Antiphospholipid syndrome (APS) is an autoimmune disease that can lead to thrombotic or obstetric complications. Recent histopathological studies have shown the absence of placental thrombosis, leading to the consideration of other pathophysiological pathways such as inflammation and complement activation. Due to this, various clinical studies are being carried out with different drug agents in order to avoid their complications. The combination of prophylactic heparin treatment and low doses of aspirin today result in successful pregnancies in most cases. Despite this, a minority of patients require alternative therapies to avoid recurrent miscarriage and decrease obstetric morbidity. Thanks to the better understanding of its pathophysiology, other treatments such as low doses of glucocorticoids, hydroxychloroquine (HCQ), immunoglobulin, pravastatin, and plasmapheresis have been considered in refractory cases, achieving favorable results. Despite the great advances regarding its treatment, unfortunately, there are no treatments with a good level of evidence to reduce late obstetric complications. The evaluation of preconception risk factors, as well as the antiphospholipid antibody profile, is necessary to establish individual risk and thus anticipate possible complications.

In the current medical literature, there is increasing evidence for the involvement of the interleukin (IL)-17/23 axis and the potential role of Th17 cells in the pathogenesis of lupus nephritis. Knowledge about the interaction of these immunological pathways in the development of autoimmune diseases has led to the identification of new therapeutic strategies aimed at blocking them. For this reason, the main objective of this review focuses on knowing the recent evidence of the different anti-IL-17/23 treatment strategies in lupus nephritis and their future perspectives. A non-systematic narrative review of the literature was carried out following the objective of having the most representative information on the different anti-IL-17/23 drugs available together with the description of the pathophysiological mechanisms of this pathway involved in systemic lupus erythematosus and lupus nephritis. Despite the great existing theoretical foundation, today few clinical studies support the use of these therapies in both contexts. Nevertheless, the publication of research with a better methodology is expected to approve the indication of some of these drugs in lupus nephritis. However, the clinical response seen with ustekinumab and secukinumab in clinical studies and case reports published to date has been encouraging.

Systemic lupus erythematosus is a multisystemic disease that usually involves the urinary tract, often in the form of lupus nephritis. However, another form of compromise of this system is lupus cystitis, which, despite being an unusual condition, turns out to be a challenging diagnosis due to the spectrum of nonspecific abdominal and urinary symptoms. Although the exact pathophysiological mechanism of bladder inflammation remains to be established, the role of small vessel vasculitis measured by immune complexes continues to be supported as a central axis for considering possible therapeutic targets. Additionally, there are no clinical studies that dictate a guideline regarding its treatment, however, the evidence from most cases described in the literature suggests the initiation of pulses of methylprednisolone and cyclophosphamide in treatment regimens similar to those of lupus nephritis. Despite its low prevalence, obstructive complications and kidney damage can lead to increased morbidity and mortality.

Cardiac abnormalities are common in patients with systemic lupus erythematosus (SLE). However, many of them tend to be mild or asymptomatic and can be recognized by non-invasive studies such as transthoracic echocardiography and cardiac magnetic resonance imaging (CMR). However, heart failure secondary to perimyocarditis as the initial manifestation of SLE remains an extremely rare form of presentation. Below, we present the case of an adult female patient who initially consulted due to symptoms of acute dyspnea, atypical chest pain, and edema of the lower limbs, who underwent a chest X-ray as part of the initial studies, which described an increase in the cardiac silhouette associated with diffuse opacities in both lung fields. The admission electrocardiogram only showed sinus tachycardia and nonspecific alterations of the T wave, with an initial report of frankly elevated cardiac biomarkers compatible with acute myocardial injury together with the positivity of specific antibodies for SLE.

Introducción: La Enfermedad de Chagas también conocida como Tripanosomiasis americana es un problema de salud pública. Se calcula que en el mundo hay entre 6 y 7 millones de personas infectadas por Trypanosoma cruzi, la mayoría de ellas en América Latina. Objetivo: Identificar la prevalencia de infección por Trypanosoma cruzi en donantes de un banco de sangre del departamento de Boyacá 2016-2018. Materiales y métodos: Estudio descriptivo retrospectivo realizado en 25.920 donantes de sangre del departamento de Boyacá. La fuente de información fue secundaria. Se determinó la prevalencia de la infección por Trypanosoma cruzi y se compararon según sexo, grupo etario y tipo de donante a través de análisis de frecuencias. Resultados: Se evaluaron 9187 donantes durante el año 2016; 8517 en el 2017 y 8216 en el 2018, de los cuales 56,1% eran de sexo femenino y 43,9% masculino. La prevalencia de la infección por Trypanosoma cruzi fue 0,17 % en la tamización y 0,08 % con las pruebas confirmatorias de las cuales el 70,0% eran mujeres, el 85,0% donantes voluntarios por primera vez, el rango de edad en el que se presentó mayor prevalencia de este marcador serológico fue de 41 a 50 y de 51 a 65 años con un 35,0% cada uno . La prevalencia de la infección de Chagas presentó asociación estadísticamente significativa con la edad (p < 0,05). Conclusiones: Los bancos de sangre resultan ser una de las fuentes de información disponibles para monitorear el comportamiento de la enfermedad de Chagas y evaluar la toma de decisiones en salud pública, teniendo en cuenta  que  la enfermedad  se caracteriza de manera asintomática y sin compromiso clínico en la mayoría de los casos.