Panniculitis associated with amyopathic dermatomyositis

Abstract: Panniculitis is a rare clinical finding in dermatomyositis, with less than 30 cases reported and there is only one case associated with the amyopathic subtype described in the literature. The present report describes a 49-year-old female patient that one year after being diagnosed with amyopathic dermatomyositis, presented indurated, painful, erythematous to violaceous nodules located on the upper limbs, thighs and gluteal region. Skin biopsy revealed lobular panniculitis with a lymphocytic infiltrate. The patient was treated with prednisone and methotrexate, but remained unresponsive to treatment.

Presença de anti-RO prediz aparecimento de lesão valvar em artrite reumatoide / Presence of anti-RO predicts onset of valve lesions in rheumatoid arthritis

JUSTIFICATIVA E OBJETIVOS: Alguns autoanticorpos são associados com achados clínicos peculiares. Pacientes com artrite reumatoide (AR) podem apresentar autoanticorpo anti-RO. O objetivo deste estudo foi estudar a prevalência e associações clínicas do anticorpo anti-RO em pacientes com AR. MÉTODO: Foram estudados 385 pacientes diagnosticados com AR e que possuíam teste Elisa para anti-RO. Também foram analisadas informações referentes ao perfil do paciente, avaliação funcional, DAS-28, manifestações extra-articulares, função tireoidiana, perfil de autoanticorpos e de tratamento.RESULTADOS: A prevalência do anticorpo anti-RO foi de 8,31%. Não houve diferença significativa em relação ao sexo, HAQ, DAS-28, classificação funcional em pacientes com anti-RO positivo (p = ns). Pacientes com anti-RO apresentaram idade menor ao diagnóstico (p = 0,02). Em relação às manifestações extra-articulares, encontrou-se maior prevalência de lesões valvares cardíacas (p < 0,001) em pacientes com anticorpo anti-RO.Não foram encontradas diferenças significativas na análise de outras desordens extra-articulares, associação com hipotireoidismo,amiloidose, tratamentos indicados, presença de fator reumatoide (FR) e anticorpo antipeptídeo cíclico citrulinado (anti-CCP). CONCLUSÃO: Pacientes com AR que apresentam o anticorpo anti-RO tem um início de doença mais precoce. O anticorpoanti-RO é um fator de risco para o desenvolvimento de lesões valvares. Não foram encontradas relações do anti-RO com tireoidopatias, amiloidose secundária e escolha de tratamento.

BACKGROUND AND OBJECTIVES: Some auto antibodies are associated with peculiar clinical findings. Patients with rheumatoid arthritis (RA) may have anti-RO antibodies. The objective of this study was to investigate the prevalence and clinical associations of anti-RO antibodies in RA patients. METHOD: We studied 385 patients with RA for anti-RO by Elisa testing and for clinical profile, functional assessment, DAS-28, extra-articular manifestations, thyroid function, auto antibodies and treatment. RESULTS : The prevalence of anti-RO was 8.31%. There was no significant difference in sex distribution, HAQ, DAS-28,functional classification in patients with positive anti-RO (p = ns). Patients with anti-RO were younger at diagnosis (p = 0.02).Analyzing extra-articular disorders we found a greater prevalence of cardiac valve lesions (p < 0.001) in patients with anti-RO antibodies. No differences were found in other extra-articular manifestations, associated hypothyroidism, amyloidosis, treatment requirements, presence of rheumatoid factor (RF) and anti citrullinated protein antibodies (ACPA). CONCLUSION : RA patients with anti-RO have disease onset at earlier age. Anti-RO is a risk factor for the development of valve lesions. There is no association between this antibody and thyroid disease, amyloidosis and treatment needs.