Caritina Vázquez-Triñanes

Complexo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain

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Publications (8)43.46 Total impact

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    ABSTRACT: There are few data regarding the existence of clinical differences between patients with systemic sclerosis (scleroderma) exposed to silica (SSc-si) and "idiopathic" cases (SSc-id). Our goal is to describe the clinical characteristics of patients with SSc-si and see if they differ from the SSc-id cases. We performed a systematic review of the literature by searching the MEDLINE, EMBASE and Web of Science databases. We also included our own series of patients diagnosed with SSc-si and SSc-id controls at the "Complejo Hospitalario Universitario de Vigo (CHUVI)" from 1985 to January 2013. The review of the literature disclosed 32 published series, with clinical data of 254 SSc-si patients (96% males). SSc-si represented 37.5-86% of the scleroderma males and 0-2.7% of the scleroderma females. Globally, more than expected proportion of diffuse forms (61%) and interstitial lung disease (81%) were observed in exposed patients. In the present series, the diagnosis of SSc exposure to silica was recorded in nine patients (9.5%), showing predominance of the diffuse form (77%, p = 0.001), positivity for anti-Scl70 (55%, p = 0.001), presence of ILD (78%, p = 0.048) and lower survival (9.2 versus 15.1, p = 0.023). Diffuse variant remained more prevalent analysing exposed versus non-exposed women (50% versus 8%, p = 0,000) and exposed versus non-exposed men (85.8% versus 50%, p = 0,000). Silica exposure is a predominant risk factor in male SSc populations. The review of the literature is consistent with an association of SSc-si and diffuse scleroderma. A trend toward lower survival was observed in our series in SSc-si group. Copyright © 2015 Elsevier Inc. All rights reserved.
    No preview · Article · Jun 2015 · Seminars in arthritis and rheumatism
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    ABSTRACT: Background Antiphospholipid syndrome (APS) is a multisystem disease, and the heart may be affected from 10 to 50% in some series [1,2]. Heart valve lesions are the most frequent manifestations. Coronary arteries and myocardium may be also affected. Other findings include chronic thromboembolic pulmonary hypertension and accelerated atherosclerosis. Some studies have suggested a higher incidence of cardiac involvement in patients with secondary APS or those with higher titers of antiphospholipid antibodies. However, cardiac involvement in APS are not yet well known because there are few published series and most of them have a short-term follow-up. Objectives The aim of our study was to determine the prevalence and the type of cardiac involvement in patients with APS. Also, risk markers of cardiac involvement in these patients were attempted to identify. Methods A case series of patients with APS diagnosed and followed for a long period in a specific unit of Thrombosis and Vasculitis was conducted. Clinical and laboratory data were collected in a retrospective manner. To attempt to identify risk markers of cardiac involvement, patients with cardiac manifestations were compared with patients without heart involvement. Chi2 and t-student were used, using the statistical package SPSS18.0. Results 32 patients with APS were included, 21 (66%) female, mean age 64.3±16.44 years [range 34-84], with a mean follow-up of 9.2 years (median 7 years). 8 patients (25%) had a secondary APS: 3 SLE, 2 Sjögren's syndrome, 1 rheumatoid arthritis, 1 systemic sclerosis and 1 demyelinating disease. 4 (13%) were pure obstetric APS, 9 (28%) had an arterial thrombosis, 9 (28%) had a venous thrombosis and 10 (31%) had mixed events (arterial, venous, and obstetric). 23 (72%) of patients had a cardiovascular risk factor (hypertension, dyslipidemia, type 2 DM). 19 patients of 32 with APS (59%) had cardiac involvement. 15 patients (79%) had valve disease (7 mitral valve, 3 aortic valve and 5 both mitral and aortic valves), and 8 (26%) had a coronary ischemic event. No patients had pulmonary hypertension. The comparison results between the two groups are shown in the following table. Conclusions More than half of patients with APS had cardiac involvement. Heart valve disease was the most frequent manifestation, almost always mitral valve. No patients had pulmonary hypertension. The only risk marker of cardiac involvement in our series was the age; patients with cardiac involvement were 10 years older on average. References Disclosure of Interest None declared
    No preview · Article · Jun 2015 · Annals of the Rheumatic Diseases
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    ABSTRACT: Background HLA-B27 uveitis has been defined as a unilateral acute syndrome without associated systemic disease [1]. However, in some patients the ocular disease precedes the occurrence of systemic diseases as ankylosing spondylitis (AS), reactive arthritis (ReA), spondyloarthritis (SpA), undifferentiated spondyloarthritis (UspA), SpA associated with psoriasis and SpA associated with inflammatory bowel disease (SpA-IBD) Objectives To determine how many patients with isolated HLA-B27 uveitis will develop systemic disease and to identify the clinical risk factors associated with their occurrence Methods Patients with HLA-B27 and at least 1 episode of uveitis diagnosed by an ophthalmologist were identified among all adult patients (>14 years) consecutively typed for HLA-B27 in our hospital from January 1, 2006 to December 31, 2011. These patients were seen in our Unit to perform a complete rheumatologic examination to look for prior or concurrent systemic disease associated with HLA-B27. Also, a comprehensive clinical, radiological and analytical evaluation to exclude autoimmune and infectious diseases that may cause uveitis was carried out. Follow-up was defined as the period of time from the first episode of uveitis confirmed by an ophthalmologist to the latest medical evaluation. Values are shown as average and standard deviation (SD) and percentage for quantitative and qualitative variables respectively. The T test and chi squared are used for comparisons Results During the 6 years of study period 1803 patients were typed for HLA-B27, of which 293 tested positive (16%). Of these patients, 42 (14%) had at least 1 episode of uveitis. 14 of these patients (33%) were excluded from the study because prior or concurrent systemic disease related with HLA-B27 positivity (8 AS, 4 UspA, 1 ReA, 1 SpA-IBD). So, a cohort of 28 patients with isolated HLA-B27 uveitis, 15 males (54%), 36.9years ± 14.19 (15-60), was follow-up during a mean of 7.7 years ±5.89 (1-20). 9 patients (33%) developed systemic disease: 5 AS, 3 UspA and 1 SpA-IBD. The diagnosis of the systemic disease was made 3.7 years ±4 (0.5-12) after the onset of uveitis. Bilateral uveitis (including alternating uveitis) was identified as the only significant risk factor for the development of systemic disease, OR 8.3 (95% confidence interval 1.25-55.35, p=0.03), so a multivariate analysis was not performed.The risk for systemic disease was 1.8 times greater for patients with bilateral HLA-B27 uveitis than for patients with unilateral involvement. Significant differences with age, gender, location of the uveitis, chronicity, response to treatment and ophthalmic complications were not found between patients with isolated uveitis and those who developed systemic diseases Conclusions A third of patients who present with isolated HLA-B27 uveitis will develop associated systemic disease. Bilateral ocular involvement was identified as the only significant risk factor for the occurrence of systemic disease in the present cohort References Disclosure of Interest : None declared DOI 10.1136/annrheumdis-2014-eular.5872
    No preview · Article · Jun 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Background Systemic lupus erythematous (SLE) represents a heterogeneous group of patients. Some of them are diagnosed with SLE with mild articular and cutaneous symptoms, while others present with severe organ damage. There are also patients with positive ANA and clinical manifestations of SLE, but who don’t fulfill classification criteria for SLE (1). They are classified as incomplete lupus erythematosus (ILE) (1). Some of them will develop SLE, but currently there is no way to identify them. The aetiology and pathogenesis of systemic lupus erythematosus (SLE) are not completely understood, but it is likely a multifactorial disease, where genetic factors play an important role. To date, the strongest genetic association has been found at genes for class II human leukocyte antigens (HLA), particularly HLA-DR2 (HLA-DRB1 alleles) and HLA-DR3 (2). Objectives To ascertain the HLA DRB1 alleles frequencies in Caucasian patients with SLE and in patients with ILE, and compare them between both groups. Methods A case-control study was designed to find out the frequency of the HLA- DRB1 alleles in ILE patients, comparing them to LES patients who were used as controls. For this purpose, 120 patients were recruited from the outpatient clinic of the CHUVI (Spain), 60 with SLE and 60 with ILE. Patients presenting with ANA antibodies (>1/320) and one or two classification criteria for SLE, but without any manifestations of other autoimmune disease after >2 years of follow-up, were considered as having ILE. All patients have been interviewed and data about their illness have been retrieved from their clinical records. Blood samples were taken from all the patients. DNA extraction was performed from peripheral blood leukocytes, and HLA DRB1 alleles were amplified by PCR, using previously reported primers (3). Results After HLA DRB1 typing of our 120 patients, frequencies showed below were obtained. Both groups showed similar frequencies for all the studied alleles except one. HLA DRB1*15 was more frequent in SLE group than in ILE group (p-value 0,0254). Conclusions HLA DRB1*15 has been found more frequently in SLE patients than in ILE group. If this finding is corroborated by larger studies, HLA DRB1*15 could be used to identify those patients diagnosed with ILE who are at higher risk to develop SLE. Disclosure of Interest None Declared
    No preview · Article · Jan 2014 · Annals of the Rheumatic Diseases
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    ABSTRACT: Objectives: To establish the frequency and describe the characteristics of a cohort of patients with SF eosinophilia (SFE) and a long clinical follow-up. A systematic review of the literature on this topic was performed. Methods: From November 2005 to May 2010, 982 consecutive arthrocentesis procedures performed at a tertiary care hospital were reviewed. Clinical and analytical data of patients with SFE at the time of diagnosis and during follow-up until 31 January 2012, were recorded. According to the percentage of eosinophils in SF, SFE was classified as minor (<10%) or major (>10%). Also, a literature search of all publications on eosinophilic synovitis found in MEDLINE, EMBASE and Web of Science without publication date restrictions was performed. Results: Eosinophils in SF were found in 10 of 982 (1.02%) patients: minor SFE was recorded in three patients, all of them with haemorrhagic fluid and without peripheral eosinophilia. Major SFE was found in seven patients, and only two of them had peripheral eosinophilia. In six patients, an underlying cause of the arthritis was found. Only one patient was classified as having idiopathic SFE. Most SFE promptly resolved with NSAIDs without relapses or new deformities. The literature search identified 56 patients with SFE; 49 of them (88%) had major SFE and 7 (12%) had minor SFE. Conclusions: Eosinophils are infrequently found in SF, and in most cases peripheral eosinophilia was not detected. Most patients with SFE had a benign course with prompt resolution and few relapses.
    Full-text · Article · Oct 2012 · Rheumatology (Oxford, England)
  • Caritina Vázquez-Triñanes · Bernardo Sopeña
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    ABSTRACT: Synovial fluid eosinophilia is defined as the presence of eosinophils, irrespective of quantity, in the synovial fluid and is a rare finding that is probably underestimated. The pathogenesis of this entity remains incompletely understood. Secondary and idiopathic forms have been described. Idiopathic forms are those not associated with systemic or rheumatic inflammatory disease or associated with chronic non-inflammatory rheumatic diseases. Idiopathic forms can be divided into pure or pseudoallergic forms when they occur in patients with an atopic background and/or intensely positive dermographism. Both forms are usually monoarthritis of the large joints with a substantial component of joint effusion but few inflammatory signs. Synovial fluid usually contains between 2,000 and 10,000 leukocytes/mm3, with a variable percentage of eosinophils. Although a major form (>10% eosinophils) and a minor form (<10% eosinophils) have been distinguished, both seem to have the same significance in terms of clinical manifestations and prognosis. Peripheral eosinophilia (>600 eosinophils/mm3) is a rare association and is not usually severe. Symptoms resolve within a few days without specific therapy and recurrences occur in approximately half of patients. Non-steroidal anti-inflammatory drugs are usually sufficient to control symptoms. Synovial fluid eosinophilia has not been associated with the development of new joint deformities nor has it been described as a chronic form of arthritis.
    No preview · Article · Jul 2012 · Seminarios de la Fundación Española de Reumatología
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    ABSTRACT: Kikuchi's disease (KD) has been associated with the presence of autoantibodies, systemic lupus erythematosus (SLE), and other autoimmune diseases. The aim of this study was to assess the frequency of autoimmune manifestations in a KD cohort with a long follow-up. Twenty patients with histologically confirmed KD since January 1990 until December 2010 were studied; 12 of them were periodically followed up as outpatients. Another 7 patients were contacted by telephone to offer them a specific consultation and a complete autoimmunity study. Thirteen of 20 patients were women (65%) with a mean age of 29 years (range, 15-79). The age at diagnosis was higher in men (44 vs 27 years, P < 0.05). Lymphopenia was present in 75% of the patients (15/20) and was the more frequent hematological abnormality. The mean follow-up of the 17 patients included in the autoimmunity study was 119 months (range, 15-252). Autoimmune diseases were detected in 9 women (53%): SLE was diagnosed in 4 patients (2 SLE before, 1 simultaneous, and 1 after KD), 2 patients developed primary Sjögren's syndrome after KD, 1 thyroiditis before KD, 1 SLE-like, and 1 antiphospholipid antibodies after KD. Leukocytoclastic vasculitis was found in 2 patients; 1 of them eventually developed SLE. Female sex, painful adenopathies, and cytopenias were significantly associated with autoimmune diseases. Among patients with KD, only women developed autoimmune manifestations. Therefore, long-term follow-up and active surveillance of autoimmune diseases in patients with KD, especially women, are recommended.
    Full-text · Article · Dec 2011 · Seminars in arthritis and rheumatism
  • C. Vázquez-Triñanes · B. Sopeña · R. Díaz · A. Rivera · M.C. Freire · I. Villaverde

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