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3.
Reumatol Clin ; 15(6): 327-332, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-29503178

RESUMEN

OBJECTIVE: This study assesses the relationship between the ability to perform productive activities and the clinical characteristics of RA, such as disease activity, quality of life, functional capacity, workload, pharmacotherapy, and comorbidities. MATERIALS AND METHODS: A cross-sectional, observational and descriptive study was conducted. Patients aged 18-75years with a diagnosis of RA according to ACR/EULAR 2010 criteria who attended regularly to the Rheumatology service in the period between January and March 2017 were included. The questionnaires, WPAI-AR, HAQ-DI and RAQoL, were applied. RA disease activity was measured by DAS28-PCR. Correlations were made between the clinical data obtained and work productivity and activity impairment measured by WPAI-AR. RESULTS: Two hundred four patients with a diagnosis of RA were included, of whom 92.6% were women. Mean age was 54.46±9.3years. Regarding the percentage of impairment of daily life activities, we found a significant difference between employed and unemployed patients (P≤.002). A positive correlation was found between RA activity measured by DAS28-PCR, quality of life, and functional ability with the percentages of absenteeism, presenteeism, overall productivity loss, and impairment of daily life activities. CONCLUSION: A correlation between RA disease activity, functional capacity, quality of life, and working impairment was found. The strongest association was established with the degree of functional capacity.

5.
Clin Rheumatol ; 37(2): 367-373, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29273832

RESUMEN

The aim of this study is to evaluate the hearing behavior of rheumatoid arthritis (RA) and primary Sjögren syndrome (PSS) patients and compare them with a healthy control group and with each other. A comparative cross-sectional study was performed with a group of 117 female RA patients, a group of 60 female PSS patients, and a 251 female healthy control group. Every subject underwent a series of studies including high-frequency audiometry, speech audiometry, and tympanometry. The high-frequency audiometry measured 250 to 16,000 Hz. The 117 patients with RA and the 60 with PSS were diagnosed according to American College of Rheumatology criteria / ACR 2010, and the validated classification of the American-European Consensus Group. Hearing loss was present in 36.8% of the RA group in 500-3000 Hz, 68.4% in 4000-8000 Hz, and 94.9% in 10,000-16,000 Hz. Hearing loss was present in 60% of the PSS group in 500-3000 Hz, 70% in 4000-8000 Hz, and 100% in 10,000-16,000 Hz. The hearing impairment prevalence of both groups was significantly different (p < 0.05) when compared with the healthy control group. We also compared the hearing thresholds between RA and PSS patients, finding a significant hearing threshold increase in 500-3000 Hz of the PSS group. This study consolidates the association between RA and PSS with hearing impairment. A deeper hearing loss was reported in PSS than in RA patients, demonstrating a greater auditory and speech recognition repercussion.


Asunto(s)
Artritis Reumatoide/complicaciones , Audiometría/métodos , Pérdida Auditiva Sensorineural/diagnóstico , Síndrome de Sjögren/complicaciones , Pruebas de Impedancia Acústica/métodos , Adulto , Anciano , Umbral Auditivo , Estudios Transversales , Diagnóstico Precoz , Femenino , Pérdida Auditiva Sensorineural/complicaciones , Humanos , Persona de Mediana Edad , Adulto Joven
6.
Rev Bras Reumatol Engl Ed ; 56(6): 504-508, 2016.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-27914597

RESUMEN

BACKGROUND: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. OBJECTIVE: We investigated the association between MPV and disease activity in adult patients with SLE. METHODS: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. RESULTS: MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. CONCLUSIONS: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.


Asunto(s)
Plaquetas/citología , Lupus Eritematoso Sistémico/sangre , Volúmen Plaquetario Medio , Adulto , Humanos , Activación Plaquetaria , Estudios Prospectivos , Estudios Retrospectivos
7.
Rev. bras. reumatol ; 56(6): 504-508, Nov.-Dec. 2016. tab, graf
Artículo en Inglés | LILACS-Express | ID: biblio-830075

RESUMEN

ABSTRACT Background: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. Objective: We investigated the association between MPV and disease activity in adult patients with SLE. Methods: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. Results: MPV was significantly decreased with respect to those of inactive patients (7.16 ± 1.39 vs. 8.16 ± 1.50, p = 0.005). At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r = 0.407, p = 0.001), which in turn is inversely associated with disease activity. Conclusions: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.


RESUMO Antecedentes: Existem poucos biomarcadores disponíveis para avaliar a atividade da doença no lúpus eritematoso sistêmico (LES). O volume plaquetário médio (VPM) foi recentemente estudado como um biomarcador inflamatório. Atualmente não está claro se o VPM também pode desempenhar um papel como um biomarcador da atividade da doença em pacientes adultos com LES. Objetivo: Investigou-se a associação entre o VPM e a atividade da doença em pacientes adultos com LES. Métodos: Neste estudo retrospectivo, compararam-se dois grupos de pacientes adultos divididos de acordo com a atividade da doença (36 por grupo). Os indivíduos foram pareados por idade e gênero. Resultados: O VPM esteve significativamente diminuído nos pacientes com doença ativa em comparação com os níveis em pacientes com doença inativa (7,16 ± 1,39 versus 8,16 ± 1,50, p = 0,005). Em um nível de corte de 8,32 fL, o VPM tem uma sensibilidade de 86% e uma especificidade de 41% para a detecção da atividade da doença. Encontrou-se uma correlação positiva modesta entre o VPM e a albumina (r = 0,407, p = 0,001), que por sua vez está inversamente associada à atividade da doença. Conclusões: Em resumo, o VPM está diminuído em pacientes adultos com lúpus ativo e positivamente correlacionado com a albumina, outro biomarcador da atividade da doença. São necessários estudos prospectivos para avaliar o valor prognóstico desse biomarcador.

9.
J Eval Clin Pract ; 22(5): 751-4, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27133797

RESUMEN

PURPOSE: It has been estimated that medication errors (ME) are responsible for 7000 deaths each year. Some studies show that electronic prescribing systems have achieved health benefits and patient safety, resulting in a saving of resources. Other studies suggest that they may increase adverse events. OBJECTIVE: The objective of this study was to compare medication errors between electronic and paper-based prescription detected during pharmacovigilance. METHODS: This was an observational, cross-sectional comparative study of 600 randomized medical records that were systematically reviewed by a pharmacovigilance team, with a deliberate search for ME. Each error was classified according to its severity, National Coordinating Council for Medication Error and Prevention taxonomy and high-risk medications. The number of errors was calculated per 100 prescribed medications, number of errors per record and number of records with an error as a quality indicator. RESULTS: A total of 229 ME were found with a mean per record of 0.38 (SD = 0.7), of which 155 corresponded to the paper-based method (1.04, SD = 1.67) and 74 to the electronic-based method (0.29, SD = 0.57) P = <0.001. The use of the electronic method was associated with an OR of 0.59 (95% CI 0.41-0.85) for the recording of at least one ME (P = 0.005), but to a greater severity of ME (<0.001). CONCLUSION: The use of the electronic system was associated with a reduction in ME, compared with the paper-based method. Despite this, it was associated with more severe ME.


Asunto(s)
Prescripciones de Medicamentos , Prescripción Electrónica , Hospitales Universitarios , Errores de Medicación/prevención & control , Atención Terciaria de Salud , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Seguridad del Paciente , Farmacovigilancia
10.
Rev Bras Reumatol ; 2016 Feb 26.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-26968762

RESUMEN

BACKGROUND: Only a few biomarkers are available for assessing disease activity in systemic lupus erythematosus (SLE). Mean platelet volume (MPV) has been recently studied as an inflammatory biomarker. It is currently unclear whether MPV may also play a role as a biomarker of disease activity in adult patients with SLE. OBJECTIVE: We investigated the association between MPV and disease activity in adult patients with SLE. METHODS: In this retrospective study, we compared two groups of adult patients divided according to disease activity (36 per group). Subjects were age- and gender-matched. RESULTS: MPV was significantly decreased with respect to those of inactive patients (7.16±1.39 vs. 8.16±1.50, p=0.005). At a cutoff level of 8.32 fL, MPV has a sensitivity of 86% and a specificity of 41% for the detection of disease activity. A modest positive correlation was found between MPV and albumin (r=0.407, p=0.001), which in turn is inversely associated with disease activity. CONCLUSIONS: In summary, MPV is decreased in adult patients with active lupus disease, and positively correlated with albumin, another biomarker of disease activity. Prospective studies are needed to evaluate the prognostic value of this biomarker.

12.
Pneumologia ; 65(3): 150-1, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-29542893

RESUMEN

Asthma is a highly prevalent chronic respiratory disease affecting millions of people worldwide. Short-acting beta 2-agonists induce bronchodilation and usually are prescribed as a rescue medication. They are recognized as a cause of hyperlactatemia and, less frequently, lactic acidosis. Short-acting beta 2-agonists are also known for their potentially adverse cardiovascular effects, such as atrial fibrillation. Differential diagnosis and subsequent treatment of the latter entity are important due to the adverse prognosis related to it. In this case report, we describe the unusual association between albuterol-induced lactic acidosis and atrial fibrillation in a patient with an asthma exacerbation.


Asunto(s)
Acidosis Láctica/inducido químicamente , Albuterol/efectos adversos , Asma/complicaciones , Fibrilación Atrial/inducido químicamente , Broncodilatadores/efectos adversos , Antiarrítmicos/uso terapéutico , Asma/tratamiento farmacológico , Fibrilación Atrial/diagnóstico , Fibrilación Atrial/tratamiento farmacológico , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Verapamilo/uso terapéutico
13.
Pneumologia ; 65(3): 161-3, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-29542896

RESUMEN

Mycobacterium tuberculosis as a cause of both chylothorax and chylous ascites is extremely rare. A 46-year-old non-adherent woman with AIDS and pulmonary tuberculosis presented to our clinic with dyspnea, pleuritic chest and abdominal pain. Chest x-ray demonstrated a left pleural effusion. Contrast-enhanced CT showed free abdominal fluid. Thoracentesis revealed a chylothorax, and paracentesis a chylous ascites. AFB staining and PCR for M. tuberculosis (GeneXpert MTB/ RIF Assay) were both negative. Malignant cells cytology also tested negative. Tuberculosis could account for both chylothorax and chylousascites, as she clinically improved when antituberculous drugs were resumed. Even when PCR tested negative, M. tuberculosis should be included in the differential diagnosis because of its therapeutic and prognostic implications. Keywords: Chylothorax, chylous ascites, Mycobacterium tuberculosis, acquired immunodeficiency syndrom, antituberculous drugs.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Quilotórax/microbiología , Ascitis Quilosa/microbiología , Huésped Inmunocomprometido , Reacción en Cadena de la Polimerasa , Tuberculosis/complicaciones , Antituberculosos/uso terapéutico , Quilotórax/diagnóstico , Quilotórax/terapia , Ascitis Quilosa/diagnóstico , Ascitis Quilosa/terapia , Femenino , Humanos , Persona de Mediana Edad , Paracentesis/métodos , Resultado del Tratamiento , Tuberculosis/diagnóstico , Tuberculosis/tratamiento farmacológico
14.
Reumatol. clín. (Barc.) ; 11(2): 78-82, mar.-abr. 2015. tab
Artículo en Español | IBECS | ID: ibc-133342

RESUMEN

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune inflamatoria sistémica crónica; se considera que la fertilidad es normal en pacientes con LES, los factores asociados con una baja reserva folicular que condicionan falla ovárica son: actividad de la enfermedad, anticuerpos antiovario y el uso de agentes citotóxicos. La hormona anti-mülleriana (HAM) es un marcador para determinar la reserva folicular. Objetivo Determinar los niveles de HAM en mujeres con LES en edad reproductiva. Material y métodos. Incluimos a 65 mujeres, de 18 a 40 años, clasificadas como LES según los criterios ACR 1997. Se obtuvieron las características demográficas, clínicas, ginecoobstétricas y niveles séricos de HAM. Se realizó un análisis bivariado entre las pacientes con baja reserva ovárica y aquellas con reserva ovárica normal. Se realizó un análisis de correlación entre los índices de actividad y daño, así como la dosis acumulada de ciclofosfamida y los niveles de HAM. Resultados. La mediana del título de HAM fue de 0,61 ng/ml. La prevalencia de baja reserva ovárica en nuestro estudio fue del 3,07%. La mediana del MEX-SLEDAI fue de 1 punto y la de SLICC 2 puntos. Veinticinco pacientes (38,4%) habían utilizado ciclofosfamida y la dosis promedio acumulada fue de 7,5 g. Conclusiones. En nuestra población, se encontró una mediana del título de HAM de 0,61 ng/ml, similar a lo reportado anteriormente. La prevalencia de baja reserva ovárica fue del 3,07%. No se encontró correlación entre el uso de ciclofosfamida, la actividad de la enfermedad o los niveles de HAM (AU)


Systemic lupus erythematosus (SLE) is an inflammatory autoimmune systemic and chronic disease. Fertility in SLE patients is considered normal; factors that have been associated in these patients with ovarian failure are: disease activity, autoantibodies, and the use of cytotoxic agents. The anti-Müllerian hormone (AMH) is a marker that helps to determine the follicular reserve. Objective. Determinate the objective was to determine AMH levels in women of reproductive age with SLE. Material and methods. We included 65 women with SLE classified according to the 1997 ACR criteria, 18- to 40-years old. We obtained demographic, clinical, obstetric, and gynecological characteristics as well as serum levels of AMH. We performed a bivariate analysis among patients with low ovarian reserve and those with normal ovarian reserve. We also performed a correlation analysis between activity and damage index and between the cumulative cyclophosphamide dose and AMH levels. Results. We found a median of serum AMH in SLE patients of .61 ng/mL. The prevalence of low ovarian reserve in our study was 3.07%. We found a median MEX-SLEDAI score of 1 point and the median SLICC score was 2 points. Twenty-five patients (38.4%) had used cyclophosphamide and their cumulative average dose was 7.5 grams. Conclusions. We found a median of AMH of .61 ng/mL in our population. The prevalence of low ovarian reserve in SLE patients was 3.07%. We did not find a correlation between AMH levels, the use of cyclophosphamide, and disease activity (AU)


Asunto(s)
Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Hormona Antimülleriana/metabolismo , Hormona Antimülleriana/uso terapéutico , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/diagnóstico , Lupus Eritematoso Sistémico/tratamiento farmacológico , Ciclofosfamida/uso terapéutico , Estudios Transversales/métodos , Estudios Transversales , Encuestas y Cuestionarios , Ensayo de Inmunoadsorción Enzimática/métodos
16.
Reumatol Clin ; 11(2): 78-82, 2015.
Artículo en Inglés, Español | MEDLINE | ID: mdl-24815955

RESUMEN

UNLABELLED: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune systemic and chronic disease. Fertility in SLE patients is considered normal; factors that have been associated in these patients with ovarian failure are: disease activity, autoantibodies, and the use of cytotoxic agents. The anti-Müllerian hormone (AMH) is a marker that helps to determine the follicular reserve. OBJECTIVE: Determinate the objective was to determine AMH levels in women of reproductive age with SLE. MATERIAL AND METHODS: We included 65 women with SLE classified according to the 1997 ACR criteria, 18- to 40-years old. We obtained demographic, clinical, obstetric, and gynecological characteristics as well as serum levels of AMH. We performed a bivariate analysis among patients with low ovarian reserve and those with normal ovarian reserve. We also performed a correlation analysis between activity and damage index and between the cumulative cyclophosphamide dose and AMH levels. RESULTS: We found a median of serum AMH in SLE patients of .61 ng/mL. The prevalence of low ovarian reserve in our study was 3.07%. We found a median MEX-SLEDAI score of 1 point and the median SLICC score was 2 points. Twenty-five patients (38.4%) had used cyclophosphamide and their cumulative average dose was 7.5 grams. CONCLUSIONS: We found a median of AMH of .61 ng/mL in our population. The prevalence of low ovarian reserve in SLE patients was 3.07%. We did not find a correlation between AMH levels, the use of cyclophosphamide, and disease activity.


Asunto(s)
Hormona Antimülleriana/sangre , Lupus Eritematoso Sistémico/sangre , Reserva Ovárica , Adolescente , Adulto , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Lupus Eritematoso Sistémico/fisiopatología , Adulto Joven
17.
Interdiscip Perspect Infect Dis ; 2014: 562610, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25210515

RESUMEN

Mucormycosis (MCM) is a life-threatening infection that carries high mortality rates despite recent advances in its diagnosis and treatment. The objective was to report 14 cases of mucormycosis infection and review the relevant literature. We retrospectively analyzed the demographic and clinical data of 14 consecutive patients that presented with MCM in a tertiary-care teaching hospital in northern Mexico. The mean age of the patients was 39.9 (range 5-65). Nine of the patients were male. Ten patients had diabetes mellitus as the underlying disease, and 6 patients had a hematological malignancy (acute leukemia). Of the diabetic patients, 3 had chronic renal failure and 4 presented with diabetic ketoacidosis. All patients had rhinocerebral involvement. In-hospital mortality was 50%. All patients received medical therapy with polyene antifungals and 11 patients underwent surgical therapy. Survivors were significantly younger and less likely to have diabetes than nonsurvivors, and had higher levels of serum albumin on admission. The clinical outcome of patients with MCM is poor. Uncontrolled diabetes and age are negative prognostic factors.

18.
Reumatol. clín. (Barc.) ; 9(3): 136-141, mayo 2013. tab, ilus
Artículo en Español | IBECS | ID: ibc-112504

RESUMEN

Objetivo. Determinar si existe una asociación entre la presencia de nódulos reumatoides y el engrosamiento de la íntima-media y de placa de las arterias carótidas. Materiales y métodos. Estudio observacional, transversal de 124 pacientes con artritis reumatoide del Servicio de Reumatología de un Hospital Universitario desde 2005 a 2006. Se dividieron los pacientes en 2 grupos, 62 con nódulos reumatoide y 62 sin nódulos reumatoides, pareados por edad y sexo. Se realizó una historia clínica completa, velocidad de sedimentación globular, medición de anticuerpos antipéptidos cíclicos citrulinados, factor reumatoide y una ecografía doppler de alta resolución de las arterias carótidas. Resultados. Las mujeres comprendieron el 89,5% de los pacientes. La prevalencia de al menos una placa en las carótidas fue del 57% en nuestra población. La presencia de placa carotídea estuvo asociada a la edad, hipertensión arterial y circunferencia abdominal. El grosor promedio de la íntima-media en pacientes con placa carotídea fue 0,085cm (±0,02). No hubo ninguna correlación entre los parámetros de laboratorio y el engrosamiento de íntima-media de la arteria carótida. Los nódulos subcutáneos estuvieron presentes en 33 (47%) de los 70 pacientes con placas de carótida y 29 (54%) de los pacientes sin una placa carótida (p=0,471). Conclusiones. No hemos encontrado una asociación entre nódulos reumatoides y la presencia de placa y/o el engrosamiento de la íntima-media de carótidas en pacientes con artritis reumatoide(AU)


Objective: To determine whether an association exists between the presence of rheumatoid nodules and thickening of the intima-media and plaque of the carotid artery, which is evidence of atherosclerosis. Materials and methods: Observational, cross-sectional study of 124 patients with rheumatoid arthritis from a University Hospital clinic from 2005 to 2006. We divided the patients into 2 groups, 62 with rheumatoid nodules and 62 without rheumatoid nodules, matched for age and sex. Medical history, erythrocyte sedimentation rate, anti-cyclic citrullinated peptide, rheumatoid factor, and a high resolution doppler ultrasound of the carotid arteries were performed. Results: Women comprised 89.5% of the patients. The prevalence of a carotid plaque was 57% in our population. The presence of a plaque was associated with age, arterial hypertension and abdominal circumference. Average intima-media thickness (IMT) in patients with a plaque was 0.085 cm (±0.02). There was no correlation between laboratory parameters and thickening of the intima-media of the carotid artery. Subcutaneous nodules were present in 33 (47%) of the 70 patients with a carotid plaque and in 29 (54%) of patients without a carotid plaque (p = .471). Conclusions: We did not find an association between rheumatoid nodules and the presence of a carotid plaque and thickening of the intima-media of the carotid in patients with rheumatoid arthritis(AU)


Asunto(s)
Humanos , Masculino , Femenino , Aterosclerosis/complicaciones , Aterosclerosis/diagnóstico , Artritis Reumatoide/complicaciones , Artritis Reumatoide/diagnóstico , Factor Reumatoide , Artritis Reumatoide/fisiopatología , Artritis Reumatoide , Arterias Carótidas/fisiopatología , Estudios Transversales/métodos , Estudios Transversales , Sedimentación Sanguínea , Encuestas y Cuestionarios
19.
Reumatol Clin ; 9(3): 136-41, 2013.
Artículo en Inglés, Español | MEDLINE | ID: mdl-23273674

RESUMEN

OBJECTIVE: To determine whether an association exists between the presence of rheumatoid nodules and thickening of the intima-media and plaque of the carotid artery, which is evidence of atherosclerosis. MATERIALS AND METHODS: Observational, cross-sectional study of 124 patients with rheumatoid arthritis from a University Hospital clinic from 2005 to 2006. We divided the patients into 2 groups, 62 with rheumatoid nodules and 62 without rheumatoid nodules, matched for age and sex. Medical history, erythrocyte sedimentation rate, anti-cyclic citrullinated peptide, rheumatoid factor, and a high resolution doppler ultrasound of the carotid arteries were performed. RESULTS: Women comprised 89.5% of the patients. The prevalence of a carotid plaque was 57% in our population. The presence of a plaque was associated with age, arterial hypertension and abdominal circumference. Average intima-media thickness (IMT) in patients with a plaque was 0.085 cm (± 0.02). There was no correlation between laboratory parameters and thickening of the intima-media of the carotid artery. Subcutaneous nodules were present in 33 (47%) of the 70 patients with a carotid plaque and in 29 (54%) of patients without a carotid plaque (p=.471). CONCLUSIONS: We did not find an association between rheumatoid nodules and the presence of a carotid plaque and thickening of the intima-media of the carotid in patients with rheumatoid arthritis.


Asunto(s)
Enfermedades de las Arterias Carótidas/etiología , Nódulo Reumatoide/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/complicaciones , Enfermedades de las Arterias Carótidas/diagnóstico por imagen , Enfermedades de las Arterias Carótidas/epidemiología , Grosor Intima-Media Carotídeo , Estudios de Casos y Controles , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
20.
Clin Rheumatol ; 32(3): 409-15, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23292521

RESUMEN

Autoimmune vasculitides can have diverse neurological manifestations, including posterior reversible encephalopathy syndrome (PRES). Takayasu's arteritis (TA) is an uncommon vasculitis rarely associated with PRES. Common clinical features of TA include hypertension, audible arterial bruits, absence of peripheral pulses, claudication of the extremities, reduced blood pressure in one or both arms, and angiographic abnormalities. PRES has been mostly associated with severe hypertension, endothelial injury, and conditions such as renal disease, immunosuppressive medication use, and rheumatologic diseases. Headaches, seizures, and altered mental status are the main clinical features as well as characteristic findings in magnetic resonance imaging. TA frequently presents with hypertension and is associated with endothelial injury, making this entity an ideal setting for the development of PRES. We report the case of a 17-year-old female who presented to the emergency department with severe hypertension, headache, and seizures. Magnetic resonance imaging findings were suggestive of PRES. She had absent pulses in the right upper extremity, abdominal bruits, and angiographic findings included subclavian and renal artery stenoses. The diagnosis of TA was made, and she responded well to treatment. We found ten additional cases of TA and PRES in the literature. All patients were females under the age of 40, had renovascular hypertension, and presented with headaches and seizures. Current literature relevant to this rare association is presented and discussed.


Asunto(s)
Síndrome de Leucoencefalopatía Posterior/diagnóstico , Síndrome de Leucoencefalopatía Posterior/epidemiología , Arteritis de Takayasu/diagnóstico , Arteritis de Takayasu/epidemiología , Adolescente , Comorbilidad , Femenino , Cefalea/etiología , Humanos , Hipertensión/etiología , Síndrome de Leucoencefalopatía Posterior/complicaciones , Convulsiones/etiología , Esteroides/uso terapéutico , Arteritis de Takayasu/complicaciones , Resultado del Tratamiento
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