Artritis Reactiva

Descripción General

Definición

La artritis reactiva ( AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation) es una espondiloartritis seronegativa postinfecciosa inmunomediada.

Mnemotecnia

Las artropatías seronegativas pueden recordarse como “PAIR” ( en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés).

• P – Psoriatic arthritis Psoriatic Arthritis A type of inflammatory arthritis associated with psoriasis, often involving the axial joints and the peripheral terminal interphalangeal joints. It is characterized by the presence of hla-b27-associated spondyloarthropathy, and the absence of rheumatoid factor. Psoriasis (artritis psoriásica)
• A – Ankylosing spondylitis Ankylosing spondylitis Ankylosing spondylitis (also known as Bechterew’s disease or Marie-Strümpell disease) is a seronegative spondyloarthropathy characterized by chronic and indolent inflammation of the axial skeleton. Severe disease can lead to fusion and rigidity of the spine. Ankylosing Spondylitis (espondilitis anquilosante)
• I – Inflammatory bowel disease–associated arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis (artritis asociada a enfermedad inflamatoria intestinal)
• R – Reactive Arthritis Arthritis Acute or chronic inflammation of joints. Osteoarthritis (artritis reactiva)

Epidemiología

• La AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation se desarrolla en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
  • El 1%–3% de los LOS Neisseria pacientes con uretritis.
  • El 1%–4% de los LOS Neisseria pacientes con una infección entérica.
• Incidencia: 0,6–27 casos por cada 100 000 habitantes a nivel mundial
• Prevalencia: 30–40 por cada 100 000 adultos
• Es más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hombres.
• Ocurre más frecuentemente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adultos jóvenes (< 40 años)
• Del 70%–90% tienen el alelo HLA-B27

Etiología

• Generalmente, ocurre entre 1–4 semanas después de ciertas infecciones:
  • Genitourinarias:
    • Chlamydia trachomatis Chlamydia trachomatis Type species of Chlamydia causing a variety of ocular and urogenital diseases. Chlamydia (más común)
    • Neisseria gonorrhoeae Neisseria gonorrhoeae A species of gram-negative, aerobic bacteria primarily found in purulent venereal discharges. It is the causative agent of gonorrhea. Neisseria
    • Ureaplasma urealyticum
  • Gastrointestinales:
    • Campylobacter jejuni Campylobacter jejuni A species of bacteria that resemble small tightly coiled spirals. Its organisms are known to cause abortion in sheep and fever and enteritis in man and may be associated with enteric diseases of calves, lambs, and other animals. Campylobacter (más común)
    • Shigella flexneri Shigella flexneri A bacterium which is one of the etiologic agents of bacillary dysentery and sometimes of infantile gastroenteritis. Shigella, S. dysenteriae S. dysenteriae A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is extremely pathogenic and causes severe dysentery. Infection with this organism often leads to ulceration of the intestinal epithelium. Shigella y S. sonnei S. sonnei A lactose-fermenting bacterium causing dysentery. Shigella
    • Salmonella Salmonella Salmonellae are gram-negative bacilli of the family Enterobacteriaceae. Salmonellae are flagellated, non-lactose-fermenting, and hydrogen sulfide-producing microbes. Salmonella enterica, the most common disease-causing species in humans, is further classified based on serotype as typhoidal (S. typhi and paratyphi) and nontyphoidal (S. enteritidis and typhimurium). Salmonella entérica
    • Yersinia Yersinia Yersinia is a genus of bacteria characterized as gram-negative bacilli that are facultative anaerobic with bipolar staining. There are 2 enteropathogenic species that cause yersiniosis, Y. enterocolitica and Y. pseudotuberculosis. Infections are manifested as pseudoappendicitis or mesenteric lymphadenitis, and enterocolitis. Yersinia spp./Yersiniosis enterocolítica y Yersinia pseudotuberculosis Yersinia pseudotuberculosis A human and animal pathogen causing mesenteric lymphadenitis, diarrhea, and bacteremia. Yersinia spp./Yersiniosis
    • Clostridioides difficile
    • Escherichia coli Escherichia coli The gram-negative bacterium Escherichia coli is a key component of the human gut microbiota. Most strains of E. coli are avirulent, but occasionally they escape the GI tract, infecting the urinary tract and other sites. Less common strains of E. coli are able to cause disease within the GI tract, most commonly presenting as abdominal pain and diarrhea. Escherichia coli
  • Pulmonares (menos común):
    • Chlamydia Chlamydia Chlamydiae are obligate intracellular gram-negative bacteria. They lack a peptidoglycan layer and are best visualized using Giemsa stain. The family of Chlamydiaceae comprises 3 pathogens that can infect humans: Chlamydia trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae. Chlamydia pneumonia Pneumonia Pneumonia or pulmonary inflammation is an acute or chronic inflammation of lung tissue. Causes include infection with bacteria, viruses, or fungi. In more rare cases, pneumonia can also be caused through toxic triggers through inhalation of toxic substances, immunological processes, or in the course of radiotherapy. Pneumonia
    • Mycobacterium tuberculosis Mycobacterium tuberculosis Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis complex bacteria. The bacteria usually attack the lungs but can also damage other parts of the body. Approximately 30% of people around the world are infected with this pathogen, with the majority harboring a latent infection. Tuberculosis spreads through the air when a person with active pulmonary infection coughs or sneezes. Tuberculosis
• Asociaciones genéticas:
  • HLA-B27 (más común)
  • HLA-B51
  • HLA-DRB1
• Se desconoce la fisiopatología exacta.

Presentación Clínica

Manifestaciones articulares

La aparición es aguda, entre 1–4 semanas después de una infección desencadenante.

Artritis periférica:

• Oligoartritis asimétrica
• Predominio de las grandes articulaciones que soportan el peso de las extremidades inferiores:
  • Rodillas
  • Tobillos
• Otras articulaciones comunes:
  • Hombros
  • Muñecas
  • Codos
  • Pequeñas articulaciones de las manos y los LOS Neisseria pies
• A la exploración física, las articulaciones se encontrarán:
  • Sensibles
  • Calientes
  • Inflamadas

Entesopatía:

• Inflamación en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lugar de inserción del ligamento, tendón, fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis o cápsula articular al AL Amyloidosis hueso.
• Causa sensibilidad e inflamación focal
• Lugares comunes de inserción:
  • Tendón de Aquiles
  • Lugar de inserción de la fascia Fascia Layers of connective tissue of variable thickness. The superficial fascia is found immediately below the skin; the deep fascia invests muscles, nerves, and other organs. Cellulitis plantar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el calcáneo.
  • Tuberosidades isquiáticas
  • Crestas ilíacas
  • Tuberosidades tibiales
  • Costillas

Tendinitis Tendinitis Ankylosing Spondylitis y periostitis Periostitis Inflammation of the periosteum. The condition is generally chronic, and is marked by tenderness and swelling of the bone and an aching pain. Acute periostitis is due to infection, is characterized by diffuse suppuration, severe pain, and constitutional symptoms, and usually results in necrosis. Reactive Arthritis:

• Inflamación del tendón o del periostio, respectivamente
• Lugares comunes:
  • Tendinitis Tendinitis Ankylosing Spondylitis de Aquiles
  • Fascitis plantar
  • Periostitis Periostitis Inflammation of the periosteum. The condition is generally chronic, and is marked by tenderness and swelling of the bone and an aching pain. Acute periostitis is due to infection, is characterized by diffuse suppuration, severe pain, and constitutional symptoms, and usually results in necrosis. Reactive Arthritis digital

Dactilitis:

• Inflamación de los LOS Neisseria dedos de las manos y de los LOS Neisseria pies (“dedos de salchicha”)

Sacroilitis:

• Inflamación de las articulaciones sacroilíacas.
• Signos y síntomas:
  • Dolor Dolor Inflammation de espalda baja
  • Disminución de la flexión lumbar

Manifestaciones extra-articulares

Oculares:

• Conjuntivitis
• Uveítis anterior
• Epiescleritis
• Queratitis

Genitourinarias:

• Uretritis
• Cervicitis Cervicitis Inflammation of the uterine cervix. Gonorrhea
• Prostatitis Prostatitis Prostatitis is inflammation or an irritative condition of the prostate that presents as different syndromes: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain, and asymptomatic. Bacterial prostatitis is easier to identify clinically and the management (antibiotics) is better established. Prostatitis
• Cistitis
• Salpingo-oforitis

Mucocutáneas:

• Queratodermia blenorrágica
  • Vesículas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las palmas de las manos, plantas de los LOS Neisseria pies y alrededor de las uñas.
  • Se vuelven hiperqueratósicas y forman costras.
  • Parece similar a la psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis pustulosa.
• Balanitis Balanitis Inflammation of the head of the penis, glans penis. Penile Anomalies and Conditions circinada
  • Úlceras superficiales e indoloras en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el glande del pene.
• Úlceras orales indoloras.
• Distrofia ungueal
• Eritema nodoso (poco común)

Gastrointestinales:

• Diarrea intermitente
  • Dolor Dolor Inflammation abdominal
  • Colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis

Cardíacas:

• Aortitis Aortitis Inflammation of the wall of the aorta. Ankylosing Spondylitis
• Insuficiencia aórtica
• Alteraciones de la conducción

Tríada clínica

Esta tríada clásica de síntomas se encuentra solo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum un 30% de los LOS Neisseria pacientes con AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation:

• Artritis post-infecciosa
• Conjuntivitis
• Uretritis

Diagnóstico

La artritis reactiva es un diagnóstico clínico basado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:

• Oligoartritis aguda y manifestaciones articulares típicas.
• Infección gastrointestinal o genitourinaria previa.
• Presencia de ≥ 1 manifestación extra-articular.
• Exclusión de otros diagnósticos.

Soporte diagnóstico

Análisis del líquido sinovial:

• Se realiza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con derrames articulares
• Pueden observarse leucocitos ↑ con predominio de neutrófilos
• Evaluaciones para descartar otras etiologías:
  • Análisis de cristales
  • Tinción de Gram y cultivo → descartar artritis gonocócica.

Resultados de laboratorio:

• Velocidad de sedimentación globular (VSG) y proteína C reactiva ( PCR PCR Polymerase chain reaction (PCR) is a technique that amplifies DNA fragments exponentially for analysis. The process is highly specific, allowing for the targeting of specific genomic sequences, even with minuscule sample amounts. The PCR cycles multiple times through 3 phases: denaturation of the template DNA, annealing of a specific primer to the individual DNA strands, and synthesis/elongation of new DNA molecules. Polymerase Chain Reaction (PCR)) ↑ o normales
• Leucocitosis leve en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el hemograma
• Coprocultivos → evaluar los LOS Neisseria organismos causantes si el paciente tiene diarrea.
• Hisopado de orina o genital → evaluar para C. trachomatis
• Cultivo de orina → Ureaplasma o Chlamydia Chlamydia Chlamydiae are obligate intracellular gram-negative bacteria. They lack a peptidoglycan layer and are best visualized using Giemsa stain. The family of Chlamydiaceae comprises 3 pathogens that can infect humans: Chlamydia trachomatis, Chlamydia psittaci, and Chlamydia pneumoniae. Chlamydia
• Prueba de HLA-B27
• Prueba para VIH y prueba cutánea de la tuberculina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum individuos de alto riesgo (alta asociación con AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation)
• Factor reumatoide (FR) y péptido citrulinado anticíclico → descartar artritis reumatoide

Radiografías de las articulaciones afectadas:

• Puede utilizarse para evaluar fracturas
• Evaluar la evidencia de espondilitis anquilosante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con sacroilitis
• Los LOS Neisseria hallazgos son generalmente inespecíficos.

Tratamiento

Tratamiento de la artritis

Los LOS Neisseria síntomas de la AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation suelen resolverse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 3‒4 meses, pero los LOS Neisseria síntomas prolongados o recurrentes pueden darse hasta en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el 50% de los LOS Neisseria pacientes.

AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation aguda (duración < 6 meses):

• Fisioterapia
• Los LOS Neisseria antiinflamatorios no esteroideos (AINE) son el pilar del tratamiento.
  • Naproxeno
  • Diclofenaco
  • Indometacina
• Glucocorticoides intraarticulares o sistémicos
  • Reservados para aquellos con una respuesta inadecuada a los LOS Neisseria AINE
• Medicamentos antirreumáticos modificadores de la enfermedad ( DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs), por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés).
  • Indicado si el paciente no responde a los LOS Neisseria tratamientos anteriores

AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation crónica (duración > 6 meses):

• DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Sulfasalazina
  • Metotrexato
• Inhibidores del factor de necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage tumoral ( TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF), por sus siglas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum inglés)
  • Considerado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes que no responden a los LOS Neisseria DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs)
  • Información limitada

Tratamiento de las manifestaciones extra-articulares

Oculares:

• Referir a una evaluación oftalmológica
• Uveítis anterior: corticosteroides y colirios midriáticos
• Conjuntivitis: tratamiento sintomático

Mucocutáneas:

• Tratamiento sintomático de las lesiones leves
• Esteroides tópicos
• Salicilatos tópicos
• Queratodermía blenorrágica grave: DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs) o inhibidores del TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF)
• Balanitis Balanitis Inflammation of the head of the penis, glans penis. Penile Anomalies and Conditions circinada: higiene genital y esteroides tópicos

Tratamiento de las infecciones subyacentes

• Infección gastrointestinal
  • Los LOS Neisseria antibióticos no suelen estar indicados.
  • Excepciones:
    • Enfermedad grave
    • Ancianos
    • Pacientes inmunocomprometidos
• Infección genitourinaria
  • Tratamiento de C. trachomatis
    • Doxiciclina
    • Azitromicina (terapia alternativa)
  • N. gonorrhoeae: ceftriaxona

Diagnóstico Diferencial

• Artritis gonocócica: es una infección debida a N. gonorrhoeae. La enfermedad diseminada puede presentarse de forma similar a la AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation con una artritis aguda, inflamatoria y asimétrica con uretritis. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria antecedentes, el análisis del líquido sinovial y los LOS Neisseria resultados del cultivo. El tratamiento incluye antibióticos.
• Enfermedad de Behcet: es una vasculitis Vasculitis Inflammation of any one of the blood vessels, including the arteries; veins; and rest of the vasculature system in the body. Systemic Lupus Erythematosus inflamatoria de pequeños y grandes vasos. Los LOS Neisseria síntomas pueden incluir artritis y úlceras orales y genitales dolorosas, a diferencia de las lesiones indoloras de la AR AR Aortic regurgitation (AR) is a cardiac condition characterized by the backflow of blood from the aorta to the left ventricle during diastole. Aortic regurgitation is associated with an abnormal aortic valve and/or aortic root stemming from multiple causes, commonly rheumatic heart disease as well as congenital and degenerative valvular disorders. Aortic Regurgitation. También se observan manifestaciones oculares, neurológicas, gastrointestinales y vasculares. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum criterios clínicos. El tratamiento depende de las manifestaciones clínicas e incluye corticosteroides, DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs) e inhibidores del TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF).
• Artritis reumatoide: enfermedad autoinmune que provoca la inflamación y destrucción de las articulaciones. Esta artritis suele ser simétrica, y los LOS Neisseria pacientes suelen presentar una inflamación sensible en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las articulaciones de las manos y los LOS Neisseria pies (aunque puede verse afectada cualquier articulación periférica). El esqueleto axial Axial Computed Tomography (CT) se incluye con menos frecuencia. El diagnóstico se realiza con estudios de laboratorio positivos de FR y péptido citrulinado anticíclico. El tratamiento incluye AINE, DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs), corticosteroides, medicamentos inmunosupresores, productos biológicos e inhibidores del TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF).
• Artritis psoriásica: es una espondiloartropatía que se produce en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis. Esta artritis inflamatoria es frecuentemente asimétrica. Están implicadas las articulaciones pequeñas y grandes, incluidas las articulaciones interfalángicas distales y la columna sacroilíaca. También se observa entesopatía y dactilitis. El diagnóstico es clínico, y la enfermedad debe sospecharse en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con psoriasis Psoriasis Psoriasis is a common T-cell-mediated inflammatory skin condition. The etiology is unknown, but is thought to be due to genetic inheritance and environmental triggers. There are 4 major subtypes, with the most common form being chronic plaque psoriasis. Psoriasis. El tratamiento incluye DMARD DMARD Disease-modifying antirheumatic drugs are antiinflammatory medications used to manage rheumatoid arthritis. The medications slow, but do not cure, the progression of the disease. The medications are classified as either synthetic or biologic agents and each has unique mechanisms of action and side effects. Disease-Modifying Antirheumatic Drugs (DMARDs) y agentes biológicos.
• Espondilitis anquilosante: es una espondiloartropatía que implica la inflamación del esqueleto axial Axial Computed Tomography (CT), lo que provoca dolor Dolor Inflammation de espalda, cifosis y pérdida de lordosis lumbar. Algunos pacientes también pueden presentar afectación articular periférica, uveítis anterior, insuficiencia aórtica, aortitis Aortitis Inflammation of the wall of the aorta. Ankylosing Spondylitis, anomalías de la conducción cardíaca y lesiones pulmonares cavitarias. El diagnóstico se basa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria hallazgos radiográficos lumbosacros (sacroilitis y “columna de bambú”) y en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la presencia de HLA-B27. El tratamiento incluye AINE, inhibidores del TNF TNF Tumor necrosis factor (TNF) is a major cytokine, released primarily by macrophages in response to stimuli. The presence of microbial products and dead cells and injury are among the stimulating factors. This protein belongs to the TNF superfamily, a group of ligands and receptors performing functions in inflammatory response, morphogenesis, and cell proliferation. Tumor Necrosis Factor (TNF) o antagonistas de la interleucina 17.
• Enfermedad inflamatoria intestinal: incluye la enfermedad de Crohn y la colitis Colitis Inflammation of the colon section of the large intestine, usually with symptoms such as diarrhea (often with blood and mucus), abdominal pain, and fever. Pseudomembranous Colitis ulcerosa, y se caracteriza por una inflamación crónica del tracto gastrointestinal debida a una respuesta inmunitaria mediada por células en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la mucosa gastrointestinal. Los LOS Neisseria síntomas incluyen diarrea, dolor Dolor Inflammation abdominal y pérdida de peso. Las manifestaciones extraintestinales pueden incluir una artritis periférica migratoria de grandes articulaciones. La enfermedad inflamatoria intestinal también se asocia a otros trastornos, como la espondilitis anquilosante, la sacroilitis y la uveítis. El diagnóstico incluye imagenología, endoscopia y biopsia. El tratamiento incluye esteroides, aminosalicilatos, inmunomoduladores y agentes biológicos