Mariusz Puszczewicz

Publications of Mariusz Puszczewicz

• [A case of antiphospholipid syndrome in course of pregnancy and puerperium with lupus-like disease suspicion].

  Authors: Anna Lorenc, Agnieszka Seremak-Mrozikiewicz, Krzysztof Drews, Paweł Ratajczak, Mariusz Puszczewicz

  Ginekologia polska. 04/2011; 82(4):297-303.

  The antiphospholipid syndrome (APS) is a systemic non-inflammatory and autoimmune connective tissue disease. ASP is characterized by formation of autoantibodies against cell membrane phospholipidsThe antiphospholipid syndrome (APS) is a systemic non-inflammatory and autoimmune connective tissue disease. ASP is characterized by formation of autoantibodies against cell membrane phospholipids which act as procaogulation factors. Association with recurrent pregnancy loss, intrauterine growth retardation, preeclampsia and placenta ablation makes ASP a serious perinatologic problem. The primary form can evaluate into lupus-like disease or full-symptomatic lupus erythematosus, both usually preceded by acute form of APS. In pregnant women this situation may present considerable diagnostic problems. The aim of this work was to present a patient with acute primary antiphospholipid syndrome during pregnancy and puerperium, which subsequently was diagnosed as systemic lupus erythematosus flare. Such progression is rare and, despite several previous reports, requires extensive explanations and research.

• [Differential diagnosis of polymyositis. Case report].

  Authors: Dominik Majewski, Mariusz Puszczewicz, Aleksandra Kołczewska

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:66-9.

  Polymyositis is a connective tissue disease of unknown etiology. Autoimmune processes in genetically predisposed individuals play an important role in the pathogenesis of this disease. It isPolymyositis is a connective tissue disease of unknown etiology. Autoimmune processes in genetically predisposed individuals play an important role in the pathogenesis of this disease. It is suspected that environmental factors operate in the initiation of the autoimmune response. The differential diagnosis of polymyositis should take into consideration various disorders presenting with muscular lesions or weakness. Our 33-year-old female was referred in 2010 to the Department of Rheumatology, Rehabilitation, and Internal Medicine, Poznań University of Medical Sciences, with suspected polymyositis. She reported symptoms of upper airway infection in December 2009 with muscle tenderness in the pelvic and pectoral girdles and the dorsum. An antibiotic was administered but aggravation of symptoms was noted instead. She was hospitalized with muscle weakness and elevated CPK (16300 U/L), LDH (2322 IU/L), aminotransferases, ESR, and CRP. Other causes of muscular lesions or weakness were ruled out. Polymyositis was tentatively diagnosed by a rheumatologist and the patient was started on non-steroid anti-inflammatory agents. After one week in hospital, improvement in the general condition and normalization of laboratory tests were noted (CPK and LDH activities declined). The patient was referred to our Department for further investigation and treatment. Basing on the anamnesis, physical examination, and laboratory findings, and taking into consideration that the patient quickly improved and the tests normalized without glucocorticoids, we decided against the diagnosis of polymyositis. Our differential diagnosis attributed the symptoms of inflammatory muscle disease to an infectious or chemical factor or to a malignancy as the primary condition.

• [LE cells in synovial fluid: prevalence and diagnostic usefulness in rheumatic diseases].

  Authors: Mariusz Puszczewicz, Grazyna Białkowska-Puszczewicz

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:105-8.

  This study was undertaken to determine the prevalence of LE cells in synovial fluid and their importance for the diagnosis of rheumatic disease. Synovial fluid was obtained from 631 patients: 31 withThis study was undertaken to determine the prevalence of LE cells in synovial fluid and their importance for the diagnosis of rheumatic disease. Synovial fluid was obtained from 631 patients: 31 with systemic lupus erythematosus (SLE), 337 with rheumatoid arthritis (RA), 4 with Still's disease, 9 with systemic scleroderma (SS), 27 with the overlap syndrome (RA/SLE), 132 with ankylosing spondylitis (AS), 57 with Reiter's syndrome, and 34 with psoriatic arthritis (PA). The fluid was centrifuged, precipitate smears were done and were May-Grünwald-Giemsa stained for cytologic assessment. The supernatant was collected for antinuclear antibody (ANA) testing. Physicochemical and serologic properties of the synovial fluid were routinely determined. All synovial fluids demonstrated signs of inflammation. The presence of LE cells was ascertained in five patients with SLE and nine patients with the overlap syndrome. In these cases, LE cells were accompanied by ANA. In addition, hematoxylin bodies were revealed in SLE patients. LE cells were observed in 2.6% of patients with RA but were not accompanied by ANA. Patients with SS, Still's disease, AS, Reiter's syndrome, and PA tested negative for LE cells. It appears from these results that LE cells are rarely present in the synovial fluid of patients with rheumatic diseases. In contrast, they occur in more than 40% of patients with the overlap syndrome and may thus be regarded as important for the diagnosis of this condition.

• [Anti-HCV and HCV RNA in patients with the primary Sjögren syndrome]

  Authors: Kazimierz Madaliński, Paulina Godzik, Irena Zimmermann-Górska, Mariusz Puszczewicz, Katarzyna Dzierzanowska-Fangrat, Joanna Jabłońska, Jan Zeromski

  Przegla̧d epidemiologiczny. 01/2009; 63(2):299-304.

  The subject of study were 104 patients with the primary Sjögren Syndrome (p. Sj. s.) in whom markers of hepatitis C infection were investigated. All the patients fulfilled the criteria of theThe subject of study were 104 patients with the primary Sjögren Syndrome (p. Sj. s.) in whom markers of hepatitis C infection were investigated. All the patients fulfilled the criteria of the European Expert Group of the Sjögren Syndrome. Antibodies anti-HCV were found in 20 patients (19.2%) and HCV-RNA found in 5 patients (4.8%). These data were compared with those observed in several European countries and Japan. The following percentages of anti-HCV were observed until now in p.Sj.s. patients: Swedish--2%, Hungarian--6%, Japanese--12%, French--17%, Polish--19% and Spanish--26%. Our patients in whom liver data were available, showed only minor elevations of ALT and AST. International team of experts postulated the delineation of the disease entity: 'HCV-related primary Sjögren syndrome', separate from the p.Sj.s. itself. If this will be substantiated, we can put forward the hypotesis that 'HCV-related p.Sj.s.' may develop in a special subgroup of persons, perhaps genetically predisposed, and is a part of extrahepatic manifestations of HCV infection.

• [The new serological markers of rheumatoid arthritis]

  Authors: Aleksandra Tuchocka-Piotrowska, Mariusz Puszczewicz

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 10/2007; 23(135):215-20.

  Rheumatoid arthritis (RA) is the most frequent human chronic inflammatory autoimmune disease. Its etiology is up to date not known. RA has been proven to be an antigen-specific lymphocyte T drivenRheumatoid arthritis (RA) is the most frequent human chronic inflammatory autoimmune disease. Its etiology is up to date not known. RA has been proven to be an antigen-specific lymphocyte T driven process. Many exo- and endogenous antigens having a possible potential to induce and maintain autoimmunologic reaction have been described. In this report RA associated autoantibodies, especially novel, most specific serological marker--anti-cyclic citrullinated peptide antibodies (aCCP) are presented.

• [Anticardiolipin and anti-beta2 glycoprotein-1 antibodies patients with breast carcinoma: a pilot study]

  Authors: Irena Zimmermann-Górska, Sylwia Grodecka-Gazdecka, Grazyna Białkowska-Puszczewicz, Mariusz Puszczewicz, Magdalena Goździecka, Paweł Kondarewicz

  Polskie archiwum medycyny wewnȩtrznej. 02/2007; 117 Suppl:24-7.

  INTRODUCTION: Thrombosis - the main manifestation of antiphospholipid syndrome (APS) - is at the same time observed in some patients with malignancies. OBJECTIVES: Evaluation of prevalence of someINTRODUCTION: Thrombosis - the main manifestation of antiphospholipid syndrome (APS) - is at the same time observed in some patients with malignancies. OBJECTIVES: Evaluation of prevalence of some antiphospholipid antibodies (aPL) in serum of patients with breast carcinoma and the possible correlation between aPL seropositivity and clinical symptoms. PATIENTS AND METHODS: 40 patients with breast carcinoma and 38 patients with non-malignant diseases of breast were studied. Anticardiolipin antibodies (aCL) and antibodies to beta2 glycoprotein-I (anti-beta2GPI) were detected by ELISA. RESULTS: The aCL as well as anti-beta2GPI were positive in 1 patient with breast carcinoma, who at the same time presented with symptoms of APS. In the control group 2 patients were positive for anti-beta2GPI. CONCLUSIONS: We have not observed a difference of aPL prevalence between the group of patients with breast carcinoma and controls. The association of breast cancer and aPL seropositivity deserves further investigations.

• [Diagnostic problems in eosinophilic fasciitis].

  Authors: Mariusz Puszczewicz, Irena Zimmermann-Górska, Honorata Pietrzak-Kaczmarek, Stanisław Lazowski

  Polskie Archiwum Medycyny Wewnętrznej. 08/2006; 116(2):777-80.

  We presented two cases with symptoms of diffuse swelling of subcutaneous tissue, stiffness and tenderness of involved areas, fever, eosinophilia and hypergammaglobulinemia. The inflammatoryWe presented two cases with symptoms of diffuse swelling of subcutaneous tissue, stiffness and tenderness of involved areas, fever, eosinophilia and hypergammaglobulinemia. The inflammatory infiltrates consisting of lymphocytes, plasma cells and eosinophils were yielded in fascia. The difficulties in differentition of the symptoms between eosinophilic fasciitis and "eosinophilia-myalgia syndrome" are discussed.

• [Prevalence of antiphospholipid antibodies in patients with primary Sjögren's syndrome]

  Authors: Mariusz Puszczewicz, Irena Zimmermann-Górska, Grazyna Białkowska-Puszczewicz

  Polskie archiwum medycyny wewnȩtrznej. 06/2006; 115(5):414-6.

  The aim of this study was to determine prevalence of antiphospholipid antibodies (aPL) including anticardiolipin antibodies (aCL), and anti-beta2GP1 in a cohort of 32 patients with primary Sjogren'sThe aim of this study was to determine prevalence of antiphospholipid antibodies (aPL) including anticardiolipin antibodies (aCL), and anti-beta2GP1 in a cohort of 32 patients with primary Sjogren's syndrome (pSS) diagnosed according to revised European criteria. aPL were found in 9/32 (28%) patients (IgG in 8 and IgM in one case). Anti-beta2GPI antibodies were detected only in two patients. Titres were usually low.

• [Polymyositis and systemic sclerosis symptoms as a clinical manifestation of a chronic graft versus host disease: a case report and literature review]

  Authors: Aleksandra Tuchocka-Piotrowska, Mariusz Puszczewicz, Aleksandra Kołczewska, Dominik Majewski

  Polskie archiwum medycyny wewnȩtrznej. 05/2006; 115(4):356-60.

  A case of a patient presenting with polymyositis and systemic sclerosis symptoms due to chronic graft versus host disease is reported. The literature review about similar disease manifestations andA case of a patient presenting with polymyositis and systemic sclerosis symptoms due to chronic graft versus host disease is reported. The literature review about similar disease manifestations and hypotheses regarding the pathophysiological origin of the clinical syndromes combined with graft versus host reaction is presented.

• [Ocular involvement in patient with Wegener's granulomatosis--a case report]

  Authors: Dominik Majewski, Mariusz Puszczewicz, Irena Zimmermann-Górska, Aleksandra Kołczewska, Aleksandra Tuchocka-Piotrowska

  Polskie archiwum medycyny wewnȩtrznej. 04/2006; 115(3):243-7.

  Wegener's granulomatosis is a systemic vasculitis. Most often granulomatous inflammation is situated in upper and lower respiratory tracts as well as kidneys. Ocular involvement affects 50-60% ofWegener's granulomatosis is a systemic vasculitis. Most often granulomatous inflammation is situated in upper and lower respiratory tracts as well as kidneys. Ocular involvement affects 50-60% of patients with Wegener's granulomatosis. Herein is reported the case of a man with Wegener's granulomatosis with ocular involvement which was a symptom of high disease activity. Intensive immunosuppressive treatment and local treatment were ineffective in eye involvement inhibition.

• [Graft-versus-host disease as the cause of symptoms mimicking Sjögren's syndrome]

  Authors: Aleksandra Tuchocka-Piotrowska, Mariusz Puszczewicz, Aleksandra Kołczewska, Dominik Majewski

  Annales Academiae Medicae Stetinensis. 02/2006; 52 Suppl 2:89-93.

  A case of chronic graft-versus-host disease (chronic GvHD) mimicking symptoms associated with idiopathic Sjögren's syndrome is presented. Hypotheses on the pathophysiological origin of clinicalA case of chronic graft-versus-host disease (chronic GvHD) mimicking symptoms associated with idiopathic Sjögren's syndrome is presented. Hypotheses on the pathophysiological origin of clinical syndromes associated with graft-versus-host disease are discussed.

• [Diagnostic difficulties in polymyositis]

  Authors: Dominik Majewski, Mariusz Puszczewicz, Aleksandra Tuchocka-Piotrowska, Aleksandra Kołczewska

  Annales Academiae Medicae Stetinensis. 02/2006; 52 Suppl 2:45-8.

  Polymyositis is a connective tissue disease. Although myositis is the dominant clinical manifestation, internal organs may also be affected. Arthritis occurs in 30% of patients, especially in thePolymyositis is a connective tissue disease. Although myositis is the dominant clinical manifestation, internal organs may also be affected. Arthritis occurs in 30% of patients, especially in the course of the anti-synthetase syndrome. We report on a case of a woman with polymyositis and interstitial lung disease. Arthritis and the presence of anti-cyclic citrullinated peptide antibodies in the patient's serum may suggest the diagnosis of the overlap syndrome.

• [Inflammation of fat tissue--panniculitis. The clinical study--part II. Case reports]

  Authors: Irena Zimmermann-Górska, Aleksandra Tuchocka-Piotrowska, Mariusz Puszczewicz

  Polskie archiwum medycyny wewnȩtrznej. 01/2005; 112(6):1527-32.

• [Inflammation of fat tissue--panniculitis. The clinical study--part I. The clinical picture of panniculitis and pathogenetic hypotheses]

  Authors: Irena Zimmnermann-Górska, Aleksandra Tuchocka-Piotrowska, Mariusz Puszczewicz

  Polskie archiwum medycyny wewnȩtrznej. 01/2005; 112(6):1521-5.

• [The influence of theophilline on oxygen metabolism of neutrophils in vitro]

  Authors: Małgorzata Zielińska, Mariusz Puszczewicz

  Polskie archiwum medycyny wewnȩtrznej. 09/2004; 112(2):925-30.

  Theophylline is a drug used in the treatment of obstructive pulmonary disease and a strong immunomodulator and has anti-inflammatory potential. However, its mechanism of definite action is stillTheophylline is a drug used in the treatment of obstructive pulmonary disease and a strong immunomodulator and has anti-inflammatory potential. However, its mechanism of definite action is still poorly defined. In the present study the effect of teophylline on the in vitro formation and release of reactive oxygen species in polymorphonuclear neutrophils (PMN) was studied at concentration of 0.9-130 microg/ml. The neutrophils oxygen metabolism was assessed with methods: luminol-dependent chemiluminescence, cytochrome C reduction, phenol red oxidation, and Griess reaction. In vitro theophylline treatment most effectively inhibit neutrophil hydrogen peroxide and nitric oxide generation (at 90 and 130 microg/ml), superoxide production (at 1.3 microg/ml), and diminish chemiluminescence (at the smallest concentrations 0.9 and 1.3 microg/m). We concluded that the effects of theophylline on granulocyte function are likely to contribute to the drug's clinical efficacy.

• [Osteitis as a symptom of SAPHO syndrome]

  Authors: Irena Zimmermann-Górska, Mariusz Puszczewicz, Honorata Pietrzak-Kaczmarek, Aleksandra Kołczewska

  Polskie archiwum medycyny wewnȩtrznej. 08/2003; 110(1):755-8.

  SAPHO syndrome is an acronym given to a spectrum of diseases with the following features: synovitis, acne, pustulosis, hyperostosis and osteitis. The main problem of the differential diagnosis in 3SAPHO syndrome is an acronym given to a spectrum of diseases with the following features: synovitis, acne, pustulosis, hyperostosis and osteitis. The main problem of the differential diagnosis in 3 cases presented in our paper was the aseptic osteitis.

• [Prevalence and specificity of antineutrophil cytoplasmic antibodies (ANCA) in connective tissue diseases]

  Authors: Mariusz Puszczewicz, Irena Zimmermann-Górska, Grazyna Białkowska-Puszczewicz, Aleksandra Tuchocka

  Polskie archiwum medycyny wewnȩtrznej. 02/2003; 109(1):35-41.

  Antineutrophil cytoplasmic antibodies (ANCA) have specificity for constituents of neutrophil granules. There are two different types of ANCA identifiable by indirect immunofluorescence method. OneAntineutrophil cytoplasmic antibodies (ANCA) have specificity for constituents of neutrophil granules. There are two different types of ANCA identifiable by indirect immunofluorescence method. One type produces the cytoplasmic staining pattern (C-ANCA) and the second-perinuclear (P-ANCA). The aim of the study was to evaluate the frequency of ANCA in patients with connective tissue diseases (CTD). Serum samples were obtained from 394 patients suffering from CTD. The patients group consisted of 86 patients with lupus erythematosus systemic (LES) (including 30 with LES accompanied with glomerulonephritis), 136 cases with rheumatoid arthritis (RA) (including 18 patients with RA and vasculitis), 42 patients with systemic sclerosis (SSc), 76 cases of Sjögren's syndrome (SS), 30 with Wegener's granulomatosis (WG), and 24 patients with polyarteritis nodosa (PAN). All patients fulfilled ARA criteria for the classification of CTD. The control group consisted of 42 healthy individuals. ANCA were detected by immunofluorescence method according to Wiik, and by an antigen-specific--enzyme-linked immunosorbent assay (ELISA). Proteinase 3 (PR-3), myeloperoxidase (MPO), elastase (ELA), lactoferrin (LC) and lysozyme (LZ), as well as cathepsin G were used as antigens in ELISA method. ANCA were detected in sera of 86 (21.8%) patients with CTD. C-ANCA pattern was observed in 28 (7.1%) cases, and p-ANCA in 58 (14.7%). C-ANCA were detected in sera of 28 (93%) patients with WG. P-ANCA were showed in 12 (13.9%) patients with LES, in 12 (50%) cases with PAN, in 20 (14.7%) with RA, in sera of 4 (9.5%) patients with SSc and in 10 (13.1%) with SS. No ANCAs were detected in healthy individuals. Ani-PR-3 antibodies were showed in sera of 26 patients, anti MPO in 30 cases, anti-ELA in sera of 12 patients, and anti-LC in 14 cases, but anti-LZ in 4 patients with CTD. The presence of ANCA in CTD patients may indicate the vascular inflammatory process during the course of the disease. It is a very important factor for the clinical course, and prognosis in the CTD patients.

• [A possible role of hepatitis C virus in the pathogenesis of Sjogren's syndrome]

  Authors: Kazimierz Madaliński, Katarzyna Dzierzanowska-Fangrat, Paulina Jóźwiak, Mariusz Puszczewicz, Irena Zimmermann-Górska

  Polskie archiwum medycyny wewnȩtrznej. 03/2002; 107(2):167-71.

• [Usefulness of the saliva ferning test in diagnosis of Sjögren's syndrome]

  Authors: Mariusz Puszczewicz, Irena Zimmermann-Górska, Grazyna Białkowska-Puszczewicz

  Polskie archiwum medycyny wewnȩtrznej. 02/2002; 107(1):13-7.

  One of the characteristics of mucous is its ability to crystallize to the form of ferns when it is dried at room temperature and observed by polarized light microscopy (ferning phenomenon-FP).One of the characteristics of mucous is its ability to crystallize to the form of ferns when it is dried at room temperature and observed by polarized light microscopy (ferning phenomenon-FP). Several studies have shown that dry mouth can be diagnosed on the basis the loss of FP in dried saliva samples. The aim of our study was to evaluate the value of saliva ferning test (SFT) in the diagnosis of Sjögren's syndrome (SS). Saliva was taken from 11 patients with primary SS, 32 patients with secondary SS as well as from 27 controls. Samples of freshly produced saliva were dropped on light-microscope slides and allowed to dry at room temperature. Crystallization was observed by polarizing light microscopy within 10 minutes after collection. The type of crystallization was classified acc. to Rolando et al. Abnormal SFT was observed in 11 (100%) patients with primary SS and 27 (84%) patients with secondary SS. Saliva from 5 (16%) patients with secondary SS and from 27 (100%) control patients yielded normal picture of crystallization. In our opinion SFT is a simple, reproducible, and useful non-invasive diagnostic test in SS.

• [Fibrodysplasia ossificans progressiva: case report]

  Authors: Mariusz Puszczewicz, Aleksandra Kołczewska, Irena Zimmermann-Górska, Dominik Majewski, Agnieszka Ogrodowicz

  Polskie archiwum medycyny wewnȩtrznej. 117(1-2):53-6.

  Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report the case of aFibrodysplasia ossificans progressiva (FOP) is a rare genetic disease characterized by widespread soft tissue ossification and congenital stigmata of the extremities. We report the case of a 33-year-old woman with clinical and radiological features of FOP. She was born with bilateral hallux valgus and at the age of 10 presented swelling and ossification of the left scapula. During the course of the disease numerous crises were observed. In this patient authors noticed FOP exacerbation after a surgical operation.