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1.
Reumatol Clin (Engl Ed) ; 19(4): 197-203, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37061281

RESUMEN

BACKGROUND: There is an increasing interest in the study of non-criteria antiphospholipid antibodies (aPL) including antibodies targeting domain 1 of the B2 glycoprotein 1 (anti-D1 B2GP1) and antibodies anti phosphatidylserine/ prothrombin (PS/PT). OBJECTIVES: Our aim was to analyze a panel of conventional and non-criteria aPL in a cohort of patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS), to describe if there are differences in aPL titers among groups, to evaluate clinical associations including risk of recurrent events of novel aPL. METHODS: Observational study that evaluated at baseline antibodies against anti-D1 B2GP1 and anti PS/PT. Anti-D1 B2GP1 antibodies were tested using a chemiluminescent immunoassay. IgG and IgM anti PS/PT, aCL and anti B2GP1 by ELISA techniques. Therefore, patients were followed in order to identify new thrombotic events. RESULTS: 133 patients with SLE and 23 with primary APS patients were included. Main APS manifestations were DVT (27%), obstetric morbidity (22%) and arterial thrombosis (10.1%). IgM anti PS/PT antibodies levels were (20.6 - 127) vs 21.9 (11.2 - 39.2) U/ml, p<0.001 in primary APS vs SLE with APS, respectively. Anti-D1 B2GP1, IgG and IgM anti PS/PT were associated with thrombotic and non-thrombotic manifestations. During follow-up, IgG B2GP1 were related with a significant cumulative risk of thrombosis. CONCLUSIONS: We found significant differences in serum titers of non-criteria aPL among patients with primary APS vs SLE with APS. Whether non-criteria aPL antibodies titers are useful to differentiate patients with primary and secondary APS requires further analysis in other populations.


Asunto(s)
Síndrome Antifosfolípido , Lupus Eritematoso Sistémico , Trombosis , Femenino , Embarazo , Humanos , Síndrome Antifosfolípido/complicaciones , Anticuerpos Antifosfolípidos , Lupus Eritematoso Sistémico/complicaciones , Inmunoglobulina G , Inmunoglobulina M
2.
Reumatol. clín. (Barc.) ; 19(4): 197-203, Abr. 2023. tab, graf
Artículo en Español | IBECS | ID: ibc-218866

RESUMEN

Antecedentes: Hay un interés creciente en el estudio de los anticuerpos antifosfolípidos (aPL) no criterio, incluyendo anticuerpos contra el dominio 1 de la B2 glicoproteína 1 (anti-D1 B2GP1) y anticuerpos antifosfatidilserina/protrombina (PS/PT). Objetivos: Nuestro objetivo fue analizar un panel de aPL convencionales y no criterio en una cohorte de pacientes con lupus eritematoso sistémico (LES) y síndrome antifosfolípido primario (SAF), para describir si hay diferencias en los títulos de aPL entre los grupos, y evaluar asociaciones clínicas incluyendo el riesgo de eventos recurrentes con aPL novedosos. Metodología: Estudio observacional que evaluó los anticuerpos anti-D1 B2GP1 y anti-PS/PT de manera basal. Los anticuerpos anti-D1 B2GP1 se evaluaron a través de inmunoanálisis por quimioluminiscencia. Los anticuerpos anti-PS/PT, anticardiolipinas (aCL) y anti-B2GP1 fueron evaluados por técnicas de ELISA. Finalmente, los pacientes fueron seguidos en el tiempo para identificar nuevos eventos trombóticos. Resultados: Se incluyeron 133 pacientes con LES y 23 pacientes con SAF primario. Las principales manifestaciones de SAF fueron TVP (27%), morbilidad obstétrica (22%) y trombosis arterial (10,1%). Los títulos de anticuerpos anti-PS/PT IgM fueron 46,5 (20,6-127) vs. 21,9 (11,2-39,2) U/ml, p<0,001, en pacientes con SAF primario vs. LES con SAF secundario, respectivamente. Los anti-D1 B2GP1, anti-PS/PT IgG e IgM se asociaron con manifestaciones trombóticas y no trombóticas. Durante el seguimiento, los anticuerpos IgG B2GP1 se relacionaron con un riesgo acumulativo significativo de trombosis. Conclusiones: Se encontraron diferencias estadísticamente significativas en títulos séricos de aPL no criterio en pacientes con SAF primario vs. pacientes con LES y SAF secundario. Si los títulos de aPL no criterio son útiles para diferenciar entre SAF primario y SAF secundario, se requieren más análisis en otras poblaciones para poder confirmar si los títulos de aPL no criterio.


Background: There is an increasing interest in the study of non-criteria antiphospholipid antibodies (aPL) including antibodies targeting domain 1 of the B2 glycoprotein 1 (anti-D1 B2GP1) and antibodies anti phosphatidylserine/ prothrombin (PS/PT). Objectives: Our aim was to analyze a panel of conventional and non-criteria aPL in a cohort of patients with systemic lupus erythematosus (SLE) and primary antiphospholipid syndrome (APS), to describe if there are differences in aPL titers among groups, to evaluate clinical associations including risk of recurrent events of novel aPL. Methods: Observational study that evaluated at baseline antibodies against anti-D1 B2GP1 and anti PS/PT. Anti-D1 B2GP1 antibodies were tested using a chemiluminescent immunoassay. IgG and IgM anti PS/PT, aCL and anti B2GP1 by ELISA techniques. Therefore, patients were followed in order to identify new thrombotic events. Results: 133 patients with SLE and 23 with primary APS patients were included. Main APS manifestations were DVT (27%), obstetric morbidity (22%) and arterial thrombosis (10.1%). IgM anti PS/PT antibodies levels were (20.6 - 127) vs 21.9 (11.2 - 39.2) U/ml, p<0.001 in primary APS vs SLE with APS, respectively. Anti-D1 B2GP1, IgG and IgM anti PS/PT were associated with thrombotic and non-thrombotic manifestations. During follow-up, IgG B2GP1 were related with a significant cumulative risk of thrombosis. Conclusions: We found significant differences in serum titers of non-criteria aPL among patients with primary APS vs SLE with APS. Whether non-criteria aPL antibodies titers are useful to differentiate patients with primary and secondary APS requires further analysis in other populations.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Lupus Eritematoso Sistémico , Anticuerpos , Trombosis , Síndrome Antifosfolípido , Reumatología , Enfermedades Reumáticas
3.
Rev. colomb. reumatol ; 28(2): 95-103, abr.-jun. 2021. tab
Artículo en Español | LILACS | ID: biblio-1357254

RESUMEN

RESUMEN Introducción: Los pacientes con lupus eritematoso sistémico (LES) tienen un riesgo aumen tado de padecer infecciones tanto adquiridas en la comunidad como asociadas con el cuidado de la salud. Las infecciones bacterianas son las más frecuentes y graves durante la hospitalización de estos pacientes. Objetivo: Desarrollar y validar internamente un modelo de predicción clínica de pronóstico del riesgo de infección bacteriana adquirida en el hospital en pacientes con LES, usando datos clínicos y de laboratorio obtenidos durante las primeras horas de hospitalización. Métodos: Se analizó una cohorte retrospectiva de pacientes con LES mayores de 16 arios, hos pitalizados por motivos diferentes a infección bacteriana en 2 hospitales de alta complejidad de Medellín entre 2011 y 2016. Se compararon las características de los pacientes que des arrollaron el desenlace de infección bacteriana entre el día 3 y el día 15 de hospitalización con aquellos que no lo presentaron. Las variables significativas en el análisis bivariado fueron consideradas para la construcción del modelo por medio de regresión logística multivariada. Resultados: Se incluyeron 765 episodios, de los cuales 98 (12,8%) presentaron el desenlace de interés. Se consideraron 35 predictores candidatos. Las variables incorporadas en el modelo final fueron: edad, recuento de neutrófilos, puntaje de actividad lúpica SLEDAI, uso de sonda vesical, uso de catéter venoso central en las primeras 72 h, dosis de glucocorticoides en el mes previo y el uso de un antimalárico en los 3 meses previos. La capacidad de discrimi nación del modelo fue aceptable a buena (AUC-ROC 0,74; IC 95% 0,69-0,80). La prueba de bondad de ajuste de Hosmer-Lemeshow (p = 0,637) evidenció una adecuada calibración. Conclusión: Desarrollamos un modelo de predicción clínica de pronóstico del riesgo de infec ción bacteriana nosocomial en pacientes con LES. El modelo desarrollado está compuesto por variables clínicas y de laboratorio simples disponibles en el momento del ingreso al hospital. Se requieren estudios de validación externa y de impacto clínico antes de su implementación rutinaria.


ABSTRACT Introduction: Patients with systemic lupus erythematosus (SLE) have an increased risk of developing community-acquired infections, as well as those associated with health care. Bacterial infections are the most common and serious while these patients are in hospital. Objective: To develop, and internally validate, a clinical prediction model for the prognosis of the risk of hospital-acquired bacterial infection in SLE patients using clinical and laboratory data obtained during the first hours of hospital admission. Methods: An analysis was performed on retrospective cohort of patients with SLE older than 16 years and admitted for reasons other than bacterial infection in 2 highly complex hospitals in Medellín between 2011 and 2016. The characteristics of the patients who developed a bacterial infection were compared between day 3 and day 15 of hospital admission with those who did not develop one. The significant variables in the bivariate analysis were used for the construction of the model using multivariate logistic regression. Results: A total of 765 episodes were included, of which 98 (12.8%) presented the outcome of interest. Thirty-five candidate predictors were considered. The variables incorporated in the final model were: age, neutrophil count, SLEDAI lupus activity score, use of a bladder catheter, use of a central venous catheter in the first 72 h, glucocorticoid doses in the previous month, and use of an antimalarial drug in the 3 previous months. The discrimination capacity of the model was acceptable to good (AUC-ROC 0.74; 95% CI 0.69-0.80). The Hosmer-Lemeshow goodness of fit test (P = .637) suggested adequate calibration. Conclusion: A clinical prediction model of prognostic risk of nosocomial bacterial infection in patients with SLE has been developed. This model is made up of simple clinical and laboratory variables available at the time of hospital admission. External validation and clinical impact studies are required before routine implementation.


Asunto(s)
Humanos , Adolescente , Adulto , Predicción , Pronóstico , Infecciones Bacterianas y Micosis , Estudios de Cohortes , Enfermedades de la Piel y Tejido Conjuntivo , Modelos Inmunológicos , Lupus Eritematoso Sistémico , Antimaláricos
4.
Clin Rheumatol ; 40(5): 1853-1859, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33079302

RESUMEN

BACKGROUND AND AIM: There are few studies of urinary biomarkers and histopathologic features in lupus nephritis (LN). The aim was to analyze the correlation between a wide panel of urinary biomarkers and serum concentrations of anti C1q antibodies with histological items of activity and chronicity on kidney biopsy in LN patients. METHODS: Patients with systemic lupus erythematosus (SLE) according to American College of Rheumatology (ACR) criteria were included. LN diagnosis was based on ACR criteria. Histologic features of activity and chronicity indices were analyzed according to the Austin classification. Serum Anti C1q levels were determined by commercial ELISA. Urinary levels of transferrin, ceruloplasmin (CP), VCAM-1, TWEAK, monocyte chemoattractant protein-1 (MCP-1), neutrophil gelatinase-associated lipocalin (NGAL), and alpha-1-acid glycoprotein were measured by commercial ELISA. RESULTS: We included 120 SLE patients (81% female, mean age 33.1 ± 9.3 years, 59.4% Mestizo, 37.8% Afro-Latin American): 64% had LN. Kidney biopsy was performed in 55 patients, but only 37 were made in our center. Anti C1q antibodies were associated with endocapillary proliferation. In patients with cellular crescents, urinary concentrations of CP were significantly higher. In patients with a chronicity index (CI) ≥ 4, fibrous crescents, tubular atrophy, and interstitial fibrosis, urinary MCP-1 levels were higher. CONCLUSIONS: In SLE patients, serum anti C1q antibodies and urinary CP were associated with activity on kidney biopsy and MCP-1 with chronic damage. This panel of biomarkers could be validated in larger, multi-ethnic population as a complementary tool for better stratification of LN patients. Key Points • Urinary biomarkers are complementary useful tools for the assessment of SLE patients. • Urinary levels of CP correlated with activity findings on kidney biopsy in LN patients. • Urinary levels of MCP-1 correlated with chronic damage, especially with fibrous crescents, tubular atrophy, and interstitial fibrosis.


Asunto(s)
Ceruloplasmina/orina , Quimiocina CCL2/orina , Lupus Eritematoso Sistémico , Nefritis Lúpica , Adulto , Biomarcadores , Proliferación Celular , Femenino , Humanos , Lupus Eritematoso Sistémico/patología , Nefritis Lúpica/patología , Masculino , Adulto Joven
5.
Reumatol. clín. (Barc.) ; 16(1): 17-23, ene.-feb. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-194255

RESUMEN

ANTECEDENTES Y OBJETIVO: El diagnóstico de la nefritis lúpica (NL) se suele hacer con la biopsia renal, que es una técnica invasiva que conlleva múltiples riesgos. Por lo tanto, han surgido diferentes biomarcadores en orina como posibles alternativas para el diagnóstico de la NL. Sin embargo, los estudios de biomarcadores en orina de pacientes latinoamericanos con lupus eritematoso sistémico (LES) son escasos; por lo tanto, el objetivo del presente estudio fue determinar el valor diagnóstico de la transferrina (TF) y la ceruloplasmina (CP) en orina, para diferenciar los pacientes que tienen compromiso renal de aquellos que no. MATERIALES Y MÉTODOS: Se incluyeron prospectivamente pacientes con diagnóstico de LES de acuerdo a los criterios del American College of Rheumatology (ACR). Se excluyeron los pacientes con otra enfermedad autoinmune concomitante, infección activa (de vías urinarias o sistémica), terapia de reemplazo renal, infección por virus de la inmunodeficiencia humana y embarazo. A cada paciente se le tomó una muestra de orina. El diagnóstico de NL se realizó mediante los criterios ACR para la definición de NL. La actividad y la cronicidad de la NL en la biopsia renal fueron medidas con el índice de Austin. La determinación de los niveles de TF y CP se realizó con kits comerciales de ELISA. Se utilizó la prueba t de Student y la prueba U de Mann Whitney para comparar los datos. Para determinar las asociaciones entre las variables se utilizaron los coeficientes de correlación de Spearman. Por último, se construyeron curvas ROC. RESULTADOS: Se incluyeron 120 pacientes con LES, de los cuales el 85% fueron de sexo femenino. El 76% fueron de raza mestiza. Presentaron una edad media de 32,8+/-12,1años, y una media del SLEDAI de 8,4+/-8,9, y un 64% presentaron compromiso renal. Los niveles de ambos biomarcadores fueron significativamente mayores en pacientes con NL comparados con aquellos sin NL. De igual manera, los niveles de ambos biomarcadores fueron significativamente mayores en pacientes con NL activa comparados con aquellos con NL inactiva. Los niveles de TF fueron significativamente mayores en pacientes afro-latinoamericanos. Por otro lado, las concentraciones de TF se correlacionaron con el SLEDAI y el rango de proteinuria, y las concentraciones de TF y CP se correlacionaron entre sí. Las curvas ROC para ambos biomarcadores mostraron un buen valor diagnóstico de la NL. CONCLUSIONES: En nuestra cohorte de pacientes con LES encontramos que la TF y la CP son potenciales biomarcadores para el diagnóstico de la NL e, incluso, de la actividad de la NL


BACKGROUND AND OBJECTIVE: Diagnosis of lupus nephritis (LN) is usually based on renal biopsy, which is an invasive technique that involves multiple risks. Therefore, different biomarkers have emerged as alternatives for the diagnosis of LN. Nonetheless, studies regarding urinary biomarkers in Latin American patients are limited. The objective of this study was to assess the diagnostic value of urinary transferrin and ceruloplasmin to differentiate patients who have renal involvement from those who do not. MATERIALS AND METHODS: Systemic lupus erythematosus (SLE) patients that met the revised American College of Rheumatology (ACR) classification criteria were recruited. Patients with another autoimmune disease, active infection (urinary tract or systemic infection), renal replacement therapy, human immunodeficiency virus infection or pregnancy were excluded. A urine sample was collected from each patient. LN was diagnosed according to ACR criteria. The activity and chronicity of LN were measured using the Austin indices. Urinary transferrin and ceruloplasmin levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kits. Mann-Whitney U test and Student's t-test were used to compare data. Spearman's rank correlation was used to determine associations. Lastly, receiver operating characteristic (ROC) curves were created. RESULTS: The study involved 120 SLE patients. In all, 85% were female, 76% mestizo, the mean age was 32.8+/-12.1years and mean systemic lupus erythematosus disease activity index (SLEDAI) was 8.4+/-8.9; 64% had renal involvement. Urinary levels of the two biomarkers were significantly higher in patients with LN compared to those without LN. Similarly, urinary levels of both biomarkers were significantly higher in patients with active LN compared to those with inactive LN. Furthermore, urinary transferrin levels were significantly higher in Afro-Latin American patients. On the other hand, urinary transferrin levels correlated with SLEDAI and proteinuria, and transferrin and ceruloplasmin levels correlated with each other. The diagnostic value of ROC curves for these urinary biomarkers for LN were good. CONCLUSIONS: In our cohort of SLE patients, we found that transferrin and ceruloplasmin were potential biomarkers for LN, and can even differentiate active LN


Asunto(s)
Humanos , Femenino , Adulto Joven , Adulto , Transferrinas/orina , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/orina , Nefritis Lúpica/diagnóstico , Biomarcadores/orina , Ceruloplasmina/orina , Estudios Prospectivos , Curva ROC , Técnica del Anticuerpo Fluorescente Indirecta/métodos , Ensayo de Inmunoadsorción Enzimática
6.
Reumatol Clin (Engl Ed) ; 16(1): 17-23, 2020.
Artículo en Inglés, Español | MEDLINE | ID: mdl-29530762

RESUMEN

BACKGROUND AND OBJECTIVE: Diagnosis of lupus nephritis (LN) is usually based on renal biopsy, which is an invasive technique that involves multiple risks. Therefore, different biomarkers have emerged as alternatives for the diagnosis of LN. Nonetheless, studies regarding urinary biomarkers in Latin American patients are limited. The objective of this study was to assess the diagnostic value of urinary transferrin and ceruloplasmin to differentiate patients who have renal involvement from those who do not. MATERIALS AND METHODS: Systemic lupus erythematosus (SLE) patients that met the revised American College of Rheumatology (ACR) classification criteria were recruited. Patients with another autoimmune disease, active infection (urinary tract or systemic infection), renal replacement therapy, human immunodeficiency virus infection or pregnancy were excluded. A urine sample was collected from each patient. LN was diagnosed according to ACR criteria. The activity and chronicity of LN were measured using the Austin indices. Urinary transferrin and ceruloplasmin levels were measured using commercial enzyme-linked immunosorbent assay (ELISA) kits. Mann-Whitney U test and Student's t-test were used to compare data. Spearman's rank correlation was used to determine associations. Lastly, receiver operating characteristic (ROC) curves were created. RESULTS: The study involved 120 SLE patients. In all, 85% were female, 76% mestizo, the mean age was 32.8±12.1years and mean systemic lupus erythematosus disease activity index (SLEDAI) was 8.4±8.9; 64% had renal involvement. Urinary levels of the two biomarkers were significantly higher in patients with LN compared to those without LN. Similarly, urinary levels of both biomarkers were significantly higher in patients with active LN compared to those with inactive LN. Furthermore, urinary transferrin levels were significantly higher in Afro-Latin American patients. On the other hand, urinary transferrin levels correlated with SLEDAI and proteinuria, and transferrin and ceruloplasmin levels correlated with each other. The diagnostic value of ROC curves for these urinary biomarkers for LN were good. CONCLUSIONS: In our cohort of SLE patients, we found that transferrin and ceruloplasmin were potential biomarkers for LN, and can even differentiate active LN.


Asunto(s)
Ceruloplasmina/orina , Lupus Eritematoso Sistémico/orina , Nefritis Lúpica/diagnóstico , Transferrina/orina , Adulto , Biomarcadores/orina , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , América Latina/etnología , Nefritis Lúpica/etnología , Nefritis Lúpica/orina , Masculino , Estudios Prospectivos , Proteinuria/orina , Curva ROC , Estadísticas no Paramétricas
9.
Rev. neurol. (Ed. impr.) ; 66(11): 373-376, 1 jun., 2018. ilus
Artículo en Español | IBECS | ID: ibc-173454

RESUMEN

Conclusiones. Si bien las manifestaciones clínicas típicas de la arteritis de células gigantes son cefalea, claudicación mandibular, pérdida visual, síntomas constitucionales y polimialgia reumática, se debe sospechar su presencia en pacientes mayores de 50 años que manifiesten alteraciones del nervio periférico, entre ellas, diplejía braquial sin otra causa demostrable


Introduction. "Man-in-the-barrel" syndrome refers to diplegia of the upper extremities in which mobility of the head and lower limbs is preserved. Brachial plexitis that presents as "man-in-the-barrel" syndrome is an unusual manifestation of giant cell arteritis. We report a case of C5-C6 plexitis as part of the clinical features of a patient with giant cell arteritis. CASE. Report: A 70-year-old male with a two-month history of weight loss, headache, facial pain and jaw claudication, associated with a persistent elevation of acute phase reactants and bilateral brachial plexopathy, with no evidence of neck or brain injuries or occult neoplasm and with negative autoimmunity tests. Results of the biopsy study of the temporal artery were compatible with giant cell arteritis, and the positron emission tomography scan revealed extensive vascular involvement of the aorta and its branches. Cconclusions: Although the typical clinical manifestations of giant cell arteritis are headache, jaw claudication, loss of sight, constitutional symptoms and polymyalgia rheumatica, its presence must be suspected in patients over the age of 50 who manifest alterations affecting the peripheral nerve, including brachial diplegia with no other demonstrable cause


Asunto(s)
Humanos , Masculino , Anciano , Arteritis de Células Gigantes/patología , Biopsia , Arteritis de Células Gigantes/diagnóstico por imagen , Plexo Braquial/lesiones , Plexo Braquial/patología , Fuerza Muscular , Arterias Temporales/diagnóstico por imagen , Arterias Temporales/patología , Tomografía de Emisión de Positrones
10.
Rev. neurol. (Ed. impr.) ; 63(3): 119-124, 1 ago., 2016. ilus
Artículo en Español | IBECS | ID: ibc-154995

RESUMEN

Introducción. La enfermedad relacionada con IgG4 es una entidad clínica multisistémica recientemente descrita y que se presenta con diferentes manifestaciones clínicas. Los órganos que están afectados con mayor frecuencia son el páncreas, la vía biliar y las glándulas salivales, y es menos frecuente la afección del sistema nervioso central. Caso clínico. Mujer de 33 años con alteraciones cognitivas, alucinaciones, cefalea, síndrome convulsivo, sinusitis maxilar con afección ósea y evidencia de paquimeningitis y panhipopituitarismo, con biopsia meníngea que confirmó una enfermedad relacionada con IgG4, tras haberse descartado causas secundarias. Se inició tratamiento con glucocorticoides y azatioprina, sin recaídas después de 12 meses de seguimiento. Conclusiones. Se debe considerar el diagnóstico de enfermedad relacionada con IgG4 en casos de paquimeningitis hipertrófica e hipofisitis, incluso sin que se acompañen de otras manifestaciones sistémicas, siempre que se hayan descartado otras causas más frecuentes. El tratamiento de elección son los glucocorticoides, y puede ser necesario añadir otro inmunosupresor como ahorrador de esteroides y para evitar las recaídas. Se necesitan estudios prospectivos para evaluar las diferentes manifestaciones clínicas y paraclínicas y establecer los resultados del tratamiento a largo plazo (AU)


Introduction. IgG4-related disease is a recently described multisystemic clinical entity that can occur with different clinical manifestations. The most often affected organs are the pancreas, bile duct and salivary glands, with unusual central nervous system affection. Case Report. A 33 year old woman who presented with cognitive impairment, hallucinations, headache, convulsive syndrome, maxillary sinus inflammation with bone involvement and evidence of pachymeningitis and panhypopytuirarism with meningeal biopsy that confirmed IgG4-related disease, after ruling out secondary causes. Treatment was started with steroids and azathioprine without relapses after 12 months follow-up. Conclusions. IgG4-related disease should be considered in cases of hypertrophic pachymeningitis and hypophysitis especially when no other cause has been found, even if they are not accompanied by other systemic disease manifestations, having ruled out other common causes. The treatment of choice is glucocorticoids and it could be needed to add another immuno­suppressant agent as steroid sparing and to prevent relapses. Prospective studies are needed to evaluate the different clinical and paraclinical manifestations and to establish the results of long-term treatment (AU)


Asunto(s)
Humanos , Femenino , Adulto , Inmunoadhesinas CD4/análisis , Deficiencia de IgG/complicaciones , Sistema Nervioso Central , Sistema Nervioso Central/fisiopatología , Glucocorticoides/uso terapéutico , Azatioprina/uso terapéutico , Inmunoglobulina G/análisis , Meninges/ultraestructura , Inmunohistoquímica/métodos , Inmunohistoquímica , Disonancia Cognitiva , Alucinaciones/complicaciones , Cefalea/complicaciones , Cefalea/diagnóstico , Epilepsia/complicaciones , Convulsiones/complicaciones , Sinusitis Maxilar/complicaciones , Sinusitis Maxilar/epidemiología , Meningitis/complicaciones , Espectroscopía de Resonancia Magnética/métodos
11.
J Clin Rheumatol ; 20(8): 433-6, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25417680

RESUMEN

Pancreatic disorders, such as chronic or acute pancreatitis, and carcinoma may be infrequently accompanied or preceded by panniculitis or polyarthritis. This triad is known in the literature as the pancreatitis, panniculitis, and polyarthritis syndrome. Although the pancreatic disease of pancreatitis, panniculitis, and polyarthritis syndrome usually includes pancreatitis, here we review the literature with report of 1 additional case of polyarthritis and panniculitis occurring in the presence of pancreatic carcinoma. Given that the diagnosis is often difficult when abdominal symptoms are absent, knowledge of the association between panniculitis and polyarthritis with pancreatic disease may lead to a prompt diagnosis and management. The histopathology of the skin lesions can be a valuable clue for focusing attention to a pancreatic disease.


Asunto(s)
Artritis/diagnóstico , Carcinoma de Células Acinares/secundario , Neoplasias Hepáticas/secundario , Neoplasias Pancreáticas/complicaciones , Paniculitis/diagnóstico , Anciano , Antiinflamatorios no Esteroideos/uso terapéutico , Artritis/complicaciones , Artritis/tratamiento farmacológico , Biopsia con Aguja , Carcinoma de Células Acinares/complicaciones , Carcinoma de Células Acinares/diagnóstico , Progresión de la Enfermedad , Resultado Fatal , Humanos , Inmunohistoquímica , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/tratamiento farmacológico , Masculino , Neoplasias Pancreáticas/diagnóstico , Pancreatitis/complicaciones , Pancreatitis/diagnóstico , Paniculitis/complicaciones , Paniculitis/tratamiento farmacológico , Prednisolona/uso terapéutico
12.
Biocell ; 21(1): 13-18, Apr. 1997.
Artículo en Inglés | LILACS | ID: lil-335979

RESUMEN

Liver extract, plasma from intact mice, ES2 tumour extract and plasma from tumour bearing mice has an inhibiting effect on the mitotic activity of hepatocytes and duodenal enterocytes. In the present experiments, the effect of these treatments on the mitotic activity of renal tubular cells was studied. C3HS 28 day-old male mice, standardized for periodicity analysis were used. The determination of normal mitotic circadian curve of the renocytes was done. A second batch of mice were injected with 0.01 ml/gr of either liver extract, plasma from intact mice, ES2 tumour extract or plasma from tumour bearing mice, at 16:00 hours and controlled at 08:00, 12:00 and 16:00 hs during 2 consecutive days post treatment. Colchicine (2 micrograms/gr) was injected 4 hours before killing. Kidneys were processed for histology and mitotic index determinations. Results were expressed as colchicine metaphases per 1000 nuclei, and showed that mitotic activity values of treated animals were significantly lower than those of controls. In conclusion, mitotic activity inhibition of renocytes may be due to some non specific plasmatic and/or tissue factors.


Asunto(s)
Animales , Masculino , Ratones , Plasma , Extractos de Tejidos , Túbulos Renales/citología , División Celular/efectos de los fármacos , Extractos Hepáticos/farmacología , Factor de Crecimiento de Hepatocito/farmacología , Mitosis , Neoplasias Experimentales , Extractos de Tejidos , Túbulos Renales/efectos de los fármacos
13.
Biocell ; 21(1): 13-18, Apr. 1997.
Artículo en Inglés | BINACIS | ID: bin-6368

RESUMEN

Liver extract, plasma from intact mice, ES2 tumour extract and plasma from tumour bearing mice has an inhibiting effect on the mitotic activity of hepatocytes and duodenal enterocytes. In the present experiments, the effect of these treatments on the mitotic activity of renal tubular cells was studied. C3HS 28 day-old male mice, standardized for periodicity analysis were used. The determination of normal mitotic circadian curve of the renocytes was done. A second batch of mice were injected with 0.01 ml/gr of either liver extract, plasma from intact mice, ES2 tumour extract or plasma from tumour bearing mice, at 16:00 hours and controlled at 08:00, 12:00 and 16:00 hs during 2 consecutive days post treatment. Colchicine (2 micrograms/gr) was injected 4 hours before killing. Kidneys were processed for histology and mitotic index determinations. Results were expressed as colchicine metaphases per 1000 nuclei, and showed that mitotic activity values of treated animals were significantly lower than those of controls. In conclusion, mitotic activity inhibition of renocytes may be due to some non specific plasmatic and/or tissue factors.(AU)


Asunto(s)
Animales , Masculino , Ratones , Túbulos Renales/citología , Plasma , Extractos de Tejidos/farmacología , División Celular/efectos de los fármacos , Factor de Crecimiento de Hepatocito/farmacología , Túbulos Renales/efectos de los fármacos , Extractos Hepáticos/farmacología , Ratones Endogámicos C3H , Mitosis/fisiología , Neoplasias Experimentales/sangre , Extractos de Tejidos/química
14.
Microsc. electron. biol. celular ; 15(1): 85-91, Jun. 1991. tab
Artículo en Inglés | LILACS | ID: lil-121636

RESUMEN

Se utilizaron ratones C3HS, endocriados, standardizados para análisis de periodicidad. Ciento setenta ratones de 25 ñ 2 días de edad fueron unyectados a las 16:00 horas con solución fisiológica, plasma o extracto de hígado de 27 machos de 90 días de edad. Los controles fueron realizados a las 08/16, 12/20, 16/24, 08/40, 12/44, 16/28, 08/64, 12/68 y 16/72 (hora día/hora post-inyección) y fue determinada la actividad mitótica de los hepatocitos y células litorales. La inyección de pequeñas dosis de extracto y plasma inhibe la actividad mitótica de los hepatocitos durante los dos primeros días de control. En el tercer día aparece una onda compensatoria. El extracto inhibe la actividad mitótica de las células litorales solo el primer día de control, mientras que el plasma inhibe esta variable el segundo y tercer día


Asunto(s)
Animales , Masculino , Ratones , Sangre/fisiología , Hígado/fisiología , Mitógenos/farmacología , Extractos de Tejidos/farmacología , División Celular , Hígado/crecimiento & desarrollo , Hígado , Mitógenos/aislamiento & purificación , Mitosis/efectos de los fármacos
15.
Microsc. electron. biol. celular ; 15(1): 85-91, Jun. 1991. tab
Artículo en Inglés | BINACIS | ID: bin-25749

RESUMEN

Se utilizaron ratones C3HS, endocriados, standardizados para análisis de periodicidad. Ciento setenta ratones de 25 ñ 2 días de edad fueron unyectados a las 16:00 horas con solución fisiológica, plasma o extracto de hígado de 27 machos de 90 días de edad. Los controles fueron realizados a las 08/16, 12/20, 16/24, 08/40, 12/44, 16/28, 08/64, 12/68 y 16/72 (hora día/hora post-inyección) y fue determinada la actividad mitótica de los hepatocitos y células litorales. La inyección de pequeñas dosis de extracto y plasma inhibe la actividad mitótica de los hepatocitos durante los dos primeros días de control. En el tercer día aparece una onda compensatoria. El extracto inhibe la actividad mitótica de las células litorales solo el primer día de control, mientras que el plasma inhibe esta variable el segundo y tercer día (AU)


Asunto(s)
Animales , Masculino , Ratones , Sangre/fisiología , Hígado/fisiología , Mitógenos/farmacología , Extractos de Tejidos/farmacología , División Celular/efectos de los fármacos , Hígado/crecimiento & desarrollo , Hígado/efectos de los fármacos , Ratones Endogámicos C3H , Mitógenos/aislamiento & purificación , Mitosis/efectos de los fármacos
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