Reumatologia clinica最新文献

{"title":"Deceptive products for pain and arthritis: an analysis of FDA health alerts.","authors":"Luis Del Carpio-Orantes","doi":"10.1016/j.reumae.2026.502271","DOIUrl":"https://doi.org/10.1016/j.reumae.2026.502271","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":" ","pages":"502271"},"PeriodicalIF":0.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121107","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":"Neuromyelitis optica spectrum disorder with positive anti-aquaporin-4 antibodies in the context of long-standing rheumatoid arthritis: A case report.","authors":"Alex Altamirano Calderón, Maybrith Cárdenas Balarezo, Doménica Rivadeneira Arregui","doi":"10.1016/j.reumae.2026.502250","DOIUrl":"https://doi.org/10.1016/j.reumae.2026.502250","url":null,"abstract":"<p><p>Neuromyelitis optica spectrum disorder (NMOSD) associated with rheumatoid arthritis (RA) is an uncommon inflammatory demyelinating condition that presents a diagnostic challenge. We report the case of a woman with a 10-year history of RA and a six-year progressive paraparesis. Magnetic resonance imaging revealed longitudinally extensive transverse myelitis from T4 to the filum terminale. Cerebrospinal fluid analysis showed negative oligoclonal bands and hyperproteinorachia without pleocytosis. The immunological profile confirmed positivity for anti-aquaporin-4 antibodies (62 UI/mL), along with markedly elevated rheumatoid factor and anti-CCP. Following intravenous methylprednisolone, a partial motor recovery to 3/5 was achieved. The patient voluntarily discontinued medical follow-up, preventing the initiation of maintenance immunosuppressive therapy. The onset of atypical neurological symptoms in patients with systemic autoimmunity requires a high clinical suspicion of NMOSD, regardless of the stability of the underlying arthropathy. Early diagnosis and strict treatment adherence are critical to prevent cumulative structural damage and permanent disability.</p>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":" ","pages":"502250"},"PeriodicalIF":0.0,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121033","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":"Stitch-free, minimally invasive salivary gland biopsy.","authors":"Angélica Vargas-Guerrero, Manuel Martínez-Lavín","doi":"10.1016/j.reumae.2026.502209","DOIUrl":"https://doi.org/10.1016/j.reumae.2026.502209","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":" ","pages":"502209"},"PeriodicalIF":0.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121084","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":"Trends and variability in the use of glucocorticoids in patients with systemic lupus erythematosus included in the RELESSER-PROS registry.","authors":"Inigo Rua-Figueroa, David Fernández-Fernández, Zulema Plaza, Karen Roberts, Belén Serrano-Benavente, María Galindo-Izquierdo, Jaime Calvo Alen, Raúl Menor, Natalia Mena-Vázquez, Esther Uriarte, Eva Tomero, Mercedes Freire, Clara Sanguesa, Silvia Gómez-Sabater, Loreto Horcada, Nuria Lozano-Rivas, María Jesús García-Villanueva, Adrián Quevedo-Rodríguez, Elvira Díez-Álvarez, Javier Narváez, Carlota Iñiguez, Javier Loricera, Javier Novoa, Esther Ruiz-Lucea, José Rosas, Lorena Expósito, Irene Carrión-Barbera, Eva Salgado, José Luis Andreu, Elena Aurrecoechea, Carlos Montilla, Jose Andrés Román Ivorra, Gema Bonilla, Tatiana Cobo-Ibañez, Alejandro Muñoz-Jiménez, Vicente Torrente-Segarra, Marta Arévalo-Salaet, Angela Pecondón-Español, Ana Pérez-Gómez, Eduardo Flores, Jose M Pego-Reigosa","doi":"10.1016/j.reumae.2026.502220","DOIUrl":"https://doi.org/10.1016/j.reumae.2026.502220","url":null,"abstract":"<p><strong>Context: </strong>Recommendations for the management of systemic lupus erythematosus (SLE) advocate increasingly restrictive use of glucocorticoids (GC). However, there are no wide-scale data on their use in clinical practice from Spain, nor on compliance with current recommendations. The objective was to analyse this aspect of SLE treatment by autonomous communities (AC).</p><p><strong>Methods: </strong>Observational, descriptive, longitudinal, and prospective study of patients with SLE included in RELESSER-PROS regarding patterns of GC use.</p><p><strong>Results: </strong>1432 patients were included, 89.8% women, mean age 56 years (±13.6), median follow-up 3.80 [2.06, 4.18] years, from 2015 to 2021. Median S-SLEDAI (5 visits): 2.00 [Q-Q3] [0-4.00], PGA: 0.3 [0, 0.9]. Median SLICC/ARC DI: 0 [0-1.00], mean: 0.83 (±1.20). Between 30% and 61% of patients received GC at baseline and between 17% and 50% at the end (V5). A progressive decrease in the percentage of patients receiving GC was observed in most AC, reaching the minimum at V5. Between 71.45% and 89.47% of patients, by autonomous community, met the criterion of ≤5 mg of prednisone at V5, with a delta between the autonomous community with the highest percentage and the lowest of 18 points. This percentage increased between visit 1 and visit 5 in all cases.</p><p><strong>Conclusions: </strong>The use of low-dose GCs is common in Spanish lupus patients, although there is a clear downward trend in their use. Most patients typically reach the recommended dose. There are differences between the different autonomous communities in the use of GCs and their dosage.</p>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":" ","pages":"502220"},"PeriodicalIF":0.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121067","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":"Case report of CRIA syndrome: progression from initial response to anakinra to sustained control with tocilizumab","authors":"Judith Hernández Sánchez,&nbsp;Doryan José García Olivas,&nbsp;Sergio Machín García,&nbsp;José Ángel Hernández Beriain","doi":"10.1016/j.reumae.2026.502170","DOIUrl":"10.1016/j.reumae.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":94193,"journal":{"name":"Reumatologia clinica","volume":"22 7","pages":"Article 502170"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671890","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 patient-centered journal club for health education in women with fibromyalgia: A pilot study","authors":"Iván Cuyul-Vásquez,&nbsp;Josefa Molina,&nbsp;Diego Quidequeo,&nbsp;Alfredo Paiva,&nbsp;Rocío Vásquez,&nbsp;Carolina Roa,&nbsp;Javier Meneses-Pinto,&nbsp;Joaquín Salazar-Méndez,&nbsp;Felipe Ponce-Fuentes","doi":"10.1016/j.reumae.2026.502204","DOIUrl":"10.1016/j.reumae.2026.502204","url":null,"abstract":"<div><h3>Background</h3><div>This study evaluated the effects of a patient journal club educational program on quality of life, cyberchondria, and key pain-related variables (intensity, catastrophizing, acceptance, self-efficacy) in women with fibromyalgia.</div></div><div><h3>Methods</h3><div>A pre–post study design was employed. Twenty women with fibromyalgia (mean age 50.8<!--> <!-->±<!--> <!-->7.5 years) participated in a three-week patient journal club educational program. The journal club included collaborative planning, material preparation, and individual reading of adapted scientific articles. The sessions were moderated in person by a speech-language pathologist with six years of university teaching experience but no prior specialized training in chronic pain, ensuring a neutral facilitation of the group discussions. Outcome measures assessed were quality of life, pain intensity, pain catastrophizing, pain self-efficacy, pain acceptance and cyberchondria.</div></div><div><h3>Results</h3><div>Significant improvements were observed in quality of life (<em>p</em> <!-->=<!--> <!-->0.001, <em>d</em> <!-->=<!--> <!-->−0.85), pain intensity (<em>p</em> <!-->=<!--> <!-->0.005, <em>d</em> <!-->=<!--> <!-->−0.74), pain catastrophizing (<em>p</em> <!-->&lt;<!--> <!-->0.001, <em>d</em> <!-->=<!--> <!-->−1.11), pain acceptance (<em>p</em> <!-->=<!--> <!-->0.028, <em>d</em> <!-->=<!--> <!-->0.53) and cyberchondria (<em>p</em> <!-->=<!--> <!-->0.003, <em>d</em> <!-->=<!--> <!-->−0.75). Pain self-efficacy showed no statistically significant change (<em>p</em> <!-->=<!--> <!-->0.083, <em>d</em> <!-->=<!--> <!-->0.41).</div></div><div><h3>Conclusions</h3><div>These findings suggest that the patient journal club is a promising tool for improving quality of life, and reducing pain intensity, pain catastrophizing and cyberchondria in women with fibromyalgia. Given the study's small sample size and lack of a control group, further research with larger, controlled trials is necessary to validate these results.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 7","pages":"Article 502204"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148915064","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":"Latent tuberculosis in rheumatological patients on biologic therapy: methodological considerations and primary care perspective","authors":"Juan Sebastián Therán León,&nbsp;Liliana Cristina Díaz Cruz,&nbsp;Gustavo Andrés Díaz Cruz","doi":"10.1016/j.reumae.2026.502173","DOIUrl":"10.1016/j.reumae.2026.502173","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 7","pages":"Article 502173"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148633411","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":"Neurolupus as the first manifestation of childhood-onset systemic lupus erythematosus: Clinical experience in a tertiary care hospital","authors":"Rodolfo Enrique Rangel Ayón,&nbsp;Enrique Cuevas Orta,&nbsp;Jorge Luis García Ramírez,&nbsp;Jorge Guillermo Reyes Vaca,&nbsp;Antonio Bravo Oro","doi":"10.1016/j.reumae.2026.502210","DOIUrl":"10.1016/j.reumae.2026.502210","url":null,"abstract":"<div><h3>Background and objective</h3><div>Paediatric-onset systemic lupus erythematosus presents a diagnostic and therapeutic challenge, particularly when the initial presentation is neurological or neuropsychiatric. The objective of this study is to describe the clinical characteristics, neuroimaging findings, therapeutic approach, and outcomes of a cohort of paediatric patients presenting with neurolupus as the first manifestation of the disease.</div></div><div><h3>Patients</h3><div>Nine paediatric patients, aged 4–17 years, were treated at a tertiary care hospital in Mexico.</div></div><div><h3>Results</h3><div>Females predominated (77.8%), with a mean age of onset of 10.8 years. Initial manifestations were heterogeneous: cerebrovascular events in 66.7%, chorea in 22.2%, psychosis and seizures in 11.1% each, and cerebellar syndrome in one case. In most cases, neuroimaging showed findings of ischemia, vasculitis, or arterial irregularities, while the electroencephalogram was abnormal in two-thirds of the available studies. All patients had positive antinuclear antibodies, and 44.4% presented with antiphospholipid antibodies, a finding associated with a higher risk of recurrence. Treatment included high-dose steroids in all cases, with immunosuppressants such as methotrexate (55.6%) and mycophenolate (44.4%) being the most frequently used. Cyclophosphamide was used in only one case. Anticoagulant therapy was indicated only in patients with antiphospholipid syndrome or thrombotic events.</div></div><div><h3>Discussion and conclusions</h3><div>The prognosis was variable. Patients with psychosis and seizures showed a favorable recovery, while those with extensive cerebrovascular events presented with permanent motor and cognitive sequelae. This series highlights the high frequency of vascular involvement and antiphospholipid antibodies as key factors in paediatric neurolupus, providing novel evidence in the Mexican population and underscoring the need for early screening protocols and a multidisciplinary approach.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 7","pages":"Article 502210"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681785","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":"Weight change patterns in rheumatoid arthritis patients treated with leflunomide: A real-world comparative study","authors":"Asadullah Khan,&nbsp;Syed Nazeer Ahmed,&nbsp;Rabbey Raza Khan,&nbsp;Fazila Nazeer,&nbsp;Hamid Ali Khan,&nbsp;Sakina Kazmi","doi":"10.1016/j.reumae.2026.502211","DOIUrl":"10.1016/j.reumae.2026.502211","url":null,"abstract":"<div><h3>Background</h3><div>Leflunomide is a widely used conventional synthetic disease-modifying antirheumatic drug (csDMARD) in rheumatoid arthritis (RA), particularly in low- and middle-income countries where biologics are cost-prohibitive. Weight loss is a recognised but understudied adverse effect. This study aimed to characterise the prevalence, magnitude, and temporal patterns of leflunomide-associated weight change in a real-world RA cohort.</div></div><div><h3>Methods</h3><div>This prospective longitudinal observational study was conducted at a rheumatology department using an exposure-defined prospective comparative cohort design. Patients newly initiated on leflunomide 20<!--> <!-->mg/day at enrollment (cases, <em>n</em> <!-->=<!--> <!-->206) were compared with RA patients not receiving leflunomide (controls, <em>n</em> <!-->=<!--> <!-->92) over 12 months. Body weight was recorded in the morning on a standardised scale by the same nurse at baseline and at 3, 6, 9, and 12 months. Primary outcomes included any weight loss, clinically significant weight loss (≥5%), severe weight loss (≥10%), and rapid weight loss (≥5% by 3 months). Multivariable logistic regression was performed, adjusting for age, gender, baseline weight, disease activity, and disease duration.</div></div><div><h3>Results</h3><div>At 6 months, 56.8% of leflunomide-treated patients experienced any weight loss, with clinically significant weight loss (≥5%) in 31.1% and severe weight loss (≥10%) in 8.3%. Rapid weight loss occurred in 17.0% of cases. Leflunomide-exposed patients showed a progressive, stepwise mean weight decline (−0.94<!--> <!-->kg at 3 months, −1.44<!--> <!-->kg at 6 months, −2.23<!--> <!-->kg at 9 months), while controls remained stable. At 12 months, severe weight loss was significantly more frequent in cases than controls (19.6% vs 8.8%; <em>p</em> <!-->=<!--> <!-->0.042). Sustained clinically significant weight loss was observed in 21.7% of cases. On multivariable analysis, leflunomide exposure was independently associated with more than twofold higher odds of ≥5% weight loss (OR 2.46, 95% CI 1.21–5.03).</div></div><div><h3>Conclusions</h3><div>Leflunomide is independently associated with clinically meaningful and often progressive weight loss in patients with RA. These findings support routine weight monitoring in leflunomide-treated patients and underscore the importance of distinguishing drug-related weight reduction from other causes to avoid unnecessary diagnostic investigations and optimise patient counselling.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 7","pages":"Article 502211"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148915057","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":"Response to the letter to the editor: “Latent tuberculosis in rheumatologic patients under biological therapy: Methodological considerations and a primary care perspective”","authors":"Luis Francisco Valdés Corona,&nbsp;Ana González Andrade,&nbsp;Aylin Luna Salazar,&nbsp;David Vega-Morales,&nbsp;Jiram Torres-Ruiz,&nbsp;Iris Jazmín Colunga-Pedraza,&nbsp;Sandra Sicsik,&nbsp;Ángel Castillo Ortiz,&nbsp;Miguel A. Saavedra Salinas,&nbsp;Guillermo Guaracha-Basáñez,&nbsp;Dafhne Guadalupe Miranda Hernández,&nbsp;Fedra Irazoque-Palazuelos,&nbsp;Sandra Carrillo Vazquez,&nbsp;Julio Cesar Casasola Vargas,&nbsp;Omar Eloy Muñoz-Monroy,&nbsp;Javier Merayo-Chalico,&nbsp;Estefanía Torres Valdez,&nbsp;Sergio Duran Barragán,&nbsp;Erick Adrián Zamora-Theozol,&nbsp;Daniel Xavier Xibille Friedmann,&nbsp;Vijaya Rivera Terán","doi":"10.1016/j.reumae.2026.502215","DOIUrl":"10.1016/j.reumae.2026.502215","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"22 7","pages":"Article 502215"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148650050","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}