Pub Date : 2025-07-01DOI: 10.1016/j.rcreu.2024.03.005
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.
Objective
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.
Materials and 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 200× 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。目的本研究旨在比较在一个毛细血管镜参考中心，混合性结缔组织病、系统性硬化症和原发性雷诺现象（pRP）患者的血管造影表现。材料与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，无血管区域较少(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<；措施)。与SS组（5%）和pRP组（0%）相比，MCTD组以浓密毛细血管为主（10%），差异无统计学意义（P = 0.122）。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":"Hallazgos capilaroscópicos en pacientes con enfermedad mixta del tejido conectivo, fenómeno de Raynaud primario y esclerosis sistémica en una institución en Medellín (Colombia), 2015-2020","authors":"Adriana Margarita Trejos Tenorio , Carlos Jaime Velásquez Franco , Libia María Rodríguez Padilla , Miguel Antonio Mesa Navas","doi":"10.1016/j.rcreu.2024.03.005","DOIUrl":"10.1016/j.rcreu.2024.03.005","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.</div></div><div><h3>Objective</h3><div>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>Materials and 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 200× 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%, <em>P</em> <!--><<!--> <!-->.001), megacapillaries (20% vs 100%, <em>P</em> <!--><<!--> <!-->.001), and haemorrhages (37.5 vs. 92.5%, <em>P</em><<!--> <!-->.001). Bushy capillaries predominated in the MCTD (10%) compared to SS (5%) and pRP (0%) groups without significance difference (<em>P</em> <!-->=<!--> <!-->.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":37643,"journal":{"name":"Revista Colombiana de Reumatologia","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":"141403652","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.rcreu.2024.05.005
Oscar Vicente Vergara Serpa , Carlos Jaime Velásquez-Franco , Luis Fernando Pinto , Neil Smith Pertuz Charris , Andrés Felipe Echeverri García , Alejandro Cardona Palacio , Javier Darío Márquez Hernández
Objective
To present the case of an immunosuppressed patient who developed an autoimmune disease.
Patients and methods
30-year-old woman, immunosuppressed due to a history of orthotopic liver transplant, who developed intestinal infection by cytomegalovirus and alveolar haemorrhage.
Results
Patient presented a positive serological finding for PR3 ANCA, classified as granulomatosis with polyangiitis. Due to her history, induction, and maintenance with an anti-CD20 were considered, with no further relapse over 6-month follow-up.
Conclusion
Immunosuppressed patients have risk factors for developing autoimmune diseases.
{"title":"De la inmunosupresión a la autoinmunidad: vasculitis ANCA-PR3+ en una paciente inmunosuprimida por trasplante hepático. Reporte de un caso","authors":"Oscar Vicente Vergara Serpa , Carlos Jaime Velásquez-Franco , Luis Fernando Pinto , Neil Smith Pertuz Charris , Andrés Felipe Echeverri García , Alejandro Cardona Palacio , Javier Darío Márquez Hernández","doi":"10.1016/j.rcreu.2024.05.005","DOIUrl":"10.1016/j.rcreu.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>To present the case of an immunosuppressed patient who developed an autoimmune disease.</div></div><div><h3>Patients and methods</h3><div>30-year-old woman, immunosuppressed due to a history of orthotopic liver transplant, who developed intestinal infection by cytomegalovirus and alveolar haemorrhage.</div></div><div><h3>Results</h3><div>Patient presented a positive serological finding for PR3 ANCA, classified as granulomatosis with polyangiitis. Due to her history, induction, and maintenance with an anti-CD20 were considered, with no further relapse over 6-month follow-up.</div></div><div><h3>Conclusion</h3><div>Immunosuppressed patients have risk factors for developing autoimmune diseases.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 286-293"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623429","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.rcreu.2024.03.004
Ana Ospina-Caicedo , Alex Imbachí-Salamanca , Ingris Peláez-Ballestas , María V. Torres-Andrade , Edgar A. Castro-Franco , Jaime Coral-Enríquez , Diana K. Rodríguez-Cerón , Jorge Izquierdo-Loaiza , en representación del Grupo Latinoamericano de Estudio de enfermedades reumáticas en pueblos originarios (Gladerpo)
Introduction
Rheumatic diseases are a frequent cause of disability, deterioration in quality of life, and high health costs.
Objective
The objective of the study was to estimate the prevalence of rheumatic diseases using COPCORD methodology in the indigenous misak people of the Guambia - Cauca reservation, over 18 years of age.
Materials and methods
A community-based cross-sectional study was carried out using systematic random sampling, in 3 stages: 1. selection of participants house by house following the main rural road of each village of the Guambia reservation. 2. Application of the COPCORD questionnaire, Spanish version or version adapted and validated to Wam, misak language), by standardized bilingual interviewers. 3. Confirmation of the diagnosis was made by rheumatologists with access to all the information. Descriptive statistics were performed.
Results
Of a total of 624 people surveyed, 67% were women, the average age was 44 years, 49.2% had basic primary education, and 79.4% spoke Spanish. Pain in the last 7 days and/or history was reported in 366 respondents (58.6%). One hundred and ninety-two patients received medical evaluation, of which 27 (4.33%) had a diagnosis of rheumatic disease and particularly 21 (3.36%) of rheumatoid arthritis.
Conclusion
The prevalence of rheumatic diseases was lower than reported, however the prevalence of rheumatoid arthritis (3.36%) was higher than that reported in the rest of the country and in other Indigenous communities in Latin America. Rheumatic diseases represent a public health problem and specific information on Indigenous groups is necessary for the design of specific interventions.
{"title":"Prevalencia de malestares musculoesqueléticos y enfermedades reumáticas en una comunidad indígena misak colombiana: estudio transversal con metodología COPCORD","authors":"Ana Ospina-Caicedo , Alex Imbachí-Salamanca , Ingris Peláez-Ballestas , María V. Torres-Andrade , Edgar A. Castro-Franco , Jaime Coral-Enríquez , Diana K. Rodríguez-Cerón , Jorge Izquierdo-Loaiza , en representación del Grupo Latinoamericano de Estudio de enfermedades reumáticas en pueblos originarios (Gladerpo)","doi":"10.1016/j.rcreu.2024.03.004","DOIUrl":"10.1016/j.rcreu.2024.03.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Rheumatic diseases are a frequent cause of disability, deterioration in quality of life, and high health costs.</div></div><div><h3>Objective</h3><div>The objective of the study was to estimate the prevalence of rheumatic diseases using COPCORD methodology in the indigenous misak people of the Guambia - Cauca reservation, over 18 years of age.</div></div><div><h3>Materials and methods</h3><div>A community-based cross-sectional study was carried out using systematic random sampling, in 3 stages: 1. selection of participants house by house following the main rural road of each village of the Guambia reservation. 2. Application of the COPCORD questionnaire, Spanish version or version adapted and validated to Wam, misak language), by standardized bilingual interviewers. 3. Confirmation of the diagnosis was made by rheumatologists with access to all the information. Descriptive statistics were performed.</div></div><div><h3>Results</h3><div>Of a total of 624 people surveyed, 67% were women, the average age was 44 years, 49.2% had basic primary education, and 79.4% spoke Spanish. Pain in the last 7 days and/or history was reported in 366 respondents (58.6%). One hundred and ninety-two patients received medical evaluation, of which 27 (4.33%) had a diagnosis of rheumatic disease and particularly 21 (3.36%) of rheumatoid arthritis.</div></div><div><h3>Conclusion</h3><div>The prevalence of rheumatic diseases was lower than reported, however the prevalence of rheumatoid arthritis (3.36%) was higher than that reported in the rest of the country and in other Indigenous communities in Latin America. Rheumatic diseases represent a public health problem and specific information on Indigenous groups is necessary for the design of specific interventions.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 198-208"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623347","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.rcreu.2024.03.006
Juan Felipe Betancur , Luz Eugenia Pérez , Verónica Bernal González , José Fernando Molina Restrepo
Osteoporosis is a skeletal disorder characterized by decreased bone mineral density (BMD) and a disruption of bone microarchitecture, leading to an increased fracture risk. Traditionally, BMD has been measured using X-ray densitometry (DXA). However, Radiofrequency Echographic Multi Spectometry (REMS) has emerged as a promising technique for the assessment of osteoporosis. Various studies have evaluated the feasibility and precision of REMS, showing significant correlations with DXA in different anatomical sites and populations, including post-menopausal women, renal transplant patients, and those with rheumatoid arthritis, among others. REMS has also demonstrated the ability to detect bone artifacts and provide reliable measurements in their presence. While DXA remains the gold standard for diagnosing osteoporosis, REMS has proven to be an effective and promising tool in assessing BMD and fracture risk. Its capability to rule out artifacts and offer precise measurements in diverse populations highlights its potential as a complement or alternative in the evaluation of osteoporosis.
{"title":"Utilidad de la multiespectrometría ecográfica por radiofrecuencia en el diagnóstico de la osteoporosis","authors":"Juan Felipe Betancur , Luz Eugenia Pérez , Verónica Bernal González , José Fernando Molina Restrepo","doi":"10.1016/j.rcreu.2024.03.006","DOIUrl":"10.1016/j.rcreu.2024.03.006","url":null,"abstract":"<div><div>Osteoporosis is a skeletal disorder characterized by decreased bone mineral density (BMD) and a disruption of bone microarchitecture, leading to an increased fracture risk. Traditionally, BMD has been measured using X-ray densitometry (DXA). However, Radiofrequency Echographic Multi Spectometry (REMS) has emerged as a promising technique for the assessment of osteoporosis. Various studies have evaluated the feasibility and precision of REMS, showing significant correlations with DXA in different anatomical sites and populations, including post-menopausal women, renal transplant patients, and those with rheumatoid arthritis, among others. REMS has also demonstrated the ability to detect bone artifacts and provide reliable measurements in their presence. While DXA remains the gold standard for diagnosing osteoporosis, REMS has proven to be an effective and promising tool in assessing BMD and fracture risk. Its capability to rule out artifacts and offer precise measurements in diverse populations highlights its potential as a complement or alternative in the evaluation of osteoporosis.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 255-266"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623335","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.rcreu.2024.11.008
Adriana Medina , Claudia Campusano , Sonia Cerdas-Pérez , Monica Calo , Sofia Wullich , Bruno Muzzi-Camargos , Patricia Clark
Introduction
After a decade since AUDIT LATAM 2012, an executive committee of the International Osteoporosis Foundation of Latin America (LATAM-IOF) updated the data on the epidemiological burden of osteoporosis and fragility fractures in Latin America to generate greater awareness about osteoporosis and prevent fragility fractures.
Objective
To describe the burden of osteoporosis and fragility fractures, their management and treatment, and the availability of health resources in Latin America over a 10-year period.
Materials and methods
A two-phase study was designed. Phase 1 collected demographic data from 2015 to 2019, described the current infrastructure for Healthcare Systems osteoporosis related as well as the related health care policies on osteoporosis. We assessed the availability of diagnosis tools and pharmacological treatment. Phase 2 focused on the incidence of major fragility fractures in men and women aged 50 and over, as well as the costs of these fractures when available.
Results
Nineteen countries completed phase 1. More than 40% of the population is over 50 years-old and life expectancy is on average 75.8 years. The availability of densitometry (DXA) is 0.68 per 100,000 inhabitants. Seven countries have FRAX® calibrated with their own epidemiological data. Bisphosphonates are the primary treatment option for osteoporosis. A larger number of countries have conducted calcium and vitamin D intake surveys. There are 68 active medical and/or patient societies involved in activities related with osteoporosis. Phase 2 included fewer countries, representing a significant gap in osteoporosis information in the region. Our rates of hip fractures are intermediate ranging between 108 and 276.2 per 100,000 inhabitants being the highest in Colombia and the lowest in Mexico. The costs of hip fracture range from USD 4959 to USD 8261.
Conclusions
Regional data from Latin America revealed that healthcare assistance and global awareness has improved in comparison to the 2012 figures. The hip fracture rates in Latin America remains at intermediate levels compared to other regions. There is a scarcity of cost studies, however, high costs of osteoporotic fractures were confirmed to have a negative impact on healthcare systems of the region.
{"title":"Epidemiological data and burden of osteoporosis and fragility fractures in Latin America: Changes over a decade","authors":"Adriana Medina , Claudia Campusano , Sonia Cerdas-Pérez , Monica Calo , Sofia Wullich , Bruno Muzzi-Camargos , Patricia Clark","doi":"10.1016/j.rcreu.2024.11.008","DOIUrl":"10.1016/j.rcreu.2024.11.008","url":null,"abstract":"<div><h3>Introduction</h3><div>After a decade since AUDIT LATAM 2012, an executive committee of the International Osteoporosis Foundation of Latin America (LATAM-IOF) updated the data on the epidemiological burden of osteoporosis and fragility fractures in Latin America to generate greater awareness about osteoporosis and prevent fragility fractures.</div></div><div><h3>Objective</h3><div>To describe the burden of osteoporosis and fragility fractures, their management and treatment, and the availability of health resources in Latin America over a 10-year period.</div></div><div><h3>Materials and methods</h3><div>A two-phase study was designed. Phase 1 collected demographic data from 2015 to 2019, described the current infrastructure for Healthcare Systems osteoporosis related as well as the related health care policies on osteoporosis. We assessed the availability of diagnosis tools and pharmacological treatment. Phase 2 focused on the incidence of major fragility fractures in men and women aged 50 and over, as well as the costs of these fractures when available.</div></div><div><h3>Results</h3><div>Nineteen countries completed phase 1. More than 40% of the population is over 50 years-old and life expectancy is on average 75.8 years. The availability of densitometry (DXA) is 0.68 per 100,000 inhabitants. Seven countries have FRAX® calibrated with their own epidemiological data. Bisphosphonates are the primary treatment option for osteoporosis. A larger number of countries have conducted calcium and vitamin D intake surveys. There are 68 active medical and/or patient societies involved in activities related with osteoporosis. Phase 2 included fewer countries, representing a significant gap in osteoporosis information in the region. Our rates of hip fractures are intermediate ranging between 108 and 276.2 per 100,000 inhabitants being the highest in Colombia and the lowest in Mexico. The costs of hip fracture range from USD 4959 to USD 8261.</div></div><div><h3>Conclusions</h3><div>Regional data from Latin America revealed that healthcare assistance and global awareness has improved in comparison to the 2012 figures. The hip fracture rates in Latin America remains at intermediate levels compared to other regions. There is a scarcity of cost studies, however, high costs of osteoporotic fractures were confirmed to have a negative impact on healthcare systems of the region.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 247-254"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623428","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.rcreu.2024.05.002
Nathalie Yepes Madrid , María del Pilar Gómez Mora , José Fernando Gómez Urrego
Behçet's disease 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, one from a website, 4 from the Colombian Ministry of Health and 4 from a review of bibliographic citations, of which 32 articles were included for the present review, finding that the prevalence at a global level it is estimated around 10.3 per 100,000 inhabitants. Behçet's disease 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":"Enfermedad de Behçet en pediatría, un reto diagnóstico: revisión sistemática cualitativa de la literatura","authors":"Nathalie Yepes Madrid , María del Pilar Gómez Mora , José Fernando Gómez Urrego","doi":"10.1016/j.rcreu.2024.05.002","DOIUrl":"10.1016/j.rcreu.2024.05.002","url":null,"abstract":"<div><div>Behçet's disease 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, one from a website, 4 from the Colombian Ministry of Health and 4 from a review of bibliographic citations, of which 32 articles were included for the present review, finding that the prevalence at a global level it is estimated around 10.3 per 100,000 inhabitants. Behçet's disease 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":37643,"journal":{"name":"Revista Colombiana de Reumatologia","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":"141840327","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.rcreu.2024.03.003
José Lucas Daza , María Victoria Cabrera , Marcelo de Rosa , Ignacio Roca , Veronica Remache , Juan Sebastián Reyes Bello
Introduction
Primary membranous nephropathy (PMN) poses a therapeutic challenge, necessitating effective treatment approaches. This study aims to assess the response of PMN patients to three treatment strategies: traditional Ponticelli scheme, monthly intravenous cyclophosphamide, and calcineurin inhibitors over a 6–12-month follow-up.
Objective
This study evaluates primary membranous nephropathy (PMN) patients diagnosed by renal biopsy, examining their response to three treatment schemes over a 6–12-month follow-up: traditional Ponticelli scheme, monthly intravenous cyclophosphamide, and calcineurin inhibitors.
Materials and methods
A multicentre retrospective analysis in three Latin American countries (Argentina, Colombia, Bolivia) encompassing 110 PMN patients diagnosed by renal biopsy over 5 years. Excluding 29 with incomplete records or a 12-month follow-up, patients were grouped by treatment: Ponticelli, intravenous cyclophosphamide, and calcineurin inhibitors. Clinical, histological, and laboratory features were compared for complete remission at one year according to KDIGO 2020 guidelines. Univariate and multivariate analyses were conducted. A comparative analysis of remission rates and adverse effects between the oral cyclophosphamide regimen versus calcineurin inhibitors was performed.
Results
Male sex showed the highest prevalence at 60.5%, with an average age of 50.3 ± 14, mainly in stage II (53.1%), and risk distribution (46.9% moderate, 53.1% high). CP IV showed higher haematuria, older age, and lower albuminaemia. While CP IV showed a trend toward higher complete remission (83%) at 12 months compared to CP PO (52%) and CNI (79%), statistical significance (p = .08) was not reached. Complications were significantly lower with CP IV (6.7%) and CNI (4.2%) than with CP PO (41%) with an OR 9.62 and a p-value of .006. These findings underscore the nuanced relationship between treatment modalities, remission rates, and complications in primary membranous nephropathy patients.
Conclusion
The traditional Ponticelli scheme did not significantly differ from intravenous cyclophosphamide and calcineurin inhibitors in achieving complete remission at 6 and 12 months. However, the Ponticelli group exhibited higher cumulative cyclophosphamide doses and more infectious complications compared to other subgroups.
{"title":"Primary membranous nephropathy in Latin America: A multicentre study","authors":"José Lucas Daza , María Victoria Cabrera , Marcelo de Rosa , Ignacio Roca , Veronica Remache , Juan Sebastián Reyes Bello","doi":"10.1016/j.rcreu.2024.03.003","DOIUrl":"10.1016/j.rcreu.2024.03.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Primary membranous nephropathy (PMN) poses a therapeutic challenge, necessitating effective treatment approaches. This study aims to assess the response of PMN patients to three treatment strategies: traditional Ponticelli scheme, monthly intravenous cyclophosphamide, and calcineurin inhibitors over a 6–12-month follow-up.</div></div><div><h3>Objective</h3><div>This study evaluates primary membranous nephropathy (PMN) patients diagnosed by renal biopsy, examining their response to three treatment schemes over a 6–12-month follow-up: traditional Ponticelli scheme, monthly intravenous cyclophosphamide, and calcineurin inhibitors.</div></div><div><h3>Materials and methods</h3><div>A multicentre retrospective analysis in three Latin American countries (Argentina, Colombia, Bolivia) encompassing 110 PMN patients diagnosed by renal biopsy over 5 years. Excluding 29 with incomplete records or a 12-month follow-up, patients were grouped by treatment: Ponticelli, intravenous cyclophosphamide, and calcineurin inhibitors. Clinical, histological, and laboratory features were compared for complete remission at one year according to KDIGO 2020 guidelines. Univariate and multivariate analyses were conducted. A comparative analysis of remission rates and adverse effects between the oral cyclophosphamide regimen versus calcineurin inhibitors was performed.</div></div><div><h3>Results</h3><div>Male sex showed the highest prevalence at 60.5%, with an average age of 50.3<!--> <!-->±<!--> <span>14, mainly in stage II (53.1%), and risk distribution (46.9% moderate, 53.1% high). CP IV showed higher haematuria, older age, and lower albuminaemia. While CP IV showed a trend toward higher complete remission (83%) at 12 months compared to CP PO (52%) and CNI (79%), statistical significance (</span><em>p</em> <!-->=<!--> <span>.08) was not reached. Complications were significantly lower with CP IV (6.7%) and CNI (4.2%) than with CP PO (41%) with an OR 9.62 and a </span><em>p</em>-value of .006. These findings underscore the nuanced relationship between treatment modalities, remission rates, and complications in primary membranous nephropathy patients.</div></div><div><h3>Conclusion</h3><div>The traditional Ponticelli scheme did not significantly differ from intravenous cyclophosphamide and calcineurin inhibitors in achieving complete remission at 6 and 12 months. However, the Ponticelli group exhibited higher cumulative cyclophosphamide doses and more infectious complications compared to other subgroups.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 190-197"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623346","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.rcreu.2024.04.001
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.rcreu.2024.04.001","DOIUrl":"10.1016/j.rcreu.2024.04.001","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":37643,"journal":{"name":"Revista Colombiana de Reumatologia","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":"144623348","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.rcreu.2024.03.007
David Vega-Morales , Alejandro Garza-Alpirez , María Fernanda Martínez-Guerra , Alondra Elizabeth Montoya-Montes
Introduction
Comorbidities contribute to the development of PsA and worsen disease severity. The aim of the study is to describe the clinical characteristics of Mexican PsA patients focusing on comorbidities and medications. The primary objective of our study was to investigate the clinical and epidemiological characteristics of patients with Psoriatic Arthritis (APs) who were undergoing treatment with biological disease-modifying antirheumatic drugs (bDMARDs).
Materials and methods
We conducted a cross-sectional observational study in a secondary care clinic in northern Mexico.
Results
Of the total sample, 38/66 (57.5%) were women, with a mean age of 47.8 (SD 11.5) years, a mean weight of 83.8 (SD 19) kg, and BMI of 31.5 (SD 6.5) kg/m2. Smoking and alcoholism were reported in 10/66 (15.1%) and 2 (3%) of patients, respectively.
Obesity occurred in 41 (62.1%) patients, followed by diabetes mellitus in 23 (34.8%) patients, and systemic arterial hypertension in 19 (28.7%) patients. Ischaemic heart disease, heart failure, and cancer were not present in any of the patients.
Conclusions
0ur study revealed a higher prevalence of chronic metabolic diseases among patients with psoriatic arthritis (PsA) compared to other cohorts without inflammatory arthropathy and the Mexican population.
{"title":"Prevalence of comorbidities and use of medication in psoriatic arthritis patients: findings from a Mexican cohort","authors":"David Vega-Morales , Alejandro Garza-Alpirez , María Fernanda Martínez-Guerra , Alondra Elizabeth Montoya-Montes","doi":"10.1016/j.rcreu.2024.03.007","DOIUrl":"10.1016/j.rcreu.2024.03.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Comorbidities contribute to the development of PsA and worsen disease severity. The aim of the study is to describe the clinical characteristics of Mexican PsA patients focusing on comorbidities and medications. The primary objective of our study was to investigate the clinical and epidemiological characteristics of patients with Psoriatic Arthritis (APs) who were undergoing treatment with biological disease-modifying antirheumatic drugs (bDMARDs).</div></div><div><h3>Materials and methods</h3><div>We conducted a cross-sectional observational study in a secondary care clinic in northern Mexico.</div></div><div><h3>Results</h3><div>Of the total sample, 38/66 (57.5%) were women, with a mean age of 47.8 (SD 11.5) years, a mean weight of 83.8 (SD 19) kg, and BMI of 31.5 (SD 6.5) kg/m2. Smoking and alcoholism were reported in 10/66 (15.1%) and 2 (3%) of patients, respectively.</div><div>Obesity occurred in 41 (62.1%) patients, followed by diabetes mellitus in 23 (34.8%) patients, and systemic arterial hypertension in 19 (28.7%) patients. Ischaemic heart disease, heart failure, and cancer were not present in any of the patients.</div></div><div><h3>Conclusions</h3><div>0ur study revealed a higher prevalence of chronic metabolic diseases among patients with psoriatic arthritis (PsA) compared to other cohorts without inflammatory arthropathy and the Mexican population.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 216-221"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692263","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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