RESUMEN
OBJECTIVE: Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (anti-CCP) are commonly used for diagnosis of rheumatoid arthritis (RA), although other rheumatic diseases with arthritis can test positive. This study aimed to determine the cutoff values for RF and anti-CCP with the best diagnostic performance in a sample of patients with RA, compared with other rheumatic diseases. METHODS: This was a descriptive, prospective study. EUROINMMUN enzyme-linked immunosorbent assays for RF isotypes immunoglobulin (Ig) A (IgA), IgG and IgM and third-generation assay IgG for anti-CCP were used in serum samples of patients with RA, other rheumatic diseases and healthy subjects. The cutoff with the best diagnostic performance was determined by the Youden Index and receiver operating characteristic analysis Results: Three hundred and thirty-two serum samples were analysed. The cutoffs proposed in our population were for RF in RA patients versus other rheumatic diseases, and healthy subjects IgM 135 IU/mL, for each disease, compared with RA, were psoriatic arthritis (Psa) IgA 47.2 IU/mL, clinically suspicious arthralgia (CSA) IgA 39.5 IU/mL, primary Sjögren's syndrome (pSS) IgM 180.6 IU/mL, systemic lupus erythematosus (SLE) IgA 42.6 IU/mL, primary fibromyalgia (pFM) IgM 68.6 IU/mL, osteoarthritis (OA) IgM 48 IU/mL, gout IgM 117 IU/mL and healthy IgM 16.3 IU/mL. For anti-CCP, in RA patients versus other rheumatic diseases, and healthy subjects 6.95 IU/mL, for each disease, compared with RA, were Psa 6.8 IU/mL, CSA 9.95 IU/mL, pSS 20.7 IU/mL, SLE 6 IU /mL, pFM 11.8 IU/mL, OA 11.9 IU/mL, gout 5 IU/mL and healthy 5 IU/mL. CONCLUSION: Irrespective of the manufacturer's suggested cutoff, the RA versus differential diagnosis cutoffs must be considered.
Asunto(s)
Artritis Reumatoide , Gota , Lupus Eritematoso Sistémico , Enfermedades Reumáticas , Humanos , Factor Reumatoide , Diagnóstico Diferencial , Anticuerpos Antiproteína Citrulinada , Estudios Prospectivos , Autoanticuerpos , Enfermedades Reumáticas/diagnóstico , Inmunoglobulina G , Inmunoglobulina M , Inmunoglobulina A , Gota/diagnóstico , Péptidos , Ensayo de Inmunoadsorción EnzimáticaAsunto(s)
Antirreumáticos , COVID-19 , Enfermedades Reumáticas , Antirreumáticos/uso terapéutico , Humanos , Hidroxicloroquina/uso terapéutico , América Latina/epidemiología , Pandemias , Enfermedades Reumáticas/tratamiento farmacológico , Enfermedades Reumáticas/epidemiología , Cumplimiento y Adherencia al TratamientoAsunto(s)
Antirreumáticos/uso terapéutico , COVID-19/terapia , Enfermedades Reumáticas/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/complicaciones , Femenino , Humanos , Masculino , México , Persona de Mediana Edad , Enfermedades Reumáticas/complicaciones , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Cysticercosis is a parasitic disease caused by the larval stage of Taenia Solium. Involvement of the central nervous system by this tapeworm is endemic in developing countries. However, isolated spinal involvement by Taenia Solium is uncommon and having clinical presentation of Brown-Séquard syndrome is even rarer. CASE PRESENTATION: A 43-year-old male who came to the emergency department with clinical presentation of complete Brown-Séquard syndrome. Computed tomography scan of the brain was normal. Magnetic resonance imaging of the thoracic spine revealed an intramedullary mass of the spinal cord at C-7/T-l level. Patient underwent surgery that revealed a cystic lesion and was resected. Histopathological report confirmed the diagnosis of neurocysticercosis. Postoperatively, oral steroid therapy and a four week course of albendazol were administered. CONCLUSIONS: Intramedullary neurcysticercosis represents a diagnostic challenge and should be considered in intramedullary lesions in settings where Taenia solium is endemic. Clinical, pathophysiological and diagnostic aspects of spinal cord intramedullary neurocysticercosis are discussed.