Undifferentiated Spondyloarthropathies (Us) and Osteoporosis

Abstract

Objectives:To describe 2 patients with the coexistence of SLE and Myasthenia Gravis (MG). Case 1: This is a 14-year-old girl with a diagnosis of MG since she was twelve. At that time a thymectomy was performed and the patient was treated with pyridostigmine and prednisone, with good clinical response. The dose of prednisone could be tapered off and the patient remained clinically stable for 2 years. Then she developed thrombocytopenic purpura, cutaneous lesions, polyarthralgias and a positive ANA 1: 640. With a diagnosis of SLE she is now on prednisone, hydroxychloroquine and ASS. Her MG remains stable. Case 2: This is a 25-year-old woman with a history of IPT 10 years ago. In 2003 she developed nephritis, polyarthritis, cutaneous lesions, muscular weakness and a secondary antiphospholipid syndrome. A simultaneous diagnosis of SLE and MG was made based on positive ANA and DNA, low complement and a positive test for anti-AChRs. The patient was treated with prednisone and azathioprine with good clinical response. Conclusions: The coexistence of SLE and MG is considered occasional. MG can precede the development of LES in 75% of cases and thymectomy may be a precipitating factor en some patients, as in case 1. The assessment for MG is suggested in every SLE patients with unexplained muscular weakness. Objectives:To study clinical and laboratory manifestations in 120 patients with SLE. Materials and Methods: 120 patients with Systemic Lupus Erythematosus (ACR criteria) were included. They were attended at Hospital Luis Vernaza (Guayaquil, Ecuador) in the past 3 years. We revised the clinical histories, laboratory results. Results: 120 SLE patients were seen in the past 36 months. 110 (92%) were women. Mean age 34.3 years (13-68), mean age at diagnosis 30.4 years (12-67), mean evolution time was 57.8 m (5-390) and mean delay at diagnosis was 14.3 m (0 -276). 11 patients (9%) were lost during the follow up. Clinical manifestations: systemic symptoms 95%, dermato-logical involvement 85%, arthritis 76%, hematologic 70%, nephritis 51%, pleural effusion 23%. Laboratory results: ANA positive 96%, DNA 73% m low C3 68%, low C4 75%, Anti Ro 26%, Anti La 9%, Anti SM 31%, Anti RNP 31%. Actual treatment: steroids 90%, inmunosuppresors 40%, antimalarials 68%. 9 patients (7.5%) died. Significative association was found between nephritis and low complement (P ϭ 0.001), nephritis and dead pts (P ϭ 0.01), thrombosis and antiphospholipids (P ϭ 0.02), hemolytic anemia and anticardiolipins IgM (P ϭ 0.03). Conclusions: Clinical and laboratory manifestations are similar to other series. High mortality rate was found. Objectives:To describe morbility and mortality on a lupus cohort of 120 patient followed at 3 years. Materials and Methods: 120 patients with Systemic Lupus Erythematosus (ACR criteria) were included. They were attended at Hospital Luis Vernaza (Guayaquil, Ecuador) in the past 3 years. We revised the clinical histories, laboratory results, searching for complications and mortality. Patients with and without complications were ...