RESUMO
INTRODUCTION: Microscopic bowel inflammation is present in up to 50% of patients with spondyloarthritis (SpA) and is associated with more severe disease. Currently no reliable biomarkers exist to identify patients at risk. Calprotectin is a sensitive marker of neutrophilic inflammation, measurable in serum and stool. OBJECTIVES: To assess whether serum and faecal calprotectin in addition to C-reactive protein (CRP) can be used to identify patients with SpA at risk of microscopic bowel inflammation. METHODS: Serum calprotectin and CRP were measured in 125 patients with SpA. In 44 of these patients, faecal samples were available for calprotectin measurement. All 125 patients underwent an ileocolonoscopy to assess the presence of microscopic bowel inflammation. RESULTS: Microscopic bowel inflammation was present in 53 (42.4%) patients with SpA. Elevated serum calprotectin and CRP were independently associated with microscopic bowel inflammation. Faecal calprotectin was also significantly higher in patients with microscopic bowel inflammation. Patients with CRP and serum calprotectin elevated had a frequency of bowel inflammation of 64% vs 25% in patients with low levels of both. When either CRP or serum calprotectin was elevated, the risk was intermediate (40%) and measuring faecal calprotectin provided further differentiation. Hence we suggest a screening approach where initially serum calprotectin and CRP are assessed and, if necessary, faecal calprotectin. The model using this scenario provided an area under the ROC curve of 74.4% for detection of bowel inflammation. CONCLUSIONS: Calprotectin measurements in stool and serum, in addition to CRP, may provide a promising strategy to identify patients with SpA at risk of bowel inflammation and could play a role in overall patient stratification.
Assuntos
Colite/etiologia , Complexo Antígeno L1 Leucocitário/análise , Espondilartrite/metabolismo , Adulto , Biomarcadores/análise , Proteína C-Reativa/análise , Estudos de Casos e Controles , Colite/metabolismo , Colite/patologia , Colonoscopia , Fezes/química , Feminino , Seguimentos , Humanos , Intestinos/patologia , Complexo Antígeno L1 Leucocitário/sangue , Masculino , Estudos Prospectivos , Curva ROC , Espondilartrite/complicações , Espondilartrite/patologiaAssuntos
Dermatite de Contato/etiologia , Detergentes/efeitos adversos , Ácidos Oleicos/efeitos adversos , Peptídeos , Compostos de Potássio , Proteínas , Tensoativos/efeitos adversos , Adulto , Colágeno/efeitos adversos , Etanolaminas/efeitos adversos , Feminino , Preparações para Cabelo/efeitos adversos , Humanos , Testes do Emplastro , PotássioRESUMO
A cleaning woman in a restaurant became sensitized to thiourea in a silver polish. The dermatitis persisted for several months and occasionally flared up after exposure to sunlight, even after she no longer used the product. Patch testing and photopatch testing showed that she had both contact and photocontact allergy.
Assuntos
Dermatite de Contato/etiologia , Dermatite Ocupacional/induzido quimicamente , Tioureia/efeitos adversos , Administração Tópica , Adulto , Anti-Inflamatórios/uso terapêutico , Feminino , Glucocorticoides , Humanos , Testes do Emplastro , Transtornos de Fotossensibilidade/etiologia , Tioureia/metabolismo , Fatores de TempoAssuntos
Dermatite de Contato/etiologia , Éteres/efeitos adversos , Palmitatos/efeitos adversos , Ácidos Palmíticos/efeitos adversos , Excipientes Farmacêuticos/efeitos adversos , Adulto , Cosméticos/efeitos adversos , Dermatite de Contato/diagnóstico , Emulsões , Feminino , Humanos , Pessoa de Meia-Idade , Testes do EmplastroRESUMO
The case is reported of a 75-year-old man with bullous pemphigoid that was resistant to conventional treatment with prednisone and azathioprine. A hypernephroma was discovered and surgically excised, whereafter the skin lesions healed completely without any other therapeutic measures being taken.
Assuntos
Carcinoma de Células Renais/complicações , Neoplasias Renais/complicações , Síndromes Paraneoplásicas/patologia , Penfigoide Bolhoso/patologia , Dermatopatias Vesiculobolhosas/patologia , Idoso , Biópsia , Humanos , Masculino , Pele/patologiaRESUMO
A general review is given of airborne-induced contact dermatoses, particularly of the irritant and allergenic types. Because the reports in the literature often omit the term airborne, 12 volumes of Contact Dermatitis (January 1975-July 1985) were screened, and the cases cited were classified in function of the anamnesis, lesion locations, causative irritants and allergens, and other factors. The present article also discusses differential diagnoses, in particular with regard to contact dermatitis of the face, ears, and neck. Finally, seven case reports of occupational and nonoccupational contact dermatitis problems caused by airborne agents are presented. In some of the cases the allergens have not been mentioned in published literature previously.