Características clínicas de la artritis familiar en España. Estudio de 73 familias
Clinical characteristics of familiar rheumatoid arthritis in Spain. A study of 73 families
Servicio de Reumatología. Hospital Universitario La Paz. Madrid
Dora Pascual-Salcedoa, Tomás Tinturéb, María Victoria Irigoyenc, Carlos Rodríguez-Lozanod, Manuel Rodrígueze, Consorcio Español para la Artritis Reumatoide (CEAR) , European Consortium for Rheumatoid Arthritis Familiar (ECRAF) *
a Sección de Inmunología. Hospital Universitario La Paz. Madrid
b Servicio de Reumatología. Hospital General de Navarra.
c Servicio de Reumatología. Hospital Carlos Haya. Málaga.
d Servicio de Reumatología. Hospital Nuestra Señora del Pino. Gran Canaria.
e Sección de Reumatología. Hospital Cristal Piñor. Orense.
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P.° de la Castellana, 241. 28046 Madrid." ] ] ] 1 => array:3 [ "autoresLista" => "Dora Pascual-Salcedo, Tomás Tinturé, María Victoria Irigoyen, Carlos Rodríguez-Lozano, Manuel Rodríguez" "autores" => array:7 [ 0 => array:3 [ "nombre" => "Dora" "apellidos" => "Pascual-Salcedo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00015" ] ] ] 1 => array:3 [ "nombre" => "Tomás" "apellidos" => "Tinturé" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff00020" ] ] ] 2 => array:3 [ "nombre" => "María" "apellidos" => "Victoria Irigoyen" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00025" ] ] ] 3 => array:3 [ "nombre" => "Carlos" "apellidos" => "Rodríguez-Lozano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff00030" ] ] ] 4 => array:3 [ "nombre" => "Manuel" "apellidos" => "Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff00035" ] ] ] 5 => array:1 [ "colaborador" => "Consorcio Español para la Artritis Reumatoide (CEAR)" ] 6 => array:2 [ "colaborador" => "European Consortium for Rheumatoid Arthritis Familiar (ECRAF)" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "fn0005" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Sección de Inmunología. Hospital Universitario La Paz. Madrid" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff00015" ] 1 => array:3 [ "entidad" => "Servicio de Reumatología. Hospital General de Navarra." "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff00020" ] 2 => array:3 [ "entidad" => "Servicio de Reumatología. Hospital Carlos Haya. Málaga." "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff00025" ] 3 => array:3 [ "entidad" => "Servicio de Reumatología. Hospital Nuestra Señora del Pino. Gran Canaria." "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff00030" ] 4 => array:3 [ "entidad" => "Sección de Reumatología. Hospital Cristal Piñor. Orense." "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff00035" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical characteristics of familiar rheumatoid arthritis in Spain. A study of 73 families" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "1999-02-04" "fechaAceptado" => "1999-04-22" "PalabrasClave" => array:1 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec220495" "palabras" => array:3 [ 0 => "Factores genéticos" 1 => "Artritis reumatoide" 2 => "Factores ambientales" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Describir las características y la homogeneidad de la enfermedad en familias españolas con más de un caso de artritis reumatoide (AR).</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se ha identificado 73 familias con dos o más hermanos con AR. En el estudio clínico sólo se han considerado 149 hermanos que forman en total 79 parejas (3 familias con 3 hermanos y 70 con 2 hermanos). Se recogieron mediante un cuestionario las características demográficas, clínicas y radiológicas.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Las características clínicas de la enfermedad fueron similares a la AR esporádica con una gran frecuencia de enfermedad en mujeres (78%), con factor reumatoide (FR) positivo (86%), erosiones (89%) y manifestaciones extrarticulares en el 25% de los casos. La variable que más influyó en la gravedad de la enfermedad fue el tiempo de evolución. La concordancia entre los hermanos en la edad y año de comienzo, así como en el resto de características clínicas, no fue mayor de lo esperado.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los factores más importantes en el desencadenamiento de la AR parecen ser los ambientales. Las características de la enfermedad familiar en España no parecen ser diferentes de la AR esporádica, existiendo diferencias entre los hermanos que pueden ser debidas a la heterogeneidad genética y ambiental que la han desencadenado y a la diferencia en el tiempo de evolución entre ellos.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To describe clinical characteristics and the homogeneity of disease expression between involved members in multicase Spanish rheumatoid arthritis (RA) families.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">73 families with two or more siblings with RA were found, with a total of 149 patients distributed in 79 pairs (70 sib pairs and 3 sib trios). Demographic, clinical and radiological characteristics were recorded in a standard questionnaire.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Clinical characteristics were similar to those of sporadic RA with a high frequency of women (78%), positive rheumatoid factor (RF) (86%), erosions (89%) and a 25% of the patients having extraarticular disease. The most important variable in disease severity was disease duration. The concordance between family members of the same age and calendar year of disease onset, and the pattern of disease expression, was not higher than expected, showing that the disease is heterogenic.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Environmental factors seem to be more important in RA susceptibility. Clinical characteristics of familiar RA in Spain do not seem to be different from sporadic RA, although differences were found in disease expression within families that may be due to variation of genetic or environmental factors, responsible for the susceptibility and disease duration.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara">Estudio financiado por el programa BIOMED BMH4-CT96-1616 de la Unión Europea. Los miembros de la CEAR aparecen relacionados al final del artículo.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias Bibliográficas" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Polyarthritis in twins" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "G. 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