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Síndrome de hiperaflujo: una causa de insuficiencia cardíaca reversible en hemodiálisis 高流量动静脉瘘：血液透析中可逆性心力衰竭的病因。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.04.016
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引用次数: 0
Anti-factor H autoantibodies in patients with lupus nephritis 狼疮性肾炎患者体内的抗因子 H 自身抗体。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.05.019
Galya Mihaylova , Vasil Vasilev , Mariya Kosturkova , Mariana Petkova , Maria Radanova

Introduction

Lupus nephritis (LN) is a disease marked by autoantibodies against complement components. Autoantibodies against negative complement regulator factor H (anti-FH) are prevalent in aHUS, are associated with deletion of factor H-related protein 1 (FHR1) gene, and have overt functional consequences. They are also observed in C3 glomerulopathies. The frequency and relevance of anti-FH in LN are poorly studied.

Aim

The aim of our investigation was to screen for the presence of anti-FH and FHR1 gene deletion in a cohort of LN patients and to evaluate their association with LN activity.

Method

ELISA test and Western blot for detection of anti-FH and FHR1 deletion were used, respectively. Patients’ clinical and laboratory parameters regarding anti-FH role were processed by statistical analysis.

Results

Anti-FH were found at low level in a small number of LN patients – 11.7% (7/60) and were not associated with deletion of FHR1. Anti-FH did not correlate with ANA titers, anti-dsDNA, C3/C4 hypocomplementemia, eGFR, proteinuria, or active urinary sediment in LN patients. A weak correlation was found between anti-FH and anti-C3 levels. Anti-FH were linked with endocapillary proliferation and histological activity index. Four anti-FH positive patients had severe to moderate LN as per the BILAG renal score.

Conclusions

Anti-FH autoantibodies are an accessory finding in LN and are more likely to manifest during the active phase of the disease. Due to their low frequency and plasma levels, they do not seem suitable for routine laboratory investigation in patients with LN.
导言狼疮性肾炎（LN）是一种以针对补体成分的自身抗体为特征的疾病。针对阴性补体调节因子H（抗-FH）的自身抗体在aHUS中很普遍，与因子H相关蛋白1（FHR1）基因缺失有关，并具有明显的功能性后果。在 C3 肾小球疾病中也可观察到抗 HFH。目的：我们调查的目的是在一组 LN 患者中筛查抗 FH 和 FHR1 基因缺失的存在，并评估它们与 LN 活动的关联：方法：分别采用酶联免疫吸附试验（ELISA）和免疫印迹法（Western blot）检测抗FH基因和FHR1基因缺失。方法：分别采用 ELISA 试验和 Western blot 检测抗-FH 和 FHR1 缺失，并对患者有关抗-FH 作用的临床和实验室参数进行统计分析：少数 LN 患者（11.7%，7/60）抗 FH 水平较低，且与 FHR1 基因缺失无关。抗 FH 与 LN 患者的 ANA 滴度、抗dsDNA、C3/C4 低补体血症、eGFR、蛋白尿或活动性尿沉渣无关。抗 FH 与抗 C3 水平之间存在微弱的相关性。抗 FH 与毛细血管内膜增生和组织学活动指数有关。根据BILAG肾脏评分，4名抗FH阳性患者患有重度至中度LN：抗FH自身抗体是LN的附属发现，更有可能在疾病的活动期表现出来。由于抗FH自身抗体的出现频率和血浆水平较低，它们似乎并不适合用于LN患者的常规实验室检查。
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引用次数: 0
Síndrome de Lemierre atípico por tromboflebitis de la vena yugular anterior. A propósito de un caso 颈前静脉血栓性静脉炎导致的非典型勒米尔综合征。病例报告。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.04.017
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引用次数: 0
Vanek's tumor: A differential diagnosis of colorectal cancer 瓦内克肿瘤：大肠癌的鉴别诊断。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.01.037
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引用次数: 0
Congenital megaureter 先天性巨输尿管
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.01.032
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引用次数: 0
Reacciones adversas a inhibidores de quinasa Janus: estudio de su incidencia y de factores predictivos en los pacientes con artritis reumatoide Janus 激酶抑制剂的不良反应：研究类风湿性关节炎患者的不良反应发生率和预测因素。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.05.007
Cristina Martinez-Molina , Jose Maria Guardiola Tey , Jesus Ruiz-Ramos , Anna Feliu , Mireia Puig-Campmany , Silvia Vidal , Hèctor Corominas

Background and objective

The safety profile of Janus Kinase (JAK) inhibitors has acquired attention due to post-marketing observed adverse drug reactions. The study focuses on the analysis of adverse reactions related to tofacitinib, baricitinib, upadacitinib, and filgotinib in rheumatoid arthritis patients, including identifying predictive factors linked to their occurrence.

Patients and methods

Observational retrospective study. Adult patients with rheumatoid arthritis from a university hospital receiving JAK inhibitor treatment between September 2017 and January 2024 were included. The cumulative incidence of each adverse reaction was calculated using the Naranjo scale. Risk factors for developing adverse reactions were identified through logistic regression analyses.

Results

Two hundred twenty-three patients were included, with 28.7% presenting adverse reaction related to JAK inhibitor treatment. The adverse drug reactions with the highest cumulative incidence were infections and gastrointestinal disorders. Infections included: upper respiratory tract (4.5%), cellulitis (3.1%), urinary tract (2.7%), herpes zoster (1.8%). Gastrointestinal disorders comprised: abdominal pain (4.0%), diarrhea (3.6%), nausea and vomiting (3.6%), gastrointestinal perforation (1.3%), diverticulitis (0.9%). Classified at 0.5% were: headache, paresthesias, skin rash, severe neutropenia, insomnia, dyspnea, hypertensive crisis. As risk factors, were identified: the treatment with a non-selective JAK inhibitor (OR adjusted: 4.03; 95% CI: 1.15-14.10; P=.029) and older age (OR adjusted: 1.03; 95% CI: 1.00-1.05; P=.036).

Conclusions

Infections and gastrointestinal disorders represented the adverse reactions related to JAK inhibitor treatment with the highest cumulative incidence, with risk factors for their occurrence being non-selective JAK inhibitor treatment and older age of the patient.
背景和目的：由于上市后观察到的药物不良反应，Janus 激酶（JAK）抑制剂的安全性备受关注。本研究重点分析类风湿性关节炎患者中与法西替尼、巴利昔尼、乌达替尼和非格替尼相关的不良反应，包括确定与不良反应发生相关的预测因素：观察性回顾研究。纳入了一家大学医院在2017年9月至2024年1月期间接受JAK抑制剂治疗的成年类风湿关节炎患者。采用纳兰霍量表计算每种不良反应的累积发生率。通过逻辑回归分析确定了发生不良反应的风险因素：共纳入 223 例患者，其中 28.7% 的患者出现与 JAK 抑制剂治疗相关的不良反应。累计发生率最高的药物不良反应是感染和胃肠功能紊乱。感染包括：上呼吸道感染（4.5%）、蜂窝织炎（3.1%）、泌尿道感染（2.7%）、带状疱疹（1.8%）。胃肠道疾病包括：腹痛（4.0%）、腹泻（3.6%）、恶心和呕吐（3.6%）、胃肠道穿孔（1.3%）、憩室炎（0.9%）。占 0.5%的病例包括：头痛、麻痹、皮疹、严重中性粒细胞减少症、失眠、呼吸困难、高血压危象。风险因素包括：使用非选择性JAK抑制剂治疗（调整后OR值：4.03；95% CI：1.15-14.10；P=.029）和年龄较大（调整后OR值：1.03；95% CI：1.00-1.05；P=.036）：感染和胃肠功能紊乱是与JAK抑制剂治疗相关的不良反应中累积发生率最高的，其发生的风险因素是非选择性JAK抑制剂治疗和患者年龄较大。
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引用次数: 0
Tuberculosis cutánea perianal: estudio de un caso 肛周皮肤结核：病例研究
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.04.027
José Juan Parra García, Marta Segado Sánchez, Miguel Lova Navarro
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引用次数: 0
Hereditary hyperferritinemia-cataract syndrome: A case report 遗传性高铁蛋白血症-白内障综合征：病例报告
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.04.033
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引用次数: 0
Tendencias en la autoría en Medicina Clínica: un análisis de 11 años sobre el género de los autores Medicina Clínica》的作者趋势：对作者性别的 11 年分析。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.01.044
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引用次数: 0
Reacción sarcoidea asociada a terapias anti-HER2 en pacientes con cáncer de mama 与乳腺癌患者接受 HER2 治疗有关的肉样瘤样反应。
IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Medicina Clinica
Pub Date : 2024-10-25 DOI: 10.1016/j.medcli.2024.04.018
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引用次数: 0
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