Janett Riega-Torres

Epidemiology of Rheumatic Diseases. A Community-Based Study in Urban and Rural Populations in the State of Nuevo Leon, Mexico

Objective. To estimate the prevalence of rheumatic diseases in rural and urban populations using the WHO-ILAR COPCORD questionnaire. Methods. We conducted a cross-sectional home survey in subjects > 18 years of age in the Mexican state of Nuevo Leon. Results were validated locally against physical examination in positive cases according to an operational definition by 2 rheumatologists. We used a random, balanced, and stratified sample by region of representative subjects. Results. We surveyed 4713 individuals with a mean age of 43.6 years (SD 17.3); 55.9% were women and 87.1% were from urban areas. Excluding trauma, 1278 individuals (27.1%, 95% CI 25.8%–28.4%) reported musculoskeletal pain in the last 7 days; the prevalence of this variable was almost twice as frequent in women (33% vs 17% in men); 529 (11.2%) had pain associated with trauma. The global prevalence of pain was 38.3%. Mean pain score was 2.4 (SD 3.4) on a pain scale of 0–10. Most subjects classified as positive according to case definition (99%) were evaluated by a rheumatologist. Main diagnoses were osteoarthritis in 17.3% (95% CI 16.2–18.4), back pain in 9.8% (95% CI 9.0–10.7), undifferentiated arthritis in 2.4% (95% CI 2.0–2.9), rheumatoid arthritis in 0.4% (95% CI 0.2–0.6), fibromyalgia in 0.8% (95% CI 0.6–1.1), and gout in 0.3% (95% CI 0.1–0.5). Conclusion. This is the first regional COPCORD study in Mexico performed with a systematic sampling, showing a high prevalence of pain. COPCORD is a useful tool for the early detection of rheumatic diseases as well as for accurately referring patients to different medical care centers and to reduce underreporting of rheumatic diseases.

Aplicación de un modelo de predicción de progresión de artritis reumatoide en pacientes con artritis indiferenciada

INTRODUCTION Different prediction rules have been applied to patients with undifferentiated arthritis (UA) to identify those that progress to rheumatoid arthritis (RA). The Leiden Prediction Rule (LPR) has proven useful in different UA cohorts. OBJECTIVE To apply the LPR to a cohort of patients with UA of northeastern Mexico. METHODS We included 47 patients with UA, LPR was applied at baseline. They were evaluated and then classified after one year of follow-up into two groups: those who progressed to RA (according to ACR 1987) and those who did not. RESULTS 43% of the AI patients developed RA. In the RA group, 56% of patients obtained a score ≤ 6 and only 15% ≥ 8. 70% who did not progress to RA had a score between 6 and ≤ 8. There was no difference in median score of LPR between groups, p=0.940. CONCLUSION Most patients who progressed to RA scored less than 6 points in the LPR. Unlike what was observed in other cohorts, the model in our population did not allow us to predict the progression of the disease.

A β2‐microglobulina salivar se correlaciona positivamente com o ESSPRI em pacientes com síndrome de Sjögren primária

Felipe Garza-Garcíaa, Guillermo Delgado-Garcíaa,∗, Mario Garza-Elizondob, Luis Ángel Ceceñas-Falcónc, Dionicio Galarza-Delgadoa,b, Janett Riega-Torresb a Universidad Autónoma de Nuevo León, Hospital Universitario, Departamento de Medicina Interna, Monterrey, Mexico b Universidad Autónoma de Nuevo León, Hospital Universitario, Servicio de Reumatología, Monterrey, Mexico c Universidad Autónoma de Nuevo León, Hospital Universitario, Servicio de Anatomía Patológica, Monterrey, Mexico

Beta-2 Microglobulin in Whole Unstimulated Saliva Can Effectively Distinguish Between Sjögren’s Syndrome and Non-Autoimmune Sicca Symptoms

Objectives This study aims to describe salivary beta-2 microglobulin (sB2M) levels in our setting and to assess the performance of sB2M for the diagnosis of Sjögrens syndrome (SS). Patients and methods This cross-sectional, comparative study included 192 SS patients (2 males, 190 females; mean age 53.1 years; range 23 to 84 years) and 64 healthy controls (1 male, 63 females; mean age 46.9 years; range 21 to 82 years). Patients were divided into three groups as those with primary SS, secondary SS, and sicca non-Sjögrens syndrome (snSS). sB2M was measured by enzyme-linked immunosorbent assay in whole unstimulated saliva (ng/mL). Differences in sB2M were evaluated using the Kruskal-Wallis test. Receiver operating curves were generated to determine the performance of sB2M for distinguishing between SS and non-autoimmune snSS groups, and between SS group and healthy controls. Results The primary SS and secondary SS groups had a significantly higher concentration of sB2M than the other two groups. There was no significant difference in the concentration of sB2M between primary SS and secondary SS groups, and neither between snSS group and healthy controls. The receiver operating curve analysis for distinguishing SS and snSS showed an area under the curve of 0.661 (95% confidence interval 0.590-0.728, p=0.0001) with an optimal cutoff value of 0.582 ng/mL. Sensitivity, specificity, positive predictive value, and negative predictive value were 68.7%, 59.3%, 20.2%, and 92.7%, respectively. The reported prevalence of SS in Mexico was considered when calculating the last two values. Conclusion In our setting, sB2M effectively distinguished between SS patients and non-autoimmune sicca symptoms. Including sB2M in our conventional diagnostic arsenal may assist in the evaluation of patients in whom SS is suspected; however, further studies are needed to clarify this hypothesis.