R Alvarez-Doforno

Hospital Universitario La Paz

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Alejandro Balsa

Hospital Universitario La Paz

Santiago Muñoz‐Fernández

Hospital Universitario Infanta Sofía

G Fontán

Hospital Universitario La Paz

Margarita López‐Trascasa

Hospital La Paz Institute for Health Research

Juan Gómez Rivas

Hospital Clínico San Carlos

R Arrieta

Hospital Universitario La Paz

Patricia Richi

Hospital Universitario Infanta Sofía

Luis Garcı́a-Guereta

Hospital Universitario La Paz

J.J. Menéndez

Hospital Universitario La Paz

JM Gonzalez-Tarrio

Hospital Universitario La Paz

Cooperative Institutions

Hospital Universitario La Paz

Universidad Autónoma de Madrid

Hospital La Paz Institute for Health Research

Hospital Materno-Infantil

Centre for Biomedical Network Research on Rare Diseases

Centro de Investigación Biomédica en Red

Center for Rheumatology

Hospital General Universitario Gregorio Marañón

Comunidad de Madrid

Consejo Superior de Investigaciones Científicas

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Antiperinuclear factor isotypes in rheumatoid arthritis.

PubMed (1995)

Santiago Muñoz‐Fernández R Alvarez-Doforno G Fontán Juan Gijón

Rheumatoid factor

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Citations (2)

Utilidad de la terapia intracoronaria con células progenitoras en pacientes con miocardiopatía dilatada: ¿puente o alternativa al trasplante cardiaco?

Anales de Pediatría (2011)

Juan Gómez Rivas J.J. Menéndez R Arrieta Javier Alves M. Romero

Some paediatric publications have recently raised the value of intracoronary therapy with autologous bone marrow-derived progenitor cells (APCs) in children with dilated cardiomyopathy (DCM) and heart failure. We describe the usefulness of this treatment in two infants with severe DCM and heart failure, who had been transferred to our hospital for cardiac transplant evaluation.The first patient was a 3 months old male weighing 4 kg. The second was a 4 months old male weighing 5 kg. At the time of admission, both were in poor clinical condition (NYHA IV), with severe dilation and systolic dysfunction (ejection fraction [EF]<30%) of the left ventricle and marked elevation of NT-proBNP, requiring treatment with mechanical ventilation and inotropic iv infusion. After mobilization with G-CSF for 4 days, APCs were obtained from peripheral blood by leukocytapheresis, administering them by a slow intracoronary bolus injection using a stop-flow technique (6.15x106 CD34-positive cells/Kg in the first patient, and 10.55x106 CD34-positive cells/Kg in the second).Since the first week after the procedure, clinical status of patients improved and echocardiography showed a decrease in left ventricular dilation. A month later, there was a significant improvement in EF (> 40%) and NT-proBNP levels, subsequently maintained throughout the follow-up. However, four months later in the first patient, the left ventricle dilated again and its function slightly worsened, but without any significant impact in his clinical status.Intracoronary therapy with APCs can be an alternative in children, especially infants, with DCM and heart failure. It can reduce the waiting list mortality, improve clinical status and provide more time on the waiting list to receive a suitable organ, or even to make transplantation unnecessary.

Dilated Cardiomyopathy

10.1016/j.anpedi.2011.02.013

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Citations (14)

The effect of a triple therapy on maternal anti-Ro/SS-A levels associated to fetal cardiac manifestations

Autoimmunity Reviews (2015)

Nuria Martínez-Sánchez Ángel Robles‐Marhuenda R Alvarez-Doforno Aurora Viejo E. Antolín

Plasmapheresis

Intravenous Immunoglobulins

10.1016/j.autrev.2015.01.005

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Citations (21)

[Linear bullous IGA dermatosis and systemic lupus erythematosus].

PubMed (1995)

De Alba R Alvarez-Doforno Mariano Casado J. Borbujo

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Citations (4)

Autoantibodies in patients with IgA and IgG2 deficiencies

Apmis (1991)

Adolfo Jiménez R Alvarez-Doforno M. Cruz García Rodríguez Antônio Walter Ferreira Margarita López‐Trascasa

Patients with primary immunodeficiencies have a high incidence of autoantibodies, mainly of no clinical significance. It has recently been suggested that patients with a combined IgA‐IgG2 deficiency have more autoantibodies than those patients with isolated deficiencies. We have studied 42 patients with selective IgA deficiency, nine with isolated IgG2 deficiency and 13 with combined IgA‐IgG2 deficiency, and have found that the combined IgA‐IgG2 deficiency has no influence on autoantibody prevalence, except for anti‐IgA antibodies. The presence of chronic respiratory infections (a clinical feature commonly associated with both selective IgA and IgG2 deficiencies) is unrelated to the prevalence of autoantibodies. The most frequent autoantibodies found are anti‐IgA and anti‐cardiolipin. Most of the autoantibodies have been found to be devoid of actual clinical significance. Only three patients had overt autoimmune disease.

Selective IgA deficiency

Clinical Significance

Immunoglobulin A

10.1111/j.1699-0463.1991.tb05157.x

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Citations (12)

Antiperinuclear factor as a prognostic marker in rheumatoid arthritis.

PubMed (1999)

Santiago Muñoz‐Fernández R Alvarez-Doforno JM Gonzalez-Tarrio Alejandro Balsa Patricia Richi

Antiperinuclear factor (APF) is an autoantibody detected in >50% of patients with rheumatoid arthritis (RA); it shows a specificity of roughly 90%. We investigated the possible role of APF as a prognostic marker in RA.A series of 103 patients with RA who fulfilled the 1987 American College of Rheumatology criteria (88 women and 15 men; mean age 55.5 yrs, mean disease duration 9 yrs) were prospectively followed. Sixteen variables were assessed in each patient at inclusion and over a 3 year period. APF was determined by indirect immunofluorescence assay using human buccal mucosal cells as substrate. APF assays were done at entry and at the end of followup without knowledge of the clinical status of the patients. Mann-Whitney U, chi-squared tests, variance analysis, and kappa index were used for statistical analysis.Eighty of 103 patients completed followup. APF was detected in 40 of 80. At inclusion, APF correlated with the visual analog scale (VAS) of pain (p = 0.02). However, patients who showed APF positivity at entry had a less favorable course than APF negative individuals, as shown by a worse VAS of well being (p = 0.01), Ritchie index (p = 0.01), number of painful joints (p = 0.03), grip strength (p = 0.01), C-reactive protein (p = 0.04), and Health Assessment Questionnaire score (p = 0.03) at the end of the study. In addition, APF positive patients showed a worse radiological course (p = 0.03).Our results suggest APF is a possible marker of poor prognosis in RA.

Rheumatoid factor

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Citations (14)

69 Intracoronary Autologous Peripheral Stem Cell Therapy: A Promising Treatment for Heart Failure in Pediatric Dilated Cardiomyopathy

The Journal of Heart and Lung Transplantation (2011)

J.J. Menéndez Juan Gómez Rivas Luis García‐Guereta Federico Gutiérrez‐Larraya R Arrieta

Dilated Cardiomyopathy

Stem Cell Therapy

10.1016/j.healun.2011.01.076

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Citations (0)

FRI0052 To evaluate antibodies antinuclear (ana) in rheumatoid arthritis with infliximab treatmentoid

Annals of the Rheumatic Diseases (2001)

Florian Ruiz G. Bonilla Gisela Diaz JM Gonzalez-Tarrio R Alvarez-Doforno

Background

Objectives

To examine the evolution of the ANA titre in patients with rheumatoid arthritis treated with infliximab (anti TNF- alpha).

Methods

14 patients with active rheumatoid arthritis and unresponsive to at least 3 DMARDs were treated with methotrexate and infliximab. Before infliximab infusion, weeks 0, 2,6,14 and 22, a physical examination, DAS 28 and blood test, which included RF, ANA, immunoglobulin quantification C3 and C4 were done.

Results

At the baseline visit 5/14 (35,71%) patients had positive ANA test,2 (1/40),1 (1/80),1 (1/160), 1 (1/640). After the fifth infusion 8/14 (57,14%) had a positive ANA test. Three patients who initially were ANA negative showed a titre of 1/160,1/320 and 1/640. Three out of 5 patients which previously had a positive test, showed an increase in the ANA titre,1/40 to 1/80,1/40 to 1/320 and 1/640 to 1/1280. After the fourth infusion of infliximab, all patients with ANA positive had a Crithidia test performed. In all cases anti DNA were negative.

Conclusion

In our experience, treatment with infliximab has shown an increase of the ANA titre in 21,42% of the patients. On the other hand, 21,4% of the patients with a previous negative test for ANA had a positive test after the fourth infusion. All cases were negative for anti-DNA antibodies.

10.1136/annrheumdis-2001.1181

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Citations (0)

Case report: lupus nephritis with autoantibodies to complement alternative pathway proteins and C3 gene mutation

BMC Nephrology (2015)

Pilar Nozal Sofía Garrido Jorge Martínez-Ara María L. Picazo Laura Yébenes

Glomerulonephritis is one of the most severe complications of lupus, a systemic disease with multi-organ involvement, with tissue damage produced mainly by complement activation. As a result of this activation, patients with active lupus present hypocomplementemia during disease flares, but C3 and C4 levels are recovered between episodes. We present a patient who suffered two lupus nephritis episodes in 5 years, achieving complete remission with treatment after both of them, but with C3 levels persistently below normal range. Genetic study revealed that the patient carried a mutation in heterozygosis in the C3 gene. Serial sera samples were analyzed, and autoantibodies to complement alternative pathway proteins (Factor I, Factor B, C3 and Properdin) were found. Functional assays showed that these autoantibodies cause alternative pathway activation. This case is the first reported of a heterozygous C3 mutation associated with lupus nephritis and autoantibodies against complement alternative pathway proteins (Factor I, Factor B, C3 and Properdin).These autoantibodies cause activation of this pathway and this fact could explain that the tissue damage is restricted to the kidney.

Nephrology

Complement

10.1186/s12882-015-0032-6

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Citations (20)

The Antiperinuclear Factor in Spondylarthropathies

Lara D. Veeken (1996)

Santiago Muñoz‐Fernández R Alvarez-Doforno M. FERNÁNDAZ Patricia Richi Alejandro Balsa

Spondylarthropathies

Factor (programming language)

10.1093/rheumatology/35.8.804-a

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Citations (0)