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Ítem A rare association of localized scleroderma type morphea, vitiligo, autoimmune hypothyroidism, pneumonitis, autoimmune thrombocytopenic purpura and central nervous system vasculitis. Case report.(BioMed Central, 2012-12-20) Muñoz Buitrón, EvelynThe localized scleroderma (LS) known as morphea, presents a variety of clinical manifestations that can include systemic involvement. Current classification schemes divide morphea into categories based solely on cutaneous morphology, without reference to systemic disease or autoimmune phenomena. This classification is likely incomplete. Autoimmune phenomena such as vitiligo and Hashimoto thyroiditis associated with LS have been reported in some cases suggesting an autoimmune basis. To our knowledge this is the first case of a morphea forming part of a multiple autoimmune syndrome (MAS) and presenting simultaneously with autoimmune thrombocytopenic purpura and central nervous system vasculitis. CASE PRESENTATION: We report an uncommon case of a white 53 year old female patient with LS as part of a multiple autoimmune syndrome associated with pneumonitis, autoimmune thrombocytopenic purpura and central nervous system vasculitis presenting a favorable response with thrombopoietin receptor agonists, pulses of methylprednisolone and cyclophosphamide. CONCLUSION: Is likely that LS have an autoimmune origin and in this case becomes part of MAS, which consist on the presence of three or more well-defined autoimmune diseases in a single patient.
Ítem Efficacy of anti-interleukin-6 receptor antibody (tocilizumab) in colombian patients with takayasu’s arteritis(BMJ Publishing Group Ltd, 2013-06-01) Izquierdo, Jorge H.Background Takayasu’s arteritis (TA) is a chronic vasculitis that involves aorta and its main branches, where interleukin-6 (IL-6) seems to play a pathogenic role (1,2). The effect in four patients treated with the anti-IL-6 receptor (IL-6R) antibody Tocilizumab was evaluated. Objectives to describe the effect of Tocilizumab in patients of Takayasu’s arteritis. Methods We reviewed the clinical records of 4 patients with TA diagnosed according to current criteria, treated between 2010 and 2011 in a tertiary center in Cali, Colombia. Four patients with a refractory disease to multiple treatments, was began treatment with Tocilizumab at a dose of 8 mg/kg every month in association with metothrexate and/or steroids. Two patients were treated previously with infliximab (IFX) without control of disease. This cases were reported previously (3). Results The cases summaries are as follows: Case 1. A 30 year-old woman with a diagnosis of TA since 2003 presented panaortitis, with involvement of supra-aortic,