Rheumatic findings in Gulf War veterans

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, Behcet
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.

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