Resumo

JAGUA GUALDRONZ, Andrés. Alternative medicine as treatment of osteoarthritis and rheumatoid arthritis. Systematic review of literature and meta-analysis. Rev.Colomb.Reumatol. [online]. 2012, vol.19, n.4, pp.234-244. ISSN 0121-8123.

Introduction: Different series have found that rituximab is effective and safe in thrombocytopenia and autoimmune hemolytic anemia in children, however studies in early onset systemic lupus erythematosus (SLE), juvenile dermatomyositis and vasculitis are scarce. Objective and Methods: Describe the clinical response to rituximab in patients ≤18 years with rheumatic disease, evaluated in a pediatric hospital in the city of Medellín, Colombia. Cross sectional study in which we reviewed the medical records of patients with SLE, antiphospholipid syndrome, vasculitis and juvenile dermatomyositis that receiving rituximab between january 2006 and july 2011. Results: 19 patients ≤18 years received rituximab. The most common indication was lupus nephritis (LN) (47.4%), followed by autoimmune thrombocytopenia (26.3%). In patients with LN steroids was reduced by 58% and control of proteinuria in most cases. In autoimmune hemolytic anemia and thrombocytopenia adequate response was observed in 83%. The case of vasculitis was found response to therapy and the patient with juvenile dermatomyositis was refractory. No adverse events were reported. Conclusions: improvement was observed with rituximab in SLE-associated hemolytic anemia and thrombocytopenia associated with SLE and antiphospholipid syndrome, who had not responded to first-line therapy. Although LN showed favorable clinical effect and saving allowed dose steroids, prospective studies are required to evaluate utility in patients with LN ≤18.

Palavras-chave : Complementary therapies; acupuncture; ayurvedic medicine; homeopathy; osteoarthritis; rheumatoid disease; systematic review as topic.

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