Reumatologia Clinica最新文献

{"title":"Síndrome antisintetasa en Chile: experiencia en una cohorte clínica","authors":"Sebastián Campos Benavente,&nbsp;Sergio Prieto-González,&nbsp;Óscar Neira Quiroga,&nbsp;Verónica Wolff Cecchi","doi":"10.1016/j.reuma.2026.502216","DOIUrl":"10.1016/j.reuma.2026.502216","url":null,"abstract":"<div><h3>Background and objective</h3><div>Antisynthetase syndrome (ASS) is an autoimmune disease characterized by the presence of autoantibodies against aminoacyl-tRNA synthetases and a variable spectrum of clinical manifestations. Its clinical expression appears to depend on the predominant antibody subtype. In Latin America, and particularly in Chile, published data on this condition remain scarce. The aim of this study was to describe and compare the clinical, immunological, and therapeutic characteristics of patients with ASS according to antib</div><div>ody subtype in a Chilean cohort.</div></div><div><h3>Methods</h3><div>An analytical cross-sectional observational study was conducted, including patients with a clinical diagnosis of ASS and positivity for an antisynthetase antibody (Jo-1, PL-7, PL-12, EJ, or OJ) from Hospital del Salvador and Instituto Nacional del Tórax between June 2018 and June 2022. Clinical manifestations were compared between Jo-1 and non–Jo-1 groups. Fulfillment of classification criteria (Connors, Solomon, and CLASS), first-line treatment strategies, and fatal outcomes were also evaluated.</div></div><div><h3>Results</h3><div>A total of 60 patients were analyzed: 36.7% were anti–Jo-1 positive and 63.3% had other antisynthetase antibodies. Interstitial lung disease (ILD) was the most frequent manifestation (73.3%), predominating in the Jo-1 group (95.5% vs. 60.5%, p=0.003). Myopathy and arthritis were more common in Jo-1 than in non–Jo-1 patients (p=0.017 and p=0.048, respectively). Patterns of clinical involvement differed significantly, with triple involvement (ILD, arthritis, and myopathy) observed in 52.4% of Jo-1 patients and 18.8% of non–Jo-1 patients (p=0.0001). Only 56.6% of the cohort fulfilled Solomon criteria, whereas 80% fulfilled CLASS criteria, with lower fulfillment rates in the non–Jo-1 group. Mycophenolate mofetil was the most frequently used immunosuppressive therapy, particularly in patients with ILD, and methylprednisolone pulse therapy was associated with pulmonary involvement and more extensive clinical phenotypes. Ro52 positivity was associated with ILD (p=0.002) and NSIP/OP patterns.</div></div><div><h3>Conclusion</h3><div>Antisynthetase syndrome in Chile demonstrated a heterogeneous clinical spectrum according to antibody subtype. Only one-third of patients were anti–Jo-1 positive, showing a more classic clinical phenotype, whereas non–Jo-1 patients tended to present with a more oligosymptomatic disease pattern. The high frequency of ILD and its association with Ro52 positivity highlight their clinical relevance. Current classification criteria appear insufficient for non–Jo-1 patients, emphasizing the need for validation s</div><div>tudies in our region.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502216"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148660833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A propósito de un caso: síndrome de CRIA. Evolución desde la respuesta inicial a anakinra hasta el control sostenido con tocilizumab","authors":"Judith Hernández Sánchez,&nbsp;Doryan José García Olivas,&nbsp;Sergio Machín García,&nbsp;José Ángel Hernández Beriain","doi":"10.1016/j.reuma.2026.502170","DOIUrl":"10.1016/j.reuma.2026.502170","url":null,"abstract":"<div><div>We present the case of a 40-day-old female infant with acute febrile illness, cutaneous lesions, severe respiratory distress, and shock refractory to antibiotic therapy. Skin biopsy revealed findings consistent with acute febrile neutrophilic dermatosis (Sweet syndrome). After excluding infectious, hematological, and hemophagocytic etiologies, an autoinflammatory syndrome was suspected, and treatment with anakinra and glucocorticoids was initiated, resulting in initial clinical improvement. However, after one year of treatment and dose tapering, the patient experienced relapses. Tocilizumab was then started, leading to a sustained clinical response to date.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 7","pages":"Article 502170"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148661156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of video DASH for upper limb disorders in rheumatic patients","authors":"David Vega-Morales ,&nbsp;Talia Dinora Galván-Lara ,&nbsp;Jorge Medina-Castillo ,&nbsp;Pablo Herrera-Sandate ,&nbsp;Luis Antonio Chavez-Alvarez ,&nbsp;Paulina Valdés Torres ,&nbsp;Ana Karen Vazquez-Bañuelos","doi":"10.1016/j.reuma.2026.502192","DOIUrl":"10.1016/j.reuma.2026.502192","url":null,"abstract":"<div><h3>Introduction</h3><div>The Disabilities of the Arm, Shoulder and Hand (DASH) is a widely validated 30-item self-administered instrument used to quantify upper limb disability. In rheumatoid arthritis, limitations in construct validity have been reported in certain subgroups; therefore, a multimedia version (video-DASH), incorporating illustrative videos for each item, may improve comprehension and response consistency.</div></div><div><h3>Objective</h3><div>To evaluate the psychometric properties and acceptability of the video-DASH in patients with rheumatological diseases affecting the upper limb.</div></div><div><h3>Materials and methods</h3><div>A prospective methodological validation study including 28 participants (≥18 years) with a confirmed rheumatological diagnosis involving the upper limb. Exclusion criteria were severe cognitive impairment, visual or hearing limitations precluding interaction with the multimedia version, and surgery or acute upper limb injury within the previous 3 months. The questionnaire was administered at three time points. Internal consistency (Cronbach's <em>α</em>), test–retest reliability (intraclass correlation coefficient, ICC), longitudinal comparisons (Wilcoxon test with Holm correction), and agreement (Bland–Altman analysis) were assessed. A comprehension and satisfaction survey was also administered.</div></div><div><h3>Results</h3><div>Mean age was 55.5<!--> <!-->±<!--> <!-->9.06 years (34–72), and the predominant diagnosis was rheumatoid arthritis (92.9%). Mean scores decreased from 31.93 to 26.53 and 23.08, with significant differences across comparisons. Internal consistency was high (<em>α</em> <!-->=<!--> <!-->0.961, 0.979, and 0.987), and reliability was adequate (ICC<!--> <!-->=<!--> <!-->0.785–0.940). Bland–Altman analysis showed minimal bias. All participants reported adequate comprehension and positive satisfaction.</div></div><div><h3>Conclusion</h3><div>The video-DASH demonstrates good reliability and acceptability, supporting its use as a tool to assess upper limb function in patients with rheumatic disease.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502192"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causas de retiro del tratamiento biológico en pacientes con enfermedades reumáticas: estudio de cohorte observacional del sureste de México","authors":"Angel Alejandro Castillo Ortiz ,&nbsp;Aaron Alejandro Barrera Rodriguez","doi":"10.1016/j.reuma.2026.502171","DOIUrl":"10.1016/j.reuma.2026.502171","url":null,"abstract":"<div><h3>Background and objective</h3><div>Biologic therapy withdrawal in inflammatory rheumatic diseases is a frequent event with direct consequences on disease control, safety, and care costs. Real-world data from southeastern Mexico remain scarce. The objective of this study was to describe the causes of biologic treatment withdrawal and to explore factors associated with drug survival in patients attending a referral rheumatology clinic in southeastern Mexico.</div></div><div><h3>Patients and methods</h3><div>Observational, retrospective cohort study. The unit of analysis was the biologic treatment episode. After data cleaning, 583 episodes from 426 unique patients were included (mean 1.37 episodes/patient). Kaplan-Meier curves were constructed for treatment line and biologic class; comparisons used the log-rank test (presented descriptively given potential within-patient correlation). A multivariable Cox proportional hazards model was fitted with a cluster-robust sandwich variance estimator grouped by patient. Significance level: <em>P</em> <!-->&lt;<!--> <!-->.05.</div></div><div><h3>Results</h3><div>84.0% of patients were female; median age 51<!--> <!-->years (IQR 41-58). Rheumatoid arthritis accounted for 76.7% of episodes and anti-TNF agents for 87.3% of biologic use. A total of 175 withdrawals (30.0%) were recorded. Among episodes with a documented reason, inefficacy was the most frequent cause (n<!--> <!-->=<!--> <!-->134; 84.3%), followed by adverse events (n<!--> <!-->=<!--> <!-->24; 15.1%) and non-medical causes (n<!--> <!-->=<!--> <!-->1; 0.6%). No significant difference in drug survival by treatment line was observed (log-rank <em>P</em> <!-->=<!--> <!-->.40). Descriptive differences were observed across biologic classes (log-rank <em>P</em> <!-->&lt;<!--> <!-->.001). In the adjusted Cox model, the anti-IL-6 class was associated with lower withdrawal risk (HR 0.14; 95%<!--> <span>C</span>I<span>:</span> 0.06-0.37; <em>P</em> <!-->&lt;<!--> <!-->.001) versus anti-TNF.</div></div><div><h3>Discussion and conclusions</h3><div>In this single-center cohort from southeastern Mexico, inefficacy was the most commonly identified medical cause of biologic withdrawal. Descriptive differences in drug survival were observed across biologic classes, with the most consistent signal in the anti-IL-6 class. These findings are hypothesis-generating and should be confirmed in larger, multicenter registries with more complete covariate adjustment.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502171"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two curious cases of muscle weakness secondary to sarcoidosis: Sarcoid myopathy, a rare entity","authors":"Sabela Castañeda Pérez,&nbsp;Nuria Vázquez Temprano,&nbsp;Ana Fernández Argüeso,&nbsp;Sara Astor Molero,&nbsp;Carmen Malvarez Martín-Aragón,&nbsp;Julia Diéguez Paz,&nbsp;Hadrián Pernas Pardavila,&nbsp;Eide Diana Alves Pereira","doi":"10.1016/j.reuma.2026.502158","DOIUrl":"10.1016/j.reuma.2026.502158","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502158"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coexistence of systemic lupus erythematosus and sarcoidosis: A case-based review","authors":"Dilara Bulut Gökten ,&nbsp;Meltem Öznur ,&nbsp;Rıdvan Mercan","doi":"10.1016/j.reuma.2026.502169","DOIUrl":"10.1016/j.reuma.2026.502169","url":null,"abstract":"<div><div>Sarcoidosis and systemic lupus erythematosus (SLE) are chronic multisystem inflammatory diseases with distinct pathogenetic mechanisms but overlapping clinical and immunological features. Their coexistence is exceedingly rare and may result in diagnostic delay or misinterpretation of disease activity. A 50-year-old woman presented with photosensitive facial rash, oral ulcers, constitutional symptoms, cytopenia, hypocomplementemia, and markedly elevated anti-double-stranded DNA titers, fulfilling the 2019 ACR/EULAR classification criteria for SLE. During follow-up, atypical cutaneous lesions involving the external auditory canal were identified. Histopathological examination revealed non-caseating granulomatous inflammation. Further evaluation with thoracic imaging and endobronchial ultrasound-guided biopsy demonstrated bilateral hilar and mediastinal lymphadenopathy with granulomatous inflammation, confirming the diagnosis of sarcoidosis. Treatment with hydroxychloroquine, systemic corticosteroids, and methotrexate led to significant clinical and laboratory improvement over a six-month follow-up period. This case highlights the importance of considering a coexisting diagnosis when atypical clinical or histopathological findings emerge in patients with established autoimmune disease, with histological confirmation playing a central role in accurate diagnosis.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502169"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"El tiempo de consulta como determinante de la calidad asistencial y seguridad del paciente en reumatología","authors":"Gabriel Horta-Baas","doi":"10.1016/j.reuma.2026.502153","DOIUrl":"10.1016/j.reuma.2026.502153","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502153"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alfabetización en inteligencia artificial en fibromialgia: la brecha inversa entre pacientes informados y clínicos no preparados","authors":"Juan Sebastián Therán-León ,&nbsp;Andrés Felipe Otero-Rueda","doi":"10.1016/j.reuma.2026.502154","DOIUrl":"10.1016/j.reuma.2026.502154","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502154"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caracterización de alteraciones capilaroscópicas en los pacientes con vasculitis sistémicas primarias","authors":"Everardo Álvarez-Hernández,&nbsp;Mariana Berenice Colli-Cortés","doi":"10.1016/j.reuma.2026.502168","DOIUrl":"10.1016/j.reuma.2026.502168","url":null,"abstract":"<div><h3>Background</h3><div>Clinical manifestations in systemic vasculitis may be due to decreased arterial and venous flow because inflammation. There are few studies characterizing the changes in microcirculation in these diseases. Capillaroscopy can help detect changes in the microvasculature.</div></div><div><h3>Objective</h3><div>Characterize capillaroscopy alterations in primary systemic vasculitiśs patients and associated factors.</div></div><div><h3>Patients</h3><div>Cross-sectional, observational, and comparative study. Thirty-two patients with systemic vasculitis (PGA n<!--> <!-->=<!--> <!-->17, PAM n<!--> <!-->=<!--> <!-->4, AT n<!--> <!-->=<!--> <!-->4, PHS n<!--> <!-->=<!--> <!-->3, PAN n<!--> <!-->=<!--> <!-->2, and others n<!--> <!-->=<!--> <!-->2) and 32 controls matched for age and sex were included. All participants underwent capillaroscopy of eight fingers (2<!--> <!-->nd to 5<!--> <!-->th finger of each hand), obtaining at least two images of each finger studied for analysis.</div></div><div><h3>Results</h3><div>No characteristic pattern was found, only nonspecific changes. Avascular areas (84.4 vs. 59.4%, p<!--> <!-->=<!--> <!-->0.026), microhemorrhages (34.4 vs. 6.3%, p<!--> <!-->&lt;<!--> <!-->0.005), and neoangiogenesis (34.4 vs. 0%, p<!--> <!-->&lt;<!--> <!-->0.001) were more frequent in the vasculitis group compared to the control group. The duration of the disease had moderate correlation with capillary density (r<!--> <!-->=<!--> <!-->−0.31, p<!--> <!-->=<!--> <!-->0.010) and avascular areas (r<!--> <!-->=<!--> <!-->0.40, p<!--> <!-->=<!--> <!-->0.001).</div><div>cumulative damage (VDI) had moderate correlation (r<!--> <!-->=<!--> <!-->0.50, p<!--> <!-->=<!--> <!-->0.050) with capillary density. Capillary neoangiogenesis correlated with the diagnosis of vasculitis (r<!--> <!-->=<!--> <!-->−0.40, p<!--> <!-->=<!--> <!-->0.001) and ischemic lesions (r<!--> <!-->=<!--> <!-->0.371, p<!--> <!-->=<!--> <!-->0.003). The factors associated with capillaroscopic changes were: disease activity (BVAS3), VDI and presence of ischemic lesions.</div></div><div><h3>Discussion and conclusions</h3><div>The search for capillaroscopic abnormalities in patients with systemic vasculitis may be useful in patients with a history of ischemic lesions and longer disease duration.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502168"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antinuclear antibody detection beyond anti-dsDNA and anti-ENA: New insights from intact HEp-2 nucleus ELISA","authors":"Faruk Dişli ,&nbsp;Sedat Yıldız","doi":"10.1016/j.reuma.2026.502165","DOIUrl":"10.1016/j.reuma.2026.502165","url":null,"abstract":"<div><h3>Background</h3><div>Intact HEp-2 nucleus-based ELISA tests are occasionally preferred for antinuclear antibody (ANA) screening, although their correlation with clinically relevant autoantibodies such as anti-dsDNA and anti-ENA remains unclear. This study analyzed the correlation between HEp-2 nucleus-based ELISA and anti-dsDNA and anti-ENA tests in a large sample to provide analytical insight into their relationship.</div></div><div><h3>Material and methods</h3><div>A total of 900 serum samples were included in the study (mean age: 39.7 years; 481 females and 419 males). Anti-dsDNA, anti-ENA, and intact HEp-2 nucleus-based ELISA tests were performed in all samples using validated ELISA methods. Correlation analyses between test results were performed using Spearman's rank correlation coefficient due to non-normal data distribution.</div></div><div><h3>Results</h3><div>HEp-2 ELISA showed a moderate correlation with anti-dsDNA (<em>r</em> <!-->=<!--> <!-->0.431, <em>p</em> <!-->&lt;<!--> <!-->0.001) and a stronger correlation with anti-ENA (<em>r</em> <!-->=<!--> <!-->0.625, <em>p</em> <!-->&lt;<!--> <!-->0.001). Among the 431 individuals who tested positive in at least one of the three assays, 96 were positive for all three. Additionally, 41 individuals were positive for both anti-dsDNA and HEp-2, and 44 for both anti-ENA and HEp-2. Isolated positivity was observed in 112 individuals for anti-dsDNA, 48 for anti-ENA, and 54 for HEp-2. This distribution reflects both overlapping and distinct patterns of antibody detection among the tests.</div></div><div><h3>Conclusions</h3><div>HEp-2 nucleus-based ELISA demonstrated analytical concordance with both anti-dsDNA and anti-ENA assays. Moreover, its ability to detect distinct autoantibody reactivities not identified by conventional methods suggests its value as a complementary tool in comprehensive ANA screening.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"22 6","pages":"Article 502165"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148208444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}