RESUMO
No existen datos exactos relativos a la prevalencia de tofos en pulpejos como manifestación inicial de la gota. El objetivo de este estudio es describir la población de pacientes con gota y evaluar la presencia de tofos en pulpejos de dedos de manos, pies y articulaciones interfalángicas distales, comparando los datos clínicos entre los pacientes con y sin tofos. Se reclutaron 161 pacientes con gota. Si bien los pacientes con tofos en pulpejos (12 pacientes) tenían mayor edad que aquellos sin tofos en esta localización, tenían mayor tiempo de evolución de la gota, mayor número de ellos tenían compromiso renal y menor porcentaje de enfermedades asociadas, ninguno de estos datos alcanzó significancia estadística.
There are no accurate data on the prevalence of tophi in finger padsas the initial manifestation of gout. The aim of this study is to describethe patients population with gout and evaluate the presence of tophiin pads of fingers, feet and distal interphalangeal joints comparingthe clinical data between patients with and without tophi.161 gout patients were recruited. While patients with tophi in pads(12 patients) were older than those without tophi at this location,had a longer history of gout, as many of them had renal involvementand lower percentage of associated diseases, none of these datareached statistical significance.
Assuntos
Gota , ReumatologiaRESUMO
Este artículo describe la coexistencia de siete pacientes con enfermedades reumáticas: lupus eritematoso sistémico, artritis reumatoide y dermatomiositis e infección concomitante por Histoplasma capsulatum. Las enfermedades del tejido conectivo y la histoplasmosis comparten varios hallazgos clínicos. Por lo tanto, la histoplasmosis puede ser mal diagnosticada como enfermedades del tejido conectivo o como un brote de estas enfermedades. Estos casos resaltan la importancia de la concientización sobre la histoplasmosis en pacientes inmunocomprometidos, especialmente en aquellos procedentes de zonas endémicas.
Assuntos
Artrite Reumatoide , Tecido Conjuntivo , Dermatomiosite , Histoplasmose , Lúpus Eritematoso SistêmicoRESUMO
Este artículo describe la coexistencia de siete pacientes con enfermedades reumáticas: lupus eritematoso sistémico, artritis reumatoide y dermatomiositis e infección concomitante por Histoplasma capsulatum. Las enfermedades del tejido conectivo y la histoplasmosis comparten varios hallazgos clínicos. Por lo tanto, la histoplasmosis puede ser mal diagnosticada como enfermedades del tejido conectivo o como un brote de estas enfermedades. Estos casos resaltan la importancia de la concientización sobre la histoplasmosis en pacientes inmunocomprometidos, especialmente en aquellos procedentes de zonas endémicas.(AU)
Assuntos
Histoplasmose , Lúpus Eritematoso Sistêmico , Artrite Reumatoide , Dermatomiosite , Tecido ConjuntivoRESUMO
This report describes the coexistence of three patients with rheumatic diseases (systemic lupus erythematosus, rheumatoid arthritis, and dermatomyositis) and infections because of Histoplasma capsulatum. Connective tissue diseases and histoplasmosis share several clinical findings. Therefore, histoplasmosis could be misdiagnosed as connective tissue disease or a flare of these diseases. Such cases highlight the importance of awareness of histoplasmosis in immunocompromised patients, particularly in those originating from endemic areas.
Assuntos
Doenças do Tecido Conjuntivo/complicações , Doenças do Tecido Conjuntivo/diagnóstico , Histoplasmose/complicações , Histoplasmose/diagnóstico , Adulto , Doenças Autoimunes/tratamento farmacológico , Terapia Biológica , Feminino , Histoplasma/metabolismo , Humanos , Imunossupressores/uso terapêutico , Pessoa de Meia-Idade , Paniculite/metabolismo , Doenças Reumáticas/metabolismo , RiscoRESUMO
There are clinical difficulties to differentiate elderly-onset rheumatoid arthritis (EORA) patients from those with polymyalgia rheumatica (PMR), especially when dealing with EORA-like PMR-onset, seronegative EORA, and PMR with peripheral synovitis, which constitute the subgroups presenting the greatest difficulties. Serum samples were obtained from two groups of patients, one with EORA diagnosis and another with a PMR diagnosis. Anticyclic citrullinated peptide (anti-CCP) antibodies (enzyme-linked immunosorbent assay method) and rheumatoid factor (RF; latex technique) were determined. Of the 16 EORA patients, 9 presented anti-CCP antibodies, 4 of whom tested positive for RF. Of the 12 EORA patients who remained negative to RF, 5 were positive for anti-CCP antibodies. Eight of the EORA patients started with polymyalgic symptoms. Three of these patients showed positive titles of anti-CCP antibodies with negative RF. All PMR patients presented negative anti-CCP antibodies, except one with weak positive titles, and all were negative for RF. Of 15 patients with PMR, 7 presented oligoarticular synovitis at the onset. After a mean follow-up of 3 months, two patients developed RA. When evaluating them for RF and anti-CCP antibodies, one tested negative, while the other was positive for both antibodies. We observed a tendency to higher values of anti-CCP antibodies in patients with extraarticular manifestations, radiological damage, and disease-modifying antirheumatic drugs. When compared to the PMR group, EORA patients presented positive anticitrulline antibodies at the beginning of the disease in a statistically significant amount. One third of the seronegative EORA patients presented positive anti-CCP antibodies at the onset.