ABSTRACT
Se presentan un caso de dermatomiositis y otro de polimiositis refractarias a varios inmunosupresores convencionales y con respuesta a tratamiento con rituximab, con el que se posibilita la disminución de dosis de corticoide y se mantiene a la enfermedad en remisión durante un largo periodo (AU)
We report one case of dermatomyositis and one of polymyositis refractory to several conventional inmunosupressive therapies, which present a response after treatment with rituximab, enabling steroid dose reduction and a prolonged remission (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Dermatomyositis/diagnosis , Dermatomyositis/drug therapy , Immunosuppressive Agents/metabolism , Immunosuppressive Agents/pharmacokinetics , Immunosuppressive Agents/therapeutic use , Cyclophosphamide/therapeutic use , Muscle Weakness/complications , Muscle Weakness/diagnosis , Hypertension/complications , Hypertension/diagnosis , Glucocorticoids/therapeutic use , Methylprednisolone/therapeutic use , Tumor Necrosis Factor-alpha/therapeutic use , Receptors, Tumor Necrosis Factor/therapeutic useABSTRACT
We report one case of dermatomyositis and one of polymyositis refractory to several conventional inmunosupressive therapies, which present a response after treatment with rituximab, enabling steroid dose reduction and a prolonged remission.
Subject(s)
Antibodies, Monoclonal, Murine-Derived/therapeutic use , Dermatomyositis/drug therapy , Immunologic Factors/therapeutic use , Polymyositis/drug therapy , Adult , Female , Humans , Middle Aged , RituximabSubject(s)
Humans , Female , Aged, 80 and over , Scleroderma, Systemic/complications , Scleroderma, Systemic/diagnosis , Hypertension/complications , Dyspnea/complications , Cardiac Catheterization/methods , Receptors, Endothelin/therapeutic use , Hypotension/complications , Cardiomegaly/complications , Cardiomegaly/diagnosis , Pleural Effusion/complications , Scleroderma, Systemic/physiopathology , Dyspnea/diagnosis , Hypertension/diagnosis , Vasodilator Agents/therapeutic use , Epoprostenol/therapeutic use , Scleroderma, Systemic/therapy , Radiography, Thoracic/methods , ElectrocardiographyABSTRACT
El diagnóstico precoz y la respuesta al tratamiento en los pacientes con espondiloartritis han supuesto, desde siempre, un reto dada la escasez de técnicas de imagen que demostrasen, de manera cuantitativa, la inflamación en columna y articulaciones sacroilíacas. Durante los últimos 2 años se han llevado a cabo importantes avances en el uso de la resonancia magnética (RM) para el estudio de las espondiloartritis. La posibilidad de cuantificar la inflamación que ocurre en estos pacientes mediante la utilización de diferentes sistemas de puntuación permite no sólo llevar a cabo el diagnóstico de forma precoz, sino además valorar la respuesta de los pacientes con espondiloartritis a diferentes agentes terapéuticos, en especial a las nuevas terapias biológicas. Se han publicado varios ensayos controlados con dichos fármacos que muestran la disminución de las lesiones inflamatorias en RM. Esta revisión se centra, brevemente, en las técnicas y los sistemas de puntuación de RM utilizados, así como en los datos aportados por dichos estudios, que valoran la respuesta al tratamiento con terapias biológicas mediante las imágenes de RM (AU)
Early diagnosis and assessment of the response to treatment in patients suffering from spondyloarthritis have always been challenging due to the lack of imaging techniques able to demonstrate spinal and sacroiliac inflammation. The last 2 years have seen important advances in the use of magnetic resonance imaging (MRI) for the study of spondyloarthritis. The possibility of quantification of inflammatory lesions using different scoring systems allows not only an early diagnosis, but the assessment of the response to several therapeutic agents, especially those known as «biological therapies». A number of randomized controlled trials of anti-tumor necrosis factor agents have been published showing regression of inflammatory lesions in MRI. This review discusses briefly the techniques and scoring systems used and all the evidences that exist about assessing treatment in spondyloarthritis (AU)
Subject(s)
Humans , Spondylarthritis/drug therapy , Biological Therapy , Magnetic Resonance Spectroscopy , Inflammation/drug therapy , Inflammation/physiopathologyABSTRACT
Early diagnosis and assessment of the response to treatment in patients suffering from spondyloarthritis have always been challenging due to the lack of imaging techniques able to demonstrate spinal and sacroiliac inflammation. The last 2 years have seen important advances in the use of magnetic resonance imaging (MRI) for the study of spondyloarthritis. The possibility of quantification of inflammatory lesions using different scoring systems allows not only an early diagnosis, but the assessment of the response to several therapeutic agents, especially those known as «biological therapies¼. A number of randomized controlled trials of anti-tumor necrosis factor agents have been published showing regression of inflammatory lesions in MRI. This review discusses briefly the techniques and scoring systems used and all the evidences that exist about assessing treatment in spondyloarthritis.
