Reumatismo Palindrómico
Resumen
El Reumatismo palindrómico (RP) se caracteriza por episodios de artritis recurrente, generalmente monoarticular, de duración promedio 24-48 horas. Un número significativo de casos evoluciona a una enfermedad reumática crónica, en especial a una artritis reumatoide (AR). Existe una controversia en relación a si el RP es una entidad por sí misma o una forma abortiva o preclínica de AR. Se ha demostrado la elevada frecuencia de anticuerpos anti peptidos cíclicos citrulinados (ACPA), los biomarcadores más específicos de la AR, en pacientes con RP, lo que fortalece aún más el vínculo con la AR. Además, aunque el fator reumatoide y los ACPA positivos son factores predictores de progresión de RP a AR, un número significativo de pacientes no evoluciona a AR después de un seguimiento a largo plazo. Por este motivo existe un renovado interés en la determinación de los factores de riesgo a fin de determinar que pacientes evolucionarán y cuáles no, lo que tendría implicancias importantes en la práctica clínica, pues dichos pacientes necesitarán sin duda un seguimiento más estrecho y una estrategia terapéutica más precoz y diferenciada. En esta revisión se analizan exhaustivamente los aspectos epidemiológicos, clínicos, diagnósticos, pronósticos y terapéuticos del RP.Descargas
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