RESUMO
Chronic pain is a healthcare problem that significantly affects the mental health, and the professional and private life of patients. It can complicate many disorders and represents a common symptom of rheumatologic diseases, but the data on its prevalence is still limited. Pain is a ubiquitous problem in systemic sclerosis (SSc). SSc-related pain has been studied on the basis of biomedical models and is considered a symptom caused by the disease activity or previous tissue damage. Effective pain management is a primary goal of the treatment strategy, although this symptom in SSc has not yet been investigated in detail. However, these patients do not all respond adequately to pharmacological pain therapies, therefore in these cases a multimodal approach needs to be adopted. This paper must be considered as retracted due to a plagiarism misconduct. See the Retraction note at: https://doi.org/10.4081/reumatismo.2018.1171
Assuntos
Dor Crônica/etiologia , Dor Musculoesquelética/etiologia , Escleroderma Sistêmico/complicações , Analgésicos/uso terapêutico , Autoanticorpos/imunologia , Bursite/etiologia , Bursite/fisiopatologia , Centrômero/imunologia , Dor Crônica/epidemiologia , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Dor Crônica/terapia , Terapia Cognitivo-Comportamental , Terapia Combinada , Emoções , Fibromialgia/etiologia , Fibromialgia/fisiopatologia , Humanos , Modelos Biológicos , Dor Musculoesquelética/epidemiologia , Dor Musculoesquelética/fisiopatologia , Dor Musculoesquelética/psicologia , Dor Musculoesquelética/terapia , Manejo da Dor , Prevalência , Escleroderma Sistêmico/imunologia , Escleroderma Sistêmico/fisiopatologia , Escleroderma Sistêmico/psicologia , Apoio SocialRESUMO
Renal amyloidosis is a complication of ankylosing spondylitis. A possible pathogenetic role is due to TNF-alpha, with a direct action on glomerular receptors TNFR2 and renal injury, secondary to deposition of amyloid fibrils. The most frequent clinical manifestation is proteinuria or nephrotic syndrome. Etanercept, a soluble receptor of TNF-alpha, binds this circulant cytokine with a progressive improvement of renal function and reduction of deposits of amyloid. Transient leukopenia, observed during ankylosing spondylitis, should not be considered a controindication to the use of Etanercept, but it requires a constant monitoring. The benefit observed in our patient can represent an indication to the use of Etanercept for the management of amyloidosis.
Assuntos
Amiloidose/tratamento farmacológico , Imunoglobulina G/uso terapêutico , Receptores do Fator de Necrose Tumoral/uso terapêutico , Espondilite Anquilosante/complicações , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Idoso , Amiloidose/diagnóstico , Amiloidose/etiologia , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/uso terapêutico , Quimioterapia Combinada , Etanercepte , Humanos , Imunossupressores/administração & dosagem , Imunossupressores/uso terapêutico , Indometacina/administração & dosagem , Indometacina/uso terapêutico , Masculino , Metotrexato/administração & dosagem , Metotrexato/uso terapêutico , Metilprednisolona/administração & dosagem , Metilprednisolona/uso terapêutico , Proteinúria/etiologia , Proteína Amiloide A Sérica/análise , Espondilite Anquilosante/diagnósticoRESUMO
The association of Systemic Sclerosis (SSc) and Psoriatic Arthritis (PsA) is unfrequent; only few cases are reported in literature. We describe a case of a patient with SSc following the onset of PsA. The disease begun with tenosynovitis, polyarthritis in association with psoriasis. After two years, Raynaud's phenomenon and sclerodactyly appeared, and, later, pulmonary interstitial fibrosis and esophageal dysfunction. The existence of a common pathogenesis of the two diseases, SSc and PsA, is discussed.
