Reumatologia Clinica最新文献

{"title":"Evaluación de la eficacia y seguridad de la terapia gravitacional en una cohorte de pacientes con esclerosis sistémica","authors":"Luisa Fernanda Servioli ,&nbsp;Eugenia Isasi ,&nbsp;Alejandra Pérez ,&nbsp;Silvia Pouquette ,&nbsp;María Eloísa Isasi","doi":"10.1016/j.reuma.2024.07.006","DOIUrl":"10.1016/j.reuma.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><div>The exposure to artificial gravity (AG) through human centrifugation is the basis of the treatment called gravity therapy (GT), in which the mechanical stimulation over the vessel wall, induces the synthesis and release of prostacyclin. It has been used for more than four decades in Uruguay in the treatment of different vascular-based pathologies. In patients with systemic sclerosis (SSc) it has shown good benefits and excellent safety profile over the years. However, there is a lack of knowledge in the scientific community about GT and its results.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of GT in cutaneous and vascular involvement, in the quality of life and functional capacity and its safety profile in patients with SSc.</div></div><div><h3>Methodology</h3><div>It is a descriptive and retrospective study of patients with SSc assisted in an autoimmunity center in Montevideo, treated with GT in the last 10<!--> <!-->years.</div></div><div><h3>Results</h3><div>Fifty patients were included, 48 women (96%) and 2 men (4%) with a mean age of 62<!--> <!-->±<!--> <!-->12 years. The mean time of evolution of SSc at the time of inclusion in the study at the beginning of GT was 6.8<!--> <!-->±<!--> <!-->3.2 years and 2.8<!--> <!-->±<!--> <!-->3.2 years respectively. After GT, a significant improvement in the modified Rodnan skin score (mRSS) was observed (pre-GT 19.2<!--> <!-->±<!--> <!-->8.7 vs post-GT 5.4<!--> <!-->±<!--> <!-->5.0, <em>P</em> <!-->&lt;<!--> <!-->.05), which was not related to the time of disease progression at the beginning of GT nor to the skin extension or immunological profile. The degree of improvement post-GT was related to a higher initial mRSS (R<!--> <!-->=<!--> <!-->0.84, <em>P</em> <!-->&lt;<!--> <!-->.05). Also, a significant improvement was observed in the number of patients with puffy fingers (pre-GT 50% vs post-GT 20% patients, <em>P</em> <!-->&lt;<!--> <!-->.05), but not in telangiectasias, pitting scars or sclerodactyly. The severity of Raynaud's phenomenon significantly decreased (pre-GT: grade 3-4, 43/48 (89.6%) patients vs post-GT: grade ≤<!--> <!-->2, 42/47 (89.4%) patients, <em>P</em> <!-->&lt;<!--> <!-->.05) as well as the vascular pain measured with VAS (0-10 scale) (pre-GT: 7.6<!--> <!-->±<!--> <!-->2.2 vs post-TG: 1.4<!--> <!-->±<!--> <!-->1.2, <em>P</em> <!-->&lt;<!--> <!-->.05). The healing of digital ulcers was also recorded. Regarding the results reported by patients, 97% reported improvement in the quality of life and 89.5% improvement in the ability to carry out activities of daily living. No significant adverse effects were recorded.</div></div><div><h3>Conclusions</h3><div>GT improved cutaneous and vascular involvement, the quality of life and the functional capacity in patients with SSc with an excellent safety profile. Randomized, controlled clinical trials are needed to corroborate these observational results.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 463-469"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578917","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":"HLA-B*51:01 in Iranian patients with Behcet uveitis syndrome","authors":"Zahra Hoseini ,&nbsp;Fatemeh Rezaei Rad ,&nbsp;Mohammad Zarei ,&nbsp;Nazanin Ebrahimiadib ,&nbsp;Zahra Salimian ,&nbsp;Mahdi Zamani","doi":"10.1016/j.reuma.2024.07.001","DOIUrl":"10.1016/j.reuma.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><div>Behcet's disease (BD) is a multisystem disorder prevalent along the historic Silk Road, with Behcet's uveitis (BU) representing a significant complication contributing to disability. Various studies have linked different HLA alleles with BD across diverse populations.</div></div><div><h3>Methods</h3><div>In this study, we investigated the association between HLA-B51:01/x and HLA-B27/x genotypes with Behcet's uveitis in 50 unrelated Iranian patients diagnosed with Behcet's uveitis, comparing them to a control group of 70 healthy individuals. Our analysis aimed to determine the susceptibility conferred by these alleles and assess their clinical relevance.</div></div><div><h3>Results</h3><div>Our findings indicate a notable susceptibility conferred by the HLA-B51:01/x genotype for Behcet's uveitis (<em>P</em> <!-->=<!--> <!-->0.0001). Conversely, the B27/x genotype did not demonstrate significant associations with Behcet's uveitis. Furthermore, we employed prevalence-corrected positive predictive value (PcPPV) calculations to gauge the clinical utility of testing for these alleles within the Iranian Behcet's uveitis patient population. The PcPPV for B27/x genotype testing was determined to be 0.05%, while the PcPPV for B51:01/x genotype testing in the same population was 0.065%. These results suggest that carriers of the B*51:01 allele, when presenting with clinical symptoms, exhibit a heightened risk for Behcet's uveitis compared to the general population.</div></div><div><h3>Conclusion</h3><div>Individuals carrying the B51:01 allele, when symptomatic, face an elevated Behcet's uveitis risk. This insight aids in targeted clinical assessments for at-risk populations.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 470-475"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578916","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":"Fabry disease in familial Mediterranean fever according to the severity of the disease","authors":"Sadettin Uslu ,&nbsp;Gökhan Kabadayi ,&nbsp;Pelin Teke Kısa ,&nbsp;Tuba Yüce Inel ,&nbsp;Zümrüt Arslan ,&nbsp;Nur Arslan ,&nbsp;Servet Akar ,&nbsp;Fatos Onen ,&nbsp;Ismail Sari","doi":"10.1016/j.reuma.2024.09.002","DOIUrl":"10.1016/j.reuma.2024.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Mutations in the α-galactosidase A (GLA) gene result in Fabry disease (FD), a rare metabolic condition. FD patients present with heterogeneous clinical manifestations, which may overlap with systemic diseases including familial Mediterranean fever (FMF). The aim of this study was to determine the frequency of FD in patients with mild and severe FMF and to prevent misdiagnosis by increasing clinicians’ awareness.</div></div><div><h3>Methods</h3><div>Based on Tel-Hashomer criteria, the study included a total of 91 FMF patients. Patients were divided into two groups according to the number of recurrent clinical episodes or failure to respond to maximum therapy: those with mild and severe forms of the disease. GLA gene mutations and α-GLA enzyme activity were assessed. Records of MEFV mutations, therapies and demographic characteristics were kept.</div></div><div><h3>Results</h3><div>FD testing was performed on a cohort of 91 FMF patients, 54.9% had mild FMF, 45.1% had severe FMF, and only one patient in the mild FMF subgroup tested positive for FD. The patient was a 39-year-old woman with a history of recurrent abdominal pain, distal limb pain and fever. She had low GLA enzyme activity and a heterozygous GLA gene mutation.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that FD should be considered in the differential diagnosis of FMF, especially in individuals with unusual symptoms.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 484-489"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578919","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":"Guías de Práctica Clínica para el tratamiento del lupus eritematoso sistémico del Colegio Mexicano de Reumatología. Actualización 2024","authors":"Lilia Andrade-Ortega ,&nbsp;Daniel Xibillé-Friedmann ,&nbsp;Dionicio A. Galarza-Delgado ,&nbsp;Miguel Ángel Saavedra ,&nbsp;José Alvarez-Nemegyei ,&nbsp;Mary-Carmen Amigo-Castañeda ,&nbsp;Hilda Fragoso-Loyo ,&nbsp;María Vanessa Gordillo-Huerta ,&nbsp;Fedra Irazoque-Palazuelos ,&nbsp;Luis Javier Jara-Quezada† ,&nbsp;Javier Merayo-Chalico ,&nbsp;Margarita Portela-Hernández ,&nbsp;Sandra Sicsik-Ayala ,&nbsp;Carlos Abud-Mendoza ,&nbsp;Deshire Alpizar-Rodriguez ,&nbsp;José Luis Amaya-Estrada ,&nbsp;Yaneth R. Barragán-Navarro ,&nbsp;Sandra M. Carrillo-Vázquez ,&nbsp;Zully Castro-Colín ,&nbsp;Luis Javier Cruz-Álvarez ,&nbsp;Leonor A. Barile-Fabris","doi":"10.1016/j.reuma.2024.07.004","DOIUrl":"10.1016/j.reuma.2024.07.004","url":null,"abstract":"<div><div>Herein we present the update for the Mexican Guidelines for the Treatment of Systemic Lupus Erythematosus. It involves the participation of several experts along the country, following the GRADE system.</div><div>We included aspects regarding vaccines, pregnancy and cardiovascular risk which were not presented in the previous guidelines in 2017.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 490-510"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578920","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":"Miositis por cuerpos de inclusión: informe de un caso de diagnóstico tardío","authors":"Deysi Andrea Hernández-Rivero ,&nbsp;Lisette Bazán-Rodríguez ,&nbsp;María del Pilar Cruz-Domínguez ,&nbsp;Gabriela Medina ,&nbsp;Ana Lilia Peralta Amaro ,&nbsp;Olga Vera-Lastra","doi":"10.1016/j.reuma.2024.07.003","DOIUrl":"10.1016/j.reuma.2024.07.003","url":null,"abstract":"<div><div>Inclusion body myositis is a idiopathic inflammatory myopathy characterized by muscle weakness and dysphagia, with muscle biopsy showing inflammation and rimmed vacuoles. We present the case of a patient who was diagnosed with polymyositis but due to lack of response to treatment, a new biopsy revealed inclusion body myositis.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 511-512"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578921","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":"Prevalencia del entesofito occipital en enfermedades reumáticas inflamatorias y no inflamatorias","authors":"Natalia de la Torre Rubio,&nbsp;Jose Campos Esteban,&nbsp;José Luis Andréu Sánchez,&nbsp;Jesús Sanz Sanz","doi":"10.1016/j.reuma.2024.06.004","DOIUrl":"10.1016/j.reuma.2024.06.004","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 513-514"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578922","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 fibromialgia con factor reumatoide elevado se asocia a mala respuesta terapéutica pero no con progresión a artritis reumatoide. Estudio de cohortes prospectivo","authors":"Freddy Liñán Ponce,&nbsp;Juan Leiva Goicochea,&nbsp;David Sevilla Rodríguez,&nbsp;Elmer Hidalgo Bravo,&nbsp;Ginna Obregón Atanacio,&nbsp;Inés Loyola Macalapú,&nbsp;Paola Jáuregui Rojas,&nbsp;Jackeline Yampufe Canani","doi":"10.1016/j.reuma.2024.06.005","DOIUrl":"10.1016/j.reuma.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>Evaluate response to treatment and progression to rheumatoid arthritis (RA) in patients with fibromyalgia (FM) associated with elevated rheumatoid factor (RF).</div></div><div><h3>Material and methods</h3><div>Prospective cohort study. The sample consisted of 124 patients with FM: 62 with high RF (&gt;<!--> <!-->20<!--> <!-->U/ml) and 62 with negative RF (0-20<!--> <!-->U/ml). All patients were evaluated using FM treatment improvement score (FIQR) and progression to RA according to EULAR/ACR 2010 criteria at 6 and 12 months. Pearson's χ² test for homogeneity was used to relate variables of improvement to FM treatment and progression to RA.</div></div><div><h3>Results</h3><div>The response to treatment was lower in the high RF group (24 and 20 patients improved at 6 and 12<!--> <!-->months, respectively, compared to 45 and 38 patients in the negative RF group), with a significant difference. Progression to rheumatoid arthritis was similar in both groups (5 in the high RF group and 4 in the negative RF group), with a non-significant relationship.</div></div><div><h3>Conclusions</h3><div>FM with elevated RF is associated with a poor therapeutic response but not with progression to RA.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 9","pages":"Pages 459-462"},"PeriodicalIF":1.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578915","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":"Multicentric reticulohistiocytosis: A 20-year diagnosis beneath the surface","authors":"David Fernández-Fernández ,&nbsp;Ivonne Lourdes Mamani-Velarde ,&nbsp;Maritza Tatiana Segarra-Ortega ,&nbsp;José María Pego-Reigosa","doi":"10.1016/j.reuma.2024.07.005","DOIUrl":"10.1016/j.reuma.2024.07.005","url":null,"abstract":"","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 8","pages":"Pages 456-457"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357986","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":"Frailty assessment in patients with Behçet's syndrome: A cross-sectional monocentric study","authors":"Hakan Apaydin ,&nbsp;Serdar Can Güven ,&nbsp;Rezan Koçak Ulucaköy ,&nbsp;Hakan Babaoğlu ,&nbsp;Esra Kayacan Erdoğan ,&nbsp;Kevser Orhan ,&nbsp;Berkan Armağan","doi":"10.1016/j.reuma.2024.04.004","DOIUrl":"10.1016/j.reuma.2024.04.004","url":null,"abstract":"<div><h3>Aims</h3><div>Evidence evaluating the association between pre-frailty and frailty, and risk of adverse health outcomes in patients with Behçet's syndrome (BS) is limited in the literature. The aim of this study was to characterize the prevalence of frailty and associated factors in a single-centre cohort of patients with BS.</div></div><div><h3>Methods</h3><div>Based on the International Study Group's criteria, this was a monocentric cross-sectional study of BS patients. The Fried frailty criteria were used to define frailty. The Turkish version of the Behçet's Disease Current Activity Form was used to measure the disease activity of BS. Damage index was assessed with the Behçet's Syndrome Overall Damage Index.</div></div><div><h3>Results</h3><div>Forty-four patients were enrolled. According to Fried frailty criteria, patients were classified as 13.6% frail, 59% pre-frail, and 27.2% robust, respectively. Compared to pre-frail and robust patients, frail patients had higher levels of inflammatory markers at the time of diagnosis. CRP levels at time of diagnosis and at the last visit were higher in the frail group than in the pre-frail and robust groups (<em>p</em> <!-->=<!--> <!-->0.039 and <em>p</em> <!-->=<!--> <!-->0.023, respectively). When active drugs for BS were evaluated, systemic glucocorticoid (50%, <em>p</em> <!-->=<!--> <!-->0.030) and cyclophosphamide (33.3%, <em>p</em> <!-->=<!--> <!-->0.006) treatments were higher in the frail group.</div></div><div><h3>Conclusions</h3><div>Frailty and pre-frailty are commonly detected even in younger patients with BS. Inflammation can be described as potential determinants of frailty status.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 8","pages":"Pages 409-415"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357999","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":"Actualización del Documento de Consenso de la Sociedad Española de Reumatología sobre el uso de terapias biológicas y sintéticas dirigidas en la artritis reumatoide","authors":"José María Álvaro-Gracia Álvaro ,&nbsp;Petra Díaz del Campo Fontecha ,&nbsp;José Luis Andréu Sánchez ,&nbsp;Alejandro Balsa Criado ,&nbsp;Rafael Cáliz Cáliz ,&nbsp;Isabel Castrejón Fernández ,&nbsp;Hèctor Corominas ,&nbsp;José A. Gómez Puerta ,&nbsp;Sara Manrique Arija ,&nbsp;Natalia Mena Vázquez ,&nbsp;Ana Ortiz García ,&nbsp;Chamaida Plasencia Rodríguez ,&nbsp;Lucía Silva Fernández ,&nbsp;Jesús Tornero Molina","doi":"10.1016/j.reuma.2024.05.007","DOIUrl":"10.1016/j.reuma.2024.05.007","url":null,"abstract":"<div><h3>Objective</h3><div>To update the consensus document of the Spanish Society of Rheumatology (SER) regarding the use of targeted biological and synthetic therapies in rheumatoid arthritis (RA) with the aim of assisting clinicians in their therapeutic decisions.</div></div><div><h3>Methods</h3><div>A panel of 13 experts was assembled through an open call by SER. We employed a mixed adaptation-elaboration-update methodology starting from the 2015 Consensus Document of the Spanish Society of Rheumatology on the use of biological therapies in RA. Starting with systematic reviews (SR) of recommendations from EULAR 2019, American College of Rheumatology 2021, and GUIPCAR 2017, we updated the search strategies for the PICO questions of GUIPCAR. An additional SR was conducted on demyelinating disease in relation to targeted biological and synthetic therapies. Following the analysis of evidence by different panelists, consensus on the wording and level of agreement for each recommendation was reached in a face-to-face meeting.</div></div><div><h3>Results</h3><div>The panel established 5 general principles and 15 recommendations on the management of RA. These encompassed crucial aspects such as the importance of early treatment, therapeutic goals in RA, monitoring frequency, the use of glucocorticoids, the application of conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), biological DMARDs (bDMARDs), and targeted synthetic DMARDs. Additionally, recommendations on dose reduction of these drugs in stable patients were included. This update also features recommendations on the use of bDMARDs and Janus Kinase inhibitors in some specific clinical situations, such as patients with lung disease, a history of cancer, heart failure, or demyelinating disease.</div></div><div><h3>Conclusions</h3><div>This update provides recommendations on key aspects in the management of RA using targeted biological and synthetic therapies.</div></div>","PeriodicalId":47115,"journal":{"name":"Reumatologia Clinica","volume":"20 8","pages":"Pages 423-439"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688982","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}