Pub Date : 2025-10-01DOI: 10.1016/j.rcreu.2024.06.005
Edgar Santiago Castro Prieto , Carlos Mauricio Martínez Montalvo , Sandra Ximena Ramírez Jimenez , Valentina Ramírez Vega , Carlos Ernesto Artega Unigarro , Cristtian Ivan Aparicio Neisa
Introduction
We present the first case reported in Colombia of Blau syndrome manifested in adults associated with a de novo mutation in the NOD2 gene in the context of a case of fever of unknown origin.
Case summary
44-year-old female patient presenting with a condition of approximately 4 years of evolution consisting of cyclical episodes of quantified fever lasting approximately 20 days, with remission intervals of 6 to 8 months, accompanied by generalized abdominal pain, polymyalgia, polyarthralgia, and general discomfort. Her medical history included treated liver tuberculosis (TB), anterior uveitis, appearance of erythema nodosum in the lower limbs with spontaneous remission, and an episode of peripheral facial paralysis. During the aetiological studies, hepatic granulomas were documented, which were taken to biopsy where multiple non-caseating granulomas were found. Angiotensin-converting enzyme levels were measured, which were found within normal limits, and molecular and microbiological limits for TB in the biopsy were negative. Subsequently, an autoinflammatory syndrome was considered a suspected diagnostic diagnosis given the persistence of the condition, so genetic studies were performed where a de novo heterozygous mutation was detected in the NOD2 gene, which is associated with Blau syndrome.
Conclusions
Autoinflammatory syndromes, although they occur mostly in childhood, should not be ruled out in adults. In our country there are no known cases of Blau syndrome manifesting in adulthood, so this case report will help us inform the scientific community about it.
{"title":"Síndrome de Blau como causa de fiebre de origen desconocido en el adulto: un reporte de caso","authors":"Edgar Santiago Castro Prieto , Carlos Mauricio Martínez Montalvo , Sandra Ximena Ramírez Jimenez , Valentina Ramírez Vega , Carlos Ernesto Artega Unigarro , Cristtian Ivan Aparicio Neisa","doi":"10.1016/j.rcreu.2024.06.005","DOIUrl":"10.1016/j.rcreu.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>We present the first case reported in Colombia of Blau syndrome manifested in adults associated with a de novo mutation in the NOD2 gene in the context of a case of fever of unknown origin.</div></div><div><h3>Case summary</h3><div>44-year-old female patient presenting with a condition of approximately 4 years of evolution consisting of cyclical episodes of quantified fever lasting approximately 20 days, with remission intervals of 6 to 8 months, accompanied by generalized abdominal pain, polymyalgia, polyarthralgia, and general discomfort. Her medical history included treated liver tuberculosis (TB), anterior uveitis, appearance of erythema nodosum in the lower limbs with spontaneous remission, and an episode of peripheral facial paralysis. During the aetiological studies, hepatic granulomas were documented, which were taken to biopsy where multiple non-caseating granulomas were found. Angiotensin-converting enzyme levels were measured, which were found within normal limits, and molecular and microbiological limits for TB in the biopsy were negative. Subsequently, an autoinflammatory syndrome was considered a suspected diagnostic diagnosis given the persistence of the condition, so genetic studies were performed where a de novo heterozygous mutation was detected in the NOD2 gene, which is associated with Blau syndrome.</div></div><div><h3>Conclusions</h3><div>Autoinflammatory syndromes, although they occur mostly in childhood, should not be ruled out in adults. In our country there are no known cases of Blau syndrome manifesting in adulthood, so this case report will help us inform the scientific community about it.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 401-408"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289596","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 : 2025-10-01DOI: 10.1016/j.rcreu.2025.07.001
{"title":"Fe de erratas sobre artículos publicados en la Revista Colombiana de Reumatología en 2023 y 2024","authors":"","doi":"10.1016/j.rcreu.2025.07.001","DOIUrl":"10.1016/j.rcreu.2025.07.001","url":null,"abstract":"","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 421-422"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145289599","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.05.004
Miguel Ángel Villarreal-Alarcón , Jorge Antonio Esquivel-Valerio , David Vega-Morales , Jorge Armando Hermosillo-Villafranca , Rocío Ortiz-López , Augusto Rojas-Martínez , Ana Arana-Guajardo , Mario Alberto Garza-Elizondo , Berenice Carrillo-Haro , Alondra Elizabeh Montoya-Montes
Introduction
Low mannose-binding lectin (MBL) concentrations in serum are due mainly to the presence of three punctual mutations in the coding region of the MBL2 gene. SLE patients, who are homozygous for MBL allele variants, have a significantly greater risk of developing infections. With the purpose of examining the association of MBL locus haplotypes with disease activity and past history of infection in SLE, we studied a group of patients treated in the Rheumatology Outpatient Clinic of the UANL University Hospital.
Objective
Determine the prevalence of MBL2 locus haplotypes and the causal associations between MBL2 locus haplotypes and SLE determining the Hardy–Weinberg law for specific genotypes in both groups of study.
Materials and methods
An observational, cross-sectional, retrospective study was performed. Hardy–Weinberg equilibrium for genotypic frequencies was proven with the X2 test. The risk of lupus associated with MBL2 genotypes as a genetic factor and the strength of the association of the genotypes with the frequency of clinical characteristics was estimated by calculation of odds ratio with a 95% confidence interval. Statistical significance was taken as a value of P < .05.
Results
The findings suggest potential genetic associations between allelic systems and the risk of SLE. A relationship was found regarding the MEX-SLEDAI index, as well as the number of infections among patients with differences in structural gene polymorphisms and promoter gene polymorphisms.
Conclusions
There are significant differences in the polymorphisms of the promoter region regarding the risk for developing SLE.
{"title":"Is there an association between MBL2 gene polymorphisms and infection susceptibility in patients with systemic lupus erythematosus? An exploratory study in Mexican mestizos","authors":"Miguel Ángel Villarreal-Alarcón , Jorge Antonio Esquivel-Valerio , David Vega-Morales , Jorge Armando Hermosillo-Villafranca , Rocío Ortiz-López , Augusto Rojas-Martínez , Ana Arana-Guajardo , Mario Alberto Garza-Elizondo , Berenice Carrillo-Haro , Alondra Elizabeh Montoya-Montes","doi":"10.1016/j.rcreu.2024.05.004","DOIUrl":"10.1016/j.rcreu.2024.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Low mannose-binding lectin (MBL) concentrations in serum are due mainly to the presence of three punctual mutations in the coding region of the MBL2 gene. SLE patients, who are homozygous for MBL<span> allele variants, have a significantly greater risk of developing infections. With the purpose of examining the association of MBL locus haplotypes with disease activity and past history of infection in SLE, we studied a group of patients treated in the Rheumatology Outpatient Clinic of the UANL University Hospital.</span></div></div><div><h3>Objective</h3><div>Determine the prevalence of MBL2 locus haplotypes and the causal associations between MBL2 locus haplotypes and SLE determining the Hardy–Weinberg law for specific genotypes in both groups of study.</div></div><div><h3>Materials and methods</h3><div>An observational, cross-sectional, retrospective study was performed. Hardy–Weinberg equilibrium for genotypic frequencies was proven with the <em>X</em><sup>2</sup> test. The risk of lupus associated with MBL2 genotypes as a genetic factor and the strength of the association of the genotypes with the frequency of clinical characteristics was estimated by calculation of odds ratio with a 95% confidence interval. Statistical significance was taken as a value of <em>P</em> <!--><<!--> <!-->.05.</div></div><div><h3>Results</h3><div>The findings suggest potential genetic associations between allelic systems and the risk of SLE. A relationship was found regarding the MEX-SLEDAI index, as well as the number of infections among patients with differences in structural gene polymorphisms and promoter gene polymorphisms.</div></div><div><h3>Conclusions</h3><div>There are significant differences in the polymorphisms of the promoter region regarding the risk for developing SLE.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 321-327"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842772","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 : 2025-10-01DOI: 10.1016/j.rcreu.2025.01.002
Luis Javier Cajas Santana , Santiago Cuero , Gabriela Guerrero , Mayelin Ceballos , María Carolina Torres , Diana Rocio Gil , Yimy F. Medina , Ana Milena Callejas , Javier Leonardo Galindo , Cesar Riascos , Wilmer Aponte , Diana Ochoa , Jennifer Delgadillo
Introduction
Interstitial lung disease (ILD) is one of the leading causes of mortality in autoimmune diseases. The extent of the disease is a determining factor in the prognosis and treatment initiation and monitoring. Quantification using the Goh method is the most commonly used method; however, it is subjective. So far, no studies have evaluated the level of agreement among various readers.
Objective
The study's objective is to determine the interobserver and intra-observer variability in using ILD quantification among physicians from various specialties and levels of experience.
Methods
Images from chest computed tomography of patients with rheumatoid arthritis (RA) or systemic sclerosis (SSc) and ILD were collected. The five necessary cuts described by Goh were extracted to be evaluated by pulmonologists, rheumatologists, radiologists, fellows, and a thoracic radiologist (gold standard). The interobserver and intra-observer variability values were calculated using the intraclass correlation coefficient test or Cohen's Kappa test, depending on the nature of the variable, between each group of medical specialties and in comparison with the gold standard.
Results
Seventy-nine patients were selected, primarily women, 56% having SSc. A total of 1098 CT scans were performed. The intraclass correlation coefficient was .75 (95% CI: .67–.81), including all nine readers. The best correlation with the gold standard was found among pulmonologists (CCI .83) and rheumatologists (CCI .81). According to severity (more significant or less than 20% extension), the Kappa coefficient was .64 among the nine readers. The intraclass correlation coefficient for the average intra-observer correlation of all readers was .89 (95% CI: .81–.93), and the Kappa coefficient was .82.
Conclusion
The Goh method is valuable and highly correlated among a diverse group of specialties that manage ILD, making it a practical tool for assessing the extent of the disease.
{"title":"Agreement in quantifying the extension of autoimmune-associated interstitial lung disease using the Goh method","authors":"Luis Javier Cajas Santana , Santiago Cuero , Gabriela Guerrero , Mayelin Ceballos , María Carolina Torres , Diana Rocio Gil , Yimy F. Medina , Ana Milena Callejas , Javier Leonardo Galindo , Cesar Riascos , Wilmer Aponte , Diana Ochoa , Jennifer Delgadillo","doi":"10.1016/j.rcreu.2025.01.002","DOIUrl":"10.1016/j.rcreu.2025.01.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Interstitial lung disease (ILD) is one of the leading causes of mortality in autoimmune diseases. The extent of the disease is a determining factor in the prognosis and treatment initiation and monitoring. Quantification using the Goh method is the most commonly used method; however, it is subjective. So far, no studies have evaluated the level of agreement among various readers.</div></div><div><h3>Objective</h3><div>The study's objective is to determine the interobserver and intra-observer variability in using ILD quantification among physicians from various specialties and levels of experience.</div></div><div><h3>Methods</h3><div>Images from chest computed tomography of patients with rheumatoid arthritis (RA) or systemic sclerosis (SSc) and ILD were collected. The five necessary cuts described by Goh were extracted to be evaluated by pulmonologists, rheumatologists, radiologists, fellows, and a thoracic radiologist (gold standard). The interobserver and intra-observer variability values were calculated using the intraclass correlation coefficient test or Cohen's Kappa test, depending on the nature of the variable, between each group of medical specialties and in comparison with the gold standard.</div></div><div><h3>Results</h3><div>Seventy-nine patients were selected, primarily women, 56% having SSc. A total of 1098 CT scans were performed. The intraclass correlation coefficient was .75 (95% CI: .67–.81), including all nine readers. The best correlation with the gold standard was found among pulmonologists (CCI .83) and rheumatologists (CCI .81). According to severity (more significant or less than 20% extension), the Kappa coefficient was .64 among the nine readers. The intraclass correlation coefficient for the average intra-observer correlation of all readers was .89 (95% CI: .81–.93), and the Kappa coefficient was .82.</div></div><div><h3>Conclusion</h3><div>The Goh method is valuable and highly correlated among a diverse group of specialties that manage ILD, making it a practical tool for assessing the extent of the disease.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 368-373"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290186","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.09.005
Hanene Lassoued Ferjani , Ben Ayed Hiba , Dorra Ben Nessib , Dhia Kaffel , Kaouther Maatallah , Wafa Hamdi
Introduction
Rheumatoid arthritis and ankylosing spondylitis are among the most common rheumatic diseases. The coexistence of both affections in a single patient is highly infrequent but seems to be underestimated in clinical practice.
Materials and methods
We described the clinical, biological, and radiological characteristics of 12 patients with concomitant rheumatoid arthritis and ankylosing spondylitis diagnosed at our hospital. The 28 disease activity score (DAS28), the Bath ankylosing spondylitis disease activity index (BASDAI), and the Ankylosing Spondylitis Disease Activity Score (ASDAS) were used as outcome measures.
Results
Twelve patients with a male-to-female ratio of 0.71 and a mean age of 62.1 ± 12.8 years were included. Rheumatoid arthritis was the first disease diagnosed in seven patients. The mean duration of rheumatoid arthritis diagnosis at the time of ankylosing spondylitis diagnosis was 20.2 ± 25 months. The first sign of ankylosing spondylitis in rheumatoid arthritis patients was incidental radiological sacroiliitis in four patients, inflammatory low back pain in three patients, and distal interphalangeal joint involvement in hands radiographs in two patients. Rheumatoid arthritis was seronegative in four patients. Erosions were observed on radiographs of the hands and/or feet in 66% of the cases and almost all the patients (11/12) had sacroiliitis on imaging studies. The mean values of the DAS28, ASDAS, and BASDAI scores at the initial diagnosis of rheumatoid arthritis/ankylosing spondylitis were 4.54 ± 1.22, 3.1 ± 0.72, and 4.1 ± 0.5, respectively.
Conclusion
The coexistence of Rheumatoid arthritis and ankylosing spondylitis is uncommon but should be considered. We could not draw a conclusion about whether the association of both disease conditions confers different characteristics.
{"title":"The coexistence of rheumatoid arthritis and ankylosing spondylitis: Case series and literature review","authors":"Hanene Lassoued Ferjani , Ben Ayed Hiba , Dorra Ben Nessib , Dhia Kaffel , Kaouther Maatallah , Wafa Hamdi","doi":"10.1016/j.rcreu.2024.09.005","DOIUrl":"10.1016/j.rcreu.2024.09.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatoid arthritis and ankylosing spondylitis are among the most common rheumatic diseases. The coexistence of both affections in a single patient is highly infrequent but seems to be underestimated in clinical practice.</div></div><div><h3>Materials and methods</h3><div>We described the clinical, biological, and radiological characteristics of 12 patients with concomitant rheumatoid arthritis and ankylosing spondylitis diagnosed at our hospital. The 28 disease activity score (DAS28), the Bath ankylosing spondylitis disease activity index (BASDAI), and the Ankylosing Spondylitis Disease Activity Score (ASDAS) were used as outcome measures.</div></div><div><h3>Results</h3><div>Twelve patients with a male-to-female ratio of 0.71 and a mean age of 62.1<!--> <!-->±<!--> <!-->12.8 years were included. Rheumatoid arthritis was the first disease diagnosed in seven patients. The mean duration of rheumatoid arthritis diagnosis at the time of ankylosing spondylitis diagnosis was 20.2<!--> <!-->±<!--> <span>25 months. The first sign of ankylosing spondylitis in rheumatoid arthritis patients was incidental radiological sacroiliitis in four patients, inflammatory low back pain in three patients, and distal interphalangeal joint involvement in hands radiographs in two patients. Rheumatoid arthritis was seronegative in four patients. Erosions were observed on radiographs of the hands and/or feet in 66% of the cases and almost all the patients (11/12) had sacroiliitis on imaging studies. The mean values of the DAS28<span><span>, ASDAS, and </span>BASDAI scores at the initial diagnosis of rheumatoid arthritis/ankylosing spondylitis were 4.54</span></span> <!-->±<!--> <!-->1.22, 3.1<!--> <!-->±<!--> <!-->0.72, and 4.1<!--> <!-->±<!--> <!-->0.5, respectively.</div></div><div><h3>Conclusion</h3><div>The coexistence of Rheumatoid arthritis and ankylosing spondylitis is uncommon but should be considered. We could not draw a conclusion about whether the association of both disease conditions confers different characteristics.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 394-400"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290189","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.07.002
Rodrigo Lozano-Lozano , Jorge Antonio Esquivel-Valerio , Mitzi Rivera-Beltrán , Oscar Martínez-Díaz , Alondra Elizabeth Montoya-Montes , David Vega-Morales
Introduction/Objectives
The prevalence of falls in RA patients ranges from 14.3% to 54%. Some tools for assessing falls risk predict this in the elderly population. As RA usually begins at a younger age, it would be worth exploring the risk of falls in this age set of patients. Downton index > 3 and a Tinetti scale < 18 are predictive of fall risk. The study aims to determine the association of RA disease activity and health assessment with falls risk.
Materials and methods
Observational, cross-sectional study in RA patients. Demographics, DAS28, HAQ-DI medications, Tinetti scale, and Downton index were obtained.
Results
We included 108 patients, 98 (90.7%) were women. Patients’ mean age was 52.5 ± 10.8 years. Median DAS-28 and HAQ-DI scores were 3.6 and .81. Sixty (55.6%) patients had previous falls. We observed a positive significant correlation between the Downton index and patient's age (rho = .44, p < .001), RA diagnosis time (rho = .23, p = .014), RA activity (DAS-28 score) (rho = .61, p < .001), and a HAQ-DI score (rho = .709, p < .001). Overall, the total Tinetti evaluation scale was significantly correlated with age (rho = −.36, p < .001), time since RA diagnosis (rho = −.20, p = .031), RA activity (DAS-28 score) (rho = −.77, p < .001), and HAQ-DI score (rho = −.835, p < .001). After a multivariate analysis, we found that for a high risk of falls by Downton score, age > 52 years had an OR 7.5 (95% CI, 3.1–17.7; p = .001), a DAS-28 > 3.5 had an OR 9.1 (95% CI, 3.7–22.1; p = .02), and a HAD-QI > .94 had an OR 27.9 (95% CI, 7.1–100.9; p = .001). For a Tinetti score that predicts risk of falls, a HAD-QI > 1.44 had an OR 1.8 (95% CI, 1.28–2.52; p = .001).
Conclusions
There is a correlation between DAS-28 and HAD-QI scores and risk of falls in younger RA patients. The DAS-28 and HAD-QI can predict falls risk using surrogate scales. The risk of falls is an assessment that should be considered RA patients.
RA患者跌倒的发生率为14.3% ~ 54%。一些评估跌倒风险的工具可以预测老年人的这种情况。由于RA通常开始于较年轻的年龄，因此值得探索这个年龄段患者跌倒的风险。唐顿指数（Downton index）和蒂内蒂指数（Tinetti scale）分别为3和18。该研究旨在确定RA疾病活动和健康评估与跌倒风险的关系。材料与方法对RA患者进行观察性横断面研究。统计数据、DAS28、HAQ-DI用药、Tinetti量表、唐顿指数。结果纳入108例患者，其中98例（90.7%）为女性。患者平均年龄52.5±10.8岁。DAS-28和HAQ-DI评分中位数分别为3.6和0.81。60例（55.6%）患者既往有跌倒史。我们观察到唐顿指数与患者年龄（rho = 0.44, p < .001）、RA诊断时间（rho = 0.23, p = 0.014）、RA活动性（DAS-28评分）（rho = 0.61, p < .001）、HAQ-DI评分（rho = 0.709, p < .001）呈正相关。总体而言，总Tinetti评价量表与年龄显著相关（rho =−）。36, p < .001)， RA诊断时间(rho = -。20 p = .031) RA活动(DAS-28分数)(ρ=−。77, p < .001)， HAQ-DI评分(rho = -。835, p < .001)。多因素分析后，我们发现，对于唐顿评分的高风险患者，52岁的OR为7.5 (95% CI, 3.1-17.7; p = .001), DAS-28 >； 3.5的OR为9.1 (95% CI, 3.7-22.1; p = .02), had - qi >； 94的OR为27.9 （95% CI, 7.1-100.9; p = .001）。对于预测跌倒风险的Tinetti评分，had - qi >； 1.44的OR为1.8 （95% CI, 1.28-2.52; p = .001）。结论DAS-28和hd - qi评分与年轻RA患者跌倒风险存在相关性。DAS-28和HAD-QI可以使用替代量表预测跌倒风险。跌倒的风险是一个评估，应该考虑RA患者。
{"title":"Association of disease activity and health assessment with the risk of falls in RA patients: Are DAS-28 and HAQ-DI scores related with the risk of falls assessed in RA patients?","authors":"Rodrigo Lozano-Lozano , Jorge Antonio Esquivel-Valerio , Mitzi Rivera-Beltrán , Oscar Martínez-Díaz , Alondra Elizabeth Montoya-Montes , David Vega-Morales","doi":"10.1016/j.rcreu.2024.07.002","DOIUrl":"10.1016/j.rcreu.2024.07.002","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>The prevalence of falls in RA patients ranges from 14.3% to 54%. Some tools for assessing falls risk predict this in the elderly population. As RA usually begins at a younger age, it would be worth exploring the risk of falls in this age set of patients. Downton index<!--> <!-->><!--> <!-->3 and a Tinetti scale<!--> <!--><<!--> <!-->18 are predictive of fall risk. The study aims to determine the association of RA disease activity and health assessment with falls risk.</div></div><div><h3>Materials and methods</h3><div>Observational, cross-sectional study in RA patients. Demographics, DAS28, HAQ-DI medications, Tinetti scale, and Downton index were obtained.</div></div><div><h3>Results</h3><div>We included 108 patients, 98 (90.7%) were women. Patients’ mean age was 52.5<!--> <!-->±<!--> <!-->10.8 years. Median DAS-28 and HAQ-DI scores were 3.6 and .81. Sixty (55.6%) patients had previous falls. We observed a positive significant correlation between the Downton index and patient's age (rho<!--> <!-->=<!--> <!-->.44, <em>p</em> <!--><<!--> <!-->.001), RA diagnosis time (rho<!--> <!-->=<!--> <!-->.23, <em>p</em> <!-->=<!--> <!-->.014), RA activity (DAS-28 score) (rho<!--> <!-->=<!--> <!-->.61, <em>p</em> <!--><<!--> <!-->.001), and a HAQ-DI score (rho<!--> <!-->=<!--> <!-->.709, <em>p</em> <!--><<!--> <!-->.001). Overall, the total Tinetti evaluation scale was significantly correlated with age (rho<!--> <!-->=<!--> <!-->−.36, <em>p</em> <!--><<!--> <!-->.001), time since RA diagnosis (rho<!--> <!-->=<!--> <!-->−.20, <em>p</em> <!-->=<!--> <!-->.031), RA activity (DAS-28 score) (rho<!--> <!-->=<!--> <!-->−.77, <em>p</em> <!--><<!--> <!-->.001), and HAQ-DI score (rho<!--> <!-->=<!--> <!-->−.835, <em>p</em> <!--><<!--> <!-->.001). After a multivariate analysis, we found that for a high risk of falls by Downton score, age<!--> <!-->><!--> <!-->52 years had an OR 7.5 (95% CI, 3.1–17.7; <em>p</em> <!-->=<!--> <!-->.001), a DAS-28<!--> <!-->><!--> <!-->3.5 had an OR 9.1 (95% CI, 3.7–22.1; <em>p</em> <!-->=<!--> <!-->.02), and a HAD-QI<!--> <!-->><!--> <!-->.94 had an OR 27.9 (95% CI, 7.1–100.9; <em>p</em> <!-->=<!--> <!-->.001). For a Tinetti score that predicts risk of falls, a HAD-QI<!--> <!-->><!--> <!-->1.44 had an OR 1.8 (95% CI, 1.28–2.52; <em>p</em> <!-->=<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>There is a correlation between DAS-28 and HAD-QI scores and risk of falls in younger RA patients. The DAS-28 and HAD-QI can predict falls risk using surrogate scales. The risk of falls is an assessment that should be considered RA patients.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 359-367"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290183","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.09.002
Pedro Arbey Quevedo Mayorga , Javier Mauricio Mora Méndez , Alejandro Aristizábal Agudelo , Lilian Marcela Estupiñán Moya , Paola Andrea Perez Benjumea , Diana Isabel Muñoz Rodriguez
Introduction
Lupus nephritis is a common complication in patients with systemic lupus erythematosus. Cyclophosphamide in induction treatment has a good efficacy profile, but greater toxicity.
Objective
To perform a systematic review and meta-analysis, updating the literature that compares the efficacy and safety of cyclophosphamide at high and low doses.
Materials and methods
PRISMA-P methodology, PROSPERO register number CRD42023485477, only randomized clinical trials were included from 2010 to October 2023, in patients over 16 years of age with lupus nephritis class III, IV, V, or V+III, V+IV. Complete response, partial response, relapses, infections, leukopenia, and amenorrhoea were measured; the RR was estimated for a 95% CI, based on the Mantel-Haenszel method, and heterogeneity by I2 and Q test.
Results
415 articles were found, only three were included with 406 patients, 217 for the high dose group and 189 low doses. There were no statistically significant differences with respect to complete response (RR = .77; 95% CI: .60-1.01; P = .06), partial response (RR = .88; 95% CI: .67-1.16; p = .35), relapses (RR = 2.16; 95% CI: .18-24.7; P = .52) and infections (RR = .68; 95% CI .45-1.04; P = .08), while leukopenia and amenorrhoea were significantly uncommon in the low dose group (RR = .41; 95% CI: .22-.77; p = .01, and RR = .40; 95% CI: .25-.64; P = .002).
Conclusions
The use of low-dose cyclophosphamide is as effective as the high-dose regimen and the probability of leukopenia and amenorrhoea is lower.
{"title":"Revisión sistemática y metaanálisis del régimen de bajas dosis de ciclofosfamida versus altas dosis para el tratamiento de inducción en pacientes con nefritis lúpica, actualización de la evidencia 2010-2023","authors":"Pedro Arbey Quevedo Mayorga , Javier Mauricio Mora Méndez , Alejandro Aristizábal Agudelo , Lilian Marcela Estupiñán Moya , Paola Andrea Perez Benjumea , Diana Isabel Muñoz Rodriguez","doi":"10.1016/j.rcreu.2024.09.002","DOIUrl":"10.1016/j.rcreu.2024.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Lupus nephritis is a common complication in patients with systemic lupus erythematosus. Cyclophosphamide in induction treatment has a good efficacy profile, but greater toxicity.</div></div><div><h3>Objective</h3><div>To perform a systematic review and meta-analysis, updating the literature that compares the efficacy and safety of cyclophosphamide at high and low doses.</div></div><div><h3>Materials and methods</h3><div>PRISMA-P methodology, PROSPERO register number CRD42023485477, only randomized clinical trials were included from 2010 to October 2023, in patients over 16<!--> <!-->years of age with lupus nephritis class<!--> <!-->III, IV, V, or V+III, V+IV. Complete response, partial response, relapses, infections, leukopenia, and amenorrhoea were measured; the RR was estimated for a 95%<!--> <!-->CI, based on the Mantel-Haenszel method, and heterogeneity by I<sup>2</sup> and Q test.</div></div><div><h3>Results</h3><div>415 articles were found, only three were included with 406 patients, 217 for the high dose group and 189 low doses. There were no statistically significant differences with respect to complete response (RR<!--> <!-->=<!--> <!-->.77; 95%<!--> <!-->CI: .60-1.01; <em>P</em> <!-->=<!--> <!-->.06), partial response (RR<!--> <!-->=<!--> <!-->.88; 95%<!--> <!-->CI: .67-1.16; p<!--> <!-->=<!--> <!-->.35), relapses (RR<!--> <!-->=<!--> <!-->2.16; 95%<!--> <!-->CI: .18-24.7; <em>P</em> <!-->=<!--> <!-->.52) and infections (RR<!--> <!-->=<!--> <!-->.68; 95%<!--> <!-->CI .45-1.04; <em>P</em> <!-->=<!--> <!-->.08), while leukopenia and amenorrhoea were significantly uncommon in the low dose group (RR<!--> <!-->=<!--> <!-->.41; 95%<!--> <!-->CI: .22-.77; p<!--> <!-->=<!--> <!-->.01, and RR<!--> <!-->=<!--> <!-->.40; 95%<!--> <!-->CI: .25-.64; <em>P</em> <!-->=<!--> <!-->.002).</div></div><div><h3>Conclusions</h3><div>The use of low-dose cyclophosphamide is as effective as the high-dose regimen and the probability of leukopenia and amenorrhoea is lower.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 374-384"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290187","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.11.004
Juan Camilo Santacruz , Marta Juliana Mantilla , Sandra Pulido , Ferney Africano , Carlos Alberto Agudelo , Rubén Darío Mantilla , Ángelo Arzuaga , John Londoño
Systemic lupus erythematosus is an autoimmune disease with a tendency to wax and wane. Unlike other autoimmune conditions, disease activity in the gastrointestinal system is relatively rare, and its approach can vary, according to different points of view. Despite its low prevalence, gastrointestinal manifestations can be potentially fatal, as occurs in cases of intestinal vasculitis and the consequent mesenteric ischaemia. The spectrum of gastrointestinal involvement in this disease is broad, and includes disease activity, infection associated with immunosuppression, adverse effects of some medications, or other intercurrent processes such as lupus cystitis. The clinical symptoms and laboratory findings are highly diverse, which leads to a delay in diagnosis with consequent organ dysfunction. Early diagnosis can be a challenge because a large proportion of patients present with nonspecific constitutional symptoms associated with nausea, emesis, and abdominal pain. These numerous factors have been an obstacle to further research in this field, making a unified diagnostic and therapeutic approach difficult. Therefore, an advanced search of the literature will be undertaken to obtain the most evidence available on the diagnostic methods and treatments currently available, providing the clinician with more tools to achieve a comprehensive approach.
{"title":"Una perspectiva práctica de las manifestaciones gastrointestinales del lupus eritematoso sistémico","authors":"Juan Camilo Santacruz , Marta Juliana Mantilla , Sandra Pulido , Ferney Africano , Carlos Alberto Agudelo , Rubén Darío Mantilla , Ángelo Arzuaga , John Londoño","doi":"10.1016/j.rcreu.2024.11.004","DOIUrl":"10.1016/j.rcreu.2024.11.004","url":null,"abstract":"<div><div>Systemic lupus erythematosus is an autoimmune disease with a tendency to wax and wane. Unlike other autoimmune conditions, disease activity in the gastrointestinal system is relatively rare, and its approach can vary, according to different points of view. Despite its low prevalence, gastrointestinal manifestations can be potentially fatal, as occurs in cases of intestinal vasculitis and the consequent mesenteric ischaemia. The spectrum of gastrointestinal involvement in this disease is broad, and includes disease activity, infection associated with immunosuppression, adverse effects of some medications, or other intercurrent processes such as lupus cystitis. The clinical symptoms and laboratory findings are highly diverse, which leads to a delay in diagnosis with consequent organ dysfunction. Early diagnosis can be a challenge because a large proportion of patients present with nonspecific constitutional symptoms associated with nausea, emesis, and abdominal pain. These numerous factors have been an obstacle to further research in this field, making a unified diagnostic and therapeutic approach difficult. Therefore, an advanced search of the literature will be undertaken to obtain the most evidence available on the diagnostic methods and treatments currently available, providing the clinician with more tools to achieve a comprehensive approach.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 385-393"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290188","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.05.003
Luz Elena Triana Vidal, Armando Lucumi Moreno, Ivonne Valeria Ortiz
Introduction
Oxidative stress occurs when there is an imbalance between the production of reactive oxygen species (ROS) and cellular antioxidant activity. Overproduction of ROS causes oxidative damage to major macromolecules, alters homeostasis and leads to the generation of different pathologies. At present, there is no totally effective treatment to counteract these diseases involved with oxidative stress, so it is necessary to investigate new treatment alternatives that suppress the ROS generated. One promising alternative is the use of plant extracts, which have demonstrated a potent antioxidant effect. Efficient cells for the study of pathological diseases related to reactive oxygen species are T lymphocytes, which share systems with neurons such as: the dopaminergic system, death signaling and survival. In vitro lymphocytes are an optimal model for the evaluation of oxidative mechanisms.
Objective
To determine the protective effect of ethanolic extract of propolis against oxidative damage induced by hydrogen peroxide (H2O2) in human lymphocytes in vitro, by means of the cell viability test with trypan blue.
Results
Anova test shows that the concentrations of 0.0225 and 0.045 mg/mL of ethanolic extract of propolis, present protective activity against cell damage caused by H2O2.
Conclusion
This study proposes the ethanolic extract of propolis as a potential pharmacological, useful for treatments against autoimmune disorders.
{"title":"Efecto protector de propóleo frente al daño oxidativo inducido con peróxido de hidrógeno en células mononucleares de sangre periférica cultivadas in vitro mediante conteo celular","authors":"Luz Elena Triana Vidal, Armando Lucumi Moreno, Ivonne Valeria Ortiz","doi":"10.1016/j.rcreu.2024.05.003","DOIUrl":"10.1016/j.rcreu.2024.05.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Oxidative stress occurs when there is an imbalance between the production of reactive oxygen species (ROS) and cellular antioxidant activity. Overproduction of ROS causes oxidative damage to major macromolecules, alters homeostasis and leads to the generation of different pathologies. At present, there is no totally effective treatment to counteract these diseases involved with oxidative stress, so it is necessary to investigate new treatment alternatives that suppress the ROS generated. One promising alternative is the use of plant extracts, which have demonstrated a potent antioxidant effect. Efficient cells for the study of pathological diseases related to reactive oxygen species are T<!--> <!-->lymphocytes, which share systems with neurons such as: the dopaminergic system, death signaling and survival. In vitro lymphocytes are an optimal model for the evaluation of oxidative mechanisms.</div></div><div><h3>Objective</h3><div>To determine the protective effect of ethanolic extract of propolis against oxidative damage induced by hydrogen peroxide (H<sub>2</sub>O<sub>2</sub>) in human lymphocytes in vitro, by means of the cell viability test with trypan blue.</div></div><div><h3>Results</h3><div>Anova test shows that the concentrations of 0.0225 and 0.045<!--> <!-->mg/mL of ethanolic extract of propolis, present protective activity against cell damage caused by H<sub>2</sub>O<sub>2</sub>.</div></div><div><h3>Conclusion</h3><div>This study proposes the ethanolic extract of propolis as a potential pharmacological, useful for treatments against autoimmune disorders.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 315-320"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290179","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 : 2025-10-01DOI: 10.1016/j.rcreu.2024.04.009
Emine Öztürk , Dilara Bulut Gökten , Rıdvan Mercan , Savaş Güzel
Introduction/Objective
In our study, we investigated the role of Parkinsonism-associated protein 7 (PARK-7), known as DJ-1, which is involved in several pathways that counteract oxidative stress. This stress is thought to contribute to the development of fibrosis and vascular damage in patients with systemic sclerosis (SSc). Our study aims to investigate the correlation between PARK-7 levels, laboratory and clinical findings related to SSc and treatment regimens.
Materials and methods
In our study, we included fifty patients aged 18 years and older diagnosed with SSc and thirty healthy individuals without any systemic, malignant, or autoimmune diseases as a control group. We collected demographic data, clinical manifestations, laboratory and radiological findings, pulmonary function test (PFT), and echocardiography reports, information on comorbidities and prescribed medications from medical records, hospital database analysis, and direct patient interviews. Disease activity was quantified and documented using activity scoring systems developed by the European Scleroderma Study Group (EScSG) and the United Kingdom's (UK) Functional Activity Scoring. PARK-7 levels in venous blood samples from participating patients were quantified by Enzyme-Linked Immunosorbent Assay (ELISA).
Results
The PARK-7 level was 21.26 ± 15.83 in the patient group and 16.11 ± 11.83 in the control group. There was no significant difference in PARK-7 levels between the patient and control groups (p = .22). In terms of disease subtypes, PARK-7 levels were 21.35 ± 18.36 in the limited form, 23.18 ± 13.83 in the diffuse form. No statistically significant differences were observed between PARK-7 levels, the control group, and the different disease forms (p > .05). In patients classified as having active disease according to the EScSG scoring system, the PARK-7 level was 25.69 ± 18.10 compared to 16.00 ± 10.91 in the inactive group. No significant correlation was found between the presence of high-resolution computed tomography (HRCT) findings, other systemic involvement, and PARK-7 levels.
Conclusions
Over the past decade, numerous reports have highlighted the therapeutic potential of PARK-7 and its related molecules for the treatment of various diseases. Whether PARK-7 can be effectively used in the treatment of SSc remains unclear due to the cross-sectional design of our study. We believe that a study measuring PARK-7 levels in patients newly diagnosed or in the early stages of SSc, followed by randomised and prospective follow-up of clinical outcomes with and without treatment, could significantly improve our understanding of the role of PARK-7 in the pathogenesis of SSc and its potential
{"title":"Retrospective evaluation of PARK-7 expression dynamics in systemic sclerosis","authors":"Emine Öztürk , Dilara Bulut Gökten , Rıdvan Mercan , Savaş Güzel","doi":"10.1016/j.rcreu.2024.04.009","DOIUrl":"10.1016/j.rcreu.2024.04.009","url":null,"abstract":"<div><h3>Introduction/Objective</h3><div>In our study, we investigated the role of Parkinsonism-associated protein 7 (PARK-7), known as DJ-1, which is involved in several pathways that counteract oxidative stress. This stress is thought to contribute to the development of fibrosis<span> and vascular damage in patients with systemic sclerosis (SSc). Our study aims to investigate the correlation between PARK-7 levels, laboratory and clinical findings related to SSc and treatment regimens.</span></div></div><div><h3>Materials and methods</h3><div>In our study, we included fifty patients aged 18 years and older diagnosed with SSc and thirty healthy individuals without any systemic, malignant, or autoimmune diseases as a control group. We collected demographic data, clinical manifestations, laboratory and radiological findings, pulmonary function test (PFT), and echocardiography reports, information on comorbidities and prescribed medications from medical records, hospital database analysis, and direct patient interviews. Disease activity was quantified and documented using activity scoring systems developed by the European Scleroderma Study Group (EScSG) and the United Kingdom's (UK) Functional Activity Scoring. PARK-7 levels in venous blood samples from participating patients were quantified by Enzyme-Linked Immunosorbent Assay (ELISA).</div></div><div><h3>Results</h3><div>The PARK-7 level was 21.26<!--> <!-->±<!--> <!-->15.83 in the patient group and 16.11<!--> <!-->±<!--> <!-->11.83 in the control group. There was no significant difference in PARK-7 levels between the patient and control groups (<em>p</em> <!-->=<!--> <!-->.22). In terms of disease subtypes, PARK-7 levels were 21.35<!--> <!-->±<!--> <!-->18.36 in the limited form, 23.18<!--> <!-->±<!--> <!-->13.83 in the diffuse form. No statistically significant differences were observed between PARK-7 levels, the control group, and the different disease forms (<em>p</em> <!-->><!--> <span>.05). In patients classified as having active disease according to the EScSG scoring system, the PARK-7 level was 25.69</span> <!-->±<!--> <!-->18.10 compared to 16.00<!--> <!-->±<!--> <!-->10.91 in the inactive group. No significant correlation was found between the presence of high-resolution computed tomography (HRCT) findings, other systemic involvement, and PARK-7 levels.</div></div><div><h3>Conclusions</h3><div>Over the past decade, numerous reports have highlighted the therapeutic potential of PARK-7 and its related molecules for the treatment of various diseases. Whether PARK-7 can be effectively used in the treatment of SSc remains unclear due to the cross-sectional design of our study. We believe that a study measuring PARK-7 levels in patients newly diagnosed or in the early stages of SSc, followed by randomised and prospective follow-up of clinical outcomes with and without treatment, could significantly improve our understanding of the role of PARK-7 in the pathogenesis of SSc and its potential ","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 4","pages":"Pages 309-314"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290110","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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