Apheresis activity in Spain: a survey of the Spanish Apheresis Group.

The Spanish Apheresis Group is a scientific association of physicians and nurses representing most of the medical centers in the country that are involved in apheresis. The group developed a survey in order to get information about the types and number of apheresis procedures performed in Spain. We received responses from 66 centers and we were able to collect data from at least one center of each autonomous region. There were 7 centers (11%) that did not perform any kind of apheresis procedures, 26 (39%) centers performed therapeutic apheresis procedures only, 18 (27%) centers performed apheresis donations only, and 15 (23%) centers performed both types of apheresis procedures. Regarding therapeutic apheresis in adult patients, plasma exchange (34%) and stem cell collections (30%) were the two therapeutic procedures most frequently reported, followed by erythrocytapheresis (13%) and extracorporeal photochemotherapy (11%). Regarding apheresis donation, our survey showed that the most frequent was multicomponent donation (45%) followed by plasmapheresis (28%) and single plateletapheresis (21%). When analyzing the current instrumentation for performing apheresis procedures, centers used the Spectra, Optia, and Trima devices (TerumoBCT) as the most frequent ones, followed by the MCS+(Haemonetics), Amicus (Fenwal), and Fresenius devices. In conclusion, we report here the first nationwide survey performed in Spain in order to get information about apheresis activities in our country. The survey is representative of Spain because we were able to collect data from at least one center from each of the different 17 autonomous regions, and we found a wide variety of therapeutic and donation procedures, as well as instrumentation used.

Prevalence and functional analysis of the S107P polymorphism (rs6647476) of the monocarboxylate transporter 8 (SLC16A2) gene in the male population of north-west Spain (Galicia).

OBJECTIVE: Mutations in SLC16A2, the gene encoding the thyroid hormone (TH)-specific transporter monocarboxylate transporter 8 (MCT8), result in a thyroid phenotype and severe mental retardation caused by neuronal TH deficiency. These mutational effects raise the question of whether polymorphic variation in SLC16A2 may also be associated with differences in serum levels of TH and/or TSH. DESIGN: This is the first major study of the frequency of the SLC16A2 rs6647476 single nucleotide polymorphism (SNP) (amino acid change Ser107Pro). We also studied the relationships of SLC16A2 genetic variants with serum levels of TSH, T4 and T3, with their mRNA expression and with expression of the TH-responsive genes ZAKI-4 and BTEB in white blood cells. Experiments in cultured fibroblasts were carried out to ascertain the dynamics of the T3 response. METHODS: A total of 276 men were studied. Genotyping of the S107P SNP was carried out using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP); serum hormone levels were determined by chemiluminescence; expression of mRNA was quantified by real-time PCR. RESULTS: The SLC16A2 S107P SNP was found in 36% of Galician males. With the present sample size we did not find any association of this polymorphism with variability in serum levels of TSH, free T4 (fT4) or fT3, or with basal expression of mRNA for SLC16A2 or the two TH-responsive genes ZAKI-4 and BTEB, either in white blood cells or in cultured human fibroblasts from either Ser107 or Pro107 genotypes under T3 stimulation. CONCLUSIONS: The S107P change in MCT8 is frequent in the male population in Galicia. In the population studied in this report an association with a thyroid phenotype was not demonstrated, even though the S107P SNP causes an important amino acid change.

Nodulose acelerada na artrite reumatóide durante terapia com Leflunomida / Accelerated nodulosis in rheumatoid arthritis during Leflunomide therapy

Nodulose acelerada (NA) é o desenvolvimento de um grande número de nódulos durante um curto intervalo de tempo em pacientes adultos com artrite reumatóide (AR) soropositiva ou soronegativa. Esses nódulos são usualmente associados à terapia com o metotrexato. Existem três relatos de casos descritos de pacientes que desenvolveram NA periférica durante o tratamento com leflunomida. Descrevemos o caso de uma paciente de 60 anos com diagnóstico de AR soropositiva que desenvolveu o quadro de NA depois de quatro meses de terapia com leflunomida. Após um período de oito meses de interrupção do uso da droga, houve regressão completa da nodulose.

Accelerated nodulosis is the development of a large number of nodules during a short time in adult patients presenting either seropositive or seronegative rheumatoid arthritis. These nodules are usually described as associated to methotrexate therapy. There have been three case reports of patients who developed peripheral accelerated nodulosis while receiving leflunomide. We describe a 60-years old woman with seropositive rheumatoid arthritis who developed accelerated nodulosis after four months receiving leflunomide therapy. The patient had a complete regression of the subcutaneous nodules eight months after cessation of leflunomide.