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          5 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital Interzonal General de Agudos General Jos&#233; de San Mart&#237;n&#44; La Plata&#44; Provincia de Buenos Aires&#44; Argentina"
            "etiqueta" => "f"
            "identificador" => "aff0030"
          ]
          6 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital Brit&#225;nico Central&#44; Ciudad Aut&#243;noma de Buenos Aires&#44; Argentina"
            "etiqueta" => "g"
            "identificador" => "aff0035"
          ]
          7 => array:3 [
            "entidad" => "Secci&#243;n Reumatolog&#237;a&#44; Departamento de Medicina&#44; Hospital Italiano de Buenos Aires&#44; Ciudad Aut&#243;noma de Buenos Aires&#44; Argentina"
            "etiqueta" => "h"
            "identificador" => "aff0040"
          ]
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          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspondencia&#46;"
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    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "Multicentric prevalence study of anti P ribosomal autoantibodies in juvenile onset systemic lupus erythematosus compared with adult onset systemic lupus erythematosus"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">El lupus eritematoso sist&#233;mico &#40;LES&#41; es una enfermedad autoinmune que puede afectar virtualmente cualquier &#243;rgano o sistema&#44; cl&#237;nicamente evoluciona con exacerbaciones y remisiones y serol&#243;gicamente se caracteriza por la presencia de anticuerpos antinucleares &#40;AAN&#41;&#44; anti-DNA nativo y anti-Sm&#46; Si bien es m&#225;s com&#250;n en adultos&#44; un 15-20&#37; de los pacientes con LES se diagnostican por primera vez antes de los 16 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a>&#46; En los pacientes con LES juvenil la edad de mayor incidencia es entre los 12 y 14 a&#241;os&#44; siendo infrecuente antes de los 5 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">El anticuerpo antirribosomal P es un anticuerpo dirigido contra una familia de fosfoprote&#237;nas asociadas a la subunidad ribosomal 60s&#46; Los anticuerpos est&#225;n dirigidos contra tres fosfoprote&#237;nas P0 &#40;38<span class="elsevierStyleHsp" style=""></span>kD&#41;&#44; P1 &#40;19<span class="elsevierStyleHsp" style=""></span>kD&#41;&#44; y P2 &#40;17<span class="elsevierStyleHsp" style=""></span>kD&#41;&#46; Varios estudios cl&#237;nicos han observado diferencias cl&#237;nicas y serol&#243;gicas entre pacientes con LES juvenil y del adulto&#46; La enfermedad en los pacientes con LES juvenil es m&#225;s grave&#44; los tratamientos utilizados son m&#225;s agresivos y acumulan mayor da&#241;o durante su evoluci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;5</span></a>&#46; Esto se debe a una mayor incidencia de compromiso renal y del sistema nervioso central observado en pacientes menores de 16 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6&#8211;9</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se ha reportado en la literatura una elevada prevalencia de anticuerpos antirribosomal P en algunas series de pacientes con LES juvenil<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a>&#44; mientras que otros grupos han encontrado una mayor prevalencia de anti-ADN nativo&#44; anti-nRNP y anti-Sm<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a>&#46; La prevalencia de anticuerpos antirribosomal P en pacientes con LES var&#237;a del 6 al 36&#37; dependiendo de la etnia&#44; la edad y las variables cl&#237;nicas analizadas<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#8211;16</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los anticuerpos antirribosomal P se han asociado con la presencia de nefritis<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#8211;21</span></a>&#44; hepatitis autoimmune<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a> y compromiso neurol&#243;gico<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#8211;27</span></a>&#46; Tres estudios evaluaron la prevalencia y asociaci&#243;n con manifestaciones cl&#237;nicas del antirribosomal P en poblaci&#243;n juvenil&#44; los hallazgos de estos estudios difieren entre s&#237;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#44;11&#44;28</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">No hay datos en la literatura sobre la prevalencia de antirribosomal P y su asociaci&#243;n con manifestaciones cl&#237;nicas en pacientes argentinos&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo de nuestro estudio fue determinar la prevalencia y correlaci&#243;n cl&#237;nica en pacientes argentinos&#44; de los anticuerpos antirribosomal P en LES juvenil y compararlos con los LES del adulto&#46; Se plantea como objetivo secundario comparar las manifestaciones cl&#237;nicas acumuladas del LES juvenil y del adulto&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Pacientes y m&#233;todos</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Pacientes</span><p id="par0035" class="elsevierStylePara elsevierViewall">Todos los pacientes incluidos en el presente estudio cumplieron con cuatro o m&#225;s criterios clasificatorios de LES del Colegio Americano de Reumatolog&#237;a revisados en 1997<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">29&#44;30</span></a>&#46; Consideramos LES juvenil a todos aquellos pacientes que comenzaron su enfermedad antes de los 16 a&#241;os&#46; Se incluyeron en el estudio 30 pacientes con LES juvenil y 92 pacientes con LES del adulto&#44; provenientes de siete centros de referencia de Argentina&#58; Centro de Educaci&#243;n M&#233;dica y de Investigaciones Cl&#237;nicas Norberto Quirno &#40;CEMIC&#41;&#44; Hospital Italiano de Buenos Aires&#44; Hospital General de Agudos Jos&#233; Penna&#44; Hospital de Cl&#237;nicas Jos&#233; de San Mart&#237;n&#44; Hospital General de Agudos Juan Antonio Fern&#225;ndez&#44; Hospital San Mart&#237;n de La Plata&#44; Hospital Brit&#225;nico de Buenos Aires y Hospital de Pediatr&#237;a Prof&#46; Dr&#46; Juan P&#46; Garrahan&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Datos cl&#237;nicos</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se dise&#241;&#243; un cuestionario espec&#237;fico para el estudio&#44; donde se recogieron los datos cl&#237;nicos sobre la base del interrogatorio y la revisi&#243;n de la historia cl&#237;nica del paciente&#46; Se detallaron las manifestaciones cl&#237;nicas que presentaron los pacientes desde el diagn&#243;stico hasta el momento de inclusi&#243;n en el estudio &#40;manifestaciones acumuladas&#41;&#46; Se consideraron las siguientes manifestaciones&#58; rash discoide&#44; &#250;lceras orales&#44; fotosensibilidad&#44; alopecia&#44; eritema malar&#44; fen&#243;meno de Raynaud&#44; leucopenia&#44; anemia hemol&#237;tica&#44; plaquetopenia&#44; serositis&#44; artritis&#44; psicosis&#44; convulsiones&#44; neuropat&#237;a&#44; mielitis transversa&#44; estado confusional agudo&#44; glomerulonefritis&#44; vasculitis&#44; boca seca&#44; ojo seco&#46; Se obtuvo informaci&#243;n sobre el tratamiento recibido desde el diagn&#243;stico de la enfermedad hasta la inclusi&#243;n en el estudio&#46; Se calcul&#243; score de actividad utilizando el score Systemic Lupus Erythematosus disease activity index &#40;SLEDAI&#41; en el momento de recolecci&#243;n de la muestra&#46;Se registraron adem&#225;s los resultados de anticuerpos presentes durante la historia del paciente &#40;AAN&#44; anti-DNA&#44; anti-Ro&#47;SSA&#44; anti-La&#47;SSB&#44; anti-Sm y anti-nRNP&#41;&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Todos los participantes firmaron el consentimiento informado&#59; el estudio fue realizado despu&#233;s de ser aprobado por los respectivos comit&#233;s de &#233;tica de cada instituci&#243;n&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Recolecci&#243;n de muestras y determinaciones de laboratorio</span><p id="par0050" class="elsevierStylePara elsevierViewall">Las muestras de sangre para la determinaci&#243;n de los anticuerpos fueron tomadas en los centros participantes&#44; y fueron analizadas de forma centralizada en el laboratorio de Inmunolog&#237;a y Reumatolog&#237;a del CEMIC&#46; La medici&#243;n de anticuerpos anti-Ro&#47;SSA&#44; anti-La&#47;SSB&#44; anti-Sm y anti-nRNP se realiz&#243; por t&#233;cnica de doble-difusi&#243;n&#46; El anticuerpo antirribosomal P fue evaluado mediante la t&#233;cnica de enzimo-inmunoensayo &#40;ELISA&#41; utilizando como ant&#237;geno&#44; prote&#237;na purificada a partir de timo bovino y&#47;o conejo &#40;ImmunoVision&#44; Inc&#46;&#41; absorbida a raz&#243;n de 0&#44;5 ug por well &#40;placa de poliestireno Maxisorb&#59; Nunc&#41;&#46; Las muestras fueron consideradas positivas con valores &#8805;<span class="elsevierStyleHsp" style=""></span>11 U&#46; La medici&#243;n de anti-Ro&#47;SSA&#44; anti-La&#47;SSB&#44; anti-Sm y anti-nRNP y antirribosomal P se realiz&#243; al mismo tiempo en todas las muestras&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">An&#225;lisis estad&#237;stico</span><p id="par0055" class="elsevierStylePara elsevierViewall">Las variables cualitativas se presentan como n&#250;mero y porcentaje y las cuantitativas como media&#47;mediana y sus desv&#237;os est&#225;ndar&#47;valores m&#237;nimos y m&#225;ximos&#46; Para determinar asociaci&#243;n se utilizaron la prueba de chi-cuadrado &#40;&#967;<span class="elsevierStyleSup">2</span>&#41; o test exacto de Fisher&#46; Para cuantificar fuerza de asociaci&#243;n se determinaron los odds ratios &#40;OR&#41; y sus intervalos de confianza 95&#37; &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#41;&#46; Para el an&#225;lisis del SLEDAI en pacientes antirribosomal P positivos y negativo y en adultos vs&#46; juveniles se utilizaron las pruebas de Wilcoxon y Mann-Whitney&#46; Se consider&#243; como significativa una p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; El an&#225;lisis estad&#237;stico fue realizado utilizando el paquete estad&#237;stico Epi Info&#8482; 7 &#40;Centers for Disease Control and Prevention &#91;CDC&#93;&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Datos demogr&#225;ficos</span><p id="par0060" class="elsevierStylePara elsevierViewall">Veinticuatro pacientes &#40;80&#37;&#41; en el grupo juvenil y 81 &#40;88&#37;&#41; en los adultos eran de etnia cauc&#225;sica&#46; Dos &#40;6&#44;7&#37;&#41; de los pacientes con LES juvenil y 6 &#40;6&#44;5&#37;&#41; pacientes en el grupo de LES del adulto fueron de sexo masculino&#46; La media de edad al diagn&#243;stico en los pacientes con LES juvenil fue de 12&#44;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#44;56 y en los adultos de 30<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;46 a&#241;os&#46; La media de edad de los pacientes en el momento de la inclusi&#243;n en el estudio fue de 22&#44;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;4 y 39&#44;76<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#44;37 a&#241;os para el grupo de LES juvenil y del adulto respectivamente&#59; la media de tiempo de evoluci&#243;n de la enfermedad en el momento de la inclusi&#243;n en el estudio fue de 10&#44;63<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;16 a&#241;os en los juveniles y de 9&#44;36<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#44;75 a&#241;os en los adultos&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Manifestaciones cl&#237;nicas y tratamientos recibidos&#58;</p><p id="par0070" class="elsevierStylePara elsevierViewall">La prevalencia de las diferentes manifestaciones cl&#237;nicas en los dos grupos &#40;adultos y juveniles&#41; se detalla en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; El eritema malar &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;9&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;11-14&#44;25&#41;&#44; la fotosensibilidad &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#44;64&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;03-6&#44;76&#41;&#44; la presencia de vasculitis &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#44;33&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;7-16&#44;0&#41;&#44; rash cut&#225;neo no discoide &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;0&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;09-8&#44;4&#41; y compromiso neurol&#243;gico&#58; convulsiones OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#44;85&#59; &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;12-13&#44;22&#41; y psicosis OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#59; &#40;IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;15-13&#44;79&#41; se encontraron con mayor frecuencia en el grupo de LES juvenil&#46; Cinco pacientes adultas desarrollaron manifestaciones neurol&#243;gicas &#40;no criterio ACR&#41;&#58; deterioro cognitivo en 3 pacientes&#44; polineuropat&#237;a perif&#233;rica sensitiva de miembros inferiores una paciente y estado confusional agudo una paciente&#46; Ninguna paciente present&#243; mielitis transversa&#44; o mononeuritis m&#250;ltiple&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Los pacientes utilizaron los siguientes tratamientos inmunosupresores&#58; metotrexato &#40;MTX&#41;&#44; micofenolato mofetil &#40;MMF&#41;&#44; azatioprina &#40;AZA&#41;&#44; ciclofosfamida &#40;CF&#41;&#44; glucocorticoides &#40;prednisona o equivalente&#41; &#62;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>mg no hubo diferencias estad&#237;sticamente significativas entre pacientes adultos y juveniles ni entre los pacientes antirribosomal P positivos o negativos &#40;datos no mostrados&#41;&#46; Los pacientes adultos recibieron con mayor frecuencia que los juveniles hidroxicloroquina &#40;95&#44;6&#37;&#59; vs&#46; 83&#44;3&#37; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;025&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El score SLEDAI en la poblaci&#243;n total &#40;adultos y juveniles&#41; fue media 3&#44;89 &#40;DS 4&#44;68&#41;&#44; en los pacientes con LES juvenil media 5&#44;11 &#40;DS 5&#44;33&#41; y en adultos media 3&#44;56 &#40;DS 4&#44;44&#41; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;09</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Prevalencia de autoanticuerpos</span><p id="par0085" class="elsevierStylePara elsevierViewall">La prevalencia de anticuerpos se detalla en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; De los anticuerpos determinados la presencia de antirribosomal P &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#44;21&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;6-16&#44;5&#41; fue significativamente mayor en el grupo de pacientes con LES juvenil&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Relaci&#243;n del antirribosomal P con otros anticuerpos</span><p id="par0090" class="elsevierStylePara elsevierViewall">En <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se detalla la prevalencia de otros autoanticuerpos en pacientes con LES juvenil y del adulto&#44; seg&#250;n sean estos antirribosomal P positivos o negativos&#46; La prevalencia de todos los otros autoanticuerpos fue similar en ambos grupos&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Relaci&#243;n del anticuerpo antirribosomal P con las manifestaciones cl&#237;nicas</span><p id="par0095" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> se detalla la prevalencia del anticuerpo antirribosomal P seg&#250;n las manifestaciones cl&#237;nicas&#46; La alopec&#237;a &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;11&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;25-97&#41; y rash cut&#225;neo &#40;no discoide&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;1&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;25-13&#44;89&#41; fueron las &#250;nicas manifestaciones cl&#237;nicas que se asociaron en forma estad&#237;sticamente significativa con la presencia del anticuerpo antirribosomal P&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">El score SLEDAI en la poblaci&#243;n con antirribosomal P negativo fue media&#58; 3&#44;93 &#40;DS 4&#44;76&#41; y en los pacientes con antirribosomal P positivo media&#58; 3&#44;58 &#40;DS 4&#44;12&#41; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;97&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0105" class="elsevierStylePara elsevierViewall">En nuestro estudio hemos analizado las caracter&#237;sticas cl&#237;nicas y de laboratorio de pacientes con LES que comenzaron su enfermedad antes de los 16 a&#241;os &#40;juvenil&#41; y los comparamos con pacientes con LES del adulto&#46; La presencia de eritema malar&#44; fotosensibilidad&#44; vasculitis&#44; rash cut&#225;neo y compromiso neurol&#243;gico &#40;convulsiones y psicosis&#41; fue m&#225;s frecuente en los pacientes con LES juvenil&#46; Cuando comparamos el perfil de los autoanticuerpos entre ambos grupos de pacientes&#44; encontramos que el anticuerpo antirribosomal P fue significativamente m&#225;s prevalente en los LES juvenil &#40;27&#37; vs&#46; 5&#44;62&#37;&#41;&#46; No encontramos asociaci&#243;n del anticuerpo antirribosomal P con otros autoanticuerpos&#46; La alopecia y rash cut&#225;neo &#40;no discoide&#41; fueron las &#250;nicas manifestaciones cl&#237;nicas que se asociaron en forma estad&#237;sticamente significativa con la presencia del anticuerpo antirribosomal P&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">La mayor&#237;a de los estudios reportados con anterioridad&#44; coinciden en que hay una mayor prevalencia de anticuerpos antirribosmal P en los LES juveniles&#59; nuestro estudio confirm&#243; estos hallazgos&#46; Es conocido que ciertas caracter&#237;sticas de la poblaci&#243;n en estudio&#44; como la etnia&#44; el estado de la enfermedad &#40;mayor prevalencia de anticuerpos antirribosomal P en LES activo&#41; y la intensidad del tratamiento hacen que la prevalencia de este autoanticuerpo sea variable&#44; y difiera entre los distintos estudios&#46; Reichlin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> reportaron una prevalencia del anticuerpo antirribosomal P de 42&#37; en pacientes con LES juvenil donde un gran porcentaje de ellos presentaba LES activo&#46; Hoffmann et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#44; a diferencia de los autores anteriores&#44; encontraron una prevalencia del 25&#37;&#44; y Press et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> en su estudio publicado previamente reportaron una prevalencia del 20&#37;&#46; En estos dos &#250;ltimos trabajos no hubo detalles sobre la actividad de la enfermedad y mostraron una prevalencia de antirribosomal P similar a nuestro estudio&#46; Existe gran discrepancia en la literatura respecto a la asociaci&#243;n entre el anticuerpo antirribosomal P y las diferentes manifestaciones cl&#237;nicas en los LES juveniles&#46; Reichlin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> hallaron que el antirribosomal P se asoci&#243; al compromiso renal&#46; Todo lo contrario fue reportado por Hoffman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#44; quienes describieron que la presencia del antirribosomal P en ausencia de anti-DNA se comportaba como protector del compromiso renal&#46; En la poblaci&#243;n de LES del adulto&#44; otros autores encontraron asociaci&#243;n entre antirribosomal P y la presencia de nefropat&#237;a membranosa<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&#46; Al igual que nosotros&#44; Press et al&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> no encontraron ninguna asociaci&#243;n entre este autoanticuerpo y el compromiso renal&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">La asociaci&#243;n del anticuerpo antirribosomal P con las manifestaciones neurol&#243;gicas en pacientes con LES juvenil tambi&#233;n es controvertida&#46; Aldar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> observaron mayor frecuencia del autoanticuerpo en pacientes con LES juvenil y ansiedad&#44; pero no con otras manifestaciones cl&#237;nicas m&#225;s graves del sistema nervioso central&#46; Reichlin et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> y Hoffman et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> no mencionaron en sus trabajos la asociaci&#243;n entre el antirribosomal P y el compromiso neurol&#243;gico&#46; En nuestro estudio&#44; si bien encontramos una mayor prevalencia de manifestaciones cl&#237;nicas neurol&#243;gicas &#40;psicosis y convulsiones&#41; en LES juvenil&#44; no hallamos una asociaci&#243;n estad&#237;sticamente significativa entre el anticuerpo antirribosomal P y dichas manifestaciones&#44; ya sea en el an&#225;lisis de la poblaci&#243;n total de pacientes estudiados como en la de LES juvenil en particular&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Se ha reportado la correlaci&#243;n del antirribosomal P con actividad de la enfermedad medida por SLEDAI y con la presencia de anti-DNA&#46; En nuestro estudio no se encontr&#243; relaci&#243;n entre la actividad de la enfermedad medida por SLEDAI y la presencia de antirribosomal P<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Una de las limitaciones m&#225;s importantes de nuestro estudio es el n&#250;mero reducido de pacientes con LES juvenil debido a dificultades en el reclutamiento&#46; El anticuerpo antirribosomal P fue medido en una &#250;nica oportunidad&#44; por lo tanto podr&#237;amos no haber detectado el anticuerpo en pacientes que est&#233;n inactivos en el momento de la toma de la muestra&#46; Por otro lado&#44; en la muestra hay solo 14 pacientes con antirribosomal P positivo&#44; esto puede haber limitado la posibilidad de encontrar asociaciones estad&#237;sticamente significativas entre el anticuerpo y las manifestaciones cl&#237;nicas&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">A pesar de las limitaciones&#44; este estudio confirma la prevalencia aumentada de anticuerpos antirribosomal P en pacientes con LES juvenil y no encuentra asociaci&#243;n del anticuerpo con manifestaciones renales y del SNC&#46; La alopecia y rash cut&#225;neo &#40;no discoide&#41; fueron las &#250;nicas manifestaciones cl&#237;nicas que se asociaron en forma estad&#237;sticamente significativa con la presencia del anticuerpo antirribosomal P&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Responsabilidades &#233;ticas</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Protecci&#243;n de personas y animales</span><p id="par0135" class="elsevierStylePara elsevierViewall">Los autores declaran que para esta investigaci&#243;n no se han realizado experimentos en seres humanos ni en animales&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Confidencialidad de los datos</span><p id="par0140" class="elsevierStylePara elsevierViewall">Los autores declaran que han seguido los protocolos de su centro de trabajo sobre la publicaci&#243;n de datos de pacientes y que todos los pacientes incluidos en el estudio han recibido informaci&#243;n suficiente y han dado su consentimiento informado por escrito para participar en dicho estudio&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Derecho a la privacidad y consentimiento informado</span><p id="par0145" class="elsevierStylePara elsevierViewall">Los autores han obtenido el consentimiento informado de los pacientes y&#47;o sujetos referidos en el art&#237;culo&#46; Este documento obra en poder del autor de correspondencia&#46;</p></span></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicto de intereses</span><p id="par0150" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "titulo" => "Abstract"
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            1 => array:2 [
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            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Recolecci&#243;n de muestras y determinaciones de laboratorio"
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              "titulo" => "An&#225;lisis estad&#237;stico"
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              "titulo" => "Datos demogr&#225;ficos"
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            1 => array:2 [
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              "titulo" => "Prevalencia de autoanticuerpos"
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              "titulo" => "Relaci&#243;n del antirribosomal P con otros anticuerpos"
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              "titulo" => "Relaci&#243;n del anticuerpo antirribosomal P con las manifestaciones cl&#237;nicas"
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              "titulo" => "Protecci&#243;n de personas y animales"
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            1 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Confidencialidad de los datos"
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              "titulo" => "Derecho a la privacidad y consentimiento informado"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2013-08-18"
    "fechaAceptado" => "2014-03-06"
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            0 => "Lupus eritematoso sist&#233;mico"
            1 => "Lupus juvenil"
            2 => "Antirribosomal P"
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            0 => "Systemic lupus erythematosus"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar la prevalencia y correlaci&#243;n cl&#237;nica de los anticuerpos antirribosomal P en lupus eritematoso sist&#233;mico &#40;LES&#41; juvenil y compararlos con LES del adulto&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">M&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron en el estudio 30 pacientes con LES juvenil y 92 pacientes con LES del adulto&#46; Consideramos LES de comienzo juvenil a todos aquellos pacientes que comenzaron su enfermedad antes de los 16 a&#241;os&#46; Se consideraron las manifestaciones cl&#237;nicas y serol&#243;gicas que presentaron los pacientes desde el diagn&#243;stico hasta el momento de inclusi&#243;n en el estudio &#40;manifestaciones acumuladas&#41;&#46; El anticuerpo antirribosomal P fue evaluado mediante la t&#233;cnica de enzimo-inmunoensayo &#40;ELISA&#41;&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La presencia de antirribosomal P fue significativamente mayor en el grupo de pacientes con LES juvenil comparado con LES del adulto &#40;26&#44;7&#37; vs&#46; 6&#44;5&#37;&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#44;21 &#91;IC95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;6-16&#44;5&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;003&#41;&#46; La alopec&#237;a &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#44;11&#59; IC95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;25-97&#41; y rash cut&#225;neo &#40;no discoide&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#44;1&#59; IC95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;25-13&#44;89&#41; fueron las &#250;nicas manifestaciones cl&#237;nicas que se asociaron en forma estad&#237;sticamente significativa con la presencia del anticuerpo antirribosomal P&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Este estudio confirma una mayor prevalencia de anticuerpos antirribosomal P en pacientes con LES juvenil&#46; La alopecia y el rash cut&#225;neo fueros las &#250;nicas manifestaciones cl&#237;nicas asociadas a la presencia de antirribosomal P&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To investigate the prevalence and associations with clinical manifestations of anti- P ribosomal antibodies in patients with juvenile-onset and adult-onset systemic lupus erythematosus &#40;SLE&#41;&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Clinical and serological data of 30 patients with juvenile-onset SLE &#40;age at onset younger than 16 years old&#41; were compared with data of 92 patients with adult-onset SLE&#46; Symptoms occurring during the entire disease course were considered&#46; Anti- P ribosomal antibodies were tested by ELISA&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Anti- P ribosomal antibodies were found significantly more often in pediatric-onset SLE patients &#40;26&#46;7&#37; vs&#46; 6&#46;5&#37;&#59; OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#46;21 &#91;CI95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;6-16&#46;5&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;003&#41;&#46; Alopecia &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>10&#46;11&#44; <span class="elsevierStyleSmallCaps">CI</span> 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;25-97&#41; and skin rash &#40;non discoid&#41; &#40;OR<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#46;1&#44; CI 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;25-13&#46;89&#41; were significantly associated with anti- P ribosomal antibodies&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Anti-ribosomal P antibodies are more often found in patients with juvenile SLE&#46; Alopecia and skin rash were the only clinical manifestations associated to anti-ribosomal P antibodies&#46;</p></span>"
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                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Manifestaciones cl&#237;nicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LES juvenil &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&#41; n &#40;&#37;&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LES adulto &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>92&#41; n &#40;5&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Piel y faneras</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Eritema malar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">26 &#40;89&#44;7&#59; 78&#44;9-99&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;5&#59; 2&#44;6-10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;9&#59; 1&#44;11-14&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Discoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;7&#44;1&#59; 0-14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;2&#59; 0&#44;1-3&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#59; 0&#44;41-22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rash cut&#225;neo &#40;otros&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;30&#59; 15-45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;12&#59; 7-17&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#59; 1&#44;09-8&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fotosensibilidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;76&#44;7&#59; 63-90&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">51 &#40;55&#59; 46-64&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;64&#59; 1&#44;03-6&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">16 &#40;53&#44;3&#59; 35&#44;7-70&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;36&#59; 27-45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;97&#59; 0&#44;85-4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Raynaud</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;24&#44;1&#59; 10&#44;4-37&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33 &#40;36&#59; 27-45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;53&#59; 0&#44;20-1&#44;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">&#218;lceras orales</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;43&#44;3&#59; 25&#44;7-60&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">34 &#40;37&#59; 28-46&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;3&#59; 0&#44;56-3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Artritis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25 &#40;83&#44;3&#59; 70-96&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76 &#40;86&#59; 81-91&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;82&#59; 0&#44;26-2&#44;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Serositis</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pleuritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;20&#44;7&#59; 7-34&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">23 &#40;25&#59; 18-32&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;70&#59; 0&#44;25-1&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pericarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;16&#44;6&#59; 4&#44;9-28&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">17 &#40;18&#59; 11-25&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&#59; 0&#44;27-2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Glomerulonefritis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;66&#44;7&#59; 51&#44;1-82&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48 &#40;52&#59; 43-61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;83&#59; 0&#44;77-4&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Neurol&#243;gico</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Convulsiones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;23&#59; 9&#44;3-36&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;5&#59; 2&#44;6-10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;85&#59; 1&#44;12-13&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Psicosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;24&#59; 10&#44;3-37&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;5&#59; 2&#44;6-10&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#59; 1&#44;15-13&#44;79&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Hematol&#243;gico</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leucopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">18 &#40;64&#44;3&#59; 48&#44;7-79&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37 &#40;40&#59; 31-49&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;3&#59; 0&#44;96-5&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Anemia hemol&#237;tica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;20&#44;7&#59; 7-34&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;11&#59; 6-16&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;93&#59; 0&#44;63-5&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Plaquetopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;24&#44;1&#59; 10&#44;4-37&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;14&#59; 9-19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;78&#59; 0&#44;63-5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Vasculitis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;30&#59; 14&#44;4-45-6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;7&#44;6&#59; 3&#44;6-11&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;33&#59; 1&#44;7-16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">S&#237;ndrome sicca</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ojo seco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;7&#44;1&#59; 0-14&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;14&#59; 9-19&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;41&#59; 0&#44;08-1&#44;94&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Boca seca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;4&#59; 0&#44;1-7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;30&#59; 0&#44;01-5&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Autoanticuerpo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LES juvenil n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">LES adulto n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&#59; 95&#37;<span class="elsevierStyleHsp" style=""></span>IC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Antirribosomal P&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;26&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;21&#59; 1&#44;6-16&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;003&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-La&#47;SSB&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;6&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;23&#59; 0&#44;01-4&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-Ro&#47;SSA&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;16&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">29 &#40;31&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;47&#59; 0&#44;16-1&#44;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-Sm&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;5&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;1&#59;0&#44;47-9&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-nRNP&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;23&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">20 &#40;21&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;22&#59; 0&#44;45-3&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;68&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Prevalencia de autoanticuerpos en pacientes con LES juvenil comparado con LES del adulto</p>"
        ]
      ]
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                0 => """
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Autoanticuerpo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antirribosomal P &#40;&#43;&#41; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antirribosomal P &#40;-&#41; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>108&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR &#40;95&#37; IC&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-La&#47;SSB&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;5&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;61&#59; 0&#44;03-11&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-Ro&#47;SSA&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">31 &#40;29&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;80&#59; 0&#44;20-3&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-Sm&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;5&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3&#44;33&#59; 0&#44;59-18&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Anti-nRNP&#59; n &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">3 &#40;21&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24 &#40;22&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;13&#59; 0&#44;28-4&#44;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;85&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Prevalencia de otros autoanticuerpos en pacientes con antirribosomal P positivo y negativo</p>"
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        "etiqueta" => "Tabla 4"
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                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Manifestaciones cl&#237;nicas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antirribosomal P &#40;&#43;&#41; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Antirribosomal P &#40;-&#41; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>108&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR&#59; IC<span class="elsevierStyleHsp" style=""></span>95&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Piel y faneras&#59; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Eritema malar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;92&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">76 &#40;70&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5&#44;4&#59; 0&#44;68-43&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Discoide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;4&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;72&#59; 0&#44;03-14&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Rash cut&#225;neo &#40;otros&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">6 &#40;42&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">14 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4&#44;1&#59; 1&#44;25-13&#44;89&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fotosensibilidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;78&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">63 &#40;58&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;6&#59; 0&#44;69-9&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alopecia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">9 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#44;1&#59; 1&#44;25-97&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;04&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Raynaud&#59; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">4 &#40;28&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">47 &#40;43&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;64&#59; 0&#44;18-2&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">&#218;lceras orales&#59; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;35&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">42 &#40;38&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;87&#59; 0&#44;27-2&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Artritis&#59; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">13 &#40;92&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">91 &#40;84&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;4&#59; 0&#44;29-19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Serositis&#59; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pleuritis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">5 &#40;4&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">25&#40;27&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2&#44;22&#59; 0&#44;64-7&#44;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pericarditis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;0&#44;90&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">22 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;33&#59; 0&#44;04-2&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;30&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Glomerulonefritis&#59; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">7 &#40;50&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">61 &#40;56&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;77&#59; 0&#44;25-2&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Neurol&#243;gico&#59; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Convulsiones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1 &#40;7&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">11 &#40;10&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;79&#59; 0&#44;09-6&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;83&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Psicosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">2 &#40;14&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10 &#40;9&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;9&#59; 0&#44;36-10&#44;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">0&#44;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry  " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Hematol&#243;gico&#59; n &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Leucopenia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">8 &#40;57&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49 &#40;45&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&#44;38&#59; 0&#44;44-4&#44;29&nbsp;\t\t\t\t\t\t\n
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