ABSTRACT
Introducción: la alopecia areata es una enfermedad autoinmune de etiología desconocida que se asocia a otras enfermedades autoinmunes. La enfermedad mano-pie-boca es una infección viral frecuente en la edad pediátrica, causada por diferentes serotipos de enterovirus y que en ocasiones asocia onicomadesis. El presente estudio pretende comprobar un incremento de los casos de alopecia areata tras un brote de enfermedad mano-pie-boca en nuestro entorno. Material y métodos: identificación de los pacientes menores de 14 años diagnosticados de enfermedad mano-pie-boca y/o alopecia areata en un área de salud entre el 1 de enero de 2011 y el 31 de diciembre de 2012. Revisión de historias clínicas, recogiendo fecha de nacimiento y diagnóstico, edad al diagnóstico y características clínicas. Resultados: se encontraron 49 pacientes diagnosticados de enfermedad mano-pie-boca y siete diagnosticados de alopecia areata. Se confirmó un brote de enfermedad mano-pie-boca con 42 casos en un periodo de ocho semanas. Se observó un incremento posterior de los casos de alopecia areata (cuatro casos en las cuatro semanas siguientes, frente a tres casos a lo largo de los 11 meses previos y ninguno durante el año anterior). Conclusiones: tras un brote de enfermedad mano-pie-boca se observó un incremento del número de casos de alopecia areata. Este hecho, unido a la asociación de la alopecia areata con otras enfermedades autoinmunes y a la relación encontrada entre infecciones por enterovirus y procesos autoinmunes como la diabetes mellitus tipo 1, plantea una posible relación causal entre infecciones por enterovirus y alopecia areata, así como un posible componente de autoinmunidad en la onicomadesis asociada a la enfermedad mano-pie-boca (AU)
Introduction: alopecia areata is an autoimmune disease of unknown etiology that is associated to other autoimmune diseases. Hand-foot-mouth disease is a common viral infection in children caused by several enterovirus serotypes, and it is sometimes associated to onychomadesis. This study intends to investigate an increase in cases of alopecia areata after an outbreak of hand-foot-mouth disease in our environment. Methods: identification of patients under 14 years old diagnosed with hand-foot-mouth disease and/or alopecia areata in a Primary Care Service Area between 1/1/2011 and 31/12/2012. Review of medical records, collecting date of birth and diagnosis, age at diagnosis and clinical characteristics. Results: forty-nine patients diagnosed with hand-foot-mouth disease and 7 diagnosed with alopecia areata were found. An outbreak of hand-foot-mouth disease was confirmed with 42 cases within a period of 8 weeks. A subsequent increase in cases of alopecia areata (4 cases within 4 weeks, compared with 3 cases over the 11 months before and none during the previous year) was observed. Conclusions: following an outbreak of hand-foot-mouth disease an increased number of cases of alopecia areata was observed. This fact, coupled with the association of alopecia areata with other autoimmune diseases, and the relationship found between enterovirus infections and autoimmune diseases such as type 1 diabetes mellitus poses a possible causal relationship between enterovirus infections and alopecia areata, and a possible component of autoimmunity in onychomadesis associated to hand-foot-mouth disease (AU)
Subject(s)
Humans , Male , Female , Child , Alopecia Areata/complications , Alopecia Areata/diagnosis , Enterovirus Infections/complications , Enterovirus Infections/diagnosis , Enterovirus Infections/drug therapy , Autoimmunity/immunology , Hand, Foot and Mouth Disease/complications , Hand, Foot and Mouth Disease/diagnosis , Enterovirus Infections/etiology , Enterovirus Infections/prevention & control , Enterovirus Infections/physiopathology , Hand, Foot and Mouth Disease/physiopathology , Primary Health Care/methods , Primary Health CareABSTRACT
INTRODUCCIÓN: Los estudios epidemiológicos sobre diabetes mellitus tipo 1 (DM1) realizados en múltiples países y regiones han contribuido al conocimiento de la epidemiología de la enfermedad en menores de 15 años. En España se han realizado estudios en casi todas las comunidades autónomas, si bien las cifras de incidencia a nivel nacional no son todavía bien conocidas. MATERIAL Y MÉTODOS: Revisión bibliográfica de las publicaciones y comunicaciones sobre epidemiología de la DM1 en menores de 15 años en España. Se han seleccionado las referencias que aportasen datos de pacientes menores de 15 años. RESULTADOS: Se han encontrado estudios en casi todas las comunidades autónomas. La metodología de los estudios realizados es heterogénea, encontrando diferencias en cuanto al ámbito de realización, duración, periodo estudiado, límite superior de edad y método de recogida de datos. Las tasas de incidencia comunicadas varían desde los 11,5 casos/100.000 habitantes-año en Asturias hasta los 27,6 de Castilla-La Mancha. En ocasiones se especifica el porcentaje de casos que presentan cetoacidosis diabética en el momento del diagnóstico, habitualmente en el rango del 25-40%. CONCLUSIONES: En España se han realizado múltiples estudios epidemiológicos de DM1 en menores de 15 años, con una metodología heterogénea. La incidencia media de DM1 en menores de 15 años en España estimada en base a los estudios revisados sería de 17,69 casos/100.000 habitantes-año. Creemos conveniente mantener los registros de DM1 en funcionamiento y crearlos en aquellas comunidades autónomas donde no existen, así como unificar en lo posible la metodología utilizada de cara a obtener datos precisos sobre la epidemiología de la DM1 en España y conocer la evolución de la incidencia de la enfermedad en los próximos años
INTRODUCTION: Epidemiological studies in many regions and countries have contributed to determining the epidemiology of type 1 diabetes (T1DM) in children less than 15 years old. Studies in many regions of Spain have been published, but the national incidence is not really known. MATERIAL AND METHODS: A review was made of the publications on the epidemiology of T1DM in Spain, selecting the references on patients less than 15 years old. RESULTS: Many epidemiological studies on T1DM in almost all regions in Spain have been published. The methodology of these studies is heterogeneous, with variations in geographical definition, duration, period of study, limit of age, and data collection. The incidence rates are variable, from 11.5 cases per 100,000/year in Asturias to 27.6 in Castilla-La Mancha. Some studies report the percentage of diabetic ketoacidosis at the time of diagnosis, which is usually in the range of 25-40%. CONCLUSIONS: Although there have been various epidemiological studies on T1DM in almost all regions in Spain, the methodology is heterogeneous. The mean incidence of T1DM in children less than 15 years old in Spain, stimated from the selected studies is 17,69 cases per 100,000/year. T1DM registers need to be created and updated, using standardized methodology, to get more reliable data of the epidemiology of T1DM in Spain in the near future
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/prevention & control , Forms and Records Control , Clinical Record , Spain/epidemiology , BibliometricsABSTRACT
INTRODUCTION: Epidemiological studies in many regions and countries have contributed to determining the epidemiology of type 1 diabetes (T1DM) in children less than 15 years old. Studies in many regions of Spain have been published, but the national incidence is not really known. MATERIAL AND METHODS: A review was made of the publications on the epidemiology of T1DM in Spain, selecting the references on patients less than 15 years old. RESULTS: Many epidemiological studies on T1DM in almost all regions in Spain have been published. The methodology of these studies is heterogeneous, with variations in geographical definition, duration, period of study, limit of age, and data collection. The incidence rates are variable, from 11.5 cases per 100,000/year in Asturias to 27.6 in Castilla-La Mancha. Some studies report the percentage of diabetic ketoacidosis at the time of diagnosis, which is usually in the range of 25-40%. CONCLUSIONS: Although there have been various epidemiological studies on T1DM in almost all regions in Spain, the methodology is heterogeneous. The mean incidence of T1DM in children less than 15 years old in Spain, stimated from the selected studies is 17,69 cases per 100,000/year. T1DM registers need to be created and updated, using standardized methodology, to get more reliable data of the epidemiology of T1DM in Spain in the near future.
