Enfermedad de Still del adulto: características clínicas y pronóstico de una cohorte de pacientes colombianos

Autor: Luis Fernando Pinto-Peñaranda, Carlos Jaime Velásquez-Franco, Estefanía Calle-Botero, Andrés Felipe Echeverri-García, Carolina Muñoz-Grajales, Javier Darío Márquez-Hernández, Miguel Antonio Mesa-Navas, María Fernanda Corrales-Sierra, Lina María Ballesteros-García
Rok vydání: 2020
Předmět:
Zdroj: Revista de la Facultad de Medicina. 68
ISSN: 2357-3848
0120-0011
Popis: espanolIntroduccion. La enfermedad de Still del adulto (ESA) es una condicion medica poco frecuente que puede presentar complicaciones graves; sin embargo, aun no se conocen con claridad sus factores de riesgo, sus factores pronosticos, ni los aspectos asociados a las recaidas y a la refractariedad a esteroides en individuos con esta condicion. Objetivos. Describir el comportamiento clinico de la ESA y determinar los factores asociados a la refractariedad a esteroides, a recaidas y a complicaciones en pacientes con esta enfermedad. Materiales y metodos. Estudio retrospectivo de cohortes que incluyo 45 pacientes diagnosticados con ESA entre enero de 2007 y enero de 2017 en 2 hospitales de referencia. Se presentan medidas de resumen. Se realizaron dos analisis de regresion logistica para identificar posibles factores que expliquen la refractariedad a esteroides, las recaidas y el desarrollo de complicaciones en la poblacion de estudio. Resultados. La edad promedio de los participantes fue 42.13±15.8 anos. De los 45 pacientes incluidos, 23 (51.1%) eran mujeres, a 42 (93.3%) se le prescribieron esteroides, y, de estos, 13 (32%) se consideraron refractarios a esteroides. Se presentaron complicaciones en 12 (26.7%) individuos y su frecuencia fue mayor en pacientes con temperatura maxima >39°C. Finalmente, 33 (73.3%) pacientes tuvieron un seguimiento mayor a 1 ano, de los cuales, 17 (37.8%) presentaron recaidas, las cuales fueron mas frecuentes en individuos refractarios a esteroides o con esplenomegalia. Conclusion. Los pacientes que recibieron cualquier tipo de terapia biologica fueron mas refractarios a esteroides; por su parte, la refractariedad a esteroides y la esplenomegalia se asociaron a un mayor numero de recaidas, y la temperatura >39°C se asocio a al desarrollo de complicaciones. EnglishIntroduction: Adult Still disease (ASD) is a rare disorder that can lead to serious complications; however, risk factors associated with the development of this disease, its prognostic factors, and aspects related to relapse and steroids refractoriness in individuals with this condition are not yet clearly known. Objectives: To describe the clinical behavior of ASD and determine factors associated with steroid refractoriness, relapse, and complications in patients with this condition. Materials and methods: A retrospective cohort study was conducted in 45 patients diagnosed with ASD between January 2007 and January 2017 in 2 reference hospitals. Summary statistics are presented. In addition, two logistic regression analysis were conducted in order to identify possible factors explaining steroid refractoriness, relapses, and the development of complications in the study population. Results: Participants’ average age was 42.13 ± 15.8 years. Out of the 45 patients, 23 (51.1%) were women, 42 (93.3%) were prescribed steroids, and of these, 13 (32%) were considered as steroid refractory. Complications were observed in 12 individuals (26.7%), and their frequency was higher in patients whose maximum body temperature was higher than 39°C. Finally, 33 (73.3% patients had a follow-up greater than 1 year, of which 17 (37.8%) suffered relapses; in addition, relapses were more frequent in patients who were steroid refractory or those with splenomegaly. Conclusion: Patients who were prescribed any type of biological therapy were more steroid refractory. On the other hand, steroid refractoriness and splenomegaly were associated with a higher frequency of relapses, while having a body temperature >39°C was associated with developing complications.
Databáze: OpenAIRE
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