Relationship of rheumatoid factor positivity to prevalence of joint manifestations in type 2 diabetes which are unrelated to rheumatoid arthritis.

Background: The present study was designed to investigate the relationship of rheumatoid factor positivity to the prevalence of joint manifestations in type 2 diabetes which are not attributable to rheumatoid arthritis. Methods: We evaluated 192 type 2 diabetes patients with rheumatological complications and age and sex matched non-diabetic controls for rheumatoid factor (RF) positivity. Diabetic patients with frozen shoulder, LJM syndrome, carpal tunnel syndrome, trigger finger, DISH and Dupuytren’s contracture were evaluated for RF positivity. Results: RF was positive in 47 patients (24.4%) when compared to controls (4.2%). RF positivity was associated with an increased prevalence of joint manifestations in diabetic group when compared to controls. RF positivity was not related to the duration of diabetes nor was it related to long term glycemic control. Conclusion: RF positivity resulted in an increased prevalence of joint manifestations in diabetes, which were unrelated to rheumatoid arthritis.

Lupus eritematoso sistémico en varones características clínicas e inmunológicas / Systemic lupus erythematosus in men clinical and immunologic features

RESUMEN Introducción:El lupus eritematoso sistémico (LES) es una enfermedad autoinmune que afecta a mujeres nueve veces más que a los varones. La marcada influencia del género sobre la ocurrencia de LES confirma la importancia de factores genéticos y hormonales en la enfermedad. El LES en varones se caracteriza por la mayor frecuencia de serositis, severa injuria renal y un peor pronóstico. Objetivo: Determinar las características clínicas e inmunológicas de pacientes varones con LES Material y Método: Diseño observacional, descriptivo, de corte transverso. Se estudiaron pacientes con diagnóstico de LES, mayores de 18 años, internados en el Hospital Nacional de Itauguá desde enero del 2005 a diciembre del 2010. Resultados: De un total de 200 pacientes con LES, 155 fueron mujeres (77,5%) y 45 varones (22,5 %). La edad media fue 41 años. El intervalo de tiempo entre el inicio de los síntomas y el diagnóstico fue 15 meses. Características clínicas predominantes: artralgias 80%, pericarditis 60%, caída de cabello 54%, pleuritis 42%, debilidad 42%, fiebre prolongada 40 %, artritis 38%, fotosensibilidad 37%, mialgias 33%, fiebre aguda 31%. Laboratorio: anemia 93%, linfopenia 65%, leucopenia 41%, trombocitopenia 4%, ANA positivo 91%, anti-DNA positivo 68%, C3 disminuido 68%, C4 disminuido 71 %. Proteinuria mayor de 1000 mg: 35%, entre 500-1000 mg: 20%, menor a 500 mg: 45%; hematuria 46%. Se realizó biopsia renal en 22 (49%) pacientes, hallándose glomerulonefritis tipo IV (63%), tipo II (27%) y tipo III (9%). Conclusión: Las características clínicas más representativas fueron las manifestaciones articulares, seguida por las serositis (pericarditis y pleuritis) y afectación renal (grado IV). En cuanto a los marcadores inmunológicos se observó un alto porcentaje de anticuerpos antinucleares positivos además de la hipocomplementemia.

ABSTRACT Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease that affects women nine times more than men. The marked influence of gender on the occurrence of SLE confirmed the importance of genetic and hormonal factors in the disease. SLE in males is characterized by a higher frequency of serositis, severe renal injury and poor outcome. Objetive: To determine the clinical and immunological features of male patients with SLE. Material an Methods: an observational, descriptive, transverse cutting, we studied 45 male patients with SLE over 18 in the National Hospital Itauguá from January 2005 to December 2010. Results: Of a total of 200 patients with SLE, 155 were women (77.5%), males 45 (22.5%), mean age was 41 years. The time interval between onset of symptoms and diagnosis was 15 months. Clinical features: 80% arthralgia, pericarditis 60%, 54% hair loss, pleuritis 42%, weakness 42%, 40% prolonged fever, arthritis 38%, photosensitivity 37%, myalgia 33%, 31% acute fever. Laboratory: anemia 93%, 65% lymphopenia, leukopenia 41%, thrombocytopenia 4%, ANA positive in 91%, anti-DNA positive 68%, decreased by 68% C3, C4 decreased by 71%. Proteinuria greater than 1000 mg. 35% between 500-1000 mg. 20%, less than 500 mg. 45%, hematuria 46%. Renal biopsy was performed in 22 (49%) patients, being glomerulonephritis type IV (63%), type II (27%) and type III (9%). Conclusion: The clinical features were more representative articular manifestations, followed by serositis (pericarditis and pleuritis) and renal (gradeIV). As for the immunological markers showed a high percentage of positive antinuclear antibodies plus hypocomplementemia.