BACKGROUND: Fibromyalgia syndrome (FMS) is a common but controversial condition. There appears to be different level of belief of its existence and awareness. We set out to explore the variations of perceptions and awareness of this condition among rheumatologists from the Southeast Asia (SEA) region.
METHODS: One hundred eight rheumatologists from the participating countries; 28 from Malaysia, 20 from Singapore, 26 from Thailand, 2 from Brunei, and 42 from Indonesia were approached to participate in this survey by answering specific questions regarding their beliefs in relation to FMS; 82% respondents from Malaysia, 100% from Singapore, 92% from Thailand, 100% from Brunei, and 90% from Indonesia completed the questionnaires.
RESULTS: Most rheumatologists (92.5%) from SEA believe that FMS is a distinct clinical entity, and also this condition is considered an illness rather than a disease. Eighty-seven percent rheumatologists from SEA believe that FMS is a mixture of medical and psychological illness, 9% believe that FMS is primarily a psychological illness, and 3% believe that it is a medical illness. Only 60% of those in a university setting include FMS in their undergraduate teaching. Eighty-five percent of the respondents ordered blood tests to exclude other serious pathologic conditions, and 100% of the respondents from SEA countries also prescribed some form of drugs to FMS patients.
CONCLUSION: FMS is apparently seen worldwide. This study confirmed that there was a variation of perceptions and knowledge of FMS among rheumatologists from SEA countries. However, most rheumatologists agreed that FMS is a distinct clinical entity with a mixture of medical and psychological factors.
OBJECTIVE: There is paucity of data for Takayasu arteritis (TAK) among South Asians. We aimed to evaluate the clinical features, angiographic findings, as well as treatment and outcome of TAK among Malaysian multiethnic groups.
METHODS: This is a retrospective review of 40 patients with TAK seen in major rheumatology centres in Malaysia between April 2006 and September 2013.
RESULTS: Majority were female patients (92.5%), with a female-to-male ratio of 12:1. Median duration of disease from diagnosis was 66 months (interquartile range, 33-177 months). Fifteen (37.5%) were Malays, 9 (22.5%) each were Indians and indigenous from East Malaysia and 7 (17.5%) were Chinese. Indian and indigenous from East Malaysia were overrepresented in this disease. The mean (SD) age of symptom onset and diagnosis were 25.5 (8.1) and 27.4 (8.4), respectively. The 3 most common clinical presentations at diagnosis were diminished or absent pulse, which occurred in 80% of the patients, followed by blood pressure discrepancy (60%) and arterial bruit (52.5%). There was no difference in clinical presentation among ethnic groups. The subclavian artery was the commonest vessel involved (72.5%), followed by the carotid artery (65%) and renal artery (47.5%). Eight patients had coronary artery involvement, and 2 patients had pulmonary artery involvement. Type I arterial involvement was the commonest (80.0%), followed by type IV (35%), present in isolation or mixed type. Glucocorticoid was the main medical treatment (90.0%). Nineteen patients (47.5%) underwent revascularization procedures. Five patients died during the follow-up period.
CONCLUSIONS: The Malaysian TAK cohort had similarities with and differences from other published TAK cohort. A nationwide TAK registry is needed to determine the prevalence of the disease among different ethnic groups.