Results. The median age was similar in both the DM and control groups (41.5 and 42.0 years, respectively; P ‫؍‬ 0.378), with a comparable predominance of women (P ‫؍‬ 0.904) and white race (P ‫؍‬ 0.623). The DM patients had a higher prevalence of metabolic syndrome (41.7% versus 7.0%; P < 0.001), diabetes mellitus (17.9% versus 1.0%; P < 0.001), stroke (4.8% versus 0%; P ‫؍‬ 0.024), and family history of CVD (23.8% versus 8.6%; P ‫؍‬ 0.004). However, the frequency of sedentarism, hypothyroidism, smoking, and alcohol intake was similar in both groups (P > 0.05). Further analysis of the DM patients with (n ‫؍‬ 35) and without (n ‫؍‬ 49) metabolic syndrome revealed that the patients with this complication were older (mean ؎ SD age 50.0 ؎ 14.5 years versus 40.9 ؎ 14.6 years; P ‫؍‬ 0.006) and had a similar disease duration (P ‫؍‬ 0.925) and higher prevalence of systemic arterial hypertension prior to the onset of disease symptoms (54.3% versus 10.2%; P < 0.001). In a multivariate analysis, only hypertension diagnosed prior to the disease was associated with metabolic syndrome (odds ratio 10.47 [95% confidence interval 2.62-44.81]). Conclusion. Metabolic syndrome is highly prevalent in DM, and prior hypertension seems to be a major determinant of its development, while disease-and therapy-related factors do not appear to play a relevant role.

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Objective: To report the results of a retrospective cohort involving 139 patients with dermatomyositis, conducted from 1991 to 2011. Methods: All patients met at least four of the fi ve Bohan and Peter criteria (1975). Results: The patients' mean age at disease onset was 41.7 ± 14.1 years, and mean disease duration was 7.2 ± 5.2 years. The sample comprised 90.2% white patients and 79.9% female patients. Constitutional symptoms occurred in less than half of the patients. Cutaneous and joint involvements occurred in 95.7% and 41.7% of the patients, respectively. Incipient pneumopathy, ground glass opacities and/or pulmonary fi brosis were present in 48.2% of the patients. All patients received prednisone (1 mg/kg/day) and 51.1% also received intravenous methylprednisolone (1 g/day for three days). Several immunosuppressants were used as corticosteroid sparing agents according to tolerance, side effects and/or refractoriness. Although disease relapse (clinical and/or laboratory) occurred in 53.2% of the patients, 76.3% were in disease remission at the end of the study. The rate of severe infection was 35.3%, and herpes zoster predominated. There were 15 (10.8%) cases of cancer, 12 within one year after the diagnosis. There were 16 deaths (11.5%), and their major causes were sepsis/septic shock (27.5%), pneumopathy attributed to the disease (31.3%), neoplasms (31.3%), and cardiovascular events (12.5%). Conclusions: In this study, the clinical and laboratory data were similar to those of other population groups described in the literature, with minimal differences regarding the frequency and characteristics of the extramuscular manifestations.

Polymyositis is a systemic and idiopathic inflammatory myopathy that, besides muscle manifestation, may occur with respiratory involvement, gastrointestinal tract and rarely renal involvement. In this latter, there are only two cases of IgA nephropathy, but both in dermatomyositis. On the other hand, we reported, for the first time, a case of IgA nephropathy in polymyositis.

Background Metabolic syndrome (MS) has been frequently associated to gout and, in fact, hyperinsulinemia enhances proximal tubular sodium reabsorption, leading to decreased renal uric acid excretion and hyperuricemia.No data regarding the prevalence of MS in gout subsets according to gout-associated clinical characteristics has been published to date. Objectives To determine the prevalence of MS in a large cohort of patients with gout followed at a single tertiary center, searching for related risk factors including metabolic profile, nephrolithiasis, reduced urate excretion and the presence of tophus. Methods This was a cross-sectional study of 158 patients with gout diagnosed according to the ACR criteria. MS was definedaccording to the National Cholesterol Education Program ATP III (NCEP-ATP III) and the International Diabetes Federation (IDF) criteria.Demographic, anthropometric (body mass index - BMI) and clinical data were collected. Fasting serum levels of uric acid, glucose, triglycerides and cholesterol fractions were analyzed by usual laboratory tests.Nephrolithiasis was demonstrated by routine ultrasonography and urate underexcretion was defined as a uric acid clearance lower than 7.5 ml/min. Fisher’s exact, chi-square, student’s T and Spearman’s test were used for statistical analysis and P≤0.05 was considered significant. Results Mean age of patients was 62.7±12.2 yrs (33 – 90 yrs), and 90.5% were males. Mean BMI was 29.13±5.70 kg/m2 (19.0 – 55.1 kg/m2). Hypertension was observed in 84.5% of patients, current alcohol consumption in 22.8%, coronary artery disease in 21% and diabetes mellitus in 19%. Mean serum uric acid, fasting glucose, triglycerides, LDL, HDL levels were 6.84 mg/dL, 107.2 mg/dL, 198.7 mg/dL, 116.7 mg/dL, 47.2 mg/dL respectively. Of note, 31% had nephrolithiasis and 52.5% had tophi. Estimated creatinine clearance was 73.15±29.35 ml/min and 86.1% patients manifested urate underexcretion.Remarkably, more than 70% of gout patients had MS (73% and 71% according to NCEP ATPIII and IDF criteria respectively). This increased prevalence of MS was alike in patients with tophaceous and non tophaceous gout, and regardless of uric acid excretionstatus (p>0,05). In contrast, the prevalence of MS was significantly higher in patients with nephrolithiasis compared to those without this complication (84.7% vs. 65.2%; p=0.026). Conclusions The elevated prevalence of MS in Brazilian gout patients (almost ¾) is higher than previously reported overall rates of MS in gout worldwide (62.8%) and in control populations (25.4%), suggesting possible interference of, dietary, geographical and/or genetic background. Our demonstration, for the first time, of increasedMS prevalence in gout unrelated to the occurrence of tophus, but associated to nephrolithiasis may suggest shared underlying physiopathologic mechanisms, such as the effect of hyperinsulinemia on the kidneys.Further studies are urged to clarify this relationship and therefore allow improvement of multiprofessional management of gout patients, in ...