Papers by Juan Manuel Miranda
Archivos de Bronconeumología, 2013
El consumo de tabaco es la principal causa de enfermedad pulmonar obstructiva crónica (EPOC). Alr... more El consumo de tabaco es la principal causa de enfermedad pulmonar obstructiva crónica (EPOC). Alrededor del 85-90% de los casos de esta enfermedad son debidos al consumo del tabaco 1 . Se * Autor para correspondencia.
Archivos de Bronconeumología, 2007
Linfoma angiocéntrico mediofacial simulando granulomatosis de Wegener limitada. Reporte de un caso
Rev Mex Reumatol, Oct 1, 2001
Reumatología Clínica, 2009
Antiphospholipid syndrome nephropathy (APSN) is now a well recognized vaso-occlusive renal lesion... more Antiphospholipid syndrome nephropathy (APSN) is now a well recognized vaso-occlusive renal lesion associated with acute thrombosis and chronic arterial and arteriolar lesions, leading to zones of cortical ischemic atrophy. Our objective was to evaluate the prevalence and clinical significance of APSN in patients with Systemic Lupus Erythematosus (SLE). Methods: Kidney biopsy specimens obtained from 162 patients with lupus glomerulonephritis were retrospectively examined for the presence of APSN. Clinical and laboratory data obtained at the time of kidney biopsy and during a mean follow-up of 7 years were recorded. In cases for which serial kidney biopsy specimens were available, the evolution of APSN was examined. Results: We found APSN in 17 (10.4%) patients with lupus glomerulonephritis (GN), 12 with focal or proliferative lesions. Both activity and chronicity indexes were higher in patients with APSN when compared with lupus nephritis without APSN. Patients with APSN had a higher frequency of hypertension and elevated serum creatinine levels at the time or kidney biopsy, as well as a higher frequency of rapidly progressive GN, nephrotic syndrome and death at the end of the follow-up. Anticardiolipin antibodies were found in 52% of those with APSN and in 27% of those without APSN. Serial kidney biopsy specimens were available from 18 patients. An increase of glomerular sclerosis was found in the second biopsy particularly in those patients with APSN in the first biopsy. Conclusions: APSN is a risk factor that contributes to an elevated prevalence of hypertension, elevated serum creatinine, nephrotic syndrome and increased glomerular sclerosis. APSN should be included in the classification criteria of APS, and the use of appropriate anticoagulant therapy should be tested.
Reumatología Clínica (English Edition), 2007
complement levels and high ab-dsDNA titers. Renal flares were present in 18 patients in G-I and 9... more complement levels and high ab-dsDNA titers. Renal flares were present in 18 patients in G-I and 9 in G-II. Conclusions: UTI in lupus nephritis patients has a negative impact. It leads to delayed CYC therapy and to a higher renal flare rate.
Interaction between Rheumatoid Arthritis and Infections
Infection and Autoimmunity, 2004
Publisher Summary Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease characteri... more Publisher Summary Rheumatoid arthritis (RA) is a systemic chronic inflammatory disease characterized by a symmetric inflammation and destruction of joints. Despite of large efforts and technology, the etiology of RA remains elusive, although it appears that genetic, infectious, environmental, and hormonal factors are all involved in complex interrelated ways. One of the most exciting areas of investigation is the application of Polymerase Chain Reaction (PCR). This technique is useful to the detection of bacterial and viral DNA in patients with RA. With PCR technique, foreign antigens of bacteria, virus, and superantigens can be found in the synovial fluid. In addition, the lymphocytes from synovial fluid can develop a local immune response stimulated by microorganisms such as Proteus mirabilis and Epstein-Barr virus. These lymphocyte responses were higher with these microorganisms than with other stimuli. Those data suggest an immune-infectious cause for RA. However, the difficulty of separating pathogens from contaminants has hampered these studies. On the other hand, the presence of foreign antigens is not specific for RA. Therefore, the role of these organisms in initiating and perpetuating inflammation in RA remains unknown; however, it continues to be actively investigated. This chapter provides an update on the various mechanisms in which infectious agents may play a role as inciting or perpetuating factors in the pathogenesis of RA.
Sulfasalazine treatment in reiter's syndrome patients may not be sufficient: comment on the article by youssef et al
Arthritis & Rheumatism, 1993
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Papers by Juan Manuel Miranda