Letter to the Editor
Hepatosplenic gammadelta T-cell lymphoma and Sjögren's syndrome
Linfoma T hepatoesplénico gamma-delta y síndrome de Sjögren
Leído
6540
Vecesse ha leído el artículo
2335
Total PDF
4205
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1699258X14000023" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2013.12.005" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "637" "copyright" => "Elsevier España, S.L.. All rights reserved" "copyrightAnyo" => "2013" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2014;10:264-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2909 "formatos" => array:3 [ "EPUB" => 164 "HTML" => 2063 "PDF" => 682 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S2173574314001063" "issn" => "21735743" "doi" => "10.1016/j.reumae.2013.12.026" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "637" "copyright" => "Elsevier España, S.L." "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2014;10:264-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1205 "formatos" => array:3 [ "EPUB" => 48 "HTML" => 879 "PDF" => 278 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hepatosplenic gammadelta T-cell lymphoma and Sjögren's syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "264" "paginaFinal" => "265" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfoma T hepatoesplénico gamma-delta y síndrome de Sjögren" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ronaldo Godinho, Paula Vanessa de Oliveira, Deonilson Ghizoni Schmoeller, Henrique L. Staub" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ronaldo" "apellidos" => "Godinho" ] 1 => array:2 [ "nombre" => "Paula Vanessa" "apellidos" => "de Oliveira" ] 2 => array:2 [ "nombre" => "Deonilson Ghizoni" "apellidos" => "Schmoeller" ] 3 => array:2 [ "nombre" => "Henrique L." "apellidos" => "Staub" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1699258X14000023" "doi" => "10.1016/j.reuma.2013.12.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14000023?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314001063?idApp=UINPBA00004M" "url" => "/21735743/0000001000000004/v1_201406280041/S2173574314001063/v1_201406280041/en/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1699258X1300226X" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2013.11.010" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "630" "copyright" => "Elsevier España, S.L." "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2014;10:265-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5297 "formatos" => array:3 [ "EPUB" => 147 "HTML" => 3962 "PDF" => 1188 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al editor</span>" "titulo" => "Elevación de transaminasas secundaria a uso de adalimumab" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "265" "paginaFinal" => "266" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Transaminase elevation secondary to the use of adalimumab" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Marietta Luz Juan-Guardela, Lisseth Fernanda Marín-Carrillo, Laura Ximena Kattah-Martínez, Daniel G. Fernández-Ávila" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Marietta Luz" "apellidos" => "Juan-Guardela" ] 1 => array:2 [ "nombre" => "Lisseth Fernanda" "apellidos" => "Marín-Carrillo" ] 2 => array:2 [ "nombre" => "Laura Ximena" "apellidos" => "Kattah-Martínez" ] 3 => array:2 [ "nombre" => "Daniel G." "apellidos" => "Fernández-Ávila" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574314000525" "doi" => "10.1016/j.reumae.2014.03.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574314000525?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X1300226X?idApp=UINPBA00004M" "url" => "/1699258X/0000001000000004/v1_201406210040/S1699258X1300226X/v1_201406210040/es/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1699258X13001526" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2013.05.003" "estado" => "S300" "fechaPublicacion" => "2014-07-01" "aid" => "584" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2014;10:262-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 8420 "formatos" => array:3 [ "EPUB" => 166 "HTML" => 6956 "PDF" => 1298 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Reumatología clínica en imágenes</span>" "titulo" => "Periostitis reactiva de la mano" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "262" "paginaFinal" => "263" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Reactive periostitis of the hand" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 824 "Ancho" => 825 "Tamanyo" => 84640 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Radiografías anteroposterior (A) y lateral (B) del quinto dedo de mano izquierda en las que se observa una lesión nodular osificada adherida al periostio de la falange distal, sin erosión de la cortical.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Ángeles Blázquez Cañamero, Walter Alberto Sifuentes Giraldo, Javier Bachiller Corral" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María Ángeles" "apellidos" => "Blázquez Cañamero" ] 1 => array:2 [ "nombre" => "Walter Alberto" "apellidos" => "Sifuentes Giraldo" ] 2 => array:2 [ "nombre" => "Javier" "apellidos" => "Bachiller Corral" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574313001524" "doi" => "10.1016/j.reumae.2013.12.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313001524?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X13001526?idApp=UINPBA00004M" "url" => "/1699258X/0000001000000004/v1_201406210040/S1699258X13001526/v1_201406210040/es/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Hepatosplenic gammadelta T-cell lymphoma and Sjögren's syndrome" "tieneTextoCompleto" => true "saludo" => "Mr. Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "264" "paginaFinal" => "265" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ronaldo Godinho, Paula Vanessa de Oliveira, Deonilson Ghizoni Schmoeller, Henrique L. Staub" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Ronaldo" "apellidos" => "Godinho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "Paula Vanessa" "apellidos" => "de Oliveira" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Deonilson Ghizoni" "apellidos" => "Schmoeller" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:4 [ "nombre" => "Henrique L." "apellidos" => "Staub" "email" => array:1 [ 0 => "reumatoacademico@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Rheumatology Department, Faculty of Medicine, Saint Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hematology Department, Faculty of Medicine, Saint Lucas Hospital, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Linfoma T hepatoesplénico gamma-delta y síndrome de Sjögren" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Individuals with primary Sjögren's syndrome (pSS) have over 40-fold increased risk of the development B-cell lymphoma.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The relationship of SS with T-cell lymphoma is, nevertheless, enigmatic. We herein describe a case of a patient with features compatible with SS who evolved to a hepatosplenic gammadelta T-cell lymphoma (GDTL).</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient, a 25-year-old white female, had complained of fatigue, “dry eyes” (confirmed by an Ophthalmologist), parotid enlargement and xerostomia for the last four years. Physical examination in December 2008 revealed increased parotid glands and hepatosplenomegaly, but no peripheral lymphadenopathy. Pancytopenia was present (hemoglobin 7.9<span class="elsevierStyleHsp" style=""></span>g/dL, white blood cell 1000<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span>, platelet count 107,000<span class="elsevierStyleHsp" style=""></span>cells/mm<span class="elsevierStyleSup">3</span>). The erythrocyte sedimentation rate was of 37<span class="elsevierStyleHsp" style=""></span>mm in the first hour. Polyclonal hypergammaglobulinemia was present. The antinuclear antibody test was strongly positive (1/5120, speckled pattern), and anti-SSA antibodies were detected in high levels (124 units in an ELISA). The rheumatoid factor test was weakly positive (45 units). Abdominal ecography confirmed hepatosplenomegaly. A bone marrow biopsy (BMB) showed hypercellularity, without evidence of malignancy. Considering the clinical and laboratory findings suggestive of pSS, the patient was treated with prednisone and azathioprine.</p><p id="par0015" class="elsevierStylePara elsevierViewall">After eight months, a notable improvement of clinical and hematological features was seen. Hepatosplenomegaly remained, however, and a new BMB plus splenectomy were carried out. At that time, hemoglobin was 10<span class="elsevierStyleHsp" style=""></span>g/dL, the leukocyte count was 21,900<span class="elsevierStyleHsp" style=""></span>cells/cm<span class="elsevierStyleSup">3</span> (with 65 erythroblasts per 100 leukocytes), and the platelet count was 106,000/cm<span class="elsevierStyleSup">3</span>. The spleen histology was inconclusive, and the BMB showed interstitial infiltration by atypical lymphoid cells. Immunohistochemistry of spleen and bone marrow revealed the following lymphocyte profile: CD3+, CD4−, CD5−, CD8−, Ki 67+ with a rate of 50% CD56+ focal. The karyotype showed, of importance, eight trisomy and absence of chromosome seven. Altogether, morphologic, phenotypic and genetic findings were compatible with a hepatosplenic GDTL. After eighteen months of standard chemotherapy, the patient died in September 2011.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Hepatosplenic GDTL is an aggressive and uncommon malignancy (<1% of lymphoid neoplasms). Intense gammadelta T-cell proliferation is characteristically seen in liver, spleen and bone marrow sinusoids.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The disorder usually affects young adults, and the outcome is poor.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Hepatosplenomegaly and severe cytopenias, both seen in our patient, are usual aspects; lymphadenopathy is rare.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Of interest, hepatosplenic GDTL can mimic the hemophagocytic syndrome.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In 2009, a cutaneous GDTL was diagnosed in a patient with rheumatoid arthritis using etanercept.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Current ACR classification criteria for SS include autoantibodies, ocular staining and salivary gland histology, suggesting that case definition requires two of the three.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> pSS was initially a suitable diagnosis for our patient due to the presence of ophthalmic sicca, parotiditis, typical autoantibodies, polyclonal hypergammaglobulinemia, and peripheral pancytopenia. The first BMB showed no malignancy, and clinical features responded well to traditional immunosuppression.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The unexpected persistence of hepatosplenomegaly led to an immunohistochemistry diagnosis of hepatosplenic GDTL eight months ahead. Thus, it is conceivable that the patient firstly had pSS and later developed a GDTL. Although one cannot rule out the possibility that she presented GDTL with SS features since the beginning, the reported median survival time of six months for GDTL<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> turns it less plausible. Also, an atypical form of SS “secondary” to GDTL could be brought about. Necessary to say, the occurrence of SS and GDTL could have been only coincidental in our patient. For any of these circumstances, no similar clinical scenario combining SS features and GDTL has been described so far.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In summary, we describe a case of a young patient with features of SS who evolved, unusually, to a hepatosplenic GDTL. The interplay of SS with non-B lymphomas has yet to be clarified.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors have no conflict of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphoproliferative disorders in Sjögren's syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Prochorec-Sobieszek" 1 => "T. Wagner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Otolaryngol Pol" "fecha" => "2005" "volumen" => "59" "paginaInicial" => "559" "paginaFinal" => "564" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16273862" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Gamma-delta T-cell lymphomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Tripodo" 1 => "E. Iannitto" 2 => "A.M. Florena" 3 => "C.E. Pucillo" 4 => "P.P. Piccaluga" 5 => "V. Franco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/nrclinonc.2009.169" "Revista" => array:6 [ "tituloSerie" => "Nat Rev Clin Oncol" "fecha" => "2009" "volumen" => "6" "paginaInicial" => "707" "paginaFinal" => "717" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19901919" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hepatosplenic gammadelta T-cell lymphoma is a rare clinicopathologic entity with poor outcome: report on a series of 21 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Belhadj" 1 => "F. Reyes" 2 => "J.P. Farcet" 3 => "H. Tilly" 4 => "C. Bastard" 5 => "R. Angonin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2003-05-1675" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2003" "volumen" => "102" "paginaInicial" => "4261" "paginaFinal" => "4269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12907441" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hepatosplenic and other gammadelta T-cell lymphomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F. Vega" 1 => "L.J. Medeiros" 2 => "P. Gaulard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1309/LRKX8CE7GVPCR1FT" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Pathol" "fecha" => "2007" "volumen" => "127" "paginaInicial" => "869" "paginaFinal" => "880" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17509984" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hepato-splenic gammadelta T-cell lymphoma: a rare entity mimicking the hemophagocytic syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Nosari" 1 => "P.L. Oreste" 2 => "A. Biondi" 3 => "M.C. Costantini" 4 => "L. Santoleri" 5 => "L. Intropido" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Hematol" "fecha" => "1999" "volumen" => "60" "paginaInicial" => "61" "paginaFinal" => "65" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9883807" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous gamma/delta T-cell lymphoma during treatment with etanercept for rheumatoid arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Koens" 1 => "N.J. Senff" 2 => "M.H. Vermeer" 3 => "H.K. Ronday" 4 => "R. Willemze" 5 => "P.M. Jansen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-0728" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2009" "volumen" => "89" "paginaInicial" => "653" "paginaFinal" => "654" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19997706" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "American College of Rheumatology classification criteria for Sjögren's syndrome: a data-driven, expert consensus approach in the Sjögren's International Collaborative Clinical Alliance cohort" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.C. Shiboski" 1 => "C.H. Shiboski" 2 => "L. Criswell" 3 => "A. Baer" 4 => "S. Challacombe" 5 => "H. Lanfranchi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis Care Res (Hoboken)" "fecha" => "2012" "volumen" => "64" "paginaInicial" => "475" "paginaFinal" => "487" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hepatosplenic T-cell lymphoma: clinicopathologic, immunophenotypic, and molecular characterization of 17 Chinese cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.L. Lu" 1 => "Y. Tang" 2 => "Q.P. Yang" 3 => "M. Wang" 4 => "S. Zhao" 5 => "C.F. Bi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.humpath.2011.01.034" "Revista" => array:6 [ "tituloSerie" => "Hum Pathol" "fecha" => "2011" "volumen" => "42" "paginaInicial" => "1965" "paginaFinal" => "1978" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21683978" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/1699258X/0000001000000004/v1_201406210040/S1699258X14000023/v1_201406210040/en/main.assets" "Apartado" => array:4 [ "identificador" => "17506" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas al editor" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/1699258X/0000001000000004/v1_201406210040/S1699258X14000023/v1_201406210040/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X14000023?idApp=UINPBA00004M" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 2 | 3 | 5 |
| 2024 Octubre | 52 | 27 | 79 |
| 2024 Septiembre | 56 | 15 | 71 |
| 2024 Agosto | 71 | 27 | 98 |
| 2024 Julio | 44 | 28 | 72 |
| 2024 Junio | 66 | 35 | 101 |
| 2024 Mayo | 45 | 28 | 73 |
| 2024 Abril | 35 | 21 | 56 |
| 2024 Marzo | 59 | 33 | 92 |
| 2024 Febrero | 42 | 31 | 73 |
| 2024 Enero | 23 | 22 | 45 |
| 2023 Diciembre | 30 | 25 | 55 |
| 2023 Noviembre | 30 | 27 | 57 |
| 2023 Octubre | 38 | 26 | 64 |
| 2023 Septiembre | 49 | 35 | 84 |
| 2023 Agosto | 25 | 14 | 39 |
| 2023 Julio | 35 | 41 | 76 |
| 2023 Junio | 27 | 54 | 81 |
| 2023 Mayo | 38 | 28 | 66 |
| 2023 Abril | 25 | 13 | 38 |
| 2023 Marzo | 41 | 31 | 72 |
| 2023 Febrero | 40 | 26 | 66 |
| 2023 Enero | 15 | 22 | 37 |
| 2022 Diciembre | 46 | 22 | 68 |
| 2022 Noviembre | 56 | 23 | 79 |
| 2022 Octubre | 26 | 27 | 53 |
| 2022 Septiembre | 27 | 34 | 61 |
| 2022 Agosto | 40 | 32 | 72 |
| 2022 Julio | 26 | 34 | 60 |
| 2022 Junio | 41 | 39 | 80 |
| 2022 Mayo | 35 | 41 | 76 |
| 2022 Abril | 33 | 37 | 70 |
| 2022 Marzo | 39 | 41 | 80 |
| 2022 Febrero | 38 | 34 | 72 |
| 2022 Enero | 28 | 35 | 63 |
| 2021 Diciembre | 35 | 37 | 72 |
| 2021 Noviembre | 37 | 43 | 80 |
| 2021 Octubre | 35 | 52 | 87 |
| 2021 Septiembre | 38 | 22 | 60 |
| 2021 Agosto | 19 | 46 | 65 |
| 2021 Julio | 36 | 36 | 72 |
| 2021 Junio | 42 | 29 | 71 |
| 2021 Mayo | 39 | 27 | 66 |
| 2021 Abril | 94 | 61 | 155 |
| 2021 Marzo | 74 | 33 | 107 |
| 2021 Febrero | 34 | 17 | 51 |
| 2021 Enero | 28 | 17 | 45 |
| 2020 Diciembre | 25 | 15 | 40 |
| 2020 Noviembre | 32 | 23 | 55 |
| 2020 Octubre | 23 | 19 | 42 |
| 2020 Septiembre | 33 | 16 | 49 |
| 2020 Agosto | 22 | 23 | 45 |
| 2020 Julio | 27 | 26 | 53 |
| 2020 Junio | 45 | 29 | 74 |
| 2020 Mayo | 22 | 15 | 37 |
| 2020 Abril | 39 | 18 | 57 |
| 2020 Marzo | 32 | 24 | 56 |
| 2020 Febrero | 31 | 29 | 60 |
| 2020 Enero | 39 | 18 | 57 |
| 2019 Diciembre | 22 | 26 | 48 |
| 2019 Noviembre | 14 | 24 | 38 |
| 2019 Octubre | 35 | 9 | 44 |
| 2019 Septiembre | 34 | 26 | 60 |
| 2019 Agosto | 34 | 31 | 65 |
| 2019 Julio | 34 | 28 | 62 |
| 2019 Junio | 18 | 26 | 44 |
| 2019 Mayo | 46 | 58 | 104 |
| 2019 Abril | 30 | 29 | 59 |
| 2019 Marzo | 25 | 20 | 45 |
| 2019 Febrero | 22 | 17 | 39 |
| 2019 Enero | 40 | 33 | 73 |
| 2018 Diciembre | 70 | 49 | 119 |
| 2018 Noviembre | 71 | 13 | 84 |
| 2018 Octubre | 57 | 8 | 65 |
| 2018 Septiembre | 25 | 8 | 33 |
| 2018 Agosto | 28 | 9 | 37 |
| 2018 Julio | 17 | 4 | 21 |
| 2018 Mayo | 5 | 0 | 5 |
| 2018 Abril | 40 | 14 | 54 |
| 2018 Marzo | 56 | 7 | 63 |
| 2018 Febrero | 61 | 0 | 61 |
| 2018 Enero | 33 | 11 | 44 |
| 2017 Diciembre | 43 | 5 | 48 |
| 2017 Noviembre | 28 | 9 | 37 |
| 2017 Octubre | 19 | 9 | 28 |
| 2017 Septiembre | 19 | 6 | 25 |
| 2017 Agosto | 30 | 5 | 35 |
| 2017 Julio | 23 | 9 | 32 |
| 2017 Junio | 45 | 11 | 56 |
| 2017 Mayo | 42 | 14 | 56 |
| 2017 Abril | 33 | 8 | 41 |
| 2017 Marzo | 17 | 5 | 22 |
| 2017 Febrero | 20 | 6 | 26 |
| 2017 Enero | 18 | 4 | 22 |
| 2016 Diciembre | 37 | 16 | 53 |
| 2016 Noviembre | 34 | 7 | 41 |
| 2016 Octubre | 53 | 12 | 65 |
| 2016 Septiembre | 32 | 5 | 37 |
| 2016 Agosto | 22 | 6 | 28 |
| 2016 Julio | 12 | 4 | 16 |
| 2016 Mayo | 1 | 0 | 1 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Enero | 1 | 0 | 1 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Septiembre | 2 | 0 | 2 |
| 2015 Agosto | 2 | 0 | 2 |
| 2015 Julio | 14 | 6 | 20 |
| 2015 Junio | 26 | 9 | 35 |
| 2015 Mayo | 26 | 16 | 42 |
| 2015 Abril | 37 | 13 | 50 |
| 2015 Marzo | 29 | 13 | 42 |
| 2015 Febrero | 28 | 0 | 28 |
| 2015 Enero | 51 | 0 | 51 |
| 2014 Diciembre | 53 | 0 | 53 |
| 2014 Noviembre | 50 | 0 | 50 |
| 2014 Octubre | 58 | 0 | 58 |
| 2014 Septiembre | 37 | 1 | 38 |
| 2014 Agosto | 84 | 0 | 84 |
| 2014 Julio | 126 | 0 | 126 |
| 2014 Junio | 29 | 0 | 29 |
Mostrar todo
