RESUMO
OBJECTIVE: To assess whether the retention rate of certolizumab pegol (CZP) was longer than that of other tumour necrosis factor inhibitors (TNFi) based on baseline rheumatoid factor (RF) levels. METHODS: Longitudinal, retrospective and multicentre study including patients with RA who were treated with any TNFi (monoclonal antibodies (mAB), etanercept (ETA) or CZP). Log-rank test and Cox regressions were conducted to evaluate the retention rate in the three groups according to the level of RF, with the third quartile of the baseline levels used as cut-off: <200 (Assuntos
Artrite Reumatoide
, Inibidores do Fator de Necrose Tumoral
, Humanos
, Estudos Retrospectivos
, Inibidores do Fator de Necrose Tumoral/uso terapêutico
, Fator Reumatoide
, Resultado do Tratamento
, Artrite Reumatoide/tratamento farmacológico
, Certolizumab Pegol/uso terapêutico
, Etanercepte/uso terapêutico
, Anticorpos Monoclonais/uso terapêutico
RESUMO
Se presenta el caso de una mujer de 50 años, fumadora, con artritis reumatoide seropositiva (FR y CCP) de 11 años de evolución en tratamiento con triple terapia, y aparición de nódulos pulmonares con diagnóstico final de histiocitosis de células de Langerhans por biopsia pulmonar. No hemos encontrado casos descritos de la coexistencia de ambas enfermedades. La abstinencia tabáquica llevó a la resolución radiológica sin necesidad de modificar la terapia inmunosupresora (AU)
We report the case of a 50-year-old female smoker with an 11-year history of seropositive rheumatoid arthritis (rheumatoid factor and anti-cyclic citrullinated peptide antibodies) receiving triple therapy. She developed pulmonary nodules diagnosed as Langerhans cell histiocytosis by lung biopsy. We found no reported cases of the coexistence of these two diseases. Smoking abstinence led to radiologic resolution without modifying the immunosuppressive therapy (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Artrite Reumatoide/complicações , Nódulos Pulmonares Múltiplos/complicações , Histiocitose de Células de Langerhans/diagnóstico , Biópsia , Imunossupressores/uso terapêutico , Diagnóstico DiferencialRESUMO
La pseudohipertrofia gemelar secundaria a una radiculopatía es un fenómeno excepcional raramente descrito. Presentamos el caso de una mujer de 67 años con antecedentes de cirugía discal lumbar que consultaba por aumento progresivo de más de un año de evolución, no doloroso, de la región gemelar derecha con ligera pérdida de fuerza asociada. Los hallazgos electromiográficos evidenciaron una radiculopatía crónica S1 y radiológicamente se apreciaba, en territorio del gastrocnemio medial y sóleo derechos, una sustitución del tejido muscular normal por tejido adiposo, sin evidencia de miopatía o degeneración sarcomatosa (AU)
Calf pseudohypertrophy due to radiculopathy is an exceptional phenomenon rarely described. We report a 67 year old woman with a previous history of lumbar disc surgery consulting by progressive increase for more than a year of evolution painless right calf associated loss of strength. Electromyographic findings showed chronic S1 radiculopathy and radiologically was appreciated in the medial gastrocnemius and soleus rights substitution of normal muscle tissue by adipose tissue without evidence of myopathy or sarcomatous degeneration (AU)
Assuntos
Humanos , Feminino , Idoso , Radiculopatia/complicações , Atrofia Muscular/diagnóstico , Músculo Esquelético/fisiopatologia , Perna (Membro) , Descompressão CirúrgicaRESUMO
We report the case of a 50-year-old female smoker with an 11-year history of seropositive rheumatoid arthritis (rheumatoid factor and anti-cyclic citrullinated peptide antibodies) receiving triple therapy. She developed pulmonary nodules diagnosed as Langerhans cell histiocytosis by lung biopsy. We found no reported cases of the coexistence of these two diseases. Smoking abstinence led to radiologic resolution without modifying the immunosuppressive therapy.
Assuntos
Artrite Reumatoide/complicações , Histiocitose de Células de Langerhans/diagnóstico , Nódulos Pulmonares Múltiplos/diagnóstico , Feminino , Histiocitose de Células de Langerhans/complicações , Humanos , Pessoa de Meia-Idade , Nódulos Pulmonares Múltiplos/complicaçõesRESUMO
Calf pseudohypertrophy due to radiculopathy is an exceptional phenomenon rarely described. We report a 67 year old woman with a previous history of lumbar disc surgery consulting by progressive increase for more than a year of evolution painless right calf associated loss of strength. Electromyographic findings showed chronic S1 radiculopathy and radiologically was appreciated in the medial gastrocnemius and soleus rights substitution of normal muscle tissue by adipose tissue without evidence of myopathy or sarcomatous degeneration.
Assuntos
Músculo Esquelético/patologia , Doenças Musculares/etiologia , Radiculopatia/diagnóstico , Idoso , Feminino , Humanos , Hipertrofia/diagnóstico por imagem , Hipertrofia/etiologia , Perna (Membro) , Imageamento por Ressonância Magnética , Músculo Esquelético/diagnóstico por imagem , Doenças Musculares/diagnóstico por imagem , Doenças Musculares/patologia , Radiculopatia/complicaçõesRESUMO
Primary infection by cytomegalovirus (CMV) commonly occurs subclinically or manifested by a self-limited mononucleosis-like syndrome in immunocompetent subjects. Severe clinical pictures are uncommon. We present a case of acute myopericarditis and hepatitis in a previously healthy 32-year-old man with primary CMV infection, assessed by serology and positive pp65 antigenemia. He was successfully treated with a course of oral valganciclovir therapy, with an immediate clinical response and normalization of laboratory tests. The literature on simultaneous presentation of CMV pericarditis and hepatitis in immunocompetent hosts, as well as the role of oral valganciclovir in this clinical setting, is reviewed.