[Update of Behçet disease. A presentation of 2 cases in primary care]. / Actualización de la enfermedad de Behçet. A propósito de 2 casos en atención primaria.

Behçet's disease is an inflammatory multisystemic chronic disease that progresses by outbreaks. It is more common in Asia and countries in the eastern Mediterranean basin (Silk Route). In Spain the prevalence is between 5 and 10 cases per 100,000 inhabitants. It is a difficult disease to diagnose because of the multiple and varied clinical manifestations, and because there are not pathognomonic laboratory tests available. The delay in the diagnosis, which is frequent in countries of low prevalence like Spain, increases the morbidity and the mortality of patients with Behçtis disease.

[Eye toxicity of antimalarial agents]. / Toxicidad ocular por antimaláricos.

We relate the evolution of a patient with Systemic Lupus Erythematosus with mucocutaneous, hematological, joint and renal expression. The skin lesions were treated with Chloroquine and Hydroxychloroquine and severe ocular toxicity related with antimalarials agent was developed. We revised the antimalarials use in Rheumatology, their utility, doses, adverse events and risk factors as cumulate doses, ideal daily doses, renal function and ophthalmological reviews recommendations.

Anticardiolipin antibodies and polyarteritis nodosa.

A patient with biopsy-diagnosed polyarteritis nodosa showed central nervous system (CNS) involvement and evidence of intrathecal synthesis of immunoglobulins, coincident with very high serum levels of anticardiolipin antibodies (aCL). Cerebral angiography was normal. We suggest that aCL could be directly implicated in the CNS damage.

[Asymmetric polyarthritis in Sézary's syndrome]. / Poliartritis asimétrica en el síndrome de Sézary.

We present the case of a patient with negative serology asymmetric polyarthritis and erythematous-squamous cutaneous lesions of two years evolution, initially attributed to psoriasis, which histopathology (hyperkeratosis, epidermic infiltration due to atypical CD4+ lymphocytes with formation of Pautrier's microabscesses) together with hematological findings (persistent lymphocytosis with cells with cerebriform nucleus, 97% CD4+) allowed the diagnosis of Sézary's syndrome. To our knowledge, this is the eight documented case of arthritis in Sézary's syndrome and the first one with asymmetric chronic polyarthritis.

[Vascular manifestations in 30 cases of Behçet's disease]. / Manifestaciones vasculares en 30 casos de enfermedad de Behçet.

Vascular manifestations on Behçet's disease (BD) vary from 25 to 65% according to different series. Affects both arteries as veins, but superficial thrombophlebitis is the most frequent disorder. Disorders with higher morbidity like deep venous thrombosis, and arterial aneurisms can appear, even in the lungs. In our series of 30 patients we found an incidence of 46% of vascular manifestations, mainly (92%) superficial thrombophlebitis. We highlight the presence of a femoral aneurism, which was resected, and discuss its evolution and response to treatment with prednisone and cyclophosphamide. We review in-depth the vascular manifestations in the Spanish and International scientific literature, paying special interest to aneurism dilatations.

HLA and Behçet's disease in northern Spain: their lack of correlation with arthritis pattern.

We have studied the characteristics of arthritis present in 32 patients with Behçet's disease (BD), and how this arthritis is related to the HLA markers class I. 84% of the patients presented arthritis, the most common being mono-arthritis as the initial presentation, and oligoarthritis in subsequent episodes. In 63% of the cases, the development was in episodes of acute/subacute arthritis. We found statistically significant association between antigens B-5 and B-51, and the group with BD, with a relative risk of 3.89 and 4.71 respectively. The attempt to relate markers B-5, B-51 and B-27 to the presence of arthritis as well as to its manifestation and further development was not conclusive.

[Osteoporosis as the first manifestation of minor beta-thalassemia]. / Osteoporosis como primera manifestación de la beta-talasemia minor.

We present the case of a 48-year-old premenopausal woman with right lumbosciatalgia secondary to osteoporosic vertebral collapses. Two of her three offsprings, a 31-year-old man and a 16-year-old woman, had chronic dorsolumbalgia, the study of which suggested the diagnosis of minor beta-thalassemia. As opposed to thalassemic osteoarthropathy, frequently observed in the forms of "major" and "minor" beta-thalassemia, rheumatic manifestations have almost never been described in the "minor" forms. We highlight the possibility of symptomatic osteoporosis as the first manifestation and we review the locomotive disorders associated to this hemoglobinopathy.

[Epidemiological study of Reiter's syndrome in a health service area]. / Estudio epidemiológico del Síndrome de Reiter en un área sanitaria.

A higher incidence of Reiter's Syndrome (RS) is observed among young white men. We have conducted an epidemiological study of RS cases from our current health area and diagnosed in our hospital between 1975 and 1989. Twenty-four patients were included in this study, with a relation between men and women of 12:1 and an average age of 33.4 years. The annual incidence rate was 2.66 for men and 0.65 for women per 100,000 population during the study period. We have observed a tendency towards younger ages in the recent years and we have detected the presence of the HLA B-27 marker in 79% of patients.

Cutaneous polyarteritis nodosa and Crohn's disease.

We report a case of a 57-year-old woman who presented simultaneously cutaneous polyarteritis nodosa and Crohn's disease of the colon. Although similar pathogenic hypotheses have been reported, the association of both diseases is exceptional.

[Sternoclavicular staphylococcal arthritis in non-immunodepressed patients. Study of 4 cases]. / Artritis estafilocócica esternoclavicular en pacientes no inmunodeprimidos. Estudio de 4 casos.

We report four patients (3 males and one female) suffering a sternoclavicular staphylococcal arthritis in whom risk factors such as parenteral drug addiction, alcoholism, diabetes, or immunosuppression were not observed. The etiopathogenesis, clinical picture, and diagnosis of this uncommon septic arthritis in reviewed.