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Introduction: Patients with sarcoidosis have a lower survival rate than the general population, in part due to cardiovascular disease, infections and neoplasms. Our objective was to evaluate the impact of haematological neoplasms (HN) and lymphomas on sarcoidosis patient mortality in a nation-wide analysis conducted in Spain, a country with a population of 47 million. Methods: Retrospective and observational comparison of the HN related deaths in sarcoidosis patients and the general Spanish population reported in the Spanish Hospital Discharge Database. To determine the impact of sarcoidosis on the risk of dying from each HN lineage, a binary logistic regression considering age, female sex, tobacco and alcohol consumption, was performed. Results: In the period 2016 and 2019, 139,531 in-hospital deaths from neoplasms were certified in Spain (77 in patients with sarcoidosis). Patients with sarcoidosis died at younger age than the general Spanish population (72.9 vs 77.6, p<0.001). Sarcoidosis patients presented a higher mortality risk from HN (20.8% vs 8.9%, p=0.001, OR=2.64, 95% CI 1.52-4.59), attributable to the higher proportion of deaths from non-Hodgkin lymphoma (NHL), (9.2% vs 2.9%, p=0.006, OR= 3.33, 95% CI 1.53-7.25) from both B cell (6.6% vs 2.5%, p=0.044, OR= 2.62, 95% 1.06-6.5) and T/NK cell lineages (2.6% vs 0.3%, p=0.024, OR= 7.88, 95% CI 1.92-32.29) as well as HN with uncertain behavior and myeloproliferative disorders (2.6% vs 0.3%, p=0.018, OR= 11.88, 95% CI 2.88-49.02). The mean age of sarcoidosis patients who died from HN (63.6 vs 71.9, p=0.032) and non-Hodgkin lymphoma (56.9 vs 71, p=0.009) was lower than that of the general population. Conclusion: Patients with sarcoidosis present a higher risk of premature death from HN, including NHL from B, T/NK cell lineage and myeloproliferative disorders in comparison with the general Spanish population. In addition to developing strategies that might help to attenuate their occurrence and impact, such as decreasing the immunosuppressive burden, specific early-detection programs for these conditions should be investigated and considered carefully.
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Patients with COVID-19 may develop a hypercoagulable state due to tissue and endothelial injury, produced by an unbalanced immune response. Therefore, an increased number of thromboembolic events has been reported in these patients. The aim of this study is to investigate the presence of antiphospholipid antibodies (aPL) in COVID-19 patients, their role in the development of thrombosis and their relationship with the severity of the disease. In this retrospective study, serum samples from 159 COVID-19 patients and 80 healthy donors were analysed for the presence of aPL. A total of 29 patients (18.2%) and 14 healthy donors (17.5%) were positive for aPL. Nineteen COVID-19 patients (12%) but no healthy donor presented a positive percentage of the IgA isotype aPL. IgA anti-ß2-glycoprotein I antibodies (anti-ß2GPI) were the most frequent type (6.3%) in patients but was not detected in any healthy donor. The positivity of this antibody was found to be significantly elevated in patients with thromboembolic events (25% vs. 5%, p = 0.029); in fact, patients with positive IgA anti-ß2GPI had an incidence of thrombosis over six times higher than those who had normal antibody concentrations [OR (CI 95%) of 6.67 (1.5-30.2), p = 0.014]. Additionally, patients with moderate-severe disease presented a higher aPL positivity than patients with mild disease according to the Brescia (p = 0.029) and CURB-65 (p = 0.011) severity scales. A multivariate analysis showed that positivity for IgA anti-ß2GPI is significantly associated with disease severity measured by CURB-65 [OR (CI 95%) 17.8 (1.7-187), p = 0.0016]. In conclusion, COVID-19 patients have a significantly higher positive percentage of the IgA isotype aPL than healthy donors. IgA anti-ß2GPI antibodies were the most frequently detected aPL in COVID-19 patients and were associated with thrombosis and severe COVID-19 and are thus proposed as a possible marker to identify high-risk patients.
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Anticuerpos Antifosfolípidos , Biomarcadores , COVID-19 , Inmunoglobulina A , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Trombosis , beta 2 Glicoproteína I , Humanos , COVID-19/inmunología , COVID-19/complicaciones , COVID-19/sangre , Masculino , beta 2 Glicoproteína I/inmunología , Femenino , Inmunoglobulina A/sangre , Persona de Mediana Edad , Trombosis/inmunología , Estudios Retrospectivos , Anticuerpos Antifosfolípidos/sangre , Adulto , Anciano , Biomarcadores/sangre , SARS-CoV-2/inmunología , Anciano de 80 o más AñosRESUMEN
OBJECTIVE: To evaluate the impact of the different types of neoplasms and lineages on mortality of patients with SLE. METHODS: Retrospective and observational comparison of the neoplasm-related deaths in patients with SLE and the general Spanish population reported in the Spanish Hospital Discharge Database. To determine the impact of SLE on the risk of dying from each neoplasm lineage, a binary logistic regression considering age, female sex, tobacco and alcohol consumption, was performed. RESULTS: During 2016-2019, 139 531 in-hospital deaths from neoplasms were certified in Spain (91 in patients with SLE). Patients with SLE presented a lower mortality rate from solid organ neoplasms, (80.2% vs 91.1%, OR 0.393), linked to their lower risk of colorectal carcinoma (1.1% vs 10.8%, OR 0.110). By contrast, gynaecological neoplasms presented a higher risk (8.8% vs 3%, OR 3.039) in the deceased patients with SLE, associated with the higher frequency of vulvar neoplasms (2% vs 0.2%, OR 14.767) and cervical carcinomas (3.3% vs 0.5%, OR 3.809). Haematological neoplasm-related deaths were also more prevalent in patients with SLE (19.8% vs 8.9%, OR 2.546), mostly attributable to the higher proportion of deaths due to non-Hodgkin's lymphoma (11% vs 2.9%, OR 4.060) of B cell lineage (9.9% vs 2.5%, OR 4.133). CONCLUSIONS: Patients with SLE present a higher risk of death from vulvar neoplasms, cervical carcinomas and B-cell non-Hodgkin's lymphoma in comparison with the general Spanish population. In addition to developing strategies that might help to attenuate their occurrence and impact, such as decreasing the immunosuppressive burden, specific early detection programmes for these conditions should be investigated and considered carefully.
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Carcinoma , Neoplasias de los Genitales Femeninos , Lupus Eritematoso Sistémico , Linfoma no Hodgkin , Femenino , Humanos , Carcinoma/complicaciones , Neoplasias de los Genitales Femeninos/complicaciones , Lupus Eritematoso Sistémico/complicaciones , Linfoma no Hodgkin/complicaciones , Linfoma no Hodgkin/epidemiología , Sistema de Registros , Estudios Retrospectivos , MasculinoRESUMEN
IntroducciónLa arteritis de la temporal es un proceso infrecuente en paciente jóvenes. Se presenta el caso de una paciente de 39 años con arteritis de la temporal con revisión de casos descritos hasta el momento.Presentación del casoMujer de 39 años sin antecedentes de interés que consulta por un nódulo subcutáneo temporal derecho, sin otros síntomas ni hallazgos a la exploración. En las pruebas realizadas destacaba la presencia de signo del halo ecográfico alrededor de la arteria temporal en la localización del nódulo. Se realizó escisión con curación de la paciente y la histopatología mostró hallazgos de arteritis temporal juvenil. ConclusionesLa arteritis temporal en pacientes jóvenes es una entidad infrecuente, ante la cual siempre hay que descartar manifestaciones sistémicas mediante una anamnesis, exploración física reglada y pruebas complementarias. La anatomía patológica establecerá el diagnóstico definitivo. El tratamiento suele ser quirúrgico. Tras dicho tratamiento, se deberá seguir a la paciente por el posible desarrollo posterior de otras enfermedades.(AU)
IntroductionTemporal arteritis is an uncommon disorder in young people. A 39-year-old woman with juvenile temporal arteritis is described and we performed a literature review of all cases of juvenile temporal arteritis described to date.Case presentationA 39-year-old woman presented with a subcutaneous temporal nodule in the right temple with no other associated symptoms or background and unremarkable physical examination. Ultrasonography of the nodule revealed an anechoic perivascular halo surrounding the temporal artery. The nodule was excised resulting in the patient's recovery. The results of the histopathological study showed features of juvenile temporal arteritis.ConclusionsJuvenile temporal arteritis is a very uncommon disorder. Systemic manifestations should be ruled out by physical examination and complementary tests. Histopathology establishes the definitive diagnosis. Treatment is surgical excision and a follow-up should be conducted to rule out complications.(AU)
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Humanos , Femenino , Adulto , Arteritis de Células Gigantes , Hiperplasia Angiolinfoide con Eosinofilia , Pacientes Internos , Examen Físico , Obesidad , Reumatología , Enfermedades ReumáticasRESUMEN
No disponible
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Humanos , Femenino , Persona de Mediana Edad , Derrame Pleural/diagnóstico , Metimazol/efectos adversos , Derrame Pleural/diagnóstico por imagen , Derrame Pleural/etiología , Radiografía Torácica/métodos , Tomografía Computarizada por Rayos X/métodos , Bocio Subesternal , Tiroidectomía/métodosRESUMEN
No disponible
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Humanos , Masculino , Persona de Mediana Edad , Pericarditis/diagnóstico , Pericarditis/tratamiento farmacológico , Recurrencia , Interleucina-1/uso terapéutico , Glucocorticoides/uso terapéutico , Prednisona/uso terapéutico , Complicaciones de la Diabetes/fisiopatología , Colchicina/uso terapéutico , Metotrexato/uso terapéutico , Azatioprina/uso terapéutico , Hidroxicloroquina/uso terapéutico , Eficacia/métodos , Resultado del TratamientoRESUMEN
No disponible
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Humanos , Femenino , Adulto , Síndrome Uveomeningoencefálico/complicaciones , Síndrome Uveomeningoencefálico/diagnóstico , Síndrome Uveomeningoencefálico/tratamiento farmacológico , Fotofobia/complicaciones , Acúfeno/complicaciones , Pérdida Auditiva Sensorineural/complicaciones , Coroiditis/complicaciones , Hiperestesia/complicaciones , Glucocorticoides/uso terapéutico , Síndrome Uveomeningoencefálico/fisiopatología , Meningitis Aséptica/complicaciones , Meningitis Aséptica/tratamiento farmacológico , Meningitis Aséptica/fisiopatología , Angiografía/métodosRESUMEN
No disponible
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Humanos , Femenino , Anciano , Síndrome de Schnitzler/tratamiento farmacológico , Trastornos Mieloproliferativos/epidemiología , Amiloidosis/epidemiología , Receptores de Interleucina-1/antagonistas & inhibidoresRESUMEN
No disponible
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Humanos , Masculino , Adulto , Pérdida Auditiva Sensorineural/complicaciones , Queratitis/complicaciones , Acúfeno/complicaciones , Metotrexato/uso terapéuticoRESUMEN
No disponible