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 r heumatology consultations, along with the diagnoses, and abnormal resu lts on serologic testing in Gulf War veterans evaluated for Gulf War s yndrome. Methods: The medical records of the first 250 consecutive Gul f War veterans referred to the comprehensive clinical evaluation progr am at Wilford Hall Air Force Medical Center and Brooke Army Medical Ce nter, 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 resu lts was recorded. Results: Of the 250 Gulf War veterans evaluated in t he comprehensive clinical evaluation program, 139 (56%) were referred for rheumatology consultation, which was the most common elective subs pecialty referral. Of the patients evaluated, 82 (59%) had soft tissue syndromes, 19 (14%) had rheumatic disease, and 38 (27%) had no rheuma tic 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 r heumatic 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 arthropat hy. Abnormal serologic test results were common among the Gulf War pat ients regardless of the presence or absence of rheumatic disease. Conc lusions: The rheumatic manifestations in Gulf War veterans are similar to symptoms and diagnoses described in previous wars and are not uniq ue to active duty soldiers. Overall, the results of serologic screenin g were poor predictors of the presence of rheumatic disease.