCTION - The aim of the study was to investigate the circulatory characteristics of primary and secondary Raynaud’s syndrome patients using the hand perfusion scintigraphic method developed by the Nuclear Medicine Department of the DUMHC. PATIENTS AND METHODS - The authors examined 84 patients presenting classical symptoms of the disease: episodic ischemia with three-phase color change of the fingers. After visual evaluation theyanalyzed the obtained images quantitatively, using of the finger/palm ratio. Statistical analysis comparisons were made between the clinically separated primary and the secondary Raynaud's group. RESULTS - With the visual evaluation regional perfusion disturbances were frequently found in the secondary group - 37 from 51 patients - while only 2 from 33 patients in the primery group; the difference was statistically significant (p<0,001). The results of the quantitative analysis showed that the finger/palm ratio (FPR) values were significantly lower (p<0.05) in primary Raynaud’s group. In the FPR values there were not any differences between genders or the fingers of the right and left hands. CONCLUSIONS - The hand perfusion scintigraphy applying Tc-99m-DTPA is a noninvasive, cost effective diagnostic tool, which reflects objectively the global and regional microcirculatory abnormalities of the hands, and offers quantitative data for the follow-up.]

Clinical Neuroscience

Cases of inborn errors of metabolism diagnosed in children with autism

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Autism spectrum disorder is a neurodevelopmental disorder with a heterogeneous presentation, the etiology of which is not clearly elucidated. In recent years, comorbidity has become more evident with the increase in the frequency of autism and diagnostic possibilities of inborn errors of metabolism. One hundred and seventy-nine patients with diagnosis of autism spectrum disorder who presented to the Pediatric Metabolism outpatient clinic between 01/September/2018-29/February/2020 constituted the study population. The personal information, routine and specific metabolic tests of the patients were analyzed retrospectively. Out of the 3261 patients who presented to our outpatient clinic, 179 (5.48%) were diagnosed with autism spectrum disorder and were included in the study. As a result of specific metabolic examinations performed, 6 (3.3%) patients were diagnosed with inborn errors of metabolism. Two of our patients were diagnosed with classical phenylketonuria, two with classical homocystinuria, one with mucopolysaccharidosis type 3D (Sanfilippo syndrome) and one with 3-methylchrotonyl Co-A carboxylase deficiency. Inborn errors of metabolism may rarely present with autism spectrum disorder symptoms. Careful evaluation of the history, physical examination and additional findings in patients diagnosed with autism spectrum disorder will guide the clinician in the decision-making process and chose the appropriate specific metabolic investigation. An underlying inborn errors of metabolism may be a treatable cause of autism.

Clinical Neuroscience

Late simultaneous carcinomatous meningitis, temporal bone infiltrating macro-metastasis and disseminated multi-organ micro-metastases presenting with mono-symptomatic vertigo – a clinico-pathological case reporT

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Clinical Neuroscience

Alexithymia is associated with cognitive impairment in patients with Parkinson’s disease

SENGUL Yildizhan, KOCAK Müge, CORAKCI Zeynep, SENGUL Serdar Hakan, USTUN Ismet

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