Reumatologia clinica最新文献

{"title":"The “target sign”: A hallmark of lupus enteritis","authors":"Adriana C. Esteves , Beatriz Mendes , Helena Assunção , Luís Inês","doi":"10.1016/j.reumae.2024.10.007","DOIUrl":"10.1016/j.reumae.2024.10.007","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 515-516"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A detailed quantitative analysis of circulating T peripheral and follicular helper lymphocytes in patients with rheumatoid arthritis and systemic lupus erythematosus","authors":"Raquel Sánchez-Gutiérrez ,&nbsp;Marlen Vitales-Noyola ,&nbsp;Larisa González-Baranda ,&nbsp;Diana P. Portales-Pérez ,&nbsp;Esther Layseca-Espinosa ,&nbsp;Mariana H. García-Hernández ,&nbsp;Roberto González-Amaro","doi":"10.1016/j.reumae.2024.10.005","DOIUrl":"10.1016/j.reumae.2024.10.005","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Peripheral and follicular helper T lymphocytes (Tph and Tfh, respectively) have an important role in B cell immune responses and the pathogenesis of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Although several studies on the number of Tph and Tfh cells in these conditions have been published, different phenotypes have been employed for their analysis. In this study, we assessed the levels and function of Tph and Tfh cells in blood samples from patients with RA and SLE by using an extended immunophenotype.</div></div><div><h3>Materials and methods</h3><div>In a cross-sectional pilot study, blood samples from twenty-seven patients with RA and fifteen with SLE, and twenty-six healthy controls were studied. The levels of Tph (CD4⁺PD-1⁺CXCR5⁻CD38⁺CD69⁺ICOS⁺) and Tfh (CD4⁺PD-1⁺CXCR5⁺CD38⁺CD69⁺ICOS⁺) cells were analyzed by flow cytometry. In addition, the function of Tph/Tfh cells was estimated by measuring the synthesis of IL-21 by these lymphocytes as well as the number of circulating plasmablasts (CD19⁺CD27⁺CD20⁻CD38^hi).</div></div><div><h3>Results</h3><div>Increased percentages of Tph and Tfh lymphocytes were detected in patients with RA and SLE. Furthermore, the synthesis of IL-21 tended to be higher in both conditions, and higher levels of plasmablasts were detected in these patients, compared to controls. In patients with SLE, the number of Tph cells was associated with disease activity and with the levels of circulating plasmablasts, whereas in patients with RA a significant correlation between Tph cells and evolution time was observed.</div></div><div><h3>Discussion and conclusions</h3><div>Our data of Tph and Tfh lymphocytes, based in the analysis of an extended phenotype of these cells, provides further evidence on their involvement in the pathogenesis of RA and SLE.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 476-483"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635276","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 Practice Mexican Guidelines for the Treatment of Systemic Lupus Erythematosus: 2024 Update","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.reumae.2024.10.003","DOIUrl":"10.1016/j.reumae.2024.10.003","url":null,"abstract":"<div><div>Herein we present the update for the Mexican Guidelines for the Treatment of Systemic Lupus Erythematosus.</div><div>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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 490-510"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592352","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.reumae.2024.10.006","DOIUrl":"10.1016/j.reumae.2024.10.006","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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 484-489"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635285","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":"Prevalence of occipital enthesophyte in non-inflammatory and inflammatory rheumatic diseases","authors":"Natalia de la Torre Rubio,&nbsp;Jose Campos Esteban,&nbsp;José Luis Andréu Sánchez,&nbsp;Jesús Sanz Sanz","doi":"10.1016/j.reumae.2024.06.002","DOIUrl":"10.1016/j.reumae.2024.06.002","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 513-514"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549885","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":"Evaluation of the efficacy and safety of gravitational therapy in a cohort of patients with systemic sclerosis","authors":"Luisa Fernanda Servioli ,&nbsp;Eugenia Isasi ,&nbsp;Alejandra Pérez ,&nbsp;Silvia Pouquette ,&nbsp;María Eloísa Isasi","doi":"10.1016/j.reumae.2024.10.004","DOIUrl":"10.1016/j.reumae.2024.10.004","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, p &lt; 0.05), 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, p &lt; 0.05). Also, a significant improvement was observed in the number of patients with puffy fingers (pre-GT 50% vs. post-GT 20% patients, p &lt; 0.05), 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, p &lt; 0.05) 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, p &lt; 0.05). 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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 9","pages":"Pages 463-469"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565050","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":"Gastrointestinal symptoms in patients using methotrexate: A cross-sectional study in a sample with rheumatoid arthritis","authors":"Carina Albuquerque Roberto,&nbsp;Isabela Stachevski,&nbsp;Barbara Stadler Kahlow,&nbsp;Renato Nisihara,&nbsp;Thelma Skare","doi":"10.1016/j.reumae.2024.09.004","DOIUrl":"10.1016/j.reumae.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal intolerance is common in rheumatoid arthritis (RA) patients using methotrexate and may lead to treatment discontinuation.</div></div><div><h3>Aim</h3><div>To study the prevalence of gastrointestinal symptoms in a sample of RA methotrexate users as well as its possible association with clinical and epidemiological variables.</div></div><div><h3>Methods</h3><div>Cross-sectional study of 192 patients with gastrointestinal symptoms using the MISS (methotrexate intolerance severity score). Clinical and epidemiological variables were collected through chart review and direct questioning. Patients’ adherence to methotrexate was evaluated through Moriski–Green–Levin questionnaire.</div></div><div><h3>Results</h3><div>The prevalence of gastrointestinal complaints was high with 55.7% of the sample classified as intolerant. Nausea and pain after drug ingestion were the most common reported complaints. This intolerance was associated with afro-descendant background (<em>p</em> <!-->=<!--> <!-->0.02); presence of associated fibromyalgia (<em>p</em> <!-->=<!--> <!-->0.04), concomitant use of glucocorticoids (<em>p</em> <!-->=<!--> <!-->0.03) and Jak inhibitors (0.03). A tendency towards association with leflunomide use was observed (<em>p</em> <!-->=<!--> <!-->0.06). Logistic regression was used to test drug associations with methotrexate intolerance, and showed that glucocorticoid use was independently associated with methotrexate intolerance OR<!--> <!-->=<!--> <!-->1.85; 95% CI<!--> <!-->=<!--> <!-->1.01–3.44; <em>p</em> <!-->=<!--> <!-->0.04. Route of administration, presence of previous gastric complaints, age and methotrexate dose did not interfere with MISS. MISS results were associated with moderate adherence to the drug.</div></div><div><h3>Conclusions</h3><div>There is a high rate of methotrexate intolerance that is more common in afro-descendants, those with associated fibromyalgia, glucocorticoid and Jak inhibitors users.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 8","pages":"Pages 403-408"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421122","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":"Adalimumab treatment of resistant chondrocalcinosis","authors":"Fatih Tastekin,&nbsp;Kenan Aksu","doi":"10.1016/j.reumae.2024.09.007","DOIUrl":"10.1016/j.reumae.2024.09.007","url":null,"abstract":"<div><div>In this article, we present a case of resistant chondrocalcinosis who had a good response with 40<!--> <!-->mg subcutaneous adalimumab. To our knowledge, this is the first report using adalimumab successfully in severe CPDD. Anti-TNF therapy can be a good therapeutic option for second line therapy in CPPD.</div></div>","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 8","pages":"Pages 452-453"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421118","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":"Update of the Consensus Statement of the Spanish Society of Rheumatology on the use of biological and synthetic targeted therapies in rheumatoid arthritis","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.reumae.2024.09.002","DOIUrl":"10.1016/j.reumae.2024.09.002","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":94193,"journal":{"name":"Reumatologia clinica","volume":"20 8","pages":"Pages 423-439"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335477","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.reumae.2024.09.008","DOIUrl":"10.1016/j.reumae.2024.09.008","url":null,"abstract":"","PeriodicalId":94193,"journal":{"name":"Reumatologia clinica","volume":"20 8","pages":"Pages 456-457"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421146","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}