Detección del déficit de alfa-1 antitripsina: estudio en pacientes con enfermedad pulmonar obstructiva crónica diagnosticados en atención primaria / Detection of alpha-1 antitrypsin deficiency: a study on patients diagnosed with chronic obstructive pulmonary disease in primary health care

La enfermedad pulmonar obstructiva crónica (EPOC) tiene una prevalencia en España del 10,2%. El principal factor etiológico es el tabaco. La exposición al humo de biomasa y el déficit de alfa-1 antitripsina (DAAT) también se relacionan con su desarrollo. El DAAT es una condición genética en la que subyace el 2-3% de los pacientes con EPOC. El objetivo de este estudio descriptivo transversal fue descartar el DAAT en pacientes con EPOC del CS Culleredo, A Coruña. Para ello se realizó la prueba de la gota de sangre gruesa en papel secante y el estudio de variantes PI*S y PI*Z del gen SERPINA1 mediante análisis de curvas de desnaturalización tras amplificación simultánea por reacción en cadena de la polimerasa. El estudió analizó 80 pacientes entre 40-80 años. Un 30% eran portadores de un alelo deficitario en heterocigosis, que en el 80% de ellos se trataba del alelo S. Se detectó un caso PiSZ (1,25%) y ninguno PiZZ. Esto representa una frecuencia alélica de 3,1% para el PiZ y 13,1% para el PiS. Las frecuencias alélicas detectadas son superiores a las descritas previamente para la población española. Este trabajo excluye el déficit grave de AAT en el 98,75% de la población estudiada. El caso con genotipo Pi*SZ fue diagnosticado en una fase precoz de la enfermedad. El estudio cumple con uno de los indicadores de calidad asistencial recomendados por GesEPOC y constata una elevada frecuencia alélica PiS y PiZ en la zona, que será referencia de futuros estudios en Galicia (AU)

The prevalence of chronic obstructive pulmonary disease (COPD) in Spain is 10.2%. Although tobacco is the main aetiological factor, biomass smoke exposure and alpha-1 antitrypsin deficiency (AATD) have also been related to its development. AATD is a genetic condition which could be causing 2-3% of COPD cases. The aim of this cross-sectional descriptive study was to exclude the existence of AATD in a population of COPD patients from CS Culleredo, A Coruña. The thick blood drop test on blotting paper, as well as the analysis of the mutations PI*S and PI*Z of the gene SERPINA 1 by the analysis of denaturing gradients after simultaneous amplification related to PCR (polymerase chain reaction). The study population included 80 patients between 40-80 years old, of whom 30% were carriers of a deficient allele (heterozygous), and 80% of them were the allele PiS. Only one PiSZ (1.25%) individual and no PiZZ was detected. This represents an allelic frequency of 3.1% (PiZ), and 13.1% (PiS). The detected allelic frequencies are higher than previously reported in the Spanish population. Severe AATD has been excluded in 98.75% of the study population. The Pi*SZ patient has been diagnosed in an early stage of the disease. We have also achieved one of the quality indicators recommended by GesEPOC. Our area has shown a high PiS and PiZ frequency, thus our study could be used as a reference for further research in the Galician population (AU)

[Detection of alpha-1 antitrypsin deficiency: A study on patients diagnosed with chronic obstructive pulmonary disease in primary health care]. / Detección del déficit de alfa-1 antitripsina: estudio en pacientes con enfermedad pulmonar obstructiva crónica diagnosticados en atención primaria.

The prevalence of chronic obstructive pulmonary disease (COPD) in Spain is 10.2%. Although tobacco is the main aetiological factor, biomass smoke exposure and alpha-1 antitrypsin deficiency (AATD) have also been related to its development. AATD is a genetic condition which could be causing 2-3% of COPD cases. The aim of this cross-sectional descriptive study was to exclude the existence of AATD in a population of COPD patients from CS Culleredo, A Coruña. The thick blood drop test on blotting paper, as well as the analysis of the mutations PI*S and PI*Z of the gene SERPINA 1 by the analysis of denaturing gradients after simultaneous amplification related to PCR (polymerase chain reaction). The study population included 80 patients between 40-80 years old, of whom 30% were carriers of a deficient allele (heterozygous), and 80% of them were the allele PiS. Only one PiSZ (1.25%) individual and no PiZZ was detected. This represents an allelic frequency of 3.1% (PiZ), and 13.1% (PiS). The detected allelic frequencies are higher than previously reported in the Spanish population. Severe AATD has been excluded in 98.75% of the study population. The Pi*SZ patient has been diagnosed in an early stage of the disease. We have also achieved one of the quality indicators recommended by GesEPOC. Our area has shown a high PiS and PiZ frequency, thus our study could be used as a reference for further research in the Galician population.

Actualización de la enfermedad de Behçet. A propósito de 2 casos en atención primaria / Update of Behçet disease. A presentation of 2 cases in Primary Care

La enfermedad de Behçet es una enfermedad inflamatoria multisistémica crónica que evoluciona por brotes. Es más común en Asia y en los países de la cuenca mediterránea oriental (Ruta de la Seda). En España la prevalencia es de 5 a 10 casos por 100.000 habitantes. Es una enfermedad de difícil diagnóstico por las numerosas y variadas manifestaciones clínicas y porque no se dispone de pruebas de laboratorio patognomónicas. El retraso en el diagnóstico, frecuente en países de baja prevalencia como España, aumenta la morbilidad y la mortalidad de los pacientes con enfermedad de Behçet (AU)

Behçet's disease is an inflammatory multisystemic chronic disease that progresses by outbreaks. It is more common in Asia and countries in the eastern Mediterranean basin (Silk Route). In Spain the prevalence is between 5 and 10 cases per 100,000 inhabitants. It is a difficult disease to diagnose because of the multiple and varied clinical manifestations, and because there are not pathognomonic laboratory tests available. The delay in the diagnosis, which is frequent in countries of low prevalence like Spain, increases the morbidity and the mortality of patients with Behçetìs disease (AU)

[Update of Behçet disease. A presentation of 2 cases in primary care]. / Actualización de la enfermedad de Behçet. A propósito de 2 casos en atención primaria.

Behçet's disease is an inflammatory multisystemic chronic disease that progresses by outbreaks. It is more common in Asia and countries in the eastern Mediterranean basin (Silk Route). In Spain the prevalence is between 5 and 10 cases per 100,000 inhabitants. It is a difficult disease to diagnose because of the multiple and varied clinical manifestations, and because there are not pathognomonic laboratory tests available. The delay in the diagnosis, which is frequent in countries of low prevalence like Spain, increases the morbidity and the mortality of patients with Behçtis disease.