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Vol. 7. Issue 1.
Pages 47-55 (March 2006)
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Vol. 7. Issue 1.
Pages 47-55 (March 2006)
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Espondiloartropatías indiferenciadas
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Iñaki Hernando-Rubio, Alberto Alonso-Ruiz
Servicio de Reumatología. Hospital de Cruces. Baracaldo. Vizcaya. España
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Resumen

Las espondiloartropatías constituyen una familia heterogénea de enfermedades articulares inflamatorias crónicas (espondilitis anquilosante, artritis reactiva, artritis psoriásica, artritis asociada a enfermedad inflamatoria intestinal y espondiloartropatía juvenil). Los pacientes que no cumplen los criterios diagnósticos establecidos para las distintas entidades del grupo, pero sí presentan unos rasgos comunes que las identifican con las espondiloartropatías reciben el diagnóstico de espondiloartropatía indiferenciada. Para ello deben cumplir los criterios propuestos por Amor o por el Grupo Europeo para el Estudio de las Espondiloartropatías. El espectro de manifestaciones clínicas de estos pacientes, su gravedad y su pronóstico son muy variables. Pueden presentar un síndrome pelvirraquídeo, una oligoartritis generalmente asimétrica con afección predominante en extremidades inferiores, una entesopatía y manifestaciones cutáneas, oftalmológicas, cardiopulmonares y renales. Algunos pacientes con espondiloartropatía indiferenciada evolucionan a formas definidas de espondiloartropatía, mientras que otros permanecen como una forma indiferenciada durante años. A los pacientes con espondiloartropatía indiferenciada se trata con antiinflamatorios no esteroideos, glucocorticoides, sulfasalazina y metotrexato. Estudios recientes han arrojado resultados prometedores acerca del papel de los fármacos anti-TNFα.

Palabras clave:
Espondiloartropatía indiferenciada
Espondilitis anquilosante
Artritis psoriásica
Abstract

The spondyloarthropathies are a heterogeneous group of chronic inflammatory diseases of the joints (ankylosing spondylitis, reactive arthritis, psoriatic arthritis, arthritis associated with inflammatory bowel disease and spondyloarthropathy in children). The patients that do not fulfill the diagnostic criteria established for the different entities of the group, but they present common features that identify them with the spondyloarthropathies. They are called undifferentiated spondyloarthropaty. For diagnosis they must fulfill the criteria proposed by Amor or by the European Group for the Study of the Spondyloarthropathies. The spectrum of clinical manifestations of these patients, the severity and prognosis is very changeable. They can present inflammatory spine pain, peripheral asymmetric arthritis predominant in low extremities, cutaneous and mucosal lesions, inflammatory eye disease, cardiovascular complications and amyloidosis. Some patients with undifferentiated spondyloarthropaty evolve to spondyloarthropathies definite forms, while others remain as a form undifferentiated for years. The patients with undifferentiated spondyloarthropaty are treated with nonsteroidal antiinflammatory drugs, glucocorticoids, sulfasalazine and methotrexate. Recent studies have given promising results with tumor necrosis factor alfa blocking agents.

Key words:
Unddiferentiated spondyloarthropathy
Ankylosing spondylitis
Psoriatic arthritis
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Copyright © 2006. Sociedad Española de Reumatología
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