Antisynthetase syndrome (ASSD) is a rare clinical condition that is characterized by the occurrence of a classic clinical triad, encompassing myositis, arthritis, and interstitial lung disease (ILD), along with specific autoantibodies that are addressed to different aminoacyl tRNA synthetases (ARS). Until now, it has been unknown whether the presence of a different ARS might affect the clinical presentation, evolution, and outcome of ASSD. In this study, we retrospectively recorded the time of onset, characteristics, clustering of triad findings, and survival of 828 ASSD patients (593 anti-Jo1, 95 anti-PL7, 84 anti-PL12, 38 anti-EJ, and 18 anti-OJ), referring to AENEAS (American and European NEtwork of Antisynthetase Syndrome) collaborative group’s cohort. Comparisons were performed first between all ARS cases and then, in the case of significance, while using anti-Jo1 positive patients as the reference group. The characteristics of triad findings were similar and the onset mainly began with a single triad finding in all groups despite some differences in overall prevalence. The “ex-novo” occurrence of triad findings was only reduced in the anti-PL12-positive cohort, however, it occurred in a clinically relevant percentage of patients (30%). Moreover, survival was not influenced by the underlying anti-aminoacyl tRNA synthetase antibodies’ positivity, which confirmed that antisynthetase syndrome is a heterogeneous condition and that antibody specificity only partially influences the clinical presentation and evolution of this condition.

We report the case of a 72-year-old man with history of ankylosing spondylitis, who, during the treatment with infliximab, developed painful, erythematous-violaceous plaques with later development of ulcers on his feet associated with cold exposure. Concomitantly with the appearance of these lesions, he presented increased antinuclear antibodies (ANA) titers, positivity for anti-DNA and IgM anticardiolipin antibodies, low complement levels, polyclonal hypergammaglobulinemia, and lymphopenia. He was diagnosed of chilblain lupus induced by infliximab, this agent was withdrawn and initiated treatment for chilblains with improvement of lesions. On reviewing of the literature, we found seven reported cases of tumor necrosis factor α (TNF-α) antagonists-induced chilblain lupus, all in rheumatoid arthritis patients and four of them with clinical and immunological characteristics available are presented and compared with our case. Although it is infrequent, chilblain lupus forms part of the spectrum of TNF-α antagonists-induced lupus erythematosus; usually is limited to skin without progression to systemic lupus erythematosus; presents ANA, anti-DNA, and antinucleosome antibodies positivity as more frequent immunological alterations; and responds appropriately to the specific treatment, TNF-α antagonists withdrawal being not necessary in almost all cases.

Introduction During the Covid-19 pandemic strategies to prevent transmission of the viral infection obliged our hospital to promote virtual consultations. Objetive The objective of this study is to describe the results obtained with the previous strategy of transferring activity to teleconsultation during the period of maximum impact of the pandemic. Material and methods Between 16/03 and 10/05/2020 all successive consultations in our unit were performed in virtual rheumatology teleconference (RTC) format. The socio-demographic, geo-functional and clinical characteristics of all patients were collected; a numeric verbal scale (NVS) (where 0 = very dissatisfied to 10 = fully satisfied) was applied to assess the degree of satisfaction of the doctor/patient with the RTC. Results 469 TC were included. Most patients seen by RTC were women, mean age: 60,83 years. Only 16% had university education. The mean distance travelled for face-to face consultation is 33 Km with a mean total time of 2 h. Most individuals were diagnosed with osteoarthritis/soft tissue rheumatic diseases and/or osteoporosis; 21% had rheumatoid arthritis. The mean length of the TC was 9.64 min. We find more patient satisfaction with the TC when their level of education is higher (OR = 4.12); doctor satisfaction was higher when the individual was better able to manage the Internet (OR = 3.01). Conclusion It is possible to transfer rheumatological care activity to TC with a considerable degree of satisfaction for both the patient and the doctor.

Durante la pandemia por Covid 19 las necesidades de prevención de transmisión de la infección viral nos obligaron a potenciar las consultas virtuales. El objetivo de estudio es describir los resultados obtenidos con la anterior estrategia y definir el perfil de paciente más idóneo para aplicarla. Material y métodos Durante el período comprendido entre el 16/3 y el 10/05/2020 todas las consultas sucesivas de nuestro servicio fueron realizadas en formato de teleconsulta reumatológica (TCR). Se recogieron las características sociodemográficas, geofuncionales y clínicas de los pacientes; se evalúo mediante escala numérica verbal (ENV) (0-10, donde 0=muy insatisfecho hasta 10= completamente satisfecho) el grado de satisfacción del paciente/médico con la TC. Resultados: La mayoría de los pacientes atendidos en las 469 TCR realizadas fueron mujeres, con una edad media de 60,83 años. Sólo el 16% habían realizado estudios universitarios. La distancia media recorrida para acudir a una consulta presencial era de 33 km, con una inversión de tiempo total promedio de 2 horas. La mayoría de los sujetos estaban diagnosticados de artrosis/reumatismos de partes blandas y/o osteoporosis; el 21% eran portadores de artritis reumatoide. La duración media de la TCR fue de 9,64 minutos. Encontramos una mayor satisfacción con la TCR por parte del paciente, cuando el nivel de estudios era más alto (OR= 4,33), y por parte del médico cuando el individuo manejaba mejor internet (OR=3,22). Conclusión Es posible transferir actividad asistencial reumatológica hacia la TCR con un grado importante de satisfacción para el paciente y el médico.

Vertebral osteonecrosis, also known as Kümmell's disease, is a disorder resulting in non-consolidation of a vertebral fracture caused by ischaemia. The main differential diagnosis of vertebral osteonecrosis is osteoporotic vertebral fracture; however, the former is associated more frequently with severe pain and neurological complications. Although HIV-infected patients have an increased risk of developing osteonecrosis in peripheral locations and osteoporotic vertebral fractures, the occurrence of vertebral osteonecrosis has not been previously reported in any of the large series of HIV-associated osteonecrosis. Here, we report an HIV-infected patient who developed vertebral osteonecrosis with refractory pain and displayed rapid kyphotic deformity development during HAART.