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Ítem ¿Son las enfermedades autoinmunes predecibles?(Elsevier Science BV, 2012-02-01) Cañas Dávila, Carlos AlbertoAutoimmune diseases are complex diseases resulting of the interaction between both genetics and environmental factors over time. Different phases in the development of autoimmune diseases are characterized by the detection of serum autoantibodies several months or years before the onset of clinical manifestations and subsequent diagnosis. In addition to serum antibodies, genetic susceptibility factors may predict the future development of the disease. Currently, prediction in type 1 diabetes is the most accurate, with the analysis of genetic susceptibility factors in first-degree relatives of patients and several autoantibody tests. In the future, multiple antibodies test, in combination with the analysis of genetics, epigenetics and immunological anomalies in fine models may allow the precise prediction in autoimmune diseases. Prevention measures might thus be introduced as an attempt to avoid or delay the disease.Ítem Autoinmunidad y autoinflamación(Asociación Colombiana de Medicina Interna, 2011-04-01) Cañas Dávila, Carlos AlbertoObjetivo: exponer los aspectos que tienen en común o aquellos que diferencien las condiciones autoinmunes y autoinflamatorias, con énfasis en los mecanismos relacionados con la inmunidad innata. Métodos: se realiza una revisión sistemática de la literatura médica expuesta en la base de datos Medline (en lo que respecta a trabajos originales y revisiones de tema de los autores de dichos trabajos), de aspectos de la inmunidad innata y su relación con las enfermedades autoinmunes y autoinflamatorias, utilizando términos “MESH” como “autoimmuny diseases, autoinflammatory diseases, periodic fever syndromes, Toll-like receptor, NOD-like receptor” y otros que fuesen necesarios para lograr el objetivo de la revisión. Se procede luego a la consecución de los artículos completos, a su lectura, complementación con artículos referenciados relevantes, y luego se procede al ordenamiento, clasificación y posterior redacción del textoÍtem Drug-induced lupus in anti-TNF-alpha therapy and its treatment with rituximab(Springer Heidelberg, 2012-10-01) Vallejo, SantiagoWe report three patients with rheumatoid arthritis (RA) who were treated with anti-TNF-α agents and who developed drug-induced lupus (DIL). Two of them received etanercept and the remainder adalimumab. We also present the favorable response observed with the withdrawal of the anti-TNF-alpha agents and the introduction of rituximab. Through this intervention, we observed a very good control of the activity of both DIL and RA without additional adverse reactions.Ítem Efficacy and safety of anti-interleukin 6 receptor monoclonal antibody (tocilizumab) in Colombian patients with Takayasu arteritis.(Lippincott, Williams & Wilkins, 2014-04-01) Cañas Dávila, Carlos AlbertoPurpose: The aim of this study was to describe the efficacy and safety of anti–interleukin 6 receptor antibody (tocilizumab [TCZ]) in patients with severe or refractory Takayasu arteritis (TA). Methods: We describe 8 Colombian patients with severe and/or refractory TA treated with TCZ during a period of at least 9 months. Clinical, radiological, biological, and associated treatments were evaluated before, during, and after TCZ infusions. Results: The median age at evaluation was 31 years (12–43 years). All patients were female and experienced clinical and biological improvement, in addition to a corticosteroid-sparing effect from a median dose of 50 mg/d at baseline (30–60 mg/d) to 6.25 mg/d (2.5–10 mg/d) at 9 months. In 4 cases, in which imaging studies were available, an improvement was observed.Ítem Multiple endovascular stent-graft implantations in a patient with aortic thoracic and abdominal aneurysms due Takayasu arteritis.(Springer Verlag, 2014-05-01) Echeverri, Andrés FelipeWe report an adult female patient with Takayasu arteritis (TA) receiving conventional medical treatment and anti-TNF therapy, which developed progressive thoracic and abdominal aortic aneurysms. She developed imminent rupture of the thoracic aneurysm and an endovascular stent-graft (EVSG) was emergency implanted and a year after this procedure the abdominal aneurysm increased in size requiring reoperation and placement of another EVSG. Both procedures had a very good outcome. This case shows the effectivity and security of multiple EVSG implantations in multiple aortic aneurisms in patients with TA.Ítem Patients with relapsing polychondritis and previous cartilage trauma present more autoimmunity phenomena(Springer Verlag, 2012-02-01) Cañas Dávila, Carlos AlbertoRelapsing polychondritis (RP) is an autoimmune disease characterized by inflammation and destruction of all type of body cartilage, and the cartilage trauma may be a trigger of the disease in a susceptible person. We describe the clinical and laboratory findings in a group of 18 patients with RP with (7 cases) or without (11 cases) anteceding cartilage trauma. The mean age was 41 years in the group with cartilage trauma and 55 years in the group without cartilage trauma. For both groups, female gender was predominant. All patients presented with auricular chondritis. Systemic manifestations and autoimmunity were more common in patients with anteceding trauma. © 2011 Springer-Verlag.