Frecuencia de anticuerpos para diagnóstico de enfermedad celíaca en pacientes con enfermedades del tejido conectivo y artropatías inflamatorias / Serum anti endomysial and anti transglutaminase antibodies in patients with connective tissue diseases

Background: The detection of anti-transglutaminase IgA (tTG) and anti-endomysial (EMA) is used for screening of celiac disease (CD) with a sensitivity and specificity of 90 and 99% respectively. There is an association between CD and connective tissue diseases (CTD). Aim: To report the frequency of IgA tTG and EMA in patients with a definite diagnosis of CTD and inflammatory arthropathies (IA). Material and Methods: One hundred forty nine patients, aged 19 to 86 years (133 females) with CTD and IA were studied. tTG were determined by ELISA and EMA by indirect immunofluorescence. Results: Eight participants had at least one positive antibody (5.4%, confidence intervals (CI) = 1.8-9), six had both (4.0% CI = 0.9-7.2) and two had only tTG positive. An intestinal biopsy was performed in four of these participants, finding a marked villous atrophy in three and partial atrophy in one. Conclusions: Five percent of this group of patients with CTD or IA had positive antibodies for CD.

[Serum anti endomysial and anti transglutaminase antibodies in patients with connective tissue diseases]. / Frecuencia de anticuerpos para diagnóstico de enfermedad celíaca en pacientes con enfermedades del tejido conectivo y artropatías inflamatorias.

BACKGROUND: The detection of anti-transglutaminase IgA (tTG) and anti-endomysial (EMA) is used for screening of celiac disease (CD) with a sensitivity and specificity of 90 and 99% respectively. There is an association between CD and connective tissue diseases (CTD). AIM: To report the frequency of IgA tTG and EMA in patients with a definite diagnosis of CTD and inflammatory arthropathies (IA). MATERIAL AND METHODS: One hundred forty nine patients, aged 19 to 86 years (133 females) with CTD and IA were studied. tTG were determined by ELISA and EMA by indirect immunofluorescence. RESULTS: Eight participants had at least one positive antibody (5.4%, confidence intervals (CI) = 1.8-9), six had both (4.0% CI = 0.9-7.2) and two had only tTG positive. An intestinal biopsy was performed in four of these participants, finding a marked villous atrophy in three and partial atrophy in one. CONCLUSIONS: Five percent of this group of patients with CTD or IA had positive antibodies for CD.

[Osteonecrosis in HIV-infected patients]. / Osteonecrosis en pacientes infectados por HIV.

Osteonecrosis, also known as avascular necrosis, is chiefly characterized by death of bone caused by vascular compromise. The true incidence of osteonecrosis in HIV-infected patients is not well known and the pathogenesis remains undefined. Hypothetical risk factors peculiar to HIV-infected individuals that might play a role in the pathogenesis of osteonecrosis include the introduction of protease inhibitors and resulting hyperlipidemia, the presence of anticardiolipin antibodies in serum leading to a hypercoagulable state, immune recovery and vasculitis. Hereby we present a series of 13 HIV-infected patients with osteonecrosis. The most common symptom upon presentation was arthralgia. The majority of the patients had received steroids, 9 had developed hyperlipidemia after the introduction of HAART, 8 were smokers and 4 patients were alcoholics. In 2 patients, seric anticardiolipin antibodies were detected. Twelve patients had AIDS and were on HAART (11 were on protease inhibitors). We believe that osteonecrosis should be included as differential diagnosis of every HIV-infected patient who complains of pain of weight bearing joints. Likewise, it seems prudent to rule out HIV infection in subjects with osteonecrosis.