array:24 [
  "pii" => "S2173574314001762"
  "issn" => "21735743"
  "doi" => "10.1016/j.reumae.2014.12.002"
  "estado" => "S300"
  "fechaPublicacion" => "2015-05-01"
  "aid" => "733"
  "copyright" => "Elsevier España, S.L.U.. All rights reserved"
  "copyrightAnyo" => "2014"
  "documento" => "simple-article"
  "subdocumento" => "cor"
  "cita" => "Reumatol Clin. 2015;11:184"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1388
    "formatos" => array:3 [
      "EPUB" => 54
      "HTML" => 1028
      "PDF" => 306
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1699258X14002216"
      "issn" => "1699258X"
      "doi" => "10.1016/j.reuma.2014.10.010"
      "estado" => "S300"
      "fechaPublicacion" => "2015-05-01"
      "aid" => "733"
      "copyright" => "Elsevier España, S.L.U."
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Reumatol Clin. 2015;11:184"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 8760
        "formatos" => array:3 [
          "EPUB" => 155
          "HTML" => 7389
          "PDF" => 1216
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "S&#237;ndrome de fatiga cr&#243;nica y sensibilidad al gluten no cel&#237;aca&#46; Asociaci&#243;n o causa&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "184"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Chronic fatigue syndrome and non-celiac gluten sensitivity&#46; Association or cause&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Carlos Isasi Zaragoz&#225;"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Carlos"
                "apellidos" => "Isasi Zaragoz&#225;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173574314001762"
          "doi" => "10.1016/j.reumae.2014.12.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001762?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14002216?idApp=UINPBA00004M"
      "url" => "/1699258X/0000001100000003/v2_201504190227/S1699258X14002216/v2_201504190227/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S217357431400166X"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2014.09.003"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "723"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "subdocumento" => "cor"
    "cita" => "Reumatol Clin. 2015;11:185"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1409
      "formatos" => array:3 [
        "EPUB" => 80
        "HTML" => 948
        "PDF" => 381
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Response to&#58; Fibromyalgia and Chronic Fatigue Syndrome Caused by Non-celiac Gluten Sensitivity"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "185"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Respuesta a&#58; Fibromialgia y fatiga cr&#243;nica causada por sensibilidad al gluten no cel&#237;aca"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Rami Qanneta, Ramon Fontova, Antoni Castel"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Rami"
              "apellidos" => "Qanneta"
            ]
            1 => array:2 [
              "nombre" => "Ramon"
              "apellidos" => "Fontova"
            ]
            2 => array:2 [
              "nombre" => "Antoni"
              "apellidos" => "Castel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1699258X14002113"
        "doi" => "10.1016/j.reuma.2014.09.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14002113?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357431400166X?idApp=UINPBA00004M"
    "url" => "/21735743/0000001100000003/v2_201505050301/S217357431400166X/v2_201505050301/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173574314001786"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2014.12.004"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "713"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "article"
    "subdocumento" => "sco"
    "cita" => "Reumatol Clin. 2015;11:182-3"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1178
      "formatos" => array:3 [
        "EPUB" => 55
        "HTML" => 893
        "PDF" => 230
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>"
      "titulo" => "Ossifying Myositis of the Neck Muscles"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "182"
          "paginaFinal" => "183"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Miositis osificante en los m&#250;sculos del cuello"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 800
              "Ancho" => 995
              "Tamanyo" => 67789
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axial maximum intensity projection &#40;MIP&#41; showing abnormal linear calcification&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Anna P&#224;mies, Alex Samitier, Javier Rodr&#237;guez-Fern&#225;ndez, Ramon Fontova"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Anna"
              "apellidos" => "P&#224;mies"
            ]
            1 => array:2 [
              "nombre" => "Alex"
              "apellidos" => "Samitier"
            ]
            2 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Rodr&#237;guez-Fern&#225;ndez"
            ]
            3 => array:2 [
              "nombre" => "Ramon"
              "apellidos" => "Fontova"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1699258X14001703"
        "doi" => "10.1016/j.reuma.2014.08.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14001703?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001786?idApp=UINPBA00004M"
    "url" => "/21735743/0000001100000003/v2_201505050301/S2173574314001786/v2_201505050301/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S217357431400166X"
      "issn" => "21735743"
      "doi" => "10.1016/j.reumae.2014.09.003"
      "estado" => "S300"
      "fechaPublicacion" => "2015-05-01"
      "aid" => "723"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
      "documento" => "simple-article"
      "subdocumento" => "cor"
      "cita" => "Reumatol Clin. 2015;11:185"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 1409
        "formatos" => array:3 [
          "EPUB" => 80
          "HTML" => 948
          "PDF" => 381
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Response to&#58; Fibromyalgia and Chronic Fatigue Syndrome Caused by Non-celiac Gluten Sensitivity"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "185"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Respuesta a&#58; Fibromialgia y fatiga cr&#243;nica causada por sensibilidad al gluten no cel&#237;aca"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rami Qanneta, Ramon Fontova, Antoni Castel"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Rami"
                "apellidos" => "Qanneta"
              ]
              1 => array:2 [
                "nombre" => "Ramon"
                "apellidos" => "Fontova"
              ]
              2 => array:2 [
                "nombre" => "Antoni"
                "apellidos" => "Castel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S1699258X14002113"
          "doi" => "10.1016/j.reuma.2014.09.008"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14002113?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357431400166X?idApp=UINPBA00004M"
      "url" => "/21735743/0000001100000003/v2_201505050301/S217357431400166X/v2_201505050301/en/main.assets"
    ]
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Chronic Fatigue Syndrome and Non-celiac Gluten Sensitivity&#46; Association or Cause&#63;"
    "tieneTextoCompleto" => true
    "saludo" => "To the editor&#58;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "184"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Carlos Isasi Zaragoz&#225;"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Carlos"
            "apellidos" => "Isasi Zaragoz&#225;"
            "email" => array:1 [
              0 => "cisasi&#46;hpth&#64;salud&#46;madrid&#46;org"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital Puerta de Hierro&#44; Majadahonda&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "S&#237;ndrome de fatiga cr&#243;nica y sensibilidad al gluten no cel&#237;aca&#46; &#191;Asociaci&#243;n o causa&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In their letter to the editor <span class="elsevierStyleItalic">Response to&#58; Fibromyalgia and chronic fatigue caused by non-celiac gluten sensitivity</span>&#44; Qanneta et al&#46; pose a conceptual problem between the association of chronic fatigue syndrome &#40;CFS&#41; with non-celiac gluten sensitivity &#40;SGNC&#41; from the prevalent conception of considering chronic fatigue as a distinct disease&#46; From this perspective&#44; being chronic fatigue the central disease associated with other processes&#44; they consider NCGS as a comorbid condition and not as an underlying cause&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">From my point of view fibromyalgia and chronic fatigue &#40;FM&#47;CFS&#41; are not defined diseases but just syndromic terms that reflect reality&#46; In the same way that diagnosing unexplained fever is no more than describing a clinical condition for which the cause of the fever is unknown&#44; diagnosing FM&#47;CFS is to describe a symptomatic set of unknown cause&#46; Considering FM&#47;CFS as defined diseases may even have negative effects&#44; since the diagnosis seems to mean that the doctor knows what is happening to the patient&#44; when I believe it is accepting a good deal of ignorance regarding the cause in the case of the physician and resignation in the case of the patient&#46; I work based on the model considering FM&#47;FC as a syndromic description&#46; In this model&#44; various more or less complex causes&#44; which are probably interrelated&#44; and that we are beginning to understand can produce the same clinical syndrome&#46; Qanneta et al&#46; proposes classifying CFS as pure and secondary&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> I believe all CFS are secondary&#46; NCGS of course does not explain all cases of FM&#47;CFS&#44; but it is an explanation for some of the patients&#46; If the treatment of NCGS solves the FM&#47;CFS syndrome&#44; it may be reasonably said that the NCGS was the cause&#44; especially if symptomatic recurrence occurs after ingesting gluten&#46; There are other causes of FM&#47;CFS different from NGCS which may not be detected using complementary explorations&#46; For example&#44; I have had patients in which the withdrawal of statins and psychotropic drugs formally resolved the symptoms of patients diagnosed with fibromyalgia&#46; Even if the clinical manifestations have been resolved&#44; one cannot say that &#8220;then the patient had no fibromyalgia&#44;&#8221; as I do not think that the case presented had FM&#47;CFS-like symptoms but in reality had no FM&#47;CFS&#44; as stated in their letter&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Qanneta et al&#46; refer poor experiences with GFD regarding systemic symptoms of patients with chronic fatigue&#46; However we have observed a clear response of systemic symptoms&#44; including mental fatigue&#44; in fibromyalgia patients when treating NCGS&#46; More than 30&#37; of patients achieved remission of fibromyalgia or regained a normal life or went back to work or suspended treatment&#46; The following case&#44; treated during the preparation of this manuscript&#44; illustrates this relationship&#58; a 23 year old woman with 3 years since the onset of FM&#47;CFS with severe fatigue that limited daily life activities&#44; mental fatigue&#44; generalized pain&#44; headache&#44; diarrhea and oral ulcers&#46; She had been evaluated by gastroenterology&#44; rheumatology&#44; internal medicine and cardiology&#44; with multiple studies that had ruled out pathology&#44; including celiac disease&#46; HLA typing showed DQ8 and the presence of duodenal biopsy showed type 1 Marsh enteropathy and intraepithelial lymphocytosis &#40;29 CD3 lymphocytes per 100 enterocytes&#41;&#46; After one year of follow-up&#44; after starting diet without gluten or dairy&#44; she presented complete remission of all her symptoms&#44; with a normal life&#44; practicing sports and without medication&#46; She chose not to eat triggering foodstuffs&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">There may be several explanations for the observed different experience with the treatment of NCGS such as patient selection&#44; time of treatment or the treatment modality of NGCS&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; we agree that the problem of FM&#47;CFS is complex and requires multifactorial treatment&#44; but there is a clear difference in perspective from which to address the problem&#46; I prefer to dispense with the prevalent concept of FM&#47;CFS as a disease&#44; avoid the use of psychotropic drugs and seek causes that not show their faces in laboratory testing we usually perform&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Isasi Zaragoz&#225; C&#46; S&#237;ndrome de fatiga cr&#243;nica y sensibilidad al gluten no cel&#237;aca&#46; &#191;Asociaci&#243;n o causa&#63; Reumatol Clin&#46; 2015&#59;11&#58;184&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Reference"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:1 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tipolog&#237;a cl&#237;nica del s&#237;ndrome de fatiga cr&#243;nica&#58; hip&#243;tesis clasificatoria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Qanneta"
                            1 => "R&#46; Fontova"
                            2 => "M&#46;J&#46; Poveda"
                            3 => "S&#46; Castro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.reuma.2013.04.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2014"
                        "volumen" => "10"
                        "paginaInicial" => "132"
                        "paginaFinal" => "133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23849741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735743/0000001100000003/v2_201505050301/S2173574314001762/v2_201505050301/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "8400"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001100000003/v2_201505050301/S2173574314001762/v2_201505050301/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001762?idApp=UINPBA00004M"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Chronic Fatigue Syndrome and Non-celiac Gluten Sensitivity. Association or Cause?
Síndrome de fatiga crónica y sensibilidad al gluten no celíaca. ¿Asociación o causa?
Carlos Isasi Zaragozá
Servicio de Reumatología, Hospital Puerta de Hierro, Majadahonda, Spain
Read
7139
Times
was read the article
2156
Total PDF
4983
Total HTML
Share statistics
 array:24 [
  "pii" => "S2173574314001762"
  "issn" => "21735743"
  "doi" => "10.1016/j.reumae.2014.12.002"
  "estado" => "S300"
  "fechaPublicacion" => "2015-05-01"
  "aid" => "733"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;. All rights reserved"
  "copyrightAnyo" => "2014"
  "documento" => "simple-article"
  "subdocumento" => "cor"
  "cita" => "Reumatol Clin. 2015;11:184"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 1388
    "formatos" => array:3 [
      "EPUB" => 54
      "HTML" => 1028
      "PDF" => 306
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S1699258X14002216"
      "issn" => "1699258X"
      "doi" => "10.1016/j.reuma.2014.10.010"
      "estado" => "S300"
      "fechaPublicacion" => "2015-05-01"
      "aid" => "733"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Reumatol Clin. 2015;11:184"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 8760
        "formatos" => array:3 [
          "EPUB" => 155
          "HTML" => 7389
          "PDF" => 1216
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta al Editor</span>"
        "titulo" => "S&#237;ndrome de fatiga cr&#243;nica y sensibilidad al gluten no cel&#237;aca&#46; Asociaci&#243;n o causa&#63;"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "184"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Chronic fatigue syndrome and non-celiac gluten sensitivity&#46; Association or cause&#63;"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Carlos Isasi Zaragoz&#225;"
            "autores" => array:1 [
              0 => array:2 [
                "nombre" => "Carlos"
                "apellidos" => "Isasi Zaragoz&#225;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S2173574314001762"
          "doi" => "10.1016/j.reumae.2014.12.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001762?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14002216?idApp=UINPBA00004M"
      "url" => "/1699258X/0000001100000003/v2_201504190227/S1699258X14002216/v2_201504190227/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S217357431400166X"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2014.09.003"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "723"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "simple-article"
    "subdocumento" => "cor"
    "cita" => "Reumatol Clin. 2015;11:185"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1409
      "formatos" => array:3 [
        "EPUB" => 80
        "HTML" => 948
        "PDF" => 381
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Response to&#58; Fibromyalgia and Chronic Fatigue Syndrome Caused by Non-celiac Gluten Sensitivity"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "185"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Respuesta a&#58; Fibromialgia y fatiga cr&#243;nica causada por sensibilidad al gluten no cel&#237;aca"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Rami Qanneta, Ramon Fontova, Antoni Castel"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Rami"
              "apellidos" => "Qanneta"
            ]
            1 => array:2 [
              "nombre" => "Ramon"
              "apellidos" => "Fontova"
            ]
            2 => array:2 [
              "nombre" => "Antoni"
              "apellidos" => "Castel"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1699258X14002113"
        "doi" => "10.1016/j.reuma.2014.09.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14002113?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357431400166X?idApp=UINPBA00004M"
    "url" => "/21735743/0000001100000003/v2_201505050301/S217357431400166X/v2_201505050301/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173574314001786"
    "issn" => "21735743"
    "doi" => "10.1016/j.reumae.2014.12.004"
    "estado" => "S300"
    "fechaPublicacion" => "2015-05-01"
    "aid" => "713"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
    "documento" => "article"
    "subdocumento" => "sco"
    "cita" => "Reumatol Clin. 2015;11:182-3"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1178
      "formatos" => array:3 [
        "EPUB" => 55
        "HTML" => 893
        "PDF" => 230
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>"
      "titulo" => "Ossifying Myositis of the Neck Muscles"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "182"
          "paginaFinal" => "183"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Miositis osificante en los m&#250;sculos del cuello"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Fig&#46; 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 800
              "Ancho" => 995
              "Tamanyo" => 67789
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Axial maximum intensity projection &#40;MIP&#41; showing abnormal linear calcification&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Anna P&#224;mies, Alex Samitier, Javier Rodr&#237;guez-Fern&#225;ndez, Ramon Fontova"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Anna"
              "apellidos" => "P&#224;mies"
            ]
            1 => array:2 [
              "nombre" => "Alex"
              "apellidos" => "Samitier"
            ]
            2 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Rodr&#237;guez-Fern&#225;ndez"
            ]
            3 => array:2 [
              "nombre" => "Ramon"
              "apellidos" => "Fontova"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S1699258X14001703"
        "doi" => "10.1016/j.reuma.2014.08.004"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14001703?idApp=UINPBA00004M"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001786?idApp=UINPBA00004M"
    "url" => "/21735743/0000001100000003/v2_201505050301/S2173574314001786/v2_201505050301/en/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S217357431400166X"
      "issn" => "21735743"
      "doi" => "10.1016/j.reumae.2014.09.003"
      "estado" => "S300"
      "fechaPublicacion" => "2015-05-01"
      "aid" => "723"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46;"
      "documento" => "simple-article"
      "subdocumento" => "cor"
      "cita" => "Reumatol Clin. 2015;11:185"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:2 [
        "total" => 1409
        "formatos" => array:3 [
          "EPUB" => 80
          "HTML" => 948
          "PDF" => 381
        ]
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
        "titulo" => "Response to&#58; Fibromyalgia and Chronic Fatigue Syndrome Caused by Non-celiac Gluten Sensitivity"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:1 [
            "paginaInicial" => "185"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Respuesta a&#58; Fibromialgia y fatiga cr&#243;nica causada por sensibilidad al gluten no cel&#237;aca"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rami Qanneta, Ramon Fontova, Antoni Castel"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Rami"
                "apellidos" => "Qanneta"
              ]
              1 => array:2 [
                "nombre" => "Ramon"
                "apellidos" => "Fontova"
              ]
              2 => array:2 [
                "nombre" => "Antoni"
                "apellidos" => "Castel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "es" => array:9 [
          "pii" => "S1699258X14002113"
          "doi" => "10.1016/j.reuma.2014.09.008"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "es"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14002113?idApp=UINPBA00004M"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357431400166X?idApp=UINPBA00004M"
      "url" => "/21735743/0000001100000003/v2_201505050301/S217357431400166X/v2_201505050301/en/main.assets"
    ]
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Chronic Fatigue Syndrome and Non-celiac Gluten Sensitivity&#46; Association or Cause&#63;"
    "tieneTextoCompleto" => true
    "saludo" => "To the editor&#58;"
    "paginas" => array:1 [
      0 => array:1 [
        "paginaInicial" => "184"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "Carlos Isasi Zaragoz&#225;"
        "autores" => array:1 [
          0 => array:3 [
            "nombre" => "Carlos"
            "apellidos" => "Isasi Zaragoz&#225;"
            "email" => array:1 [
              0 => "cisasi&#46;hpth&#64;salud&#46;madrid&#46;org"
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital Puerta de Hierro&#44; Majadahonda&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "S&#237;ndrome de fatiga cr&#243;nica y sensibilidad al gluten no cel&#237;aca&#46; &#191;Asociaci&#243;n o causa&#63;"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In their letter to the editor <span class="elsevierStyleItalic">Response to&#58; Fibromyalgia and chronic fatigue caused by non-celiac gluten sensitivity</span>&#44; Qanneta et al&#46; pose a conceptual problem between the association of chronic fatigue syndrome &#40;CFS&#41; with non-celiac gluten sensitivity &#40;SGNC&#41; from the prevalent conception of considering chronic fatigue as a distinct disease&#46; From this perspective&#44; being chronic fatigue the central disease associated with other processes&#44; they consider NCGS as a comorbid condition and not as an underlying cause&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">From my point of view fibromyalgia and chronic fatigue &#40;FM&#47;CFS&#41; are not defined diseases but just syndromic terms that reflect reality&#46; In the same way that diagnosing unexplained fever is no more than describing a clinical condition for which the cause of the fever is unknown&#44; diagnosing FM&#47;CFS is to describe a symptomatic set of unknown cause&#46; Considering FM&#47;CFS as defined diseases may even have negative effects&#44; since the diagnosis seems to mean that the doctor knows what is happening to the patient&#44; when I believe it is accepting a good deal of ignorance regarding the cause in the case of the physician and resignation in the case of the patient&#46; I work based on the model considering FM&#47;FC as a syndromic description&#46; In this model&#44; various more or less complex causes&#44; which are probably interrelated&#44; and that we are beginning to understand can produce the same clinical syndrome&#46; Qanneta et al&#46; proposes classifying CFS as pure and secondary&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> I believe all CFS are secondary&#46; NCGS of course does not explain all cases of FM&#47;CFS&#44; but it is an explanation for some of the patients&#46; If the treatment of NCGS solves the FM&#47;CFS syndrome&#44; it may be reasonably said that the NCGS was the cause&#44; especially if symptomatic recurrence occurs after ingesting gluten&#46; There are other causes of FM&#47;CFS different from NGCS which may not be detected using complementary explorations&#46; For example&#44; I have had patients in which the withdrawal of statins and psychotropic drugs formally resolved the symptoms of patients diagnosed with fibromyalgia&#46; Even if the clinical manifestations have been resolved&#44; one cannot say that &#8220;then the patient had no fibromyalgia&#44;&#8221; as I do not think that the case presented had FM&#47;CFS-like symptoms but in reality had no FM&#47;CFS&#44; as stated in their letter&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Qanneta et al&#46; refer poor experiences with GFD regarding systemic symptoms of patients with chronic fatigue&#46; However we have observed a clear response of systemic symptoms&#44; including mental fatigue&#44; in fibromyalgia patients when treating NCGS&#46; More than 30&#37; of patients achieved remission of fibromyalgia or regained a normal life or went back to work or suspended treatment&#46; The following case&#44; treated during the preparation of this manuscript&#44; illustrates this relationship&#58; a 23 year old woman with 3 years since the onset of FM&#47;CFS with severe fatigue that limited daily life activities&#44; mental fatigue&#44; generalized pain&#44; headache&#44; diarrhea and oral ulcers&#46; She had been evaluated by gastroenterology&#44; rheumatology&#44; internal medicine and cardiology&#44; with multiple studies that had ruled out pathology&#44; including celiac disease&#46; HLA typing showed DQ8 and the presence of duodenal biopsy showed type 1 Marsh enteropathy and intraepithelial lymphocytosis &#40;29 CD3 lymphocytes per 100 enterocytes&#41;&#46; After one year of follow-up&#44; after starting diet without gluten or dairy&#44; she presented complete remission of all her symptoms&#44; with a normal life&#44; practicing sports and without medication&#46; She chose not to eat triggering foodstuffs&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">There may be several explanations for the observed different experience with the treatment of NCGS such as patient selection&#44; time of treatment or the treatment modality of NGCS&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">In conclusion&#44; we agree that the problem of FM&#47;CFS is complex and requires multifactorial treatment&#44; but there is a clear difference in perspective from which to address the problem&#46; I prefer to dispense with the prevalent concept of FM&#47;CFS as a disease&#44; avoid the use of psychotropic drugs and seek causes that not show their faces in laboratory testing we usually perform&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Isasi Zaragoz&#225; C&#46; S&#237;ndrome de fatiga cr&#243;nica y sensibilidad al gluten no cel&#237;aca&#46; &#191;Asociaci&#243;n o causa&#63; Reumatol Clin&#46; 2015&#59;11&#58;184&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Reference"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:1 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tipolog&#237;a cl&#237;nica del s&#237;ndrome de fatiga cr&#243;nica&#58; hip&#243;tesis clasificatoria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Qanneta"
                            1 => "R&#46; Fontova"
                            2 => "M&#46;J&#46; Poveda"
                            3 => "S&#46; Castro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.reuma.2013.04.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Reumatol Clin"
                        "fecha" => "2014"
                        "volumen" => "10"
                        "paginaInicial" => "132"
                        "paginaFinal" => "133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23849741"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735743/0000001100000003/v2_201505050301/S2173574314001762/v2_201505050301/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "8400"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001100000003/v2_201505050301/S2173574314001762/v2_201505050301/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001762?idApp=UINPBA00004M"
]
Article information
ISSN: 21735743
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 12 10 22
2024 October 44 39 83
2024 September 75 13 88
2024 August 93 36 129
2024 July 77 32 109
2024 June 103 45 148
2024 May 101 31 132
2024 April 81 25 106
2024 March 88 29 117
2024 February 50 25 75
2024 January 45 16 61
2023 December 59 27 86
2023 November 52 31 83
2023 October 62 37 99
2023 September 73 25 98
2023 August 52 11 63
2023 July 79 25 104
2023 June 59 27 86
2023 May 60 20 80
2023 April 45 17 62
2023 March 66 25 91
2023 February 59 30 89
2023 January 64 27 91
2022 December 58 43 101
2022 November 89 29 118
2022 October 73 47 120
2022 September 62 36 98
2022 August 62 44 106
2022 July 59 43 102
2022 June 69 29 98
2022 May 84 42 126
2022 April 74 47 121
2022 March 101 46 147
2022 February 102 33 135
2022 January 78 38 116
2021 December 58 41 99
2021 November 73 51 124
2021 October 68 47 115
2021 September 62 40 102
2021 August 68 44 112
2021 July 56 33 89
2021 June 73 46 119
2021 May 81 38 119
2021 April 180 108 288
2021 March 91 32 123
2021 February 79 29 108
2021 January 57 23 80
2020 December 65 38 103
2020 November 78 21 99
2020 October 54 13 67
2020 September 108 32 140
2020 August 54 23 77
2020 July 52 21 73
2020 June 66 30 96
2020 May 55 22 77
2020 April 45 28 73
2020 March 22 10 32
2020 February 1 0 1
2018 May 5 0 5
2018 April 39 10 49
2018 March 62 7 69
2018 February 29 3 32
2018 January 41 9 50
2017 December 27 6 33
2017 November 26 9 35
2017 October 35 7 42
2017 September 34 3 37
2017 August 20 12 32
2017 July 31 10 41
2017 June 38 19 57
2017 May 56 15 71
2017 April 30 8 38
2017 March 19 4 23
2017 February 18 6 24
2017 January 31 4 35
2016 December 55 18 73
2016 November 49 3 52
2016 October 68 10 78
2016 September 64 11 75
2016 August 55 6 61
2016 July 26 8 34
2015 December 2 0 2
2015 November 1 21 22
2015 October 1 22 23
2015 September 3 0 3
2015 August 1 22 23
2015 July 24 10 34
2015 June 67 21 88
2015 May 70 22 92
Show all

Follow this link to access the full text of the article

Idiomas
Reumatología Clínica (English Edition)
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?