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"tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "55" "paginaFinal" => "56" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Lymphadenopathy syndrome in systemic lupus erythematosus: Is it Kikuchi-Fujimoto disease?" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1113 "Ancho" => 1500 "Tamanyo" => 328448 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Hematoxilina-eosina: ganglio linfático cervical. Linfocitos con áreas de necrosis en diferentes etapas de maduración. B) Ganglio linfático cervical. Presencia de linfocitos con expresión CD8 en relación con áreas de necrosis. C) Ganglio linfático cervical. Presencia de linfocitos con expresión TIA1 en relación con áreas de necrosis. D) Ganglio linfático supraclavicular. 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Lymphocytes with areas of necrosis at different stages of maturation. (B) Cervical lymph node. Presence of lymphocytes expressing CD8 in relation to areas of necrosis. (C) Cervical lymph node. Presence of lymphocytes expressing TIA1 in relation to the areas of necrosis. (D) Supraclavicular lymph node. Hematoxylin-eosin: lymphocytes with areas of necrosis at different stages of maturation.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Lymphadenopathy syndrome is a common manifestation of systemic lupus erythematosus (SLE). In general, enlarged lymph nodes are small and can be found in the cervical, inguinal and axillary regions. Lymph node involvement is present in up to 25% of the patients and normally appears in the first stages of the disease or during relapses.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The differential diagnosis of lymphadenopathy syndrome in SLE includes histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease (KFD), Castleman's disease, syphilis, tuberculosis, sarcoidosis, infectious mononucleosis (Epstein–Barr virus [EBV], cytomegalovirus), herpes simplex, human immunodeficiency virus (HIV), hepatitis B virus (HBV), hepatitis C virus (HCV), other infections and lymphoma.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is a rare clinical disorder characterized by lymph node involvement (generally cervical), fever, night sweats and leukopenia. It mainly affects young Asian women. It was first described by Kikuchi and Fujimoto in 1972.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> The associated mortality is increased by heart, lung and liver involvement. The exact cause of KFD is not yet known, but recent publications are inclined toward a viral infection (EBV and others) or an autoimmune disorder (an exaggerated immune response mediated by T cells).<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> To diagnosis the disease, it is necessary to perform an excisional biopsy of the affected lymph nodes. The association between KFD and SLE is rare, and whether it is incidental or a clinical manifestation of SLE continues to be a matter of debate.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The coexistence of these 2 diseases is reported in 2 young SLE patients (cases nos. 1 and 2) and we describe another case of lymphadenopathy syndrome in SLE (case no. 3) in which the affected lymph node was studied by cytology rather than excisional biopsy (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). In all 3 cases, the results of serological testing for HIV, HBV, HCV, EBV, cytomegalovirus, herpes simplex virus, rubella, toxoplasma, parvovirus B19, <span class="elsevierStyleItalic">Yersinia enterocolitica</span>, <span class="elsevierStyleItalic">Salmonella</span> and <span class="elsevierStyleItalic">Brucella</span> were negative, as were the results of interferon-γ release assays (IGRA) for all 3 patients.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Kikuchi-Fujimoto disease has been associated with SLE and other connective tissue diseases, such as antiphospholipid syndrome, Sjögren's syndrome, relapsing polychondritis and autoimmune hepatitis.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6,7</span></a> It is generally a benign disease that resolves spontaneously in 1–4 months, but cases with a poor outcome and atypical presentation have been reported.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Biopsy of the affected lymph nodes reveals irregular necrotized regions, mostly in the paracortical areas, with partial or complete loss of the follicular architecture, karyorrhexis and the absence of neutrophils, with the presence of transformed lymphocytes (immunoblasts) around the necrotic areas. The lesional cells have also been reported to infiltrate the perinodal fibroadipose tissue.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Findings that are not common in KFD are skin lesions, mesenteric lymph node involvement, splenomegaly, myalgia and parotid swelling.</p><p id="par0025" class="elsevierStylePara elsevierViewall">There is no effective treatment but, in cases without complications or in self-limiting disease, glucocorticoids are usually efficacious, as in the 3 cases documented here, although studies reveal that the rate of recurrence of the disease is 3%–4%.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In the third case, excisional biopsy was not performed, a fact that means that, in this patient, we cannot speak of histiocytic necrotizing lymphadenitis. However, the course and outcome of the disease are consist with that possibility (the good response to glucocorticoids rules out an infectious or malignant disease). The early diagnosis is fundamental for the correct management of the disease, and the association with SLE requires more research. Our experience supports the hypothesis that it is necessary to perform excisional biopsy of the lymph nodes in cases of lymphadenopathy syndrome in SLE that have not been diagnosed. Thus, not only is it necessary to exclude malignancy by means of cytology; the best alternative is to completely remove the lymph node to attempt to identify the disorder, because the therapeutic approach will be different in each case depending on the result (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Salman-Monte TC, Pérez Ruiz J, Almirall M, Campillo Ibáñez MÁ, Barranco Sanz LC, Carbonell Abelló J. Síndrome poliadenopático en lupus eritematoso sistémico: ¿es la enfermedad de Kikuchi-Fujimoto? Reumatol Clin. 2017;13:55–56.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1123 "Ancho" => 1510 "Tamanyo" => 334903 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Hematoxylin-eosin: cervical lymph node. Lymphocytes with areas of necrosis at different stages of maturation. (B) Cervical lymph node. Presence of lymphocytes expressing CD8 in relation to areas of necrosis. (C) Cervical lymph node. Presence of lymphocytes expressing TIA1 in relation to the areas of necrosis. (D) Supraclavicular lymph node. Hematoxylin-eosin: lymphocytes with areas of necrosis at different stages of maturation.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">ANA, antinuclear antibodies; CT, computed tomography; dsDNA, double-stranded DNA; FNAC, fine-needle aspiration cytology.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case no. 1 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case no. 2 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case no. 3 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleItalic">Demographic</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">37 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Sex \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Race \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Latin American \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Caucasian \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Clinical manifestations</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cervical lymph node involvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Axillary and supraclavicular lymph node involvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cervical lymph node involvement \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Arthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Polyarthritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Night sweats (2 months) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Asthenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Asthenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Painful oral ulcers \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Weight loss \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Weight loss \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Fever \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Laboratory</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ANA 1/320 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ANA 1/320 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ANA 1/40 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anti-dsDNA: 417<span class="elsevierStyleHsp" style=""></span>IU/mL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anti dsDNA: 310<span class="elsevierStyleHsp" style=""></span>IU/mL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anti dsDNA: 732<span class="elsevierStyleHsp" style=""></span>IU/mL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C3: 75<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C3: 112<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C3: 57<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C4: 12<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C4: 24<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">C4: 16<span class="elsevierStyleHsp" style=""></span>mg/dL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Image</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cervical CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thoracoabdominal CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cervical CT \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Pathology</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Cervical lymph node: lymphocytes with areas of necrosis at different stages of maturation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Supraclavicular lymph node: lymphocytes with areas of necrosis at different stages of maturation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Excisional biopsy not performed \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Numerous CD8-positive lymphocytes with TIA1+ cytotoxic granules (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A–C) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Numerous CD8-positive lymphocytes with TIA1+ cytotoxic granules (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Malignancy ruled out using ultrasound-guided FNAC \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="4" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Treatment and outcome</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Glucocorticoids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Glucocorticoids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Glucocorticoids \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lymph node involvement almost completely disappeared \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Azathioprine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lymph node involvement almost completely disappeared \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lymph node involvement almost completely disappeared \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1338630.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Description of the Three Cases.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphadenopathy in systemic lupus erythematosus. 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Dorfman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Pathol Lab Med" "fecha" => "1987" "volumen" => "111" "paginaInicial" => "1026" "paginaFinal" => "1029" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3662766" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001300000001/v1_201702040035/S2173574316301253/v1_201702040035/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/21735743/0000001300000001/v1_201702040035/S2173574316301253/v1_201702040035/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574316301253?idApp=UINPBA00004M" ]
Year/Month | Html | Total | |
---|---|---|---|
2024 November | 27 | 17 | 44 |
2024 October | 182 | 34 | 216 |
2024 September | 244 | 18 | 262 |
2024 August | 285 | 40 | 325 |
2024 July | 381 | 36 | 417 |
2024 June | 286 | 41 | 327 |
2024 May | 305 | 38 | 343 |
2024 April | 306 | 24 | 330 |
2024 March | 290 | 43 | 333 |
2024 February | 170 | 26 | 196 |
2024 January | 405 | 34 | 439 |
2023 December | 172 | 31 | 203 |
2023 November | 201 | 36 | 237 |
2023 October | 161 | 48 | 209 |
2023 September | 205 | 40 | 245 |
2023 August | 185 | 15 | 200 |
2023 July | 211 | 32 | 243 |
2023 June | 207 | 28 | 235 |
2023 May | 185 | 29 | 214 |
2023 April | 187 | 25 | 212 |
2023 March | 257 | 46 | 303 |
2023 February | 244 | 36 | 280 |
2023 January | 230 | 21 | 251 |
2022 December | 253 | 49 | 302 |
2022 November | 263 | 34 | 297 |
2022 October | 237 | 53 | 290 |
2022 September | 248 | 42 | 290 |
2022 August | 281 | 39 | 320 |
2022 July | 247 | 53 | 300 |
2022 June | 204 | 47 | 251 |
2022 May | 273 | 51 | 324 |
2022 April | 282 | 76 | 358 |
2022 March | 306 | 55 | 361 |
2022 February | 335 | 38 | 373 |
2022 January | 327 | 43 | 370 |
2021 December | 281 | 49 | 330 |
2021 November | 308 | 50 | 358 |
2021 October | 323 | 68 | 391 |
2021 September | 262 | 59 | 321 |
2021 August | 258 | 73 | 331 |
2021 July | 290 | 33 | 323 |
2021 June | 321 | 44 | 365 |
2021 May | 278 | 59 | 337 |
2021 April | 611 | 124 | 735 |
2021 March | 441 | 52 | 493 |
2021 February | 235 | 34 | 269 |
2021 January | 220 | 27 | 247 |
2020 December | 775 | 48 | 823 |
2020 November | 206 | 26 | 232 |
2020 October | 152 | 25 | 177 |
2020 September | 202 | 37 | 239 |
2020 August | 232 | 38 | 270 |
2020 July | 152 | 23 | 175 |
2020 June | 131 | 26 | 157 |
2020 May | 140 | 25 | 165 |
2020 April | 114 | 27 | 141 |
2020 March | 20 | 4 | 24 |
2020 February | 1 | 0 | 1 |
2018 May | 6 | 0 | 6 |
2018 April | 57 | 6 | 63 |
2018 March | 60 | 12 | 72 |
2018 February | 36 | 7 | 43 |
2018 January | 29 | 6 | 35 |
2017 December | 41 | 16 | 57 |
2017 November | 22 | 4 | 26 |
2017 October | 25 | 3 | 28 |
2017 September | 22 | 8 | 30 |
2017 August | 15 | 10 | 25 |
2017 July | 27 | 16 | 43 |
2017 June | 41 | 14 | 55 |
2017 May | 57 | 20 | 77 |
2017 April | 42 | 21 | 63 |
2017 March | 52 | 37 | 89 |
2017 February | 36 | 27 | 63 |
2017 January | 6 | 19 | 25 |
2016 December | 0 | 4 | 4 |