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J A Maldonado Cocco

Publications and source records attributed to J A Maldonado Cocco.

At least 19 recordsLinked to original sources
PubMed2001

Influence of HLA-DR alleles on rheumatoid arthritis: susceptibility and severity in Argentine patients.

OBJECTIVE: To determine the frequency of shared epitopes in our population of patients with rheumatoid arthritis (RA) and to investigate whether the presence of these alleles is associated with a more aggressive form of disease. METHODS: Demographic and clinical data were obtained from 140 patients with RA, 123 female, mean age 49.9+/-11.7 years and mean disease duration 9.4+/-6.3 years. Radiographs of both hands were taken and scored by Larsen's method. HLA-DR alleles were determined by PCR-SSP. The control group comprised 202 healthy ethnic-matched subjects. RESULTS: DR4 was significantly more frequent in patients with RA than controls, and was observed in 70/140 patients (50%) versus 47/202 controls (23.27%) (odds ratio 3.25, CI 1.99-5.35, Pcorr 5 x 10(-5)). Within DR4 subtypes *0404 and *0401 were the most commonly found (37.7 and 29%, respectively). DR3 and DR11 exerted a protective effect with significantly higher frequency in controls than in patients with RA. When patients were divided into 2 groups according to disease severity (radiographic score) the frequency of alleles with QKRAA and QRRAA sequences was similar in both groups. Although with lower frequency, subtype *1001 alone was significantly more frequent in the severe-condition group [7 (13.5%) vs 3 (3.4%), p = 0.03]. CONCLUSION: These results are in accordance with findings observed in Caucasians and differ from other Latin American populations. However shared epitope alleles failed to correlate with more severe disease with the exception of subtype *1001 which, although infrequent, was significantly more frequent in patients with relevant radiological damage.

Adult↗
PubMed2000

Systemic lupus erythematosus: mortality and survival in Argentina. A multicenter study.

OBJECTIVE: To analyze the factors associated with mortality, survival and causes of death in patients with systemic lupus erythematosus (SLE) in Argentina. PATIENTS AND METHOD: A series of 366 patients with SLE (45 men and 321 women), mean age 29 y (range 11-70 y) and mean disease duration 6 y, was evaluated from 1990 to 1998. A total of 57 clinical, serological and therapeutic variables were studied. RESULTS: Five- and 10-year survival was 91% and 85% respectively. Forty four patients died (12%): 54% due to sepsis and 32% due to active SLE. Mortality risk factors included heart involvement CRR 3.82), hyperlipidemia (RR 2.72), renal damage (RR 2. 62), infections (RR 2.44), lung disease (RR 2.20) and myositis (RR 2. 07). High-dose prednisone (RR 3.4) or cyclophosphamide (RR 9.19) treatments increased the risk of sepsis (P=0.003) as a cause of death. However, corticosteroids, antimalarial agents and accumulated cyclophosphamide doses proved to be protective factors in overall mortality figures (RR <1). CONCLUSIONS: The main risk factors of death in SLE were heart involvement, hyperlipidemia and renal damage. Treatment with steroids, antimalarial agents and cyclophosphamide improved survival. High-dose corticosteroids and cyclophosphamide were associated with sepsis as a cause of death.

Adolescent↗
PubMed1997

Jaccoud's arthropathy of the hands in overlap syndrome.

The objective of this work was to evaluate the frequency and features of Jaccoud's syndrome of the hands in patients with overlap syndrome. Twenty-three patients with overlap syndrome were prospectively evaluated by means of a complete physical examination, serological assessment, and hand X-rays. The presence of Jaccoud's syndrome was defined by Kahn's criteria. Patients with or without Jaccoud's arthropathy were compared in their clinical, serological and radiological features. Five out of 23 patients (21.7%) presented Jaccoud's syndrome. Clinical and serological features of patients with or without the syndrome proved similar except for alignment abnormalities, which by definition were more frequent in the group with Jaccoud. A significantly greater number of patients meeting diagnostic criteria for SLE were observed in the Jaccoud group (80% versus 21%; p = 0.03). There was no other disease or associated condition such as chronic renal failure or high-dose steroid treatment concomitant with the development of Jaccoud's syndrome. It may be concluded that in patients with overlap syndrome, Jaccoud' arthropathy seems to be more frequent in patients who meet criteria for SLE.

Adult↗
PubMed1997

Clinico-radiological correlation of enthesitis in seronegative spondyloarthropathies (SNSA).

The goal of this work was to evaluate clinico-radiological correlation of enthesitis in SNSA patients, selected for presenting at least one radiological enthesopathy. Out of 50 patients with SNSA, 40 were selected for having had at least one radiological enthesitis. In a cross-sectional study, 32 males and 8 females, whose mean age was 40.4 years and mean disease duration 13 years, were evaluated. Nineteen patients had ankylosing spondylitis, 15 psoriatic arthritis and 6 Reiter's syndrome. Sites evaluated were pelvis and lower limbs. Radiological enthesopathies were identified by the presence of calcifications, new bone formation and/or erosions in tendinous and ligamentous insertion sites, and clinical enthesitis due to pain or tenderness and/or swelling at such locations. The site most commonly involved radiologically was the sciatic tuberosity in 33/40 cases, followed by the calcaneus with 12/40 on its inferior and 11/40 on its posterior aspect. Fifteen patients (37%) presented clinical manifestations at tendinous insertion sites, but clinico-radiological correlation was found in only 4 (22%). We conclude that clinical and radiological manifestations correlate poorly in SNSA enthesitis, perhaps due to the wide diversity of developmental stages of the disease.

Adolescent↗
PubMed1996

Sjögren's in adult Still's disease?

The objective of the study was to search for clinical, ophthalmological and serological manifestations of Sjögren's syndrome in patients with adult onset Still's Disease (AOSD). Eight consecutive patients with AOSD were evaluated. In all cases a standardized questionnaire to disclose sicca symptoms as well as extraglandular manifestations commonly associated with Sjögren's syndrome(SS) was conducted. Ophthalmological and serological evaluation was undertaken in all patients. Oral involvement was investigated by minor salivary gland biopsy in 7 patients. One case presented symptomatic keratoconjunctivitis sicca and grade III Chisholm labial biopsy. A further 2 patients had grade IV (4 foci per 4 mm2) salivary gland biopsy, in the absence of xerostomia or xerophthalmia. The search for autoantibodies proved negative throughout. It was concluded that focal sialoadenitis was not uncommon in our patients with AOSD. Whether this finding corresponds to a true SS is not yet clearly determined.

Adult↗
PubMed1996

Apatite deposition in polymyositis subluxing arthropathy.

We describe a 47-year-old woman who developed chronic subluxing arthropathy associated with polymyositis (PM) and positive anti-Jo1 antibodies. After a followup of 3 years, PM did not recur and polyarthritis dominated her clinical picture, leading to deformities and periarticular calcifications in her hands, shoulders, and feet. Patients with myositis, anti-Jo1 antibodies, and periarticular calcifications are at risk of developing deforming arthritis unresponsive to conventional therapy.

Adult↗
PubMed1994

Joint involvement in polymyositis/dermatomyositis.

The frequency and features of joint involvement were evaluated in 29 patients with polymyositis/dermatomyositis (PM/DM); eight of them (27.5%) presented arthritis. Mean age was 30 years, and mean disease duration was 5.3 years. Oligoarthritis was observed in 5 cases, while 3 presented polyarthritis; in most cases arthritis was concurrent with the musculocutaneous picture. On comparing the 8 arthritis patients with the remaining 21, no significant clinical or serological differences were found. However, males predominated in the arthritis group, 75% vs 19% (p < 0.05). Arthritis responded favourably to underlying disease treatment and articular sequelae were not observed.

Adolescent↗
PubMed1994

Idiopathic osteoporosis during pregnancy.

Among the idiopathic forms of osteoporosis, the one developing during pregnancy is the least common and scarcely studied. Poorly understood, it seems to stem from transient failure of calcitropic hormones and decreased osteoblast activity. A 25-year-old patient presented with coxofemoral pain during the last three months of pregnancy, followed by multiple vertebral compression fractures at postpartum. Laboratory, radiological, densitometric and histological examinations led to a diagnosis of idiopathic osteoporosis in pregnancy, once other causes of osteopenia had been ruled out. Bone densitometries performed 12 and 24 months later showed an increase in mineral density, thus demonstrating the self-limited nature of this entity.

Absorptiometry, Photon↗
PubMed1993

Protrusio acetabuli in juvenile rheumatoid arthritis.

Acetabular protrusion (PA) as measured by a line crossing method was studied in 73 patients with juvenile rheumatoid arthritis (JRA) and its frequency found to be 12% (9/73), presenting bilaterally in 5 cases and unilaterally in 4. All patients had some other forms of radiological damage and the presence of PA was predominantly observed in the JRA group with greater age at onset (8 vs 4.2 years; p < 0.001) and lower frequency of extraarticular manifestations (22% vs 72%; p < 0.01). There was no correlation with type of JRA onset, course of disease, sex, disease duration, seropositivity for rheumatoid factor, and prior steroid intake.

Acetabulum↗
PubMed1993

Protrusio acetabuli in seronegative spondyloarthropathy.

Protrusio acetabuli (PA) is a complication of many disorders involving the hip joint. Its frequency and clinical features in seronegative sponyloarthropathy (SNSA) are unknown. The prevalence and characteristics of PA were studied in 50 adults and 25 children with SNSA (40 ankylosing spondylitis, 24 psoriatic arthropathy, and 11 Reiter's syndrome). PA was considered present when the acetabular line medially exceeded the ilioischial line by 3 mm or more in men, 6 mm or more in women, more than 1 mm in boys, and more than 3 mm in girls. PA prevalence was 25% in the total group (19 of 75 patients), 22% in adults, and 32% in children. There were no significant differences in seronegative disease type; PA was present with similar frequency between genders and did not correlate with disease duration, clinical severity of hip involvement, or previous medication. Radiological damage was similar in adults and children and did not differ in those with and without PA. Similarly, functional capacity did not differ between groups. It is concluded that PA is a frequent complication in SNSA; however, its presence does not seem to modify the functional prognosis of these patients.

Acetabulum↗
PubMed1993

Sequential development of 2 connective tissue diseases in juvenile patients.

The sequential development of two connective tissue diseases in the same patient has been rarely reported. We describe 2 juvenile patients, a 15-year-old girl who, after having juvenile rheumatoid arthritis (JRA) for a 7-year period presented with clearly defined features of systemic lupus erythematosus with diffuse proliferative glomerulonephritis. The 2nd case, a 9-year-old boy developed erosive polyarticular JRA after having had a clear picture of dermatomyositis in infancy. In both cases there was a lengthy disease free period between the 2 diseases.

Arthritis, Juvenile↗
PubMed1992

Rheumatoid nodulosis: a puzzling variant of rheumatoid arthritis.

Four patients with rheumatoid nodulosis are here described, together with a review of cases reported to date in the literature. This particular variant of rheumatoid arthritis (RA) is characterized by the presence of subcutaneous rheumatoid nodules, scanty or absent systemic manifestations and a clinically benign course. Joint involvement appears more commonly as palindromic rheumatism, although patients with arthralgia episodes alone and others with chronic polyarthritis have been described. Seldom reported up to now, a consideration of this entity may help to avoid diagnostic pitfalls and the use of aggressive therapy.

Adult↗
PubMed1992

Adult onset Still's disease: clinical features and course.

Fifteen patients with adult onset Still's disease are described, all diagnosed according to recognized criteria. Mean delay in reaching a firm diagnosis was 16 months. Besides the typical clinical picture, there was a high frequency of pruriginous rash, one instance of overlapping polymyositis and recurrent systemic manifestations in most cases. Chronic polyarticular involvement predominated, with radiological progression particularly in wrist, proximal interphalangeal and hip joints. However, functional prognosis at the end of a mean 4.8-year course was satisfactory, as also the response to treatment mainly with steroid drugs and, on occasion, with remitting agents to alleviate arthritis.

Adolescent↗
PubMed1992

Tuberculous arthritis in the course of connective tissue disease: report of 4 cases.

We describe 4 female patients with diverse connective tissue diseases who developed tuberculous arthritis concurrently with their underlying disease, in the absence of lung involvement. Throughout, diagnosis was delayed but later confirmed by detection of Mycobacterium tuberculosis in synovial membrane culture. Two patients died of unrelated causes, while the other 2 recovered with chronic joint sequelae. Despite the rarity of this association, M. tuberculosis infection should be considered in the differential diagnosis of chronic mono or oligoarthritis in patients with connective tissue diseases.

Adult↗