Osteomalacia hipofosfatémica en un paciente infectado por VIH en tratamiento con Tenofovir / Hypophosphatemic osteomalacia in a patient HIV-positive treated with Tenofovir

En pacientes infectados por VIH en tratamiento con tenofovir se ha comunicado la ocurrencia de hipofosfatemia y osteomalacia. Presentamos un caso que debutó clínicamente con fracturas vertebrales y dolor óseo. La suspensión de la medicación y la corrección de la acidosis mejoraron la sintomatología. El caso ilustra la importancia de considerar la osteomalacia en pacientes tratados con tenofovir

Cases of hypophosphatamia and osteomalacia have been reported in HIVpositive patients on tenofovir-containing active antiretroviral therapy. We present a case in which vertebral fractures and bone pain were the presenting features. The symptoms resolved after discontinuation of tenofovir and with mineral supplementation. The case highlights the importance of considering the diagnosis of osteomalacia in patients treated with tenofovir

[Fluoroquinolone-induced tendon diseases]. / Tendinopatías por fluoroquinolonas.

Tendinitis and tendon ruptures induced by fluoroquinolones, while uncommon, have been documented in the literature since 1983. We report five cases of tendinitis induced by fluoroquinolones, three caused by levofloxacin and two by ciprofloxacin. We revise actual knowledge of this association and we insist on how important is an early detection to prevent tendon rupture.

Tendinopatías por fluoroquinolonas / Fluoroquilone-induced tenden diseases

Las tendinitis y roturas tendinosas inducidas por fluoroquinolonas, aunque infrecuentes, han sido documentadas en la literatura desde 1983. Presentamos cinco casos de temdinitis inducidas por fluoroquinolonas, tres por levofloxacino y dos por ciprofloxacino. Revisamos los conocimientos actuales de esta asociación e insistimos en la importancia de la detección precoz para evitar roturas tendinosas

Tendinitis and tendon ruptures induced by fluoroquinolones, while uncommon, have beeb documented in the literature since 1983. We report five cases of tendinitis induced by fluoroquinolones, three caused by levofloxacin and two by ciprofloxacin. We revise actual knowledge of this association and we insist on how important is an early detection to prevent tendon rupture

[Polytopic and recurrent reflex sympathetic dystrophy in lower limbs in two siblings]. / Distrofia simpático refleja de extremidades inferiores, politópica y recurrente en dos hermanos.

Reflex sympathetic dystrophy (RSD) has been related to a variety of inciting and predisposing factors. However, there are few reports of a familiar or genetic background in RSD. This paper describes two cases of RSD polytopic and recurrent in lower limbs of two brothers with similar HLA.

Dolor lumbo-sacro atípico / Atypical lumbosacral pain

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Distrofia simpático refleja en el post-parto / Algodystrophie in the post-partum

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[Reflex sympathetic dystrophy: psychological and psychopathologic features]. / Distrofia simpático refleja: aspectos psicológicos y psicopatológicos.

It has traditionally been accepted that a predisposing psychological field exists with the appearance of the reflex sympathetic dystrophy. Nevertheless, there is no unanimous agreement in this interpretation, since surveys exist unanimous are in favour the reactive character of the psychological effect on reflex sympathetic dystrophy. In this study, we revise literature already published on the subject, present arguments on the psychological evaluation tests carried out to date and propose the possibility of using other test unanimous are easier to manage and to interpret.

Distrofia simpático refleja: aspectos psicológicos y psicopatológicos / Reflex sympathetic dystrophy: psychological and psychopathological aspects

Clásicamente se ha admitido un terreno psicológico predisponente en la aparición de la distrofia simpático refleja. No obstante, no hay unanimidad en esta apreciación ya que existen estudios que abogan por el carácter reactivo de la afectación psicológica en la distrofia simpático refleja. En el presente trabajo revisamos la literatura publicada al respecto, discutimos sobre los test de evaluación psicológica utilizados hasta el momento, y planteamos la posibilidad de utilizar otros de más fácil manejo e interpretación. (AU)

[RS3PE syndrome: report of 11 cases]. / Síndrome RS3PE: a propósito de 11 casos.

The RS3P syndrome or remitting seronegative symmetrical synovitis with pitting oedema, was described in 1985 by McCarty. The description refers to a rheumatologic set of symptoms with an acute commence, with no erosive lesions, with seronegativity, affecting more frequently to elderly males and showing an excellent prognosis. These characteristics make it possible to difference from the rheumatoid arthritis and from the rheumatic polymyalgia. We present eleven cases which confirm the good prognosis already described, but we suggest the possibility of this syndrome could be a manifestation or the beginning of other possible diseases.

Síndrome RS3PE: a propósito de 11 casos / RS3PE syndrome: report of 11 cases

El síndrome RS3PE o poliartritis edematosa del anciano fue descrito por Mc Carty en 1985. La descripción hacía referencia a un cuadro reumatológico de comienzo agudo, afectando más frecuentemente a varones ancianos, con seronegatividad, sin lesiones erosivas y presentando un excelente pronóstico. Estas características permiten diferenciarlo de la artritis reumatoide y de la polimialgia reumática. Presentamos 11 casos que confirman el buen pronóstico descrito, pero planteamos la posibilidad de que dicho síndrome pueda ser una manifestación o el inicio de otras enfermedades (AU)

[Hypergammaglobulinemia D syndrome]. / Síndrome hipergammaglobulinemia D.

The hyperimmunoglobulinemia D syndrome is characterized by early onset of attacks of periodic fever and an elevated serum polyclonal Ig D (> 100 U/ml). Symptoms during attacks include joint involvements (arthralgia/arthritis), skin lesions, swollen lymph nodes, headache and abdominal complaints (vomiting, diarrhea and pain). The ethiopathogenia is unknown. It is transmitted by autosomal recessive inheritance. The hyperimmunoglobulinemia D syndrome should be distinguished from other periodic febrile syndroms such as systemic-onset juvenile rheumatoid arthritis, CINCA syndrome, FADA syndrome, familial mediterranean fever and adult-onset Still disease. There is no therapy for the syndrome but the prognosis is good because the frequency and severity of the attacks tends to diaeminish with age.

Síndrome hipergammaglobulinemia D / Hypergammaglobulinemia D syndrome

El síndrome hipergammaglobulinemia D se caracteriza por la presencia de ataques febriles recurrentes de inicio precoz y por el aumento policlonal de la Ig D (> 100 U/ml). Durante los ataques también puede haber manifestaciones articulares (artralgias/ artritis), lesiones cutáneas, adenopatías, cefaleas y manifestaciones abdominales (vómitos, diarreas y dolor). La etiopatogenia es desconocida y se transmite de forma autosómica recesiva. Hay que realizar diagnóstico diferencial con otros síndromes de fiebre periódica como la forma sistémica de la artritis idiopática juvenil, el síndrome CINCA, el síndrome FAPA, la fiebre mediterránea familiar y la enfermedad de Still del adulto. No existe tratamiento específico y su pronóstico es bueno, ya que la frecuencia y severidad de los ataques disminuyen con la edad (AU)

[Multiple osteonecrosis in a patient with chronic alcoholism]. / Osteonecrosis múltiple en paciente con etilismo crónico.

The osteonecrosis is usually due to various precipitating circumstances or predisposing factors that quite often appear mixed, although it can also appear with no evident cause. In this report, we provide a case of multiple osteonecrosis caused by chronic alcoholism, we review the literature and go over the general characteristics of the aseptic necrosis.

[Algodystrophy in the child and the adolescent: the comparative aspects with that in the adult]. / Algodistrofia del niño y del adolescente: aspectos comparativos con la del adulto.

Algodystrophy is a pathology of the adult which rarely affects children. During childhood, it may appear between the ages of 3 and 16 years, with great prevalence among the female sex. It is usually associated to predisposing factors and the most frequent starting factor is of a traumatic nature. It affects mainly the lower limbs. From a clinical perspective, it is characterized by hyperesthesia and cutaneous hypothermia. The radiological findings are usually normal during the whole evolution and the bone gammagraphy usually shows hypofixation. The evolution is generally favourable. It can be clearly distinguished from algodystrophy in the adult due to its higher prevalence among the female sex, the already mentioned clinical aspects, the radiological normality and the isotopic hypofixation.

[Hip algodystrophy and pregnancy]. / Algodistrofia de cadera y embarazo.

Pregnancy is a potential cause of hip algodystrophy. Mechanical loco-regional factors, as well as other potential factors, can explain this preference for the hip. This pathology must be always kept in mind when attending a pregnant patient or a patient with inguino-crural pain and functional impotence during the postpartum.