Revista Colombiana de Reumatologia最新文献

Introduction

Social media is a powerful tool in providing information and support for patients with chronic diseases. The aim was to assess the link between using social media and depression in a sample population of Turkish ankylosing spondylitis (AS) patients.

Materials and methods

The patients completed a self-administered questionnaire, which was designed by the authors. Their demographic data, educational status, diagnosis, and favorite social network were also recorded. The Beck Depression Inventory-IA amended (revised) (BDI-IA-Turkish) was used to screen the AS patients for depression.

Results

A total of 155 AS patients were included in the study. The depression scores of the patients who used the Internet (12.18 ± 6.85) and social media (12.35 ± 6.90) were compared with those who did not (27.19 ± 10.51 vs. 25.20 ± 11.66) and a significant difference (p ≤ 0.001) was found. Smartphone users were in the majority (73.5%). WhatsApp was the preferred social network (66.5%), followed by Facebook (52.9%), Instagram (52.3%), Twitter (19.4%) and Pinterest (5.8%). Social media users and non-users were similar in age, gender, educational level and marital status. There were no significant differences in terms of the type and duration of social media use with depression score.

Conclusion

The results of this cross-sectional study confirmed that using social media can help patients with AS to cope with or be less affected by depression. Finding the most appropriate and commonly used form of social media may be an important concept for stewardship in health policies.

Sarcoidosis is a multisystemic disease of unknown cause, secondary to a genetically determined immune reaction triggered by environmental factors, which leads to the formation of non-caseating granulomas. Ocular involvement is the second most frequent after pulmonary involvement. The most common finding is anterior granulomatous uveitis, but posterior uveitis, retinal peri-phlebitis, chorioretinitis, conjunctivitis, scleritis and optic neuritis can also be seen. We describe the case of a paediatric patient with long-standing multisystem involvement disease, in whom the demonstration of non-caseating granulomas in the conjunctival biopsy allowed a presumptive diagnosis of sarcoidosis.

Infectious spondylodiscitis (ISD) is a rare infection of the spine. ISD caused by Acinetobacter baumannii and Citrobacter koseri is even rarer. Moreover, the association between ISD and malignancy is uncommon. In these case series, we report the remarkable case of a patient diagnosed with ISD associated with bone metastatic lesions of an unknown cancer and multiple myeloma accidentally discovered due to COVID-19 infection. We also reported two cases of ISD caused by rare organisms: the first case is a man with ISD caused by a multidrug resistant A. baumannii, and the second is a man with C. koseri bacteraemia complicated by paraspinal abscess and ISD.

Psoriasis is a disease that is not limited to skin involvement, the importance of systemic compromise is recognized more than ever, especially because of the associated comorbidities, which are explained by the marked chronic systemic inflammatory response mediated by pro-inflammatory cytokines (mainly TNF-α, IL23, IL 17), which play an important role in the induction of insulin resistance, endothelial dysfunction, accelerated atherosclerosis and the increased risk of cardio-cerebrovascular events. The relationship with these outcomes has been demonstrated and hence the concept of psoriatic march, a term that is gaining increasing importance aimed at maintaining and reinforcing the approach to a skin disease with systemic compromise, associated morbidity and mortality that can be preventable and manageable. The pathophysiological mechanisms that explain these phenomena are variable, however, new concepts have been identified, which have made it possible to improve the current approach to the disease and thus establish mechanisms to reduce cardiovascular risk in patients with psoriasis.

Synovial chondromatosis is an uncommon lesion characterized by cartilaginous metaplasia of the synovial layer with the usual formation of free osteocartilaginous bodies and typically involving large joints. Location in the ankle and foot is rare and, in turn, very rare in the synovial sheath of the foot tendons. The diagnosis of this little recognized entity is of great importance because it is a progressive condition that carries a substantial risk of local recurrence. Imaging tests such as CT or MRI help to identify the characteristic findings and the exact location to guide the orthopaedic surgeon in surgery. Its definitive treatment is surgical, through complete resection of the synovium (synovectomy).

Idiopathic inflammatory myopathy is a heterogeneous group of autoimmune disorders, that share some common manifestations, such as muscle weakness and elevation of serum creatine kinase. However, classification of idiopathic inflammatory myopathy into an existing clinical subtype is not always possible. The case is a 25-year-old male with an unrecognized form of idiopathic inflammatory myopathy, the onset of which resembled amyotrophic lateral sclerosis. The paper includes differential diagnosis with amyotrophic lateral sclerosis and congenital myopathies, and response to corticosteroid therapy.

The leading complication of antiphospholipid syndrome (APS) is arterial and venous thrombotic diathesis, which usually manifests as deep vein thrombosis or cerebrovascular events. However, it can occur in any blood vessel, rarely including the adrenal vessels. This can be the first manifestation of APS, it is frequently bilateral and triggers adrenal insufficiency (Addison's disease). It has been proposed that the initial phenomenon is thrombosis of the adrenal veins leading to infarction. Bilateral involvement is usually irreversible and requires permanent hormone replacement therapy. Unilateral involvement is even more infrequent and appears to have a better prognosis. We report the case of a 35-year-old female patient with a history of APS (repeated spontaneous abortions, livedo reticularis, presence of antiphospholipid antibodies and lupus anticoagulant), who presented with right adrenal infarction during the puerperium and whose clinical manifestation was sudden and severe lumbar pain. The diagnosis was made with contrast enhanced tomography. The patient made satisfactory progress, with no evidence of adrenal insufficiency.

Rowell syndrome is a rare disease which consists of lesions of lupus erythematosus and erythema multiforme in patients with a characteristic immunological pattern, given by the presence of positive antinuclear antibodies in a mottled pattern and the absence of infectious and/or pharmacologic triggers. We present a case of a 23-year-old woman with a 4-year history of recurrent episodes of vesicles and blisters, of soft consistency and erythematous base on upper and lower limbs, affecting the oral and nasal mucosa; associated with chilblains, Raynaud's phenomenon, ulcers in oral and nasal mucosa and polyarthralgia; skin biopsy reported erythema multiforme, with negative direct immunofluorescence and positive speckled pattern antinuclear antibodies, findings that fulfil the diagnostic criteria of Zeitouni et al. (2000) and Torchia et al. (2012) for the diagnosis of Rowell's syndrome.

Autoimmune polyglandular syndrome (SPA) is a rare disorder that leads to endocrine gland dysfunction and can affect other organs. Several types of polyglandular syndrome are described. Type III may be associated with skin disorders of autoimmune origin such as vitiligo. Although the relationship between psoriasis and vitiligo has been widely documented, the association between psoriasis and SPA is rare and fewer than 5 cases have been reported in the literature. We present the case of a 34-year-old woman with SPA III associated with vulgar psoriasis and vitiligo.