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1.
Reumatol. clín. (Barc.) ; 13(3): 150-155, mayo-jun. 2017. tab
Artigo em Espanhol | IBECS | ID: ibc-162470

RESUMO

Objetivo. Determinar los niveles en los títulos de anticuerpos antinucleares (ANA) observados por inmunofluorescencia indirecta en sustrato de célula HEp-2, y su asociación con el diagnóstico de enfermedad del tejido conectivo sistémica en las pruebas solicitadas por una Unidad de Reumatología. Método. Se seleccionaron muestras de pacientes que acudían por primera vez a consulta de reumatología, sin prueba de ANA previa, durante el periodo comprendido entre enero de 2010 y diciembre de 2012. Se registró el título de dilución, patrón y especificidad antigénica. En enero de 2015 se valoraron los diagnósticos de los pacientes y se clasificaron en conectivopatías sistémicas (lupus eritematoso sistémico, síndrome de Sjögren, esclerosis sistémica, conectivopatía indiferenciada, síndrome antifosfolípido, enfermedad mixta del tejido conectivo y miopatía inflamatoria) o no conectivopatía sistémica. Resultado. De un total de 1.282 pruebas solicitadas por la Unidad de Reumatología en sujetos sin estudio previo 293 resultaron positivas, predominando las mujeres (81,9%). Con conectivopatía sistémica se registraron 105 pacientes y 188 sin conectivopatía. En diluciones 1/640 el valor predictivo positivo en las conectivopatías fue de 73,3% frente al 26,6% de las no conectivopatías, y para valores ≥1/1.280, 85% frente al 15% respectivamente. Al realizar el análisis multivariante se observó una asociación positiva entre las diluciones 1/320 OR 3,069 (IC 95%: 1,237-7,614; p=0,016), 1/640 OR 12,570 (IC 95%: 3,659-43,187; p=0,000) y ≥1/1.280 OR 42,136 (IC 95%: 8,604-206,345; p=0,000). Conclusión. Estos resultados muestran asociación de títulos de dilución ≥1/320 para la primera prueba de ANA realizada en una Unidad de Reumatología con pacientes con conectivopatía sistémica. El VPP en estos pacientes resultó superior a estudios previos desarrollados por otras especialidades médicas. Esto puede indicar la importancia de una solicitud de la prueba de forma dirigida (AU)


Objective. To determine the dilution titles at antinuclear antibodies (ANA) by indirect immunofluorescence observed in cell substrate HEp-2 and its association with the diagnosis of systemic connective tissue disease in ANA test requested by a Rheumatology Unit. Method. Samples of patients attended for the first time in the rheumatology unit, without prior ANA test, between January 2010 and December 2012 were selected. The dilution titers, immunofluorescence patterns and antigen specificity were recorded. In January 2015 the diagnosis of the patients were evaluated and classified in systemic disease connective tissue (systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, undifferentiated connective, antiphospholipid syndrome, mixed connective tissue and inflammatory myophaty) or not systemic disease connective tissue. Result. A total of 1282 ANA tests requested by the Rheumatology Unit in subjects without previous study, 293 were positive, predominance of women (81.9%). Patients with systemic connective tissue disease were recorded 105, and 188 without systemic connective tissue disease. For 1/640 dilutions the positive predictive value in the connective was 73.3% compared to 26.6% of non-connective, and for values ≥1/1,280 85% versus 15% respectively. When performing the multivariate analysis we observed a positive association between 1/320 dilution OR 3.069 (95% CI: 1.237-7.614; P=.016), 1/640 OR 12.570 (95% CI: 3.659-43.187; P=.000) and ≥1/1,280 OR 42.136 (95% CI: 8.604-206.345; P=.000). Conclusion. These results show association titles dilution ≥1/320 in ANA's first test requested by a Rheumatology Unit with patients with systemic connective tissue disease. The VPP in these patients was higher than previous studies requested by other medical specialties. This may indicate the importance of application of the test in a targeted way (AU)


Assuntos
Humanos , Anticorpos Antinucleares/análise , Doenças do Colágeno/epidemiologia , Doenças do Tecido Conjuntivo/epidemiologia , Técnica Indireta de Fluorescência para Anticorpo , Doenças Reumáticas/epidemiologia
2.
Reumatol Clin ; 13(3): 150-155, 2017 May - Jun.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27221374

RESUMO

OBJECTIVE: To determine the dilution titles at antinuclear antibodies (ANA) by indirect immunofluorescence observed in cell substrate HEp-2 and its association with the diagnosis of systemic connective tissue disease in ANA test requested by a Rheumatology Unit. METHOD: Samples of patients attended for the first time in the rheumatology unit, without prior ANA test, between January 2010 and December 2012 were selected. The dilution titers, immunofluorescence patterns and antigen specificity were recorded. In January 2015 the diagnosis of the patients were evaluated and classified in systemic disease connective tissue (systemic lupus erythematosus, Sjögren's syndrome, systemic sclerosis, undifferentiated connective, antiphospholipid syndrome, mixed connective tissue and inflammatory myophaty) or not systemic disease connective tissue. RESULT: A total of 1282 ANA tests requested by the Rheumatology Unit in subjects without previous study, 293 were positive, predominance of women (81.9%). Patients with systemic connective tissue disease were recorded 105, and 188 without systemic connective tissue disease. For 1/640 dilutions the positive predictive value in the connective was 73.3% compared to 26.6% of non-connective, and for values ≥1/1,280 85% versus 15% respectively. When performing the multivariate analysis we observed a positive association between 1/320 dilution OR 3.069 (95% CI: 1.237-7.614; P=.016), 1/640 OR 12.570 (95% CI: 3.659-43.187; P=.000) and ≥1/1,280 OR 42.136 (95% CI: 8.604-206.345; P=.000). CONCLUSION: These results show association titles dilution ≥1/320 in ANA's first test requested by a Rheumatology Unit with patients with systemic connective tissue disease. The VPP in these patients was higher than previous studies requested by other medical specialties. This may indicate the importance of application of the test in a targeted way.


Assuntos
Anticorpos Antinucleares/sangue , Doenças do Tecido Conjuntivo/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Doenças do Tecido Conjuntivo/sangue , Doenças do Tecido Conjuntivo/imunologia , Feminino , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Valor Preditivo dos Testes , Estudos Prospectivos , Reumatologia
3.
Reumatol. clín. (Barc.) ; 12(5): 256-262, sept.-oct. 2016. tab, graf
Artigo em Inglês | IBECS | ID: ibc-155875

RESUMO

Objective. Several antibodies have proven to be useful in autoimmune diseases, as markers for diagnosis, prognosis or clinical manifestations. Our objective was to evaluate the diagnosis and manifestations associated for antibodies anti-Ro52, anti-Ro60 and anti-La at a referral hospital in Spain. Methods. We retrospectively analyzed the antigenic specificities of the consecutive samples submitted to the Immunology Unit for antinuclear antibody screening between 2002 and 2012. We included patients with more than one positive sample for some of the autoantibodies anti-Ro52, anti-Ro60 or anti-La. We also reviewed diagnosis, clinical and laboratory features. As dependent variable we evaluated possible combinations of anti-Ro52, anti-Ro60 and anti-La. Results. 322 patients, 91% females, were studied (age 44.3±15.51 years). The most frequent diagnosis was Sjögren's syndrome (40.06%) and systemic lupus erythematosus (SLE) (36.6%). The most prevalent pattern by indirect immunofluorescence was the fine speckled (69.9%). Anti-Ro52+/anti-Ro60+/anti-La+ combination was positively associated with fine speckled pattern (p: 0.001) and negatively with homogeneous (p: 0.016) and cytoplasmic pattern (p: 0.002). Isolated anti-Ro52+ was negatively associated with fine speckled pattern (p<0.001) and positively with the cytoplasmic one (p<0.001). The main positive associations with clinical symptoms were xerostomia and xerophthalmia with anti-Ro52+/anti-Ro60+/anti-La+ (p<0.001), oral ulcers with anti-Ro52+/anti-Ro60+/anti-La− (p: 0.002) and alopecia with anti-Ro52−/anti-Ro60+/anti-La− (p: 0.003). Negative associations were xerophthalmia and photosensitivity with anti-Ro52+/anti-Ro60−/anti-La− (p: 0.003). Laboratory positive associations were hypergammaglobulinemia with anti-Ro52+/anti-Ro60+/anti-La+ (p: 0.003), and hypocomplementemia with anti-Ro52−/anti-Ro60+/anti-La− (p: 0.003). Leucopenia was negatively associated with anti-Ro52+/anti-Ro60−/anti-La− (p: 0.003). Conclusion. Our study found significant relationships between clinical and laboratory manifestations with different patterns of antibodies to anti-Ro52, anti-Ro60 and anti-La. The combination of antibodies might be clinically useful due to prognostic and therapeutic implications (AU)


Objetivo. Varios anticuerpos han demostrado ser útiles en enfermedades autoinmunes, como marcadores de diagnóstico, pronóstico o manifestaciones clínicas. Nuestro objetivo fue evaluar el diagnóstico y las manifestaciones asociadas a anticuerpos anti-Ro52, anti-Ro60 y anti-La en un hospital de referencia en España. Métodos. Se analizaron retrospectivamente las especificidades antigénicas de todas las muestras consecutivas solicitadas a la Unidad de Inmunología para la detección de anticuerpos antinucleares entre 2002 y 2012. Se incluyeron pacientes con más de una muestra positiva para algunos de los autoanticuerpos anti-Ro52, anti-Ro60 o anti-La, y se revisaron sus características diagnósticas, clínicas y de laboratorio. Como variable dependiente se evaluaron las combinaciones de anti-Ro52, anti-Ro60 y anti-La. Resultados. 322 pacientes, 91% mujeres, fueron estudiados (edad 44.3±15.51 años). El diagnóstico más frecuente fue el síndrome de Sjögren (40.06%), y el lupus eritematoso sistémico (LES) (36.6%). El patrón por inmunofluorescencia indirecta más prevalente fue el moteado fino (69.9%). La combinación Anti-Ro52+/anti-Ro60+/anti-La+ se asoció positivamente con el patrón moteado fino (p: 0.001) y negativamente con el homogéneo (p: 0.016) y el citoplasmático (p: 0.002). Anti-Ro52+ aislado se asoció negativamente con el patrón moteado fino (p<0.001) y positivamente con el citoplasmático (p<0.001). La principal asociación con síntomas clínicos fue de xerostomía y xeroftalmia con anti-Ro52+/anti-Ro60+/anti-La+ (p<0.001), úlceras orales con anti-Ro52+/anti-Ro60+/anti-La− (p: 0.002) y alopecia con anti-Ro52−/anti-Ro60+/anti-La−. Asociaciones negativas fueron xeroftalmia y fotosensibilidad con anti-Ro52+/anti-Ro60−/anti-La− (p: 0.003). Asociaciones positivas de laboratorio fueron hipergammaglobulinemia con anti-Ro52+/anti-Ro60+/anti-La+ (p: 0.003) e hipocomplementemia con anti-Ro52−/anti-Ro60+/anti-La− (p: 0.003). Leucopenia se asoció negativamente con anti-Ro52+/anti-Ro60−/anti-La− (p: 0.003). Conclusión. Nuestro estudio encontró una relación significativa entre las manifestaciones clínicas y de laboratorio con diferentes patrones de anticuerpos anti-Ro52, anti-Ro60 y anti-La. La combinación de anticuerpos podría ser clínicamente útil, debido a implicaciones pronósticas y terapéuticas (AU)


Assuntos
Humanos , Masculino , Feminino , Doenças Autoimunes/diagnóstico , Autoanticorpos/administração & dosagem , Autoanticorpos/análise , Xerostomia/complicações , Prognóstico , Estudos Retrospectivos , Técnica Indireta de Fluorescência para Anticorpo/instrumentação , Técnica Indireta de Fluorescência para Anticorpo/métodos , Técnica Indireta de Fluorescência para Anticorpo , Transtornos de Fotossensibilidade/diagnóstico
4.
Medicine (Baltimore) ; 95(9): e2891, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26945378

RESUMO

The aim of the study was to profile those patients included in the RELESSER registry with histologically proven renal involvement in order to better understand the current state of lupus nephritis (LN) in Spain. RELESSER-TRANS is a multicenter cross-sectional registry with an analytical component. Information was collected from the medical records of patients with systemic lupus erythematosus who were followed at participating rheumatology units. A total of 359 variables including demographic data, clinical manifestations, disease activity, severity, comorbidities, LN outcome, treatments, and mortality were recorded. Only patients with a histological confirmation of LN were included. We performed a descriptive analysis, chi-square or Student's t tests according to the type of variable and its relationship with LN. Odds ratio and confidence intervals were calculated by using simple logistic regression. LN was histologically confirmed in 1092/3575 patients (30.5%). Most patients were female (85.7%), Caucasian (90.2%), and the mean age at LN diagnosis was 28.4 ±â€Š12.7 years. The risk for LN development was higher in men (M/F:47.85/30.91%, P < 0.001), in younger individuals (P < 0.001), and in Hispanics (P = 0.03). Complete response to treatment was achieved in 68.3% of patients; 10.35% developed ESRD, which required a kidney transplant in 45% of such cases. The older the patient, the greater was the likelihood of complete response (P < 0.001). Recurrences were associated with persistent lupus activity at the time of the last visit (P < 0.001) and with ESRD (P < 0.001). Thrombotic microangiopathy was a risk factor for ESRD (P = 0.04), as for the necessity of dialysis (P = 0.01) or renal transplantation (P = 0.03). LN itself was a poor prognostic risk factor of mortality (OR 2.4 [1.81-3.22], P < 0.001). Patients receiving antimalarials had a significantly lower risk of developing LN (P < 0.001) and ESRD (P < 0.001), and responded better to specific treatments for LN (P = 0.014). More than two-thirds of the patients with LN from a wide European cohort achieved a complete response to treatment. The presence of positive anti-Sm antibodies was associated with a higher frequency of LN and a decreased rate of complete response to treatment. The use of antimalarials reduced both the risk of developing renal disease and its severity, and contributed to attaining a complete renal response.


Assuntos
Nefrite Lúpica/epidemiologia , Sistema de Registros , Adolescente , Adulto , Feminino , Humanos , Nefrite Lúpica/terapia , Masculino , Recidiva , Estudos Retrospectivos , Reumatologia , Espanha/epidemiologia , Adulto Jovem
5.
Reumatol Clin ; 12(5): 256-62, 2016 Sep-Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-26725021

RESUMO

OBJECTIVE: Several antibodies have proven to be useful in autoimmune diseases, as markers for diagnosis, prognosis or clinical manifestations. Our objective was to evaluate the diagnosis and manifestations associated for antibodies anti-Ro52, anti-Ro60 and anti-La at a referral hospital in Spain. METHODS: We retrospectively analyzed the antigenic specificities of the consecutive samples submitted to the Immunology Unit for antinuclear antibody screening between 2002 and 2012. We included patients with more than one positive sample for some of the autoantibodies anti-Ro52, anti-Ro60 or anti-La. We also reviewed diagnosis, clinical and laboratory features. As dependent variable we evaluated possible combinations of anti-Ro52, anti-Ro60 and anti-La. RESULTS: 322 patients, 91% females, were studied (age 44.3±15.51 years). The most frequent diagnosis was Sjögren's syndrome (40.06%) and systemic lupus erythematosus (SLE) (36.6%). The most prevalent pattern by indirect immunofluorescence was the fine speckled (69.9%). Anti-Ro52+/anti-Ro60+/anti-La+ combination was positively associated with fine speckled pattern (p: 0.001) and negatively with homogeneous (p: 0.016) and cytoplasmic pattern (p: 0.002). Isolated anti-Ro52+ was negatively associated with fine speckled pattern (p<0.001) and positively with the cytoplasmic one (p<0.001). The main positive associations with clinical symptoms were xerostomia and xerophthalmia with anti-Ro52+/anti-Ro60+/anti-La+ (p<0.001), oral ulcers with anti-Ro52+/anti-Ro60+/anti-La- (p: 0.002) and alopecia with anti-Ro52-/anti-Ro60+/anti-La- (p: 0.003). Negative associations were xerophthalmia and photosensitivity with anti-Ro52+/anti-Ro60-/anti-La- (p: 0.003). Laboratory positive associations were hypergammaglobulinemia with anti-Ro52+/anti-Ro60+/anti-La+ (p: 0.003), and hypocomplementemia with anti-Ro52-/anti-Ro60+/anti-La- (p: 0.003). Leucopenia was negatively associated with anti-Ro52+/anti-Ro60-/anti-La- (p: 0.003). CONCLUSION: Our study found significant relationships between clinical and laboratory manifestations with different patterns of antibodies to anti-Ro52, anti-Ro60 and anti-La. The combination of antibodies might be clinically useful due to prognostic and therapeutic implications.


Assuntos
Anticorpos Antinucleares/sangue , Autoantígenos/imunologia , Doenças Autoimunes/diagnóstico , RNA Citoplasmático Pequeno/imunologia , Doenças Reumáticas/diagnóstico , Ribonucleoproteínas/imunologia , Adulto , Idoso , Doenças Autoimunes/sangue , Doenças Autoimunes/imunologia , Biomarcadores/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Doenças Reumáticas/sangue , Doenças Reumáticas/imunologia , Espanha , Centros de Atenção Terciária
6.
Reumatol. clín. (Barc.) ; 11(2): 68-72, mar.-abr. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-133340

RESUMO

Introducción. Las enfermedades crónicas impactan en la morbimortalidad y en la calidad de vida relacionada con la salud (CVRS) de los pacientes a nivel mundial. El impacto de las enfermedades reumáticas no ha sido totalmente reconocido. Objetivos. Determinar la CVRS y evaluar áreas específicas en artritis reumatoide (AR), osteoartritis (OA), diabetes mellitus, insuficiencia renal terminal, población geriátrica y un grupo control. Pacientes y métodos. Estudio transversal, realizado en el Hospital General de Morelia. Los sujetos cumplían criterios para AR, OA, diabetes mellitus, insuficiencia renal terminal, un grupo de población geriátrica (≥ 65 años) y un grupo control ≥ 30 años. Se determinaron características sociodemográficas y se aplicaron instrumentos: SF-36, escala visual analógica de dolor, valoración global del paciente y médico, inventario para depresión de Beck, e instrumentos específicos (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] y Kidney Disease Questionnaire of Life [KDQOL]). Mediciones bioquímicas: velocidad de sedimentación globular (VSG), biometría hemática (BH), glucosa, HbA1C, creatinina y urea. Resultados. Fueron evaluados 290 sujetos (un grupo control: 100, población geriátrica 30 y 160 en los demás grupos). Se detectaron diferencias (p < 0,0001) en las características basales. Los puntajes del SF-36 fueron diferentes entre los grupos (p = 0,007). La peor CVRS se observó en el grupo de insuficiencia renal terminal (media ± DE: 48,06 ± 18,84). En el grupo de AR la salud en general fue el área más afectada. El dolor fue mayor en las enfermedades reumáticas: OA (5,2 ± 2,4) y AR (5,1 ± 3). El HAQ-Di fue mayor en OA comparado con AR (1,12 ± 0,76 vs. 0,82 ± 0,82 respectivamente; p = 0,001). El 45% de los sujetos tuvo depresión. Conclusiones. La CVRS en pacientes con AR es mala y equiparable a lo que sucede en pacientes con enfermedades crónicas (insuficiencia renal terminal y diabetes mellitus). Las enfermedades reumáticas deben considerarse padecimientos de alto impacto y por ello merecen mayor atención (AU)


Introduction. Chronic diseases have a great impact in the morbidity and mortality and in the health-related quality of life (HRQoL) of patients around the world. The impact of rheumatic diseases has not been fully recognized. We conducted a comparative study to evaluate the HRQoL in different chronic diseases. Objectives. The aim of the present study was to assess the HRQoL and identify specific areas affected in patients with rheumatoid arthritis (RA), osteoarthritis (OA), diabetes mellitus, end-stage renal disease, geriatric subjects and a control group. Patients and methods. We conducted a cross-sectional study, in a General Hospital in Morelia, Mexico. All patients met classification criteria for RA, OA, diabetes mellitus, end-stage renal disease; the geriatric subjects group was ≥ 65 years, and the control group ≥ 30 years. Demographic characteristics were recorded, different instruments were applied: SF-36, visual analogue scale for pain, patient's and physician's global assessments, Beck Depression Inventory and specific instruments (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] and Kidney Disease Questionnaire of Life [KDQOL]). Biochemical measures: erythrocyte sedimentation rate, blood count, glucose, HbA1C, serum creatinine and urea. Results. We evaluated 290 subjects (control group: 100; geriatric subjects: 30 and 160 for the rest of groups). Differences were detected in baseline characteristics (P < .0001). The SF-36 scores were different between control group and others groups (P = 0.007). The worst HRQoL was in end-stage renal disease group ( ± SD: 48.06 ± 18.84 x/SD). The general health was the principal affected area in RA. The pain was higher in rheumatic diseases: OA (5.2 ± 2.4) and RA (5.1 ± 3). HAQ was higher in OA compared to RA (1.12 ± 0.76 vs 0.82 ± 0.82, respectively; P = .001). Forty five percent of all subjects had depression. Conclusions. The HRQoL in RA patients is poor and comparable to other chronic diseases (end-stage renal disease and diabetes mellitus). Rheumatic diseases should be considered high impact diseases and therefore should receive more attention (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Qualidade de Vida , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/prevenção & controle , Osteoartrite/epidemiologia , Diabetes Mellitus/epidemiologia , Insuficiência Renal/complicações , Insuficiência Renal/epidemiologia , Doença Crônica/epidemiologia , Indicadores de Morbimortalidade , Estudos Transversais/métodos , Estudos Transversais , Inquéritos e Questionários
7.
Reumatol. clín. (Barc.) ; 11(1): 41-44, ene.-feb. 2015. ilus
Artigo em Espanhol | IBECS | ID: ibc-132362

RESUMO

La mielitis transversa es una inflamación focal poco frecuente de la médula espinal. Su etiología es múltiple y entre ellas se encuentran las enfermedades autoinmunes, incluyendo principalmente el lupus eritematoso sistémico y el síndrome de Sjögren. Su presentación clínica puede ser de forma aguda o subaguda, con peor pronóstico en la mielitis transversa aguda. Un diagnóstico precoz y tratamiento intensivo desde el inicio es de gran importancia en la evolución de este tipo de pacientes. Presentamos 3 casos con mielitis transversa asociados a enfermedades autoinmunes y discutimos sus distintas manifestaciones clínicas, la asociación a autoanticuerpos, las imágenes radiológicas, el tratamiento y el pronóstico (AU)


Transverse myelitis is a rare focal inflammation of the spinal cord. Multiple etiologies have been identified including autoimmune diseases, mainly systemic lupus erythematosus and Sjögren’ syndrome. It can occur in an acute or subacute clinical onset, with the acute presentation having a worse prognosis. An early diagnosis and intensive treatment are important features recommended in these patients. We present three cases with transverse myelitis associated with autoimmune diseases. We discuss different clinical manifestations, association with autoantobodies, radiologic findings, and therapeutic and prognostic issues (AU)


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Mielite Transversa/complicações , Mielite Transversa/diagnóstico , Mielite Transversa/terapia , Síndrome de Sjogren/complicações , Síndrome de Sjogren/diagnóstico , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/diagnóstico , Prognóstico , Mielite Transversa/tratamento farmacológico , Mielite Transversa/fisiopatologia , Mielite Transversa , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Lúpus Eritematoso Sistêmico/fisiopatologia , Lúpus Eritematoso Sistêmico , Diagnóstico Precoce , Imagem por Ressonância Magnética/métodos
8.
Reumatol Clin ; 11(1): 41-4, 2015 Jan-Feb.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24913964

RESUMO

Transverse myelitis is a rare focal inflammation of the spinal cord. Multiple etiologies have been identified including autoimmune diseases, mainly systemic lupus erythematosus and Sjögren' syndrome. It can occur in an acute or subacute clinical onset, with the acute presentation having a worse prognosis. An early diagnosis and intensive treatment are important features recommended in these patients. We present three cases with transverse myelitis associated with autoimmune diseases. We discuss different clinical manifestations, association with autoantobodies, radiologic findings, and therapeutic and prognostic issues.


Assuntos
Lúpus Eritematoso Sistêmico/diagnóstico , Mielite Transversa/etiologia , Síndrome de Sjogren/diagnóstico , Adulto , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Pessoa de Meia-Idade , Mielite Transversa/diagnóstico , Síndrome de Sjogren/complicações
9.
Reumatol Clin ; 11(2): 68-72, 2015 Mar-Apr.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-24816341

RESUMO

INTRODUCTION: Chronic diseases have a great impact in the morbidity and mortality and in the health-related quality of life (HRQoL) of patients around the world. The impact of rheumatic diseases has not been fully recognized. We conducted a comparative study to evaluate the HRQoL in different chronic diseases. OBJECTIVES: The aim of the present study was to assess the HRQoL and identify specific areas affected in patients with rheumatoid arthritis (RA), osteoarthritis (OA), diabetes mellitus, end-stage renal disease, geriatric subjects and a control group. PATIENTS AND METHODS: We conducted a cross-sectional study, in a General Hospital in Morelia, Mexico. All patients met classification criteria for RA, OA, diabetes mellitus, end-stage renal disease; the geriatric subjects group was≥65 years, and the control group≥30 years. Demographic characteristics were recorded, different instruments were applied: SF-36, visual analogue scale for pain, patient's and physician's global assessments, Beck Depression Inventory and specific instruments (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] and Kidney Disease Questionnaire of Life [KDQOL]). Biochemical measures: erythrocyte sedimentation rate, blood count, glucose, HbA1C, serum creatinine and urea. RESULTS: We evaluated 290 subjects (control group: 100; geriatric subjects: 30 and 160 for the rest of groups). Differences were detected in baseline characteristics (P<.0001). The SF-36 scores were different between control group and others groups (P=0.007). The worst HRQoL was in end-stage renal disease group (±SD: 48.06±18.84 x/SD). The general health was the principal affected area in RA. The pain was higher in rheumatic diseases: OA (5.2±2.4) and RA (5.1±3). HAQ was higher in OA compared to RA (1.12±0.76 vs 0.82±0.82, respectively; P=.001). Forty five percent of all subjects had depression. CONCLUSIONS: The HRQoL in RA patients is poor and comparable to other chronic diseases (end-stage renal disease and diabetes mellitus). Rheumatic diseases should be considered high impact diseases and therefore should receive more attention.


Assuntos
Artrite Reumatoide , Diabetes Mellitus , Indicadores Básicos de Saúde , Falência Renal Crônica , Osteoartrite , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Doença Crônica , Estudos Transversais , Feminino , Hospitais Gerais , Humanos , Masculino , México , Pessoa de Meia-Idade
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