Análisis de una serie de 55 pacientes con arteritis de células gigantes confirmada por biopsia

Maldonado, E. Bustamante; Alfonso, Begoña Marí; Jiménez, M. Monteagudo; Martínez, Arsenio; Comajuncosa, Rosa Jordana; Vilella, Carles Tolosa; Salvà, Joaquim Oristrell

doi:10.4321/s0212-71992004001000002

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…Furthermore, reported incidence rates vary widely between regions, and no study has collected sufficient data to estimate the national incidence of this disease. [14][15][16] This observation is in line with most epidemiology studies performed in other parts of Europe, where authors also collect data from specific regions of a country, [17][18][19][20] with very few establishing a national registry of GCA. 21 22 Additionally, knowledge of the incidence of the disease is essential to determine its full impact on society and healthcare systems.…”

Section: How This Study Might Affect Research Practice or Policysupporting

confidence: 71%

“…However, this variation may be due to differences in the methodology applied. [14][15][16] Analysis of our data reveals no statistically significant differences between the incidence of the disease in a central region such as Madrid and a Northeastern Mediterranean region such as Barcelona, although it is true that there is little difference in latitude between these both regions. However, in the above-mentioned metaanalysis, a statistically significant positive linear correlation was observed between latitude and incidence.…”

Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 61%

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Incidence and clinical manifestations of giant cell arteritis in Spain: results of the ARTESER register

Fernández-Lozano,

Hernández-Rodríguez,

Narvaez

et al. 2024

RMD Open

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ObjectiveThis study aimed to estimate the incidence of giant cell arteritis (GCA) in Spain and to analyse its clinical manifestations, and distribution by age group, sex, geographical area and season.MethodsWe included all patients diagnosed with GCA between 1 June 2013 and 29 March 2019 at 26 hospitals of the National Health System. They had to be aged ≥50 years and have at least one positive results in an objective diagnostic test (biopsy or imaging techniques), meet 3/5 of the 1990 American College of Rheumatology classification criteria or have a clinical diagnosis based on the expert opinion of the physician in charge. We calculated incidence rate using Poisson regression and assessed the influence of age, sex, geographical area and season.ResultsWe identified 1675 cases of GCA with a mean age at diagnosis of 76.9±8.3 years. The annual incidence was estimated at 7.42 (95% CI 6.57 to 8.27) cases of GCA per 100 000 people ≥50 years with a peak for patients aged 80–84 years (23.06 (95% CI 20.89 to 25.4)). The incidence was greater in women (10.06 (95% CI 8.7 to 11.5)) than in men (4.83 (95% CI 3.8 to 5.9)). No significant differences were found between geographical distribution and incidence throughout the year (p=0.125). The phenotypes at diagnosis were cranial in 1091 patients, extracranial in 337 patients and mixed in 170 patients.ConclusionsThis is the first study to estimate the incidence of GCA in Spain at a national level. We found a predominance among women and during the ninth decade of life with no clear variability according to geographical area or seasons of the year.

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Section: How This Study Might Affect Research Practice or Policysupporting

confidence: 71%

Section: Rmd Open Rmd Open Rmd Openmentioning

confidence: 61%

Incidence and clinical manifestations of giant cell arteritis in Spain: results of the ARTESER register

Fernández-Lozano,

Hernández-Rodríguez,

Narvaez

et al. 2024

RMD Open

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“…Síntomas sistémicos, como mialgias y otros, secundarios a la producción de citocinas (astenia, anorexia, adelgazamiento y fiebre) (13)(14)(15). Puede presentarse con manifestaciones pulmonares, como por ejemplo tos seca, que en algunas series llega hasta un 4% de casos (10).…”

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Arteritis de células gigantes: una causa infrecuente de tos crónica

Zamora¹,

López²,

García³

et al. 2008

An. Med. Interna (Madrid)

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Las manifestaciones sistémicas no habituales de la arteritis de células gigantes incluyen las respiratorias, pudiendo ser éstas también secundarias al propio tratamiento y ser el síntoma de inicio, según algunas series, en hasta el 4% de los casos. Dentro de ellas, la tos crónica, entendida como aquella que persiste durante al menos tres semanas ha sido descrita como síntoma raro, que habitualmente lleva a un retraso en el diagnóstico de la enfermedad y responde muy pronto al tratamiento esteroideo. El mecanismo fisiopatológico no está totalmente aclarado habiéndose propuesto, entre otras hipótesis, la formación de granulomas en la pared bronquial con vasculitis pulmonar, la alveolitis linfocitaria o la vasculitis de la arteria maxilar interna.Presentamos el caso de un varón de 73 años, con historia laboral de trabajo en planta petroquímica y antecedentes personales de pielonefritis hace 45 años, neumonía hace 5, y cirugía de dos hernias inguinales. Exfumador de unos 20 años/paquete desde hace más de diez años, no refería otros hábitos tóxicos.Acudió a consulta por presentar desde hacía unos seis meses tos no productiva, sin ritmo circadiano, no acompañada de disnea, dolor torácico ni fiebre, que había sido tratada inicialmente por su médico de Atención Primaria (MAP) con omeprazol 40 mg, con mejoría inicial para luego empeorar de nuevo a pesar de continuar tomándolo. Refería también astenia y pérdida de apetito, y de unos seis kilogramos de peso en los primeros tres meses, manteniéndose luego sin variaciones ponderales. La exploración física era normal. En la analítica inicial destacaba: Gluc: 148; proteínas totales: 6,3; albúmina: 2,3; PCR: 18,9; fibrinógeno: 1.326; hemoglobina: 11,9. La radiografía de tórax no mostró alteraciones parenquimatosas pulmonares, pleurales ni mediastíni-cas, pero una ecografía abdominal detectó varias lesiones ocupantes de espacio (loes) hepáticas. Con todo esto, se decidió ingresar al paciente por cuadro constitucional acompañado de tos crónica y presencia de loes hepáticas para estudio.Durante la hospitalización se continuó el estudio analítico, obteniéndose valores normales de TSH, alfa FP, CEA, PSA, sistemático de orina, ANA, ENA e IgE. El proteinograma dio valores ligeramente elevados de alfa1 globulina. Tanto la inmunofijación en suero como la inmunoelectroforesis en orina mostraron una banda monoclonal de precipitación correspondiente a cadenas ligeras kappa. Las pruebas serológicas para VHC, coxiella, CMV y VHS fueron negativas, y de infección pasada frente a VHB y toxoplasma. Las radiografías de senos paranasales fueron normales, así como una espirometría con test de broncodilatación, pese a lo cual se probó con un tratamiento broncodilatador debido a la persistencia de los síntomas y las dificultades para llevar a cabo otras pruebas de función pulmonar que apoyaran o descartaran con mayor seguridad el diagnóstico de asma por no realizarse en nuestro hospital. Una TAC toraco-abdominal destacaba como únicos hallazgos: Elongación del cayado aórtico y dos imágenes hipodensas ...

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Temporal and Cartographic Analyses of the Distribution within Spain of Mortality Due to Granulomatosis with Polyangiitis (1984–2016)

Sánchez-Díaz

Escobar

Villaverde-Hueso

et al. 2019

IJERPH

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The aim is to conduct a descriptive, population-based study in order to assess temporal and spatial changes in mortality due to granulomatosis with polyangiitis (GPA) in Spain from 1984 to 2016. Mortality data were obtained from the Spanish Annual Death Registry. Deaths in which GPA was the underlying cause were selected using the 446.4 and M31.3 codes from the International Classification of Diseases, 9th and 10th revision. Annual average age at death and age-adjusted mortality rates were calculated. Geographic analysis was performed at municipality and district level. Variations in mortality according to the type of municipality (urban, agro-urban or rural), district and geographic location (degrees of latitude) were assessed using standardized mortality ratios (SMRs) and smoothed-SMRs. Over the whole period, 620 deaths due to GPA were identified. Age at death increased at an average annual rate of 0.78% over the period 1987–2016 (p < 0.05). Age-adjusted mortality rates increased by an annual average of 20.58% from 1984 to 1992, after which they fell by 1.91% a year (p < 0.05). The agro-urban category had the highest percentage (4.57%) of municipalities with a significantly higher GPA mortality rate than expected. Geographic analysis revealed four districts with a higher risk of death due to GPA, two in the North of Spain and two in the South. This population-based study revealed an increase in the age at death attributed to GPA. Age-adjusted mortality rates went up sharply until 1992, after which they started to decline until the end of the study period. Geographic differences in mortality risk were identified but further studies will be necessary to ascertain the reasons for the distribution of GPA disease.

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Análisis de una serie de 55 pacientes con arteritis de células gigantes confirmada por biopsia

Cited by 3 publications

References 9 publications

Incidence and clinical manifestations of giant cell arteritis in Spain: results of the ARTESER register

Incidence and clinical manifestations of giant cell arteritis in Spain: results of the ARTESER register

Arteritis de células gigantes: una causa infrecuente de tos crónica

Temporal and Cartographic Analyses of the Distribution within Spain of Mortality Due to Granulomatosis with Polyangiitis (1984–2016)

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