RESUMEN
This article presents a case report of a three and half year-old boy with functional constipation and sensory hyperreactivity. The Integrated Sensory Toileting® approach was used to guide clinical reasoning and identify the sensory underlying factors that were impacting the child's ability to acquire age-appropriate toileting habits and gastrointestinal health. The six months of treatment in occupational therapy and gastroenterology, as well as six months of follow-up are described. Improvements in sensory reactivity are documented using the Sensory Processing Measure-2 and the Toileting Habit Profile Questionnaire-Revised and corroborate with improvements in the child's ability to participate in toileting routines and improved gastrointestinal health.
RESUMEN
Non-steroidal anti-inflammatories, corticoids and antihistamines, as well as a great many other molecules, have classically been used to control the symptoms of cryopyrin-associated periodic syndromes (CAPS), with very few encouraging results. Knowledge of its genetic character, and its aetiopathogenesis associated with inflammasome and the production of interleukin-1 (IL-1) has led to the development of new therapeutic weapons that have not just obtained improvements of the symptoms and quality of life of the patients, but also managed to control the underlying inflammation. Results show that anakinra, an IL-1 receptor antagonist molecule, improved the clinical symptoms and the inflammatory markers of patients with CAPS has motivated research with other molecules directed against IL-1: rilonacept and canakinumab. It is likely that the use of these molecules could prevent the development of the late complications associated with chronic inflammation.
Asunto(s)
Antiinflamatorios/uso terapéutico , Síndromes Periódicos Asociados a Criopirina/tratamiento farmacológico , Antagonistas de los Receptores Histamínicos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Anticuerpos Monoclonales Humanizados , Síndromes Periódicos Asociados a Criopirina/genética , Humanos , Inflamasomas/antagonistas & inhibidores , Proteína Antagonista del Receptor de Interleucina 1/uso terapéutico , Interleucina-1/antagonistas & inhibidores , Interleucina-1beta/antagonistas & inhibidores , Interleucina-1beta/inmunología , Estudios Multicéntricos como Asunto/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Receptores de Interleucina-1/antagonistas & inhibidores , Proteínas Recombinantes de Fusión/uso terapéuticoRESUMEN
En el tratamiento de los síndromes periódicos asociados a la criopirina (CAPS), clásicamente se han usado los antiinflamatorios no esteroideos, glucocorticoides y antihistamínicos, además de un sinfín de otras moléculas, con resultados poco alentadores. El conocimiento de su carácter genético y de su etiopatogenia relacionada con el inflamasoma y la producción de interleucina 1(IL1) ha permitido el desarrollo de nuevas terapias biológicas que consiguen no sólo mejorar la sintomatología y la calidad de vida de los pacientes, sino que logran el control de la inflamación subyacente. Las terapias anti_IL-1 han demostrado en los pacientes con CAPS tener una respuesta clínica espectacular, con normalización de los marcadores inflamatorios. Es posible que el uso de estas moléculas evite el desarrollo de complicaciones tardías derivadas de la inflamación crónica (AU)
Non-steroidal anti-inflammatories, corticoids and antihistamines, as well as a great many other molecules, have classically been used to control the symptoms of cryopyrin-associated periodic syndromes (CAPS), with very few encouraging results. Knowledge of its genetic character, and its aetiopathogenesis associated with inflammasome and the production of interlekin-1 (IL-1) has led to the development of new therapeutic weapons that have not just obtained improvements of the symptoms and quality of life of the patients, but also managed to control the underlying inflammation. Results show that anakinra, an IL-1 receptor antagonist molecule, improved the clinical symptoms and the inflammatory markers of patients with CAPS has motivated research with other molecules directed against IL-1: rilonacept and canakinumab. It is likely that the use of these molecules could prevent the development of the late complications associated with chronic inflammation (AU)