Acute respiratory involvement in Colombian patients with systemic lupus erythematosus undergoing chest computed tomography.

INTRODUCTION: Systemic lupus erythematosus (SLE) is an inflammatory disease which affects multiple organs. The respiratory system is compromised in 1.6% to 36% of the patients with SLE. The objective of this study was to know the prevalence of these alterations, their associated variables, and outcomes in patients with SLE between 2012 and 2017. METHODS: A cross-sectional study of 200 patients with SLE underwent chest computed tomography (CT). The primary outcome was acute respiratory involvement (ARI). A descriptive, bivariate and multivariate analysis were performed using Stata 12.0 software. RESULTS: ARI was present in 40% of the SLE patients undergoing chest CT. The most frequent ARI was pleural effusion in 33%, followed by pneumonia (16.5%), lupus pneumonitis (9%), pulmonary embolism (3%) and pulmonary hemorrhage (2.5%). In bivariate and multivariate analysis a statistically significant association between ARI and nephropathy, hematological impairment, active disease, dead, readmission and prolonged hospital stay was found. CONCLUSION: This is the first Colombian study that evaluates ARI in patients with SLE. ARI is an important and frequent condition in patients with SLE, pleural effusion being the most prevalent cause of ARI. There are some variables (nephropathy, hematological impairment and activity disease) that are associated with ARI and could be the basis of intervention.

Prevalencia y caracterización de las enfermedades autoinmunitarias en pacientes mayores de 13 años en un hospital de Colombia / Prevalence and characterization of autoimmune diseases in patients older than 13 years in a hospital of Colombia

Resumen ANTECEDENTES Las enfermedades autoinmunitarias afectan alrededor de 3 a 5% de los seres humanos, especialmente a las mujeres. Por su poca prevalencia se desconocen los datos clínicos locales del comportamiento de esta enfermedad. OBJETIVO Encontrar la prevalencia de las enfermedades autoinmunitarias en el Hospital Universitario de Santander, Santander, Colombia, así como realizar la caracterización clínica y sociodemográfica de las enfermedades. MATERIAL Y MÉTODO Estudio observacional, descriptivo de corte transversal, retrospectivo de la prevalencia de enfermedades autoinmunitarias en el Hospital Universitario de Santander entre 2012 y 2016 en pacientes mayores de 13 años que ingresaron a la institución. RESULTADOS Se encontraron 1463 enfermedades autoinmunitarias con prevalencia de 378 casos por cada 100,000 pacientes mayores de 13 años, atendidos en el Hospital Universitario de Santander y la población con enfermedad autoinmunitaria fue de 0.4%. Las enfermedades más prevalentes fueron la artritis reumatoide, psoriasis, enfermedad de Graves, púrpura trombocitopénica inmunitaria y lupus eritematoso sistémico y los órganos más afectados fueron la piel, la glándula tiroides, el sistema hematológico, el páncreas y el sistema nervioso. CONCLUSIONES Los datos encontrados sugieren que la prevalencia en nuestro medio es similar a la de otras poblaciones; sin embargo, estas prevalencias son multifactoriales y pueden variar entre las diferentes poblaciones.

Abstract BACKGROUND Autoimmune diseases affect around 3-5% of human beings, especially women. Due to its low prevalence, local clinical data on the behavior of this disease are unknown. OBJECTIVE To find the prevalence of autoimmune diseases in the University Hospital of Santander, as well as to carry out the clinical and sociodemographic characterization of the diseases. MATERIAL AND METHOD An observational, descriptive and retrospective cross-sectional study on the prevalence of autoimmune diseases was done at the University Hospital of Santander between 2012 and 2016 in patients over 13 years of age who entered to the institution. RESULTS A total of 1463 autoimmune diseases were found, with a prevalence of 378 cases per 100,000 patients over 13 years of age treated at the University Hospital of Santander and the population with autoimmune disease was 0.4%. The most prevalent diseases were rheumatoid arthritis, psoriasis, Graves' disease, immune thrombocytopenic purpura and systemic lupus erythematosus and the most affected organs were the skin, thyroid gland, hematology system, pancreas and nervous system. CONCLUSIONS The data suggest that the prevalence in our environment is similar to that of studies in other populations; however, these prevalences are multifactorial and may vary among different populations.

Bacteremia por Aeromonas caviae en paciente con hepatitis autoinmune: presentación de caso / Bacteremia caused by Aeromonas caviae in-patient with autoinmune hepatitis: case report

Resumen La hepatitis autoinmune es una enfermedad inflamatoria hepática mediada por un mecanismo de autoinmunidad. Este trastorno tiene un amplio espectro clínico y debe ser sospechado en presencia de elevación de inmunoglobulinas y aminotransferasas en un paciente con histopatología positiva para hepatitis. El diagnóstico se realiza descartando otras causas de hepatitis (viral, secundaria a medicamentos) y complementado con los estudios de autoanticuerpos típicos de esta enfermedad. El tratamiento se fundamenta en la monoterapia con corticoesteroides o su asociación con otros inmunomoduladores, obteniéndose buenas tasas de respuesta terapéutica. La tasa de infección hospitalaria en pacientes con cirrosis hepática oscila entre 32-34% siendo la bacteremia la cuarta fuente más frecuente, la cual tiene como etiología al género Aeromonas en un 5%. Se presenta el caso de una paciente de 51 años con hepatitis autoinmune quien consulta por descompensación de enfermedad hepática secundaria a bacteremia por un microorganismo poco común. MÉD.UIS. 2017;30(3):121-7.

Abstract Autoimmune hepatitis is an inflammatory hepatic disease mediated by an autoimmune mechanism. This disorder has a broad clinical spectrum and should be suspected in the presence of elevated aminotransferases and immunoglobulins in a patient with histopathology hepatitis. Diagnosis is made by ruling out other causes of hepatitis (viral, secondary to drugs) and confirmation with positive autoantibodies. Treatment is based on corticosteroid monotherapy or its association with other immunomodulators, obtaining good therapeutic response rates. Rate of hospital infection in patients with hepatic cirrhosis ranges from 32-34%, with bacteremia being the fourth most frequent source, where Aeromonas represents 5% of these cases. We report the case of a 51-year-old patient with autoimmune hepatitis who consults for decompensation of secondary liver disease with a rare microorganism. MÉD.UIS. 2017; 30(3):121-7.