Reumatologia Clinica最新文献

{"title":"Infecciones graves en vasculitis necrosantes sistémicas","authors":"Claudia Pena,&nbsp;Ana Carolina Costi,&nbsp;Lucila García,&nbsp;Mercedes García","doi":"10.1016/j.reuma.2024.01.003","DOIUrl":"10.1016/j.reuma.2024.01.003","url":null,"abstract":"<div><p>Infections in patients with systemic vasculitis represent one of the main causes of mortality. Corticosteroid use, immunosuppressive therapy, age, associated organic involvement and dialysis dependence are risk factors of infection.</p></div><div><h3>Objectives</h3><p>To determine the prevalence of severe infection and associated factors in patients diagnosed with ANCA-associated vasculitis and polyarteritis nodosa (PAN).</p></div><div><h3>Methods</h3><p>Retrospective study was conduced in a single rheumatology center (2000-2018). We included patients diagnosed with ANCA-associated vasculitis (granulomatosis with polyangiitis, eosinophilic granulomatosis with polyangiitis and microscopic polyangiitis and PAN. Serious infectious events requiring hospitalization or prolonged antibiotic/antiviral treatment, recurrent infection of herpes zoster virus or opportunistic infections were evaluated. Sites of infection, isolated microorganisms and mortality related were analyzed.</p></div><div><h3>Results</h3><p>A total of 105 patients were analyzed, follow-up time median 18 months, 58.7% were women and median age was 52 years. Types of vasculitis: 41.9% microscopic polyangiitis, 16.2% eosinophilic granulomatosis with polyangiitis, 40% granulomatosis with polyangiitis, 1.9% PAN. Constitutional, pulmonary, renal and otorhinolaryngology manifestations were the most frequent.</p></div><div><h3>The prevalence of infection</h3><p>was 34,2%, with a median of 3 months from diagnosis of vasculitis to the infectious event. Low respiratory tract (42.8%), sepsis (31.4%), and urinary tract (14.3%) were the most common sites of infections. Bacterial etiology was the most prevalent (67.7%). Mortality at the first event was 14.3% and a 72.2% of patients were in the induction phase of treatment.</p><p>Infectious events were significantly associated with age<!--> <!-->&gt; 65 years (<em>P</em> <!-->=<!--> <!-->0.030), presence of lung (<em>P</em> <!-->=<!--> <!-->0.016) and renal involvement (<em>P</em> <!-->=<!--> <!-->0.001), BVASv3<!--> <!-->&gt; 15 and mortality (<em>P</em> <!-->=<!--> <!-->0.0002).</p></div><div><h3>Conclusions</h3><p>The prevalence of infection was 34.2%. Lower airway infections, septicemia and urinary tract infections were the most prevalent. Infections were associated with renal and pulmonary involvement, age older than 65 years and score BVAS<!--> <!-->&gt;15. Severe infections were associated with mortality, especially in elderly patients.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140469368","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":"Cardiovascular disease in patients with systemic autoimmune diseases: The relationship between self-perceived risk and actual risk","authors":"Cristiana Sieiro Santos ,&nbsp;Maria Miguel Oliveira ,&nbsp;Paulo Ney Solari ,&nbsp;Pedro Mateus ,&nbsp;Maria José Santos ,&nbsp;Hector Corominas ,&nbsp;Carolina Álvarez Castro ,&nbsp;Elvira Díez Álvarez","doi":"10.1016/j.reuma.2024.01.002","DOIUrl":"10.1016/j.reuma.2024.01.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Autoimmune diseases are known to be associated with an elevated risk of cardiovascular diseases; however, there exists a lack of awareness regarding this increased risk among patients.</p></div><div><h3>Objective</h3><p>This study aimed to assess the prevalence of cardiovascular risk factors and events in various systemic autoimmune diseases, including Systemic Sclerosis (SSc), Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), and Sjögren's syndrome (SS), matched by age, sex, and disease duration. Additionally, the study aimed to evaluate the perceived and actual risks of cardiovascular disease among patients.</p></div><div><h3>Methods</h3><p>A cross-sectional self-reported survey on the patient's perspective of cardiovascular risk was conducted between January and June 2023. Sociodemographic and clinical data, including disease activity, were collected through medical records and questionnaires. Traditional cardiovascular risk factors and events were assessed, alongside the perceived cardiovascular risk. The SCORE calculation and Charlson Comorbidity Index (CCI) were employed for cardiovascular risk assessment.</p></div><div><h3>Results</h3><p>Survey responses from 180 patients (45 patients each with SSc, SLE, RA, and SS) with systemic autoimmune diseases revealed that 20% perceived a low risk, 23% perceived neither lower nor higher, and 56% perceived a higher risk of developing cardiovascular diseases in the next ten years. Only 45% agreed that their autoimmune disease could increase the risk of a heart attack, even in the absence of other risk factors, and 46.7% were unaware that NSAIDs pose a cardiovascular risk. An association between cardiovascular risk measured by SCORE, comorbidities, and risk perception was observed in RA, SSc, and SS patients, with no association found in SLE patients (<em>p</em> <!-->=<!--> <!-->0.27). Except for SS patients (<em>p</em> <!-->=<!--> <!-->0.02), no association between CCI and disease activity level was found. Regarding the influence of age, working status, and education in CVD risk perception, an association between CVD risk perception and age was observed (<em>p</em> <!-->=<!--> <!-->0.01), with patients over 40 years exhibiting a higher perception of CVD risk. No differences were found regarding working status (<em>p</em> <!-->=<!--> <!-->0.19) nor education level (<em>p</em> <!-->=<!--> <!-->0.06).</p></div><div><h3>Conclusions</h3><p>Patients with SS, RA, and SSc displayed a heightened perception of cardiovascular risk, correlating with their actual risk and preexisting comorbidities. However, patients exhibited unawareness of certain cardiovascular risk behaviors. This underscores the need for tailored education programs on cardiovascular risk for autoimmune disease patients, to be implemented at the time of diagnosis and during follow-up in outpatient clinics.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140763732","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":"Comunicaciones orales","authors":"","doi":"10.1016/S1699-258X(24)00059-7","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00059-7","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094891","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":"Pósteres: P1-P99","authors":"","doi":"10.1016/S1699-258X(24)00061-5","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00061-5","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094893","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":"Pósteres: P100-P199","authors":"","doi":"10.1016/S1699-258X(24)00062-7","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00062-7","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094894","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":"Pósteres: P400-P465","authors":"","doi":"10.1016/S1699-258X(24)00065-2","DOIUrl":"https://doi.org/10.1016/S1699-258X(24)00065-2","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141095360","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":"Cytokine storm in Chikungunya: Can we call it multisystem inflammatory syndrome associated with Chikungunya?","authors":"Zoilo Morel ,&nbsp;Tamara Martínez ,&nbsp;Fernando Galeano ,&nbsp;Judith Coronel ,&nbsp;Lorena Quintero ,&nbsp;Rolando Jimenez ,&nbsp;Jorge Ayala ,&nbsp;Sara Amarilla ,&nbsp;Dolores Lovera ,&nbsp;Celia Martínez de Cuellar","doi":"10.1016/j.reuma.2023.10.003","DOIUrl":"10.1016/j.reuma.2023.10.003","url":null,"abstract":"<div><p>Paraguay is currently facing a new outbreak of Chikungunya virus. This report summarizes two severe cases of Chikungunya (CHIKV) infection, confirmed by real-time reverse transcription polymerase chain reaction. We present the cases of patients with acute CHIKV infection and multisystem involvement, with fever, rash, abdominal pain, vomiting, myocarditis, and coronary artery anomalies, very similar to the cases described in MIS-C related to SARS-CoV-2 during the COVID-19 Pandemic. Both patients received IVIG and methylprednisolone, with good clinical response. In this setting of cytokine storm in Chikungunya, can we call it “Multisystem inflammatory syndrome associated with Chikungunya”?.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139293529","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":"Does sacroiliitis is a mandatory criterion for enthesitis-related arthritis diagnosis?","authors":"Hanene Lassoued Ferjani ,&nbsp;Lobna Kharrat ,&nbsp;Dorra Ben Nessib ,&nbsp;Dhia Kaffel ,&nbsp;Kaouther Maatallah ,&nbsp;Wafa Hamdi","doi":"10.1016/j.reuma.2023.12.005","DOIUrl":"10.1016/j.reuma.2023.12.005","url":null,"abstract":"<div><h3>Introduction and objectives</h3><p>Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA).</p><p>We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients.</p></div><div><h3>Materials and methods</h3><p>We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype.</p></div><div><h3>Results</h3><p>ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1<!--> <!-->=<!--> <!-->16 versus G2<!--> <!-->=<!--> <!-->3, <em>p</em> <!-->=<!--> <!-->0.005).</p><p>Sacroiliac joints MRI's sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68–28.09; <em>p</em> <!-->=<!--> <!-->0.006).</p></div><div><h3>Conclusion</h3><p>Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538619","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":"La p.(Tyr135His), una nueva variante asociada a la fiebre mediterránea familiar","authors":"Francisco José Nicolás-Sánchez ,&nbsp;Lluis Eleuteri Pons I Ferré ,&nbsp;Francesc Josep Nicolás-Sarrat ,&nbsp;Alberto González Barranquero","doi":"10.1016/j.reuma.2023.09.010","DOIUrl":"10.1016/j.reuma.2023.09.010","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135850287","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":"Recomendaciones SER sobre el tratamiento del síndrome de Behçet refractario","authors":"Clara Moriano Morales ,&nbsp;Jenaro Graña Gil ,&nbsp;Noé Brito García ,&nbsp;José Luis Martín Varillas ,&nbsp;Vanesa Calvo del Río ,&nbsp;Patricia Moya Alvarado ,&nbsp;Francisco Javier Narváez García ,&nbsp;Gerard Espinosa ,&nbsp;Petra Díaz del Campo Fontecha ,&nbsp;Mercedes Guerra Rodríguez ,&nbsp;José Mateo Arranz ,&nbsp;Manuela López Gómez ,&nbsp;Félix Manuel Francisco Hernández ,&nbsp;M. Mar Trujillo ,&nbsp;Raquel dos Santos Sobrín ,&nbsp;Juan Ignacio Martín Sánchez ,&nbsp;Jesús Maese Manzano ,&nbsp;Julio Suárez Cuba","doi":"10.1016/j.reuma.2023.12.001","DOIUrl":"10.1016/j.reuma.2023.12.001","url":null,"abstract":"<div><h3>Objective</h3><p>To develop multidisciplinary recommendations based on available evidence and expert consensus for the therapeutic management of patients with refractory Behçet's syndrome (difficult to treat, severe resistant, severe relapse) to conventional treatment.</p></div><div><h3>Methods</h3><p>A group of experts identified clinical research questions relevant to the objective of the document. These questions were reformulated in PICO format –patient, intervention, comparison and outcome–. Systematic reviews of the evidence were conducted; the quality of the evidence was evaluated following the methodology of the international working group <em>Grading of Recommendations, Assessment, Development, and Evaluation</em>. After that, the multidisciplinary panel formulated the specific recommendations.</p></div><div><h3>Results</h3><p>Four PICO questions were selected regarding the efficacy and safety of systemic pharmacological treatments in patients with Behçet's syndrome with clinical manifestations refractory to conventional therapy related to mucocutaneous and/or articular, vascular, neurological parenchymal and gastrointestinal phenotypes. A total of 7 recommendations were made, structured by question, based on the identified evidence and expert consensus.</p></div><div><h3>Conclusions</h3><p>The treatment of most severe clinical manifestations of Behçet's syndrome lacks solid scientific evidence and, besides, there are no specific recommendation documents for patients with refractory disease. With the aim of providing a response to this need, here we present the first official recommendations of the Spanish Society of Rheumatology for the management of these patients. They are devised as a tool for assistance in clinical decision making, therapeutic homogenisation and to reduce variability in the care of these patients.</p></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395267","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}