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Reumatol Clin ; 2019 Jan 19.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30665856


INTRODUCTION: IgG4 related disease is a fibroinflammatory condition characterised by lymphoplasmocytic infiltration with predominance of IgG4+ plasma cells, fibrosis, and in most cases elevated IgG4 serum levels. It can affect any organ and result in varying clinical manifestations. Steroids are the cornerstone of treatment, however there is a high percentage of relapse. Recent studies have demonstrated favourable effects with rituximab. OBJECTIVE: To evaluate effectiveness related to the response to treatment with rituximab in patients with IgG4 related disease refractory to steroids and other immunosuppressant therapies. MATERIALS AND METHODS: We undertook a systematic search of the specialist databases EMBASE, LILACS, PUBMED and OVID-Cochrane for publications up until December 2017. RESULTS: After the quality analysis, we selected 27 articles (264 patients in total) for the final review, of which 23 were case reports and case series (105 patients), 3 were observational follow-up cohort studies (129 patients), and there was one clinical trial (30 patients). IgG4 related disease presents predominantly in male patients aged between 50 and 70 years on average. Multiple organs are compromised with an average of 3.5 compromised organs. Orbital, glandular and lymph-node compromise is most frequent. Patients in the different studies we included had received various treatments prior to starting rituximab, including glucocorticoids and disease-modifying anti-rheumatic drugs. There was 90.7% response in the cases where rituximab was used as second line therapy; rituximab was used as first line treatment for 10% of the patients with a 100% response rate. CONCLUSION: The use of rituximab for patients refractory to first-line treatments was associated with a high response percentage and less dependence on glucocorticoids.

Medicina (Bogotá) ; 40(1(120)): 96-98, Ene-Mar, 2018.
Artigo em Espanhol | LILACS | ID: biblio-910052


Introducción: El lupus eritematoso sistémico (LES) es una enfermedad autoinmune caracterizada por compromiso de múltiples órganos, siendo la nefritis lúpica (NL)1 una de las manifestaciones mas graves. Objetivo: Establecer factores asociados a nefritis lúpica en los pacientes con LES. Métodos: Estudio de corte trasversal tomado de una cohorte de 1175 pacientes con LES que cumplieron criterios clasificatorios para ACR 1997 o SLICC 2012, atendidos en una IPS especializada entre 2007 y 2015. Se realizó análisis bivariado de múltiples características entre pacientes con presencia y ausencia de NL a través de chi2 para variables cuantitativas y U de Mann Whitney para variables politómicas o cuantitativas sin distribución normal en búsqueda de asociación estadística.

Lúpus Eritematoso Sistêmico , Nefrite Lúpica