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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">TNF receptor-associated periodic syndrome &#40;TRAPS&#41; is an autosomal dominant disease characterised by recurrent episodes of fever&#44; migratory myalgias&#44; skin rash&#44; conjunctivitis&#44; orbital oedema and abdominal or chest pain due to muscle inflammation&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> and even chronic refractory arthritis&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Leukocytosis&#44; neutrophilia&#44; thrombocytosis and elevated acute phase reactants can occur&#46; We present the case of an 83-year-old male with amyloidosis type AA and the p&#46;R92Q variant in the <span class="elsevierStyleItalic">TNFRSF1A</span> gene&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Clinical case</span><p id="par0010" class="elsevierStylePara elsevierViewall">An 83-year-old male with a history of gastrointestinal bleeding and iron-deficiency anaemia due to gastritis and duodenal ulcer&#44; benign prostatic hypertrophy&#44; high blood pressure treated with tamsulosin &#40;&#46;4<span class="elsevierStyleHsp" style=""></span>mg&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; dutasteride &#40;&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41; and omeprazole &#40;20<span class="elsevierStyleHsp" style=""></span>mg&#47;24<span class="elsevierStyleHsp" style=""></span>h&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">He consulted with tiredness and instability&#44; with haemoglobin of 7&#46;3<span class="elsevierStyleHsp" style=""></span>g&#47;dl&#46; Gastroscopy revealed a duodenal ulcer&#46; Gastric biopsy showed mild chronic gastritis&#46; Duodenal biopsy showed focal ulceration of mucosa with preserved villi and lamina propria expanded by deposit of amorphous eosinophilic material &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#59; this deposit was also observed in the capillary walls and the submucosa&#44; it was accompanied by minimal non-specific lymphocytic inflammatory infiltrate&#59; Congo red stain was intensely positive and showed apple-green birefringence in polarised light &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; Immunohistochemical staining was also performed for AA protein&#44; which was intensely positive&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Enteroscopy demonstrated from the distal bulb&#44; and continuously the length of the path explored&#44; intestinal mucosa with superficial ulcerations and of infiltrative appearance&#44; with areas of spontaneous bleeding on passing the endoscope&#46; The most significant findings were located in the distal bulb and the second and third duodenal portions&#44; with totally denuded and ulcerated mucosal areas&#46; Colonoscopy was normal&#46; Rectal biopsy showed no amyloid material&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Thoracic CT was normal&#44; while abdominal CT revealed discrete thickening with dilation of the duodenal wall and first jejunal loops &#40;up to 3&#46;2<span class="elsevierStyleHsp" style=""></span>cm&#41; with involvement of the adjacent fat&#44; of probable inflammatory origin&#59; ureteral and bladder lithiasis&#46; Abdominal CT-angiography showed no valuable findings&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Aetiological study of secondary amyloidosis was performed&#46; Liver and kidney function&#44; proteinogram&#44; and serum amyloid A protein were normal&#46; Antinuclear antibodies&#44; rheumatoid factor&#44; citrullinated peptide&#44; neutrophil antibody and serum beta-2-microglobulin were negative&#46; C-reactive protein &#40;CRP&#41; was normal on admission&#44; but intermittent elevations of around 50<span class="elsevierStyleHsp" style=""></span>mg&#47;l <span class="elsevierStyleItalic">&#40;normal &#46;0-6-0</span>&#41; were evidenced in some of the routine checks&#59; there were no associated symptoms&#46; Abdominal fat biopsy showed no amyloid material&#46; The 24-h urine protein test was negative&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Studies of genes for familial Mediterranean fever &#40;FMF&#41; and familial amyloid polyneuropathy &#40;FAP&#41; were negative&#44; while analysis of the <span class="elsevierStyleItalic">TNFRSF1A</span> gene revealed the heterozygous variant p&#46;R92Q &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The electrocardiogram was normal&#44; and the echocardiogram showed a left ventricle that was neither dilated nor hypertrophied&#44; preserved ejection fraction with impaired relaxation&#46; Electromyography showed slight signs of chronic radicular involvement bilateral L4&#44; L5 and S1&#44; there were no conclusive signs of polyneuropathy&#46; Lumbar-sacral magnetic resonance showed osteodegenerative changes in the interapophyseal joints L4-L5-S1&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">TRAPS syndrome is a monogenic auto-inflammatory disease that can affect different ethnic groups&#46; The mutations that cause this syndrome are located in the <span class="elsevierStyleItalic">TNFRSF1A</span> gene&#44; and about 114 variants have been described&#46; Among them&#44; the p&#46;R92Q variant stands out in terms of frequency&#44; currently classified as a variant of uncertain significance&#44; and also presenting a low incidence of secondary amyloidosis&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">In TRAPS syndrome&#44; symptoms usually appear during the first decade of life&#46; In the case of adult onset&#44; it is common to identify low-penetrance variants&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Prolonged febrile episodes &#40;between 1 and 4 weeks&#41; are most frequent manifestation of the syndrome&#44; which recur at irregular intervals of weeks or months&#44; accompanied by myalgias and migratory skin exanthema&#46; There may be triggers such as infections&#44; trauma&#44; stress&#44; etc&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">It is the prolonged elevation of acute phase reactants&#44; and especially serum amyloid protein&#44; that increases the risk of type AA amyloidosis&#46; The patient we describe presented elevated CRP in some of the routine tests without any symptoms&#46; Concentric ventricular hypertrophy was not observed&#44; nor was amyloid deposition evidenced in the abdominal fat or rectal biopsies&#46; Duodenal biopsy ruled out Crohn&#39;s disease &#40;CD&#41;&#44; since in CD there may be ulceration and fissures&#44; but with predominance of severe&#47;moderate lymphoplasmocellular inflammatory infiltration&#44; granulomas and acute glandular inflammation&#44; which were not present in this case&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Thoracic and abdominal CT&#44; gastroscopy&#44; enteroscopy and colonoscopy did not reveal neoplasms&#44; and the proteinogram did not show monoclonal bands&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Amyloidosis can occur in TRAPS&#44;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;8</span></a> but to date its association with the p&#46;RQ92 variant&#44; has not been demonstrated&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">In conclusion&#44; amyloidosis may be present in carriers of the p&#46;RQ92 variant&#44; and therefore its diagnosis is important to avoid possible complications&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflict of interests</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Secondary amyloidosis can be found in some monogenic autoinflammatory diseases&#46; In this study we present an 83-year-old man with no relevant medical history who presented with iron deficiency anaemia&#46; In the study&#44; a gastroscopy was performed with duodenum biopsy showing secondary AA-type amyloidosis&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Genetic analyses of monogenic autoinflammatory diseases revealed the heterozygous p&#46;R92Q variant in the <span class="elsevierStyleItalic">TNFRSF1A</span> gene&#44; with negative results in the complementary tests for other causes of amyloidosis&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In TRAPS&#44; secondary amyloidosis has usually been associated with mutations affecting cysteine residues&#44; but until now no association has been demonstrated with the p&#46;RQ92 variant&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Secondary amyloidosis may be present in carriers of the p&#46;RQ92 variant&#44; therefore it is important to diagnose it to prevent possible complications&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La amiloidosis secundaria puede encontrarse en algunas enfermedades autoinflamatorias monog&#233;nicas&#46; Presentamos el caso de un var&#243;n de 83 a&#241;os sin antecedentes patol&#243;gicos de inter&#233;s&#46; Tras detectarse una anaemia ferrop&#233;nica&#44; se realiz&#243; una gastroscopia y la biopsia duodenal evidenci&#243; amiloidosis secundaria de tipo AA&#46; El estudio de enfermedades autoinflamatorias revel&#243; la variante heterocigota p&#46;R92Q en el gen <span class="elsevierStyleItalic">TNFRSF1A</span>&#44; siendo negativas las pruebas complementarias para otras causas de amiloidosis&#46; En el s&#237;ndrome TRAPS la amiloidosis secundaria puede asociarse a mutaciones que afectan a residuos ciste&#237;na&#44; no habi&#233;ndose evidenciado su asociaci&#243;n con la variante p&#46;R92Q&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conclusi&#243;n</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La amiloidosis secundaria puede estar presente en individuos portadores de la variante p&#46;RQ92&#44; por lo que es importante su diagn&#243;stico para intentar prevenir posibles complicaciones&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Nicol&#225;s-S&#225;nchez FJ&#44; Ar&#243;stegui-Gorospe JI&#44; Pallar&#233;s-Quixal J&#44; Nicol&#225;s-Sarrat FJ&#44; Sarrat-Nuevo RM&#44; Nogue Bou RM&#44; et al&#46; Mutaci&#243;n p&#46;RQ92 asociada a amiloidosis&#46; Reumatol Clin&#46; 2021&#59;17&#58;46&#8211;48&#46;</p>"
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              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The autoinflammatory disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Federici"
                            1 => "R&#46; Caorsi"
                            2 => "M&#46; Gattorno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4414/smw.2012.13602"
                      "Revista" => array:5 [
                        "tituloSerie" => "Swiss Med Wkly"
                        "fecha" => "2012"
                        "volumen" => "142"
                        "paginaInicial" => "w13602"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22714396"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The phenotype of TNF receptor-associated autoinflammatory syndrome &#40;TRAPS&#41; at presentation&#58; a series of 158 cases from the Eurofever&#47;EUROTRAPS international registry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;J&#46; Lachmann"
                            1 => "R&#46; Papa"
                            2 => "K&#46; Gerhold"
                            3 => "L&#46; Obici"
                            4 => "I&#46; Touitou"
                            5 => "L&#46; Cantarini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/annrheumdis-2013-204184"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2014"
                        "volumen" => "73"
                        "paginaInicial" => "2160"
                        "paginaFinal" => "2167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23965844"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adult-onset tumour necrosis factor receptor-associated periodic syndrome presenting with refractory chronic arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Lopalco"
                            1 => "D&#46; Rigante"
                            2 => "A&#46; Vitale"
                            3 => "M&#46; Galeazzi"
                            4 => "F&#46; Iannone"
                            5 => "L&#46; Cantarini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2015"
                        "volumen" => "33"
                        "numero" => "Suppl&#46; 94"
                        "paginaInicial" => "S171"
                        "paginaFinal" => "S172"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25936627"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Disease phenotype and outcome depending on the age at disease onset in patients carrying the R92Q low-penetrance variant in <span class="elsevierStyleItalic">TNFRSF1A</span> gene"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Ruiz-Ortiz"
                            1 => "E&#46; Iglesias"
                            2 => "A&#46; Soriano"
                            3 => "S&#46; Buj&#225;n-Rivas"
                            4 => "M&#46; Espa&#241;ol-Rego"
                            5 => "R&#46; Castellanos-Moreira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fimmu.2017.00299"
                      "Revista" => array:5 [
                        "tituloSerie" => "Front Immunol"
                        "fecha" => "2017"
                        "volumen" => "8"
                        "paginaInicial" => "299"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28396659"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical significance of P46L and R92Q substitutions in the tumour necrosis factor superfamily 1A gene"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "N&#46; Ravet"
                            1 => "S&#46; Rouaghe"
                            2 => "C&#46; Dod&#233;"
                            3 => "J&#46; Bienvenu"
                            4 => "J&#46; Stirnemann"
                            5 => "P&#46; L&#233;vy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/ard.2005.048611"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "2006"
                        "volumen" => "65"
                        "paginaInicial" => "1158"
                        "paginaFinal" => "1162"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16569687"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Heterogeneity among patients with tumor necrosis factor receptor-associated periodic syndrome phenotypes"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Aganna"
                            1 => "L&#46; Hammond"
                            2 => "P&#46;N&#46; Hawkins"
                            3 => "A&#46; Aldea"
                            4 => "S&#46;A&#46; McKee"
                            5 => "H&#46;K&#46; van Amstel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/art.11215"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "2003"
                        "volumen" => "48"
                        "paginaInicial" => "2632"
                        "paginaFinal" => "2644"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13130484"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Autosomal-dominant periodic fever with AA amyloidosis&#58; novel mutation in tumor necrosis factor receptor 1 gene"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "J&#46;P&#46; Cosyns"
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