Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad

ilustraciones, diagramas, tablas

Autores:: Delgado Marrugo, Raul David

Tipo de recurso:: Doctoral thesis

Fecha de publicación:: 2024

Institución:: Universidad Nacional de Colombia

Repositorio:: Universidad Nacional de Colombia

Idioma:: spa

id	UNACIONAL2_55fe87744581b1945f97aca61fad0b8e
oai_identifier_str	oai:repositorio.unal.edu.co:unal/86796
network_acronym_str	UNACIONAL2
network_name_str	Universidad Nacional de Colombia
repository_id_str
dc.title.spa.fl_str_mv	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
dc.title.translated.eng.fl_str_mv	Prevalence and co-prevalence of immunogenetic factors in patients with idiopathic inflammatory idiopathic myopathies in a third level of complexity
title	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
spellingShingle	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad 610 - Medicina y salud::616 - Enfermedades 610 - Medicina y salud::615 - Farmacología y terapéutica Miotoxicidad Miositis Autoanticuerpos Anticuerpos Fosfo-Específicos Myotoxicity Myositis Autoantibodies Antibodies, Phospho-Specific Dermatomiositis Polimiositis Autoanticuerpos HLA Dermatomyositis Polymyositis Autoantibodies
title_short	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
title_full	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
title_fullStr	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
title_full_unstemmed	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
title_sort	Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad
dc.creator.fl_str_mv	Delgado Marrugo, Raul David
dc.contributor.advisor.spa.fl_str_mv	Rondón Herrera, Federico Patricia Rojas, Angela
dc.contributor.author.spa.fl_str_mv	Delgado Marrugo, Raul David
dc.contributor.researchgroup.spa.fl_str_mv	Biología Celular y Autoinmunidad
dc.subject.ddc.spa.fl_str_mv	610 - Medicina y salud::616 - Enfermedades 610 - Medicina y salud::615 - Farmacología y terapéutica
topic	610 - Medicina y salud::616 - Enfermedades 610 - Medicina y salud::615 - Farmacología y terapéutica Miotoxicidad Miositis Autoanticuerpos Anticuerpos Fosfo-Específicos Myotoxicity Myositis Autoantibodies Antibodies, Phospho-Specific Dermatomiositis Polimiositis Autoanticuerpos HLA Dermatomyositis Polymyositis Autoantibodies
dc.subject.decs.spa.fl_str_mv	Miotoxicidad Miositis Autoanticuerpos Anticuerpos Fosfo-Específicos
dc.subject.decs.eng.fl_str_mv	Myotoxicity Myositis Autoantibodies Antibodies, Phospho-Specific
dc.subject.proposal.spa.fl_str_mv	Dermatomiositis Polimiositis Autoanticuerpos
dc.subject.proposal.eng.fl_str_mv	HLA Dermatomyositis Polymyositis Autoantibodies
description	ilustraciones, diagramas, tablas
publishDate	2024
dc.date.accessioned.none.fl_str_mv	2024-09-05T18:33:09Z
dc.date.available.none.fl_str_mv	2024-09-05T18:33:09Z
dc.date.issued.none.fl_str_mv	2024
dc.type.spa.fl_str_mv	Trabajo de grado - Especialidad Médica
dc.type.driver.spa.fl_str_mv	info:eu-repo/semantics/doctoralThesis
dc.type.version.spa.fl_str_mv	info:eu-repo/semantics/acceptedVersion
dc.type.coar.spa.fl_str_mv	http://purl.org/coar/resource_type/c_db06
dc.type.content.spa.fl_str_mv	Text
dc.type.redcol.spa.fl_str_mv	http://purl.org/redcol/resource_type/TD
format	http://purl.org/coar/resource_type/c_db06
status_str	acceptedVersion
dc.identifier.uri.none.fl_str_mv	https://repositorio.unal.edu.co/handle/unal/86796
dc.identifier.instname.spa.fl_str_mv	Universidad Nacional de Colombia
dc.identifier.reponame.spa.fl_str_mv	Repositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourl.spa.fl_str_mv	https://repositorio.unal.edu.co/
url	https://repositorio.unal.edu.co/handle/unal/86796 https://repositorio.unal.edu.co/
identifier_str_mv	Universidad Nacional de Colombia Repositorio Institucional Universidad Nacional de Colombia
dc.language.iso.spa.fl_str_mv	spa
language	spa
dc.relation.references.spa.fl_str_mv	Damoiseaux J, Vulsteke JB, Tseng CW, Platteel ACM, Piette Y, Shovman O, et al. Autoantibodies in idiopathic inflammatory myopathies: Clinical associations and laboratory evaluation by mono- and multispecific immunoassays. Autoimmun Rev. 2019 Mar 1;18(3):293–305. Oldroyd A, Lilleker J, Chinoy H. Idiopathic inflammatory myopathies-a guide to subtypes, diagnostic approach and treatment. Clinical Medicine. 2017;17(4):322– 30. Smoyer-Tomic KE, Amato AA, Fernandes AW. Incidence and prevalence of idiopathic inflammatory myopathies among commercially insured, Medicare supplemental insured, and Medicaid enrolled populations: An administrative claims analysis. BMC Musculoskelet Disord. 2012;13. McHugh NJ, Tansley SL. Autoantibodies in myositis. Nat Rev Rheumatol. 2018 May 1;14(5):290–302. Pina Cruellas MG, Trindade Viana V dos S, Levy-Neto M, Carlos de Souza FH, Shinjo SK. Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis. Clinics. 2013 Jul;68(7):909–14. O’Hanlon TP, Carrick DM, Arnett FC, Reveille JD, Carrington M, Gao X, et al. Immunogenetic risk and protective factors for the idiopathic inflammatory myopathies: Distinct HLA-A, -B, -Cw, -DRB1 and -DQA1 allelic profiles and motifs define clinicopathologic groups in Caucasians. Medicine. 2005 Nov;84(6):338–49. Miller FW, Chen W, O’Hanlon TP, Cooper RG, Vencovsky J, Rider LG, et al. Genome-wide association study identifies HLA 8.1 ancestral haplotype alleles as major genetic risk factors for myositis phenotypes. Genes Immun. 2015 Oct 1;16(7):470–80. Patricia K, Castro V. Descripción de los anticuerpos, y manifestaciones clínicas de pacientes con polimiositis y dermatomiositis. 2014. Rothwell S, Cooper RG, Lundberg IE, Miller FW, Gregersen PK, Bowes J, et al. Dense genotyping of immune-related loci in idiopathic inflammatory myopathies confirms HLA alleles as the strongest genetic risk factor and suggests different genetic background for major clinical subgroups. Ann Rheum Dis. 2016 Aug 1;75(8):1558–66. Tieu J, Lundberg IE, Limaye V. Idiopathic inflammatory myositis. Best Pract Res Clin Rheumatol [Internet]. 2016;30(1):149–68. Available from: https://www.sciencedirect.com/science/article/pii/S1521694216300225 Mammen AL. Autoimmune Myopathies. Continuum (N Y) [Internet]. 2016;22(6):1852–70. Available from: www.ContinuumJournal.com McGrath ER, Doughty CT, Amato AA. Autoimmune Myopathies: Updates on Evaluation and Treatment. Neurotherapeutics [Internet]. 2018 Oct 14;15(4):976–94. Available from: https://doi.org/10.1007/s13311-018-00676-2 Dalakas MC. Pathophysiology of inflammatory and autoimmune myopathies.Presse Med [Internet]. 2011;40(4, Part 2):e237–47. Available from: https://www.sciencedirect.com/science/article/pii/S0755498211000534 Hilton-Jones D. Inflammatory muscle diseases. Curr Opin Neurol [Internet]. 2001;14(5). Available from: https://journals.lww.com/coneurology/fulltext/2001/10000/inflammatory_muscle_diseases.7.aspx Dimachkie MM, Barohn RJ, Amato AA. Idiopathic inflammatory myopathies. Vol.32, Neurologic Clinics. W.B. Saunders; 2014. p. 595–628. Hill CL, Zhang Y, Sigurgeirsson B, Pukkala E, Mellemkjaer L, Airio A, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. The Lancet [Internet]. 2001 Jan 13;357(9250):96–100. Available from: https://doi.org/10.1016/S0140-6736(00)03540-6 Clark KEN, Isenberg DA. A review of inflammatory idiopathic myopathy focusing on polymyositis. Eur J Neurol [Internet]. 2018 Jan 1;25(1):13–23. Available from: https://doi.org/10.1111/ene.13357 Stenzel W, Goebel HH, Aronica E. Review: Immune-mediated necrotizing myopathies – a heterogeneous group of diseases with specific myopathological features. Neuropathol Appl Neurobiol [Internet]. 2012 Dec 1;38(7):632–46. Available from: https://doi.org/10.1111/j.1365-2990.2012.01302.x Grable-Esposito P, Katzberg HD, Greenberg SA, Srinivasan J, Katz J, Amato AA. Immune-mediated necrotizing myopathy associated with statins. Muscle Nerve [Internet]. 2010 Feb 1;41(2):185–90. Available from: https://doi.org/10.1002/mus.21486 Noguchi E, Uruha A, Suzuki S, Hamanaka K, Ohnuki Y, Tsugawa J, et al. Skeletal Muscle Involvement in Antisynthetase Syndrome. JAMA Neurol [Internet]. 2017 Aug 1;74(8):992–9. Available from: https://doi.org/10.1001/jamaneurol.2017.0934 Dalakas MC. Inflammatory muscle diseases: a critical review on pathogenesis and therapies. Curr Opin Pharmacol [Internet]. 2010;10(3):346–52. Available from: https://www.sciencedirect.com/science/article/pii/S1471489210000275 Schmidt J, Dalakas MC. Pathomechanisms of inflammatory myopathies: recent advances and implications for diagnosis and therapies. Expert Opin Med Diagn [Internet]. 2010 May 1;4(3):241–50. Available from: https://doi.org/10.1517/17530051003713499 Frikha F, Saidi N, Snoussi M, Ben Salah R, Ben Ayed M, Daoud E, et al. Le syndrome des antisynthétases : à propos de quatre observations et revue de la littérature. Rev Pneumol Clin [Internet]. 2012;68(6):351–60. Available from: https://www.sciencedirect.com/science/article/pii/S0761841712000971 Benveniste O, Stenzel W, Allenbach Y. Advances in serological diagnostics of inflammatory myopathies. Curr Opin Neurol [Internet]. 2016;29(5). Available from: https://journals.lww.com/coneurology/fulltext/2016/10000/advances_in_serological_diagnostics_of.18.aspx Bevilacqua JA, Earle N. Inflammatory myopathies. Vol. 29, Revista Medica Clinica Las Condes. Ediciones Doyma, S.L.; 2018. p. 611–21. Lundberg IE, Tjärnlund A, Bottai M, Werth VP, Pilkington C, Visser M de, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis. 2017 Dec 1;76(12):1955–64. Nakashima R. Clinical significance of myositis-specific autoantibodies. Immunol Med [Internet]. 2018 Jul 3;41(3):103–12. Available from: https://doi.org/10.1080/25785826.2018.1531188 Zampeli E, Venetsanopoulou A, Argyropoulou OD, Mavragani CP, Tektonidou MG, Vlachoyiannopoulos PG, et al. Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies. Clin Rheumatol [Internet]. 2019;38(1):125–32. Available from: https://doi.org/10.1007/s10067-018-4267-z Temmoku J, Sato S, Fujita Y, Asano T, Suzuki E, Kanno T, et al. Clinical significance of myositis-specific autoantibody profiles in Japanese patients with polymyositis/dermatomyositis. Medicine (United States). 2019 May 1;98(20). Platteel ACM, Wevers BA, Lim J, Bakker JA, Bontkes HJ, Curvers J, et al. Frequencies and clinical associations of myositis-related antibodies in The Netherlands: A one-year survey of all Dutch patients. J Transl Autoimmun [Internet]. 2019;2:100013. Available from: https://www.sciencedirect.com/science/article/pii/S2589909019300139 Selva-O’Callaghan A, Pinal-Fernandez I, Trallero-Araguás E, Milisenda JC, GrauJunyent JM, Mammen AL. Classification and management of adult inflammatory myopathies. Lancet Neurol [Internet]. 2018 Sep 1;17(9):816–28. Available from: https://doi.org/10.1016/S1474-4422(18)30254-0 Joyce NC, Oskarsson B, Jin LW. Muscle Biopsy Evaluation in Neuromuscular Disorders. Phys Med Rehabil Clin N Am [Internet]. 2012;23(3):609–31. Available from: https://www.sciencedirect.com/science/article/pii/S1047965112000459 Staron RS, Hagerman FC, Hikida RS, Murray TF, Hostler DP, Crill MT, et al. Fiber Type Composition of the Vastus Lateralis Muscle of Young Men and Women. Journal of Histochemistry & Cytochemistry [Internet]. 2000 May 1;48(5):623–9. Available from: https://doi.org/10.1177/002215540004800506 Witt LJ, Curran JJ, Strek ME. The diagnosis and treatment of antisynthetase syndrome. Clin Pulm Med. 2016;23(5):218–26. Barsotti S, Lundberg IE. Current Treatment for Myositis. Curr Treatm Opt Rheumatol. 2018 Dec;4(4):299–315. Sasaki H, Kohsaka H. Current diagnosis and treatment of polymyositis and dermatomyositis. Mod Rheumatol [Internet]. 2018 Nov 2;28(6):913–21. Available from: https://doi.org/10.1080/14397595.2018.1467257 Rothwell S, Cooper RG, Lamb JA, Chinoy H. Europe PMC Funders Group Strategies for Evaluating Idiopathic Inflammatory Myopathy Disease Susceptibility Genes. 2015;16(10). Salazar-Villa G, Rodríguez-Prada C, Bonfante-Tamara M, Restrepo-Correa R, Rodríguez-Padilla LM, Mesa-Navas MA, et al. Clinical characterisation of patients with inflammatory myopathy in 2 tertiary care hospitals in Colombia: A descriptive survey. Revista Colombiana de Reumatologia. 2022 Jan 1;29(1):9–18. Santos VA, Aragón CC, Posso-Osorio I, Obando MA, Barrera T, Zamorano L, et al. Caracterización epidemiológica de pacientes con miopatía inflamatoria en un hospital de cuarto nivel en Cali, Colombia. Revista Colombiana de Reumatología [Internet]. 2022;29(1):83–8. Available from: https://www.elsevier.es/es-revistarevista-colombiana-reumatologia-374-articulo-caracterizacion-epidemiologicapacientes-con-miopatia-S0121812320301638 Bernal-Macías S, Fernández-Ávila DG, Rincón-Riaño DN, Gutiérrez JM, Rosselli D. Prevalence of inflammatory myopathies in Colombia: Demographic analysis from the National Health Registry 2012–2018. Revista Colombiana de Reumatología [Internet]. 2023;30(2):81–6. Available from: https://www.sciencedirect.com/science/article/pii/S0121812321001262 Valenzuela A, Torres M, Devés JD. Performance of the 2017 EULAR/ACR criteria for idiopathic inflammatory myopathies in a cohort of patients from Latin America. Medicine (United States). 2022 Oct 28;101(43):E31015. Zamudio GL, Barbosa Cobos RE, Solorzano Ruiz A, Morales EL, Delgado Ochoa D. HLA class I and II alleles may influence susceptibility to adult dermatomyositis in a Mexican mestizo population. Int J Clin Rheumtol. 2018;13(2). Arechiga T, Villareal M, Villafranca J, Perez I, Lozoya A, Delgado D. Seventeen myositis autoantibodies: serological profile of hispanic patients with idiopathic inflammatory myopathies. In BMJ; 2018. p. 1536.3-1537. Nuño L, Nuño N, Joven B, Carreira P, Maldonado V, Larena C, et al. Multicenter Registry on Inflammatory Myositis From the Rheumatology Society in Madrid, Spain: Descriptive Analysis. Vol. 13, Reumatol Clin. 2017. Leclair V, Galindo-Feria AS, Rothwell S, Kryštůfková O, Zargar SS, Mann H, et al. Distinct HLA associations with autoantibody-defined subgroups in idiopathic inflammatory myopathies. EBioMedicine. 2023 Oct 1;96. Satoh M, Tanaka S, Ceribelli A, Calise SJ, Chan EKL. A Comprehensive Overview on Myositis-Specific Antibodies: New and Old Biomarkers in Idiopathic Inflammatory Myopathy. Vol. 52, Clinical Reviews in Allergy and Immunology. Humana Press Inc.; 2017.
dc.rights.coar.fl_str_mv	http://purl.org/coar/access_right/c_abf2
dc.rights.license.spa.fl_str_mv	Reconocimiento 4.0 Internacional
dc.rights.uri.spa.fl_str_mv	http://creativecommons.org/licenses/by/4.0/
dc.rights.accessrights.spa.fl_str_mv	info:eu-repo/semantics/openAccess
rights_invalid_str_mv	Reconocimiento 4.0 Internacional http://creativecommons.org/licenses/by/4.0/ http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv	openAccess
dc.format.extent.spa.fl_str_mv	73 páginas
dc.format.mimetype.spa.fl_str_mv	application/pdf
dc.coverage.temporal.none.fl_str_mv	2016-2022
dc.coverage.city.spa.fl_str_mv	Bogotá
dc.coverage.country.spa.fl_str_mv	Colombia
dc.publisher.spa.fl_str_mv	Universidad Nacional de Colombia
dc.publisher.program.spa.fl_str_mv	Bogotá - Medicina - Especialidad en Medicina Interna
dc.publisher.faculty.spa.fl_str_mv	Facultad de Medicina
dc.publisher.place.spa.fl_str_mv	Bogotá, Colombia
dc.publisher.branch.spa.fl_str_mv	Universidad Nacional de Colombia - Sede Bogotá
institution	Universidad Nacional de Colombia
bitstream.url.fl_str_mv	https://repositorio.unal.edu.co/bitstream/unal/86796/2/10324833552024.pdf https://repositorio.unal.edu.co/bitstream/unal/86796/3/license.txt https://repositorio.unal.edu.co/bitstream/unal/86796/4/10324833552024.pdf.jpg
bitstream.checksum.fl_str_mv	68adf6d70cec20a892f12af36018e591 eb34b1cf90b7e1103fc9dfd26be24b4a a1efa22b0bd09896cbce0c28f5102dcc
bitstream.checksumAlgorithm.fl_str_mv	MD5 MD5 MD5
repository.name.fl_str_mv	Repositorio Institucional Universidad Nacional de Colombia
repository.mail.fl_str_mv	repositorio_nal@unal.edu.co
_version_	1814090003827916800
spelling	Reconocimiento 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Rondón Herrera, Federico9014453c01ed18f6d6c8ce7f0b2dba06Patricia Rojas, Angela1325c8d846e595b7d9a563d9e0545c33Delgado Marrugo, Raul David675a82bd398b9ea5fc090c04ca1c93f6Biología Celular y Autoinmunidad2016-2022BogotáColombia2024-09-05T18:33:09Z2024-09-05T18:33:09Z2024https://repositorio.unal.edu.co/handle/unal/86796Universidad Nacional de ColombiaRepositorio Institucional Universidad Nacional de Colombiahttps://repositorio.unal.edu.co/ilustraciones, diagramas, tablasIntroducción: En pacientes con miopatías inflamatorias idiopáticas (MII) se han correlacionado autoanticuerpos y alelos HLA con fenotipos clínicos en diferentes regiones del mundo. Objetivo: Evaluamos las características inmunogénicas en una población de la ciudad de Bogotá, Colombia. Métodos: Estudio transversal de 68 pacientes con MII. Panel de 15 autoanticuerpos específicos y asociados a miositis. Se realizó determinación de alelos HLA-DQA1, DQB1, DR mediante técnica de reacción en cadena de la polimerasa en tiempo real. Resultados: La población del estudio tenía una edad media de 52,2 años, y el 73% de los participantes eran mujeres. En el grupo, los tipos de MII más frecuentemente observados fueron Dermatomiositis (DM) (58%), Polimiositis (PM) (25%), Síndrome Antisintetasa (ASyS) (5,8%), Miositis Necrotizante Inmunomediada (MNIM) (5,8%) y Miositis por Cuerpos de Inclusión (MCI) (4%). Se realizó un panel de autoanticuerpos en 23 pacientes. Los resultados mostraron que Mi-2 (52%) era el anticuerpo más prevalente relacionado con DM (83%), características clínicas Gottron (75%) y Heliotropo (58%) con HLA-DQB103 (50%); ASyS Jo-1 (7; 30%) relacionados con PM (85%), neumonía intersticial inespecífica (NINE) (14%) y HLA-DQB103 (28%); anticuerpos asociados a Ku (13%) relacionados con DM (66%), Gottron y Heliotropo (66%), NINE (33%) y HLA-DQB103 (33%) Conclusiones: Este es el primer estudio realizado en Colombia que determina alelos HLA y autoanticuerpos de miositis en pacientes con MII, se encontraron diferentes co-prevalencias entre las manifestaciones clínicas y el perfil inmunogénico, lo que permite conocer las características de la población en nuestra comunidad e incentiva la investigación para estudios con una población mayor (Texto tomado de la fuente).Introduction: In patients with idiopathic inflammatory myopathies (IIM) autoantibodies and HLA alleles have been correlated with clinical phenotypes in different regions worldwide. Aim: We evaluated immunogenic characteristics in a population from the city of Bogota, Colombia. Methods: A cross-sectional study of 68 patients with IIM. Panel of 15 specific and myositisassociated autoantibodies, determination of HLA-DQA1, DQB1, DR alleles was performed by real-time polymerase chain reaction technique. Results: The study population had a mean age of 52.2 years, with 73% of the participants being female. Among the group, the most frequently observed types of IIM were Dermatomyositis (DM) (58%), Polymyositis (PM) (25%), Antisynthetase Syndrome (ASyS) (5.8%), Immune-Mediated Necrotizing Myositis (IMNM) (5.8%), and Inclusion Body Myositis (IBM) (4%). Table 1 shows other clinical features. An autoantibody panel was performed on 23 patients. Results showed that Mi-2 (52%) was the most prevalent antibody, relating to DM (83%), clinical features Gottron′s (75%) and Heliotrope (58%) with HLA-DQB103 (50%); ASyS Jo-1 (7; 30%) related to PM (85%), Nonspecific interstitial pneumonia (NSIP) (14%) and HLA-DQB103 (28%); Ku-associated antibodies (13%) related to DM (66%), Gottron and Heliotrope (66%), NSIP (33%) and HLA-DQB103 (33%). Conclusions: This is the first study conducted in Colombia determining HLA alleles and myositis autoantibodies in patients with MI, different co-prevalences were found between clinical manifestations and immunogenic profile, which allows us to know the characteristics of the population in our community and encourages research for studies with a larger population.Especialidades MédicasEspecialista en Medicina InternaEstudio observacional corte transversal descriptivo. Pacientes >18 años con diagnóstico de miopatía inflamatoria probable o definitiva dado por los criterios EULAR/ACR 2017 en pacientes hospitalizados o que asistieron a consulta externa de reumatología en el Hospital Universitario Nacional, durante el periodo entre enero de 2016 a julio de 2022. Pacientes con miopatías inflamatorias probables o definitivas secundarias a procesos neoplásicos.73 páginasapplication/pdfspaUniversidad Nacional de ColombiaBogotá - Medicina - Especialidad en Medicina InternaFacultad de MedicinaBogotá, ColombiaUniversidad Nacional de Colombia - Sede Bogotá610 - Medicina y salud::616 - Enfermedades610 - Medicina y salud::615 - Farmacología y terapéuticaMiotoxicidadMiositisAutoanticuerposAnticuerpos Fosfo-EspecíficosMyotoxicityMyositisAutoantibodiesAntibodies, Phospho-SpecificDermatomiositisPolimiositisAutoanticuerposHLADermatomyositisPolymyositisAutoantibodiesPrevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidadPrevalence and co-prevalence of immunogenetic factors in patients with idiopathic inflammatory idiopathic myopathies in a third level of complexityTrabajo de grado - Especialidad Médicainfo:eu-repo/semantics/doctoralThesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_db06Texthttp://purl.org/redcol/resource_type/TDDamoiseaux J, Vulsteke JB, Tseng CW, Platteel ACM, Piette Y, Shovman O, et al. Autoantibodies in idiopathic inflammatory myopathies: Clinical associations and laboratory evaluation by mono- and multispecific immunoassays. Autoimmun Rev. 2019 Mar 1;18(3):293–305.Oldroyd A, Lilleker J, Chinoy H. Idiopathic inflammatory myopathies-a guide to subtypes, diagnostic approach and treatment. Clinical Medicine. 2017;17(4):322– 30.Smoyer-Tomic KE, Amato AA, Fernandes AW. Incidence and prevalence of idiopathic inflammatory myopathies among commercially insured, Medicare supplemental insured, and Medicaid enrolled populations: An administrative claims analysis. BMC Musculoskelet Disord. 2012;13.McHugh NJ, Tansley SL. Autoantibodies in myositis. Nat Rev Rheumatol. 2018 May 1;14(5):290–302.Pina Cruellas MG, Trindade Viana V dos S, Levy-Neto M, Carlos de Souza FH, Shinjo SK. Myositis-specific and myositis-associated autoantibody profiles and their clinical associations in a large series of patients with polymyositis and dermatomyositis. Clinics. 2013 Jul;68(7):909–14.O’Hanlon TP, Carrick DM, Arnett FC, Reveille JD, Carrington M, Gao X, et al. Immunogenetic risk and protective factors for the idiopathic inflammatory myopathies: Distinct HLA-A, -B, -Cw, -DRB1 and -DQA1 allelic profiles and motifs define clinicopathologic groups in Caucasians. Medicine. 2005 Nov;84(6):338–49.Miller FW, Chen W, O’Hanlon TP, Cooper RG, Vencovsky J, Rider LG, et al. Genome-wide association study identifies HLA 8.1 ancestral haplotype alleles as major genetic risk factors for myositis phenotypes. Genes Immun. 2015 Oct 1;16(7):470–80.Patricia K, Castro V. Descripción de los anticuerpos, y manifestaciones clínicas de pacientes con polimiositis y dermatomiositis. 2014.Rothwell S, Cooper RG, Lundberg IE, Miller FW, Gregersen PK, Bowes J, et al. Dense genotyping of immune-related loci in idiopathic inflammatory myopathies confirms HLA alleles as the strongest genetic risk factor and suggests different genetic background for major clinical subgroups. Ann Rheum Dis. 2016 Aug 1;75(8):1558–66.Tieu J, Lundberg IE, Limaye V. Idiopathic inflammatory myositis. Best Pract Res Clin Rheumatol [Internet]. 2016;30(1):149–68. Available from: https://www.sciencedirect.com/science/article/pii/S1521694216300225Mammen AL. Autoimmune Myopathies. Continuum (N Y) [Internet]. 2016;22(6):1852–70. Available from: www.ContinuumJournal.comMcGrath ER, Doughty CT, Amato AA. Autoimmune Myopathies: Updates on Evaluation and Treatment. Neurotherapeutics [Internet]. 2018 Oct 14;15(4):976–94. Available from: https://doi.org/10.1007/s13311-018-00676-2Dalakas MC. Pathophysiology of inflammatory and autoimmune myopathies.Presse Med [Internet]. 2011;40(4, Part 2):e237–47. Available from: https://www.sciencedirect.com/science/article/pii/S0755498211000534Hilton-Jones D. Inflammatory muscle diseases. Curr Opin Neurol [Internet]. 2001;14(5). Available from: https://journals.lww.com/coneurology/fulltext/2001/10000/inflammatory_muscle_diseases.7.aspxDimachkie MM, Barohn RJ, Amato AA. Idiopathic inflammatory myopathies. Vol.32, Neurologic Clinics. W.B. Saunders; 2014. p. 595–628.Hill CL, Zhang Y, Sigurgeirsson B, Pukkala E, Mellemkjaer L, Airio A, et al. Frequency of specific cancer types in dermatomyositis and polymyositis: a population-based study. The Lancet [Internet]. 2001 Jan 13;357(9250):96–100. Available from: https://doi.org/10.1016/S0140-6736(00)03540-6Clark KEN, Isenberg DA. A review of inflammatory idiopathic myopathy focusing on polymyositis. Eur J Neurol [Internet]. 2018 Jan 1;25(1):13–23. Available from: https://doi.org/10.1111/ene.13357Stenzel W, Goebel HH, Aronica E. Review: Immune-mediated necrotizing myopathies – a heterogeneous group of diseases with specific myopathological features. Neuropathol Appl Neurobiol [Internet]. 2012 Dec 1;38(7):632–46. Available from: https://doi.org/10.1111/j.1365-2990.2012.01302.xGrable-Esposito P, Katzberg HD, Greenberg SA, Srinivasan J, Katz J, Amato AA. Immune-mediated necrotizing myopathy associated with statins. Muscle Nerve [Internet]. 2010 Feb 1;41(2):185–90. Available from: https://doi.org/10.1002/mus.21486Noguchi E, Uruha A, Suzuki S, Hamanaka K, Ohnuki Y, Tsugawa J, et al. Skeletal Muscle Involvement in Antisynthetase Syndrome. JAMA Neurol [Internet]. 2017 Aug 1;74(8):992–9. Available from: https://doi.org/10.1001/jamaneurol.2017.0934Dalakas MC. Inflammatory muscle diseases: a critical review on pathogenesis and therapies. Curr Opin Pharmacol [Internet]. 2010;10(3):346–52. Available from: https://www.sciencedirect.com/science/article/pii/S1471489210000275Schmidt J, Dalakas MC. Pathomechanisms of inflammatory myopathies: recent advances and implications for diagnosis and therapies. Expert Opin Med Diagn [Internet]. 2010 May 1;4(3):241–50. Available from: https://doi.org/10.1517/17530051003713499Frikha F, Saidi N, Snoussi M, Ben Salah R, Ben Ayed M, Daoud E, et al. Le syndrome des antisynthétases : à propos de quatre observations et revue de la littérature. Rev Pneumol Clin [Internet]. 2012;68(6):351–60. Available from: https://www.sciencedirect.com/science/article/pii/S0761841712000971Benveniste O, Stenzel W, Allenbach Y. Advances in serological diagnostics of inflammatory myopathies. Curr Opin Neurol [Internet]. 2016;29(5). Available from: https://journals.lww.com/coneurology/fulltext/2016/10000/advances_in_serological_diagnostics_of.18.aspxBevilacqua JA, Earle N. Inflammatory myopathies. Vol. 29, Revista Medica Clinica Las Condes. Ediciones Doyma, S.L.; 2018. p. 611–21.Lundberg IE, Tjärnlund A, Bottai M, Werth VP, Pilkington C, Visser M de, et al. 2017 European League Against Rheumatism/American College of Rheumatology classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. Ann Rheum Dis. 2017 Dec 1;76(12):1955–64.Nakashima R. Clinical significance of myositis-specific autoantibodies. Immunol Med [Internet]. 2018 Jul 3;41(3):103–12. Available from: https://doi.org/10.1080/25785826.2018.1531188Zampeli E, Venetsanopoulou A, Argyropoulou OD, Mavragani CP, Tektonidou MG, Vlachoyiannopoulos PG, et al. Myositis autoantibody profiles and their clinical associations in Greek patients with inflammatory myopathies. Clin Rheumatol [Internet]. 2019;38(1):125–32. Available from: https://doi.org/10.1007/s10067-018-4267-zTemmoku J, Sato S, Fujita Y, Asano T, Suzuki E, Kanno T, et al. Clinical significance of myositis-specific autoantibody profiles in Japanese patients with polymyositis/dermatomyositis. Medicine (United States). 2019 May 1;98(20).Platteel ACM, Wevers BA, Lim J, Bakker JA, Bontkes HJ, Curvers J, et al. Frequencies and clinical associations of myositis-related antibodies in The Netherlands: A one-year survey of all Dutch patients. J Transl Autoimmun [Internet]. 2019;2:100013. Available from: https://www.sciencedirect.com/science/article/pii/S2589909019300139Selva-O’Callaghan A, Pinal-Fernandez I, Trallero-Araguás E, Milisenda JC, GrauJunyent JM, Mammen AL. Classification and management of adult inflammatory myopathies. Lancet Neurol [Internet]. 2018 Sep 1;17(9):816–28. Available from: https://doi.org/10.1016/S1474-4422(18)30254-0Joyce NC, Oskarsson B, Jin LW. Muscle Biopsy Evaluation in Neuromuscular Disorders. Phys Med Rehabil Clin N Am [Internet]. 2012;23(3):609–31. Available from: https://www.sciencedirect.com/science/article/pii/S1047965112000459Staron RS, Hagerman FC, Hikida RS, Murray TF, Hostler DP, Crill MT, et al. Fiber Type Composition of the Vastus Lateralis Muscle of Young Men and Women. Journal of Histochemistry & Cytochemistry [Internet]. 2000 May 1;48(5):623–9. Available from: https://doi.org/10.1177/002215540004800506Witt LJ, Curran JJ, Strek ME. The diagnosis and treatment of antisynthetase syndrome. Clin Pulm Med. 2016;23(5):218–26.Barsotti S, Lundberg IE. Current Treatment for Myositis. Curr Treatm Opt Rheumatol. 2018 Dec;4(4):299–315.Sasaki H, Kohsaka H. Current diagnosis and treatment of polymyositis and dermatomyositis. Mod Rheumatol [Internet]. 2018 Nov 2;28(6):913–21. Available from: https://doi.org/10.1080/14397595.2018.1467257Rothwell S, Cooper RG, Lamb JA, Chinoy H. Europe PMC Funders Group Strategies for Evaluating Idiopathic Inflammatory Myopathy Disease Susceptibility Genes. 2015;16(10).Salazar-Villa G, Rodríguez-Prada C, Bonfante-Tamara M, Restrepo-Correa R, Rodríguez-Padilla LM, Mesa-Navas MA, et al. Clinical characterisation of patients with inflammatory myopathy in 2 tertiary care hospitals in Colombia: A descriptive survey. Revista Colombiana de Reumatologia. 2022 Jan 1;29(1):9–18.Santos VA, Aragón CC, Posso-Osorio I, Obando MA, Barrera T, Zamorano L, et al. Caracterización epidemiológica de pacientes con miopatía inflamatoria en un hospital de cuarto nivel en Cali, Colombia. Revista Colombiana de Reumatología [Internet]. 2022;29(1):83–8. Available from: https://www.elsevier.es/es-revistarevista-colombiana-reumatologia-374-articulo-caracterizacion-epidemiologicapacientes-con-miopatia-S0121812320301638Bernal-Macías S, Fernández-Ávila DG, Rincón-Riaño DN, Gutiérrez JM, Rosselli D. Prevalence of inflammatory myopathies in Colombia: Demographic analysis from the National Health Registry 2012–2018. Revista Colombiana de Reumatología [Internet]. 2023;30(2):81–6. Available from: https://www.sciencedirect.com/science/article/pii/S0121812321001262Valenzuela A, Torres M, Devés JD. Performance of the 2017 EULAR/ACR criteria for idiopathic inflammatory myopathies in a cohort of patients from Latin America. Medicine (United States). 2022 Oct 28;101(43):E31015.Zamudio GL, Barbosa Cobos RE, Solorzano Ruiz A, Morales EL, Delgado Ochoa D. HLA class I and II alleles may influence susceptibility to adult dermatomyositis in a Mexican mestizo population. Int J Clin Rheumtol. 2018;13(2).Arechiga T, Villareal M, Villafranca J, Perez I, Lozoya A, Delgado D. Seventeen myositis autoantibodies: serological profile of hispanic patients with idiopathic inflammatory myopathies. In BMJ; 2018. p. 1536.3-1537.Nuño L, Nuño N, Joven B, Carreira P, Maldonado V, Larena C, et al. Multicenter Registry on Inflammatory Myositis From the Rheumatology Society in Madrid, Spain: Descriptive Analysis. Vol. 13, Reumatol Clin. 2017.Leclair V, Galindo-Feria AS, Rothwell S, Kryštůfková O, Zargar SS, Mann H, et al. Distinct HLA associations with autoantibody-defined subgroups in idiopathic inflammatory myopathies. EBioMedicine. 2023 Oct 1;96.Satoh M, Tanaka S, Ceribelli A, Calise SJ, Chan EKL. A Comprehensive Overview on Myositis-Specific Antibodies: New and Old Biomarkers in Idiopathic Inflammatory Myopathy. Vol. 52, Clinical Reviews in Allergy and Immunology. Humana Press Inc.; 2017.EstudiantesInvestigadoresMaestrosORIGINAL10324833552024.pdf10324833552024.pdfTesis de Especialista en Medicina Internaapplication/pdf902179https://repositorio.unal.edu.co/bitstream/unal/86796/2/10324833552024.pdf68adf6d70cec20a892f12af36018e591MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-85879https://repositorio.unal.edu.co/bitstream/unal/86796/3/license.txteb34b1cf90b7e1103fc9dfd26be24b4aMD53THUMBNAIL10324833552024.pdf.jpg10324833552024.pdf.jpgGenerated Thumbnailimage/jpeg5251https://repositorio.unal.edu.co/bitstream/unal/86796/4/10324833552024.pdf.jpga1efa22b0bd09896cbce0c28f5102dccMD54unal/86796oai:repositorio.unal.edu.co:unal/867962024-09-05 23:04:55.246Repositorio Institucional Universidad Nacional de Colombiarepositorio_nal@unal.edu.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

Prevalencia y coprevalencia de los factores inmuno genéticos en pacientes con miopatías inflamatorias idiopáticas de un centro de tercer nivel de complejidad

Publicaciones similares