No abstract

Systemic lupus erythematosus (SLE) patients are at higher risk of developing opportunistic infections such as tuberculosis (TB), especially extrapulmonary forms like osteoarticular TB, compared to the general population. However, tuberculous sacroiliitis has been scarcely reported in these patients. We present a 34-year-old woman with SLE who developed articular tuberculosis simultaneously affecting the right sacroiliac joint and the left knee. The patient was successfully treated with antituberculosis therapy for nine months. In this case, in addition to the immunological abnormalities of lupus, the long-term glucocorticoid therapy at high dosages was the main risk factor for the development of osteoarticular tuberculosis.

La alogenosis iatrogénica es la enfermedad causada por la aplicación de biopolímeros con fines estéticos. Sus manifestaciones clínicas pueden presentarse entre las seis horas y los 30 años posteriores a la aplicación, con síntomas locales o sistémicos. El principal rasgo de la histopatología es la presencia de granulomas por cuerpo extraño con reacción de tipo sarcoideo, la cual es difícil de interpretar por su asociación con la sarcoidosis. Se reporta aquí el caso de una paciente con lesiones granulomatosas de tipo sarcoideo por reacción a cuerpo extraño, secundaria a la aplicación de múltiples sustancias desconocidas en cara y glúteos.

BackgroundAntineutrophil cytoplasmic antibodies (ANCA) are present in up to 90% granulomatosis with polyangiitis, 80% microscopic polyangiitis and 70% eosinophilic granulomatosis with polyangiitis. MPO-ANCA has been associated with vasculitis limited to the kidney, chronic renal damage and less frequent gastrointestinal or respiratory tract involvement. PR3-ANCA are characterised by destructive lesions of the ears, nose and throat, alveolar haemorrhage, combination of upper and/or lower respiratory tract involvement with renal compromise and increased number of relapses. The frequency of pulmonary involvement is similar in both serotypes, and most ANCA associated vasculitis (AAV) patients are diagnosed between ages 50 and 70 years.ObjectivesTo describe differences in clinical profiles of patients with AAV regarding ANCA specificity against MPO or PR3 in a Colombian based adult populationMethodsAll medical records of patients with a diagnosis of AAV in two high complexity hospitals in Medellín, Colombia from January 1, 2014 to December 31, 2016 were reviewed. The clinical and demographic characteristics were abstracted and analysed with descriptive and inferential statistics in SPSS.22ResultsOf 59 cases of AAV, 44 were positive for MPO or PR3-ANCA with male predominance (65.5% men vs 34.5% women) and similar age at diagnosis (47 years in MPO-ANCA vs 50 in PR3-ANCA). MPO-ANCA group had more fever and weight loss (34.8% vs 20%), arterial hypertension (34.5% vs 26.7%), hematuria (34.5% vs 26.7%), proteinuria (31% vs 26.7%), creatinin higher than 5.6 mg/dL (20.7 vs 13.3%), myalgias (13.8 vs 0%) pachymeningitis (7% vs 0%) and skin compromise. PR3-ANCA patients had more arthralgias/arthritis (40% vs 31%), escleritis (33% vs 13.8%), episcleritis (13.3% vs 0%) and uveítis (10% vs 7%).ConclusionsIn this Latin American population ANCA specificity affected the phenotype of clinical disease. MPO-ANCA patients had more constitutional symptoms, renal and central nervous system compromise while PR3-ANCA patients showed more articular and ocular involvement.References[1] Cornec D, et al. Nat Rev Rheumatol. 2016Oct;12(10):570–9.[2] Hilhorst M, et al. J Am Soc Nephrol. 2015Oct;26(10):2314–27.[3] Lionaki S, et al. Arthritis Rheum. 2012Oct;64(10):3452–62.[4] Savige J, et al. Best Pract Res Clin Rheumatol. 2005Apr;19(2):263–76.[5] Schirmer JH, et al. Arthritis Rheumatol. 2016Dec;68(12):2953–2963.Disclosure of InterestNone declared