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Fanlo P, Román MLDS, Fonollosa A, Ilarramendi J, Heras H, Grayson P. Episcleritis and periorbital edema secondary to VEXAS syndrome. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:607-610. [PMID: 37595794 DOI: 10.1016/j.oftale.2023.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 07/07/2023] [Indexed: 08/20/2023]
Abstract
VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly described autoinflammatory entity caused by a UBA-1 gene mutation. Among the most frequent symptoms it produces fever, cytopenias, polychondritis, pulmonary infiltrates and up to 40% ocular involvement such as periorbital edema, uveitis, episcleritis, scleritis and retinal vasculitis. Patients respond to high doses of corticosteroids, however, many end up being refractory to them and to the classic immunosuppressants. We described the case of a 77-year-old male patient with ocular involvement in the form of episcleritis and periorbital edema who was later diagnosed with VEXAS Syndrome. The patient, after failing treatment with immunosuppressants, is currently receiving treatment with oral steroids and tocilizumab. Ophthalmologist must be aware of the ophthalmological affectation of autoinflammatory diseases and especially of this new entity described as the VEXAS Syndrome.
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Affiliation(s)
- P Fanlo
- Servicio de Medicina Interna, Hospital Universitario de Navarra, Pamplona, Spain.
| | - M López de San Román
- Servicio de Medicina Interna, Hospital Universitario de Navarra, Pamplona, Spain
| | - A Fonollosa
- Department of Ophthalmology, Instituto de Investigación Sanitaria de Vizcaya Biocruces, Hospital Universitario de Cruces, Universidad del País Vasco, Instituto Oftalmológico Bilbao, Bilbao, Spain
| | - J Ilarramendi
- Servicio de Hematología, Hospital Universitario de Navarra, Pamplona, Spain
| | - H Heras
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - P Grayson
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH, Bethesda, Maryland, Spain
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Fanlo P, Garralda A, Gómez-Cerezo JF, Echeverria M, López M, Heras H, Riera-Mestre A. Results of the screening program for Fabry disease in patients with cornea verticillata at the University Hospital of Navarre. Rev Clin Esp 2023; 223:25-31. [PMID: 36528303 DOI: 10.1016/j.rceng.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/18/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Cornea verticillata (CV) or vortex keratopathy is characterized by the presence of spiral-shaped deposits in the corneal epithelium. The most frequent causes are antimalarial drugs and amiodarone and, among systemic causes, Fabry disease (FD). MATERIAL AND METHODS A multidisciplinary, prospective, descriptive study was conducted in a tertiary reference center in Spain's Autonomous Community of Navarre after the implementation of a FD screening program for patients attended to in the Ophthalmology Department. The study analyzed those diagnosed with CV, who were subsequently referred to the rare disease clinic of the University Hospital of Navarre's Internal Medicine Department for an FD study. RESULTS Two women and four men with a mean age of 76.8 years were diagnosed with CV out of a total of 17,280 patients evaluated in outpatient consultations by three ophthalmology specialists during the period from April 2018 to April 2020. One patient died before performing the screening study and no patients were diagnosed with FD. CONCLUSIONS Despite the fact that the University Hospital of Navarre's FD screening program for patients with CV did not confirm any cases of FD, ophthalmology specialists should consider the possible diagnosis of FD in patients with CV in their routine consultations.
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Affiliation(s)
- P Fanlo
- Unidad de Enfermedades Autoinmunes Sistémicas, Consulta de Enfermedades Minoritarias, Servicio de Medicina Interna, Hospital Universitario de Navarra, Pamplona, Spain.
| | - A Garralda
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - J F Gómez-Cerezo
- Servicio de Medicina Interna, Hospital Universitario Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain; Docencia titular de Medicina, Universidad Europea de Madrid, Madrid, Spain
| | - M Echeverria
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - M López
- Unidad de Enfermedades Sistémicas Autoinmunes y Minoritarias, Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - H Heras
- Servicio de Oftalmología, Hospital Universitario de Navarra, Pamplona, Spain
| | - A Riera-Mestre
- Servicio de Medicina Interna, Hospital Universitari de Bellvitge, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Departamento de Ciencias Clínicas, Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona, Barcelona, Spain
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Fanlo P, Garralda A, Gómez-Cerezo J, Echeverria M, López M, Heras H, Riera-Mestre A. Resultados del programa de cribado de enfermedad de Fabry en pacientes con córnea verticillata en el Hospital Universitario de Navarra. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Llorenç V, Sainz-de-la-Maza M, García-Aparicio Á, Blanco A, Hernando-Hernández C, Cincunegui-Gutiérrez J, Fanlo P, Heras H, García-García O, Hernández-Garfella M, Veroz Gonzalez R, Rodriguez-Melian L, Jovani V. POS1331 CERTOLIZUMAB PEGOL IN UVEITIS. RETENTION PROBABILITY AND CAUSES OF DISCONTINUATION. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundA personalized disease-specific treatment for non-infectious uveitis (NIU) is challenging. Around 50% of adults with NIU who required classic DMARDs or adalimumab in clinical trials, failed at 6 months during open label phase [1,2]. Therefore, to investigate treatment alternatives for NIU are most needed.ObjectivesTo study Certolizumab pegol (CZP) retention rate (RR) at 24 months in NIU and susceptibility factors for discontinuation.MethodsAdults with NIU who received CZP for this indication were included. Data were gathered from the BioÚvea Spanish registry, detailed elsewhere[3]. Demographics, clinical, and therapeutic data was recorded from Nov 2016 to Nov 2017. The primary endpoint assessed was CZP RR at 24 months. Causes and susceptibility factors for definitive discontinuation of CZP were analyzed as well. CZP RR was calculated with the Kaplan-Meier method, Log-rank test was used for the univariate, and the Cox proportional hazard model was implemented for the multivariate analysis.ResultsThirty patients with a median of 41 (IQR 16) years, 18 (60%) females, were included. NIUs were bilateral in 19 (63%) patients and were active at CZP onset in 20 (71%). Half of the patients suffered from non-anterior NIUs, and etiologically 2 (7%) were unclassifiable, 7 (23%) had ocular syndromes, and 21 (70%) were associated to systemic disorders. Seven (23%) patients were bio-naïve, whereas 23 (77%) started CZP as a 2nd (5, 17%) or ≥ 3rd (18, 60%) biologic. With a median follow-up of 21.2 (Range 0.2 to 54.8) months, 12 (40%) patients discontinued CZP, 6 (20%) due to adverse events and 6 (20%) due to lack of efficacy. The overall CZP RR at 24 months was 53.6%, with a median Retention Time (RT) of 27.1 months. In the multivariate analysis, CZP started as a first biologic (HR 0.053, 95%CI 0.003 to 0.809; p = 0.035), and male gender (HR 0.1, 95%CI 0.015 to 0.694; p = 0.02) were protective factors for discontinuation. CZP RR at 24 months as a 1st line biologic was 100% with a median RT of 27.1 months. Conversely, CZP RR at 24 months as a ≥2nd line was 41.1% with a median RT of 17.1 months. When given as a 1st biologic, one (14%) patient discontinued CZP due to loss of efficacy at 27.1 months. Conversely, discontinuation of CZP when administered in ≥2nd line was more frequent, either due to lack or loss of efficacy in 5 (22%) patients or adverse events (AEs) in 6 (26%) (Figure 1).Figure 1.Retention rate of Certolizumab pegol in bio-naïve and bio-experienced patients with non-infectious uveitis.Abbreviations: DRT, Drug Retention Time; LTFU, lost to follow-up; DRR, Drug Retention Rate; PAR, Patients at Risk; AE, adverse event.ConclusionCZP in NIU showed an excellent retention rate at 24 months in bio-naïve patients. However, it was more than halved when CZP was started as a ≥2nd biologic. Discontinuation of CZP in bio-experienced patients was due to lack or loss of efficacy in 22% and to adverse events in an additional 26% of patients.References[1]Rathinam SR, Gonzales JA, Thundikandy R, et al. Effect of Corticosteroid-Sparing Treatment With Mycophenolate Mofetil vs Methotrexate on Inflammation in Patients With Uveitis: A Randomized Clinical Trial. JAMA. 2019;322(10):936-945.[2]Jaffe GJ, Dick AD, Brézin AP, et al. Adalimumab in Patients with Active Noninfectious Uveitis. N Engl J Med. 2016;375:932-943.[3]Llorenç V, Cordero-Coma M, Blanco-Esteban A, et al. Drug Retention Rate and Causes of Discontinuation of Adalimumab in Uveitis: Real-World Data from the Biotherapies in Uveitis (BioUvea) Study Group. Ophthalmology. 2020;127(6):814-825.Disclosure of InterestsVictor Llorenç Speakers bureau: Optos, Alimera, Consultant of: AbbVie, Alimera, Allergan, UCB, Grant/research support from: AbbVie, Maite Sainz-de-la-Maza: None declared, Ángel García-Aparicio: None declared, Ana Blanco: None declared, Cristina Hernando-Hernández: None declared, Joseba Cincunegui-Gutiérrez: None declared, Patricia Fanlo: None declared, Henar Heras: None declared, Olga García-García: None declared, Marisa Hernández-Garfella: None declared, Raul Veroz Gonzalez: None declared, Luís Rodriguez-Melian: None declared, Vega Jovani: None declared
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Fanlo P, Salman Monte TC, Callejas-Rubio JL, Galindo M, Robles Marhuenda Á, Pallares Ferreres L, Ángel Torres MJ, Pérez Ortega S. OP0292 SURVEY ON THE PERCEPTIONS AND EXPERIENCES OF SPANISH LUPUS PATIENTS. RESULTS ABOUT KNOWLEDGE OF THE DISEASE AND RELATIONSHIP TO DISEASE-FELUPUS SURVEY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Despite great advances in the diagnosis and treatment of lupus, the scientific community does not know the perception of our patients regarding the knowledge of the disease and the relationship between patients and disease. Fatigue had the greatest impact on activities of daily living, yet the majority reported receiving no support or poor support in managing it1.Objectives:Through this initiative, it is intended to investigate about the knowledge of the disease and impact of the disease on quality of life of Lupus patients. Another objective is to give visibility to the current needs of people living with lupus.Methods:It was performed a national survey with 1,263 interviews with Lupus patients who reside in Spanish territory and belonging to lupus patient associations in Spain. The survey was carried out by the Spanish Lupus Federation (FELUPUS) in collaboration with GSK company.Online interview lasting approximately 25 minutes. The collection of information was anonymously carried out from May 21 to June 30, 2020.Results:1.263 lupus patients were interviewed, 92% diagnosed with SLE and 8% with CLE. Survey sample is representative of the Lupus patient population in Spain [associated sampling error: 2.76%]. Questions about knowledge of the disease showed that 73% of patients considered that there is very little knowledge of the disease by society. Patient awareness of lupus increases as the disease progresses, so at the time of diagnosis, level of knowledge of the patient about Lupus is low in 92% of patients and at the moment of survey, 68% of patient had high knowledge. In terms of the perception of his illness, the affectation of the kidneys and heart (97%), fatigue and skin rashes (97%), are the statements that generate the greatest consensus. The survey about the relationship to disease demonstrated that 3 out of 4 patients have symptoms related to the disease, muscle and joint pain (75%) and fatigue (74%) are the symptoms that cause the greatest discomfort (Graph 1). Remarkable degree of agreement with the fact of not being able to sunbathe (78%), as well as the lack of energy (61%) and weakness in the body (60%). Flare-ups (86%), followed by fatigue (78%) and pain (77%) cause great concern. At diagnosis, 92% of patients have some organic involvement and regarding the diagnosis, at present, a greater number of patients present damage to the CNS (17%) and bones (21%). Many patients do not understand the concept of organ damage, wrongly relating it to fatigue (38%) or joint pain (47%).Graph 1.Conclusion:Among the conclusions of the survey, it stands out that society and the general population are unaware of what lupus is, while in the case of lupus patients, knowledge increases as the disease progresses. Citizen awareness campaigns about this disease are necessary, where patient associations together with health authorities have a crucial job. On the other hand, 92% of patients present organ damage at diagnosis. This means that we are arriving late to the diagnosis of many patients, which makes it necessary to promote a close collaboration between Primary Care and Hospitals, to refer patients as soon as they suspect SLE.References:[1]Sloan M, Harwood R, Sutton S, D’Cruz D, Howard P, Wincup C, Brimicombe J, Gordon C. Medically explained symptoms: a mixed methods study of diagnostic, symptom and support experiences of patients with lupus and related systemic autoimmune diseases. Rheumatol Adv Pract. 2020 Feb 26;4(1):rkaa006.What worries the most to Lupus patients?Question P12. Please indicate your level of concern with the following aspects of Lupus. Percentage of patients who have scored a 4 or 5 for each item (% T2B).Acknowledgements:GSK funded the study presented in the abstract.Disclosure of Interests:Patricia Fanlo Grant/research support from: GSK funded the study presented in the abstract.
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Gracia Tello B, Ramos E, Simeón-Aznar CP, Fonollosa Pla V, Guillén-Del-Castillo A, Selva-O’callaghan A, Sáez-Comet L, Martínez Robles E, Rios JJ, Espinosa G, Todolí Parra JA, Callejas-Rubio JL, Ortego N, Marí-Alfonso B, Freire M, Fanlo P. POS1408 REPRODUCIBILITY OF A NEW AUTOMATIC SYSTEM (CAPILLARY.IO) IN THE ANALYSIS OF NAILFOLD CAPILLAROSCOPY IMAGES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Nailfold Capillaroscopy is a simple, inexpensive and non-invasive technique that allows microvascular damage to be observed, gaining recent importance in the diagnosis, monitoring and prognosis of many diseases with microangiopathy. However, the variability in the results interpretation has led to the development of new computerized systems that allow the automatic analysis of capillaroscopic images.Objectives:to compare the degree of agreement between the automatic system Capillary.io and a gold standard obtained from the agreement of 9 expert capillaroscopists and to know the degree of the interobserver reliability To demonstrate the validity of the system to detect normal and enlarged capillaries, hemorrhages, megacapillaries, ramifications and tortuosities.Methods:a cross-sectional study was performed in which 300 random and anonymous nailfold capillaroscopic images (1165 capillaries) were analyzed by 9 experienced observers. The degree of interobserver agreement was calculated from the 5 users. Likewise, the system performed an automatic assessment of the images and their agreement with the gold standard was calculated (interobserver agreement greater than 5, 6, 7, 8 and 9 successively). The validity of the program for each variable was also analyzed using sensitivity and specificity, positive and negative predictive values, and likelihood ratios, as well as their degree of agreement using the weighted kappa statistic (95% CI, p <0.05). The programs used for statistical calculations were SPSS 22.0 and EPIDAT 3.0.Results:the degree of interobserver agreement was 76.5% for the agreement of 5 or more observers, progressively decreasing to 15.4% for the 9 observers. Capillary.io obtained higher levels of agreement, reaching 97.7% for the 9 observers. Statistically significant results were obtained in the automated detection of all the morphological alterations analyzed Capillary.io presented a sensitivity (S) of 79.82% and a specificity (E) of 82% in the recognition of normal capillaries. The automatized system was able to recognize enlarged capillaries with a sensitivity of 86.97% and a specificity of 81.38%. Megacapillaries were detected with 89.41% sensitivity and 78.75% specificity. Similarly, the system was able to detect tortuosities (S 66.94%; E 67.71%), ramifications (S 54.34%; E 58.61%) and hemorrhages (S 71.36; E 73.97%).Conclusion:Capillary.io demonstrated a high degree of agreement with the gold standard, stronger with greater consensus among observers. It was able to detect with great sensitivity and specificity hemorrhages and megacapillaries, very relevant alterations in microangiopathies.References:[1]Roldán LMC, Franco CJV, Navas MAM. Capillaroscopy in systemic sclerosis: A narrative literature review. Rev Colomb Reumatol; 2016; 23: 250-8.[2]Ingegnoli F, Gualtierotti R, Lubatti C, Bertolazzi C, Gutierrez M, Boracchi P, et al. Nailfold capillary patterns in healthy subjects: A real issue in capillaroscopy. Microvasc Res. 2013;90:90-5.[3]Cutolo M, Pizzorni C, Secchi ME, Sulli A. Capillaroscopy. Best Pract Res Clin Rheumatol. 2008; 22:1093-108.[4]Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated? BioMed Res Int. 2015; 2015: 974530.[5]Smith V, Herrick AL, Ingegnoli F, Damjanov N, De Angelis R, Denton CP, et al. Standardisation of nailfold capillaroscopy for the assessment of patients with Raynaud’s phenomenon and systemic sclerosis. Autoimmunity Reviews. 2020; 19: 102458.Disclosure of Interests:Borja Gracia Tello Shareholder of: Co-founder and shareholder of Capillary.io., Eduardo Ramos Shareholder of: Co-founder and shareholder of Capillary.io., Carmen Pilar Simeón-Aznar: None declared, Vicent Fonollosa Pla: None declared, Alfredo Guillén-Del-Castillo: None declared, Albert Selva-O’Callaghan: None declared, Luis Sáez-Comet: None declared, Elena Martínez Robles: None declared, Juan José Rios: None declared, Gerard Espinosa: None declared, Jose Antonio Todolí Parra: None declared, Jose Luis Callejas-Rubio: None declared, Norberto Ortego: None declared, Begoña Marí-Alfonso: None declared, Mayka Freire: None declared, Patricia Fanlo: None declared
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Martín-Varillas JL, Calvo-Río V, Sanchez-Bilbao L, González-Mazón I, Adan A, Hernanz Rodríguez I, Gallego A, Beltrán E, Castro S, Fanlo P, García Martos A, Torre-Salaberri I, Cordero-Coma M, De Dios-Jiménez Aberásturi J, García-Aparicio Á, Hernández-Garfella M, Sanchez-Andrade A, García-Valle A, Maiz O, Miguélez R, Rodríguez Montero S, Urruticoechea-Arana A, Veroz Gonzalez R, Conesa A, Fernández-Carballido C, Jovani V, Martínez González O, Moya P, Romero-Yuste S, Rubio Muñoz P, Peña Sainz-Pardo E, González-Gay MA, Hernández JL, Blanco R. POS1340 MULTICENTER STUDY OF 71 PATIENTS WITH REFRACTORY UVEITIS RELATED TO IMMUNE-MEDIATED INFLAMMATORY DISEASES ON CERTOLIZUMAB PEGOL TREATMENT. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Prognosis of non-infectious refractory uveitis has improved markedly with biologic therapy (BT) (1-5). Most data are with monoclonal anti-TNF drugs, especially Adalimumab (ADA) and Infliximab (IFX). However, there is not enough evidence for the use of Certolizumab Pegol (CZP).Objectives:To evaluate the efficacy and safety of CZP in refractory uveitis secondary to Immune-Mediated Inflammatory Diseases (IMID).Methods:Multicenter study of 71 patients with uveitis due to IMID refractory to glucocorticoids and conventional immunosuppressants. Efficacy was assessed with the following ocular parameters: best corrected visual acuity (BCVA), anterior chamber cells, vitritis, macular thickness and presence of retinal vasculitis. These outcomes were compared between baseline, 1st week, 1st and 6th month, and 1st and 2nd year. Statistical analysis was performed with IBM SPSS Statistics v.23.Results:71 patients/100 affected eyes (29 men/42 women) with mean age of 40.0±11.3 years were studied. Underlying IMIDs were: spondyloarthritis (n=38), Behçet (10), psoriatic arthritis (8), Crohn disease (3), sarcoidosis (2), JIA (1), reactive arthritis (1), rheumatoid arthritis (1), relapsing polychondritis (1), TINU (1), pars planitis (1), Birdshot (1) and idiopathic uveitis (3). Uveitis pattern was anterior (n=55), posterior (6), panuveitis (6) and intermediate (4).Prior to CZP, patients had received: methotrexate (37), sulfasalazine (26), azathioprine (14), cyclosporine (10), leflunomide (3), mycophenolate mofetil (3) and cyclophosphamide (1). Previous BT was administered in 48 (67.6%) patients, with a mean of 1.4±1.3 drugs per patient as follows: ADA (n=56), IFX (27), golimumab (14), tocilizumab (5) and etanercept (3). Pregnancy was the reason for prescribing CZP in 19 patients. CZP was administered in monotherapy (n=39) or combined with conventional immunosuppressants (n=32).After a mean follow-up of 27.1±21.1 months, most of the ocular variables showed a rapid and significantly improvement (Table 1). A decrease in the median number [IQR] of flares of uveitis before and after CZP, (3 [1-4] vs. 0 [0-1], p<0.001) was observed. CZP was discontinued in 15 patients due to remission (n=2), ocular insufficient response (2) and incomplete response of extraocular manifestations (11). No serious adverse events were reported.Conclusion:CZP seems to be effective and safe in patients with refractory uveitis due to IMID.References:[1]Martín-Varillas JL, et al. Ophthalmology 2018; 125:1444-1451. doi: 10.1016/j.ophtha.2018.02.020.[2]Atienza-Mateo B, et al. Arthritis Rheumatol 2019; 71:2081-2089. doi: 10.1002/art.41026.[3]Santos-Gómez M, et al. Clin Exp Rheumatol 2016; 34(6 Suppl 102):S34-S40. PMID: 27054359[4]Vegas-Revenga N, et al. Am J Ophthalmol 2019; 200:85-94. doi: 10.1016/j.ajo.2018.12.019[5]Calvo-Río V, et al. Clin Exp Rheumatol. 2014; 32 (4 Suppl 84):S54-7. PMID: 25005576Table 1.Baseline1stweek1stMonth6thMonth1styear2ndyearBCVA (mean±SD)0.68±0.270.72±0.27*0.79±0.25*0.84±0.24*0.85±0.25*0.87±0.22*Improvement in AC Cells, n (%)Patients with AC cells at baseline (n=48)-21 (43.7)30 (62.5)*41 (85.4)*48 (100)*48 (100)*Improvement in Vitritis, n (%)Patients with vitritis at baseline (n=13)-3 (23.1)8 (61.5)*11 (84.6)*13 (100)*13 (100)*OCT (µ) (mean±SD)292.5±47.7294±47.4286.7±41.9*274.7±38.7*272.8±38.9*266.31±36.2*Choroiditis; affected eyes, n, (%)3 (4.2)3 (4.2)2 (2.8)2 (2.8)1 (1.4)0 (0)Retinal Vasculitis; affected eyes, n, (%)2 (2.8)0 (0)1 (1.4)0 (0)0 (0)0 (0)*p<0.001Disclosure of Interests:None declared
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Ramos E, Guillén-Del-Castillo A, Simeón-Aznar CP, Gracia Tello B, Fonollosa Pla V, Selva-O’callaghan A, Sáez-Comet L, Martínez Robles E, Rios JJ, Espinosa G, Todolí Parra JA, Callejas-Rubio JL, Ortego N, Marí-Alfonso B, Freire M, Fanlo P. POS1409 AUTOMATED DETECTION OF SCLERODERMIFORM PATTERNS USING CAPILLARY.IO. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:A nailfold capillaroscopy procedure is a non-invasive, low-cost, and well-established examination that can be used to diagnose several rheumatic autoimmune diseases and support the necessary follow-up of patients. While the clinical implications of the technique are known, a rigorous and in-depth examination of nailfold capillaries remains as one of the major challenges to produce new advances in research and diagnosis, due to practical limitations for analysing the whole nailfold area of each patient. The difference between the different patterns established by Maricq and Cutolo makes it possible to predict the evolution that the patient will present. We introduce Capillary.io, an automatic image reading system able to recognize capillaries in images obtained with any microscope, generate automatic measurements of each capillary and take advantage of this information to report capillary morphology and patterns.Objectives:to determine the ability to detect active and early scerodermiform patterns of Capillary.io.Methods:Forty-nine complete capillaroscopies, reported by expert capillaroscopists according to the different patterns manually (gold standard), were compared with the pattern detection capability of Capillary.io. A scoring system based on the algorithm of the Spanish Capillaroscopy Study Group (GREC) was performed and interpreted by capillary.io for the global interpretation of each of the capillaroscopies analyzed.Results:Overall, 37 of the 49 capillaroscopies reported agreed with the diagnosed pattern (75.51%). Separately, the early pattern presented a concordance of 77.27% and the active pattern of 74.07%. In reference to the findings detected by the Capillary.io system, the mean overall density was 5.01 capillaries/mm in the group with the active pattern compared to 6.46 capillaries/mm in the early pattern. The density of dilations and megacapillaries was 2.81/mm and 1.21/mm in the active pattern group versus 4.69/mm and 0.4/mm in the early pattern group. Global diameters were greater in the active pattern group with an apical mean of 37.3 μm compared to 28.5 μm in the early pattern subgroup.Conclusion:Capillary.io is a simple, easy-to-learn web system for interpreting capillaroscopic images of nail folds. It can be a very useful tool to standardize the interpretation of capillaroscopic images, not only individually for each capillary, but also jointly through the detection of different patterns.References:[1]Chen K, Wang J, Pang J, Cao Y, Xiong Y, Li X, et al. MMDetection: Open MMLab Detection Toolbox and Benchmark. arXiv preprint arXiv:190607155 2019;.[2]Cutolo M, Pizzorni C, Sulli A. Nailfold videocapillaroscopy assessment of microvascular damage in systemic sclerosis - Reply. The Journal of Rheumatology 2000 11;27:2722–2723.[3]Cutolo M, Trombetta AC, Melsens K, Pizzorni C, Sulli A, Ruaro B, et al. Automated assessment of absolute nailfold capillary number on videocapillaroscopic images: Proof of principle and validation in systemic sclerosis. Microcirculation 2018 May;25(4):e12447.[4]Smith V, Vanhaecke A, Herrick AL, Distler O, Guerra MG, Denton CP, et al. Fast track algorithm: How to differentiate a “scleroderma pattern” from a “non-scleroderma pattern”. Autoimmu- nity Reviews 2019 nov;18(11):102394.[5]Tavakol ME, Fatemi A, Karbalaie A, Emrani Z, Erlandsson BE. Nailfold Capillaroscopy in Rheumatic Diseases: Which Parameters Should Be Evaluated? BioMed Research International 2015;2015:1–17.Disclosure of Interests:Eduardo Ramos Shareholder of: Co-founder and shareholder of Capillary.io, Alfredo Guillén-Del-Castillo: None declared, Carmen Pilar Simeón-Aznar: None declared, Borja Gracia Tello Shareholder of: Co-founder and shareholder of Capillary.io, Vicent Fonollosa Pla: None declared, Albert Selva-O’Callaghan: None declared, Luis Sáez-Comet: None declared, Elena Martínez Robles: None declared, Juan José Rios: None declared, Gerard Espinosa: None declared, Jose Antonio Todolí Parra: None declared, Jose Luis Callejas-Rubio: None declared, Norberto Ortego: None declared, Begoña Marí-Alfonso: None declared, Mayka Freire: None declared, Patricia Fanlo: None declared
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Fanlo P, Espinosa G, Adán A, Arnáez R, Fonollosa A, Heras H, Oteiza J, Del Carmelo Gracia Tello B, Sáez Comet L, Pallarés L. Impact of novel coronavirus infection in patients with uveitis associated with an autoimmune disease: Result of the COVID-19-GEAS patient survey. Arch Soc Esp Oftalmol (Engl Ed) 2021; 96:347-352. [PMID: 34217471 PMCID: PMC8133494 DOI: 10.1016/j.oftale.2020.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/15/2020] [Indexed: 01/08/2023]
Abstract
Introduction The objective of these study is to know the characteristics of COVID-19 in patients with uveitis associated with Systemic Autoimmune Disease (SAD) through telematic survey. Material and methods Internal Medicine Society and Group of Systemic Autoimmune disease conducted a telematic survey of patients with SAD to learn about the characteristics of COVID-19 in this population. Results A total of 2,789 patients answered the survey, of which 28 had a diagnosis of uveitis associated with SAE. The majority (82%) were female and caucasian (82%), with a mean age of 48 years. The most frequent SAEs were Behçet’s disease followed by sarcoidosis and systemic lupus erythematosus. 46% of the patients were receiving corticosteroid treatment at a mean prednisone dose of 11 mg/day. Regarding infection, 14 (50%) patients reported symptoms compatible with SARS-CoV-2 infection. RT-PCR was performed on the nasopharyngeal smear in two patients and in one of them (4%) it was positive. Conclusions Both asymptomatic and symptomatic COVID-19 patients with ASD-associated UNI had received similar immunosuppressive treatment.
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Affiliation(s)
- P Fanlo
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona, Spain.
| | - G Espinosa
- Servicio de Enfermedades Autoinmunes, Institut Clínic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain
| | - A Adán
- Institut Clínic de Oftalmología, Hospital Clínic, Barcelona, Spain
| | - R Arnáez
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - A Fonollosa
- Servicio de Oftalmología, Hospital Universitario Cruces, Barakaldo, Spain
| | - H Heras
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - J Oteiza
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B Del Carmelo Gracia Tello
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Clínico Lozano Blesa, Zaragoza, Spain
| | - L Sáez Comet
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - L Pallarés
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Son Espases, Balearic Islands, Spain
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Fanlo P, Espinosa G, Adan A, Fonollosa A, Segura A. Multidisciplinary care and units for uveitis in the internal medicine departments in Spain: Survey of the Systemic Autoimmune Diseases Group. Rev Clin Esp 2021; 221:221-225. [PMID: 32111438 DOI: 10.1016/j.rce.2019.11.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/22/2019] [Accepted: 11/02/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To identify the multidisciplinary uveitis units in which internal medicine departments participate in collaboration with ophthalmology departments in Spain. MATERIAL AND METHODS We conducted a multicentre, observational cross-sectional study that collected information using a structured survey sent by email to 1015 partners of the Systemic Autoimmune Diseases Workgroup of the Spanish Society of Internal Medicine (GEAS-SEMI) from the 1st to the 31st of March 2017. RESULTS We identified a total of 21 support units/consultations for the ophthalmology departments. Seventeen (81%) of the units were specific internal medicine-ophthalmology consultations, and 5 (24%) units had been created in the past 5 years. A median of 460 patients were assessed per unit by the end of the year. CONCLUSIONS This study shows, for the first time in Spain, the important and close collaboration between ophthalmologists and internists, especially in highly specialised national reference institutions.
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Affiliation(s)
- P Fanlo
- Servicio de Medicina Interna, Unidad de Enfermedades Autoinmunes Sistémicas, Complejo Hospitalario de Navarra, Pamplona, Navarra, España.
| | - G Espinosa
- Servicio de Enfermedades Autoinmunes, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, España
| | - A Adan
- Institut Clinic d́Oftalmologia, Hospital Clínic, Barcelona, España
| | - A Fonollosa
- Servicio de Oftalmología, Hospital Universitario Cruces, Barakaldo, Vizcaya, España
| | - A Segura
- Servicio de Medicina Interna, Hospital Vall d́Hebron, Barcelona, España
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Fanlo P, Espinosa G, Adán A, Arnáez R, Fonollosa A, Heras H, Oteiza J, Del Carmelo Gracia Tello B, Comet LS, Pallarés L. Impact of novel coronavirus infection in patients with uveitis associated with an autoimmune disease: result of the COVID-19-GEAS patient survey. ACTA ACUST UNITED AC 2021; 96:347-352. [PMID: 34629695 PMCID: PMC7826000 DOI: 10.1016/j.oftal.2020.12.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/15/2020] [Indexed: 01/08/2023]
Abstract
Introducción El objetivo de este estudio es conocer las características de la COVID-19 en pacientes con uveítis asociada a enfermedades autoinmunes sistémicas (EAS) mediante una encuesta telemática. Material y métodos La Sociedad Española de Medicina Interna por medio del Grupo de Trabajo de Enfermedades Autoinmunes realizó una encuesta telemática a pacientes con EAS para conocer las características de la COVID-19 en esta población. Resultados Un total de 2.789 pacientes contestaron la encuesta, de los que 28 tenían un diagnóstico de uveítis asociada a una EAS. La mayoría (82%) eran mujeres y caucásicas (82%), con una media de 48 años. Las EAS más frecuentes fueron la enfermedad de Behçet seguida de la sarcoidosis y del lupus eritematoso sistémico. El 46% de los pacientes estaban recibiendo tratamiento con corticoides a una dosis media de prednisona de 11 mg/día. Respecto a la infección, 14 (50%) pacientes referían síntomas compatibles con infección por SARS-CoV-2. Se realizó RT-PCR en el frotis nasofaríngeo en dos pacientes y en uno de ellos (4%) fue positivo. Conclusiones Los pacientes con UNI asociada a EAS tanto los asintomáticos como los sintomáticos de COVID-19 habían recibido de forma similar tratamiento inmunosupresor.
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Affiliation(s)
- P Fanlo
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona, España.
| | - G Espinosa
- Servicio de Enfermedades Autoinmunes, Institut Clínic de Medicina i Dermatología, Hospital Clínic, Barcelona, España
| | - A Adán
- Institut Clínic de Oftalmología, Hospital Clínic, Barcelona, España
| | - R Arnáez
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona, España
| | - A Fonollosa
- Servicio de Oftalmología, Hospital Universitario Cruces, Barakaldo, España
| | - H Heras
- Servicio de Oftalmología, Complejo Hospitalario de Navarra, Pamplona, España
| | - J Oteiza
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra, Pamplona, España
| | - B Del Carmelo Gracia Tello
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Clínico Lozano Blesa, Zaragoza, España
| | - L Sáez Comet
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España
| | - L Pallarés
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Hospital Son Espases, Islas Baleares, España
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Fanlo P, Espinosa G, Adan A, Fonollosa A, Segura A. Multidisciplinary care and units for uveitis in the internal medicine departments in Spain: Survey of the Systemic Autoimmune Diseases Group. Rev Clin Esp 2020; 221:221-225. [PMID: 33998501 DOI: 10.1016/j.rceng.2019.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 11/02/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To identify the multidisciplinary uveitis units in which internal medicine departments participate in collaboration with ophthalmology departments in Spain. MATERIAL AND METHODS We conducted a multicentre, observational cross-sectional study that collected information using a structured survey sent by email to 1015 partners of the Systemic Autoimmune Diseases Workgroup of the Spanish Society of Internal Medicine (GEAS-SEMI) from the 1st to the 31st of March 2017. RESULTS We identified a total of 21 support units/consultations for the ophthalmology departments. Seventeen (81%) of the units were specific internal medicine-ophthalmology consultations, and 5 (24%) units had been created in the past 5 years. A median of 460 patients were assessed per unit by the end of the year. CONCLUSIONS This study shows, for the first time in Spain, the important and close collaboration between ophthalmologists and internists, especially in highly specialized national reference institutions.
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Affiliation(s)
- P Fanlo
- Servicio de Medicina Interna, Unidad de Enfermedades Autoinmunes Sistémicas, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain.
| | - G Espinosa
- Servicio de Enfermedades Autoinmunes, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Spain
| | - A Adan
- Institut Clinic d'Oftalmologia, Hospital Clínic, Barcelona, Spain
| | - A Fonollosa
- Servicio de Oftalmología, Hospital Universitario Cruces, Barakaldo, Vizcaya, Spain
| | - A Segura
- Servicio de Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
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Fanlo P, Heras H, Espinosa G, Adan A. Complications and visual acuity of patients with uveitis: Epidemiological study in a reference unit in northern Spain. Arch Soc Esp Oftalmol (Engl Ed) 2019; 94:419-425. [PMID: 31277806 DOI: 10.1016/j.oftal.2019.05.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/20/2019] [Accepted: 05/01/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To describe uveitis complications and visual acuity in a cohort of 500 patients in a multidisciplinary unit in northern Spain. MATERIAL AND METHODS Retrospective-prospective study of complications and visual acuity of 500 adult patients evaluated in the Multidisciplinary Unit of the Navarra Hospital Complex from the period January 2010 until March 2015. An analysis was made of the complications, visual acuity and visual loss, with a follow-up of one-year. A comparative study was also made of the complications with 2 previous series published in Madrid and Holland. RESULTS Moderate-severe visual loss was 13.5% in the right eye, and 13% in the left eye. Visual loss was associated with an age of 65 years or above. Complications were observed in 35% of patients, and cataract was the most frequent complication (10%), followed by synechiae (8%), and macular oedema (5%). Compared with the 2 other series, the present cohort showed a higher proportion of cataracts. CONCLUSIONS Visual loss was associated with older age and cataract was the most common complication in our study.
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Affiliation(s)
- P Fanlo
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra-B, Pamplona, Navarra, España.
| | - H Heras
- Servicio de Oftalmología, Complejo Hospitalario de Navarra-B, Pamplona, Navarra, España
| | - G Espinosa
- Servicio de Enfermedades Autoinmunes Sistémicas, Institut Clínic de Medicina Dermatologia, Hospital Clínic, Barcelona, Cataluña, España
| | - A Adan
- Institut Clínic d'Oftalmologia, Hospital Clínic, Barcelona, Cataluña, España
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Fanlo P, Heras H, Pérez D, Tiberio G, Espinosa G, Adan A. Profile of patients with uveitis referred to a multidisciplinary unit in northern Spain. ACTA ACUST UNITED AC 2016; 92:202-209. [PMID: 27956325 DOI: 10.1016/j.oftal.2016.10.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 10/18/2016] [Accepted: 10/26/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the main characteristics of a cohort of patients with uveitis referred to a multidisciplinary unit in northern Spain. MATERIAL AND METHODS Retrospective analysis of clinical records of patients evaluated in the Multidisciplinary Unit of the Navarra Hospital Complex from the period January 2010 until March 2015. An analysis was performed on the demographic characteristics, origin, types of uveitis, laterality, and aetiology. The present series was also compared with 2 previous series from Castilla y León and Barcelona. RESULTS A total of 500 patients were identified, with a mean age of 47.9±16.4 years, with 50% women. The most frequent type of uveitis was anterior uveitis (65.4%), followed by posterior uveitis (17.6%), panuveitis (15.2%), and intermediate uveitis (1.8%). The origin was unclassifiable in 31.2%, followed by non-infectious systemic disease in 29.2%. Ankylosing spondylitis was the most frequent cause in 10.8% of patients, followed by herpes infection in 9.2%, and toxoplasmosis in 7.8%, respectively. Compared with the 2other cohorts, the present cohort showed a higher proportion of unilateral anterior uveitis. Furthermore, the patients from the Navarra series had a higher prevalence of unilateral and idiopathic uveitis compared to the series from Barcelona. CONCLUSIONS The main characteristics of the present cohort of patients with uveitis are similar to those of patients from other regions of our country. Unilateral anterior uveitis and idiopathic uveitis were the most frequent in our series.
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Affiliation(s)
- P Fanlo
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra-B, Pamplona, Navarra, España.
| | - H Heras
- Servicio de Oftalmología, Complejo Hospitalario de Navarra-B, Pamplona, Navarra, España
| | - D Pérez
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra-B, Pamplona, Navarra, España
| | - G Tiberio
- Unidad de Enfermedades Autoinmunes Sistémicas, Servicio de Medicina Interna, Complejo Hospitalario de Navarra-B, Pamplona, Navarra, España
| | - G Espinosa
- Servicio de Enfermedades Autoinmunes, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Cataluña, España
| | - A Adan
- Institut Clinic d́Oftalmologia, Hospital Clínic, Barcelona, Cataluña, España
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Solans-Laqué R, Fraile G, Escalante B, Fonseca E, Martinez-Zapico A, Perez-Conesa M, Abdilla M, Montegaudo M, Caminal L, Gracia B, Del Castillo M, Fanlo P, Ramentol M. SAT0365 Risk Factors for Visual Loss in Giant Cell Arteritis (GCA). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.5355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Solans-Laqué R, Rodriguez-Carballeira M, Rios J, Saez L, Fraile G, Solanich X, Pasquau F, Oristrell J, Fonseca E, Callejas J, Zamora M, del Castillo M, Frutos B, Caminal L, Abdilla M, Fanlo P, Garcia-Sanchez I, Sopeña B, Lopez-Dupla M, Perez-Iglesias A. FRI0388 Ussefulnes of Bvas and Ffs at Diagnosis To Predict Survival in Anca Associated Vasculitis (AAV). Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rodriguez-Carballeira M, Fraile G, Martinez-valle F, Saez L, Rios J, Solanich X, Pasquau F, Fonseca E, Zamora M, Calleja J, Oristrell J, Frutos B, Abdilla M, Castillo M, Caminal L, Fanlo P, Garcia-Sanchez I, Sopeña B, Lopez-Dupla M, Perez A, Solans-Laqué R. FRI0362 Pronostic Factors of Survival in ANCA-Associated Vasculitis (AAV). Changes in The New Century. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Solans-Laqué R, Rodriguez-Carballeira M, Fraile G, Castillo M, Rios J, Saez L, Solanich X, Caminal L, Oristrell J, Pasquau F, Fonseca E, Calleja J, Zamora M, Fanlo P, Abdilla M, Garcia I, Sopeña B, Lopez-Dupla M, Pérez A, Frutos B. FRI0275 Long-Term Survival and Baseline Prognostic Factors in a Wide Series of Patients with AAV from Spain. Usefulness of Prognostic Scores (Revas Study). Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Ortiz-Fernández L, Carmona F, Montes-Cano MA, García-Lozano JR, Conde-Jaldόn M, Ortego-Centeno N, Castillo-Palma MJ, Espinosa G, Graña-Gil G, Sánchez-Bursόn J, Juliá M, Solans R, Blanco R, Barnosi-Marín AC, Fanlo P, Rodriguéz-Carballeira M, Camps T, Castañeda S, Martín J, González-Escribano M. AB0009 The HLA Class I Region in Behçet's Disease: Identifying the Most Relevant Amino Acid Positions. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Solans-Laqué R, Fraile G, Castillo M, Solanich X, Caminal L, Rodriguez M, Rios J, Zamora M, Calleja J, Fanlo P, Garcia I, Saez L, Oristrell J, Abdilla M, Pasquau F, Lopez-Dupla M, Perez A, Fonseca E, Sopeña B. SAT0288 Eosinophilic Granulomatosis with Poliangeitis (EGPA): Clinical Features and Outcome in A Large Serie of Spanish Patients. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Solans-Laqué R, Caminal L, Saez L, Rios J, Zamora M, Solanich X, Rodriguez M, Lopez-Dupla M, Castillo M, Fonseca E, Calleja J, Fanlo P, Abdilla M. THU0226 Clinical features and mortality causes in a large cohort of spanish patients with anca associated vasculitides. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Solans-Laqué R, Fraile G, Monteagudo M, Caminal L, Abdilla M, Fanlo P. SAT0174 Clinical and Histological Features in Patients with Permanent Visual Los Due to Biopsy-Proven Giant Cell Arteritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Duro V, Perez C, Fanlo P, Elejalde I, Etxebarria M, Gonzalez M. Initial presentation of giant cell arteritis with ischemic optic neuropathy without headache: Report of four cases. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Mellado M, Fanlo P, Bidegain E, Lopez De Goicoechea M, Garcia Carasusan M, Arejola J. Refractory cutaneous vasculitis associated with MAGIC syndrome: Case report. Presse Med 2013. [DOI: 10.1016/j.lpm.2013.02.095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Fanlo P, Tiberio G. [Extrapulmonary tuberculosis]. An Sist Sanit Navar 2007; 30 Suppl 2:143-62. [PMID: 17898834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
In spite of the lung being the target organ par excellence of tuberculosis, any other organ and system can be affected. In this article we review the forms of extrapulmonary tuberculosis, with the exception of the pleural form that requires the use of good diagnostic skills. From the dreaded tuberculous meningitis, by way of the insidious affectation of the spondylodiscitis, the so-called ganglionary affectation , the genitourinary affectation, pericarditis, and ending with less frequent forms such as ocular and cutaneous tuberculosis. In each section we will indicate what is most characteristic with the aim of providing a diagnostic and therapeutic orientation.
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Affiliation(s)
- P Fanlo
- Servicio de Medicina Interna, Hospital Virgen del Camino, Pamplona, 31008. Spain
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Abú-Shams K, Fanlo P, Lorente MP. [Silicosis]. An Sist Sanit Navar 2005; 28 Suppl 1:83-9. [PMID: 15915175 DOI: 10.4321/s1137-66272005000200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Silicosis, which acquired great significance during the period of increase in mining and construction, continues to be a pathology with a high morbidity and mortality within pneumoconiosis. Exposure to silica produces pathological, clinical and radiological alterations that together with compatible personal antecedents suggests its diagnosis in a simple way. The associated complications as well as its differential diagnosis from other types of pneumopathy mean that a review of this entity is needed.
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Affiliation(s)
- K Abú-Shams
- Sección de Neumología, Hospital Virgen del Camino, Pamplona, 31008, Spain.
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Cebollero P, Echechipía S, Echegoyen A, Lorente MP, Fanlo P. [Hypersensitivity Pneumonitis (extrinsic allergic alveolitis)]. An Sist Sanit Navar 2005; 28 Suppl 1:91-9. [PMID: 15915176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Farmer's lung was first described in 1932. We can define hypersensitivity pneumonitis as a pulmonary and systemic disease that is accompanied by dyspnoea and coughing; it is caused by an immunological type of inflammation of the alveolar walls and the terminal airways and it is secondary to the repeated inhalation of a variety of antigens by a susceptible host. It can be said that it is an underdiagnosed disease and only a high degree of clinical manifestations and a detailed history of exposure can lead to an early diagnosis and satisfactory treatment. A combination among clinical-radiological, functional, cytological or pathological findings leads in some cases to a diagnosis. Treatment is based on avoiding further exposure to the causal agent and in the more serious cases the administration of systemic corticoid treatment.
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Affiliation(s)
- P Cebollero
- Sección de Neumología, Hospital Virgen del Camino, Pamplona, 31008, Spain.
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