This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (15)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Pathology & Laboratory Medicine  • Musculoskeletal Syndromes (Chronic Fatigue, Gulf War)  • Alert me on articles by topic  Social Bookmarking   What's this?

Eugene P. Grady, MD; Matthew T. Carpenter, MD; Christopher D. Koenig, MD; Steven A. Older, MD; Daniel F. Battafarano, DO

Arch Intern Med. 1998;158:367-371.

Background  Rheumatic symptoms were commonly described among soldiers who served in previous wars.

Objective  To describe the frequency of rheumatology consultations, along with the diagnoses, and abnormal results on serologic testing in Gulf War veterans evaluated for Gulf War syndrome.

Methods  The medical records of the first 250 consecutive Gulf War veterans referred to the comprehensive clinical evaluation program at Wilford Hall Air Force Medical Center and Brooke Army Medical Center, San Antonio, Tex, were reviewed for demographic characteristics and frequency of subspecialty consultations. A retrospective review of rheumatic diagnoses and the frequency of abnormal serologic test results was recorded.

Results  Of the 250 Gulf War veterans evaluated in the comprehensive clinical evaluation program, 139 (56%) were referred for rheumatology consultation, which was the most common elective subspecialty referral. Of the patients evaluated, 82 (59%) had soft tissue syndromes, 19 (14%) had rheumatic disease, and 38 (27%) had no rheumatic disease. The most common soft tissue syndromes were patellofemoral syndrome (33 patients [25]), mechanical low back pain (23 patients [18]), and fibromyalgia (22 patients [17]). Of the 19 patients with rheumatic disease, 10 had osteoarthritis, 2 had rheumatoid arthritis, 2 had gout, and 1 each had systemic lupus erythematosus, Behçet disease, parvovirus arthritis, psoriatic arthritis, and hypothyroid arthropathy. Abnormal serologic test results were common among the Gulf War patients regardless of the presence or absence of rheumatic disease.

Conclusions  The rheumatic manifestations in Gulf War veterans are similar to symptoms and diagnoses described in previous wars and are not unique to active duty soldiers. Overall, the results of serologic screening were poor predictors of the presence of rheumatic disease.

From the Rheumatology Service, Wilford Hall Medical Center (Drs Grady and Carpenter), and the Internal Medicine (Dr Koenig) and Rheumatology (Drs Older and Battafarano) Services, Brooke Army Medical Center, San Antonio, Tex. Dr Grady is now with the Rheumatology Service, Tripler Army Medical Center, Honolulu, Hawaii; Dr Carpenter is now with the Department of Internal Medicine, Keesler Air Force Base, Biloxi, Miss; and Dr Koenig is with the Rheumatology Service, Walter Reed Army Medical Center, Washington, DC.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Healthcare utilization and mortality among veterans of the Gulf War
Gray and Kang
Phil Trans R Soc B 2006;361:553-569.
ABSTRACT | FULL TEXT  

Clinical Challenges in a Prison Rheumatology Referral Practice
Anderson et al.
J Correct Health Care 2003;9:425-437.
ABSTRACT