RESUMEN
AIM: To determine the correlation and concordance between different clinimetric scores in patients with rheumatoid arthritis in two high-complexity reference centers in northwestern Colombia. METHOD: A cross-sectional study in adults diagnosed with rheumatoid arthritis was conducted according to the 2010 American College of Rheumatology and European League Against Rheumatism Classification Criteria, between January and June, 2013. The correlation was evaluated using Spearman's correlation coefficient, and concordance with quadratic weighted kappa with the respective confidence intervals, for which patients were classified into different categories of disease activity. RESULTS: One hundred patients were included, of whom 83% were women; 58 and 75% received methotrexate and glucocorticoids, respectively. Most individuals were in remission or low activity. High correlations between Disease Activity Score of 28 joints - erythrocyte sedimentation rate (DAS28-ESR) values with DAS28 C-reactive protein and Simple Disease Activity Index (SDAI) with Clinical Disease Activity Index (P < 0.0001; r = 0.82 and r = 0.86, respectively) were observed; likewise, the scores obtained with different indices correlated well with gold standard values for remission (SDAI), where the correlation with DAS28-ESR was slightly lower. Excellent concordance among all clinimetric scores was observed, although it was lower among DAS28-ESR and SDAI. CONCLUSION: Clinimetric indices had high concordance and correlation, especially for rheumatoid arthritis patients in remission or low disease activity, without being interchangeable among them.
Asunto(s)
Artritis Reumatoide/diagnóstico , Anciano , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/epidemiología , Colombia/epidemiología , Estudios Transversales , Femenino , Glucocorticoides/uso terapéutico , Humanos , Masculino , Metotrexato/uso terapéutico , Persona de Mediana Edad , Variaciones Dependientes del Observador , Valor Predictivo de las Pruebas , Inducción de Remisión , Reproducibilidad de los Resultados , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
La artritis postestreptocóccica es una entidad que se manifiesta por compromiso articular secundario a infección orofaríngea secundaria a Streptococcus beta hemolítico del grupo A. Se presenta el caso de un paciente de 43 años, previamente sano, que siete semanas después de un episodio de faringoamigdalitis desarrolló un cuadro oligoarticular, aditivo, no migratorio, con lesiones dermatológicas. Se documentaron títulos elevados de antiestrep-tolisina O, cumpliendo con los criterios propuestos por Ayoub y Ahmed, y se diagnosticó artritis postestreptocóccica. El paciente presentó respuesta adecuada a dosis moderadas de corticoesteroides.
Post-streptococcal reactive arthritis is an entity that includes joint involvement secondary to oropharyngeal infectious process associated with beta hemolytic group A Streptococcus. We report a clinical case of 43 year-old man, previously healthy, that seven weeks after a tonsillopharyngitis, developed an additive, non-migratory oligoarthritis, with skin lesions. High titers of antistreptolysin O antibodies are documented, with fulfillment of Ayoub and Ahmed proposed criteria for post streptococcal reactive arthritis. The patient presented adequate response to moderate doses of corticosteroids.