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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Systemic sclerosis &#40;SSc&#41; is a chronic autoimmune disease that affects the connective tissue&#44; characterised by inflammatory changes&#44; excessive fibrosis of the skin and internal organs&#44; microvascular disturbances and autoimmunity&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Ninety percent of patients with SSc have antinuclear antibodies &#40;ANA&#41;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and specific antibodies such as anti-topoisomerase1 &#40;anti-Scl70&#41;&#44; anti-RNA polymerase III&#44; anti-U3-RNP&#44; anticentromere &#40;ACA&#41; and anti-Th&#47;To&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> The presence of specific antibodies classifies patients into groups with different frequency of organ involvement&#44; clinical course and disease prognosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;5</span></a> Anti-Scl70 and anti-U3-RNP are associated with the diffuse cutaneous form&#44; while the presence of ACA and anti-Th&#47;To are associated with the limited cutaneous form&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> The patients&#8217; serological profile is not altered by treatment or the course of the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The anti-RNA polymerase III antibody has been described in patients with SSc&#44; especially diffuse SSc and scleroderma renal crisis &#40;SRC&#41;&#44; a severe complication affecting up to 5&#37; of SSc patients in the first years of the disease&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;7</span></a> Anti-RNA polymerase III is also associated with the presence of gastric antral vascular ectasia &#40;GAVE&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and with some types of cancer in patients with SSc&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#8211;11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The frequency of positive anti-RNA polymerase III in SSc varies widely in different series&#46; The frequency was 25&#37; in a U&#46;S&#46; cohort of patients&#44; whereas it was 4&#37; in a French cohort&#46; The frequency of this antibody has been little studied in the Latin American population&#46; A frequency of 1&#46;4&#37; was found in a cohort of mixed-race Mexican patients&#46; No reports were found in the Argentine population&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The aims of this study were to describe the frequency of positive anti-RNA polymerase III antibody in patients with SSc from a group of healthcare centres in Argentina&#44; and to explore the differences in clinical and demographic characteristics between patients with positive and negative anti-RNA polymerase III antibodies&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Patients</span><p id="par0025" class="elsevierStylePara elsevierViewall">Patients of both sexes&#44; over 18 years of age&#44; who met the 2013 American College of Rheumatology and European League Against Rheumatism classification criteria &#40;ACR&#47;EULAR 2013&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> for SSc were included in the study&#46; The project was approved by the Teaching and Ethics Committee&#46; All participants signed an informed consent form&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The patients came from 7 healthcare centres in Argentina &#40;4 in the Autonomous City of Buenos Aires&#44; 2 in the province of Buenos Aires and one in the province of Santa Fe&#41; that form part of the Scleroderma Study Group of the Argentine Society of Rheumatology &#40;GESAR <span class="elsevierStyleItalic">Esclerodermia</span>&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Clinical data</span><p id="par0035" class="elsevierStylePara elsevierViewall">With information from the interview&#44; physical examination and clinical history&#44; the rheumatologists completed a form for each patient in which demographic data &#8211; including ethnicity as defined by the GLADEL group<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> &#8211; personal history of hypertension&#44; dyslipidaemia&#44; smoking&#44; primary biliary cholangitis &#40;PBC&#41;&#44; and cancer were recorded&#46; The type of SSc&#44; disease progression &#8211; defined as the time from onset of the first symptom attributable to SSc until the time of completing the form &#8211; and the clinical manifestations of the disease were recorded&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Clinical manifestations</span><p id="par0040" class="elsevierStylePara elsevierViewall">Clinical involvement was categorised according to the classification of organs and systems of the SSc severity scale&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> The clinical manifestations that were considered to define the involvement of different organs and the studies used for the diagnosis of each complication are detailed below&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0045" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Vascular involvement&#58;</span> report of Raynaud&#8217;s phenomenon&#44; pitting scars &#40;defined as a lesion with central depression&#44; surrounded by hyperkeratosis on the finger pads&#41;&#44; ulcers or digital necrosis&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0050" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Skin involvement&#58;</span> presence of sclerosis assessed by modified Rodnan skin score&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> telangiectasias and&#47;or calcinosis &#8212; documented by clinical findings or imaging&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0055" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Joint involvement&#58;</span> presence of arthritis and&#47;or tendon friction rubs &#40;&#8220;leather crepitus&#8221; on palpation of the hands&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Muscle involvement&#58;</span> detection of muscle weakness on physical examination&#44; or due to increased muscle enzymes &#40;creatine phosphokinase &#91;CPK&#93; and&#47;or aldolase&#41; in complementary studies&#44; or due to myopathic changes on electromyogram&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Digestive tract involvement&#58;</span> Gastrointestinal tract involvement&#58; included swallowing involvement assessed by video swallow study&#59; oesophageal disturbances detected by digestive video-endoscopy&#44; oesophageal manometry or barium swallow&#59; gastric involvement defined by the presence of GAVE-type or &#8220;watermelon stomach&#8221; involvement on panendoscopy &#40;gastroscopy&#41;&#59; small bowel and colon involvement defined by the presence of malabsorption syndrome&#44; diarrhoea&#44; constipation or malnutrition with or without supplementary enteral nutrition requirement&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Cardiac involvement&#58;</span> included the presence of pericarditis&#44; impaired systolic and&#47;or diastolic function&#44; both detected by Doppler echocardiogram&#59; or conduction system disturbances detected by electrocardiogram or Holter monitoring&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Pulmonary involvement&#58;</span> pulmonary involvement was subject to the presence of interstitial lung disease &#40;ILD&#41; and pulmonary arterial hypertension &#40;PAH&#41;&#46; ILD was defined as the presence of a forced vital capacity &#60;70&#37; and a forced expiratory volume in the first second &#62;80&#37; on the functional respiratory examination with plethysmography&#59; or the presence of interstitial fibrosis or ground-glass changes on radiography or high-resolution computed tomography&#46; PAH was defined as a pulmonary artery systolic pressure by echocardiogram &#62;45&#160;mmHg and a mean pulmonary artery pressure by right heart catheterisation &#62;25&#160;mmHg&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Renal involvement&#58;</span> the SRC report was considered&#44; defined by a history of abrupt-onset hypertension&#44; microangiopathic anaemia and rapidly progressing oliguric renal failure&#46;</p></li></ul></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Antibody testing</span><p id="par0085" class="elsevierStylePara elsevierViewall">The results of ANA testing by indirect immunofluorescence assay &#40;IFA&#41;&#44; of ACA and anti-Scl70 were obtained if available in the clinical histories&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">A serum sample was taken from each patient to detect anti-RNA polymerase III isotype IgG antibodies&#44; and sent to and processed in the immunology laboratory of the Instituto de Investigaciones M&#233;dicas &#34;Dr&#46; Alfredo Lanari&#34;&#46; The antibody was measured by ELISA using a commercial semi-quantitative kit &#40;Quanta Lite RNA Pol III&#44; INOVA&#174;&#44; San Diego&#44; USA&#41;&#44; currently available for healthcare purposes&#44; which uses a purified recombinant immunodominant fragment of RNA polymerase III as the antigenic target&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> The cut-off value of the assay is 20U&#46; Antibody values between 20&#8722;39U were considered weak positive&#44; values between 40&#8722;80U moderate positive&#44; and values greater than 80U strong positive&#46; According to the manufacturer&#39;s information&#44; the clinical specificity of anti-RNA polymerase III ELISA is greater than 99&#37; and the clinical sensitivity is 23&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Statistical analysis</span><p id="par0095" class="elsevierStylePara elsevierViewall">The results are reported as mean&#160;&#177;&#160;standard deviation or median &#40;range&#58; minimum-maximum&#41; for quantitative variables&#44; and as frequencies and percentages for qualitative variables&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">To explore differences in clinical and demographic characteristics between anti-RNA polymerase III positive and negative patients&#44; the group of anti-RNA polymerase III positive patients was compared with 3 different groups of anti-RNA polymerase III negative patients considered the control groups&#58; a&#41; a group consisting of ACA positive patients only&#59; b&#41; a group consisting of anti-Scl70 positive patients&#59; and c&#41; a group of anti-Scl70&#44; ACA and anti-RNA polymerase III negative patients&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> test or Fisher&#8217;s test were used to compare proportions&#46; Numerical variables were compared using the test of variance or the Kruskal&#8211;Wallis test&#46; A 2-tailed p-value&#160;&#60;&#160;&#46;05 was considered significant&#46; STATA v&#46;11&#46;0 was used for the statistical analysis of the data&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Description of the sample</span><p id="par0110" class="elsevierStylePara elsevierViewall">Data from 135 patients with SSc &#40;125 females and 10 males&#41; were analysed with a median age at diagnosis of 53 years &#40;range&#58;12&#8211;87&#41;&#59; 26 patients were Caucasian &#40;19&#46;2&#37;&#41;&#44; 72 were of mixed race &#40;53&#46;3&#37;&#41;&#44; 19 were Amerindian &#40;14&#46;2&#37;&#41;&#44; and the ethnicity of the remaining 18 patients was not recorded &#40;13&#46;3&#37;&#41;&#46; A history of dyslipidaemia was recorded in 44 patients &#40;32&#46;6&#37;&#41;&#44; hypertension in 54 &#40;40&#37;&#41; and smoking in 35 &#40;25&#46;9&#37;&#41;&#46; The clinical form of SSc was limited in 105 patients &#40;77&#46;7&#37;&#41;&#44; diffuse in 26 &#40;19&#46;3&#37;&#41;&#44; and SSc sine scleroderma in 4 &#40;2&#46;9&#37;&#41;&#46; The median disease progression was 5&#46;5 years &#40;range&#58; 0&#8722;41&#41;&#46; <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> describes the comorbidities and clinical manifestations found in the patients with diffuse and limited SSc&#46; The median Rodnan skin score was 24&#46;5 in diffuse SSc &#40;range&#58; 0&#8722;36&#41; and 4 in limited SSc &#40;range&#58; 0&#8722;30&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">All 4 patients with SSc sine scleroderma had Raynaud&#8217;s phenomenon&#59; digital necrosis was observed in 3 and arthritis in one&#46; Two of the 4 patients had telangiectasias and oesophageal and pulmonary involvement&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Frequency of antibodies</span><p id="par0120" class="elsevierStylePara elsevierViewall">ANAs were positive in 93&#46;3&#37; of the patients studied &#40;126&#47;135&#41;&#46; ACA was positive in 57&#46;7&#37; &#40;75&#47;130&#41; and anti-Scl70 in 13&#46;2&#37; of the patients &#40;17&#47;129&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Anti-RNA polymerase III was positive in 8 out of 135 patients&#44; a frequency of 5&#46;9&#37;&#46; Two anti-RNA polymerase III positive patients were also ACA positive&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">A higher frequency of positive ACA was observed in limited SSc &#40;71&#46;3 versus 4&#37;&#41; and of anti-Scl70 in diffuse SSc &#40;52 versus 3&#37;&#41;&#46; Anti-RNA polymerase III was positive in 3 out of 26 patients &#40;11&#46;5&#37;&#41; with diffuse SSc&#44; and in 3 out of 10 patients &#40;4&#46;8&#37;&#41; with limited SSc&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> shows the frequency of positive antibodies according to the type of SSc&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0135" class="elsevierStylePara elsevierViewall">Both ACA and anti-Scl70 were negative in 36 patients &#40;11 patients with diffuse SSc&#44; 24 with limited SSc and one with <span class="elsevierStyleItalic">sine</span> scleroderma&#41;&#46; Of these patients&#44; 16&#46;7&#37; &#40;6 of 36&#41; were anti-RNA polymerase III positive &#40;3 with diffuse SSc and 3 with limited SSc&#41; and the median antibody titre was 104U &#40;range&#58; 87&#8211;117&#41;&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In 2 patients with limited SSc&#44; anti-RNA polymerase III coexisted with positive ACA and the titres were 43 and 44U&#44; respectively&#46; All 4 patients with limited SSc and tendon friction rubs were anti-RNA polymerase III negative&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Comparison of anti-RNA polymerase III positive and negative groups</span><p id="par0145" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> shows the comparison of demographic and clinical characteristics between the 4 groups of patients&#58; the anti-RNA polymerase III positive group&#44; the anti-Scl70 positive group&#44; the ACA positive group only&#44; and the anti-RNA polymerase III&#44; ACA and anti-Scl70 negative group&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">The anti-RNA polymerase III positive group was older at diagnosis&#44; although this did not reach statistical significance&#46; No significant differences were observed in terms of sex&#44; years of disease progression or mixed ethnicity among the 4 groups of patients studied&#46; However&#44; the highest frequency of mixed ethnicity was found in the anti-RNA polymerase III&#44; anti-Scl70 and ACA negative group&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">The anti-RNA polymerase III positive group had a lower proportion of patients with diffuse SSc than the anti-Scl70 positive group&#44; which was statistically significant&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">The anti-RNA polymerase III positive group had the highest proportion of patients with pitting scars&#44; although this did not reach statistical significance&#46; Similar Rodnan skin scores were observed in the 4 patient groups&#44; although the ACA-positive group showed the lowest median value&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">The group of anti-RNA polymerase positive patients had the highest proportion of pulmonary arterial hypertension &#40;37&#46;5&#37;&#41;&#44; but the difference was not statistically significant&#46; This group also showed the lowest proportion of interstitial lung disease &#40;12&#46;5&#37;&#41;&#44; with statistically significant differences compared to the Scl70-positive group&#46; The only patient with SRC was anti-RNA polymerase III positive&#46; None of the anti-RNA polymerase III positive patients had GAVE or cancer&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discussion</span><p id="par0170" class="elsevierStylePara elsevierViewall">SSc is characterised by specific antibodies directed against ribonuclear proteins&#44; kinetochore proteins&#44; and cellular enzymes such as topoisomerase and RNA polymerase&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5</span></a> RNA polymerases are a set of enzymes involved in the synthesis of messenger RNA or DNA transcription&#46; There are 3 types of RNA polymerase &#40;I&#44; II and III&#41; in the eukaryotic cells&#44; each specialised in the synthesis of a specific RNA&#46; Anti-RNA polymerase I and III antibodies are specific to SSc&#44; while anti-RNA polymerase II antibodies are also present in patients with SLE and overlap syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">The frequency of positive anti-RNA polymerase III is different according to the technique used and the geographical origin of the population studied&#46; Immunoprecipitation is the gold standard method to detect anti-RNA polymerase III&#44; which is not always available in daily practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a> Several studies have measured anti-RNA polymerase III using this technique and reported frequencies of 4&#37; in a cohort from France&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> 12&#37; in a cohort from the UK&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> and 25&#37; in a cohort from the USA&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> The IFA technique in Hep-2 cells has also been used as a strategy to detect anti-RNA polymerase III by several authors&#46;<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">23&#44;25</span></a> However&#44; there is no consensus on a specific fluorescence pattern produced by this antibody&#46;<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;22&#44;23&#44;25</span></a> Using the commercial ELISA assay to measure anti-RNA polymerase III antibodies in serum&#44; highly variable frequencies were also reported among different cohorts&#44; at 6&#37; in Japan&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> 9&#46;4&#37; in France<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> and up to 19&#37; in Canada&#44;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> among others&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">The present series of 135 patients from a group of healthcare centres in Argentina included 67&#46;5&#37; of patients of mixed and Amerindian ethnicity&#46; The antibody was measured by ELISA&#44; which detected positive anti-RNA polymerase III in 5&#46;9&#37; of patients&#46; This frequency is among the lowest compared to other cohorts&#46; Sobanski et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> despite the heterogeneity of the studies included in a meta-analysis of 8437 adult patients with SSc&#44; estimated an overall prevalence of anti-RNA polymerase III of 11&#37; &#40;95&#37; CI 8&#8211;14&#41;&#46; However&#44; a study that included 139 mixed-race Mexican patients with SSc found an anti-RNA polymerase III frequency of 1&#46;4&#37;&#59; only two patients had positive anti-RNA polymerase III &#40;measured by ELISA&#41;&#44; one with diffuse SSc and the other with limited SSc&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> These data suggest that the frequency of anti-RNA polymerase III would be lower in cohorts that include mixed-race or Amerindian patients compared to cohorts with predominantly Caucasian patients&#46; Although the lower frequency could be explained by environmental or genetic factors&#44; one study describes a similar immunogenetic predisposition among Caucasian&#44; African American and Hispanic individuals with SSc in Texas&#44; although it finds significant sociodemographic&#44; clinical&#44; and serological differences in disease expression among the 3 ethnic groups&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">In the present study&#44; in line with Cavazzana et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> the only serological marker was positive anti-RNA polymerase III in 16&#46;7&#37; of ACA-negative&#44; anti-Scl70-negative SSc patients&#46; Although further studies are needed to evaluate the usefulness of the antibody&#44; the results suggest a possible benefit of measuring anti-RNA polymerase III in patients with SSc and other negative specific antibodies&#46;<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#8211;28</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Although some authors have posited that specific antibodies are mutually exclusive in SSc&#44; in this series 2 patients had positive anti-RNA polymerase III and ACA&#46; The anti-RNA polymerase III titres detected in these 2 patients were lower than those found in patients whose only positive antibody was anti-RNA polymerase III&#46; Other papers also describe a small number of patients in whom positive anti-RNA polymerase III coexists with anti-U3-RNP or anti-Scl70 or ACA25-28&#46; There is still insufficient information available to assess the clinical significance of the coexistence of these antibodies&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Although the frequency of specific antibodies varies according to the type of SSc and the cohort studied&#44; it has been reported that anti-RNA polymerase III is more frequent in patients with diffuse SSc&#46; In this study&#44; in line with the literature&#44; the frequency of anti-RNA polymerase III was 4&#46;8&#37; in patients with limited SSc and 11&#46;5&#37; in diffuse SSc&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">In this study&#44; we found no significant differences in terms of sex&#44; mixed ethnicity&#44; and years of disease progression between the anti-RNA polymerase III-positive patients and the patients in groups with different antibody profiles&#46; It was observed that&#44; although not statistically significant&#44; anti-RNA polymerase III-positive patients were older at diagnosis of the disease&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The patients with anti-RNA polymerase III also had a higher frequency of pitting scars&#46; Pitting scars are considered a clinical expression of progressive ischaemic damage associated with Raynaud&#39;s phenomenon&#44; but not always associated with more severe disease&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Although different studies describe that patients with positive anti-RNA polymerase III experience more rapid and severe skin thickening&#44;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;28</span></a> in this study no significant difference was found in median Rodnan skin score between the anti-RNA polymerase III positive group&#44; the anti-Scl70 positive group and the anti-RNA polymerase III&#44; ACA and anti-Scl70 negative group&#46; Although the difference did not reach statistical significance&#44; the ACA-positive group had the lowest median Rodnan score&#59; this could be explained by the association of ACA with the limited form of the disease&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">The presence of SSc-specific antibodies has already been linked to the development of pulmonary complications&#46; Interstitial lung disease is more frequent in patients with diffuse skin involvement and anti-Scl70 positive&#44; and pulmonary arterial hypertension with limited skin involvement and presence of ACA&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a> The positive anti-RNA polymerase III group had a higher frequency of pulmonary arterial hypertension than interstitial lung disease&#44; a predictable result&#44; as other series describe a lower frequency of severe pulmonary disease in patients with diffuse SSc and positive anti-RNA polymerase III&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">Gastrointestinal tract involvement is a frequent complication in SSc&#59; GAVE-type involvement is described in 5&#46;7&#37; of patients&#44;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> and anti-RNA polymerase III is proposed as a predictive antibody for its diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Cavazzana et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> reported GAVE-type involvement of 16&#46;7&#37; in patients with positive anti-RNA polymerase III&#46; However&#44; in the present study&#44; all 3 patients with this condition were anti-RNA polymerase III negative&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Several authors flag up the relationship between SRC and positive anti-RNA polymerase III in diffuse SSc&#46; In line with the literature&#44; the only patient in this series with scleroderma renal crisis had diffuse SSc and was anti-RNA polymerase III positive&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;5&#44;27&#44;28</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">Positive anti-RNA polymerase III was also associated with the development of cancer at the time the SSc was diagnosed&#46;<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9&#8211;11</span></a> In this study&#44; only 3 patients had a history of cancer&#44; and all were anti-RNA polymerase III negative&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">A limitation of this study is that patients with SSc were included regardless of whether the diagnosis was recent&#46; This resulted in a heterogeneous sample&#44; with a median progression of 5&#46;5 years&#44; therefore it was not possible to establish the temporal relationship between the onset of the disease&#44; the presence of some manifestations and the history of cancer&#46; In this series&#44; only 8&#37; calcinosis was found in the group of patients with limited SSc&#44; a low frequency compared to the 24&#46;7&#37; reported by Valenzuela et al&#46;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> in 5218 patients with SSc&#46; However&#44; calcinosis is considered a late manifestation of the disease &#40;over 7&#46;5 years&#41;&#44; which possibly explains the lower frequency in this sample&#46; Tendon friction rubs were another manifestation that proved infrequent&#46; Tendon friction rubs are a physical examination finding&#44; which usually precede skin thickening and can be considered a sign of poor prognosis&#44; usually associated with the diffuse form of the disease&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> It is striking that&#44; in this study&#44; four patients with tendon friction rubs belonged to the limited SSc group&#44; but no follow-up data are available for these patients to ascertain whether these were early forms of diffuse SSc&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">In conclusion&#44; this multicentre study that included patients from 7 healthcare centres in Argentina&#44; whose anti-RNA polymerase III antibodies were tested with a commercial ELISA assay&#44; found a frequency of positive results of 5&#46;9&#37;&#46; This is one of the lowest frequencies reported&#44; which suggests that the frequency of anti-RNA polymerase III could be lower in cohorts that include mixed-race or Amerindian patients&#44; compared to those with a predominance of Caucasian patients&#46; Of the ACA and anti-Scl70 negative patients&#44; 16&#46;7&#37; were anti-RNA polymerase III positive&#46; It is possible that detecting anti-RNA polymerase III may enable better classification&#44; prognosis&#44; and follow-up in these patients&#46; Further studies involving larger numbers of patients are needed to analyse the clinical impact of anti-RNA polymerase III in SSc&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Funding</span><p id="par0245" class="elsevierStylePara elsevierViewall">This research received no specific support from public sector agencies&#44; commercial sector&#44; or non-profit organisations&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Conflict of interests</span><p id="par0250" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare&#46;</p></span></span>"
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              "titulo" => "Clinical manifestations"
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              "titulo" => "Antibody testing"
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          "titulo" => "Results"
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              "identificador" => "sec0045"
              "titulo" => "Description of the sample"
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              "identificador" => "sec0050"
              "titulo" => "Frequency of antibodies"
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              "identificador" => "sec0055"
              "titulo" => "Comparison of anti-RNA polymerase III positive and negative groups"
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          "titulo" => "Conflict of interests"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-03-12"
    "fechaAceptado" => "2021-02-11"
    "PalabrasClave" => array:2 [
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        0 => array:4 [
          "clase" => "keyword"
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          "identificador" => "xpalclavsec1526323"
          "palabras" => array:3 [
            0 => "Systemic sclerosis"
            1 => "Autoantibodies"
            2 => "Anti-RNA polymerase III"
          ]
        ]
      ]
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1526322"
          "palabras" => array:3 [
            0 => "Esclerosis sist&#233;mica"
            1 => "Autoanticuerpos"
            2 => "Anti-RNA polimerasa III"
          ]
        ]
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    "resumen" => array:2 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To describe the frequency of anti-RNA polymerase III antibody in patients with Systemic Sclerosis &#40;SSc&#41; of a group of healthcare centres from Argentina and to explore differences among patients with positive and negative anti-RNA polymerase III antibody&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Patients and methods</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Data from clinical records&#44; anamnesis and physical examination were collected from 135 patients with SSc &#40;ACR&#47;EULAR 2013&#41;&#46; A serum sample from each patient was obtained for the detection of anti-RNA polymerase III IgG antibodies by ELISA&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">In all&#44; 97&#46;8&#37; were women and the median age at diagnosis was 53 years &#40;range 12&#8211;87&#41;&#44; 77&#46;7&#37; had limited cutaneous SSc &#40;lcSSC&#41;&#44; 19&#44;3&#37; patients had diffuse cutaneous SSc &#40;dcSSC&#41; and 2&#46;9&#37; had scleroderma sine scleroderma&#46; The 67&#46;5&#37; of the patients were from a Mestizos or Amerindian ethnic group&#46; Anti-RNA polymerase III was positive in 5&#46;9&#37; of the patients&#46; In 36 patients&#44; the anticentromere &#40;ACA&#41; and anti-Scl70 antibodies were negative&#59; anti-RNA polymerase III was positive in 16&#46;7&#37; of these 36 patients&#46; Pitting scars and pulmonary artery hypertension were more frequent in anti-RNA polymerase III positive patients who were also older at diagnosis&#46; No association with gastric antral vascular ectasia was found&#46; The only patient with scleroderma renal crisis was anti-RNA polymerase III positive&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Anti-RNA polymerase III frequency found in this study was one of the lowest reported&#44; which could be related to the predominance of the Amerindian and Mestizo ethnic group&#46; It is possible that the detection of anti RNA polymerase III allows better classification of SSc patients&#44; to know their prognosis and to improve their follow-up&#44; therefore more studies are needed&#46;</p></span>"
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            "identificador" => "abst0005"
            "titulo" => "Objective"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Patients and methods"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Results"
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            "titulo" => "Conclusions"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Describir la frecuencia del anticuerpo anti-RNA polimerasa III positivo en pacientes con esclerosis sist&#233;mica &#40;ES&#41; de un grupo de centros asistenciales de Argentina&#44; y explorar las diferencias entre pacientes con anti-RNA polimerasa III positivo y negativo&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Pacientes y m&#233;todos</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Se recopilaron datos de las historias cl&#237;nicas&#44; anamnesis y ex&#225;menes f&#237;sicos de 135 pacientes con ES &#40;ACR&#47;EULAR 2013&#41;&#44; de los cuales se obtuvo una muestra de suero para la detecci&#243;n de anti-RNA polimerasa III IgG por ELISA&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">El 92&#44;6&#37; fueron mujeres&#44; la mediana de edad al diagn&#243;stico fue de 53 a&#241;os &#40;rango 12&#8211;87&#41;&#44; el 77&#44;7&#37; ten&#237;a ES limitada&#44; el 19&#44;3&#37; ten&#237;a ES difusa y el 2&#44;9&#37; con ES <span class="elsevierStyleItalic">sine</span> esclerodermia&#46; El 67&#44;5&#37; de los pacientes pertenec&#237;an a la etnia mestiza o amerindia&#46; La frecuencia de anti-RNA polimerasa III positivo fue del 5&#44;9&#37;&#46; En 36 pacientes los anticuerpos anticentr&#243;mero &#40;ACA&#41; y anti-Scl70 fueron negativos&#59; el anti-RNA polimerasa III fue positivo en el 16&#44;7&#37; de estos 36 pacientes&#46; El grupo de pacientes con anti-RNA polimerasa III positivo tuvo una mayor frecuencia de cicatrices puntiformes e hipertensi&#243;n arterial pulmonar&#44; y una mayor edad al diagn&#243;stico&#46; No se encontr&#243; asociaci&#243;n con ectasia vascular g&#225;strica antral&#46; La &#250;nica paciente con crisis renal esclerod&#233;rmica&#44; fue anti-RNA polimerasa III positiva&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">La frecuencia de anti-RNA polimerasa III encontrada en este estudio fue una de las m&#225;s bajas reportadas&#44; lo cual podr&#237;a estar relacionado con el predominio de la etnia mestiza y amerindia&#46; Si bien se necesitan m&#225;s estudios&#44; es posible que la detecci&#243;n del anti-RNA polimerasa III permita clasificar mejor a los pacientes con ES&#44; conocer su pron&#243;stico y mejorar el seguimiento&#46;</p></span>"
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            "titulo" => "Pacientes y m&#233;todos"
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            "titulo" => "Resultados"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Please cite this article as&#58; Gargiulo M&#193;&#44; P&#233;rez N&#44; Khoury M&#44; Buhl M&#44; Su&#225;rez L&#44; Sarano J&#44; et al&#46; Anticuerpos anti-RNA polimerasa III en esclerosis sist&#233;mica&#58; estudio multic&#233;ntrico de Argentina&#46; Reumatol Cl&#237;n&#46; 2022&#59;18&#58;368&#8211;373&#46;</p>"
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          "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The values are expressed as number of patients and the values in percentages &#40;&#37;&#41; are shown in brackets&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">GAVE&#58; gastric antral vascular ectasia&#59; SSc&#58; systemic sclerosis&#46;</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical characteristics&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diffuse SSc &#40;n&#160;&#61;&#160;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arterial hypertension&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">42 &#40;40&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dyslipidaemia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">34 &#40;32&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Smoking&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">27 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Primary biliary cholangitis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cancer&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">3 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Vascular involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Raynaud&#8217;s phenomenon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">102 &#40;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pitting scars&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Digital ulcers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Digital necrosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;11&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Skin involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sclerodactyly&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">59 &#40;56&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Calcinosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Telangiectasias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;38&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Joint involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tendon friction rubs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arthritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;18&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Muscular involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Myositis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Gastrointestinal involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Oesophagus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;69&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 &#40;64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>GAVE<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Bowel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Cardiac involvement</span><a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Impaired conduction system&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;12&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Pulmonary involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pulmonary arterial hypertension&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Interstitial lung disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;65&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Renal involvement</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Scleroderma renal crisis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">A panendoscopy report was available for 126 patients&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">None of the patients presented systolic and&#47;or diastolic dysfunction&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical characteristic of the patients with diffuse and limited SSc&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The results are reported as the number of positives&#47;total results available&#46; The percentage values &#40;&#37;&#41; are shown in brackets&#46; ACA&#58; Anticentromere antibodies&#59; ANA&#58; antinuclear antibodies&#59; RNA Pol III&#58; anti-RNA polymerase III&#59; SSc&#58; systemic sclerosis&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Positive antibody&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diffuse SSc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Limited SSc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Scleroderma <span class="elsevierStyleItalic">sine</span> scleroderma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ANA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#47;26 &#40;88&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">101&#47;105 &#40;96&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;4 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ACA<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;25 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#47;101 &#40;713&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#47;4 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-Scl70<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#47;25 &#40;52&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;100 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#47;4 &#40;25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">RNA Pol III&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#47;26 &#40;11&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#47;105 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">ACA result not available for 5 patients&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Anti-Scl70&#58; result not available for 6 patients&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Frequency of positive antibodies in patients with SSc&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">ACA&#58; anticentromere&#59; anti-Scl70&#58; anti-topoisomerase1&#59; GAVE&#58; gastric antral vascular ectasia&#59; n&#58; number of patients&#59; &#37;&#58; percentage&#59; SRC&#58; scleroderma renal crisis&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:1 [
              "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="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variables&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anti-RNA polymerase III&#44; anti-Scl70 and ACA negative &#40;n&#160;&#61;&#160;30&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ACA positive &#40;n&#160;&#61;&#160;73&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anti-Scl70 positive &#40;n&#160;&#61;&#160;17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Anti-RNA polymerase III positive &#40;n&#160;&#61;&#160;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p-Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female sex&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;93&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;93&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;82&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;412&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median age at diagnosis &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;12&#8722;78&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54 &#40;15&#8722;87&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57 &#40;24&#8722;75&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;53&#8722;67&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;108&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Median years of disease progression &#40;range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0&#8722;41&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;0&#8722;31&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;0&#8722;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;0&#8722;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;508&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mixed ethnicity&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;733&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;47&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;41&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;50&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;076&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diffuse form&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;26&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;76&#46;5&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;37&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pitting scars&#44; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;32&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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Original Article
Anti-RNA polymerase III antibodies in systemic sclerosis: Multicentric study from Argentina
Anticuerpos anti-RNA polimerasa III en esclerosis sistémica: estudio multicéntrico de Argentina
María de los Ángeles Gargiuloa,
Corresponding author
angegargiulo@hotmail.com

Corresponding author.
, Nicolás Pereza, Marina Khouryb, Manuel Buhla, Lorena Suáreza, Judith Saranoa, Fabiana Montoyac, Ignacio Bazzaloc, Sandra Navarrod, Gisela Pendóne, María Josefina Molinaf, Marta Mamanig, Mariano Riveroh, Graciela Gómeza
a Servicio de Inmunología, Instituto de Investigaciones Médicas “Dr. Alfredo Lanari”, UBA, Ciudad Autónoma de Buenos Aires, Argentina
b Docencia e Investigación, Instituto de Investigaciones Médicas “Dr. Alfredo Lanari”, UBA, Ciudad Autónoma de Buenos Aires, Argentina
c Servicio de Reumatología y Colagenopatías, Hospital General de Agudos José María Ramos Mejía, Ciudad Autónoma de Buenos Aires, Argentina
d Servicio de Reumatología, Hospital Provincial del Centenario, Rosario, Santa Fe, Argentina
e Unidad de Reumatología, Hospital “Dr. Ricardo Gutiérrez”, La Plata, Buenos Aires, Argentina
f Consultorio de Reumatología, Hospital Central de San Isidro “Dr. Melchor A Posse”, San Isidro, Buenos Aires, Argentina
g Servicio de Reumatología, Hospital General de Agudos Bernardino Rivadavia, Ciudad Autónoma de Buenos Aires. Argentina
h Servicio de Reumatología, Hospital Británico de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina
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