RESUMO
BACKGROUND: Raynaud's phenomenon (RP) and anticardiolipin antibodies (ACL) are two common clinical manifestations in patients with systemic lupus erythematosus (SLE). RP may lead to digital or limb loss. ACL are associated to thrombotic episodes. It is not yet clear if there is an association between RP and the presence of ACL in patients with SLE. OBJECTIVES: To study if the presence of both RP and ACL in patients with SLE may be associated with certain clinical manifestations or thrombotic events compared to SLE patients without RP or ACL. METHODS: SLE patients from two lupus clinics were recruited. The patients were divided into 4 groups. Patients with RP and positive ACL (RP+ ACL+), patients with RP but negative ACL (RP+ ACL-), patients with negative RP and positive ACL (RP- ACL+), and patients that were negative for RP and ACL (RP- ACL-) used as the control group. Demographic data, diagnostic criteria, clinical manifestations, history of arterial thrombosis, venous thrombosis and abortions were recorded. A physical examination was done. Anticardiolipin antibodies IgG and IgM were done in the rheumatology laboratory at the University of Puerto Rico School of Medicine. Descriptive statistics as well as analysis of variances (ANOVA), and polytomous logistic regression were used. RESULTS: 236 patients with SLE were studied. There was a tendency toward an increase in arterial thrombosis (p-value = 0.094) and venous thrombosis (p-value = 0.067) in the group that were positive for RP and ACL (RP+ ACL+). Although it was not statistical significant, when polytomous logistic regression was used, both arterial and venous thrombosis had an increase in relative risk 3.21 for arterial and 3.11 for venous thrombosis. Abortions were not increased in any of the four groups. Clinical manifestations from SLE did not differ among the four groups. CONCLUSIONS: Patients with both RP and ACL seem to be at an increase risk for both arterial and venous thrombotic events; these patients may benefit from an antiplatelet medication to prevent these events to occur.
Assuntos
Anticorpos Anticardiolipina/sangue , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/complicações , Doença de Raynaud/sangue , Doença de Raynaud/complicações , Trombose/sangue , Trombose/etiologia , Adulto , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: To determine the most common causes of death among Puerto Ricans with systemic lupus erythematosus. METHODS: Chart and record review of all deaths related to SLE complications from 1960 to 1994 at the University of Puerto Rico Hospital. RESULTS: Out of 662 patients diagnosed with SLE 161 (24) died. There were 151 (94) females and 10 (6) males. Mean duration of disease was 11.5 years. Mean age at death was 37 years. The primary causes of death were infection in 44 (27), uremia in 42 (26), cardiovascular complications in 33 (20), central nervous system complications in 18 (11), and pulmonary complications (other than infectious pneumonia) in 12 (7). CONCLUSIONS: The most common causes of death in SLE were infections and renal disease.
Assuntos
Humanos , Masculino , Feminino , Adulto , Lúpus Eritematoso Sistêmico/mortalidade , Causas de Morte , Porto Rico , Estudos RetrospectivosRESUMO
Dieciseis pacientes con evidencia angiográfica de arteritis de Takayasu fueron estudiados retrospectivamente. Los hallazgos más comunes al momento del diagnóstico fueron disminución en los pulsos, periféricos e hipertensión arterial. Los resultados de laboratório no fueron específicos. La mayoria de los pacientes respondieron favorablemente a los esteroides y/o inmunosupresores, con un buen pronóstico a largo plazo. Nuestra población de pacientes con arteritis de Takayasu es similar a otras series