Marek Brzosko

Publications of Marek Brzosko

• Antiphospholipid Antibodies and Their Association with Atherosclerotic Changes in Patients with Systemic Lupus Erythematosus � Review of Literature and Own Experiences

  Authors: Katarzyna Fischer, Jacek Flicinnski, Marek Brzosko

  04/2012;

  ISBN: 978-953-51-0526-8

• The distribution of human endogenous retrovirus K-113 in health and autoimmune diseases in Poland.

  Authors: Maja Krzysztalowska-Wawrzyniak, Magdalena Ostanek, Jeremy Clark, Agnieszka Binczak-Kuleta, Lidia Ostanek, Mariusz Kaczmarczyk, Beata Loniewska, Lucjan S Wyrwicz, Marek Brzosko, Andrzej Ciechanowicz

  Rheumatology (Oxford, England). 02/2011; 50(7):1310-4.

  During the evolution of the human genome, a number of retroviral integrations have occurred creating a group of human endogenous retroviruses (HERVs). As of now several studies have pointed to theDuring the evolution of the human genome, a number of retroviral integrations have occurred creating a group of human endogenous retroviruses (HERVs). As of now several studies have pointed to the association of HERVs with certain autoimmune diseases such as RA, SLE, multiple sclerosis (MS) and SS as well as various neoplasms. In this study, we investigated the prevalence of HERV-K113 in patients with RA, SLE and in healthy subjects in the Polish population. Genomic DNA samples from 155 RA patients, 139 SLE patients and 261 newborns (as controls) were tested for the presence of the HERV-K113 allele using PCR. Each individual's DNA was genotyped for null, homozygous or heterozygous insertion of HERV-K113. Our data revealed statistically significant differences in the insertion frequencies of HERV-K113 between the groups of RA and SLE patients vs healthy controls (provirus DNA was found in 14.19, 15.11 and 8.05% of individuals, respectively). No homozygous individuals for the K113 allele were found in each of the groups. There was no evidence for HERV-K113 association with clinical features in either group. Our study-the first such performed for the Polish population-provides a consistent observation with previous reports on the genetic association of HERV-K113 integrations in autoimmune disorders. Here, we found that the prevalence of insertionally polymorphic HERV-K113 was significantly increased in Polish patients with SLE and RA.

• Polyarteritis nodosa and Sjögren's syndrome: overlap syndrome.

  Authors: Krzysztof Prajs, Danuta Bobrowska-Snarska, Magdalena Skała, Marek Brzosko

  Rheumatology international. 05/2010;

  Polyarteritis nodosa (PAN) belongs to a group of necrotic angiitis. During the illness, necrotic changes are found in small and middle dimensions arteries. Primary Sjögren's syndrome is a chronic,Polyarteritis nodosa (PAN) belongs to a group of necrotic angiitis. During the illness, necrotic changes are found in small and middle dimensions arteries. Primary Sjögren's syndrome is a chronic, autoimmunological systematic illness of connective tissue with characteristic infiltration of lymphocytes and plasmatic cells in endocrine glands. Despite the fact that both disease entities are well known and primary Sjögren's syndrome is the second most commonly appearing autoimmunological sickness, the coexistence of both simultaneously is described very rarely. So far only three such cases have been presented. The case of 53-year-old woman is presented, who since 2003 has been hospitalized due to her ailments several times, at surgery, internal medicine, and rheumatology wards. In 2006, she was admitted to rheumatology clinic of Pomeranian Medical University (PAM) to be diagnosed both subjectively and objectively. Additional examinations proved that she had been suffering from overlapping PAN and primary Sjögren's syndrome (PSS). She fulfilled 5 out of 10 criteria for PAN and all criteria for PSS. For treatment the boluses of methyloprednisolon and cyclophosphamid every 4 weeks were used what resulted in curing the patient.

• [Cardiovascular manifestations of seronegative inflammatory spondyloarthropathies].

  Authors: Hanna Przepiera-Bedzak, Iwona Brzosko, Małgorzata Peregud-Pogorzelska, Marek Wódecki, Marek Brzosko

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:62-5.

  Cardiovascular manifestations of seronegative spondyloarthropathies represent an important clinical problem which has not been fully elucidated. Clinically significant cardiovascular symptoms areCardiovascular manifestations of seronegative spondyloarthropathies represent an important clinical problem which has not been fully elucidated. Clinically significant cardiovascular symptoms are present in 10% of patients with ankylosing spondylitis (AS), usually in the case of long-standing disease. The following echocardiographic abnormalities have been reported in AS: ascending aortitis, aortic insufficiency (1-34%), mitral insufficiency (1-76%), mitral valve prolapse (5.7-10%), and diastolic dysfunction (20-50%). Abnormalities of the cardiac conduction system may develop in 1% to 33% of AS patients as a consequence of postinflammatory scarring of the myocardium. Cardiovascular diseases are the leading cause of death (36.2%) of patients with psoriatic arthritis (PsA). The risk of death in PsA is 1.3 times greater than in the general population. The following echocardiographic abnormalities can be seen in PsA: fibrinous pericarditis (18.2%), myocarditis (15.9%), and valvular disease (5.7%). Diastolic dysfunction in PsA correlates with the presence of articular lesions and duration of psoriasis. The importance of a thorough investigation of the cardiovascular system in patients with seronegative spondyloarthropathies is emphasized.

• Ocular circulation in systemic lupus erythematosus.

  Authors: Monika Modrzejewska, Lidia Ostanek, Danuta Bobrowska-Snarska, Danuta Karczewicz, Grazyna Wilk, Marek Brzosko, Alon Harris

  Medical science monitor : international medical journal of experimental and clinical research. 11/2009; 15(11):CR573-8.

  BACKGROUND: Mean vascular resistance in the retrobulbar arteries of SLE patients and the statistical relationship between its parameters and the presence of certain antibodies were determined.BACKGROUND: Mean vascular resistance in the retrobulbar arteries of SLE patients and the statistical relationship between its parameters and the presence of certain antibodies were determined. MATERIAL/METHODS: Forty-three eyes of 43 SLE female patients aged 46.28+/-8.45 years with disease duration of 10.03+/-7.96 years were examined. Physical and ophthalmic examinations with assessments of the immunological markers ANA/IgG-IgM, aCL, anti-beta2GPI, LA, and anti-dsDNA antibodies were performed. color Doppler imaging (CDI) was used in the OA, CRA, LPCA, and MPCA vessels. The vascular resistance indices (RIs) were compared with those of 43 eyes of 43 female controls. Covariance and multiple regression analysis with chi squared, Pearson, Shapiro-Wilk, and Levene tests were used in the statistical analysis (significance levels at p<or=0.01 and p<or=0.05). RESULTS: Significantly increased RIs in the OA, CRA, LPCA, and MPCA were recorded. aCL, abeta2GPI, and LAC correlated significantly with increased RI in the CRA. SLE diagnosis significantly correlated with RI in the OA and PCAs. Significant relationship between age and RI in the CRA and LPCA was detected. CONCLUSIONS: Retrobulbar resistance disturbances were detected in SLE patients by CDI. SLE diagnoses and presence of aPLs antibodies were associated with an increased resistivity index in ophthalmic and retino-choroidal vessels.

• Diagnosis of early atherosclerotic lesions, and selected atherosclerotic risk factors, in patients with systemic lupus erythematosus.

  Authors: Katarzyna Fischer, Marek Brzosko

  Polskie archiwum medycyny wewnetrznej. 11/2009; 119(11):736-742.

  Early diagnosis of subclinical atherosclerosis can be established using noninvasive imaging techniques, which enable to assess atherosclerotic lesions at different stages of their development, fromEarly diagnosis of subclinical atherosclerosis can be established using noninvasive imaging techniques, which enable to assess atherosclerotic lesions at different stages of their development, from endothelial dysfunction, through morphological lesions in the arteries, to advanced atherosclerotic plaques. Given high risk of accelerated development of atherosclerotic lesions in patients with systemic lupus erythematosus (SLE), these techniques should be incorporated in routine diagnostic evaluation in this population. Cardiovascular risk factors in patients with SLE differ significantly from those observed in the general population. Chronic inflammation and the presence of autoantibodies play the key role, while classic risk factors are less important. Subclinical atherosclerotic lesions can be detected in 30% to 40% of the SLE patients. The occurrence of severe symptoms in the cardiovascular and central nervous systems can be caused by such lesions. Recent data indicate that the main causes of death in this patient group represent cardiovascular complications. Early identification of patients in the risk group allows to implement appropriate prophylactic and therapeutic procedures.

• High prevalence of anti-beta-2 glycoprotein-I and anti-prothrombin antibodies in adult-onset Still's disease. Comment on "Portal vein thrombosis in adult-onset Still's disease: a case report and literature review"

  Authors: Marcin Milchert, Katarzyna Fisher, Jacek Fliciński, Lidia Ostanek, Marek Brzosko

  Rheumatology international. 10/2009;

• Comment on "Polymyalgia rheumatica as the manifestation of unclassified aortitis"

  Authors: Marcin Milchert, Marek Brzosko

  Modern rheumatology / the Japan Rheumatism Association. 05/2008;

• [Chorea as a rare symptom of systemic lupus erythematosus in the elderly]

  Authors: Danuta Bobrowska-Snarska, Lidia Ostanek, Marek Brzosko

  Polskie archiwum medycyny wewnȩtrznej. 02/2008; 118 Suppl:75-9.

  The opinion that systemic lupus erythematosus (SLE) is a young people disease translates into its rare diagnosing in subjects in their 6th decade of life and older. The variability ofThe opinion that systemic lupus erythematosus (SLE) is a young people disease translates into its rare diagnosing in subjects in their 6th decade of life and older. The variability of neuropsychiatric disorders that may be the first symptoms of the disease suggest the need for their in-depth diagnostics and treatment. Chorea is one of the rarest neuropsychiatric symptoms of SLE. It may be present in an early stage of the disease and it is one of the most common motor disorders in SLE. The presented case of diagnosing SLE in a 79-year-old male shows the importance of individual and thorough assessment of the clinical picture of every patient regardless of his/her age and gender. In the discussed case the clinical course of the disease denies common opinions about the picture of SLE in the elderly.

• White matter lesions in a group of six patients with relapsing polychondritis.

  Authors: Marcin Milchert, Lidia Ostanek, Monika Mak, Lech Cyrylowski, Marek Brzosko

  The New Zealand medical journal. 02/2008; 121(1275):96-9.

• [Eosinophilic fasciitis--diagnostic and therapeutic difficulties]

  Authors: Danuta Bobrowska-Snarska, Lidia Ostanek, Marek Brzosko

  Annales Academiae Medicae Stetinensis. 02/2008; 54(2):47-51.

  Eosinophilic fasciitis is a rare disease classified by some authors to scleroderma like syndromes. It occurs the most frequently between the second and the sixth decade of life, mainly in Caucasians.Eosinophilic fasciitis is a rare disease classified by some authors to scleroderma like syndromes. It occurs the most frequently between the second and the sixth decade of life, mainly in Caucasians. It usually appears in young males and exceptionally in children. It has an abrupt onset. The etiology of this disease is unknown. Hardening of the skin and subcutaneous tissue, eosinophilia in peripheral blood and hypergammaglobulinaemia are the most characteristic features of the disease. Inflammation and fibrosis of the fascia that spreads over into the deeper layers of skin and muscles are typical for its histological picture. The infiltration is composed of the lymphocytes, plasmocytes and eosinophiles. The involvement of internal organs in the course of the disease is rare. The course of eosinophilic fasciitis can be different. Prognosis is generally good, however recurrences of the disease can happen. The treatment with nonsteroidal anti-inflammatory drugs and/or with glucocorticosteroids is not satisfactory in some cases. It is not uncommon that intense immunosuppressive treatment is required.

• Familial association of laryngeal, lung, stomach and early-onset breast cancer.

  Authors: Ewa Jaworowska, Pablo Serrano-Fernández, Czesława Tarnowska, Jakub Lubiński, Marek Brzosko, Jacek Flicinski, Bartołomej Masojc, Joanna Matyjasik, Rodney Scott, Steven Narod, Jan Lubiński

  Breast cancer research and treatment. 01/2008;

  This study analyzes the incidence of different types of cancer among 2839 first-degree relatives of 760 consecutive, unselected laryngeal cancer patients, compared with the general population. AThis study analyzes the incidence of different types of cancer among 2839 first-degree relatives of 760 consecutive, unselected laryngeal cancer patients, compared with the general population. A statistically significant excess was seen for other cancers of the larynx (SIR: 400), lung (SIR: 135) and stomach (SIR: 271), and early-onset breast cancer (SIR: 287). Familial laryngeal cancer may not be a single site-specific cancer syndrome.

• [Fasciitis eosinophilica: personal observations and a review of the literature]

  Authors: Danuta Bobrowska-Snarska, Lidia Ostanek, Marek Brzosko

  Polskie archiwum medycyny wewnȩtrznej. 05/2007; 117(4):64-71.

  Eosinophilic fasciitis is a rare disease that is classified by some authors to scleroderma-like syndromes. Symmetrical induration of skin and subcutaneous tissue associated by eosinophilia inEosinophilic fasciitis is a rare disease that is classified by some authors to scleroderma-like syndromes. Symmetrical induration of skin and subcutaneous tissue associated by eosinophilia in peripheral blood are characteristic features of the disease. Internal organ involvement is uncommon. It is often difficult to diagnose eosinophilic fasciitis and its course may be variable. Glucocorticosteroids are most commonly used in the treatment but in many cases they are ineffective. Then other immunosuppressive therapy must be considered. Prognosis is rather favorable. The remission is not always achieved and sometimes flares of the disease are observed as evidenced by the described cases. It should be emphasized that a majority of our patients were females. In four out of five patients anti-thyreoglobulin antibodies and/or anti-thyroid peroxidase antibodies were present suggesting their involvement in the pathogenesis of eosinophilic fasciitis. Neither indicators of inflammation nor peripheral blood eosinophilia were pathognomonic. Results of glucocorticosteroid treatment were satisfactory in three patients, but two patients required combined immunosuppressive treatment.

• [Ear involvement in Wegener's granulomatosis]

  Authors: Marek Wódecki, Iwona Brzosko, Hanna Przepiera-Bedzak, Marek Brzosko

  Wiadomości lekarskie (Warsaw, Poland : 1960). 02/2007; 60(11-12):574-7.

  Clinical manifestation of Wegener's granulomatosis could be multiorgan. Authors present the review of literature concerning on inflammatory changes in ears that in consequence could lead to hearingClinical manifestation of Wegener's granulomatosis could be multiorgan. Authors present the review of literature concerning on inflammatory changes in ears that in consequence could lead to hearing impairment or deafness.

• Chronic urticaria and mild arthritis associated with autoimmune thyroid disease: successful treatment with L-thyroxine.

  Authors: Marcin Milchert, Jacek Fliciński, Lidia Ostanek, Marek Brzosko

  Acta dermato-venereologica. 02/2007; 87(3):263-4.

• [Candida spondylodiscitis--review of the literature]

  Authors: Małgorzata Łukjanowicz, Andrzej Bohatyrewicz, Marek Brzosko

  Annales Academiae Medicae Stetinensis. 02/2007; 53(3):128-33; discussion 133.

  Infectious spondylodiscitis due to Candida species is rarely reported, not well known entity with low frequency. Most probably its frequency is underestimated, partly because of chronic course andInfectious spondylodiscitis due to Candida species is rarely reported, not well known entity with low frequency. Most probably its frequency is underestimated, partly because of chronic course and difficulties with establishing of final diagnosis. Candida can be considered as the opportunistic pathogens. The infection proceeds as the systemic mycosis and most commonly develops in individuals with immune deficiency. In forthcoming years, the higher frequency of opportunistic infections, including mycotic spondylodiscitis, can be expected because of an increasing number of individuals treated with immunosuppressive drugs, and an increasing number of medical invasive procedures. A purpose of our paper is to describe a natural history of infectious spondylodiscitis due to Candida, usefull diagnostic methods, and recommended treatment.

• [Significance of antiphospholipid syndrome and antiphospholipid antibodies in patients with systemic lupus erythematosus in estimation of risk of subclinical atherosclerosis development]

  Authors: Katarzyna Fischer, Marek Brzosko, Anna Walecka, Lidia Ostanek, Marcin Sawicki

  Polskie archiwum medycyny wewnȩtrznej. 02/2007; 117 Suppl:13-7.

  INTRODUCTION: Atherosclerosis is an important clinical problem in patients with systemic lupus erythematosus (SLE), because of very severe cardiovascular and central nervous system manifestations.INTRODUCTION: Atherosclerosis is an important clinical problem in patients with systemic lupus erythematosus (SLE), because of very severe cardiovascular and central nervous system manifestations. OBJECTIVES: Estimation if antiphospholipid syndrome (APS) and antiphospholipid antibodies (aPL) are risk factors for subclinical atherosclerosis in patients with SLE. PATIENTS AND METHODS: We examined 103 patients with SLE and 30 healthy volunteers, included as the control group. Coexistence of APS was confirmed in 35 patients. Evaluation of subclinical atherosclerosis was done on the basis of measurement of intima-media thickness (IMT) in B-mode ultrasound examination. We considered classical atherosclerotic risk factors and determined profile of aPL: anti-cardiolipine antibodies (aCL), anti beta2 glycoprotein-I antibodies, antiprothrombin antibodies (aPT), anti-oxidized low-density lipoprotein antibodies and lupus anticoagulant (LA). Statistical analysis was performed with chi2 Yates, chi2 Pearson and R rang Spearman tests. Multivariate regression analysis was also done. RESULTS: Thickened IMT was significantly more frequent in patients with SLE than in controls (p = 0.0002). We found that coexistence of APS is a risk factor for moderate thickening of IMT (OR: 3.41; 95% CI: 1.0-11.5). We also confirmed that the presence of aPL is significantly correlated with IMT ranging from 0.66 to 0.86 mm. The highest risk was found in patients with the presence of aPT IgA (OR: 5.50; 95% CI: 1.1-30.2), aCL IgM (OR: 4.36; 95% CI: 1.1-20.7), LA (OR: 4.02; 95% CI: 1.1-19.4) and aCL IgG (OR: 2.99; 95% CI: 1.1-9.7). Moreover, we found that ischaemic heart disease, nephropathy and myocardial infarction were significantly more frequent in patients with thickened IMT. CONCLUSIONS: Patients with SLE develop subclinical atherosclerosis significantly more frequent than the general population. Coexistence of APS and presence of aPL are risk factors for subclinical atherosclerosis development in patients with SLE. Thickened intima-media in patients with SLE is significantly associated with an increased risk of cardiovascular manifestations.

• [Ocular manifestations in patients with systemic lupus erythematosus and antiphospholipid syndrome]

  Authors: Lidia Ostanek, Monika Modrzejewska, Danuta Bobrowska-Snarska, Marek Brzosko

  Polskie archiwum medycyny wewnȩtrznej. 02/2007; 117 Suppl:18-23.

  INTRODUCTION: Systemic lupus erythematosus (SLE) is a systemic disease of connective tissue with broad band of symptoms. It could be the reason for many organs and tissues impairment. Changes in eyesINTRODUCTION: Systemic lupus erythematosus (SLE) is a systemic disease of connective tissue with broad band of symptoms. It could be the reason for many organs and tissues impairment. Changes in eyes that occurr in SLE are not frequent, but can lead to severe impairment of sight including blindness. OBJECTIVES: The aim of the work was to asses the frequency of eye changes among patients with SLE and SLE with antiphospholipid syndrome (APS). Another aim was to asses the association between antiphospholipid antibodies and ocular lesions. PATIENTS AND METHODS: There were 75 patients enrolled with SLE, 26 of them ha APS. All of patients had a comprehensive ophthalmological and physical examination. Moreover biochemica analysis including lipid profile and glucose metabolism and serological markers of APS and SLE were performe RESULTS: Thirty-six patients complained of ophthalmologic disturbances (48%), with "dry eyes" being the most common symptom (20 patients). The reduced visual acuity was detected in 17 patients (22.6%). Conjunctivitis was found in 8 patients (10.67%), corneal involvement in 31 (41.3%), and sclera changes in 40 patients (53.3%). Changes in retina were found in 15 (20%) of patients, the most frequent were sub-retinal edema in the region of yellow spot. Changes in yellow spot were found in 8 patients; in 2 of them it was associated with dry degenerative changes, in 6 patients exudates with or without hemorrhages were found. Vascular changes including their lumen diameter were found in 33 patients (44%). In 4 patients there were changes in optical nerve disc. Schirmer's test was pathological in 43 patients (57.3%), but in only 4 patients Sjögren's syndrome was diagnosed. In the group of SLE patients intraocular pressure was significantly higher. The presence of anticardiolipin antibodies IgG class (aCL IgG) was associated with reduced visual acuity. The presence of lupus anticoagulant and anti-beta2, glycoprotein-I antibodies (anti-beta2GPI) was associated with conjunctive involvement. The presence of aCL IgM and anti-beta2GPI was associated with less frequent symptoms of eye dryness. CONCLUSIONS: We found the following significant factors of the occurrence of eye involvement in our series of SLE patients: high activity of disease (conjuctiva, iris, uvea, retina, spot, vessels and optical nerve disc involvement), late diagnosis of SLE (retinopathy and conjuctive involvement), arterial hypertension (reduced visual acuity, cornea involvement, vessels involvement), age (reduced visual acuity, cornea involvement, retinopathy), glucose metabolism disorders (changes in optical nerve disc) and presence of anti-double stranded DNA antibodies (retinopathy).

• [Therapy resistance antiphosholipid syndrome in the course of systemic lupus erythematosus: case report]

  Authors: Danuta Bobrowska-Snarska, Lidia Ostanek, Beata Trzcińska-Butkiewicz, Marek Brzosko

  Polskie archiwum medycyny wewnȩtrznej. 02/2007; 117 Suppl:65-9.

  Antiphospholipid syndrome (APS) is one of the most common reasons of thromboembolic complications in the course of connective tissue diseases. There is a strong relationship between presence ofAntiphospholipid syndrome (APS) is one of the most common reasons of thromboembolic complications in the course of connective tissue diseases. There is a strong relationship between presence of antiphospholipid antibodies and the risk of thrombosis. APS related thromboembolic complications range from superficial vein thrombosis up to rapidly developing, life threatening, multi-organ embolism. We present a case of a 21-year old female who presented with myocardial infarction as the first symptom of systemic lupus erythematosus and APS. Afterwards she was consequently treated with antithrombotic and anti-aggregation agents but it did not prevent her from reoccurrence of middle retinal vein. During the 10-year follow up she presented with reoccurring neurological symptoms i.e.: headache, memory deficits, concentration loss and impairment of the cognitive functions. She was found many times to be positive for IgG and IgM anticardiolipin antibodies, anti-beta2glicoprotein-I antibodies and lupus anticoagulant.

• Fungal spondylodiscitis in a patient with ulcerative colitis - case report.

  Authors: Małgorzata Lukjanowicz, Lidia Ostanek, Andrzej Bohatyrewicz, Dariusz Bielicki, Marek Brzosko

  Ortopedia, traumatologia, rehabilitacja. 01/2007; 8(6):708-13.

  We report a case of a 34 year old women with spondylodiscitis due to Candida albicans infection. One and a half year earlier a ulcerative colitis she was diagnosed and treated with sulfasalazine,We report a case of a 34 year old women with spondylodiscitis due to Candida albicans infection. One and a half year earlier a ulcerative colitis she was diagnosed and treated with sulfasalazine, short course of glucocorticosteroids and with azathioprine. The diagnosis of fungal spondylodiscitis was made by culture of material collected from involved part of vertebral column during the surgery. Initially the patient was treated with fluconazole intravenously for 20 days, then the treatment was continued orally for one year. During the treatment all complaints disappeared and reduction of the laboratory acute phase indices was observed. Follow-up magnetic resonance's have shown gradual improvement. To our knowledge no similar case has been reported in the Polish literature before.