RESUMO
Pseudo-pseudo Meigs' syndrome (PPMS) has been reported to be a rare presentation of patients with systemic lupus erythematosus (SLE). However, such a presentation is not common in other forms of connective tissue disease. We presented a case of gross ascites, pleural effusion, and marked elevation of CA-125 level (PPMS-like features) that led to a diagnosis of MCTD. The patient responded to systemic steroid therapy.
Assuntos
Síndrome de Meigs/diagnóstico , Doença Mista do Tecido Conjuntivo/diagnóstico , Doença de Raynaud/patologia , Adulto , Anti-Inflamatórios/administração & dosagem , Diagnóstico Diferencial , Feminino , Humanos , Lúpus Eritematoso Sistêmico/patologia , Síndrome de Meigs/diagnóstico por imagem , Síndrome de Meigs/tratamento farmacológico , Síndrome de Meigs/patologia , Metilprednisolona/administração & dosagem , Doença Mista do Tecido Conjuntivo/tratamento farmacológico , Doença Mista do Tecido Conjuntivo/patologia , Prednisolona/administração & dosagem , RadiografiaRESUMO
The objective of this study was to compare the tolerability of methotrexate in two different regimes of folic acid (FA) supplementation in rheumatoid arthritis (RA). We performed a multicenter, cross-sectional observational cohort study on 240 RA patients with 120 patients each in 5 mg of FA weekly and 30 mg of FA weekly supplementation. There were no significant differences for side effects (14.2 versus 22.5%, P=0.523) and discontinuation of methotrexate (3.6 versus 13.3%, P=0.085). RA patients given 5 mg of FA weekly supplementation had a lower disease activity score 28 compared to 30 mg of FA weekly supplementation [3.44 (1.10) versus 3.85 (1.40), P=0.014]. FA supplementation of 5 mg per week and 30 mg per week was associated with similar tolerability of methotrexate in RA patients.