Pub Date : 2025-07-01DOI: 10.1016/j.rcreu.2024.02.005
Ángel Estuardo Plasencia Ezaine , Marco Aurelio Ramírez Huaranga , Rocío Arenal López , David Castro Corredor , Verónica Salas Manzanedo , María Dolores Mínguez Sánchez , Elisa Sánchez Rodríguez
Introduction
Raynaud's phenomenon (RP) is a vasospastic condition that carries a significant burden of pain and disability. When conventional therapies are not sufficiently effective, the need arises to explore other therapeutic alternatives such as interdigital botulinum toxin (BT) injection.
Objective
To determine clinical improvement in patients with RP (number of daily episodes, Visual Analogue Scale (VAS) during episodes, duration of episodes, and Raynaud Condition Score).
Materials and methods
Observational, descriptive, retrospective study of patients with RP who received ultrasound-guided interdigital injection of type A BT. Data from post-procedure controls (months 1, 3, and 6) were obtained, and analysis was performed using the Wilcoxon test through the StatPlus programme.
Results
The study was conducted on 8 patients (100% female) with a mean age of 48.5 years, all of whom had RP secondary to a systemic disease (87.5% systemic sclerosis). Significant differences were observed (median and interquartile range) in the number of RP episodes in the first month (P = .043). The pain VAS for each episode decreased in the first month (P = .027) and in the third month (P = .043). Differences were found in the Raynaud condition score in the first month (P = .027) and the third month (P = .043).
Conclusions
Ultrasound-guided interdigital injection of type A BT could be an adjuvant treatment for patients with RP.
{"title":"Estudio retrospectivo sobre la efectividad de la infiltración ecoguiada interdigital de toxina botulínica para el tratamiento del fenómeno de Raynaud","authors":"Ángel Estuardo Plasencia Ezaine , Marco Aurelio Ramírez Huaranga , Rocío Arenal López , David Castro Corredor , Verónica Salas Manzanedo , María Dolores Mínguez Sánchez , Elisa Sánchez Rodríguez","doi":"10.1016/j.rcreu.2024.02.005","DOIUrl":"10.1016/j.rcreu.2024.02.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Raynaud's phenomenon (RP) is a vasospastic condition that carries a significant burden of pain and disability. When conventional therapies are not sufficiently effective, the need arises to explore other therapeutic alternatives such as interdigital botulinum toxin (BT) injection.</div></div><div><h3>Objective</h3><div>To determine clinical improvement in patients with RP (number of daily episodes, Visual Analogue Scale (VAS) during episodes, duration of episodes, and Raynaud Condition Score).</div></div><div><h3>Materials and methods</h3><div>Observational, descriptive, retrospective study of patients with RP who received ultrasound-guided interdigital injection of type<!--> <!-->A BT. Data from post-procedure controls (months<!--> <!-->1, 3, and<!--> <!-->6) were obtained, and analysis was performed using the Wilcoxon test through the StatPlus programme.</div></div><div><h3>Results</h3><div>The study was conducted on 8 patients (100% female) with a mean age of 48.5<!--> <!-->years, all of whom had RP secondary to a systemic disease (87.5% systemic sclerosis). Significant differences were observed (median and interquartile range) in the number of RP episodes in the first month (<em>P</em> <!-->=<!--> <!-->.043). The pain VAS for each episode decreased in the first month (<em>P</em> <!-->=<!--> <!-->.027) and in the third month (<em>P</em> <!-->=<!--> <!-->.043). Differences were found in the Raynaud condition score in the first month (<em>P</em> <!-->=<!--> <!-->.027) and the third month (<em>P</em> <!-->=<!--> <!-->.043).</div></div><div><h3>Conclusions</h3><div>Ultrasound-guided interdigital injection of type<!--> <!-->A BT could be an adjuvant treatment for patients with RP.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 183-189"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141028003","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}
To date, few epidemiological studies compare the incidence and prevalence of systemic lupus erythematosus (SLE) and isolated cutaneous lupus erythematosus (CLE). The information is even more scarce in Latin America. The aim of this study is to describe the phenotype of CLE in a reference center in Colombia.
Materials and methods
A retrospective cross-sectional study was carried out. SLE was confirmed according to EULAR/ACR 2019 classification criteria and patients were simultaneously evaluated in the rheumatology and dermatology clinics. A descriptive and bivariate analysis was carried out. The institutional committee approved the study.
Results
Thirty participants were diagnosed with SLE and CLE. Most patients were female (83.3%), with a mean age of 37 ± 13 years. Chronic CLE was the most prevalent subtype (46.7%), followed by acute (30%) and subacute (16.7%) CLE. There were statistically significant differences when comparing acute CLE and reduced C4 (p = .032); in subacute CLE and interstitial lung disease (p = .010); and in lymphopenia (p = .012) and thrombocytopenia (p = .046). Finally, there was a difference in patients with chronic CLE and the use of topical corticosteroid (p = .026), methotrexate (p = .036), and SLEDAI > 3 points (p = .025).
Conclusion
This study provides valuable insights into the phenotypic characteristics and associations of CLE with systemic manifestations in the Colombian population, contributing to the understanding and managing of this complex autoimmune disease.
{"title":"Cutaneous spectrum of lupus erythematosus: A cohort of patients from a referral-center in Colombia","authors":"Verónica Noguera-Castro , Claudia-Lorena Cano-Cuadros , Mariana Botero-Varón , Daniela Marín-Acevedo , Omar-Javier Calixto , Juan-Manuel Bello-Gualtero , Consuelo Romero-Sánchez","doi":"10.1016/j.rcreu.2024.04.007","DOIUrl":"10.1016/j.rcreu.2024.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>To date, few epidemiological studies compare the incidence and prevalence of systemic lupus erythematosus (SLE) and isolated cutaneous lupus erythematosus (CLE). The information is even more scarce in Latin America. The aim of this study is to describe the phenotype of CLE in a reference center in Colombia.</div></div><div><h3>Materials and methods</h3><div>A retrospective cross-sectional study was carried out. SLE was confirmed according to EULAR/ACR 2019 classification criteria and patients were simultaneously evaluated in the rheumatology and dermatology clinics. A descriptive and bivariate analysis was carried out. The institutional committee approved the study.</div></div><div><h3>Results</h3><div>Thirty participants were diagnosed with SLE and CLE. Most patients were female (83.3%), with a mean age of 37<!--> <!-->±<!--> <!-->13 years. Chronic CLE was the most prevalent subtype (46.7%), followed by acute (30%) and subacute (16.7%) CLE. There were statistically significant differences when comparing acute CLE and reduced C4 (<em>p</em> <!-->=<!--> <!-->.032); in subacute CLE and interstitial lung disease (<em>p</em> <!-->=<!--> <!-->.010); and in lymphopenia (<em>p</em> <!-->=<!--> <!-->.012) and thrombocytopenia (<em>p</em> <!-->=<!--> <!-->.046). Finally, there was a difference in patients with chronic CLE and the use of topical corticosteroid (<em>p</em> <!-->=<!--> <!-->.026), methotrexate (<em>p</em> <!-->=<!--> <span>.036), and SLEDAI</span> <!-->><!--> <!-->3 points (<em>p</em> <!-->=<!--> <!-->.025).</div></div><div><h3>Conclusion</h3><div>This study provides valuable insights into the phenotypic characteristics and associations of CLE with systemic manifestations in the Colombian population, contributing to the understanding and managing of this complex autoimmune disease.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 231-235"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623426","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.2024.10.001
Lina María Franco González , Leonor Victoria González Pérez , Mónica Vanessa Posso Zapata , Vanessa Andrea Flórez Arango
Introduction
Sicca syndrome is characterized by the presence of dry eye (xerophthalmia - keratoconjunctivitis sicca), dry mouth (xerostomia), and dry skin (xeroderma), this triad may be related to Sjögren's syndrome.
Objective
To associate the clinical, scintigraphic, and histopathological characteristics of patients with xerostomia and diagnosis of SS and presumptive diagnosis of Sjögren's syndrome in Medellín-Colombia, 2018-2020.
Materials and methods
The study was a quantitative approach, with cross-sectional analysis. The participants were grouped into two groups: diagnosis of Sicca syndrome and presumptive diagnosis of Sjögren's syndrome, and a survey of sociodemographic data was applied. For each group, salivary flow measurements, Schirmer's test, salivary gland scintigraphic study, and histological evaluation were performed. Statistical analysis was performed using measures of central tendency (median) and dispersion (interquartile range), Fisher's exact test, and the Mann-Whitney U test.
Results
The sample consisted of 24 women. The most frequent systemic clinical sign was joint pain which was present in 90% of cases of Sicca syndrome and in 92.9% of cases of diagnosis presumptive Sjogren's syndrome, while the clinical signs of tongue depapillation were present in 100% of cases of Sicca syndrome and in 92.9% of cases of Sjögren's syndrome. Functional tests, unstimulated salivary flow rate, and salivary gland scintigraphy showed greater involvement in the group of presumptive diagnosis of Sjögren's syndrome. Histopathological analysis showed atrophic changes, fibrosis, and fatty changes in both categories.
Conclusion
The findings suggest that patients with a presumptive diagnosis of Sicca syndrome may be in an early phase of Sjögren's syndrome progression, so this study aims to establish an association of signs, symptoms, and diagnostic aids to define an accurate diagnosis and therapy.
{"title":"Evaluación de las características clínicas, gammagráficas e histopatológicas en pacientes con diagnóstico presuntivo de síndrome de Sjögren","authors":"Lina María Franco González , Leonor Victoria González Pérez , Mónica Vanessa Posso Zapata , Vanessa Andrea Flórez Arango","doi":"10.1016/j.rcreu.2024.10.001","DOIUrl":"10.1016/j.rcreu.2024.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Sicca syndrome is characterized by the presence of dry eye (xerophthalmia - keratoconjunctivitis sicca), dry mouth (xerostomia), and dry skin (xeroderma), this triad may be related to Sjögren's syndrome.</div></div><div><h3>Objective</h3><div>To associate the clinical, scintigraphic, and histopathological characteristics of patients with xerostomia and diagnosis of SS and presumptive diagnosis of Sjögren's syndrome in Medellín-Colombia, 2018-2020.</div></div><div><h3>Materials and methods</h3><div>The study was a quantitative approach, with cross-sectional analysis. The participants were grouped into two groups: diagnosis of Sicca syndrome and presumptive diagnosis of Sjögren's syndrome, and a survey of sociodemographic data was applied. For each group, salivary flow measurements, Schirmer's test, salivary gland scintigraphic study, and histological evaluation were performed. Statistical analysis was performed using measures of central tendency (median) and dispersion (interquartile range), Fisher's exact test, and the Mann-Whitney <em>U</em> test.</div></div><div><h3>Results</h3><div>The sample consisted of 24 women. The most frequent systemic clinical sign was joint pain which was present in 90% of cases of Sicca syndrome and in 92.9% of cases of diagnosis presumptive Sjogren's syndrome, while the clinical signs of tongue depapillation were present in 100% of cases of Sicca syndrome and in 92.9% of cases of Sjögren's syndrome. Functional tests, unstimulated salivary flow rate, and salivary gland scintigraphy showed greater involvement in the group of presumptive diagnosis of Sjögren's syndrome. Histopathological analysis showed atrophic changes, fibrosis, and fatty changes in both categories.</div></div><div><h3>Conclusion</h3><div>The findings suggest that patients with a presumptive diagnosis of Sicca syndrome may be in an early phase of Sjögren's syndrome progression, so this study aims to establish an association of signs, symptoms, and diagnostic aids to define an accurate diagnosis and therapy.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 236-246"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623427","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.2024.06.003
Jesica Gallo , Alejandro Varizat , Sergio Paira
A 52-year-old male presented with pain and induration of the skin and muscles. Physical examination revealed swelling and induration of the skin and muscles of the arms, forearms, hands, thorax, abdomen, and legs, accompanied by the characteristic orange peel appearance. In addition to bilateral hearing impairment, there was enlargement of both lacrimal glands. Laboratory results revealed hyper-eosinophilia, elevated C-reactive protein, and erythrocyte sedimentation rate, hypocomplementaemia, polyclonal hypergammaglobulinaemia, elevated IgE, IgG, and increased IgG1 and IgG4. MRI of the lower limbs reported enhanced contrast in the muscles of both thighs with thickening of the semimembranosus vastus lateralis fascia and arms. A skin and fascia biopsy indicated lymphoplasmacytic infiltrate, eosinophils, and non-storiform fibrosis. Immunohistochemistry showed IgG4 positivity in less than 10%, with an IgG4/lgG range of less than 40%. The patient meets the criteria for eosinophilic fasciitis and ACR/EULAR criteria for IgG4-RD. For this reason, we would like to report the first case found of eosinophilic fasciitis associated with IgG4-RD.
{"title":"Eosinophilic fasciitis associated with IgG4-related disease","authors":"Jesica Gallo , Alejandro Varizat , Sergio Paira","doi":"10.1016/j.rcreu.2024.06.003","DOIUrl":"10.1016/j.rcreu.2024.06.003","url":null,"abstract":"<div><div>A 52-year-old male presented with pain and induration of the skin and muscles. Physical examination revealed swelling and induration of the skin and muscles of the arms, forearms, hands, thorax, abdomen, and legs, accompanied by the characteristic orange peel appearance. In addition to bilateral hearing impairment, there was enlargement of both lacrimal glands. Laboratory results revealed hyper-eosinophilia, elevated C-reactive protein, and erythrocyte sedimentation rate, hypocomplementaemia, polyclonal hypergammaglobulinaemia, elevated IgE, IgG, and increased IgG1 and IgG4. MRI of the lower limbs reported enhanced contrast in the muscles of both thighs with thickening of the semimembranosus vastus lateralis fascia and arms. A skin and fascia biopsy indicated lymphoplasmacytic infiltrate, eosinophils, and non-storiform fibrosis. Immunohistochemistry showed IgG4 positivity in less than 10%, with an IgG4/lgG range of less than 40%. The patient meets the criteria for eosinophilic fasciitis and ACR/EULAR criteria for IgG4-RD. For this reason, we would like to report the first case found of eosinophilic fasciitis associated with IgG4-RD.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 3","pages":"Pages 294-297"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreu.2024.01.001
Alejandra Betancur Herrera , Juan José Mariño Restrepo , Tulio Lopera Restrepo , Laura Robledo Montoya , Juan Felipe Soto Restrepo , Adriana Lucía Vanegas García , Carlos Horacio Muñoz Vahos , Juan Camilo Díaz Coronado , Ricardo Antonio Pineda Tamayo , Gloria Vásquez
Introduction
Systemic lupus erythematosus (SLE) is a complex autoimmune disease in which B cell hyperactivity plays a key role in its pathophysiology. In this disease, the B cell activating factor (BAFF) is implicated in the loss of immunological tolerance, and high concentrations of this factor have been linked to disease progression. It is unknown how induction therapies with cyclophosphamide (CFM) or mycophenolate (MMF) modulate BAFF levels.
Objective
To determine how induction therapies modulate BAFF concentrations.
Materials and methods
An analytical observational study was performed with 20 patients with SLE from two institutions between 2020-2022, clinical and laboratory information was obtained from medical records. Measurement of serum BAFF levels was performed using an ELISA kit and statistical analyses with GraphPad Prism version 9.
Results
20 patients with a diagnosis of SLE, 18 with CFM and 2 with MMF, were included, nine patients at baseline and eleven at 3-6 months. The median BAFF in SLE patients was 902.2 pg/mL and 379.7 pg/mL in healthy controls, statistically significant differences (p = .0003). BAFF levels were also found to be different among patients treated with antimalarials (p = .0465) and an inverse correlation with creatinine values and prednisolone doses was also observed.
Conclusions
BAFF levels are affected during induction therapy, observing an initial reduction and subsequent recovery at 3-6 months, our results suggest that chloroquine and high doses of prednisolone maintain lower serum BAFF levels.
{"title":"Efecto de la terapia de inducción con micofenolato o ciclofosfamida sobre los niveles séricos del factor activador de células B (BAFF) en pacientes con lupus eritematoso sistémico","authors":"Alejandra Betancur Herrera , Juan José Mariño Restrepo , Tulio Lopera Restrepo , Laura Robledo Montoya , Juan Felipe Soto Restrepo , Adriana Lucía Vanegas García , Carlos Horacio Muñoz Vahos , Juan Camilo Díaz Coronado , Ricardo Antonio Pineda Tamayo , Gloria Vásquez","doi":"10.1016/j.rcreu.2024.01.001","DOIUrl":"10.1016/j.rcreu.2024.01.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic lupus erythematosus (SLE) is a complex autoimmune disease in which B cell hyperactivity plays a key role in its pathophysiology. In this disease, the B cell activating factor (BAFF) is implicated in the loss of immunological tolerance, and high concentrations of this factor have been linked to disease progression. It is unknown how induction therapies with cyclophosphamide (CFM) or mycophenolate (MMF) modulate BAFF levels.</div></div><div><h3>Objective</h3><div>To determine how induction therapies modulate BAFF concentrations.</div></div><div><h3>Materials and methods</h3><div>An analytical observational study was performed with 20 patients with SLE from two institutions between 2020-2022, clinical and laboratory information was obtained from medical records. Measurement of serum BAFF levels was performed using an ELISA kit and statistical analyses with GraphPad Prism version 9.</div></div><div><h3>Results</h3><div>20 patients with a diagnosis of SLE, 18 with CFM and 2 with MMF, were included, nine patients at baseline and eleven at 3-6 months. The median BAFF in SLE patients was 902.2 pg/mL and 379.7 pg/mL in healthy controls, statistically significant differences (p<!--> <!-->=<!--> <!-->.0003). BAFF levels were also found to be different among patients treated with antimalarials (p<!--> <!-->=<!--> <!-->.0465) and an inverse correlation with creatinine values and prednisolone doses was also observed.</div></div><div><h3>Conclusions</h3><div>BAFF levels are affected during induction therapy, observing an initial reduction and subsequent recovery at 3-6 months, our results suggest that chloroquine and high doses of prednisolone maintain lower serum BAFF levels.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 2","pages":"Pages 118-129"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140282998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreu.2024.02.006
Yeimy Paola Trujillo , Alfonso Kerguelen , Sandra Amado , Santiago Bernal-Macías , Daniel Gerardo Fernández-Ávila , Alfonso Barreto-Prieto , Luz-Stella Rodríguez
Objective
To describe the urinary levels of molecules related to removing apoptotic cells and triggering inflammation, as well as cytokines involved in Colombian patients with systemic lupus erythematosus without and with lupus nephritis compared to healthy controls.
Materials and methods
Urine samples were taken from three groups of patients: healthy controls (n = 7), patients with systemic lupus erythematosus without lupus nephritis (n = 7), and patients with lupus and lupus nephritis (n = 4). The urine sample was collected and concentrated by ultrafiltration. A western blot evaluated HMGB1, Histone H3, Calreticulin (CRT), Annexin A1 and CD46, CX3CL1 by ELISA and cytokines such as IL-8, IL-6, IL-12p70, TNF-α, and IL-1β by flow cytometry.
Results
Histone H3 was detected in two patients, one with systemic lupus erythematosus without lupus nephritis and one with systemic lupus erythematosus and lupus nephritis. The detected band suggests a post-translational modification. There were no differences between the levels of HMGB1 and CX3CL1 in the study groups. CD46, Annexin A1, and CRT were not detected in our samples. When evaluating cytokines in urine, an increase in IL-8 was observed in the group of patients with systemic lupus erythematosus without nephritis compared to controls. For IL-6, an increase was found among patients without lupus nephritis when compared with patients with lupus nephritis. No differences were found between the urinary levels of the other cytokines evaluated (IL-12p70, TNF-α, IL-1β, and IL-10).
Conclusion
Urinary histone H3 and IL-8 levels may be interesting molecules to be evaluated in more patients with systemic lupus erythematosus, while HMGB1 and CX3CL1 are not useful. Further evaluation of patients is required to confirm these findings.
{"title":"Potenciales biomarcadores presentes en orina de pacientes con lupus eritematoso sistémico: estudio exploratorio en pacientes colombianos","authors":"Yeimy Paola Trujillo , Alfonso Kerguelen , Sandra Amado , Santiago Bernal-Macías , Daniel Gerardo Fernández-Ávila , Alfonso Barreto-Prieto , Luz-Stella Rodríguez","doi":"10.1016/j.rcreu.2024.02.006","DOIUrl":"10.1016/j.rcreu.2024.02.006","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the urinary levels of molecules related to removing apoptotic cells and triggering inflammation, as well as cytokines involved in Colombian patients with systemic lupus erythematosus without and with lupus nephritis compared to healthy controls.</div></div><div><h3>Materials and methods</h3><div>Urine samples were taken from three groups of patients: healthy controls (n<!--> <!-->=<!--> <!-->7), patients with systemic lupus erythematosus without lupus nephritis (n<!--> <!-->=<!--> <!-->7), and patients with lupus and lupus nephritis (n<!--> <!-->=<!--> <!-->4). The urine sample was collected and concentrated by ultrafiltration. A western blot evaluated HMGB1, Histone H3, Calreticulin (CRT), Annexin A1 and CD46, CX3CL1 by ELISA and cytokines such as IL-8, IL-6, IL-12p70, TNF-α, and IL-1β by flow cytometry.</div></div><div><h3>Results</h3><div>Histone H3 was detected in two patients, one with systemic lupus erythematosus without lupus nephritis and one with systemic lupus erythematosus and lupus nephritis. The detected band suggests a post-translational modification. There were no differences between the levels of HMGB1 and CX3CL1 in the study groups. CD46, Annexin A1, and CRT were not detected in our samples. When evaluating cytokines in urine, an increase in IL-8 was observed in the group of patients with systemic lupus erythematosus without nephritis compared to controls. For IL-6, an increase was found among patients without lupus nephritis when compared with patients with lupus nephritis. No differences were found between the urinary levels of the other cytokines evaluated (IL-12p70, TNF-α, IL-1β, and IL-10).</div></div><div><h3>Conclusion</h3><div>Urinary histone H3 and IL-8 levels may be interesting molecules to be evaluated in more patients with systemic lupus erythematosus, while HMGB1 and CX3CL1 are not useful. Further evaluation of patients is required to confirm these findings.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 2","pages":"Pages 159-167"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreu.2023.12.008
Fabiola Pazos-Pérez , Aida Martínez-Badajoz , Francisco M. Bravo-Rojas , Estafanía Garduño-Hernández , María I. Gil-Arredondo , Rocío Catana-Hernández , Mario C. Ocampo-Torres , Juan C. Hernández-Rivera
Introduction
Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease that presents great clinical heterogeneity, so that up to 60% of patients may develop lupus nephropathy (LN).
Objective
To identify demographic, clinical, and biochemical characteristics of patients presenting with and without lupus nephritis at the time of SLE diagnosis in a cohort of Mexican patients.
Materials and methods
This is a cross-sectional, analytical, and single-centre study. Frequencies and percentages were used for categorical variables and the comparison was made with Pearson's Chi2 statistical test or Fisher's exact test. For the quantitative variables, their distribution was calculated and according to this, Student's t was used in case of normal distribution and Mann-Whitney U for those with free distribution.
Results
Of 160 patients, 79 (49.37%) had LN. These individuals had a higher prevalence of serositis (14.3 vs 8.1%, p = .048) and arterial hypertension (40.50% vs 24.6%, p = .033), while those without LN had a higher prevalence of rheumatoid arthritis and joint disease (6 vs 1%, p = .052), allergies (43.2 vs 20.25%, p = .002), infections (23.45 vs 10%, p = .020), and lower levels of C3 (52.25 ± 28.7 vs 74.6 ± 32.2 mg/dl, p < .001).
Conclusions
The characteristics described in our cohort are like those presented in other Latino and Asian series. However, the presence of concomitant infections at the time of SLE diagnosis has not been described and should be considered for future research.
系统性红斑狼疮（SLE）是一种自身免疫性炎症性疾病，具有很大的临床异质性，因此高达60%的患者可发展为狼疮肾病（LN）。目的在一组墨西哥患者中，确定SLE诊断时伴有和不伴有狼疮性肾炎患者的人口学、临床和生化特征。材料和方法这是一项横断面、分析性、单中心研究。分类变量采用频率和百分比，采用Pearson's Chi2统计检验或Fisher's精确检验进行比较。对于定量变量，计算其分布，在正态分布情况下使用Student’st，在自由分布情况下使用Mann-Whitney U。结果160例患者中有79例（49.37%）发生LN。这些人有较高的血清炎患病率（14.3 vs 8.1%, p = 0.048）和动脉高血压患病率（40.50% vs 24.6%, p = 0.033），而那些没有LN的人有较高的类风湿关节炎和关节疾病患病率（6 vs 1%, p = 0.052）、过敏（43.2 vs 20.25%, p = 0.002）、感染（23.45 vs 10%, p = 0.020）和较低的C3水平(52.25±28.7 vs 74.6±32.2 mg/dl, p <；措施)。结论：在我们的队列中描述的特征与其他拉丁美洲和亚洲系列的特征相似。然而，在SLE诊断时是否存在合并感染尚未被描述，应在未来的研究中予以考虑。
{"title":"Características sociodemográficas, clínicas y bioquímicas de pacientes que debutaron con y sin nefritis lúpica en una cohorte de pacientes mexicanos con lupus eritematoso sistémico en un centro de referencia","authors":"Fabiola Pazos-Pérez , Aida Martínez-Badajoz , Francisco M. Bravo-Rojas , Estafanía Garduño-Hernández , María I. Gil-Arredondo , Rocío Catana-Hernández , Mario C. Ocampo-Torres , Juan C. Hernández-Rivera","doi":"10.1016/j.rcreu.2023.12.008","DOIUrl":"10.1016/j.rcreu.2023.12.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Systemic lupus erythematosus (SLE) is an autoimmune inflammatory disease that presents great clinical heterogeneity, so that up to 60% of patients may develop lupus nephropathy (LN).</div></div><div><h3>Objective</h3><div>To identify demographic, clinical, and biochemical characteristics of patients presenting with and without lupus nephritis at the time of SLE diagnosis in a cohort of Mexican patients.</div></div><div><h3>Materials and methods</h3><div>This is a cross-sectional, analytical, and single-centre study. Frequencies and percentages were used for categorical variables and the comparison was made with Pearson's Chi2 statistical test or Fisher's exact test. For the quantitative variables, their distribution was calculated and according to this, Student's t was used in case of normal distribution and Mann-Whitney U for those with free distribution.</div></div><div><h3>Results</h3><div>Of 160 patients, 79 (49.37%) had LN. These individuals had a higher prevalence of serositis (14.3 vs 8.1%, p<!--> <!-->=<!--> <!-->.048) and arterial hypertension (40.50% vs 24.6%, p<!--> <!-->=<!--> <!-->.033), while those without LN had a higher prevalence of rheumatoid arthritis and joint disease (6 vs 1%, p<!--> <!-->=<!--> <!-->.052), allergies (43.2 vs 20.25%, p<!--> <!-->=<!--> <!-->.002), infections (23.45 vs 10%, p<!--> <!-->=<!--> <!-->.020), and lower levels of C3 (52.25<!--> <!-->±<!--> <!-->28.7 vs 74.6<!--> <!-->±<!--> <!-->32.2<!--> <!-->mg/dl, p <<!--> <!-->.001).</div></div><div><h3>Conclusions</h3><div>The characteristics described in our cohort are like those presented in other Latino and Asian series. However, the presence of concomitant infections at the time of SLE diagnosis has not been described and should be considered for future research.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 2","pages":"Pages 110-117"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140274096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreu.2024.01.005
Jaime Andrés Escobar Sáenz , Oscar Muñoz Velandia , Paula Ruiz Talero , Daniel Fernández Ávila
Introduction
In clinical practice, there is no established guidance on the timing of sample collection when suspicion of antiphospholipid syndrome (APS) arises. Instead, only a list of risk factors for APS exists, without adequate quantification of the significance of each factor.
Materials and methods
Analytical observational case-control study, nested in a retrospective cohort of patients with venous or arterial thrombosis in whom APS was suspected. Patients with a confirmed diagnosis of APS according to the Sapporo criteria or triple positive initial result (cases) were compared with patients negative for APS (controls). The aim was to assess the association between the diagnosis of APS and various clinical and paraclinical factors.
Results
68 patients were included (72% women, 41.2% with deep venous thromboembolism and 29.4% with pulmonary embolism). In 18 patients APS was confirmed. There were no significant differences in age in patients with and without confirmation of the diagnosis (44.0 ± 17.9 vs. 51.2 ± 14.9, P = .069). In the multivariate analysis, a significant and independent association was found between having APS and rheumatic disease (OR: 12.1, P = .02), PTT prolongation (OR: 17.6, P = .014), platelet count < 150,000 (OR: 18.6, P = .008), and a history of previous thrombosis events (OR: 6.1 for each event, P = .027).
Conclusions
In patients with arterial or venous thrombosis, there is a greater possibility of confirming APS if there is a history of rheumatic disease, prolongation of PTT to more than 5 seconds, thrombocytopenia, and previous events of thrombotic disease. In these patients, it is advisable to screen for APS, to prevent the further occurrence of thrombotic events.
在临床实践中，当怀疑出现抗磷脂综合征（APS）时，没有既定的样本采集时间指导。相反，只有APS的危险因素列表存在，没有充分量化每个因素的重要性。材料和方法分析观察性病例对照研究，纳入了一组疑似APS的静脉或动脉血栓患者的回顾性队列。根据Sapporo标准确诊APS的患者或初始结果三阳性的患者（病例）与APS阴性的患者（对照组）进行比较。目的是评估APS的诊断与各种临床和临床旁因素之间的关系。结果共纳入68例患者（72%为女性，41.2%为深静脉血栓栓塞，29.4%为肺栓塞）。18例患者确诊APS。确诊与未确诊患者的年龄差异无统计学意义（44.0±17.9∶51.2±14.9,P = 0.069）。在多因素分析中，APS与风湿病（OR: 12.1, P = 0.02）、PTT延长（OR: 17.6, P = 0.014）、血小板计数和lt之间存在显著且独立的关联；15万（OR: 18.6, P = 0.008），以及既往血栓事件（OR: 6.1, P = 0.027）。结论在动脉或静脉血栓形成的患者中，有风湿病史、PTT延长5秒以上、血小板减少、血栓性疾病既往事件的患者，APS的确诊可能性较大。在这些患者中，建议筛查APS，以防止血栓事件的进一步发生。
{"title":"Factores asociados con el diagnóstico de síndrome antifosfolípido: ¿cuándo debemos solicitar los estudios?","authors":"Jaime Andrés Escobar Sáenz , Oscar Muñoz Velandia , Paula Ruiz Talero , Daniel Fernández Ávila","doi":"10.1016/j.rcreu.2024.01.005","DOIUrl":"10.1016/j.rcreu.2024.01.005","url":null,"abstract":"<div><h3>Introduction</h3><div>In clinical practice, there is no established guidance on the timing of sample collection when suspicion of antiphospholipid syndrome (APS) arises. Instead, only a list of risk factors for APS exists, without adequate quantification of the significance of each factor.</div></div><div><h3>Materials and methods</h3><div>Analytical observational case-control study, nested in a retrospective cohort of patients with venous or arterial thrombosis in whom APS was suspected. Patients with a confirmed diagnosis of APS according to the Sapporo criteria or triple positive initial result (cases) were compared with patients negative for APS (controls). The aim was to assess the association between the diagnosis of APS and various clinical and paraclinical factors.</div></div><div><h3>Results</h3><div>68 patients were included (72% women, 41.2% with deep venous thromboembolism and 29.4% with pulmonary embolism). In 18 patients APS was confirmed. There were no significant differences in age in patients with and without confirmation of the diagnosis (44.0<!--> <!-->±<!--> <!-->17.9 vs. 51.2<!--> <!-->±<!--> <!-->14.9, <em>P</em> <!-->=<!--> <!-->.069). In the multivariate analysis, a significant and independent association was found between having APS and rheumatic disease (OR: 12.1, <em>P</em> <!-->=<!--> <!-->.02), PTT prolongation (OR: 17.6, <em>P</em> <!-->=<!--> <!-->.014), platelet count <<!--> <!-->150,000 (OR: 18.6, <em>P</em> <!-->=<!--> <!-->.008), and a history of previous thrombosis events (OR: 6.1 for each event, <em>P</em> <!-->=<!--> <!-->.027).</div></div><div><h3>Conclusions</h3><div>In patients with arterial or venous thrombosis, there is a greater possibility of confirming APS if there is a history of rheumatic disease, prolongation of PTT to more than 5<!--> <!-->seconds, thrombocytopenia, and previous events of thrombotic disease. In these patients, it is advisable to screen for APS, to prevent the further occurrence of thrombotic events.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 2","pages":"Pages 137-144"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140402098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-01DOI: 10.1016/j.rcreu.2024.02.004
Santiago Guzmán-García , Goethe Sacoto-Flores , Johanna Román-Bermeo , Fabiana Samaniego-Burneo , María Ochoa , Franklin Uguña-Sari , Gladis Molina-Alvarado , Luis M. Amezcua-Guerra
Introduction/objectives
The understanding of COVID-19 progression among patients with autoimmune rheumatic diseases (SARDs) in Latin America remains limited. This study aimed to identify risk predictors associated with poor outcomes of COVID-19 in patients with SARDs.
Materials and methods
An observational multicentre study including patients with SARDs from Ecuador and Mexico.
Results
A total of 103 patients (78% women), aged 52.5 ± 17.7 years, were enrolled. The most prevalent SARDs were rheumatoid arthritis (59%) and systemic lupus erythematosus (SLE; 24%). Severe COVID-19 was observed in 28% of patients at admission, 43% experienced complications during follow-up, and 8% ultimately died. Mortality rates were highest in patients with antiphospholipid syndrome (27%) or SLE (20%). Poor prognostic factors included acute respiratory distress syndrome (odds ratio [OR] = 17.07), severe COVID-19 at admission (OR = 11.45), and presence of SLE (OR = 4.62). In multivariate analysis, SLE emerged as the sole predictor of mortality (OR = 15.61).
Conclusions
Patients with SARDs in Latin America face significant risks of adverse COVID-19 outcomes, with SLE being a major risk factor for mortality.
{"title":"Risk predictors for adverse COVID-19 outcomes in Latin American patients with autoimmune rheumatic diseases: A multicentre study in Ecuador and Mexico","authors":"Santiago Guzmán-García , Goethe Sacoto-Flores , Johanna Román-Bermeo , Fabiana Samaniego-Burneo , María Ochoa , Franklin Uguña-Sari , Gladis Molina-Alvarado , Luis M. Amezcua-Guerra","doi":"10.1016/j.rcreu.2024.02.004","DOIUrl":"10.1016/j.rcreu.2024.02.004","url":null,"abstract":"<div><h3>Introduction/objectives</h3><div>The understanding of COVID-19 progression among patients with autoimmune rheumatic diseases (SARDs) in Latin America remains limited. This study aimed to identify risk predictors associated with poor outcomes of COVID-19 in patients with SARDs.</div></div><div><h3>Materials and methods</h3><div>An observational multicentre study including patients with SARDs from Ecuador and Mexico.</div></div><div><h3>Results</h3><div>A total of 103 patients (78% women), aged 52.5<!--> <!-->±<!--> <!-->17.7 years, were enrolled. The most prevalent SARDs were rheumatoid arthritis (59%) and systemic lupus erythematosus (SLE; 24%). Severe COVID-19 was observed in 28% of patients at admission, 43% experienced complications during follow-up, and 8% ultimately died. Mortality rates were highest in patients with antiphospholipid syndrome (27%) or SLE (20%). Poor prognostic factors included acute respiratory distress syndrome (odds ratio [OR]<!--> <!-->=<!--> <!-->17.07), severe COVID-19 at admission (OR<!--> <!-->=<!--> <!-->11.45), and presence of SLE (OR<!--> <!-->=<!--> <!-->4.62). In multivariate analysis, SLE emerged as the sole predictor of mortality (OR<!--> <!-->=<!--> <!-->15.61).</div></div><div><h3>Conclusions</h3><div>Patients with SARDs in Latin America face significant risks of adverse COVID-19 outcomes, with SLE being a major risk factor for mortality.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 2","pages":"Pages 152-158"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143767990","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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