Registro Iberoamericano de Espondiloartritis (RESPONDIA): Chile / RESPONDIA. Iberoamerican Spondyloarthritis Registry: Chile

Objetivos: Describir las principales características demográficas y clínicas de los pacientes chilenos con espondiloartritis ingresados en el Registro Iberoamericano de Espondiloartritis (RESPONDIA). Pacientes y métodos: Estudio descriptivo y transversal de un grupo de pacientes chilenos con espondiloartritis ingresados en RESPONDIA según criterios preestablecidos, entre enero de 2006 y diciembre de 2007. Participaron 5 centros universitarios chilenos, 4 de Santiago y uno de Valparaíso. Resultados: Se incluyó a 109 pacientes, 66 varones (58,4%), con una edad media desviación estándar de 42 22 años y una duración promedio de enfermedad en el momento del diagnóstico de 7,1 años (1-29 años). Los diagnósticos fueron de espondilitis anquilosante (58,7%), artritis psoriásica (25,6%), espondiloartritis indiferenciada (7,3%), artritis asociada a enfermedad inflamatoria intestinal (5,5%), espondiloartritis de inicio juvenil (1,8%) y artritis reactiva (0,9%). Respecto a su presentación clínica, el 42,5% tuvo afectación mixta (axial y periférica); el 36,3%, afectación axial exclusivo, y el 9,7%, afectación periférica exclusiva. El dolor lumbar inflamatorio fue el síntoma más frecuente (74,3%) seguido de artritis de las extremidades inferiores (59,3%). La manifestación extraarticular más frecuente fue la uveítis (18,6%). El 40% de los pacientes tenía algún grado de incapacidad laboral. Conclusiones: El perfil clínico más frecuente en este grupo de pacientes chilenos con espondiloartritis fue la combinación de manifestaciones axiales y periféricas. El diagnóstico más frecuente fue el de espondilitis anquilosante, seguido por el de artritis psoriásica (AU)

Objectives:To describe the main demographic and clinical characteristics of Chilean patients with Spondyloarthritis included in the Ibero American Spondyloarhtritis Registry (RESPONDIA). Patients and methods: Descriptive and cross-sectional study of Chilean patients with Spondyloarthritis registered in the RESPONDIA database. Five Chilean university hospitals participated in the inclusion of patients (4 from Santiago and 1 from Valparaiso), between January 2006 and December 2007, according to the defined protocol. Results: 109 patients were included in the registry, 66 males (58.4%) with an average age of 42 22 years, and average disease duration of 7.1 years (range 1-29 years). Diagnoses of the patients were Ankilosing Spondylitis (58.7%), Psoriatic Arthritis (25.6%), Undifferentiated Spondyloarthritis (7.3%), Inflammatory Bowel Disease Arthritis (5.5%), Juvenile Onset Spondyloarthritis (1.8%) and Reactive Arthritis (0.9%). Regarding clinical forms, 42.5% had mixed disease, 36.3% had axial disease, and 9.7% had peripheral disease. Inflammatory low back pain was the most frequent symptom reported (74.3%) followed by arthritis of the lower extremities (59.3%). The most common extra-articular disease manifestation was uveitis (18.6%). Some kinds of work disability were reported in 40% of the patients. Conclusions: The most frequent clinical profile in this group of Chilean patients with Spondiloarthritis was the combination of axial and peripheral diseases. The most common diagnosis was ankilosing spondylitis and psoriatic arthritis (AU)

Circulating platelet-derived microparticles in systemic lupus erythematosus. Association with increased thrombin generation and procoagulant state.

The risk for thrombosis is significantly increased in systemic lupus erythematosus (SLE), affecting both venous and arterial vessels. Activated platelets are known to participate in thrombus formation and growth. A general feature of activated cells is the shedding of microparticles (MP) which support coagulation by exposure of negatively charged phospholipids and possibly tissue factor (TF). In this work we characterized circulating MP in patients with SLE and their relationship with a procoagulant state. Thirty patients with SLE (aged 15-72 years, mean age 38 years) and 20 healthy controls (aged 22-54 years, mean age 34 years) were studied; patients fulfilled 4 revised criteria for SLE. The number and cellular source of circulating MP were determined by flow cytometry using double labeling with specific monoclonal antibodies and annexin V. Thrombin generation was measured as the endogenous thrombin potential (ETP) without the addition of exogenous phospholipids and TF; under these conditions the generation of thrombin depended directly on the number of MP present in plasma. Thrombin anti-thrombin (TAT) and plasmin-antiplasmin (PAP) complexes were measured by ELISA. Compared to the controls, circulating MP were significantly elevated in the patient group (1218 +/- 136 vs 653 +/- 74 x 10(3)/ml plasma, p: 0.0007). In both groups, most of these MP were of platelet origin (927 +/- 131 vs 517 +/- 72 x 10(3)/ml plasma, p:0.009 ). ETP was higher among patients as compared to the controls (804 +/- 64 vs 631 +/- 37 nM thrombin, p: 0.025). Plasma levels ofTAT in patients and controls were 3.4 +/- 0.8 and 1.4 +/- 0.5 microg/L, respectively (p:0.04), and of PAP complexes were 62.5 +/- 14 and 24.05 +/- 2.5 microg/ml, respectively (p: 0.014). The number of platelet-derived MP correlated significantly with thrombin generation (r: 0.42; p: 0.038) and TAT levels (r: 0.40; p: 0.035). We did not find an association of circulating MP with disease activity nor with the presence of antiphospholipid antibodies. The increased number of circulating platelet-derived microparticles and their association with high ETP and activation of the coagulation system suggest that these microparticles play an important role in the pathogenesis of the prothrombotic state in SLE patients.