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Gracia Tello BC, Ramos Ibañez E, Saez Comet L, Guillén Del Castillo A, Simeón Aznar CP, Selva O'Callaghan A, Espinosa G, Lledó G, Freire Dapena M, Martinez Robles E, Ríos JJ, Todolí Parra JA, Marí Alfonso B, Ortego Centeno N, Marín Ballvé A, Callejas Rubio JL, Fonollosa Plá V, Fanlo P. External clinical validation of automated software to identify structural abnormalities and microhaemorrhages in nailfold videocapillaroscopy images. Clin Exp Rheumatol 2023:19447. [PMID: 37140670 DOI: 10.55563/clinexprheumatol/m6obl3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/02/2023] [Indexed: 05/05/2023]
Abstract
OBJECTIVES Automated systems to analyse nailfold videocapillaroscopy (NVC) images are needed to promptly and comprehensively characterise patients with systemic sclerosis (SSc) or Raynaud's phenomenon (RP). We previously developed, and validated in-house, a deep convolutional neural network-based algorithm to classify NVC-captured images according to the presence/absence of structural abnormalities and/or microhaemorrhages. We present its external clinical validation. METHODS A total of 1,164 NVC images of RP patients were annotated by 5 trained capillaroscopists according to the following categories: normal capillary; dilation; giant capillary; abnormal shape; tortuosity; microhaemorrhage. The images were also presented to the algorithm. Matches and discrepancies between algorithm predictions and those annotations obtained by consensus of ≥3 or ≥4 interobservers were analysed. RESULTS Consensus among ≥3 capillaroscopists was achieved in 86.9% of images, 75.8% of which were correctly predicted by the algorithm. Consensus among ≥4 experts occurred in 52.0% of cases, in which 87.1% of the algorithm's results matched with those of the expert panel. The algorithm's positive predictive value was >80% for microhaemorrhages and unaltered, giant or abnormal capillaries. Sensitivity was >75% for dilations and tortuosities. Negative predictive value and specificity were >89% for all categories. CONCLUSIONS This external clinical validation suggests that this algorithm is useful to assist in the diagnosis and follow-up of SSc or RP patients in a timely manner. It may also be helpful in the management of patients with any pathology presenting with microvascular changes, as the algorithm has been designed to also be useful for research aiming at extending the usage of nailfold capillaroscopy to more conditions.
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Affiliation(s)
- Borja C Gracia Tello
- Unit of Autoimmune Diseases, Lozano Blesa University Hospital, Zaragoza, and Instituto de Investigación Sanitaria Aragón (ISSA), Aragón, Spain.
| | | | - Luis Saez Comet
- Autoimmune Department, Hospital Universitario Miguel Servet, Zaragoza, and Sociedad Española de Medicina Interna, Grupo de Enfermedades Autoinmunes Sistémicas (GEAS), Spain
| | | | | | | | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
| | - Gema Lledó
- Department of Autoimmune Diseases, Hospital Clínic, Barcelona, Spain
| | - Mayka Freire Dapena
- Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Spain
| | | | - Juan José Ríos
- Unit of Autoimmune Diseases, Hospital Universitario La Paz, Madrid, Spain
| | | | | | | | - Adela Marín Ballvé
- Unit of Autoimmune Diseases, Lozano Blesa University Hospital, Zaragoza, and Instituto de Investigación Sanitaria Aragón (ISSA), Aragón, Spain
| | | | | | - Patricia Fanlo
- Unit of Autoimmune Diseases, Hospital Virgen del Camino, Pamplona, and Sociedad Española Multidisciplinar de Enfermedades Autoinmunes Sistémicas (SEMAIS), Spain
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Ramos-Rincón JM, Ventura PS, Casas-Rojo JM, Mauri M, Bermejo CL, de Latierro AO, Rubio-Rivas M, Mérida-Rodrigo L, Pérez-Casado L, Barrientos-Guerrero M, Giner-Galvañ V, Gallego-Lezaun C, Milián AH, Manzano L, Blázquez-Encinar JC, Solís-Marquínez MN, García MG, Lobo-García J, Valente VAR, Roig-Martí C, León-Téllez M, Tellería-Gómez P, González-Juárez MJ, Gómez-Huelgas R, López-Escobar A, Bermejo CL, Núñez-Cortés JM, Santos JMA, Huelgas RG, Corbella X, Pérez FF, Homs N, Montero A, Mora-Luján JM, Rubio-Rivas M, Bandera VA, Alegría JG, Jiménez-García N, del Pino JL, Escalante MDM, Romero FN, Rodriguez VN, Sierra JO, de Blas PA, Cañas CA, Ayuso B, Morejón JB, Escudero SC, Frías MC, Tejido SC, de Miguel Campo B, Pedroche CD, Simon RD, Reyne AG, Veganzones LI, Huerta LJ, Blanco AL, Gonzalo JL, Lora-Tamayo J, Bermejo CL, de la Calle GM, Godoy RM, Perpiña BO, Ruiz DP, Fernández MS, Montes JT, Suárez AMÁ, Vergés CD, Martínez RFM, Aizpuru EMF, Carrasco AG, Amezua CH, Caleya JFL, Martínez DL, del Mar Martínez López M, Zapico AM, Iscar CO, Casado LP, Martínez MLT, Chamorro LMT, Casas LA, de Oña ÁA, Beato RA, Gonzalo LA, Muñoz JA, Oblitas CMA, García CA, Cebrián MB, Corral JB, Guerrero MB, Estrada ADB, Moreno MC, Fernández PC, Carrillo R, Pérez SC, Muñoz EC, Moreno ADC, Carvajal MCC, de Santos S, Gómez AE, Carracedo EF, Jenaro MMFM, Valle FG, Garcia A, Fernandez-Bravo IG, Leoni MEG, Antúnez MG, Narciso CGS, Gurjian AA, Ibáñez LJ, Olleros CL, Mendo CL, García SL, Jimeno VM, Nohales CM, Núñez-Cortés JM, Ledesma SM, Míguez AM, Delgado CM, Ortega LO, Sánchez SP, Virto AP, Sanz MTP, Llorente BP, Ruiz SP, Fernández-Llamazares GS, Macías MT, Samaniego NT, do Rego AT, Garcia MVV, Villarreal G, Etayo MZ, Lara RA, Fernandez IC, García JCC, García García GM, Granados JG, Sánchez BG, Periáñez FJM, Perez MJP, Pérez JLB, Méndez MLS, Rivera NA, Vieitez AC, del Corral Beamonte E, Manglano JD, Mera IF, del Mar Garcia Andreu M, Aseguinolaza MG, Lezaun CG, Laorden CJ, Murgui RM, Sanz MTM, Ayala-Gutiérrez MM, López RB, Fonseca JB, Buonaiuto VA, Martínez LFC, Palacios LC, Muriel CC, de Windt F, Christophel ATFT, Ocaña PG, Huelgas RG, García JG, Oliver JAH, Jansen-Chaparro S, López-Carmona MD, Quirantes PL, Sampalo AL, Lorenzo-Hernández E, Sevilla JJM, Carmona JM, Pérez-Belmonte LM, de Pedro IP, Pineda-Cantero A, Gómez CR, Ricci M, Cánovas JS, Troncoso JÁ, Fernández FA, Quintana FB, Arenzana CB, Molina SC, Candalija AC, Bengoa GD, de Gea Grela A, de Lorenzo Hernández A, Vidal AD, Capitán CF, Iglesias MFG, Muñoz BG, Gil CRH, Martínez JMH, Hontañón V, Hernández MJJ, Lahoz C, Calvo CM, Gutiérrez JCM, Prieto MM, Robles EM, Saldaña AM, Fernández AM, Prieto JMM, Mozo AN, López CMO, Peláez EP, Pampyn MP, Simón MAQ, Ramos Ramos JC, Ruperto LR, Purificación AS, Bueso TS, Torre RS, Abanedes CIS, Tabares YU, Mayoral MV, Manau JV, del Carmen Beceiro Abad M, Romero MAF, Castro SM, Guillan EMP, Nuñez MP, Fontan PMP, de Larriva APA, Espinal PC, Lista JD, Fuentes-Jiménez F, del Carmen Guerrero Martínez M, Vázquez MJG, Torres JJ, Pérez LL, López-Miranda J, Piedra LM, Orge MM, Vinagre JP, Pérez-Martinez P, Vílchez MER, Martínez AR, Cabrera JLR, Torres-Peña JD, Tomás MA, Balaz D, Tur DB, Navarro RC, Pérez PC, Redondo JC, White ED, Espínola ME, Del Barrio LE, Atiénzar PJE, Cervera CG, Núñez DFG, Navarro FG, Galvañ VG, Uranga AG, Martínez JG, Isasi IH, Villar LL, Sempere VM, Cruz JMN, Fernández SP, García JJP, Pleguezuelos RP, Pérez AR, Ripoll JMS, Mira AS, Wikman-Jorgensen P, Ayllón JAA, Artero A, del Mar Carmona Martín M, Valls MJF, de Mar Fernández Garcés M, Belda ABG, Cruz IL, López MM, Sanchis EM, Gandia JM, Roger LP, Belmonte AMP, García AV, Eisenhofer AA, Milla AA, Pérez IB, Gutiérrez LB, Garay JB, Parra JC, Díaz AC, Da Silva EC, Hernández MC, Díaz RC, Sánchez MJC, Gozalo CC, Martínez VCM, Doblado LD, de la Fuente Moral S, de Santiago AD, Yagüe ID, Velasco ID, Duca AM, del Campo PD, López GE, Palomo EE, Cruz AF, Gómez AG, Prieto SG, Revilla BG, Viejo MÁG, Irusta JG, Merino PG, Abreu EVG, Martín IG, Rojas ÁG, Villanueva AG, Jiménez JH, Estéllez FI, del Estal PL, Sáiz MCM, de Mendoza Fernández C, Urbistondo MM, Vera FM, Seirul-lo MM, Pita SM, Sánchez PAM, Hernández EM, Vargas AM, Concha VMT, De La Torre IM, Rubio EM, de Benito RM, Serrano AM, Palomo PN, Pascual IP, Martín-Vegue AJR, Martínez AR, Olleros CR, Montaud AR, Pizarro YR, García SR, de Domingo DR, Ortiz DS, Chica ES, Almena IS, Martin ES, Chen YT, de Ureta PT, Alijo ÁV, Comendador JMV, Núñez JAV, Yeguas IA, Gómez JA, Cuchillo JB, López IB, Clotet NC, Elías AEC, Manuel EC, de Luque CMC, Benbunan CC, Vilan LD, Hernández CD, Peralta EED, Pérez VE, Fernandez-Castelao S, Saavedra MOF, Klepzig JLG, del Rosario Iguarán Bermúdez M, Ferrer EJ, Rodríguez AM, de Pedro AM, Sánchez RÁM, Bailón MM, Álvarez SM, Orantos MJN, Mata CO, García EO, Mata DO, González CO, Perez-Somarriba J, Mateos PP, Muñoz MER, Regaira XR, Gallardo LMR, Fornie IS, Botrán AS, Robles MS, Urbano ME, González AMV, Martínez MV, Monge Monge D, Pasos EMF, García AV, Comet LS, Giménez LL, Samper UA, Repiso GA, Bruñén JMG, Barrio ML, Martínez MAC, Igual JJG, Fenoll RG, García MA, Monge EA, Rodríguez JÁ, Varela CA, Gòdia MB, Molina MB, Vega MB, Curbelo J, de las Heras Moreno A, Godoy ID, Alvarez ACE, Martín-Caro IF, López-Mosteiro AF, Marquez GG, Blanco MJG, del Álamo Hernández YG, Encina CGR, González NG, Rodríguez CG, Martín NLS, Báez MM, Delgado CM, Caballero PP, Serrano JP, Rodríguez LR, Cortés PR, Franco CR, Roy-Vallejo E, Vega MR, Lloret AS, Moreno BS, Alba MS, Ballesteros JS, Somovilla A, Fernández CS, Tirado MV, Marti AV, Pareja JFP, Fraile IP, Blanco AM, del Castillo Cantero R, López JLV, Lorite IR, Martínez RF, García IS, Rangel LS, Álvarez AA, Juarros OA, López AA, Castiñeira CC, Calviño AC, Sánchez MC, Varela RF, Castro SJF, Trigo AP, Jarel RP, Varea FR, Freán IR, Alonso LR, Pensado FJS, Porto DV, Saavedra CC, Gómez JF, López BG, Garrido MSH, Amorós AIL, Gil SL, de los Reyes Pascual Pérez M, Perea NR, García AT, Lobo JA, Casanovas LF, Amigo JL, Fernández MM, Bermúdez IO, Fernández MP, Rhyman N, Piqueras NV, Pedrajas JNA, García AM, Vargas I, Jiménez IA, González MC, Cobos-Siles M, Corral-Gudino L, Cubero-Morais P, Fernández MG, González JPM, Dehesa MP, Espinosa PS, Blanco SC, Gamboa JOM, Mosteiro CS, Asiain AS, Santos JMA, Barrera ABB, Vela BB, Muiño CB, Fernández CB, Hernáiz RC, López IC, Rojo JMC, Troncoso AC, Romano PC, Deodati F, Santiago AE, Sánchez GGC, Guijarro EG, Sánchez FJG, de la Torre PG, de Guzmán García-Monge M, Luordo D, González MM, Bermejo JAM, Valverde CP, Quero JLP, Rojas FR, García LR, Gonzalo ES, Muñoz FJT, de la Sota JV, Martínez JV, Gómez MG, Sánchez PR, Gonzalez GA, Iraurgi AL, Arostegui AA, Martínez PA, Fernández IMP, Becerro EM, Jiménez AI, Núñez CV, López MA, López EG, Losada MSA, Estévez BR, Muñoz AMA, Fernández MB, Cano V, Moreno RC, Garcia-Tenorio FC, Nájera BDT, González RE, Butenegro MPG, Díez AG, Caverzaschi VG, Pedraza PMG, Moraleja JG, Carvajal RH, Aranda PJ, González RL, Caparachini ÁL, Castañeyra PL, Ancin AL, Garcia JDM, Romero CM, Saiz MJM, Moríñigo HM, Nicolás GM, Platon EM, Oliveri F, Ortiz Ortiz E, Rafael RP, Galán PR, Berrocal MAS, de Ávila VSR, Sierra PT, Aranda YU, Clemente JV, Bergua CY, de la Peña Fernández A, Milián AH, Manrique MA, Erdozain AC, Ruiz ALI, Luque FJB, Carrasco-Sánchez FJ, de-Sousa-Baena M, Leal JD, Rubio AE, Huertas MF, Bravo JAG, Macías AG, Jiménez EG, Jiménez AH, Quintero CL, Reguera CM, Marcos FJM, Beamud FM, Pérez-Aguilar M, Jiménez AP, Castaño VR, dedel AlcazarRío AS, Ruiz LT, González DA, de Zabalza IAP, Hernández SA, Sáenz JC, Dendariena B, del Mazo MG, de Narvajas Urra IM, Hernández SM, Fernández EM, Somovilla JLP, Pejenaute ER, Rodríguez-Solís JB, Osorio LC, del Pilar Fidalgo Montero M, Soriano MIF, Rincón EEL, Hermida AM, Carrilero JM, Santiago JÁP, Robledo MS, Rojas PS, Yebes NJT, Vento V, Vaca LFA, Arnanz AA, García OA, González MB, Sanz PB, Llisto AC, de Pedro Baena S, Del Hoyo Cuenda B, Fabregate-Fuente M, Osorio MAG, Sánchez IG, García AG, Cisneros OAL, Manzano L, Martínez-Lacalzada M, Ortiz BM, Rey-García J, González ER, Díaz CS, Fajardo GS, Carantoña CS, Viteri-Noël A, Zhilina Zhilina S, Claudio GMA, Rodríguez VB, Muñoz CC, Pérez AC, Orbes MVC, Sánchez DE, Revuelta SI, Martín MM, González JIM, Oterino JÁM, Alonso LM, Balbuena SP, García MLP, Prados AR, Rodríguez-Alonso B, Alegría ÁR, Ledesma MS, Pérez RJT, Encinar JCB, Cilleros CM, Martínez IJ, Delange TG, González RF, Noya AG, Ceron CH, Avanzini II, Diez AL, Mato PL, Vizcaya AML, Benítez DP, Zemsch MMP, Expósito LP, Bar MP, González LR, Lara LR, Cabañero D, Ballester MC, Fernández PC, Sánchez RG, Escrig MJ, Amela CM, Gómez LP, Navarro CP, Parra JAT, de Almeida CT, Villarejo MEF, Calvo VP, Otero SP, López BG, Frías CA, Romero VM, Pérez LA, Velado EM, González RA, Boixeda R, Fernández Fernández J, Mármol CL, Navarro MP, Guzmán AR, Fustier AS, Castro JL, Reboiro MLL, González CS, Sala ER, Izuel JMP, Zamrani ZK, Diaz HA, Lopez TD, Pego EM, Pérez CM, Ferro AP, Trigo SS, Sambade DS, Ferrin MT, del Carmen Vázquez Friol M, Maneiro LV, Rodríguez BC, Espartero MEG, Rivas LM, de la Sierra Navas Alcántara M, Tirado-Miranda R, Marquínez MNS, García VA, Suárez DB, Arenas NG, García PM, Copa DC, García AÁ, Álvarez JC, Calderón MJM, Noriega RG, Rubia MC, García JL, Martínez LT, Celeiro JF, Aguilar DEO, Riesco IM, Bécares JV, Mateos AB, García AAT, Casamayor JD, Silvera DG, Díaz AA, Carballo CH, Tejera A, Prieto MJM, Muñoz MBM, Del Arco Delgado JM, Díaz DR, Feria MB, Herrera Herrera FJ, de la Luz Padilla Salazar M, Luis RH, Ledezma EMC, del Mar López Gámez M, Hernández LT, Pérez SC, García SGA, Gainett GC, Hidalgo AG, Daza JM, Peraza MH, Santos RA, Bernabeu-Wittel M, Suárez SR, Nieto M, Miranda LG, Mancera RMG, Torre FE, Quiles CH, Guzmán CC, de la Cuesta JD, Vega JET, del Carmen López Ríos M, Jiménez PD, Franco BB, de Juan CJ, Rivero SG, Tenllado JL, Lara VA, Estrada AG, Ena J, Segado JEG, Ferrer RG, Lorenzo VG, Arroyo RM, García MG, Hernández FJV, González ÁLM, Montes BV, Die RMG, Molinero AM, Regidor MM, Díez RR, Sierra BH, García LFD, Acedo IEA, Cano CMS, García VH, Bernal BR, Jiménez JC, Bazán EC, Reniu AC, Grabalosa JR, Solà JF, De Boulle IC, Xancó CG, Núñez OR, Ripper CJ, Gutiérrez AG, Trallero LER, Novo MFA, Lecumberri JJN, Ruiz NP, Riancho J, García IS, Baena PC, Sevilla JE, Padilla LG, Ronquillo PG, Bustos PG, Botías MN, Taboada JR, Rodríguez MR, Alvarez VA, Suárez NM, Suárez SR, Díaz SS, Pérez LS, Gómez MF, Castaño CM, Rodríguez LM, Vázquez C, Estévanez IC, Gutiérrez CY, Sela MM, Cosío SF, Álvaro CMG, García JL, Piñeiro AP, Viera YC, Rodríguez LC, de Juan Alvarez C, Benitez GF, Escudero LG, Torres JM, Escriche PM, Canteli SP, Pérez MCR, Soler JA, Remolar MB, Álvarez AC, Carlotti DD, Gimeno MJE, Juana SF, López PG, Soler MTG, de la Sota DP, Castellanos GP, Catalán IP, Martí CR, Monzó PR, Padilla JR, Gaya NT, Blasco JU, Pascual MAM, Vidal LJ, Conesa AA, Rivas MCA, Alsina MH, Romero JM, Diez-Canseco AMU, Martínez FA, Vásquez EA, Stablé JCE, Belmonte AH, Peiró AM, Goñi RM, Castellanos MCP, Belda BS, Navarro DV, Lombraña AS, Ugartondo JC, Plaza ABM, Asensio AN, Alves BP, López NV, Téllez ML, Epelde F, Torrente I, Vasco PG, Santacruz AR, Muñoz AV, Giner MJE, Calvo-Sotelo AE, Sardón EG, González JG, Salazar LG, Garcia AA, Días IM, Gomez AS, Matos MC, Gaspar SN, Nieto AG, Méndez RG, Álvarez AR, Hernández OP, Ramírez AP, González MCM, Lorite MNN, Navarrete LG, Negrin JCA, González JFA, Jiménez I, Toledo PO, Ponce EM, Torres XTE, González SG, Fernández CN, Gómez PT, Gisbert OA, Llistosella MB, Casanova PC, Flores AG, Hinojo AG, Martínez AIM, del Carmen Nogales Nieves M, Austrui AR, Cervantes AZ, Castro VA, Lomba AMB, Aparicio RB, Morales MF, Villar JMF, Monteagudo MTL, García CP, Ferreira LR, Llovo DS, Feijoo MBV, Romero JAM, de Albornoz JLSC, Pérez MJS, Martín ES, Astrua TC, Giraldo PTG, Juárez MJG, Fernandez VM, Echevarry AVR, Arche JFV, Rivero MGR, Martínez AM, Bernad RV, Limia C, Fernández CA, Fernández AT, Fajardo LP, de Vega Santos T, Ruiz AL, Míguez HM. Validation of the RIM Score-COVID in the Spanish SEMI-COVID-19 Registry. Intern Emerg Med 2023; 18:907-915. [PMID: 36680737 PMCID: PMC9862219 DOI: 10.1007/s11739-023-03200-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/09/2023] [Indexed: 01/22/2023]
Abstract
The significant impact of COVID-19 worldwide has made it necessary to develop tools to identify patients at high risk of severe disease and death. This work aims to validate the RIM Score-COVID in the SEMI-COVID-19 Registry. The RIM Score-COVID is a simple nomogram with high predictive capacity for in-hospital death due to COVID-19 designed using clinical and analytical parameters of patients diagnosed in the first wave of the pandemic. The nomogram uses five variables measured on arrival to the emergency department (ED): age, sex, oxygen saturation, C-reactive protein level, and neutrophil-to-platelet ratio. Validation was performed in the Spanish SEMI-COVID-19 Registry, which included consecutive patients hospitalized with confirmed COVID-19 in Spain. The cohort was divided into three time periods: T1 from February 1 to June 10, 2020 (first wave), T2 from June 11 to December 31, 2020 (second wave, pre-vaccination period), and T3 from January 1 to December 5, 2021 (vaccination period). The model's accuracy in predicting in-hospital COVID-19 mortality was assessed using the area under the receiver operating characteristics curve (AUROC). Clinical and laboratory data from 22,566 patients were analyzed: 15,976 (70.7%) from T1, 4,233 (18.7%) from T2, and 2,357 from T3 (10.4%). AUROC of the RIM Score-COVID in the entire SEMI-COVID-19 Registry was 0.823 (95%CI 0.819-0.827) and was 0.834 (95%CI 0.830-0.839) in T1, 0.792 (95%CI 0.781-0.803) in T2, and 0.799 (95%CI 0.785-0.813) in T3. The RIM Score-COVID is a simple, easy-to-use method for predicting in-hospital COVID-19 mortality that uses parameters measured in most EDs. This tool showed good predictive ability in successive disease waves.
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Affiliation(s)
| | - Paula Sol Ventura
- Fundacio Institut d’Investigacio en Ciències de La Salut Germans Trias I Pujol (IGTP), 08916 Badalona, Spain
| | - José-Manuel Casas-Rojo
- Internal Medicine Department, Infanta Cristina University Hospital, Parla, 28981 Madrid, Spain
| | - Marc Mauri
- Data Scientist, Kaizen AI, Barcelona, Spain
| | | | | | - Manuel Rubio-Rivas
- Department of Internal Medicine, Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | | | - Vicente Giner-Galvañ
- Internal Medicine Department. Hospital, Clínico Universitario de Sant Joan d’Alacant, Alicante, Spain
| | | | | | - Luis Manzano
- Internal Medicine Department, Ramón y Cajal University Hospital, Madrid, Spain
| | | | | | | | | | | | | | | | | | | | - Ricardo Gómez-Huelgas
- Internal Medicine Department, Regional University Hospital of Málaga, Biomedical Research Institute of Málaga (IBIMA), University of Málaga (UMA), Málaga, Spain
| | - Alejandro López-Escobar
- Pediatrics Department, Clinical Research Unit, Hospital Universitario Vithas Madrid La Milagrosa, Fundación Vithas. Madrid, Madrid, Spain
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García AG, Fabregate M, Manzano L, Guillén del Castillo A, Rivas MR, Argibay A, Ballvé AM, Pintó IR, Salas XP, Marí-Alfonso B, Moraga EC, Argüelles DC, Comet LS, González-Echávarri C, Ortego-Centeno N, Hitos JAV, Parra JAT, Martínez LT, Marín MTH, Freire M, Chamorro AJ, Fraile IP, Vuelta ABM, Trigo SS, Vilella CT, Pla VF, Aznar CPS. Left Ventricular Diastolic Dysfunction in Systemic Sclerosis: Clinical, immunological and survival differences in the Spanish RESCLE Registry. Semin Arthritis Rheum 2022; 55:152033. [DOI: 10.1016/j.semarthrit.2022.152033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/07/2022] [Accepted: 05/24/2022] [Indexed: 11/15/2022]
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Rubio-Rivas M, Corbella X, Guillén-Del-Castillo A, Tolosa Vilella C, Colunga Argüelles D, Argibay A, Vargas Hitos JA, Todolí Parra JA, González-Echávarri C, Ortego-Centeno N, Trapiella Martínez L, Rodríguez Carballeira M, Marín Ballvé A, Pla Salas X, Perales Fraile I, Chamorro AJ, Madroñero Vuelta AB, Freire M, Ruiz Muñoz M, González García A, Pons Martín Del Campo I, Sánchez García ME, Bernal Bello D, Espinosa G, García Hernández FJ, Sáez Comet L, Ríos Blanco JJ, Fernández de la Puebla Giménez RÁ, Sánchez Trigo S, Fonollosa Pla V, Simeón Aznar CP. Corrigendum to 'Spanish scleroderma risk score (RESCLESCORE) to predict 15-year all-cause mortality in scleroderma patients at the time of diagnosis based on the RESCLE cohort: Derivation and internal validation' [AUTREV 19-5 (2020) 102507]. Autoimmun Rev 2021; 20:102793. [PMID: 33766615 DOI: 10.1016/j.autrev.2021.102793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Manuel Rubio-Rivas
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Corbella
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Group of Evaluation of Health Determinants and Health Policies, Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alfredo Guillén-Del-Castillo
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carles Tolosa Vilella
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - Dolores Colunga Argüelles
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ana Argibay
- Unit of Systemic Autoimmune Diseases and Thrombosis, Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | | | - Cristina González-Echávarri
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain
| | - Norberto Ortego-Centeno
- Inst Invest Biosanitaria Ibs Granada, Department of Internal Medicine, Unit of Systemic Autoimmune Diseases, Department of Medicine, Facultad de Medicina, Hospital Universitario San Cecilio, Granada, Spain
| | - Luis Trapiella Martínez
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Hospital de Cabueñes, Gijón, Asturias, Spain
| | | | - Adela Marín Ballvé
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Xavier Pla Salas
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Consorci Hospitalari de Vic, Vic, Barcelona, Spain
| | - Isabel Perales Fraile
- Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Antonio-J Chamorro
- Department of Internal Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Mayka Freire
- Department of Internal Medicine, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Manuel Ruiz Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | | | | | - David Bernal Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain
| | | | - Luis Sáez Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Juan José Ríos Blanco
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Rafael Ángel Fernández de la Puebla Giménez
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Group of Evaluation of Health Determinants and Health Policies, Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sabela Sánchez Trigo
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Vicent Fonollosa Pla
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Pilar Simeón Aznar
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Iniesta Arandia N, Espinosa G, Tolosa Vilella C, Guillén Del Castillo A, Rubio Rivas M, Freire M, Vargas Hitos JA, Todolí Parra JA, Rodríguez Carballeira M, Marín Ballvé A, Colunga Argüelles D, González de Echávarri Pérez de Heredia C, Ortego-Centeno N, Trapiella Martínez L, Pla Salas X, Chamorro AJ, Perales Fraile I, Ruiz Muñoz M, Fernández de la Puebla Giménez RÁ, Madroñero Vuelta AB, Pons Martín Del Campo I, Jiménez Pérez de Heredia I, González García A, Fonollosa Pla V, Simeón Aznar CP. Serodiscordant patients with systemic sclerosis: when antibody does not correspond to skin involvement. Clin Exp Rheumatol 2020; 38 Suppl 125:106-114. [PMID: 31969223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 09/26/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Diffuse cutaneous systemic sclerosis (dcSSc) is associated with anti-topoisomerase (ATA) whereas limited cutaneous (lcSSc) and sine scleroderma (ssSSc) are mainly associated with anti-centromere antibody (ACA). Serodiscordant patients were defined as lcSSc subjects with ATA, dcSSc with ACA, and ssSSc with ATA. The aim of the present study was to compare the clinical manifestations and prognosis between serodiscordant patients and their counterparts (those with lcSSc with ACA, dcSSc with ATA and ssSSc with ACA, respectively). METHODS From the Spanish Scleroderma Registry we selected those patients for whom skin involvement (dcSSc, lcSSc or ssSSc) was detailed at baseline and last visit and ACA and ATA had been determined. Demographic, clinical characteristics, and survival data were compared according to the antibody status. RESULTS The whole cohort comprised 901 patients and six mutually exclusive groups were defined: lcSScACA in 511 (57%) patients, lcSScATA group in 87 (10%), dcSScATA group in 172 (19%), dcSScACA group in 21 (2%), ssSScACA group in 92 (10%), and ssSScATA group in 18 (2%) patients, respectively. Interstitial lung disease (ILD) and severe ILD were more frequent in patients with dcSScATA than in those with dcSScACA. Conversely, the prevalence of isolated pulmonary hypertension (without ILD) was higher in those with dcSScACA (15% vs. 2%; p=0.018). No differences were found regarding survival when comparing serodiscordant patients with the seroconcordants patients. CONCLUSIONS In our cohort, the prevalence of serodiscordant SSc patients was low. They differed from their counterparts in some clinical manifestations. The management of patients with SSc should be guided by both serology and cutaneous subtype.
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Affiliation(s)
- Nerea Iniesta Arandia
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Spain
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatologia, Hospital Clínic, Barcelona, Spain.
| | - Carles Tolosa Vilella
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Manuel Rubio Rivas
- Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Mayka Freire
- Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Spain
| | | | | | | | - Adela Marín Ballvé
- Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | | | - Norberto Ortego-Centeno
- Systemic Autoimmune Diseases Unit, Hospital Campus de la Salud, Complejo Universitario de Granada, Spain
| | | | - Xavier Pla Salas
- Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain
| | | | - Isabel Perales Fraile
- Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Manuel Ruiz Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | | | | | | | | | | | - Vicent Fonollosa Pla
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Pilar Simeón Aznar
- Autoimmune Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Rubio-Rivas M, Corbella X, Guillén-Del-Castillo A, Tolosa Vilella C, Colunga Argüelles D, Argibay A, Vargas Hitos JA, Todolí Parra JA, González-Echávarri C, Ortego-Centeno N, Trapiella Martínez L, Rodríguez Carballeira M, Marín Ballvé A, Pla Salas X, Perales Fraile I, Chamorro AJ, Madroñero Vuelta AB, Freire M, Ruiz Muñoz M, González García A, Pons Martín Del Campo I, Sánchez García ME, Bernal Bello D, Espinosa G, García Hernández FJ, Sáez Comet L, Ríos Blanco JJ, Fernández de la Puebla Giménez RÁ, Sánchez Trigo S, Fonollosa Pla V, Simeón Aznar CP. Spanish scleroderma risk score (RESCLESCORE) to predict 15-year all-cause mortality in scleroderma patients at the time of diagnosis based on the RESCLE cohort: Derivation and internal validation. Autoimmun Rev 2020; 19:102507. [PMID: 32194200 DOI: 10.1016/j.autrev.2020.102507] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 12/17/2019] [Indexed: 01/06/2023]
Abstract
A few scores predicting the short-term risk of mortality in Systemic sclerosis (SSc) have been reported to date. Our study aimed to create a predictive 15-year all-cause mortality score at the time of the diagnosis of SSc. The study was based on the Spanish Scleroderma Registry (RESCLE). The cohort was split up in derivation (DC) and validation cohort (VC). A multivariate analysis to detect variables related to all-cause mortality within the first 15 years from SSc diagnosis was performed, assigning points to the rounded beta values to create the score (RESCLESCORE). 1935 SSc patients were included. The variables in the final model were as follows: age at diagnosis (+2 points > 65 years-old), male gender (+1 point), lcSSc subset (-1 point), mode of onset other than Raynaud's (+1 point), cancer (+1 point) and visceral involvement, such as ILD (+1 point), PAH (+1 point), heart (+1 point) and renal involvement (+2 points). Autoantibodies did not achieve statistical significance in the multivariate analysis. The 3 categories of risk to predict 15-year all-cause mortality at the time of diagnosis were as follows: low risk (5% vs. 7%, p = .189), intermediate risk (26.5% vs. 25.5%, p = .911) and high risk (47.8% vs. 59%, p = .316). The AUC was 0.799 (DC) vs. 0.778 (VC) (p = .530). In conclusion, the RESCLESCORE demonstrated an excellent ability to categorize SSc patients at the time of diagnosis in separate 15-year all-cause mortality risk strata at the time of diagnosis.
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Affiliation(s)
- Manuel Rubio-Rivas
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Xavier Corbella
- Autoimmune Diseases Unit, Department of Internal Medicine, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Group of Evaluation of Health Determinants and Health Policies, Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Alfredo Guillén-Del-Castillo
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carles Tolosa Vilella
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | - Dolores Colunga Argüelles
- Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
| | - Ana Argibay
- Unit of Systemic Autoimmune Diseases and Thrombosis, Department of Internal Medicine, Complejo Hospitalario Universitario de Vigo, Vigo, Pontevedra, Spain
| | | | | | - Cristina González-Echávarri
- Autoimmune Diseases Research Unit, Department of Internal Medicine, Biocruces Bizkaia Health Research Institute, Hospital Universitario Cruces, University of the Basque Country, Barakaldo, Spain
| | - Norberto Ortego-Centeno
- Inst Invest Biosanitaria Ibs Granada, Department of Internal Medicine, Unit of Systemic Autoimmune Diseases, Department of Medicine, Facultad de Medicina, Hospital Universitario San Cecilio, Granada, Spain
| | - Luis Trapiella Martínez
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Hospital de Cabueñes, Gijón, Asturias, Spain
| | | | - Adela Marín Ballvé
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Xavier Pla Salas
- Unit of Systemic Autoimmune Diseases, Department of Internal Medicine, Consorci Hospitalari de Vic, Vic, Barcelona, Spain
| | - Isabel Perales Fraile
- Department of Internal Medicine, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, Spain
| | - Antonio-J Chamorro
- Department of Internal Medicine, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | | | - Mayka Freire
- Department of Internal Medicine, Hospital Clínico Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
| | - Manuel Ruiz Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | | | | | - David Bernal Bello
- Department of Internal Medicine, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, Spain
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain
| | | | - Luis Sáez Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | | | - Sabela Sánchez Trigo
- Department of Internal Medicine, Complejo Hospitalario Universitario de Ferrol, Ferrol, A Coruña, Spain
| | - Vicent Fonollosa Pla
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Carmen Pilar Simeón Aznar
- Unit of Autoimmune Diseases, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
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Iniesta Arandia N, Simeón-Aznar CP, Guillén Del Castillo A, Colunga Argüelles D, Rubio-Rivas M, Trapiella Martínez L, García Hernández FJ, Sáez Comet L, Egurbide Arberas MV, Ortego-Centeno N, Freire M, Marí Alfonso B, Vargas Hitos JA, Ríos Blanco JJ, Todolí Parra JA, Rodríguez-Carballeira M, Marín Ballvé A, Chamorro Fernández AJ, Pla Salas X, Madroñero Vuelta AB, Ruiz Muñoz M, Fonollosa Pla V, Espinosa G. Influence of antibody profile in clinical features and prognosis in a cohort of Spanish patients with systemic sclerosis. Clin Exp Rheumatol 2017; 35 Suppl 106:98-105. [PMID: 28980912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/01/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To assess the clinical manifestations and prognosis of Spanish patients with systemic sclerosis (SSc) according to their immunological profile. METHODS From the Spanish Scleroderma Study Group or RESCLE (Registro de ESCLErodermia as Spanish nomenclature) Registry we selected those patients in which anti-centromere (ACA), anti-topoisomerase I (ATA), and anti-RNA polymerase III (ARA) antibodies had been determined, and a single positivity for each SSc specific antibody was detected. Demographic, clinical, laboratory, and survival data were compared according to the serologic status of these antibodies. RESULTS Overall, 209 SSc patients were included. In 128 (61%) patients ACA was the only positive antibody, 46 (22%) were only positive for ATA, and 35 (17%) for ARA. Of note, the three groups were mutually exclusive. In univariate analysis, patients with ACA presented more frequently limited cutaneous SSc (lcSSc) (p<0.001), whereas diffuse cutaneous SSc (dcSSc) was the most frequent subtype in patients with ATA (54%) and ARA (62%) (both p<0.001). Positive patients for ARA showed the highest prevalence of joint involvement (p<0.001) and those from ATA group had a higher prevalence of interstitial lung disease (ILD) (p<0.001). Scleroderma renal crisis was more frequent in the ARA group (p<0.001). In multivariate analysis, ACA were associated with female gender and were protective for dcSSc and ILD. ATA were found to be protective for lcSSc and they were independently associated with interstitial reticular pattern. ARA positivity was independently associated with dcSSc. We did not find differences in mortality between the three groups. CONCLUSIONS In Spanish SSc patients, the presence of SSc specific antibodies conferred a distinctive clinical profile.
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Affiliation(s)
- Nerea Iniesta Arandia
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain
| | - Carmen Pilar Simeón-Aznar
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Alfredo Guillén Del Castillo
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | | | - Manuel Rubio-Rivas
- Department of Internal Medicine, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Luis Sáez Comet
- Department of Internal Medicine, Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - Norberto Ortego-Centeno
- Systemic Autoimmune Diseases Unit, Hospital Campus de la Salud, Complejo Universitario de Granada, Spain
| | - Mayka Freire
- Thrombosis and Vasculitis Unit, Department of Internal Medicine, Complexo Hospitalario Universitario de Vigo, Spain
| | - Begoña Marí Alfonso
- Department of Internal Medicine, Corporación Sanitaria Universitaria Parc Taulí, Sabadell, Barcelona, Spain
| | | | | | | | | | - Adela Marín Ballvé
- Department of Internal Medicine, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | | | - Xavier Pla Salas
- Department of Internal Medicine, Consorci Hospitalari de Vic, Barcelona, Spain
| | | | - Manuel Ruiz Muñoz
- Department of Internal Medicine, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - Vicent Fonollosa Pla
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Gerard Espinosa
- Department of Autoimmune Diseases, Institut Clinic de Medicina i Dermatología, Hospital Clínic, Barcelona, Spain.
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