
Santiago Bernal-MacíasHospital Universitario San Ignacio | HUSI · Department of Internal Medicine
Santiago Bernal-Macías
Doctor of Medicine
Rheumatologist in Hospital Universitario San Ignacio and Pontificia Universidad Javeriana
About
61
Publications
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325
Citations
Introduction
Médico - Colegio Mayor de Nuestra Señora del Rosario // Epidemiología clínica - Universidad CES //
Asistente de investigación - Centro de Estudio de Enfermedades Autoinmunes //
Médico internista - Pontificia Universidad Javeriana //
Reumatología - Universidad de la Sabana
Additional affiliations
February 2019 - present
December 2013 - December 2015
Education
January 2024 - January 2027
August 2019 - July 2021
January 2016 - January 2019
Publications
Publications (61)
Background:
Data on the effect of gender in rheumatoid arthritis (RA) in non-Caucasian populations is scarce. Latin America and the Caribbean (LAC) is a large population with unique characteristics, including high admixture.
Objective:
Our aim was to examine the effect of gender in patients with RA in LAC.
Methods:
This was a 2-phase study. Fi...
Objectives The interest on autoimmune diseases (ADs) and their outcome at the intensive care unit (ICU) has increased due to the clinical challenge for diagnosis and management as well as for prognosis. The current work presents a-year experience on these topics in a tertiary hospital.
Methods The mixed-cluster methodology based on multivariate de...
Thrombocytopenia is defined as a platelet count of less than 100,000 platelets per microlitre (mcL). Thrombocytopenia develops in approximately 6-7% of women during pregnancy and at least 3% of these cases are caused by immunological platelet destruction. Herein, we present a pregnant woman who develops at the first trimester autoimmune thrombocyto...
We describe a case of Takayasu arteritis with unusual presentation, having chest pain as the main symptom and a nasal septal perforation as a rare complication, without upper and lower extremities, abdominal, neck or cerebral compromise. The patient, a 34 year-old male, previously healthy, presented with acute onset of chest pain, dyspnea and sever...
OBJECTIVE: To calculate the prevalence and describe the main demographic characteristics of Sjögren's syndrome in adults in Colombia.
MATERIAL AND METHODS:
Descriptive cross-sectional study which utilized data from the Integral Information System of Social Protection of the Ministry of Health of the Republic of Colombia during the years 2012 to 201...
Background: Fever of unknown origin (FUO) is a diagnostic challenge with highly heterogeneous causes. Its etiology can change according to the studied regions, and the chance of reaching a diagnosis depends on available resources. The aim of this study is to describe the clinical characteristics, etiology and the usefulness of diagnostic aids in ca...
In rare instances, patients with SLE may exhibit atypical clinical manifestations, such as Hypocomplementemic Urticarial Vasculitis, which can pose diagnostic challenges. Here, we present a case report of a 28-year-old female with a history of SLE with lupus nephritis clase IV who developed HUV-like symptoms, ultimately leading to a diagnosis of C1...
Lupus enteritis denotes inflammation of the intestinal walls resulting from the influence of systemic lupus erythematosus. It represents a rare manifestation associated with notable morbidity and mortality, marked by nonspecific gastrointestinal symptoms. In this article, we present two cases of individuals experiencing severe gastrointestinal symp...
Registries allow ascertaining the epidemiology of chronic diseases such as axial spondyloarthritis (axSpA). The Colombian Ministry of Health has implemented a National Health Registry (SISPRO) that collects data from each medical contact in the system, which provides close to universal coverage (around 98%).
To establish the 5-year prevalence of ax...
El síndrome de abscesos asépticos es una condición poco frecuente, probablemente subdiagnosticada, que se caracteriza por la aparición de colecciones neutrofílicas estériles en diferentes tejidos, las cuales no responden a antimicrobianos y cuyo tratamiento es basado en terapia antiinflamatoria. La literatura que relaciona dicha condición con la ar...
Interosseous atrophy of the hand is not an exclusive finding of rheumatoid arthritis, and in the case of amyotrophic lateral sclerosis it has a significant diagnostic and prognostic value. The physical examination and evidence of the “split hand” sign or sign of the double anatomical snuffbox is a finding that should alert the clinician to the need...
Introduction
Psoriatic arthritis is an inflammatory arthritis with a wide range of manifestations. The complexity of the disease is a barrier to understanding it, however knowledge about the disease has increased considerably over time, due to advances in genetics, immunology, imaging, and a better understanding of epidemiology. The exact prevalenc...
The coexistence of systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (AAV) as an overlapping syndrome is not common. Here, we report a case of a 33-year-old woman, with recent SLE diagnosis due to skin, kidney, articular, and immunologic compromise, in whom a chest CT scan showed bilateral nodules, consolidations, and tree-in-bud pa...
Chikungunya virus (CHIKV) is an alphavirus from the Togaviridae family that causes acute
arthropathy in humans. It is an arthropod-borne virus transmitted initially by the Aedes
(Ae) aegypti and after 2006’s epidemic in La Reunion by Ae albopictus due to an adaptive
mutation of alanine for valine in the position 226 of the E1 glycoprotein genome (A...
Dressler’s syndrome is a rare entity which was first described in 1956 by Dr. William Dressler. It consists of secondary pericarditis, at times associated with pericardial effusion with an apparently autoimmune etiology, which is one of the post-cardiac injury syndromes. We present a case of Dressler’s syndrome in a young patient.
Host immune response and virulence factors are key to disease susceptibility. However, there are no known association studies of human leukocyte antigen (HLA) class I and II alleles with chikungunya virus (CHIKV) infection in the Latin American population. Here we aimed to identify HLA alleles present in patients with CHIKV infection versus healthy...
Resumen
La presencia de manifestaciones extraglandulares del síndrome de Sjögren abre un amplio debate en el campo de la neurología, en el cual la asociación o similitud con la esclerosis múltiple y el espectro de la neuromielitis óptica plantea la necesidad de mejores marcadores, dentro de los cuales los anticuerpos contra la acuaporina 4 han gana...
Objective
Using data from the Ministry of Health of Colombia, we performed an analysis of prevalence and general demographic characteristics of patients with inflammatory myopathies, with data from 2012 to 2018.
Design
A descriptive cross-sectional study based on data from the Ministry of Health of Colombia. We used as key terms the diagnostic cod...
Host immune response as well as virulence factors are key in disease susceptibility. There are no known association studies of HLA class I and II alleles with chikungunya (CHIKV) infection in Latin American population. We aim to identify Human Leukocyte Antigen (HLA) alleles present in patients with CHIKV infection when compared to healthy controls...
Introduction
Osteoporosis is considered a healthcare problem due to the increased risk of fractures and high cost of care. In Colombia, the Ministry of Health introduced SISPRO, a tool to collect nationwide information from the health system. The information collected from SISPRO is available for scientific analysis. This article presents an analys...
Resumen
La atrofia de interóseos de la mano no es un hallazgo exclusivo de la artritis reumatoide, en el caso de la esclerosis lateral amiotrófica tiene un valor diagnóstico y pronóstico significativo, por lo que la exploración física y la evidencia del signo de la mano partida o signo de la doble tabaquera anatómica es un hallazgo que debe alertar...
Introduction
Osteoporosis is considered a healthcare problem due to the increased risk of fractures and high cost of care. In Colombia, the Ministry of Health introduced SISPRO, a tool to collect nationwide information from the health system. The information collected from SISPRO is available for scientific analysis. This article presents an analys...
The relevance of polyautoimmunity, defined as the presence of two or more autoimmune diseases in the same individual, is one of the issues not yet elucidated in medical practice. The coexistence of myasthenia gravis (MG) and systemic lupus erythematosus (SLE) is a clinical challenge due to the possible differential diagnoses of muscle involvement i...
Objective:
To determine the association between endoplasmic reticulum aminopeptidase (ERAP)1 and ERAP2 single-nucleotide polymorphisms (SNPs) and human leukocyte antigens (HLA)-B27+ or HLA-B15+ patients with spondyloarthritis (SpA).
Methods:
104 patients with SpA according to Assessment of Spondyloarthritis International Society criteria were in...
Resumen
El síndrome de Sjögren primario (SSp) es una enfermedad autoinmune que afecta principalmente al tejido glandular. A pesar de ello, puede involucrar otros sistemas, siendo el compromiso neuropsiquiátrico una manifestación extraglandular común. Su presentación clínica varía ampliamente según el dominio que se encuentre afectado, y por tanto p...
Abstract. Methotrexate (MTX) is the most commonly used disease‑modifying antirheumatic drug for the treatment of rheu‑matoid arthritis (RA). However, over time, ~40% of patients may experience therapeutic failure or drug toxicity. The genetic vari‑ability of the enzymes involved in the MTX metabolic pathway seem to serve an important role in the ev...
Objective
To calculate the prevalence and describe the main demographic characteristics of Sjögren's syndrome in adults in Colombia.
Material and methods
Descriptive cross-sectional study which utilised data from the Integral Information System of Social Protection of the Ministry of Health of the Republic of Colombia during the years 2012 to 2016...
Purpose
To describe health-related QOL (HRQOL) in patients with musculoskeletal symptoms, compared to a population with other comorbidities, and a healthy population.
Methods
A cross-sectional study was carried out on an open population involved in a community-oriented program for control of rheumatic diseases (COPCORD) study in Colombia, using EQ...
Purpose
To describe health-related QOL (HRQOL) in patients with musculoskeletal symptoms, compared to a population with other comorbidities, and a healthy population.
Methods
A cross-sectional study was carried out on an open population involved in a community-oriented program for control of rheumatic diseases (COPCORD) study in Colombia, using EQ...
Introduction
Registries are essential to keep track of inflammatory bowel disease (IBD) and related arthritis epidemiology, and to provide better care to patients. In Colombia, the health ministry has adopted a tool, SISPRO, to gather all information coming from the whole health system structure. Given that the information collected from SISPRO is...
Resumen
Introducción
Los registros son esenciales para seguir la epidemiología de la enfermedad inflamatoria intestinal (EII) y el compromiso articular asociado y brindar mejor atención a los pacientes. En Colombia, el Ministerio de Salud y de la Protección Social utiliza la herramienta SISPRO para recolectar información del sistema de salud, la c...
To estimate prevalence and describe the main demographic characteristics of Behcet disease in Colombia. Cross-sectional study, based on official Ministry of Health registry data. 523 cases of Behcet disease (ICD-10 code: M352) were reported between 2012 and 2016, for a prevalence in people over 18 years old of 1.10 per 100,000 inhabitants, of which...
Introduction
Systemic sclerosis is an autoimmune disease that characteristically presents with fibrosis and vasculopathy. In Latin America, the information on the epidemiology of this disease is scarce and records are essential to know its behavior in the populations. In Colombia, the Ministry of Health uses the SISPRO tool to collect information o...
Polymyalgia rheumatica (PMR) affects elderly patients and is characterized by pain and stiffness of the shoulder girdle, pelvic girdle and cervical region, which can be associated with the presence of giant cell arteritis. Data on the epidemiology of this disease in Latin America are scarce. In Colombia, the Ministry of Health introduced SISPRO, a...
Introduction
Registries are essential to keep track of systemic lupus erythematosus (SLE) epidemiology and to provide better care to patients. The Colombian Ministry of Health has adopted a registry (SISPRO) to gather comprehensive information coming from the Colombian health system, which provides close to universal coverage (around 95%). The info...
Objetivo: Calcular la prevalencia y describir las principales características demográficas dela artritis reumatoide en adultos en Colombia.
Materiales y métodos: Estudio descriptivo de corte transversal en el que se tomaron los datos del Sistema Integral de Información de la Protección Social del Ministerio de Salud, durante los años 2012-2016.
Res...
Background
The ministry of health and social protection of Colombia uses a system named SISPRO as a tool to establish the basic information of the health system. This information is public and available for anyone to search. We analyze the prevalence and specific characteristics of patients with rheumatic diseases registered in colombian health sys...
Objetivo
Calcular la prevalencia y describir las principales características demográficas de la artritis reumatoide en adultos en Colombia.
Materiales y métodos
Estudio descriptivo de corte transversal en el que se tomaron los datos del Sistema Integral de Información de la Protección Social del Ministerio de Salud, durante los años 2012-2016.
Re...
The relevance of polyautoimmunity, defined as the presence of 2 or more autoimmune diseases in thesame individual, is one of the issues not yet elucidated in medical practice. The coexistence of myast-henia gravis (MG) and systemic lupus erythematosus (SLE) is a clinical challenge due to the possibledifferential diagnoses of muscle involvement in p...
Métodos: Es un estudio descriptivo epidemiológico donde se utilizó el manual internacional de enfermedades (CIE-10) como palabras clave de cada una de las enfermedades reumáticas para analizar los datos obtenidos de SISPRO. Adicionalmente se utilizó la proyecciones poblacionales del Departamento Nacional de Estadística (DANE) a partir del último ce...
Introducción: La enfermedad inflamatoria intestinal (EII) es una enfermedad crónica con inicio en la edad adulta temprana. Puede afectar a la mujer a lo largo de las muchas etapas de su vida, enfrentando problemas de salud únicos de cada etapa, alterando el curso de la EII. Teniendo en cuenta lo anterior, en una cohorte de pacientes con EII, realiz...
Se trata de una paciente que cursa con nefropatía por IgA paraneoplasica secundaria a un tumor del sitio de inserción placentaria, haciéndolo un caso interesante a tener en cuenta por aspectos epidemiológicos, pues es un tumor infrecuente y el compromiso paraneoplásico tipo nefropatía por IgA no está descrito en la literatura asociado a tumores gin...
El prototipo de enfermedad autoinmune del sistema digestivo es la EII, afectando principalmente el intestino, ocasionando dolor abdominal y diarrea crónica asociado a manifestaciones extraintestinales (MEI) en el 20 a 40%, siendo el mas frecuente el compromiso articular, presentándose compromiso periférico y axial, aumentando aun mas su morbimortal...
Descripción de la prevalencia y características demográficas de algunas entidades reumatológicas de acuerdo al registro RIPS
La existencia de trastornos motores gastrointestinales (TMG) también se relaciona con enfermedades del tejido conectivo (ETC) diferentes a la esclerodermia, como son: el síndrome de Sjögren (SS), lupus eritematoso sistémico (LES), artritis reumatoide (AR) y la enfermedad mixta del tejido conectivo (EMTC). A pesar de que cualquier parte del tracto g...
Establecer la prevalencia y algunas características demográficas de diferentes entidades reumatológicas de acuerdo al registro oficial RIPS
Introduction: Systemic sclerosis (SSc) is a chronic disease of the connective tissue that has manifesta- tions in multiple organs, which commonly affects the gastrointestinal system, and the esophagus most of all. Because of the systemic implications, impacts not only on mortality, but also in morbidity and dete- rioration in the quality of life, w...
Debido a las repercusiones sistémicas de la esclerosis sistémica (SSc) que impactan no solo en mortalidad, sino también en morbilidad y deterioro de la calidad de vida, realizamos una descripción de un grupo de pacientes que fueron llevados a manometría esofágica de alta resolución.
La existencia de trastornos motores gastrointestinales (TMG) también se relaciona con enfermedades del tejido conectivo (ETC) diferentes a la esclerodermia, como son, el síndrome de Sjögren (SS), lupus eritematoso sistémico (LES), artritis reumatoide (AR) y la ETC no diferenciada. A pesar de que cualquier parte del tracto gastrointestinal puede com...
Background: Non-infectious pediatric uveitis has the potential to produce severe visual
complications and its traditional pharmacologic treatment is associated with severe adverse
effects.1
Infliximab and Adalimumab are two Biologic Response Modifiers available for the
treatment of refractory pediatric uveitis. They specifically attach to TNFα and...
The number of cesarean sections has risen during the recent years, leading to an increase in abnormal placentation in future pregnancies, as well as other materno-fetal complications. Placental abnormalities and the surgical management they usually required, drastically obscure maternal and fetal outcomes. We report the case of a multiparous woman...
Questions
Question (1)
Cyclophosphamide vs Anti TNF