<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Medical and Social Expert Evaluation and Rehabilitation</journal-id><journal-title-group><journal-title xml:lang="en">Medical and Social Expert Evaluation and Rehabilitation</journal-title><trans-title-group xml:lang="ru"><trans-title>Медико-социальная экспертиза и реабилитация</trans-title></trans-title-group></journal-title-group><issn publication-format="print">1560-9537</issn><issn publication-format="electronic">2412-2092</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">35167</article-id><article-id pub-id-type="doi">10.17816/MSER35167</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Current problems of medical and social expertise</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Эпидемиология и статистика инвалидности</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Assessment of disability in patients with alkaptonuria</article-title><trans-title-group xml:lang="ru"><trans-title>Оценка инвалидизации у пациентов с алкаптонурией</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1262-932X</contrib-id><name-alternatives><name xml:lang="en"><surname>Kuzin</surname><given-names>Alexander V.</given-names></name><name xml:lang="ru"><surname>Кузин</surname><given-names>Александр Васильевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>к.м.н., доцент кафедры</p></bio><email>alexandr.kuzin@list.ru</email><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9092-9398</contrib-id><name-alternatives><name xml:lang="en"><surname>Zaytseva</surname><given-names>Elena M.</given-names></name><name xml:lang="ru"><surname>Зайцева</surname><given-names>Елена Михайловна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD</p></bio><bio xml:lang="ru"><p>к.м.н., ассистент кафедры ревматологии</p></bio><email>zayele@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5382-6357</contrib-id><name-alternatives><name xml:lang="en"><surname>Amirdzhanova</surname><given-names>Vera N.</given-names></name><name xml:lang="ru"><surname>Амирджанова</surname><given-names>Вера Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>д.м.н., в.н.с. лаборатории патофизиологии боли и полиморфизма скелетно-мышечных заболеваний</p></bio><email>amirver@yandex.ru</email><xref ref-type="aff" rid="aff3"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8563-0631</contrib-id><name-alternatives><name xml:lang="en"><surname>Makarov</surname><given-names>Sergey A.</given-names></name><name xml:lang="ru"><surname>Макаров</surname><given-names>Сергей Анатольевич</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>к.м.н., ст.н.с. лаборатории ревмоортопедии и реабилитации</p></bio><email>ortopedniir@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Agzamov</surname><given-names>Jahangir S.</given-names></name><name xml:lang="ru"><surname>Агзамов</surname><given-names>Джахангир Салимович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>д.м.н.</p></bio><email>dr.agzamov@gmail.com</email><xref ref-type="aff" rid="aff4"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Ismailov</surname><given-names>Khalid G.</given-names></name><name xml:lang="ru"><surname>Исмаилов</surname><given-names>Халид Габибович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>Ismailov_endo@mail.ru</email><xref ref-type="aff" rid="aff5"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4021-798X</contrib-id><name-alternatives><name xml:lang="en"><surname>Zar</surname><given-names>Vadim V.</given-names></name><name xml:lang="ru"><surname>Зар</surname><given-names>Вадим Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>к.м.н., в.н.с. отделения травматологии и ортопедии</p></bio><email>Vzar@list.ru</email><xref ref-type="aff" rid="aff6"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4992-7953</contrib-id><name-alternatives><name xml:lang="en"><surname>Dolzhenkova</surname><given-names>Elena A.</given-names></name><name xml:lang="ru"><surname>Долженкова</surname><given-names>Елена Александровна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><email>79109012823@yandex.ru</email><xref ref-type="aff" rid="aff7"/></contrib><contrib contrib-type="author"><name-alternatives><name xml:lang="en"><surname>Politova</surname><given-names>Natalia N.</given-names></name><name xml:lang="ru"><surname>Политова</surname><given-names>Наталья Николаевна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>MD, PhD</p></bio><bio xml:lang="ru"><p>к.м.н., доцент кафедры</p></bio><email>nnpolitova@yandex.ru</email><xref ref-type="aff" rid="aff8"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Russian Medical Academy of Continuous Professional Education (FSBEI FPE RMACPE)</institution></aff><aff><institution xml:lang="ru">ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России (ФГБОУ ДПО РМАНПО)</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Federal State Budgetary Scientific Institution Research Institute of Rheumatogy named after V.A. Nasonova</institution></aff><aff><institution xml:lang="ru">ФГБНУ «Научно-исследовательский институт ревматологии имени В.А. Насоновой» (НИИР им. В.А. Насоновой)</institution></aff></aff-alternatives><aff-alternatives id="aff3"><aff><institution xml:lang="en">2 Federal State Budgetary Scientific Institution Research Institute of Rheumatogy named after V.A. Nasonova</institution></aff><aff><institution xml:lang="ru">ФГБНУ «Научно-исследовательский институт ревматологии имени В.А. Насоновой» (НИИР им. В.А. Насоновой)</institution></aff></aff-alternatives><aff-alternatives id="aff4"><aff><institution xml:lang="en">Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies FMBA of Russia (FRCC FMBA)</institution></aff><aff><institution xml:lang="ru">ФГБУ «Федеральный научно-клинический центр специализированных видов медицинской помощи и медицинских технологий (ФНКЦ ФМБА России)»</institution></aff></aff-alternatives><aff-alternatives id="aff5"><aff><institution xml:lang="en">A.A. Vishnevsky Central Military Clinical Hospital № 3</institution></aff><aff><institution xml:lang="ru">ФГКУ «3-й Центральный военный клинический госпиталь имени им. А.А. Вишневского» Минобороны России (ЦВКГ)</institution></aff></aff-alternatives><aff-alternatives id="aff6"><aff><institution xml:lang="en">The State Budgetary Healthcare Institution of Moscow Area Moscows regional research clinical institute n.a. M.F. Vladimirskiy (MRRCI n.a. M.F. Vladimirskiy)</institution></aff><aff><institution xml:lang="ru">ГБУЗ МО «Московский областной научно-исследовательский клинический институт имени М.Ф. Владимирского» (МОНИКИ им. М.Ф. Владимирского)</institution></aff></aff-alternatives><aff-alternatives id="aff7"><aff><institution xml:lang="en">Ryazan Regional Clinical Hospital</institution></aff><aff><institution xml:lang="ru">Рязанская областная клиническая больница</institution></aff></aff-alternatives><aff-alternatives id="aff8"><aff><institution xml:lang="en">Kirov State Medical University</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Кировский государственный медицинский университет» Минздрава России (Кировский ГМУ)</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2020-09-15" publication-format="electronic"><day>15</day><month>09</month><year>2020</year></pub-date><volume>23</volume><issue>2</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>42</fpage><lpage>45</lpage><history><date date-type="received" iso-8601-date="2020-07-17"><day>17</day><month>07</month><year>2020</year></date><date date-type="accepted" iso-8601-date="2020-07-22"><day>22</day><month>07</month><year>2020</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2020, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2020, ООО "Эко-Вектор"</copyright-statement><copyright-year>2020</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">ООО "Эко-Вектор"</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2025-01-01"/></permissions><self-uri xlink:href="https://rjmseer.com/1560-9537/article/view/35167">https://rjmseer.com/1560-9537/article/view/35167</self-uri><abstract xml:lang="en"><p><bold>Background. </bold>Alkaptonuria is an orphan, autosomal recessive disease in which clinical symptoms debut in adulthood and are characterized by progressive degenerative changes in large joints (knee, hip, shoulder) and the spine, often leading to the need for joint replacement. Developing changes often lead to persistent disability.</p> <p><bold>The purpose</bold> of this study was to evaluate disability among adult patients with alkaptonuria.</p> <p><bold>Materials and methods.</bold> The study included 46 adult patients (31 m − 67.4% and 15 w − 32.6%) with a reliable diagnosis of alkaptonuria at the age of 20 to 76 years (avg age 56.83 ± 10.52). The assessment of the presence of a disability group at the time of patients’ treatment to a rheumatologist was carried out.</p> <p><bold>Results.</bold> It turned out that disability was determined in 34 (75.6%) patients, there were no signs of persistent disability in 11 patients (24.4%). Among the patients who had signs of persistent disability, most often during the survey period, group 2 disability was established (61.8%), the differences between this and other groups were statistically significant (p &lt; 0.05). For the first time, disability in the study cohort of patients was established at the age of 31 to 59 years (the average age was 50.83 ± 5.5 years).</p> <p><bold>Conclusions.</bold> It is important to note that in the vast majority of cases, persistent disability occurs in patients who were of working age, which underscores the importance of alkaptonuria as a medical and social problem.</p></abstract><trans-abstract xml:lang="ru"><p><bold>Обоснование.</bold> Алкаптонурия ― орфанное, аутосомно-рецессивное заболевание, при котором клиническая симптоматика дебютирует во взрослом возрасте и характеризуется прогрессирующими дегенеративными изменениями в крупных суставах (коленных, тазобедренных, плечевых) и позвоночнике, часто требующими эндопротезирования. Развивающиеся изменения нередко приводят к стойкой утрате трудоспособности.</p> <p><bold>Цель</bold> настоящего исследования ― оценка инвалидизации среди взрослых пациентов с алкаптонурией.</p> <p><bold>Материалы и методы.</bold> В исследование были включены 46 взрослых пациентов (мужчин ― 31; 67,4%; женщин ― 15; 32,6%) с достоверным диагнозом алкаптонурии в возрасте от 20 до 76 (средний возраст 56,83 ± 10,52) лет. Проведена оценка наличия группы инвалидности на момент обращения пациентов к ревматологу.</p> <p><bold>Результаты.</bold> Оказалось, что инвалидность была определена у 34 (75,6%) пациентов, не имелось признаков стойкой утраты трудоспособности у 11 (24,4%) больных. У пациентов, имевших признаки стойкой утраты трудоспособности, чаще всего на период обследования была установлена II группа инвалидности (61,8%), имевшиеся различия между этой и другими группами были статистически значимыми (р &lt; 0,05). Впервые инвалидность в исследуемой когорте больных была установлена в возрасте от 31 до 59 (средний возраст 50,83 ± 5,5) лет.</p> <p><bold>Заключение.</bold> Важно отметить, что в подавляющем большинстве случаев стойкая утрата трудоспособности происходила у пациентов, находившихся в трудоспособном возрасте, что подчеркивает важное значение алкаптонурии как медико-социальной проблемы.</p></trans-abstract><kwd-group xml:lang="en"><kwd>alkaptonuria</kwd><kwd>ochronosis</kwd><kwd>arthropathy</kwd><kwd>disability</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>алкаптонурия</kwd><kwd>охроноз</kwd><kwd>артропатия</kwd><kwd>инвалидизация</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Vilboux T, Kayser M, Introne W, Suwannarat P, et al. Mutation spectrum of homogentisic acid oxidase (HGD) in alkaptonuria. Hum Mutat. 2009;30(12):1611-1619. https://doi.org/10.1002/humu.21120.</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>Taylor AM, Wlodarski B, Prior IA, et al. Ultrastructural examination of tissue in a patient with alkaptonuric arthropathy reveals a distinct pattern of binding of ochronotic pigment. Rheumatology. 2010;49:1412-1414. https://doi.org/10.1093/rheumatology/keq027.</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>Phornphutkul C, Anderson P, Huizing M, et al. Natural history of alkaptonuria. N Engl J Med. 2002;347(26):2111-2121. https://doi.org/10.1056/NEJMoa021736.</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>Башкова И.Б., Кичигин В.А., Шаипов Р.Ш., и др. Охроноз как причина вторичного остеоартроза // Русский медицинский журнал. ― 2017. ― Т.25. ― №7. ― С. 474−480. [Bashkova IB, Kichigin VA, Shaipov RSh., et al. Okhronoz kak prichina vtorichnogo osteoartroza. Russkiy meditsinskiy zhurnal. 2017;25(7):474-480. (In Russ.)]</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Perry MB, Suwannarat P, Furst GP, et al. Musculoskeletal findings and disability in alkaptonuria. J Rheumatol. 2006;33(11):2280-2285.</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>Ranganath LR, Milan AM, Hughes AT, et al. Suitability of nitisinone in alkaptonuria 1 (SONIA 1): an international, multicentre, randomised, open-label, no-treatment controlled, parallel-group, dose-response study to investigate the effect of once daily nitisinone on 24-h urinary homogentisic acid excretion in patients with alkaptonuria after 4 weeks of treatment. Ann Rheum Dis. 2016;75:362-367. https://doi.org/10.1136/annrheumdis-2014-206033.</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>Carrier DA, Harris CM. Bilateral hip and bilateral knee arthroplasties in a patient with ochronotic arthropathy. Orthop Rev. 1990;19(11):1005-1009.</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>Peretz A, Dupont M, Famaey JP. Ochronosis: a case report with severe ochronotic arthropathy. Clin Rheumatol. 1983 Sep;2(3):293-8. https://doi.org/10.1007/BF02041405</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Ventura-Ríos L, Hernández-Díaz C, Gutiérrez-Pérez L, et al. Ochronotic arthropathy as a paradigm of metabolically induced degenerative joint disease. A case-based review. Clin Rheumatol. 2016;35(5):1389-1395. https://doi.org/10.1007/s10067-014-2557-7.</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>Doganavsargil B, Pehlivanoglu B, Bicer EK, et al. Black joint and synovia: Histopathological evaluation of degenerative joint disease due to ochronosis. Pathol Res Pract. 2015;211(6):470-477. https://doi.org/10.1016/j.prp.2015.03.001.</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Saigal R, Tank ML, Pathak P, et al. Alkaptonuric ochronosis. J Assoc Physicians India. 2016;64(4):79-80.</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>Zmerly H, Moscato M, Di Gregori V. Arthroplasty in alkaptonuric ochronosis. J Popul Ther Clin Pharmacol. 2019;26(2):e20-e24. https://doi.org/10.15586/jptcp.v26i2.624.</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>Sabater M, Alías A, Segur JM. Total knee prosthesis in a patient diagnosed with ochronotic arthropathy. Rev Esp Cir Ortop Traumatol. 2020;S1888-4415(20)30013-8. https://doi.org/10.1016/j.recot.2020.01.005.</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>Rajkumar N, Soundarrajan D, Dhanasekararaja P, Rajasekaran S. Clinical and radiological outcomes of total joint arthroplasty in patients with ochronotic arthropathy. Eur J Orthop Surg Traumatol. 2020;30(5):923-929. https://doi.org/10.1007/s00590-020-02651-0.</mixed-citation></ref></ref-list></back></article>
