RESUMO
Objective: The aim was to assess clinical improvement after US-guided injection of CSs into the SI joint of patients with SpA. Methods: This was an observational, descriptive, retrospective study of patients with SpA and sacroiliitis who received an US-guided injection into the SI joint between 1 June 2020 and 31 May 2021. Means were compared using Student's paired t-test for the variables visual analog scale (VAS), BASDAI, ASDAS, CRP and ESR before and after the procedure. We evaluated the association between these variables and the clinical response using the odds ratio. Results: We analysed 32 patients with SpA [age 42.69 (8.19) years; female sex, 56.25%], with a VAS score of 7.88 (0.79), BASDAI of 5.43 (1.48) and ASDAS of 3.27 (0.86) before the procedure. At 2-3 months, 75% of patients had improved: VAS 3.81 (2.33) (-4.07, P < 0.0001) and BASDAI 3.24 (1.6) (-2.19, P < 0.0001). At 5-6 months, 59.37% had improved: VAS 4.63 (2.31) (-3.25, P < 0.0001), BASDAI 3.57 (1.67) (-1.86, P < 0.0001) and ASDAS 2.27 (0.71) (-1.0, P < 0.0001). Bone marrow oedema resolved in 87.5% of cases compared with the previous MRI scan. No significant association was identified with the clinical response to the injection. Conclusion: US-guided injection of CSs into the SI joint of patients with SpA and active sacroiliitis leads to an improvement in symptoms that is maintained at 5-6 months. The procedure is effective, safe, inexpensive and easy to apply.
RESUMO
La crioglobulinemia es una enfermedad rara en la cual se producen inmunoglobulinas monoclonales y/o policlonales que precipitan con el frío. Si bien este fenómeno puede observarse en una gran cantidad de trastornos, se ha asociado más frecuentemente a la infección por el virus de la hepatitis C en más del 90%. El porcentaje restante, llamado crioglobulinemia esencial, se ha caracterizado por curso más severo y falta de respuesta al tratamiento convencional. El presente artículo describe el caso de un paciente con crioglobulinemia esencial que se presenta con acronecrosis, en la que su mala evolución, a pesar del tratamiento, la lleva a la amputación (AU)
Cryoglobulinemia is a rare disease characterized by the production of monoclonal or polyclonal immunoglobulins that precipitate in cold temperature. While this phenomenon can be observed in a large number of disorders, it has been associated with hepatitis C virus infection in more than 90% of cases. The remaining 10%, called essential cryoglobulinemia, has been characterized by a more severe course and a failure to respond to conventional treatment. This article describes the case of a patient with essential cryoglobulinemia presenting with acronecrosis with a poor outcome, despite treatment, leading to amputation (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Crioglobulinemia/complicações , Crioglobulinemia/diagnóstico , Necrose/complicações , Hepatite C/complicações , Hepatite C/diagnóstico , Amputação Cirúrgica , Crioglobulinemia/fisiopatologia , Crioglobulinemia , Plasmaferese/métodos , Plasmaferese/tendênciasRESUMO
Cryoglobulinemia is a rare disease characterized by the production of monoclonal or polyclonal immunoglobulins that precipitate in cold temperature. While this phenomenon can be observed in a large number of disorders, it has been associated with hepatitis C virus infection in more than 90% of cases. The remaining 10%, called essential cryoglobulinemia, has been characterized by a more severe course and a failure to respond to conventional treatment. This article describes the case of a patient with essential cryoglobulinemia presenting with acronecrosis with a poor outcome, despite treatment, leading to amputation.
