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Pigmented villonodular synovitis in type 1 diabetes mellitus: a cross-sectional study in Sardinian people

Carlo Doria, Giulia Raffaella Mosele, Francesca Badessi, Leonardo Puddu & Gianfilippo Caggiari

Background: To evaluate the prevalence of Pigmented Villonodular Synovitis (PVNS) in Type 1 Diabetes Mellitus (T1DM) patients in Sardinian people. Materials and Methods: In this cross-sectional study, we evaluated 578 patients T1DM attending the division of Endocrinology and Metabolism in Sassari University Hospital. Age, gender, duration of diabetes, blood pressure levels and presence of neuropathy and retinopathy were noted. Metabolic control of diabetes was evaluated with glycosylated hemoglobin A1c (HbA1c) blood concentrations. 137 of these selected patients had articular pain at least one month, recurrent joint effusion, an inability to lie on the affected joints, and restricted active and passive articular movements. All patients denied a previous trauma. In 89 cases the most affected joints were the knees; in 13 cases the shoulders and in the remaining cases the hips. All patients were submitted to pharmacological therapy with NSAIDs obtaining a good resolution of clinical symptoms in 77 cases; the remaining 60 patients underwent arthroscopy and biopsy of the synovium. As control group 60 patients were selected and underwent knee arthroscopy with biopsy of synovium. Results: The prevalence of PVNS in the group of T1DM patients was in 17 patients; the mean age was 36.4 years with significant higher incidence on males than females. The age, sex and duration of diabetes mellitus were parameters statistically significant. The results achieved from the analysis of the control group data showed a prevalence of PVNS in 6 cases with higher mean age. Conclusions: PVNS is a no rare disorder in T1DM patients in Sardinian people respect remaining population without history of diabetes mellitus. It is associated with age, sex and duration of diabetes. Although no significant association was demonstrated between PVNS and the control of diabetes the most good therapy is prophylaxis with good control of glycemic values.

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