Análise do perfil clínico e epidemiológico de pacientes com artrite psoriásica em ambulatório de reumatologia na Região Amazônica / Clinical and epidemiological profile analysis of patients with psoriatic arthritis in a rheumatology clinic in the Amazon Region

Objetivo: Conhecer o perfil clínico e epidemiológico de pacien- tes portadores de artrite psoriásica de uma região brasileira. Método: Pesquisa observacional, transversal, epidemiológica e documental, baseada na coleta de dados obtidos a partir da análise de 53 prontuários de pacientes cadastrados do Ambu- latório de Reumatologia da Universidade do Estado do Pará, na Região Amazônica. Resultados: Houve predominância do padrão do tipo poliartrite simétrica, sem distinção entre os sexos, com a presença de manifestações extra-articulares, pso- ríase em placas, em uso de metotrexato em doses médias. Con- clusão: Apesar da etiopatogenia da doença ser dependente de fatores genéticos, ambientais e imunológicos e da população amazônica ser muito particular, de uma miscigenação entre eu- ropeus, ameríndios e negros, o perfil clínico e epidemiológicos dos pacientes do Ambulatório de Reumatologia da Universidade do Estado do Pará é semelhante ao das literaturas nacional e internacional.

Objective: To know the clinical and epidemiologic profile of pso- riatic arthritis patients of a Brazilian region. Method: This is an observational, cross-sectional, epidemiological, and documental study, based on the data obtained from the analysis of the medi- cal records of 53 patients registered on the Rheumatology Cli- nic of the Universidade do Estado do Pará, in the Amazon area. Results: There was a predominance of the symmetrical polyar- ticular pattern, with no sexual distinction, extra articular invol- vement, plaque psoriasis, and treatment withn methotrexate, in medium doses. Conclusion: Despite the etiopathogenesis being dependent on genetic, environmental, and immunological fac- tors, and the population of the Amazon being a mix of Europeans, Amerindians, and black people, the clinical and epidemiological profile of the patients of the Rheumatology clinic of the Univer- sidade do Estado do Pará is similar to the ones described on the national and international literature.

Comparison of mean platelet volume in patients with psoriasis and healthy individuals

To compare mean platelet volume in patients with psoriasis and healthy individuals. This case control study was conducted in outpatients department and indoor of department of Dermatology, DHQ Hospital, Faisalabad. The duration of study was six months. Thirty consecutive patients of psoriais, 20 to 60 years of age and thirty age and gender matched healthy individuals were selected. 2cc venous blood sample from each subject was sent to the pathology laboratory of DHQ Hospital. Mean platelet volume [MPV] was measured as a part of blood complete analysis in Medonic M series Haematology analser. MPV was found higher in the patients of psoriasis as compared to the healthy individuals. The mean value of MPV in the case group was 8.24 +/- 1.22 fl, whereas in the control group, it was 7.29 +/- 0.77 fl [p<0.05]. The study demonstrated that mean platelet volume is increased in patients with psoriasis as compared to healthy individuals. Such patients are at an increased risk of cardiovascular complications

Pesquisa de autoanticorpos em pacientes com artrite psoriásica sob terapia anti-TNFα / Autoantibodies in patients with psoriatic arthritis on anti-TNFα therapy

INTRODUÇÃO: A terapia imunobiológica anti-TNFα tem-se mostrado efetiva no tratamento de pacientes com artrite psoriásica (APs) refratária. No entanto, não está bem definido o risco de desenvolvimento de autoanticorpos comumente encontrados nas doenças reumatológicas em pacientes com APs na vigência desse tratamento. OBJETIVO: avaliar a indução de autoanticorpos específicos durante a terapia anti-TNFα em pacientes com APs. PACIENTES E MÉTODOS: Foram analisadas amostras de soro de 23 pacientes com APs (mulheres: 61 por cento, idade: 45,04 ± 12,68 anos, quadro poliarticular: 69,6 por cento, duração da doença: 13,3 ± 7,7 anos, infliximabe: 82,60 por cento) obtidas imediatamente antes (basal) e cerca de um ano após a introdução da terapia anti-TNF (última amostra) (385 ± 131,45 dias). A pesquisa incluiu a detecção de anticorpos antinucleares (ANA) e anticorpos para dsDNA (imunofluorescência indireta em células Hep-2 e em Crithidia luciliae, respectivamente); RNP e Sm (hemaglutinação passiva); Ro/SS-A e/ou La/SS-B, cromatina, histona, peptídeo citrulinado (CCP) e cardiolipina (ELISA). RESULTADOS: A pesquisa basal de ANA revelou positividade em 47,8 por cento dos pacientes, com predomínio do padrão nuclear homogêneo (81,8 por cento). Todas as amostras de soro testadas foram negativas para fator reumatoide e anticorpos anticardiolipina, RNP, Sm, Ro/SS-A, La/SS-B, histona e dsDNA, enquanto dois pacientes apresentaram positividade para anticromatina e um para anti-CCP. Todas as amostras de ANA positivas no tempo basal, exceto uma, mantiveram essa reatividade após a introdução da terapia anti-TNF. Reatividade "de novo" ANA foi observada em quatro dos pacientes originalmente negativos (33,3 por cento). Anticorpos anti-Ro/SS-A, La/SS-B, cardiolipina, histona, dsDNA e fator reumatoide foram sistematicamente negativos em todas as amostras finais de soro testadas e positividade anticromatina foi detectada em outros três...

INTRODUCTION: Anti-TNFα therapy has been effective in the treatment of patients with refractory psoriatic arthritis (PSA). However, the risk of developing autoantibodies commonly found in rheumatic diseases in PSA patients undergoing this therapy is not clear. OBJECTIVE: To evaluate the induction of specific autoantibodies after anti-TNFα therapy in PSA patients. PATIENTS AND METHODS: Serum samples from 23 PSA patients (women: 61 percent, age: 45.04 ± 12.68 years, polyarticular: 69.6 percent, disease duration: 13.3 ± 7.7 years, infliximab: 82.60 percent) obtained immediately before (baseline) and approximately one year after the introduction of anti-TNF therapy (last sample) (385 ± 131.45 days), were analyzed. The analysis included detection of antinuclear antibodies (ANA) and anti-dsDNA antibodies (indirect immunofluorescence on Hep-2 cells and Crithidia luciliae, respectively); anti-RNP and anti-Sm (passive hemagglutination); and anti-Ro/ SS-A and/or anti-La/SS-B, anti-chromatin, anti-histones, anti-citrullinated peptide (CCP), and anti-cardiolipin (ELISA) antibodies. RESULTS: At baseline, ANA was positive in 47.8 percent of patients, with predominance of homogeneous nuclear pattern (81.8 percent). All baseline serum samples were negative for rheumatoid factor and antibodies to cardiolipin, RNP, Sm, Ro/SS-A, anti-La/SS-B, anti-histone, and anti-dsDNA antibodies, while two patients were positive for anti-chromatin and one for anti-CCP. All ANA-positive samples at baseline, except for one, remained positive after the introduction of anti-TNF therapy; however, de novo ANA reactivity was observed in four originally negative patients (33.3 percent). Anti-Ro/SS-A, La/SS-B, cardiolipin, histones, dsDNA, and rheumatoid factor antibodies remained negative in all final serum samples tested, and anti-chromatin positivity was detected in three other patients. CONCLUSION: Our findings have shown that anti-TNF therapy induced ANA positivity...

Serum and synovial fluid anti-cyclic citrullinated peptide [anti-CCP] antibodies in rheumatoid factor negative psoriatic arthritis

To detect serum and synovial fluid anti-CCP antibodies in psoriatic arthritis patients [PsA] as compared to rheumatoid arthritis [RA] and psoriasis [Ps] patients. Anti-CCP antibodies and rheumatoid factor [RF] were measured in the serum of 30 patients with RF negative PsA, 30 patients with RA, 30 patients with Ps and 20 sex and age matched healthy controls. Synovial fluid anti-CCP antibodies were also measured in 10 patients with PsA and 12 RA patients having synovitis and knee effusion. Two out of thirty patients [6.66%] with PsA, 28/30 [93%] with RA, none [0%] of patients with psoriasis without arthritis, or healthy controls had serum anti-CCP antibodies above the cut off level. All patients with PsA with positive anti-CCP antibodies had polyarthritis. Anti-CCP Abs were detected in the synovial fluid in 1/10 [10%] of patients with PsA with knee effusion and in 11/12 [91.6%] of patients with RA with knee effusions. RF was positive in 85% of RA patients and negative in all patients with PsA. Anti-CCP antibodies may be present in patients with psoriatic arthritis in both serum and synovial fluid. Patients with psoriatic arthritis positive for anti-CCP antibodies more often had poly articular disease, more severe disease and erosive changes. Anti-CCP antibodies in both serum and synovial fluid were more prevalent in patients with rheumatoid arthritis than in patients with psoriatic arthritis while it was negative in serum of patients with psoriasis without arthritis

A clinical study of psoriatic arthropathy.

BACKGROUND: The incidence of uncomplicated psoriasis is 1-3% in the general population. Arthritis is found in increased frequency in psoriatic patients and its incidence is estimated to be 5-7%. AIM: To assess the prevalence of arthritis in psoriatic patients. METHODS: Four hundred and seventy-two psoriatic patients were enrolled in the study out of which 40 patients had (psoriatic) arthropathy (PsA). Severity of psoriasis was assessed by the psoriasis area and severity index (PASI). Routine blood investigations were carried out along with radiological investigations. RESULTS: Forty percent of the 40 PsA patients were in the age group of 51-60 years. Seven patients out of the 40 (17.5%) psoriatic arthropathic (PsA) patients had a family history of psoriasis. Nail involvement was observed in 37 cases (92.5%). Rheumatoid factor was present in five out of the 40 (12.5%) PsA patients. Serum uric acid levels were above normal in eighteen out of the 40 (45%) PsA patients. Asymmetric oligoarthropathy was the most commonly observed feature in 42.5% of the 40 PsA patients. Narrowing of joint spaces and erosions were observed in 62.5% and 45% of the 40 PsA patients. CONCLUSION: There is an association between the duration of skin lesions and duration of arthropathy. Similarly the PASI score is also directly related with arthropathy.