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Caracterización y prevalencia del compromiso ocular en pacientes con enfermedad autoinmune y autoinflamatoria en un centro de referencia reumatológica en Colombia entre los años 2000 a 2015

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dc.contributor.advisorde-la-Torre, Alejandra
dc.contributor.advisorMantilla Hernández, Rubén Darío
dc.creatorVargas Villanueva, Andrés
dc.creatorSarmiento Forero, Diana Marcela
dc.creator.degreeEspecialista en Epidemiología (en Convenio con el CES)
dc.date.accessioned2016-10-21T15:50:03Z
dc.date.available2016-10-21T15:50:03Z
dc.date.created2016-10-08
dc.date.issued2016
dc.descriptionObjetivo: Estimar la prevalencia de las diferentes enfermedades oftalmológicas que aparecen en el contexto de una enfermedad autoinmune (EAI) en pacientes de un centro de referencia reumatológica en Colombia, según características clínicas y sociodemográficas durante un período de 15 años, comprendido entre los años 2000 a 2015. Métodos: Se realizó un estudio descriptivo, observacional de prevalencia. El tipo de muestreo fue aleatorio estratificado con asignación proporcional en el programa Epidat 3.4. Los datos se analizaron en el programa SPSS v22.0 y se realizó análisis univariado de las variables categóricas, para las variables cuantitativas se realizaron medidas de tendencia central. Resultados: De 1640 historias clínicas revisadas, se encontraron 634 pacientes (38,65%) con compromiso ocular. Si excluimos los pacientes con SS, que por definición presentan ojo seco, 222 pacientes (13,53%) presentaron compromiso oftalmológico. Del total de pacientes, el 83,3% fueron mujeres. La AR fue la enfermedad autoinmune con mayor compromiso oftalmológico con 138 pacientes (62,2%), y en último lugar la sarcoidosis con 1 solo paciente afectado. La QCS fue la manifestación más común en todos los grupos diagnósticos de EAI, con 146 pacientes (63,5%). De 414 pacientes con Síndrome de Sjögren (SS) y QCS 8 presentaron compromiso ocular adicional, siendo la uveítis la segunda patología ocular asociada en pacientes con SS y la primera causa en las espondiloartropatias (71,4 %). Los pacientes con catarata (4,1%) presentaron la mayor prevalencia de uso de corticoide (88.8%). De 222 pacientes, 28 (12,6%) presentaron uveítis. Del total de pacientes, 16 (7,2%) presentaron maculopatía por antimalaráricos y 6 (18,75%) de los pacientes con LES. Los ANAS se presentaron en el 100% los pacientes con trastorno vascular de la retina. Los pacientes con epiescleritis presentaron la mayor proporción de positivización de anticuerpos anti-DNA. La EAI que más presentó epiescleritis fue LES con 4 pacientes (12,5%) El 22% de paciente con anticuerpos anti-RNP presentaron escleritis y 32,1% de los pacientes con uveítis presentaron HLA-B27 positivo. Las manifestaciones oftalmológicas precedieron a las sistémicas entre un 11,1% y un 33,3% de los pacientes. Conclusión: Las enfermedades oculares se presentan con frecuencia en los pacientes colombianos con EAI (38.65%), siendo la AR la enfermedad con mayor compromiso ocular (62,2%) y la QCS la enfermedad ocular con mayor prevalencia en todas las EAI (63,5%). La uveítis se presentó en 28 pacientes (12,6%). Las manifestaciones oftalmológicas pueden preceder a las sistémicas. El examen oftalmológico debe ser incluido en los pacientes con EAI, por ser la enfermedad ocular una comorbilidad frecuente. Adicionalmente, los efectos oftalmológicos de las medicaciones sistémicas utilizadas en EAI deben ser estrechamente monitorizados, durante el curso del tratamiento.spa
dc.description.abstractObjectives: To estimate the prevalence of various ocular diseases occuring in the context of an autoimmune disease in patients from a rheumatology clinic referral center in Colombia, according to clinical features and socio-demographic factors from 2000 to 2015. Methods: We conducted an observational, descriptive prevalence study. Randomized stratified sampling with proportional assignment was carried out using Epidat 3.4. Data analysis was fulfilled through SPSS v22.0. Categorical variables were subjected to univariate analysis. Measures of central tendency were performed for cuantitative variables. Results: Ocular involvement was present in 634 patients (38,65%). Excluding patients with Sjögren´s syndrome (SS) and dry eye, which account for 100% (by definition, dry eye is present in all patients with SS), ocular involvement was present in 222 patients (13,53%). 83,3% subjects were women. Rheumatoid arthritis (RA) posed the greatest eye disease prevalence (62,2%), sarcoidosis the lesser (10%). Keratoconjunctivitis sicca (KCS) was the most common ophthalmic manifestation (63,5%) in all autoimmune diseases except the spondyloarthropaties. Out of 414 patients with SS and KCS, additional eye disease was present on 8 individuals, the most common being uveitis (10,6%). The highest prevalence of corticosteroid drug usage (88,8%) was present in patients with cataract (4.1% of the total population). 28 of 222 (12,6%) patients had uveitis. 16 (7,2%) of the total patients (and 18,75% of the total patients with Systemic lupus erythematosus –SLE- ) had ocular toxicity due to antimalarial drugs. Antinuclear antibodies were present in the whole vascular retinal disease group. The highest anti-DNA antibody serum positivity was present in patients with episcleritis; accordingly, SLE rendered the highest episcleritis prevalence (12,5%). 22% of anti-RNP positive patients presented scleritis. 32,1% of uveitis patients were HLA-B27 positive. Eye manifestations preceded systemic involvement in 11,1 to 33,3% of patients. Conclusions: Eye disease is present with relative frequency in Colombian patients with autoimmune disease (38,65%), RA being the condition with the highest prevalence (62,2%) and KCS being the most prevalent ocular manifestation (63,5%). 12,6% of patients had uveitis. On occasion, eye disease can precede systemic compromise. Eye examination should be included as part of these patient population assessment because it is a frequent co-morbidity. In addition, rheumatic drug ocular adverse effects should be monitored during the course of treatment.eng
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dc.identifier.doihttps://doi.org/10.48713/10336_12479
dc.identifier.urihttp://repository.urosario.edu.co/handle/10336/12479
dc.language.isospa
dc.publisherUniversidad del Rosariospa
dc.publisher.departmentFacultad de medicinaspa
dc.rights.accesRightsinfo:eu-repo/semantics/openAccess
dc.rights.accesoAbierto (Texto completo)spa
dc.rights.licenciaEL AUTOR, manifiesta que la obra objeto de la presente autorización es original y la realizó sin violar o usurpar derechos de autor de terceros, por lo tanto la obra es de exclusiva autoría y tiene la titularidad sobre la misma. PARGRAFO: En caso de presentarse cualquier reclamación o acción por parte de un tercero en cuanto a los derechos de autor sobre la obra en cuestión, EL AUTOR, asumirá toda la responsabilidad, y saldrá en defensa de los derechos aquí autorizados; para todos los efectos la universidad actúa como un tercero de buena fe. EL AUTOR, autoriza a LA UNIVERSIDAD DEL ROSARIO, para que en los términos establecidos en la Ley 23 de 1982, Ley 44 de 1993, Decisión andina 351 de 1993, Decreto 460 de 1995 y demás normas generales sobre la materia, utilice y use la obra objeto de la presente autorización. -------------------------------------- POLITICA DE TRATAMIENTO DE DATOS PERSONALES. Declaro que autorizo previa y de forma informada el tratamiento de mis datos personales por parte de LA UNIVERSIDAD DEL ROSARIO para fines académicos y en aplicación de convenios con terceros o servicios conexos con actividades propias de la academia, con estricto cumplimiento de los principios de ley. Para el correcto ejercicio de mi derecho de habeas data cuento con la cuenta de correo habeasdata@urosario.edu.co, donde previa identificación podré solicitar la consulta, corrección y supresión de mis datos.spa
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dc.source.instnameinstname:Universidad del Rosariospa
dc.source.reponamereponame:Repositorio Institucional EdocURspa
dc.subjectEnfermedad autoinmunespa
dc.subjectCompromiso ocularspa
dc.subjectPrevalenciaspa
dc.subjectUveítisspa
dc.subjectQueraconjuntivitisspa
dc.subjectSiccaspa
dc.subject.ddcEnfermedades
dc.subject.decsOftalmopatías -- estudio de casos -- Colombia, 200-2015spa
dc.subject.decsArtritis reumatoide -- consecuenciasspa
dc.subject.keywordautoimmune disease, rheumatoid arthritis, eye involvement, prevalence, uveitis, keratoconjunctivitis sicca.eng
dc.subject.keywordrheumatoid arthritiseng
dc.subject.keywordeye involvementeng
dc.subject.keywordprevalenceeng
dc.subject.keywordeye involvementeng
dc.subject.keywordPrevalenceeng
dc.subject.keywordUveitiseng
dc.subject.keywordKeratoconjunctivitiseng
dc.subject.keywordSiccaeng
dc.subject.lembEnfermedades autoimunes -- investigaciónspa
dc.titleCaracterización y prevalencia del compromiso ocular en pacientes con enfermedad autoinmune y autoinflamatoria en un centro de referencia reumatológica en Colombia entre los años 2000 a 2015spa
dc.typebachelorThesiseng
dc.type.hasVersioninfo:eu-repo/semantics/acceptedVersion
dc.type.spaTrabajo de gradospa
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