Revista Colombiana de Reumatología (English Edition)最新文献

Introduction and objective

Materials and methods

Results

Conclusion

Introduction

Materials and methods

Results

Conclusions

Introduction

Osteoarthritis (OA) is a common degenerative disease associated with functional impairment, activity limitation, participation restriction, and poor quality of life. Therefore, comprehensive assessment is important to determine how complex problems affect patients with OA.

Objectives

The first aim of this study was to link and allocate items of The Western Ontario and McMaster Universities (WOMAC) OA index with the ICF Comprehensive Core Set for OA. The second aim was to examine the relationship between quality of life and each ICF component score based on WOMAC clinical data in OA.

Materials and methods

Health status was evaluated with WOMAC and quality of life with the Nottingham Health Profile (NHP). The WOMAC items were linked with codes of the ICF Comprehensive Core Set for OA and allocated with the ICF components by three researchers. The relationship between WOMAC scores and the NHP was determined by Pearson correlation analysis.

Results

87 patients with OA were included. As distinguished by the researchers, 7 items of WOMAC covered body function and 17 covered activity-participation. Body function and activity-participation had a moderate correlation with the pain subtest of the NHP and low correlation with the energy level subtest and total score of the NHP. Activity-participation had a high correlation with the physical abilities subtest of the NHP.

Conclusion

Although WOMAC does not cover environmental factors, it is a comprehensive tool to assess health status and quality of life. Our results showed that in OA physical abilities can lead to limitations in activity and participation, and these limitations are associated with the individual's pain, energy level, and quality of life.

Clinical trial registration number: NCT04956510.

Introduction

Adjuvant-induced autoimmune/inflammatory syndrome (ASIA) comprises a spectrum of clinical manifestations associated with exposure to diverse adjuvants that have in common the generation of non-specific autoantibodies and loss of immune tolerance.

Objective

This study aimed to develop a narrative review of the literature about the pathogenesis underlying ASIA syndrome, its differentiation from other defined autoimmune diseases, and prospects for future research in this field.

Materials and methods

A narrative review of the literature was conducted using Pubmed, Embase, and LILACS. All publications on the subject were included, with no time limit in English and Spanish. Finally, 25 articles published since 1990 were included, from which we reviewed the pathogenesis, diagnostic criteria, and its differentiation from other defined autoimmune processes.

Results

The appearance of ASIA syndrome seems to be linked to an individual’s genetic predisposition (HLA-DRB1*01 or HLA-DRB4) and is the result of the interaction of external and endogenous factors that trigger autoimmune phenomena. In recent years, physicians have become more aware of the relationship between exposure to adjuvants and the development of underlying signs and symptoms that may correspond to ASIA syndrome. The current evidence supporting its existence is still contradictory. A timely diagnosis requires a multidisciplinary approach and could require immunosuppressive treatment in particular cases.

Conclusions

In recent years a relationship between exposure to adjuvants and the appearance of autoimmunity phenomena has been recognized. In clinical practice, physicians can find cases of ASIA syndrome. However, the evidence is still debated on the relationship between adjuvants and autoimmune clinical manifestations. ASIA syndrome classification criteria require validation in various populations before being applied to select patients for clinical studies. It is necessary to identify the risk factors for ASIA syndrome to understand its pathophysiology and make a timely diagnosis.

Introduction/Objective

This study aimed to describe the frequency of antinuclear antibody (ANA) staining patterns by indirect immunofluorescence assay observed in patients from a tertiary health center in Latin America.

Materials and methods

This retrospective, descriptive, and observational study evaluated data from all patients undergoing antinuclear antibody indirect immunofluorescence assay from a single-tertiary center (University Hospital Fundación Valle del Lili, Cali-Colombia) in 2020.

Results

One thousand and eight patients met the inclusion criteria. The median patient age was 47 (34–59.2) years, and most were female (769, 75.3%). A positive ANA immunofluorescence assay was observed in approximately two-thirds of patients (664, 65.8%). ANA test results were primarily used to exclude a suspected diagnosis in approximately half of the patients (466, 46.2%). Thirty-seven percent (250/664) of the cohort with ANA-positive titers had a systemic autoimmune rheumatic disease (SARD). The most prevalent SARDs included rheumatoid arthritis (RA) (55, 8.2%) followed by systemic lupus erythematosus (SLE) (37, 5.5%). The vast majority of ANA-positive patients had a reported speckled pattern (anti-cell [AC]-2,4,5; 269; 40.5%) followed by homogenous (AC-1; 266; 40%), nucleolar (AC-8,9,10; 46; 6.9%), and centromere (AC-3; 16; 2.4%). The most frequent patterns observed among SLE patients included homogenous (AC-1) patterns in 17 (45.9%) patients, speckled (AC-2,4,5) nuclear patterns in 11 (29.7%) patients, mixed patterns in 7 (18.9%) patients, and reticular/anti-mitochondrial antibody (AMA, AC-21) cytoplasmic patterns in 2 (5.4%) patients.

Conclusion

This study is the first to describe ANA patterns in a Colombian population. Speckled and homogenous patterns were predominant in patients with SARDs.

Introduction

Patients with fibromyalgia experience pain at a constant and incapacitating pace. It is still a complex entity yet to be fully understood but meanwhile affects patients in every aspect of their lives.

Objective

The purpose of this study is to describe what living with fibromyalgia means for Peruvian women and how it affects their family, work, and social lives in 2021.

Materials and methods

The study has a qualitative design with a phenomenological approach; snowball sampling and theoretical saturation sample size; 10 patients were interviewed through semi-structured in-depth interviews. An ideographic and a nomothetic analysis were conducted, divergences and convergences in the statements were sought and units of analysis were obtained.

Results

There were 12 categories: meaning of fibromyalgia, clinical picture, complications and sequelae, diagnostic process, impact on work, impact on family life, impact on social life, experience with health personnel, lessons learned from fibromyalgia, ecclesiastical support, and myths, misinformation, and prejudices about fibromyalgia.

Conclusion

The experiences and the clinical picture are diverse, the family remains an active and reliable support network for patients, unlike social and work lives, where there is a lack of initiative or empathy towards patients. In light of our findings, we expect healthcare workers and the public in general to learn and see beyond “just histrionics” or “attention seekers” and thus improve the patient's quality of life.

The use of glucocorticoids is the most frequent cause of osteoporosis and osteoporotic fractures. Considering that glucocorticoid-induced osteoporosis (GIOP) is an underestimated and generally untreated problem, the Bone Metabolism study group of the Colombian Association of Rheumatology decided to create this Clinical Practice Guideline (CPG) in order to support rheumatologists and other specialists in the country who use this type of medication to manage inflammatory and autoimmune conditions, with recommendations on prevention, diagnosis, and treatment of GIOP. The recommendations presented here were constructed following the GRADE-ADOLOPMENT methodology. The American College of Rheumatology guideline, Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis, was selected as the source for updating the literature searches. The development of this CPG also included the participation of clinical experts from different specialties, patients, and the EpiThink Health Consulting technical-methodological team.

Introduction

Reactive arthritis (ReA) is a monoarthritis or oligoarthritis that mainly affects the extremities, it can be related to bacterial or viral infections. Currently, COVID-19 has been linked to the development of arthropathies due to its inflammatory component.

Objective

A scoping review of the literature that describes the clinical characteristics of ReA in survivors of SARS-CoV-2 infection.

Materials and methods

A systematic review based on the guidelines for reporting systematic reviews adapted for Prisma-P exploratory reviews and steps proposed by Arksey and adjusted by Levan. Experimental and observational studies published in PubMed and Scopus, English and Spanish, which answered the research questions posed, were included.

Results

Twenty-five documents were included describing the main clinical manifestations of ReA in 27 patients with a history of SARS-Cov-2 infection. The time from the onset of symptoms or microbiological diagnosis of COVID-19 to the development of articular and/or extra-articular manifestations compatible with ReA ranged from 7 days to 120 days. The clinical joint manifestations described were arthralgia and oedema, predominantly in knee, ankle, elbow, interphalangeal, metatarsophalangeal, and metacarpophalangeal joints.

Conclusions

Arthralgias in the extremities are the main symptom of ReA in patients with a history of COVID-19, whose symptoms can present in a period of days to weeks from the onset of clinical symptoms or microbiological diagnosis of SARS-CoV-2 infection.

Introduction

Alveolar hemorrhage syndrome can be secondary to multiple autoimmune disorders. The objective is to describe three diffuse alveolar hemorrhage (DAH) cases secondary to anti-synthetase syndrome (ASSD).

Presentation of the case

Three cases of ADH secondary to ASSD are described: one positive to anti-PL7, another positive to anti-PL12, and the last patient with double positivity to anti-Jo1 and anti-OJ. The patients presented improvement after receiving immunosuppressive treatment.

Discussion

The evolution with therapeutic response and resolution of DAH supports the conclusion that ASSD is a potentially treatable cause of DAH and should be considered within the differential diagnosis in diagnosing DAH.

Conclusion

The described cases contribute to the knowledge of DAH, where ASSD should be considered in diagnosing DAH.