Pub Date : 2025-07-01DOI: 10.1016/j.rcreue.2025.03.004
Adriana Margarita Trejos Tenorio , Carlos Jaime Velásquez Franco , Libia María Rodríguez Padilla , Miguel Antonio Mesa Navas
Introduction
Nailfold capillaroscopy is a useful tool to evaluate microcirculation. In mixed connective tissue disease (MCTD), microvascular changes are not clearly defined. This study aims to compare the angiographic findings between patients with mixed connective tissue disease, systemic sclerosis, and primary Raynaud phenomenon (pRP) in a capillaroscopy reference centre.
Methods
A retrospective descriptive study with an exploratory analytical component was designed. Clinical and capillaroscopic characteristic information was obtained from medical records and capillaroscopic reports from an expert capillaroscopy service using an Optilia 200x videocapillaroscope. To compare qualitative variables, the Pearson or Fisher exact chi-square test was used in case of expected frequencies lower than five.
Results
One hundred and twenty capillaroscopy charts were reviewed. In the MCTD group, 42.5% of patients showed a normal pattern, 37.5% had a non-scleroderma pattern, and 20% exhibited a scleroderma pattern. Among pRP patients, 62.5% had a normal and 37.5% had a non-specific pattern; both groups preserved capillary density. In MCTS, compared to SS, there were fewer avascular areas (10% vs. 62.5% p < .001), megacapillaries (20% vs 100%, p < .001), and haemorrhages (37.5 vs. 92.5% p < .001). Bushy capillaries predominated in the MCTD (10%) compared to SS (5%) and pRP (0%) groups without significance difference (p = .122).
Conclusions
Compared to systemic sclerosis, mixed connective tissue disease presents greater capillary density and a greater frequency of arborescent capillaries.
甲襞毛细血管镜是评估微循环的有效工具。在混合性结缔组织病（MCTD）中，微血管的改变没有明确的定义。本研究旨在比较混合结缔组织病、系统性硬化症和原发性雷诺现象（pRP）患者在毛细血管镜参考中心的血管造影结果。方法设计回顾性描述性研究，并结合探索性分析成分。临床和毛细血管检查特征信息来自医疗记录和专家毛细血管检查服务报告，使用Optilia 200x视频毛细血管镜。为了比较定性变量，在预期频率低于5的情况下，使用Pearson或Fisher精确卡方检验。结果回顾了120张毛细血管镜检查图。在MCTD组中，42.5%的患者表现为正常模式，37.5%的患者表现为非硬皮病模式，20%表现为硬皮病模式。pRP患者中62.5%为正常型，37.5%为非特异性型；两组均保持了毛细血管密度。在MCTS中，与SS相比，无血管区域（10% vs. 62.5% p <； .001）、巨毛细血管（20% vs. 100% p <； .001）和出血（37.5 vs. 92.5% p <； .001）较少。与SS组（5%）和pRP组（0%）相比，MCTD组（10%）以浓密毛细血管为主，但无显著性差异（p = .122）。结论与系统性硬化症相比，混合性结缔组织病毛细血管密度大，树形毛细血管出现频率高。
{"title":"Nailfold capillaroscopy in mixed connective tissue disease, systemic sclerosis, and primary Raynaud phenomenon in a capillaroscopy service from Medellin, Colombia 2015–2020","authors":"Adriana Margarita Trejos Tenorio , Carlos Jaime Velásquez Franco , Libia María Rodríguez Padilla , Miguel Antonio Mesa Navas","doi":"10.1016/j.rcreue.2025.03.004","DOIUrl":"10.1016/j.rcreue.2025.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Nailfold capillaroscopy is a useful tool to evaluate microcirculation. In mixed connective tissue disease (MCTD), microvascular changes are not clearly defined. This study aims to compare the angiographic findings between patients with mixed connective tissue disease, systemic sclerosis, and primary Raynaud phenomenon (pRP) in a capillaroscopy reference centre.</div></div><div><h3>Methods</h3><div>A retrospective descriptive study with an exploratory analytical component was designed. Clinical and capillaroscopic characteristic information was obtained from medical records and capillaroscopic reports from an expert capillaroscopy service using an Optilia 200x videocapillaroscope. To compare qualitative variables, the Pearson or Fisher exact chi-square test was used in case of expected frequencies lower than five.</div></div><div><h3>Results</h3><div>One hundred and twenty capillaroscopy charts were reviewed. In the MCTD group, 42.5% of patients showed a normal pattern, 37.5% had a non-scleroderma pattern, and 20% exhibited a scleroderma pattern. Among pRP patients, 62.5% had a normal and 37.5% had a non-specific pattern; both groups preserved capillary density. In MCTS, compared to SS, there were fewer avascular areas (10% vs. 62.5% p < .001), megacapillaries (20% vs 100%, p < .001), and haemorrhages (37.5 vs. 92.5% p < .001). Bushy capillaries predominated in the MCTD (10%) compared to SS (5%) and pRP (0%) groups without significance difference (p = .122).</div></div><div><h3>Conclusions</h3><div>Compared to systemic sclerosis, mixed connective tissue disease presents greater capillary density and a greater frequency of arborescent capillaries.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 3","pages":"Pages 209-215"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.rcreue.2025.06.006
Yimy F. Medina , Henry F. Cárdenas-Sánchez , Carlos Jaime Velásquez-Franco
<div><h3>Introduction</h3><div>Videocapillaroscopy is a diagnostic procedure that allows an assessment of the microcirculation in the nailfold of patients with Raynaud's phenomenon. There are few reports of videocapillaroscopic findings in healthy subjects, none in Colombia. It is important to know the findings that exist in the Colombian healthy population to have a reference and define abnormalities in people with diseases.</div></div><div><h3>Objective</h3><div>Our aim was to describe the standardized qualitative, quantitative videocapillaroscopic findings and the sociodemographic characteristics in healthy volunteers from a Colombian population.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional descriptive study was conducted at the Simon Bolívar and Hospital Universitario Nacional de Colombia in Bogota, Colombia. Healthy adult volunteers over 18 years of age were included in the study. Two images were taken per finger from the second to fifth of each hand. A pilot test was conducted to refine the procedure and establish the agreement between the evaluators of the test, in which a kappa concordance index was estimated for the findings of capillary density, presence of dilated capillaries, megacapillaries, abnormal morphologies and avascular areas. Subsequently, measurements of the venous loop, arterial loop, apical portion, intercapillary distance, capillary density, presence of dilated capillaries, megacapillaries, avascular zones, and description of capillary morphology were performed. Finally, a capillaroscopic diagnosis was issued by Fast-track flowchart.</div></div><div><h3>Results</h3><div>One hundred one videocapillaroscopy studies were performed. The age range of the participants was 20–62 years (average 31 years). 59 women and 42 men. A total of 1611 photographs at 200× were analyzed. Agreement between the two observers was excellent for capillary density, dilated capillaries, microhemorrhages and abnormal shapes. The average of each the findings was as follows: capillary density of 8.2<!--> <!-->capillaries/mm, apical diameter 14.1<!--> <!-->μm, arterial loop 10.8<!--> <!-->μm, venous loop 13.7<!--> <!-->μm, and intercapillary distance 147<!--> <!-->μm. Morphology was evaluated in 10,855 capillaries. The predominant morphology was hairpin with 58.8%, followed by crossed 30.2% tortuous 10.4%, and abnormal forms corresponded to 0.48% of the sample. No avascular or megacapillary zones were documented. In 53 individuals, there were some dilated capillaries (182), corresponding to 1.7% of the capillaries analyzed (median of apical diameter: 23.3<!--> <!-->μm). Microhemorrhages was found in 16 volunteers, most of them hemosiderin content. The capillaroscopic diagnosis using the Fast-Track algorithm and standardization criteria were category I (a non-scleroderma pattern) in the entire sample, non-specific abnormal findings were observed in 67 (66.3%) of the 101 videocapillaroscopy analyzes.</div></div><div><h3>Conclusion
{"title":"Videocapillaroscopy findings in a Colombian population of healthy volunteers with standardization criteria","authors":"Yimy F. Medina , Henry F. Cárdenas-Sánchez , Carlos Jaime Velásquez-Franco","doi":"10.1016/j.rcreue.2025.06.006","DOIUrl":"10.1016/j.rcreue.2025.06.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Videocapillaroscopy is a diagnostic procedure that allows an assessment of the microcirculation in the nailfold of patients with Raynaud's phenomenon. There are few reports of videocapillaroscopic findings in healthy subjects, none in Colombia. It is important to know the findings that exist in the Colombian healthy population to have a reference and define abnormalities in people with diseases.</div></div><div><h3>Objective</h3><div>Our aim was to describe the standardized qualitative, quantitative videocapillaroscopic findings and the sociodemographic characteristics in healthy volunteers from a Colombian population.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional descriptive study was conducted at the Simon Bolívar and Hospital Universitario Nacional de Colombia in Bogota, Colombia. Healthy adult volunteers over 18 years of age were included in the study. Two images were taken per finger from the second to fifth of each hand. A pilot test was conducted to refine the procedure and establish the agreement between the evaluators of the test, in which a kappa concordance index was estimated for the findings of capillary density, presence of dilated capillaries, megacapillaries, abnormal morphologies and avascular areas. Subsequently, measurements of the venous loop, arterial loop, apical portion, intercapillary distance, capillary density, presence of dilated capillaries, megacapillaries, avascular zones, and description of capillary morphology were performed. Finally, a capillaroscopic diagnosis was issued by Fast-track flowchart.</div></div><div><h3>Results</h3><div>One hundred one videocapillaroscopy studies were performed. The age range of the participants was 20–62 years (average 31 years). 59 women and 42 men. A total of 1611 photographs at 200× were analyzed. Agreement between the two observers was excellent for capillary density, dilated capillaries, microhemorrhages and abnormal shapes. The average of each the findings was as follows: capillary density of 8.2<!--> <!-->capillaries/mm, apical diameter 14.1<!--> <!-->μm, arterial loop 10.8<!--> <!-->μm, venous loop 13.7<!--> <!-->μm, and intercapillary distance 147<!--> <!-->μm. Morphology was evaluated in 10,855 capillaries. The predominant morphology was hairpin with 58.8%, followed by crossed 30.2% tortuous 10.4%, and abnormal forms corresponded to 0.48% of the sample. No avascular or megacapillary zones were documented. In 53 individuals, there were some dilated capillaries (182), corresponding to 1.7% of the capillaries analyzed (median of apical diameter: 23.3<!--> <!-->μm). Microhemorrhages was found in 16 volunteers, most of them hemosiderin content. The capillaroscopic diagnosis using the Fast-Track algorithm and standardization criteria were category I (a non-scleroderma pattern) in the entire sample, non-specific abnormal findings were observed in 67 (66.3%) of the 101 videocapillaroscopy analyzes.</div></div><div><h3>Conclusion","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 3","pages":"Pages 222-230"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-01DOI: 10.1016/j.rcreue.2025.04.006
Nathalie Yepes Madrid , María del Pilar Gómez Mora , José Fernando Gómez Urrego
Behçet’s disease (BD) is a systemic inflammatory disease that mainly affects the oral and genital mucosa, skin and eyes. A qualitative systematic review of the literature is carried out in search of finding the epidemiology, etiopathogenesis, spectrum of clinical manifestations, diagnosis, treatment approach and current Clinical Trials of Behçet's disease in the pediatric population. A bibliographic search was performed in PubMed without language or publication date restrictions. References of included articles were examined for additional relevant literature. The initial search yielded a total of 570 studies from PubMed, 1 from a website, 4 from the Colombian Ministry of Health and 4 from a review of bibliographic citations, of which 32 articles were included used for the present review, finding that the prevalence At a global level it is estimated around 10.3 per 100,000 inhabitants. BD is a vasculitis that affects vessels of all sizes including veins. It was recently reclassified as variable type vasculitis. Other frequent clinical manifestations are joint, skin and digestive manifestations. Although its etiopathogenesis is not clear, in recent years it has been considered a multicausal autoinflammatory entity. Its diagnosis is mainly clinical. Management should be individualized based on the manifestations of the disease given the clinical variability. Multicenter, placebo-controlled, standardized studies that involve large series of patients, use clinical scores, and have long-term follow-up are needed to better understand the nature of this disease.
{"title":"Behçet’s disease in pediatrics, a diagnostic challenge: Qualitative systematic review of the literature","authors":"Nathalie Yepes Madrid , María del Pilar Gómez Mora , José Fernando Gómez Urrego","doi":"10.1016/j.rcreue.2025.04.006","DOIUrl":"10.1016/j.rcreue.2025.04.006","url":null,"abstract":"<div><div>Behçet’s disease (BD) is a systemic inflammatory disease that mainly affects the oral and genital mucosa, skin and eyes. A qualitative systematic review of the literature is carried out in search of finding the epidemiology, etiopathogenesis, spectrum of clinical manifestations, diagnosis, treatment approach and current Clinical Trials of Behçet's disease in the pediatric population. A bibliographic search was performed in PubMed without language or publication date restrictions. References of included articles were examined for additional relevant literature. The initial search yielded a total of 570 studies from PubMed, 1 from a website, 4 from the Colombian Ministry of Health and 4 from a review of bibliographic citations, of which 32 articles were included used for the present review, finding that the prevalence At a global level it is estimated around 10.3 per 100,000 inhabitants. BD is a vasculitis that affects vessels of all sizes including veins. It was recently reclassified as variable type vasculitis. Other frequent clinical manifestations are joint, skin and digestive manifestations. Although its etiopathogenesis is not clear, in recent years it has been considered a multicausal autoinflammatory entity. Its diagnosis is mainly clinical. Management should be individualized based on the manifestations of the disease given the clinical variability. Multicenter, placebo-controlled, standardized studies that involve large series of patients, use clinical scores, and have long-term follow-up are needed to better understand the nature of this disease.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 3","pages":"Pages 267-275"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144657073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2024.12.005
Silvia Méndez-Flores , Dulce María Carrillo-Córdova , Rafael López-Loya , Bruno Estañol-Vidal
Introduction/objective
Secondary Raynaud's phenomenon is one of the primary cutaneous manifestations of various rheumatological diseases, which can significantly impact quality of life and whose systemic treatment can lead to several adverse effects. Therefore, this study was conducted to assess the effectiveness of glyceryl trinitrate (in transdermal patch form) in patients with secondary Raynaud's phenomenon (SRP), evaluated through vascular flow photoplethysmography.
Materials and methods
A comparative, analytical, open-label, non-randomized study was conducted to evaluate the efficacy of 4.5 mg of glyceryl trinitrate in a transdermal patch placed on the proximal region of one hand in patients diagnosed with SRP compared to the untreated contralateral hand. To determine the primary outcome, vascular flow photoplethysmography assessment was performed 30 days after daily patch use. Secondary results were obtained using an infrared thermometer to measure local temperature in both hands before patch application, 30 min after patch use, and at the end of the follow-up period. Additionally, various questionnaires, including the Visual Analogue Scale for pain, Raynaud's Condition Score (RCS), and Dermatology Quality of Life Index (DLQI), were administered on the first and last days of the study.
Results
Sixteen patients, all female, with a median age of 54 years, were included. Regarding the rheumatological diseases associated with secondary Raynaud's phenomenon, twelve patients (75% of the sample) were associated with systemic sclerosis, three patients (19%) with lupus erythematosus, and one (6%) with mixed connective tissue disease (MCTD). There was a significant increase in peripheral blood flow after 30 days of treatment with 4.5 mg of glyceryl trinitrate every 24 h, along with improvement in clinical symptom and quality of life questionnaires.
Conclusions
This study supports the use of low-dose glyceryl trinitrate via transdermal patches to improve vascular flows, translating into short-term clinical symptom improvement associated with SRP.
{"title":"Effectiveness of glyceryl trinitrate patch use in secondary Raynaud's phenomenon","authors":"Silvia Méndez-Flores , Dulce María Carrillo-Córdova , Rafael López-Loya , Bruno Estañol-Vidal","doi":"10.1016/j.rcreue.2024.12.005","DOIUrl":"10.1016/j.rcreue.2024.12.005","url":null,"abstract":"<div><h3>Introduction/objective</h3><div>Secondary Raynaud's phenomenon is one of the primary cutaneous manifestations of various rheumatological diseases, which can significantly impact quality of life and whose systemic treatment can lead to several adverse effects. Therefore, this study was conducted to assess the effectiveness of glyceryl trinitrate (in transdermal patch form) in patients with secondary Raynaud's phenomenon (SRP), evaluated through vascular flow photoplethysmography.</div></div><div><h3>Materials and methods</h3><div>A comparative, analytical, open-label, non-randomized study was conducted to evaluate the efficacy of 4.5 mg of glyceryl trinitrate in a transdermal patch placed on the proximal region of one hand in patients diagnosed with SRP compared to the untreated contralateral hand. To determine the primary outcome, vascular flow photoplethysmography assessment was performed 30 days after daily patch use. Secondary results were obtained using an infrared thermometer to measure local temperature in both hands before patch application, 30 min after patch use, and at the end of the follow-up period. Additionally, various questionnaires, including the Visual Analogue Scale for pain, Raynaud's Condition Score (RCS), and Dermatology Quality of Life Index (DLQI), were administered on the first and last days of the study.</div></div><div><h3>Results</h3><div>Sixteen patients, all female, with a median age of 54 years, were included. Regarding the rheumatological diseases associated with secondary Raynaud's phenomenon, twelve patients (75% of the sample) were associated with systemic sclerosis, three patients (19%) with lupus erythematosus, and one (6%) with mixed connective tissue disease (MCTD). There was a significant increase in peripheral blood flow after 30 days of treatment with 4.5 mg of glyceryl trinitrate every 24 h, along with improvement in clinical symptom and quality of life questionnaires.</div></div><div><h3>Conclusions</h3><div>This study supports the use of low-dose glyceryl trinitrate via transdermal patches to improve vascular flows, translating into short-term clinical symptom improvement associated with SRP.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 130-136"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2025.04.004
Santiago Guzmán-García , Goethe Sacoto-Flores , Johanna Román-Bermeo , Fabiana Samaniego-Burneo , María Ochoa , Franklin Uguña-Sari , Gladis Molina-Alvarado , Luis M. Amezcua-Guerra
Introduction/objectives
The understanding of COVID-19 progression among patients with autoimmune rheumatic diseases (SARDs) in Latin America remains limited. This study aimed to identify risk predictors associated with poor outcomes of COVID-19 in patients with SARDs.
Materials and methods
An observational multicentre study including patients with SARDs from Ecuador and Mexico.
Results
A total of 103 patients (78% women), aged 52.5 ± 17.7 years, were enrolled. The most prevalent SARDs were rheumatoid arthritis (59%) and systemic lupus erythematosus (SLE; 24%). Severe COVID-19 was observed in 28% of patients at admission, 43% experienced complications during follow-up, and 8% ultimately died. Mortality rates were highest in patients with antiphospholipid syndrome (27%) or SLE (20%). Poor prognostic factors included acute respiratory distress syndrome (odds ratio [OR] = 17.07), severe COVID-19 at admission (OR = 11.45), and presence of SLE (OR = 4.62). In multivariate analysis, SLE emerged as the sole predictor of mortality (OR = 15.61).
Conclusions
Patients with SARDs in Latin America face significant risks of adverse COVID-19 outcomes, with SLE being a major risk factor for mortality.
{"title":"Risk predictors for adverse COVID-19 outcomes in Latin American patients with autoimmune rheumatic diseases: A multicentre study in Ecuador and Mexico","authors":"Santiago Guzmán-García , Goethe Sacoto-Flores , Johanna Román-Bermeo , Fabiana Samaniego-Burneo , María Ochoa , Franklin Uguña-Sari , Gladis Molina-Alvarado , Luis M. Amezcua-Guerra","doi":"10.1016/j.rcreue.2025.04.004","DOIUrl":"10.1016/j.rcreue.2025.04.004","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The understanding of COVID-19 progression among patients with autoimmune rheumatic diseases (SARDs) in Latin America remains limited. This study aimed to identify risk predictors associated with poor outcomes of COVID-19 in patients with SARDs.</div></div><div><h3>Materials and methods</h3><div>An observational multicentre study including patients with SARDs from Ecuador and Mexico.</div></div><div><h3>Results</h3><div>A total of 103 patients (78% women), aged 52.5<!--> <!-->±<!--> <!-->17.7 years, were enrolled. The most prevalent SARDs were rheumatoid arthritis (59%) and systemic lupus erythematosus (SLE; 24%). Severe COVID-19 was observed in 28% of patients at admission, 43% experienced complications during follow-up, and 8% ultimately died. Mortality rates were highest in patients with antiphospholipid syndrome (27%) or SLE (20%). Poor prognostic factors included acute respiratory distress syndrome (odds ratio [OR]<!--> <!-->=<!--> <!-->17.07), severe COVID-19 at admission (OR<!--> <!-->=<!--> <!-->11.45), and presence of SLE (OR<!--> <!-->=<!--> <!-->4.62). In multivariate analysis, SLE emerged as the sole predictor of mortality (OR<!--> <!-->=<!--> <!-->15.61).</div></div><div><h3>Conclusions</h3><div>Patients with SARDs in Latin America face significant risks of adverse COVID-19 outcomes, with SLE being a major risk factor for mortality.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 152-158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2024.12.006
Yeimy Paola Trujillo , Alfonso Kerguelen , Sandra Amado , Santiago Bernal-Macías , Daniel Gerardo Fernández-Ávila , Alfonso Barreto-Prieto , Luz-Stella Rodríguez
Objective
To describe the urinary levels of molecules related to removing apoptotic cells and triggering inflammation, as well as cytokines involved in Colombian patients with systemic lupus erythematosus without and with lupus nephritis compared to healthy controls.
Materials and methods
Urine samples were taken from three groups of patients: healthy controls (n = 7), patients with systemic lupus erythematosus without lupus nephritis (n = 7), and patients with lupus and lupus nephritis (n = 4). The urine sample was collected and concentrated by ultrafiltration. A western blot evaluated HMGB1, HISTONE H3, CALRETICULIN (CRT), ANNEXIN A1 and CD46, CX3CL1 by ELISA and cytokines such as IL-8, IL-6, IL-12p70, TNF-α, and IL-1β by flow cytometry.
Results
Histone H3 was detected in two patients, one with systemic lupus erythematosus without lupus nephritis and one with systemic lupus erythematosus and lupus nephritis. The detected band suggests a post-translational modification. There were no differences between the levels of HMGB1 and CX3CL1 in the study groups. CD46, ANNEXIN A1, and CRT were not detected in our samples. When evaluating cytokines in urine, an increase in IL-8 was observed in the group of patients with systemic lupus erythematosus without nephritis compared to controls. For IL-6, an increase was found among patients without lupus nephritis when compared with patients with lupus nephritis. No differences were found between the urinary levels of the other cytokines evaluated (IL-12p70, TNF-α, IL-1β, and IL-10).
Conclusion
Urinary histone H3 and IL-8 levels may be interesting molecules to be evaluated in more patients with systemic lupus erythematosus, while HMGB1 and CX3CL1 are not useful. Further evaluation of patients is required to confirm these findings.
{"title":"Potential biomarkers present in the urine of patients with systemic lupus erythematosus: An exploratory study in Colombian patients","authors":"Yeimy Paola Trujillo , Alfonso Kerguelen , Sandra Amado , Santiago Bernal-Macías , Daniel Gerardo Fernández-Ávila , Alfonso Barreto-Prieto , Luz-Stella Rodríguez","doi":"10.1016/j.rcreue.2024.12.006","DOIUrl":"10.1016/j.rcreue.2024.12.006","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the urinary levels of molecules related to removing apoptotic cells and triggering inflammation, as well as cytokines involved in Colombian patients with systemic lupus erythematosus without and with lupus nephritis compared to healthy controls.</div></div><div><h3>Materials and methods</h3><div>Urine samples were taken from three groups of patients: healthy controls (n = 7), patients with systemic lupus erythematosus without lupus nephritis (n = 7), and patients with lupus and lupus nephritis (n = 4). The urine sample was collected and concentrated by ultrafiltration. A western blot evaluated HMGB1, HISTONE H3, CALRETICULIN (CRT), ANNEXIN A1 and CD46, CX3CL1 by ELISA and cytokines such as IL-8, IL-6, IL-12p70, TNF-α, and IL-1β by flow cytometry.</div></div><div><h3>Results</h3><div>Histone H3 was detected in two patients, one with systemic lupus erythematosus without lupus nephritis and one with systemic lupus erythematosus and lupus nephritis. The detected band suggests a post-translational modification. There were no differences between the levels of HMGB1 and CX3CL1 in the study groups. CD46, ANNEXIN A1, and CRT were not detected in our samples. When evaluating cytokines in urine, an increase in IL-8 was observed in the group of patients with systemic lupus erythematosus without nephritis compared to controls. For IL-6, an increase was found among patients without lupus nephritis when compared with patients with lupus nephritis. No differences were found between the urinary levels of the other cytokines evaluated (IL-12p70, TNF-α, IL-1β, and IL-10).</div></div><div><h3>Conclusion</h3><div>Urinary histone H3 and IL-8 levels may be interesting molecules to be evaluated in more patients with systemic lupus erythematosus, while HMGB1 and CX3CL1 are not useful. Further evaluation of patients is required to confirm these findings.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 159-167"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2025.04.005
Lamia Bengherbia, Said Taharboucht, Oussama Souas, Hassina Chicha, Ahcene Chibane
Introduction
Common variable immunodeficiency (CVID) is a rare condition characterized by a constitutional humoral immune deficiency. Its association with systemic lupus is extremely rare.
Case presentation
In this case report, we present a 21-year-old woman with a history of Hashimoto's thyroiditis, who, following the onset of nephrotic syndrome revealing her lupus disease, subsequently developed clinical and laboratory features consistent with CVID, alongside recurrent lupus flares. Her initial therapeutic management was intricate, ultimately resulting in stable remission achieved through monthly immunoglobulin infusions.
Conclusion
This case illustrates the diagnostic and therapeutic difficulty of lupus disease and a common variable immune deficiency.
{"title":"Common variable immune deficiency complicating proliferative lupus nephropathy: A diagnostic and therapeutic challenge","authors":"Lamia Bengherbia, Said Taharboucht, Oussama Souas, Hassina Chicha, Ahcene Chibane","doi":"10.1016/j.rcreue.2025.04.005","DOIUrl":"10.1016/j.rcreue.2025.04.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Common variable immunodeficiency (CVID) is a rare condition characterized by a constitutional humoral immune deficiency. Its association with systemic lupus is extremely rare.</div></div><div><h3>Case presentation</h3><div>In this case report, we present a 21-year-old woman with a history of Hashimoto's thyroiditis, who, following the onset of nephrotic syndrome revealing her lupus disease, subsequently developed clinical and laboratory features consistent with CVID, alongside recurrent lupus flares. Her initial therapeutic management was intricate, ultimately resulting in stable remission achieved through monthly immunoglobulin infusions.</div></div><div><h3>Conclusion</h3><div>This case illustrates the diagnostic and therapeutic difficulty of lupus disease and a common variable immune deficiency.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 168-172"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2024.12.004
Jaime Alberto Coral Enríquez , Victoria Eugenia Cajas Bravo
Introduction
Cold agglutinin autoimmune haemolytic anaemia (AIHA) secondary to systemic lupus erythematosus (SLE) is a rare manifestation. There are no cohorts or case series that allow us to evaluate the characteristics of this group of patients.
Objective
To describe the clinical and serological characteristics of patients with systemic lupus erythematosus (SLE) and cold agglutinin hemolytic anemia.
Materials and methods
We present two cases with SLE that debuted with cold agglutinin AHAI, their clinical and immunological profile and response to immunosuppressive treatment.
Results
Eleven cases reported in the literature from 1950 to 2023 are described.
Conclusion
Cold agglutinin AIHA secondary to SLE is rare, with unclear clinical features compared to idiopathic forms and usually not associated with manifestations or serious organic involvement.
{"title":"Autoimmune haemolytic anaemia due to cold agglutinins associated with systemic lupus erythematosus. Case presentation and literature review","authors":"Jaime Alberto Coral Enríquez , Victoria Eugenia Cajas Bravo","doi":"10.1016/j.rcreue.2024.12.004","DOIUrl":"10.1016/j.rcreue.2024.12.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Cold agglutinin autoimmune haemolytic anaemia (AIHA) secondary to systemic lupus erythematosus (SLE) is a rare manifestation. There are no cohorts or case series that allow us to evaluate the characteristics of this group of patients.</div></div><div><h3>Objective</h3><div>To describe the clinical and serological characteristics of patients with systemic lupus erythematosus (SLE) and cold agglutinin hemolytic anemia.</div></div><div><h3>Materials and methods</h3><div>We present two cases with SLE that debuted with cold agglutinin AHAI, their clinical and immunological profile and response to immunosuppressive treatment.</div></div><div><h3>Results</h3><div>Eleven cases reported in the literature from 1950 to 2023 are described.</div></div><div><h3>Conclusion</h3><div>Cold agglutinin AIHA secondary to SLE is rare, with unclear clinical features compared to idiopathic forms and usually not associated with manifestations or serious organic involvement.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 173-179"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2025.02.004
Jaime Andrés Escobar Sáenz , Oscar Muñoz Velandia , Paula Ruiz Talero , Daniel Fernández Ávila
Introduction
In clinical practice, there is no specific recommendation on when to take samples in case of clinical suspicion of antiphospholipid syndrome, only a list of factors that generate APS risk, without adequately quantifying the weight of each of these factors.
Materials and methods
Analytical observational case-control study, nested in a retrospective cohort of patients with venous or arterial thrombosis in whom antiphospholipid syndrome was clinically suspected. Patients with a confirmed diagnosis of antiphospholipid syndrome according to the Sapporo criteria or triple positive initial result (cases) are compared with patients negative for APS (controls). The association between the diagnosis of APS and different clinical and paraclinical factors was evaluated.
Results
68 patients were included (72% women, 41.2% with deep venous thromboembolism and 29.4% with pulmonary embolism). In 18 SAF was confirmed. There were no significant differences in age in patients with and without confirmation of the diagnosis (44.0±17.9 vs. 51.2±14.9, p = 0.069). In the multivariate analysis, a significant and independent association was found between having APS and rheumatic disease (OR 12.1, p = 0.02), PTT prolongation (OR 17.6, p = 0.014), platelet count < 150000 (OR 18.6, p = 0.008), and a history of previous thrombosis events (OR: 6.1 for each event, p = 0.027).
Conclusions
In patients with arterial or venous thrombosis, there is a greater possibility of confirming antiphospholipid syndrome if there is a history of rheumatic disease, prolongation of PTT to more than 5 seconds, thrombocytopenia, and previous events of thrombotic disease. In these patients it is advisable to search for APS, in order to prevent new events.
在临床实践中，当临床怀疑为抗磷脂综合征时，对于何时取样没有具体的建议，只有产生APS风险的因素列表，没有充分量化这些因素的权重。材料和方法分析观察性病例对照研究，对临床怀疑为抗磷脂综合征的静脉或动脉血栓患者进行回顾性队列研究。根据Sapporo标准确诊为抗磷脂综合征的患者或初始结果为三阳性的患者（病例）与APS阴性的患者（对照组）进行比较。评估APS的诊断与不同临床和临床旁因素的关系。结果共纳入68例患者（72%为女性，41.2%为深静脉血栓栓塞，29.4%为肺栓塞）。18年SAF得到确认。确诊和未确诊患者的年龄差异无统计学意义（44.0±17.9比51.2±14.9,p = 0.069）。在多因素分析中，APS与风湿病（OR 12.1, p = 0.02）、PTT延长（OR 17.6, p = 0.014）、血小板计数和lt之间存在显著且独立的关联；15万（OR 18.6, p = 0.008），以及既往血栓事件（OR: 6.1, p = 0.027）。结论在动脉或静脉血栓形成的患者中，有风湿病史、PTT延长超过5秒、血小板减少、血栓性疾病既往事件的患者确诊抗磷脂综合征的可能性较大。在这些患者中，建议寻找APS，以防止新的事件。
{"title":"Associated factors of antiphospholipid syndrome. When do we need antiphospholipid antibodies?","authors":"Jaime Andrés Escobar Sáenz , Oscar Muñoz Velandia , Paula Ruiz Talero , Daniel Fernández Ávila","doi":"10.1016/j.rcreue.2025.02.004","DOIUrl":"10.1016/j.rcreue.2025.02.004","url":null,"abstract":"<div><h3>Introduction</h3><div>In clinical practice, there is no specific recommendation on when to take samples in case of clinical suspicion of antiphospholipid syndrome, only a list of factors that generate APS risk, without adequately quantifying the weight of each of these factors.</div></div><div><h3>Materials and methods</h3><div>Analytical observational case-control study, nested in a retrospective cohort of patients with venous or arterial thrombosis in whom antiphospholipid syndrome was clinically suspected. Patients with a confirmed diagnosis of antiphospholipid syndrome according to the Sapporo criteria or triple positive initial result (cases) are compared with patients negative for APS (controls). The association between the diagnosis of APS and different clinical and paraclinical factors was evaluated.</div></div><div><h3>Results</h3><div>68 patients were included (72% women, 41.2% with deep venous thromboembolism and 29.4% with pulmonary embolism). In 18 SAF was confirmed. There were no significant differences in age in patients with and without confirmation of the diagnosis (44.0±17.9 vs. 51.2±14.9, p = 0.069). In the multivariate analysis, a significant and independent association was found between having APS and rheumatic disease (OR 12.1, p = 0.02), PTT prolongation (OR 17.6, p = 0.014), platelet count < 150000 (OR 18.6, p = 0.008), and a history of previous thrombosis events (OR: 6.1 for each event, p = 0.027).</div></div><div><h3>Conclusions</h3><div>In patients with arterial or venous thrombosis, there is a greater possibility of confirming antiphospholipid syndrome if there is a history of rheumatic disease, prolongation of PTT to more than 5 seconds, thrombocytopenia, and previous events of thrombotic disease. In these patients it is advisable to search for APS, in order to prevent new events.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 137-144"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreue.2025.04.002
Carlos Andrés Díaz-Garza , Alejandro Garza-Alpirez , David Vega-Morales , Deshiré Alpizar-Rodríguez , Berenice Carrillo-Haro
Introduction/Objective
Our aim was to know patient's understanding and concerns about biosimilars, switching, and non-medical switch in Mexican population.
Materials and methods
A cross-sectional social media survey via the Mexican Foundation for Rheumatic Patients (FUMERAC) was conducted from November 2020 to January 2021. Patients were eligible if they were >18 years of age with any inflammatory rheumatic condition.
Results
A total of 165 participants completed the survey. The most frequent diagnoses were Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis. Disease-modifying antirheumatic drugs as monotherapy was the most common treatment. Prior or current users of biologics were reported. Most participants had never heard the term biosimilar. Some would accept the change from an originator to its biosimilar and few would take legal measure or file a complaint if a non-medical switch were to happen. Patients had concerns on treatment effectiveness, adverse effects, reason for change, treatment duration, and other patient's experience.
Conclusion
In Mexico, the concept of biosimilars is barely known. Most patients would not take any measure if they were changed from an originator to its biosimilar.
{"title":"Knowledge of medications and understanding of Mexican patients regarding the non-medical switch from originator to its biosimilar in inflammatory arthritis","authors":"Carlos Andrés Díaz-Garza , Alejandro Garza-Alpirez , David Vega-Morales , Deshiré Alpizar-Rodríguez , Berenice Carrillo-Haro","doi":"10.1016/j.rcreue.2025.04.002","DOIUrl":"10.1016/j.rcreue.2025.04.002","url":null,"abstract":"<div><h3>Introduction/Objective</h3><div>Our aim was to know patient's understanding and concerns about biosimilars, switching, and non-medical switch in Mexican population.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional social media survey via the Mexican Foundation for Rheumatic Patients (FUMERAC) was conducted from November 2020 to January 2021. Patients were eligible if they were >18 years of age with any inflammatory rheumatic condition.</div></div><div><h3>Results</h3><div>A total of 165 participants completed the survey. The most frequent diagnoses were Rheumatoid Arthritis, Ankylosing Spondylitis, and Psoriatic Arthritis. Disease-modifying antirheumatic drugs as monotherapy was the most common treatment. Prior or current users of biologics were reported. Most participants had never heard the term biosimilar. Some would accept the change from an originator to its biosimilar and few would take legal measure or file a complaint if a non-medical switch were to happen. Patients had concerns on treatment effectiveness, adverse effects, reason for change, treatment duration, and other patient's experience.</div></div><div><h3>Conclusion</h3><div>In Mexico, the concept of biosimilars is barely known. Most patients would not take any measure if they were changed from an originator to its biosimilar.</div></div>","PeriodicalId":101099,"journal":{"name":"Revista Colombiana de Reumatología (English Edition)","volume":"32 2","pages":"Pages 105-109"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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