Pub Date : 2025-01-01DOI: 10.1016/j.rcreu.2023.11.003
Eduardo Tuta-Quintero , Isabella Perna-Reyes , Juan Olivella-Gómez , Daniela Rodríguez-Fraile , Juan C. Santacruz , Andrea A. Mayorga-Borja , John Londoño
Mepolizumab (MPZ) is a therapeutic option for eosinophilic granulomatosis with polyangiitis (EGPA). However, the evidence on its efficacy, effectiveness, and safety is limited. Our results included 17 full-text articles evaluating the use of MPZ in patients diagnosed with EGPA, 47% (8/17) of the documents were case reports, 18% (3/17) retrospective cohort studies, 12% (2/17) clinical trials, and 6% corresponded to a prospective cohort (1/17), ambispective cohort (1/17), case series (1/17), and pilot study (1/17). The most frequently used dose of MPZ was 300 mg/month, described in 59% (10/17) of the included manuscripts. The decrease in the Birmingham Vasculitis Activity Score (BVAS), reduction in the dose of corticosteroids, and modulation in the number of eosinophils in the blood were the variables most used to determine the clinical effect in patients. Finally, 10 clinical trial records were included describing the design, conduct, and administration of the ongoing studies. The use of MPZ in patients with EGPA shows a reduction in the BVAS, saving oral corticosteroids and modulating blood hypereosinophilia. The adverse events described were mild and moderate in all the included studies.
{"title":"Evidencia terapéutica del mepolizumab en la granulomatosis eosinofílica con poliangeítis: una revisión exploratoria","authors":"Eduardo Tuta-Quintero , Isabella Perna-Reyes , Juan Olivella-Gómez , Daniela Rodríguez-Fraile , Juan C. Santacruz , Andrea A. Mayorga-Borja , John Londoño","doi":"10.1016/j.rcreu.2023.11.003","DOIUrl":"10.1016/j.rcreu.2023.11.003","url":null,"abstract":"<div><div>Mepolizumab (MPZ) is a therapeutic option for eosinophilic granulomatosis with polyangiitis (EGPA). However, the evidence on its efficacy, effectiveness, and safety is limited. Our results included 17 full-text articles evaluating the use of MPZ in patients diagnosed with EGPA, 47% (8/17) of the documents were case reports, 18% (3/17) retrospective cohort studies, 12% (2/17) clinical trials, and 6% corresponded to a prospective cohort (1/17), ambispective cohort (1/17), case series (1/17), and pilot study (1/17). The most frequently used dose of MPZ was 300 mg/month, described in 59% (10/17) of the included manuscripts. The decrease in the Birmingham Vasculitis Activity Score (BVAS), reduction in the dose of corticosteroids, and modulation in the number of eosinophils in the blood were the variables most used to determine the clinical effect in patients. Finally, 10 clinical trial records were included describing the design, conduct, and administration of the ongoing studies. The use of MPZ in patients with EGPA shows a reduction in the BVAS, saving oral corticosteroids and modulating blood hypereosinophilia. The adverse events described were mild and moderate in all the included studies.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 69-83"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139818067","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}
The diagnosis of sarcoidosis is challenging, especially if the patient has concomitant infectious symptoms. Furthermore, the overlap of immune-mediated and infectious pathologies is not uncommon.
Objective
To report a rare case of association between tuberculosis and sarcoidosis.
Materials and methods
Description of the clinical characteristics of a patient who presented with sarcoidosis superimposed on tuberculosis.
Results
The case of a 29-year-old man with ocular, cutaneous, and systemic symptoms is described. Uveitis and chronic non-caseating granulomatous findings were diagnosed in the skin, lungs, and lymph nodes. Suspicion of tuberculosis led to positive molecular biology tests only in the lymph node biopsy. An overlap of sarcoidosis and tuberculosis was determined, and combined treatment with glucocorticoids and anti-tuberculosis agents was initiated, resulting in improvement of the patient.
Conclusions
Sarcoidosis and tuberculosis share characteristics from their aetiology to clinical manifestations, posing a challenge in clinical differentiation. Cases have been documented where both diseases overlap in the same patient.
{"title":"Convergencia clínica: un caso excepcional de sarcoidosis y tuberculosis con múltiples manifestaciones orgánicas. Reporte de caso","authors":"Néstor Correa-González , María Claudia Díaz , Keyla Jemihah Triana Ángel , María Daniela Polania , Natalia Remolina Murillo , Pilar Alarcón Robles","doi":"10.1016/j.rcreu.2024.01.004","DOIUrl":"10.1016/j.rcreu.2024.01.004","url":null,"abstract":"<div><h3>Introduction</h3><div>The diagnosis of sarcoidosis is challenging, especially if the patient has concomitant infectious symptoms. Furthermore, the overlap of immune-mediated and infectious pathologies is not uncommon.</div></div><div><h3>Objective</h3><div>To report a rare case of association between tuberculosis and sarcoidosis.</div></div><div><h3>Materials and methods</h3><div>Description of the clinical characteristics of a patient who presented with sarcoidosis superimposed on tuberculosis.</div></div><div><h3>Results</h3><div>The case of a 29-year-old man with ocular, cutaneous, and systemic symptoms is described. Uveitis and chronic non-caseating granulomatous findings were diagnosed in the skin, lungs, and lymph nodes. Suspicion of tuberculosis led to positive molecular biology tests only in the lymph node biopsy. An overlap of sarcoidosis and tuberculosis was determined, and combined treatment with glucocorticoids and anti-tuberculosis agents was initiated, resulting in improvement of the patient.</div></div><div><h3>Conclusions</h3><div>Sarcoidosis and tuberculosis share characteristics from their aetiology to clinical manifestations, posing a challenge in clinical differentiation. Cases have been documented where both diseases overlap in the same patient.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 95-102"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140399070","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 : 2025-01-01DOI: 10.1016/j.rcreu.2024.01.007
Elías Gonzalo Forero Illera , Andrés Ricardo Fernández Aldana , Daniel Gerardo Fernández Ávila , Edwin Antonio Jáuregui Cuartas , Gloria Vásquez , Monique Chalem , Wilson Bautista Molano
{"title":"Consenso para la gestión de riesgo en la prescripción de terapias biológicas o de antirreumáticos sintéticos con blanco dirigido: Asociación Colombiana de Reumatología 2023","authors":"Elías Gonzalo Forero Illera , Andrés Ricardo Fernández Aldana , Daniel Gerardo Fernández Ávila , Edwin Antonio Jáuregui Cuartas , Gloria Vásquez , Monique Chalem , Wilson Bautista Molano","doi":"10.1016/j.rcreu.2024.01.007","DOIUrl":"10.1016/j.rcreu.2024.01.007","url":null,"abstract":"","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 56-68"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133938","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 : 2025-01-01DOI: 10.1016/j.rcreu.2024.11.001
Jorge Alberto Cortés
{"title":"Riesgo de tuberculosis en pacientes con inmunosupresión: en búsqueda de una vieja conocida","authors":"Jorge Alberto Cortés","doi":"10.1016/j.rcreu.2024.11.001","DOIUrl":"10.1016/j.rcreu.2024.11.001","url":null,"abstract":"","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 1-2"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143133946","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 : 2025-01-01DOI: 10.1016/j.rcreu.2023.10.005
Luz Adriana Gómez-Ramírez , Laura Betancur-Gómez , Estefanía Tabares-Ramírez , Sofía Villada-Montoya , Libia María Rodríguez-Padilla , María Fernanda Álvarez-Barreneche , Carlos Jaime Velásquez-Franco , Miguel Antonio Mesa-Navas , Marcela Posada-Velásquez
Introduction
Salivary gland biopsy is the gold standard for the diagnosis of Sjogren's syndrome. There are several approaches for the realization of the biopsy, being generally used an approach to the mucosa with the use of various instruments and incisions that vary in its length, passing through trucut biopsy to scraping with needle.
Objective
Evaluate the performance, complications and histological report systems of the minor salivary gland biopsy with a minimally invasive technique.
Materials and methods
We conducted a descriptive study that included adult patients undergoing salivary gland biopsy between 2017-2022. Medical records and salivary gland biopsy reports were used to collect information and registered in the Magpi platform. Sociodemographic, clinical, and histopathological variables were recorded. The qualitative variables were expressed in absolute and relative frequencies; the quantitative ones were by median and interquartile range. Seventy-two biopsies were included.
Results
Regarding demographic characteristics, 87,5% were women with a median age of 52 years. The biopsy characteristics showed that 70 (97,2%) corresponded to a representative sample. Twenty-seven (38,5%) biopsies showed lymphocytic infiltration and reported a classification system, of which the most used one was the Chisholm Mason used in 18 (66,6%) of such biopsies. Complications were present in four (5,7%) patients.
Conclusions
Despite the recommendation of using Focus Score for classification criteria, the Chisholm Mason system is still the most widely used. The present technique is a safe and effective for the realization of minor salivary gland biopsy.
{"title":"Hallazgos histológicos y complicaciones en pacientes con biopsia de glándula salival en dos instituciones de Medellín, Colombia: estudio descriptivo","authors":"Luz Adriana Gómez-Ramírez , Laura Betancur-Gómez , Estefanía Tabares-Ramírez , Sofía Villada-Montoya , Libia María Rodríguez-Padilla , María Fernanda Álvarez-Barreneche , Carlos Jaime Velásquez-Franco , Miguel Antonio Mesa-Navas , Marcela Posada-Velásquez","doi":"10.1016/j.rcreu.2023.10.005","DOIUrl":"10.1016/j.rcreu.2023.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Salivary gland biopsy is the gold standard for the diagnosis of Sjogren's syndrome. There are several approaches for the realization of the biopsy, being generally used an approach to the mucosa with the use of various instruments and incisions that vary in its length, passing through trucut biopsy to scraping with needle.</div></div><div><h3>Objective</h3><div>Evaluate the performance, complications and histological report systems of the minor salivary gland biopsy with a minimally invasive technique.</div></div><div><h3>Materials and methods</h3><div>We conducted a descriptive study that included adult patients undergoing salivary gland biopsy between 2017-2022. Medical records and salivary gland biopsy reports were used to collect information and registered in the Magpi platform. Sociodemographic, clinical, and histopathological variables were recorded. The qualitative variables were expressed in absolute and relative frequencies; the quantitative ones were by median and interquartile range. Seventy-two biopsies were included.</div></div><div><h3>Results</h3><div>Regarding demographic characteristics, 87,5% were women with a median age of 52 years. The biopsy characteristics showed that 70 (97,2%) corresponded to a representative sample. Twenty-seven (38,5%) biopsies showed lymphocytic infiltration and reported a classification system, of which the most used one was the Chisholm Mason used in 18 (66,6%) of such biopsies. Complications were present in four (5,7%) patients.</div></div><div><h3>Conclusions</h3><div>Despite the recommendation of using Focus Score for classification criteria, the Chisholm Mason system is still the most widely used. The present technique is a safe and effective for the realization of minor salivary gland biopsy.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 3-9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139634928","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 : 2025-01-01DOI: 10.1016/j.rcreu.2023.11.002
Juan Fernando Rivadeneira Jácome, Lara Montserrat González García
Introduction
The prevalence of rheumatic disease in the general population is approximately 10%. At the same time, there has been an increase in the workload of rheumatology services, particularly concerning consultations. Many health institutions have limited the duration of rheumatology consultation to about 15 min. This article demonstrates the need to lengthen the duration rheumatology consultations.
Objective
The goal of this work is to review the literature about the standards for the duration of rheumatology consultations and to propose new organizational strategies in this regard.
Materials and methods
A narrative review of the current literature related to care standards in rheumatology consultations was carried out, including the wide variety of diagnostic procedures, which decisively influence the duration of these consultations.
Results
Organizational strategies are proposed, based on classifying consultations into first, second, and follow-up visits, with a specific daily number, and giving more time to the first 2 types of consultations.
Conclusion
Although this planning implies greater effort on the part of administrative staff, it will undoubtedly result in a better quality of care for rheumatology patients.
{"title":"Estrategias para la organización de las consultas de reumatología","authors":"Juan Fernando Rivadeneira Jácome, Lara Montserrat González García","doi":"10.1016/j.rcreu.2023.11.002","DOIUrl":"10.1016/j.rcreu.2023.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The prevalence of rheumatic disease in the general population is approximately 10%. At the same time, there has been an increase in the workload of rheumatology services, particularly concerning consultations. Many health institutions have limited the duration of rheumatology consultation to about 15<!--> <!-->min. This article demonstrates the need to lengthen the duration rheumatology consultations.</div></div><div><h3>Objective</h3><div>The goal of this work is to review the literature about the standards for the duration of rheumatology consultations and to propose new organizational strategies in this regard.</div></div><div><h3>Materials and methods</h3><div>A narrative review of the current literature related to care standards in rheumatology consultations was carried out, including the wide variety of diagnostic procedures, which decisively influence the duration of these consultations.</div></div><div><h3>Results</h3><div>Organizational strategies are proposed, based on classifying consultations into first, second, and follow-up visits, with a specific daily number, and giving more time to the first 2 types of consultations.</div></div><div><h3>Conclusion</h3><div>Although this planning implies greater effort on the part of administrative staff, it will undoubtedly result in a better quality of care for rheumatology patients.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 84-89"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139879923","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 : 2025-01-01DOI: 10.1016/j.rcreu.2023.11.007
Maria Pía Izaguirre Germain , Paola Ávila , Nauan Fara , Julia Pretini , María Elena Gaona , Pia Pissani , Maira Arias Saavedra , Valeria Aquino , Mariana Espindola Echazu , Manuela Laffont , Magdalena Acevedo , Lucrecia Garcia Faura , Romina Hassan , Karen Roberts , Jorge Alejandro Brigante , Damaris Álvarez , Marina Laura Micelli , Vanesa Laura Cosentino , Sandra Fabiana Montoya , Gabriel Sequeira , Eduardo Mario Kerzberg
Introduction
Many patients use the Internet as a source of health information and to create and share content of diverse quality of evidence, complementing and even competing with traditional sources of information.
Objectives
To evaluate differences between rheumatic patients who consult digital information sources (DISs) and those who do not (Non-DISs), and their perception of the credibility attributed to these sources by both groups.
Materials and methods
An observational cross-sectional study was conducted through an anonymous survey of patients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and spondyloarthritis. Patients were asked about their search for information from different DISs or Non-DISs. Patients rated the credibility they assigned to the different sources on a scale of 0 to 10, where 0 was no credibility and 10 was the maximum possible credibility.
Results
A total of 402 patients (79% female) were surveyed. Two hundred and 7 (51%) had consulted at least one DIS during the previous year (DISs group). The DISs group had consulted a total of 5 DISs and Non-DISs (First-Third Quartile: 3-7) vs. 2 (First-Third Quartile: 1-3) in the Non-DISs group (p< .001). The number of searches in DISs was higher at younger ages (OR .97 95% CI .95-.99) and at higher levels of education (secondary vs. primary OR 2.0; 95% CI 1.05-3.85). The DISs group assigned higher credibility to Facebook and YouTube than the other patients (median credibility of 6/10 and 6/10 vs. 2/10 and 1/10 respectively; P<.001). However, they did not assign lower credibility to traditional sources.
Conclusions
DISs are more frequently consulted by a younger population with a higher level of education. These patients consult multiple sources, but do not assign lower credibility to traditional information sources.
许多患者使用互联网作为健康信息的来源，并创建和分享各种质量证据的内容，与传统的信息来源相补充，甚至竞争。目的评价咨询数字信息源（DISs）和不咨询数字信息源（Non-DISs）的风湿病患者之间的差异，以及两组患者对数字信息源可信度的感知。材料和方法通过匿名调查对类风湿关节炎、系统性红斑狼疮、系统性硬化症和脊椎关节炎患者进行了一项观察性横断面研究。患者被问及他们从不同的DISs或非DISs中搜索信息的情况。患者对他们分配给不同来源的可信度进行评分，从0到10，其中0代表没有可信度，10代表最大可能的可信度。结果共调查402例患者，其中女性79%。277人（51%）在前一年至少咨询过一次DIS （DIS组）。DISs组共咨询了5位DISs和Non-DISs（第一-第三四分位数：3-7），而Non-DISs组(p<；措施)。DISs的搜索次数在较年轻的年龄（OR .97 95% CI .95- 0.99）和较高的教育水平(中学对小学OR 2.0；95% ci 1.05-3.85)。与其他患者相比，DISs组对Facebook和YouTube的可信度更高(中位可信度分别为6/10和6/10 vs. 2/10和1/10；术;措施)。然而，他们并没有降低传统消息来源的可信度。结论较年轻、受教育程度较高的人群更常咨询diss。这些患者咨询了多个来源，但并不认为传统信息来源的可信度较低。
{"title":"Características de los pacientes reumáticos que consultan fuentes de información digitales","authors":"Maria Pía Izaguirre Germain , Paola Ávila , Nauan Fara , Julia Pretini , María Elena Gaona , Pia Pissani , Maira Arias Saavedra , Valeria Aquino , Mariana Espindola Echazu , Manuela Laffont , Magdalena Acevedo , Lucrecia Garcia Faura , Romina Hassan , Karen Roberts , Jorge Alejandro Brigante , Damaris Álvarez , Marina Laura Micelli , Vanesa Laura Cosentino , Sandra Fabiana Montoya , Gabriel Sequeira , Eduardo Mario Kerzberg","doi":"10.1016/j.rcreu.2023.11.007","DOIUrl":"10.1016/j.rcreu.2023.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Many patients use the Internet as a source of health information and to create and share content of diverse quality of evidence, complementing and even competing with traditional sources of information.</div></div><div><h3>Objectives</h3><div>To evaluate differences between rheumatic patients who consult digital information sources (DISs) and those who do not (Non-DISs), and their perception of the credibility attributed to these sources by both groups.</div></div><div><h3>Materials and methods</h3><div>An observational cross-sectional study was conducted through an anonymous survey of patients with rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, and spondyloarthritis. Patients were asked about their search for information from different DISs or Non-DISs. Patients rated the credibility they assigned to the different sources on a scale of 0 to 10, where 0 was no credibility and 10 was the maximum possible credibility.</div></div><div><h3>Results</h3><div>A total of 402 patients (79% female) were surveyed. Two hundred and 7<!--> <!-->(51%) had consulted at least one DIS during the previous year (DISs group). The DISs group had consulted a total of 5 DISs and Non-DISs (First-Third Quartile: 3-7) vs. 2 (First-Third Quartile: 1-3) in the Non-DISs group (p<<!--> <!-->.001). The number of searches in DISs was higher at younger ages (OR .97 95% CI .95-.99) and at higher levels of education (secondary vs. primary OR 2.0; 95% CI 1.05-3.85). The DISs group assigned higher credibility to Facebook and YouTube than the other patients (median credibility of 6/10 and 6/10 vs. 2/10 and 1/10 respectively; <em>P</em><.001). However, they did not assign lower credibility to traditional sources.</div></div><div><h3>Conclusions</h3><div>DISs are more frequently consulted by a younger population with a higher level of education. These patients consult multiple sources, but do not assign lower credibility to traditional information sources.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 43-48"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139883063","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 : 2025-01-01DOI: 10.1016/j.rcreu.2024.01.003
Alejandra Espinosa Trujillo , Francisco Brañas Fernández , Aitor Abuín Blanco , Robustiano Pego Reigosa , María Rodríguez Rodríguez
Erdheim Chester disease (ECD) is a rare non-Langerhans cell histiocytosis. It is characterized by the infiltration of various organs and tissues by foamy histiocytes with a heterogeneous clinical course that varies from mild forms to disseminated forms with progressive and lethal behaviour. The case of a patient who presented with a cerebellar syndrome associated with autoimmune pathology is presented. In the course of the disease, refractoriness to glucocorticoids and clinical manifestation with bone involvement in the form of symmetrical osteosclerosis of long bones were determining factors for suspicion of this entity. We reviewed scientific articles through the PubMed metasearch engine with the keywords «erdheim chester disease», «erdheim chester and nervous system», and «autoimmunity and erdheim chester disease», selecting those with greater emphasis on clinical presentation with neurological involvement and associated autoimmune pathology. Advances in the pathogenesis of ECD have allowed us to understand the nature of the disease, as well as the use of targeted therapies. It is interesting to keep this entity in mind, as well as the pathologies with which it is frequently associated, with the objective of an early diagnosis and a better clinical approach.
{"title":"Enfermedad de Erdheim-Chester, una histiocitosis de células no Langerhans infrecuente y su asociación con el síndrome de Sjögren","authors":"Alejandra Espinosa Trujillo , Francisco Brañas Fernández , Aitor Abuín Blanco , Robustiano Pego Reigosa , María Rodríguez Rodríguez","doi":"10.1016/j.rcreu.2024.01.003","DOIUrl":"10.1016/j.rcreu.2024.01.003","url":null,"abstract":"<div><div>Erdheim Chester disease (ECD) is a rare non-Langerhans cell histiocytosis. It is characterized by the infiltration of various organs and tissues by foamy histiocytes with a heterogeneous clinical course that varies from mild forms to disseminated forms with progressive and lethal behaviour. The case of a patient who presented with a cerebellar syndrome associated with autoimmune pathology is presented. In the course of the disease, refractoriness to glucocorticoids and clinical manifestation with bone involvement in the form of symmetrical osteosclerosis of long bones were determining factors for suspicion of this entity. We reviewed scientific articles through the PubMed metasearch engine with the keywords «erdheim chester disease», «erdheim chester and nervous system», and «autoimmunity and erdheim chester disease», selecting those with greater emphasis on clinical presentation with neurological involvement and associated autoimmune pathology. Advances in the pathogenesis of ECD have allowed us to understand the nature of the disease, as well as the use of targeted therapies. It is interesting to keep this entity in mind, as well as the pathologies with which it is frequently associated, with the objective of an early diagnosis and a better clinical approach.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 90-94"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140405044","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 : 2025-01-01DOI: 10.1016/j.rcreu.2023.10.006
Luis Javier Cajas , María Carolina Torres , Mayelin Fernanda Ceballos
Introduction and objective
One-third of the world's population has latent tuberculosis. Because it can be reactivated by immunosuppressive treatments, screening is suggested. In Colombia, the tuberculin test with the booster is recommended in this population because of the risk of false negative results and anergy caused by treatments. Currently, the number of patients detected with this second test is unknown, so the primary objective is to determine the percentage of additional positive detections.
Materials and methods
From 2017 to 2022, a cross-sectional, analytical study was conducted on a group of patients from a rheumatology service who had a tuberculin test and a booster within a year to check for latent tuberculosis. Over the course of a year and three weeks, we looked at the number of patients whose booster tests showed new findings. A study was conducted to see if there were any differences in treatment based on the first tuberculin result.
Results
A tuberculin test was performed on 674 subjects, of whom 496 were immunosuppressed. From the 382 whose test was negative, 191 and 74 booster tests were performed within a year and three weeks; 8 (4.1%) and 3 (3.6%) were positive, respectively. When evaluating the differences in treatments between the groups with a positive and negative first tuberculin test, significant differences were found. Use of prednisolone at 5 mg or more per day (p = .02) and three immunosuppressants (p = .005) was more frequent in negative tuberculin tests.
Conclusions
It can be said that the booster test raises the number of people with latent tuberculosis by 4%. More use of prednisolone at 5 mg/day or three immunosuppressants in the group with the negative tuberculin test was found to be statistically significant.
{"title":"Detection of latent tuberculosis by tuberculin booster in patients with immunosuppressive treatment","authors":"Luis Javier Cajas , María Carolina Torres , Mayelin Fernanda Ceballos","doi":"10.1016/j.rcreu.2023.10.006","DOIUrl":"10.1016/j.rcreu.2023.10.006","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>One-third of the world's population has latent tuberculosis. Because it can be reactivated by immunosuppressive treatments, screening is suggested. In Colombia, the tuberculin test with the booster is recommended in this population because of the risk of false negative results and anergy caused by treatments. Currently, the number of patients detected with this second test is unknown, so the primary objective is to determine the percentage of additional positive detections.</div></div><div><h3>Materials and methods</h3><div>From 2017 to 2022, a cross-sectional, analytical study was conducted on a group of patients from a rheumatology service who had a tuberculin test and a booster within a year to check for latent tuberculosis. Over the course of a year and three weeks, we looked at the number of patients whose booster tests showed new findings. A study was conducted to see if there were any differences in treatment based on the first tuberculin result.</div></div><div><h3>Results</h3><div>A tuberculin test was performed on 674 subjects, of whom 496 were immunosuppressed. From the 382 whose test was negative, 191 and 74 booster tests were performed within a year and three weeks; 8 (4.1%) and 3 (3.6%) were positive, respectively. When evaluating the differences in treatments between the groups with a positive and negative first tuberculin test, significant differences were found. Use of prednisolone at 5<!--> <!-->mg or more per day (<em>p</em> <!-->=<!--> <!-->.02) and three immunosuppressants (<em>p</em> <!-->=<!--> <!-->.005) was more frequent in negative tuberculin tests.</div></div><div><h3>Conclusions</h3><div>It can be said that the booster test raises the number of people with latent tuberculosis by 4%. More use of prednisolone at 5<!--> <!-->mg/day or three immunosuppressants in the group with the negative tuberculin test was found to be statistically significant.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 10-15"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139187672","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 : 2025-01-01DOI: 10.1016/j.rcreu.2023.12.006
Esther Casablanca Alarcón , Mabel de la Cruz Mendoza , María de los Ángeles Terán de Baudoin , Rolando Pastén Vargas , Manuel Montero Jauregui , Carlos Guachalla Castro , Luis Fernando Sosa Tordoya
Introduction
Lupus nephropathy (LN) is a chronic inflammatory process, characterized by the activation of T cells and high levels of various cytokines, such as MCP-1 at the level of the renal glomerulus and the interstitial tubule. MCP-1 is a chemoattractant of monocytes and lymphocytes, it is responsible for the infiltration of leukocytes in the kidney, which is why MCP-1 levels in urine of patients with LN correlate with the active form of the disease.
Objective
The present study aims to evaluate the expression levels of MCP-1 in patients with LN and to correlate their urinary levels with serum autoimmunity markers.
Material and methods
Our study is of the case-control type, where the groups were made up of 112 patients diagnosed with SLE or LN, and 28 apparently healthy people with no clinical or family history of autoimmune diseases, respectively. MCP-1 expression levels were estimated using qRT-PCR. In addition, clinical parameters and serum levels were evaluated (anti-ds-DNA, anti-nucleosome, anti-C1q antibodies, β2-microglobulin levels, and C3 and C4 complement fraction). Finally, clinical, and molecular data were correlated.
Results
Our study included 39 patients with active SLE (median 36 years), 32 with active LN (median 32.5 years), 28 with inactive SLE (median 41.5 years), 13 with inactive LN (median 38 years), and 28 control patients (median 28.5 years). The comparison of MCP-1 expression levels between patients with active LN and active SLE did not show statistically significant values (P > .05). Likewise, a statistically significant correlation was observed between the expression levels of MCP-1 with the levels of anti-C1q (r = .255; P < .025); however, no correlation was found with the other markers.
Conclusion
The use of MCP-1 expression levels in the Bolivian population would not be a useful biomarker to evaluate lupus nephropathy. However, the anti-C1q biomarker is suggested as a serological marker for monitoring the disease.
{"title":"Niveles de expresión génica relativa del gen codificante de la proteína quimioatractante de monocitos-1 (MCP-1) como biomarcador urinario en nefropatía lúpica","authors":"Esther Casablanca Alarcón , Mabel de la Cruz Mendoza , María de los Ángeles Terán de Baudoin , Rolando Pastén Vargas , Manuel Montero Jauregui , Carlos Guachalla Castro , Luis Fernando Sosa Tordoya","doi":"10.1016/j.rcreu.2023.12.006","DOIUrl":"10.1016/j.rcreu.2023.12.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Lupus nephropathy (LN) is a chronic inflammatory process, characterized by the activation of T<!--> <!-->cells and high levels of various cytokines, such as MCP-1 at the level of the renal glomerulus and the interstitial tubule. MCP-1 is a chemoattractant of monocytes and lymphocytes, it is responsible for the infiltration of leukocytes in the kidney, which is why MCP-1 levels in urine of patients with LN correlate with the active form of the disease.</div></div><div><h3>Objective</h3><div>The present study aims to evaluate the expression levels of MCP-1 in patients with LN and to correlate their urinary levels with serum autoimmunity markers.</div></div><div><h3>Material and methods</h3><div>Our study is of the case-control type, where the groups were made up of 112 patients diagnosed with SLE or LN, and 28 apparently healthy people with no clinical or family history of autoimmune diseases, respectively. MCP-1 expression levels were estimated using qRT-PCR. In addition, clinical parameters and serum levels were evaluated (anti-ds-DNA, anti-nucleosome, anti-C1q antibodies, β2-microglobulin levels, and C3 and C4 complement fraction). Finally, clinical, and molecular data were correlated.</div></div><div><h3>Results</h3><div>Our study included 39 patients with active SLE (median 36<!--> <!-->years), 32 with active LN (median 32.5<!--> <!-->years), 28 with inactive SLE (median 41.5<!--> <!-->years), 13 with inactive LN (median 38<!--> <!-->years), and 28 control patients (median 28.5<!--> <!-->years). The comparison of MCP-1 expression levels between patients with active LN and active SLE did not show statistically significant values (<em>P</em> <!-->><!--> <!-->.05). Likewise, a statistically significant correlation was observed between the expression levels of MCP-1 with the levels of anti-C1q (r<!--> <!-->=<!--> <!-->.255; <em>P</em> <!--><<!--> <!-->.025); however, no correlation was found with the other markers.</div></div><div><h3>Conclusion</h3><div>The use of MCP-1 expression levels in the Bolivian population would not be a useful biomarker to evaluate lupus nephropathy. However, the anti-C1q biomarker is suggested as a serological marker for monitoring the disease.</div></div>","PeriodicalId":37643,"journal":{"name":"Revista Colombiana de Reumatologia","volume":"32 1","pages":"Pages 49-55"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140091889","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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