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desde los a&#241;os 1965 y 1986&#44; respectivamente&#44; hasta febrero del a&#241;o 2014&#46; Los t&#233;rminos de b&#250;squeda&#44; en espa&#241;ol y en ingl&#233;s&#44; fueron s&#237;ndrome de Churg-Strauss &#40;Churg-Strauss syndrome&#41;&#44; granulomatosis eosinof&#237;lica con poliangitis &#40;eosinophilic granulomatosis with polyangiitis&#41;&#44; ange&#237;tis granulomatosa al&#233;rgica &#40;allergic granulomatous angiitis&#41;&#44; RXT y anticuerpo monoclonal anti-CD20 &#40;anti-CD20 monoclonal antibody&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se analizaron los siguientes datos&#58; edad&#44; sexo&#44; &#243;rganos&#47;sistemas afectados cuando se indic&#243; RTX&#44; estado cl&#237;nico de la enfermedad &#40;definido como reca&#237;da&#44; refractariedad al tratamiento o nuevo diagn&#243;stico&#41;&#44; determinaci&#243;n de ANCA&#44; recuento de eosin&#243;filos y de linfocitos B en sangre perif&#233;rica&#44; n&#250;mero de f&#225;rmacos inmunodepresores utilizados antes y durante el tratamiento con RTX&#44; posolog&#237;a utilizada de RTX&#44; evoluci&#243;n cl&#237;nica de los pacientes y eventos adversos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Fueron excluidas para el an&#225;lisis final todas aquellas publicaciones que no contaron con los datos anteriormente detallados&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">An&#225;lisis estad&#237;stico</span>&#58; las variables cualitativas se presentaron como n y porcentaje&#44; y las cuantitativas como media &#177; desviaci&#243;n est&#225;ndar o mediana y sus valores m&#237;nimos y m&#225;ximos&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se detallan las caracter&#237;sticas generales de los 27 pacientes con diagn&#243;stico de EGPA incluidos para el an&#225;lisis&#46; Quince &#40;55&#44;5&#37;&#41; fueron de sexo masculino y 12 &#40;44&#44;5&#37;&#41; de sexo femenino&#46; La mediana de seguimiento fue de 15 meses &#40;3-60 meses&#41;&#46; La indicaci&#243;n de RTX fue por enfermedad refractaria en 20 &#40;74&#44;1&#37;&#41;&#44; reca&#237;da en 5 &#40;18&#44;5&#37;&#41; y nuevo diagn&#243;stico en 2 &#40;7&#44;4&#37;&#41; pacientes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Los &#243;rganos afectados que motivaron el uso de RTX fueron los pulmones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#44; 66&#44;6&#37;&#41; &#40;asma&#44; infiltrados pulmonares o hemorragia alveolar&#41;&#44; el sistema nervioso perif&#233;rico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#44; 59&#44;3&#37;&#41; &#40;mono o polineuropat&#237;a&#41;&#44; el ri&#241;&#243;n &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44; 33&#44;3&#37;&#41;&#44; los ojos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44; 33&#44;3&#37;&#41; y el coraz&#243;n &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 22&#44;2&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Los ANCA se reportaron en 14 pacientes &#40;51&#44;8&#37;&#41;&#44; 11 &#40;78&#44;6&#37;&#41; con patr&#243;n perinuclear &#40;P-ANCA&#41; y 3 &#40;21&#44;4&#37;&#41; con patr&#243;n citoplasm&#225;tico &#40;C-ANCA&#41;&#46; En 10 &#40;33&#44;1&#37;&#41; pacientes&#44; el ANCA fue negativo y en 3 &#40;11&#44;1&#37;&#41; el estatus del ANCA no fue comunicado&#46; El n&#250;mero de eosin&#243;filos&#44; antes del comienzo del tratamiento con RTX&#44; estaba elevado en todos los pacientes &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La mediana de f&#225;rmacos inmunodepresores &#40;incluidos los GC&#41; utilizados antes del comienzo del tratamiento con RTX fue de 3 &#40;rango 1-6&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Los esquemas posol&#243;gicos de RTX utilizados fueron&#58; <span class="elsevierStyleItalic">1&#41;</span> 375<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span> de superficie corporal cada 7 d&#237;as&#44; total 4 infusiones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#59; <span class="elsevierStyleItalic">2&#41;</span> 1&#46;000<span class="elsevierStyleHsp" style=""></span>mg cada 15 d&#237;as&#44; total 2 infusiones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41; y variantes de los anteriores &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#46; En 2 pacientes la infusi&#243;n de RTX debi&#243; suspenderse por reacci&#243;n adversa&#44; no pudiendo completarse el esquema posol&#243;gico&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Excluyendo el uso de GC&#44; en 14 pacientes se utiliz&#243; concomitantemente otro f&#225;rmaco inmunodepresor junto a RTX &#40;CF&#44; AZA&#44; metotrexato y micofenolato mofetilo&#41;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Respuesta al tratamiento</span><p id="par0075" class="elsevierStylePara elsevierViewall">Se observ&#243; remisi&#243;n cl&#237;nica de la enfermedad en 16 &#40;59&#44;2&#37;&#41; pacientes y respuesta en 8 &#40;29&#44;6&#37;&#41; pacientes &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1 y 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En 3 &#40;12&#37;&#41; pacientes se observ&#243; una reca&#237;da&#44; las manifestaciones cl&#237;nicas fueron menores y en 2 de ellos coincidi&#243; con la reaparici&#243;n de linfocitos B CD20 &#43; en sangre perif&#233;rica&#46; Los 3 pacientes fueron tratados nuevamente con RTX&#44; observ&#225;ndose respuesta cl&#237;nica&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se detalla la evoluci&#243;n de los ANCA&#44; el recuento de eosin&#243;filos y la determinaci&#243;n de linfocitos B CD20 &#43; en los pacientes antes y despu&#233;s de la administraci&#243;n de RTX&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Los eventos adversos comunicados se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; En 2 pacientes debi&#243; suspenderse la primera infusi&#243;n de RTX por broncoespasmo grave&#59; los restantes eventos adversos fueron infecciones respiratorias y un episodio de herpes z&#243;ster&#46; A un paciente se le diagnostic&#243; un seminoma 12 meses despu&#233;s de recibir RTX&#46; No hubo muertes&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">La EGPA forma parte del grupo de las VAA junto a la GPA y MPA&#59; sin embargo&#44; se diferencia de ellas en varios aspectos&#46; El r&#233;gimen de tratamiento actual de la EGPA es similar al de las restantes VAA&#44; pero difiere en que el RTX no tiene una indicaci&#243;n definida como en la GPA y la MPA&#44; ya que no se incluy&#243; a pacientes con EGPA en los ensayos cl&#237;nicos aleatorizados&#44; como el RAVE y el RITUXVAS<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Hasta el momento&#44; solo existen publicaciones de casos anecd&#243;ticos de EGPA tratados con RTX&#44; lo cual hace dif&#237;cil valorar la eficacia terap&#233;utica de este f&#225;rmaco en esta entidad&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El an&#225;lisis de la literatura muestra que la mayor&#237;a de los pacientes con EGPA tratados con RTX eran refractarios a los tratamientos de primera l&#237;nea o que presentaron una reca&#237;da durante el tratamiento inmunodepresor de mantenimiento&#46; Solo 5 pacientes recibieron RTX como tratamiento de inducci&#243;n en primera l&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En todos los pacientes se observ&#243; una respuesta r&#225;pida despu&#233;s del tratamiento con RTX&#59; 2 pacientes no completaron la infusi&#243;n del f&#225;rmaco por una reacci&#243;n adversa grave durante la misma<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; En la mayor&#237;a de los pacientes se observ&#243; remisi&#243;n cl&#237;nica de la enfermedad&#46; Tres pacientes presentaron una o m&#225;s reca&#237;das&#44; pero respondieron a un nuevo ciclo de RTX&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se detalla la respuesta al tratamiento con RTX de los casos analizados junto con 2 series de casos recientemente comunicadas en forma de res&#250;menes<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Un aspecto importante en los pacientes con EGPA es la persistencia de los s&#237;ntomas del asma a pesar del tratamiento y la morbilidad que conlleva la dependencia de los GC a largo plazo&#46; Si bien en los trabajos analizados no se especifica la respuesta terap&#233;utica del RTX sobre el asma&#44; recientemente en una comunicaci&#243;n presentada en el 16th International Vasculitis &#38; ANCA Workshop &#40;Par&#237;s&#44; Francia&#41; por Hot et al&#46; se encontr&#243; que el 39&#37; de los pacientes con EGPA tratados con RTX continuaban con requerimientos de GC por persistencia del asma<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Los valores de eosin&#243;filos en sangre perif&#233;rica disminuyeron o se normalizaron despu&#233;s del tratamiento con RTX&#44; independientemente del r&#233;gimen posol&#243;gico utilizado&#44; en la mayor&#237;a de los pacientes&#46; Este hallazgo pone en consideraci&#243;n la estrecha relaci&#243;n que tienen las diferentes c&#233;lulas del sistema inmunitario&#44; y en particular la importante interacci&#243;n existente entre el linfocito Th2&#44; a trav&#233;s de la secreci&#243;n de citocinas &#40;IL-4&#44; IL-5 y IL-13&#41;&#44; con el linfocito B y la posterior producci&#243;n y secreci&#243;n de eotaxina-1&#44; IgG4&#44; IgE y de los ANCA<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;24</span></a>&#46; La IgE est&#225; elevada en el suero de los pacientes con EGPA&#46; Esta inmunoglobulina&#44; que es producida por c&#233;lulas plasm&#225;ticas&#44; se encuentra unida a receptores &#40;Fc¿R1&#41; en la superficie de los eosin&#243;filos&#44; que&#44; al unirse a ant&#237;genos&#44; induce su intervenci&#243;n en la respuesta inflamatoria&#46; Por otro lado&#44; la eotaxina-1 participa en el reclutamiento de los eosin&#243;filos al sitio de inflamaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Estos mecanismos podr&#237;an explicar en parte el descenso de los eosin&#243;filos despu&#233;s del tratamiento con RTX&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Los linfocitos CD20 &#43; circulantes despu&#233;s del uso de RTX fueron indetectables y persistieron de ese modo por tiempo variable&#46; El periodo hasta la repoblaci&#243;n de c&#233;lulas CD20 &#43; no fue uniforme y en algunos pacientes no se correlacion&#243; con la evoluci&#243;n cl&#237;nica de la enfermedad&#46; En el estudio RAVE<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#44; en un elevado porcentaje de pacientes el recuento s&#233;rico de linfocitos B CD20 &#43; era indetectable despu&#233;s de la infusi&#243;n de RTX &#40;al igual que el grupo que utiliz&#243; CF&#41; y el tiempo hasta la repoblaci&#243;n de los mismos era variable&#46; A&#250;n m&#225;s importante fue el hallazgo de que la repoblaci&#243;n de linfocitos B CD20 &#43; como variable aislada no predijo sobre el riesgo de reca&#237;da en el paciente individual&#46; Sin embargo&#44; aquellos pacientes que despu&#233;s del uso de RTX permanec&#237;an con los valores s&#233;ricos de linfocitos B CD20 &#43; indetectables y el ANCA negativo ten&#237;an pocas probabilidades de presentar una reca&#237;da&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Los ANCA no son el &#250;nico mecanismo involucrado en la patog&#233;nesis de esta vasculitis&#59; los pacientes con EGPA tendr&#237;an una fuerte respuesta de tipo IgG4 independientemente del estatus del ANCA&#59; la evidencia del di&#225;logo entre el linfocito B y el eosin&#243;filo&#44; y la capacidad de la c&#233;lula B de secretar eotaxina-1&#44; la cual interviene en el reclutamiento de los eosin&#243;filos en los sitios de inflamaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24-26</span></a> podr&#237;an ser otras v&#237;as patog&#233;nicas involucradas en la respuesta mediada por el RTX&#59; por tanto&#44; el hecho de que un paciente sea ANCA negativo no predice la falta de respuesta al tratamiento con RTX&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">El RTX fue bien tolerado&#59; solo 2 pacientes presentaron reacciones adversas durante su infusi&#243;n&#46; Los eventos adversos fueron menores&#44; generalmente infecciones respiratorias de manejo ambulatorio&#46; No se reportaron muertes directamente atribuidas al RTX&#46; Esto coincide con los efectos adversos comunicados en grandes series y estudios cl&#237;nicos extensos que demostraron la seguridad de RTX en el tratamiento de las VAA<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5-8</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Los esquemas posol&#243;gicos m&#225;s utilizados fueron&#58; 1&#46;000<span class="elsevierStyleHsp" style=""></span>mg de RTX cada 15 d&#237;as &#40;total 2 infusiones&#41; y 375<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span> de RTX por semana &#40;total 4 infusiones&#41;&#46; Si bien ambos esquemas no fueron comparados formalmente&#44; parecen ser igualmente eficaces para la inducci&#243;n de la remisi&#243;n en las VAA&#59; la recomendaci&#243;n de expertos sobre el uso de RTX en VAA es la utilizaci&#243;n indistinta de ambos esquemas por igual<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Este estudio tiene limitaciones&#59; el n&#250;mero de pacientes es peque&#241;o&#44; el tiempo de seguimiento es limitado&#44; las definiciones de actividad y da&#241;o no fueron uniformes &#8212;solo en algunos trabajos fue utilizado el Birmingham Vasculitis Activity Score y en diferentes versiones&#8212;&#44; los inmunodepresores y los esquemas posol&#243;gicos de RTX difieren entre los pacientes&#46; Adem&#225;s&#44; no encontramos publicaciones de pacientes con EGPA que no respondieran al RTX&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Sin embargo&#44; existe una tendencia generalizada a reconsiderar los est&#225;ndares de tratamiento de las VAA&#44; incluyendo la EGPA&#44; tanto en la inducci&#243;n como en el mantenimiento<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Finalmente&#44; el RTX parece ser eficaz y seguro para el tratamiento de la EGPA refractaria&#44; la reca&#237;da y con nuevo diagn&#243;stico independiente del estatus del ANCA&#46; Es necesaria la realizaci&#243;n de estudios cl&#237;nicos aleatorizados para confirmar esta observaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Responsabilidades &#233;ticas</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Protecci&#243;n de personas y animales</span><p id="par0155" 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="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Confidencialidad de los datos</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Derecho a la privacidad y consentimiento informado</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Algunos pacientes con granulomatosis eosinof&#237;lica con poliangitis &#40;EGPA&#41; y factores de mal pron&#243;stico son refractarios o presentan efectos adversos al tratamiento de inducci&#243;n &#40;glucocorticoides &#91;GC&#93; y ciclofosfamida &#91;CF&#93;&#41;&#44; o recaen durante el mantenimiento &#40;GC y azatioprina&#41;&#44; haciendo necesaria la b&#250;squeda de alternativas terap&#233;uticas&#46; En ensayos cl&#237;nicos&#44; el rituximab &#40;RTX&#41; demostr&#243; ser eficaz para el tratamiento de las vasculitis asociadas al ANCA&#59; sin embargo&#44; los pacientes con EGPA no fueron incluidos&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Revisar y analizar la bibliograf&#237;a sobre la uso de RTX para el tratamiento de la EGPA&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La b&#250;squeda se realiz&#243; en MEDLINE y LILACS &#40;1965 y 1986&#44; respectivamente&#44; hasta febrero del 2014&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 27 pacientes&#46; La indicaci&#243;n de RTX fue por enfermedad refractaria &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; reca&#237;da &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; y nuevo diagn&#243;stico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; Los &#243;rganos afectados fueron los pulmones&#44; el sistema nervioso perif&#233;rico&#44; el ri&#241;&#243;n y los ojos&#46; Se observ&#243; remisi&#243;n en 16 y respuesta en 8 pacientes&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El RTX fue eficaz y bien tolerado para el tratamiento de la EGPA&#46;</p></span>"
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            "identificador" => "abst0005"
            "titulo" => "Antecedentes"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The general consensus is that for patients with EGPA with poor prognosis&#44; intensive therapy with both GC and CF is indicated&#46; The maintenance of remission is made with GC and AZA&#46; A considerable number of patients with EGPA are refractory to first line therapy&#44; experience dose-limiting side effects or relapse&#46; In clinical trials&#44; RTX was effective for the treatment of ANCA-associated vasculitis&#46; However&#44; patients with a diagnosis of EGPA were not included&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">to review and analyze the published literature regarding the use of RTX in the treatment of EGPA&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The literature search was performed in MEDLINE and LILACS from 1965 and 1986 respectively until february 2014&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">27 patients were included&#46; RTX treatment was due to refractory disease &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; relapse &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; and with newly diagnosed &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; The affected organs were the lungs&#44; peripheral nervous system&#44; kidney and the eyes&#46; Sixteen patients had clinical remission and 8 patients had clinical response&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">RTX was effective and well tolerated for the treatment of EGPA&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AZA&#58; azatioprina&#59; CF&#58; ciclofosfamida&#59; CSP&#58; ciclosporina&#59; Dn&#58; nuevo diagn&#243;stico&#59; F&#58; femenino&#59; Ig&#58; inmunoglobulina&#59; M&#58; masculino&#59; MFM&#58; micofenolato mofetilo&#59; MP&#58; metilprednisolona&#59; MTX&#58; metotrexate&#59;NC&#58; no corresponde&#59; NR&#58; no reportado&#59; PF&#58; plasmaf&#233;resis&#59; PS&#58; prednisona&#59; Rc&#58; reca&#237;da&#59; Rf&#58; refractaria&#59; RP&#58; respuesta&#59; RS&#58; remisi&#243;n&#59; SNC&#58; sistema nervioso central&#59; SNP&#58; sistema nervioso perif&#233;rico&#59; RTX&#58; rituximab&#59; VAS&#58; v&#237;as a&#233;reas superiores&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Paciente&#47;cita&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">Edad&#47;sexo&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">Estado&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">&#211;rganos afectados&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">Tratamientos <span class="elsevierStyleBold">previos</span> y concomitantes&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">Tiempo seguimiento&#40;meses&#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">N&#46;&#176; de ciclosde RTX e indicaci&#243;n&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">Resultado&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">Eventos adversos&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">1<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Piel&#44; pulm&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; herpes z&#243;ster&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">2<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; SNP&#44; VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; Ig&#44; MFM&#44; alentuzumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&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;reca&#237;da&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">3<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; VAS&#44; SNP&#44; articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; AZA&#44; MFM&#44; INF alentuzumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infecci&#243;n respiratoria&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">4<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Piel&#44; ri&#241;&#243;n&#44; ojo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS&#44; CF</span>&#44; PF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">5<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; coraz&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS</span>&#44; Ig&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">6<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; articular&#44; piel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS</span>&#44; CF&#44; Ig&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">7<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; pulm&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PS&#44; AZA&#44; MTX&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Broncoespasmo&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">8<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PS&#44; CF&#44; MFM&#44; AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Broncoespasmo&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">9<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; <span class="elsevierStyleBold">MFM</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">10<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; o&#237;do&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; AZA&#44; <span class="elsevierStyleBold">MTX</span>&#44; CSP&#44; infliximab&#44; anakinra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">11<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">12<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&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;reca&#237;da&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">13<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&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;reca&#237;da&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">14<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dn&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&#44; pulm&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">15<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dn&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&#44; m&#250;sculo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">16<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF</span>&#44; AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">17<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; s&#237;ndrome febril&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS</span>&#44; Ig&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">18<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; CF&#44; PF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">19<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">20<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&#44; SNP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">21<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; SNP&#44; SNC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; MTX&#44; <span class="elsevierStyleBold">AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">22<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&#44; SNC&#44; piel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">23<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA&#44;</span> AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Seminoma&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">24<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; SNP&#44; piel&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; <span class="elsevierStyleBold">MFM</span>&#44; MTX&#44; LF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">25<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&#44; piel&#44; SNP&#44; SNC&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; AZA</span>&#44; CF&#44; MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">26<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; SNP&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">27<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; SNP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; MTX</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pacientes estudiados&#47;totalPrevio rituximab&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">ANCA&#47;especificidad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Recuento de eosin&#243;filos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Casos analizados<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9-21</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dubrau et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hot et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
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                            3 => "P&#46; Brogan"
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                  ]
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                    0 => array:2 [
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Rituximab en el tratamiento de la granulomatosis eosinofílica con poliangitis
Rituximab in the treatment of eosinophilic granulomatosis with polyangiitis
Sebastián Andrés Muñoza,
Autor para correspondencia
, Ignacio Javier Gandinoa, Alberto Omar Ordenb, Alberto Allievic
a Servicio de Clínica Médica División «A», Hospital General de Agudos Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina
b Servicio de Reumatología, Hospital Aeronáutico Central, Ciudad Autónoma de Buenos Aires, Argentina
c Exjefe del Servicio de Clínica Médica División «A», Hospital General de Agudos Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina
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definidas como una puntuaci&#243;n de los 5 factores &#40;FFS&#41; igual o mayor a 1&#44; con GC y CF hasta lograr la remisi&#243;n cl&#237;nica&#46; El mantenimiento de la remisi&#243;n se hace con GC y AZA&#46; Las formas cl&#237;nicas leves &#40;FFS de 0&#41; se tratan solo con GC&#46; Sin embargo&#44; la elevada tasa de eventos adversos&#44; la falta de respuesta al tratamiento de inducci&#243;n y las reca&#237;das frecuentes observadas con los tratamientos de primera l&#237;nea hacen necesaria la b&#250;squeda de alternativas terap&#233;uticas<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2-4</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El rituximab &#40;RTX&#41; es un anticuerpo monoclonal quim&#233;rico que se une espec&#237;ficamente al ant&#237;geno CD20&#44; una fosfoprote&#237;na de transmembrana no glucosilada&#44; expresada en los linfocitos pre-B y B&#46; El uso razonable de este f&#225;rmaco en la EGPA se basa principalmente en sus buenos resultados en comunicaciones de casos y peque&#241;as series de pacientes refractarios al tratamiento de primera l&#237;nea&#44; y adem&#225;s es apoyado por su eficacia probada en ensayos cl&#237;nicos aleatorizados en las VAA &#40;GPA y MPA&#41;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5-8</span></a>&#46; Como no se incluy&#243; a pacientes con EGPA en estos ensayos cl&#237;nicos&#44; la aprobaci&#243;n del RTX no se extendi&#243; a EGPA&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El prop&#243;sito del presente estudio es revisar y analizar los estudios publicados en la literatura m&#233;dica sobre el uso RTX en el tratamiento de la EGPA&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Materiales y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Estrategia de b&#250;squeda bibliogr&#225;fica</span>&#58; consultamos las bases de datos Medical Literature Analysis and Retrieval System on Line &#40;MEDLINE&#41;&#47;National Library of Medicine &#40;NLM&#41;-Biblioteca de Medicina de los Estados Unidos y Literatura Latinoamericana y del Caribe en Ciencias de la Salud &#40;LILACS&#41; desde los a&#241;os 1965 y 1986&#44; respectivamente&#44; hasta febrero del a&#241;o 2014&#46; Los t&#233;rminos de b&#250;squeda&#44; en espa&#241;ol y en ingl&#233;s&#44; fueron s&#237;ndrome de Churg-Strauss &#40;Churg-Strauss syndrome&#41;&#44; granulomatosis eosinof&#237;lica con poliangitis &#40;eosinophilic granulomatosis with polyangiitis&#41;&#44; ange&#237;tis granulomatosa al&#233;rgica &#40;allergic granulomatous angiitis&#41;&#44; RXT y anticuerpo monoclonal anti-CD20 &#40;anti-CD20 monoclonal antibody&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Se analizaron los siguientes datos&#58; edad&#44; sexo&#44; &#243;rganos&#47;sistemas afectados cuando se indic&#243; RTX&#44; estado cl&#237;nico de la enfermedad &#40;definido como reca&#237;da&#44; refractariedad al tratamiento o nuevo diagn&#243;stico&#41;&#44; determinaci&#243;n de ANCA&#44; recuento de eosin&#243;filos y de linfocitos B en sangre perif&#233;rica&#44; n&#250;mero de f&#225;rmacos inmunodepresores utilizados antes y durante el tratamiento con RTX&#44; posolog&#237;a utilizada de RTX&#44; evoluci&#243;n cl&#237;nica de los pacientes y eventos adversos&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Fueron excluidas para el an&#225;lisis final todas aquellas publicaciones que no contaron con los datos anteriormente detallados&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">An&#225;lisis estad&#237;stico</span>&#58; las variables cualitativas se presentaron como n y porcentaje&#44; y las cuantitativas como media &#177; desviaci&#243;n est&#225;ndar o mediana y sus valores m&#237;nimos y m&#225;ximos&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0045" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> se detallan las caracter&#237;sticas generales de los 27 pacientes con diagn&#243;stico de EGPA incluidos para el an&#225;lisis&#46; Quince &#40;55&#44;5&#37;&#41; fueron de sexo masculino y 12 &#40;44&#44;5&#37;&#41; de sexo femenino&#46; La mediana de seguimiento fue de 15 meses &#40;3-60 meses&#41;&#46; La indicaci&#243;n de RTX fue por enfermedad refractaria en 20 &#40;74&#44;1&#37;&#41;&#44; reca&#237;da en 5 &#40;18&#44;5&#37;&#41; y nuevo diagn&#243;stico en 2 &#40;7&#44;4&#37;&#41; pacientes&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Los &#243;rganos afectados que motivaron el uso de RTX fueron los pulmones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>18&#44; 66&#44;6&#37;&#41; &#40;asma&#44; infiltrados pulmonares o hemorragia alveolar&#41;&#44; el sistema nervioso perif&#233;rico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>16&#44; 59&#44;3&#37;&#41; &#40;mono o polineuropat&#237;a&#41;&#44; el ri&#241;&#243;n &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44; 33&#44;3&#37;&#41;&#44; los ojos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>9&#44; 33&#44;3&#37;&#41; y el coraz&#243;n &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>6&#44; 22&#44;2&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Los ANCA se reportaron en 14 pacientes &#40;51&#44;8&#37;&#41;&#44; 11 &#40;78&#44;6&#37;&#41; con patr&#243;n perinuclear &#40;P-ANCA&#41; y 3 &#40;21&#44;4&#37;&#41; con patr&#243;n citoplasm&#225;tico &#40;C-ANCA&#41;&#46; En 10 &#40;33&#44;1&#37;&#41; pacientes&#44; el ANCA fue negativo y en 3 &#40;11&#44;1&#37;&#41; el estatus del ANCA no fue comunicado&#46; El n&#250;mero de eosin&#243;filos&#44; antes del comienzo del tratamiento con RTX&#44; estaba elevado en todos los pacientes &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La mediana de f&#225;rmacos inmunodepresores &#40;incluidos los GC&#41; utilizados antes del comienzo del tratamiento con RTX fue de 3 &#40;rango 1-6&#41;&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Los esquemas posol&#243;gicos de RTX utilizados fueron&#58; <span class="elsevierStyleItalic">1&#41;</span> 375<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span> de superficie corporal cada 7 d&#237;as&#44; total 4 infusiones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>8&#41;&#59; <span class="elsevierStyleItalic">2&#41;</span> 1&#46;000<span class="elsevierStyleHsp" style=""></span>mg cada 15 d&#237;as&#44; total 2 infusiones &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>13&#41; y variantes de los anteriores &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4&#41;&#46; En 2 pacientes la infusi&#243;n de RTX debi&#243; suspenderse por reacci&#243;n adversa&#44; no pudiendo completarse el esquema posol&#243;gico&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Excluyendo el uso de GC&#44; en 14 pacientes se utiliz&#243; concomitantemente otro f&#225;rmaco inmunodepresor junto a RTX &#40;CF&#44; AZA&#44; metotrexato y micofenolato mofetilo&#41;&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Respuesta al tratamiento</span><p id="par0075" class="elsevierStylePara elsevierViewall">Se observ&#243; remisi&#243;n cl&#237;nica de la enfermedad en 16 &#40;59&#44;2&#37;&#41; pacientes y respuesta en 8 &#40;29&#44;6&#37;&#41; pacientes &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tablas 1 y 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">En 3 &#40;12&#37;&#41; pacientes se observ&#243; una reca&#237;da&#44; las manifestaciones cl&#237;nicas fueron menores y en 2 de ellos coincidi&#243; con la reaparici&#243;n de linfocitos B CD20 &#43; en sangre perif&#233;rica&#46; Los 3 pacientes fueron tratados nuevamente con RTX&#44; observ&#225;ndose respuesta cl&#237;nica&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> se detalla la evoluci&#243;n de los ANCA&#44; el recuento de eosin&#243;filos y la determinaci&#243;n de linfocitos B CD20 &#43; en los pacientes antes y despu&#233;s de la administraci&#243;n de RTX&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Los eventos adversos comunicados se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; En 2 pacientes debi&#243; suspenderse la primera infusi&#243;n de RTX por broncoespasmo grave&#59; los restantes eventos adversos fueron infecciones respiratorias y un episodio de herpes z&#243;ster&#46; A un paciente se le diagnostic&#243; un seminoma 12 meses despu&#233;s de recibir RTX&#46; No hubo muertes&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Discusi&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">La EGPA forma parte del grupo de las VAA junto a la GPA y MPA&#59; sin embargo&#44; se diferencia de ellas en varios aspectos&#46; El r&#233;gimen de tratamiento actual de la EGPA es similar al de las restantes VAA&#44; pero difiere en que el RTX no tiene una indicaci&#243;n definida como en la GPA y la MPA&#44; ya que no se incluy&#243; a pacientes con EGPA en los ensayos cl&#237;nicos aleatorizados&#44; como el RAVE y el RITUXVAS<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Hasta el momento&#44; solo existen publicaciones de casos anecd&#243;ticos de EGPA tratados con RTX&#44; lo cual hace dif&#237;cil valorar la eficacia terap&#233;utica de este f&#225;rmaco en esta entidad&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">El an&#225;lisis de la literatura muestra que la mayor&#237;a de los pacientes con EGPA tratados con RTX eran refractarios a los tratamientos de primera l&#237;nea o que presentaron una reca&#237;da durante el tratamiento inmunodepresor de mantenimiento&#46; Solo 5 pacientes recibieron RTX como tratamiento de inducci&#243;n en primera l&#237;nea &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En todos los pacientes se observ&#243; una respuesta r&#225;pida despu&#233;s del tratamiento con RTX&#59; 2 pacientes no completaron la infusi&#243;n del f&#225;rmaco por una reacci&#243;n adversa grave durante la misma<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&#46; En la mayor&#237;a de los pacientes se observ&#243; remisi&#243;n cl&#237;nica de la enfermedad&#46; Tres pacientes presentaron una o m&#225;s reca&#237;das&#44; pero respondieron a un nuevo ciclo de RTX&#46; En la <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> se detalla la respuesta al tratamiento con RTX de los casos analizados junto con 2 series de casos recientemente comunicadas en forma de res&#250;menes<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">22&#44;23</span></a>&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Un aspecto importante en los pacientes con EGPA es la persistencia de los s&#237;ntomas del asma a pesar del tratamiento y la morbilidad que conlleva la dependencia de los GC a largo plazo&#46; Si bien en los trabajos analizados no se especifica la respuesta terap&#233;utica del RTX sobre el asma&#44; recientemente en una comunicaci&#243;n presentada en el 16th International Vasculitis &#38; ANCA Workshop &#40;Par&#237;s&#44; Francia&#41; por Hot et al&#46; se encontr&#243; que el 39&#37; de los pacientes con EGPA tratados con RTX continuaban con requerimientos de GC por persistencia del asma<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Los valores de eosin&#243;filos en sangre perif&#233;rica disminuyeron o se normalizaron despu&#233;s del tratamiento con RTX&#44; independientemente del r&#233;gimen posol&#243;gico utilizado&#44; en la mayor&#237;a de los pacientes&#46; Este hallazgo pone en consideraci&#243;n la estrecha relaci&#243;n que tienen las diferentes c&#233;lulas del sistema inmunitario&#44; y en particular la importante interacci&#243;n existente entre el linfocito Th2&#44; a trav&#233;s de la secreci&#243;n de citocinas &#40;IL-4&#44; IL-5 y IL-13&#41;&#44; con el linfocito B y la posterior producci&#243;n y secreci&#243;n de eotaxina-1&#44; IgG4&#44; IgE y de los ANCA<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;24</span></a>&#46; La IgE est&#225; elevada en el suero de los pacientes con EGPA&#46; Esta inmunoglobulina&#44; que es producida por c&#233;lulas plasm&#225;ticas&#44; se encuentra unida a receptores &#40;Fc¿R1&#41; en la superficie de los eosin&#243;filos&#44; que&#44; al unirse a ant&#237;genos&#44; induce su intervenci&#243;n en la respuesta inflamatoria&#46; Por otro lado&#44; la eotaxina-1 participa en el reclutamiento de los eosin&#243;filos al sitio de inflamaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; Estos mecanismos podr&#237;an explicar en parte el descenso de los eosin&#243;filos despu&#233;s del tratamiento con RTX&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Los linfocitos CD20 &#43; circulantes despu&#233;s del uso de RTX fueron indetectables y persistieron de ese modo por tiempo variable&#46; El periodo hasta la repoblaci&#243;n de c&#233;lulas CD20 &#43; no fue uniforme y en algunos pacientes no se correlacion&#243; con la evoluci&#243;n cl&#237;nica de la enfermedad&#46; En el estudio RAVE<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#44; en un elevado porcentaje de pacientes el recuento s&#233;rico de linfocitos B CD20 &#43; era indetectable despu&#233;s de la infusi&#243;n de RTX &#40;al igual que el grupo que utiliz&#243; CF&#41; y el tiempo hasta la repoblaci&#243;n de los mismos era variable&#46; A&#250;n m&#225;s importante fue el hallazgo de que la repoblaci&#243;n de linfocitos B CD20 &#43; como variable aislada no predijo sobre el riesgo de reca&#237;da en el paciente individual&#46; Sin embargo&#44; aquellos pacientes que despu&#233;s del uso de RTX permanec&#237;an con los valores s&#233;ricos de linfocitos B CD20 &#43; indetectables y el ANCA negativo ten&#237;an pocas probabilidades de presentar una reca&#237;da&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Los ANCA no son el &#250;nico mecanismo involucrado en la patog&#233;nesis de esta vasculitis&#59; los pacientes con EGPA tendr&#237;an una fuerte respuesta de tipo IgG4 independientemente del estatus del ANCA&#59; la evidencia del di&#225;logo entre el linfocito B y el eosin&#243;filo&#44; y la capacidad de la c&#233;lula B de secretar eotaxina-1&#44; la cual interviene en el reclutamiento de los eosin&#243;filos en los sitios de inflamaci&#243;n<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24-26</span></a> podr&#237;an ser otras v&#237;as patog&#233;nicas involucradas en la respuesta mediada por el RTX&#59; por tanto&#44; el hecho de que un paciente sea ANCA negativo no predice la falta de respuesta al tratamiento con RTX&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">El RTX fue bien tolerado&#59; solo 2 pacientes presentaron reacciones adversas durante su infusi&#243;n&#46; Los eventos adversos fueron menores&#44; generalmente infecciones respiratorias de manejo ambulatorio&#46; No se reportaron muertes directamente atribuidas al RTX&#46; Esto coincide con los efectos adversos comunicados en grandes series y estudios cl&#237;nicos extensos que demostraron la seguridad de RTX en el tratamiento de las VAA<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5-8</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Los esquemas posol&#243;gicos m&#225;s utilizados fueron&#58; 1&#46;000<span class="elsevierStyleHsp" style=""></span>mg de RTX cada 15 d&#237;as &#40;total 2 infusiones&#41; y 375<span class="elsevierStyleHsp" style=""></span>mg&#47;m<span class="elsevierStyleSup">2</span> de RTX por semana &#40;total 4 infusiones&#41;&#46; Si bien ambos esquemas no fueron comparados formalmente&#44; parecen ser igualmente eficaces para la inducci&#243;n de la remisi&#243;n en las VAA&#59; la recomendaci&#243;n de expertos sobre el uso de RTX en VAA es la utilizaci&#243;n indistinta de ambos esquemas por igual<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a>&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Este estudio tiene limitaciones&#59; el n&#250;mero de pacientes es peque&#241;o&#44; el tiempo de seguimiento es limitado&#44; las definiciones de actividad y da&#241;o no fueron uniformes &#8212;solo en algunos trabajos fue utilizado el Birmingham Vasculitis Activity Score y en diferentes versiones&#8212;&#44; los inmunodepresores y los esquemas posol&#243;gicos de RTX difieren entre los pacientes&#46; Adem&#225;s&#44; no encontramos publicaciones de pacientes con EGPA que no respondieran al RTX&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Sin embargo&#44; existe una tendencia generalizada a reconsiderar los est&#225;ndares de tratamiento de las VAA&#44; incluyendo la EGPA&#44; tanto en la inducci&#243;n como en el mantenimiento<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">28&#44;29</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Finalmente&#44; el RTX parece ser eficaz y seguro para el tratamiento de la EGPA refractaria&#44; la reca&#237;da y con nuevo diagn&#243;stico independiente del estatus del ANCA&#46; Es necesaria la realizaci&#243;n de estudios cl&#237;nicos aleatorizados para confirmar esta observaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Responsabilidades &#233;ticas</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Protecci&#243;n de personas y animales</span><p id="par0155" 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="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Confidencialidad de los datos</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Derecho a la privacidad y consentimiento informado</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los autores declaran que en este art&#237;culo no aparecen datos de pacientes&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Ninguno&#46;</p></span></span>"
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              "titulo" => "Protecci&#243;n de personas y animales"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Confidencialidad de los datos"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Derecho a la privacidad y consentimiento informado"
            ]
          ]
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicto de intereses"
        ]
        10 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2014-03-11"
    "fechaAceptado" => "2014-08-08"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec500765"
          "palabras" => array:3 [
            0 => "Rituximab"
            1 => "Granulomatosis eosinofilica con poliangitis"
            2 => "Vasculitis asociadas a anticuerpos anticitoplasma de neutr&#243;filo"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec500764"
          "palabras" => array:3 [
            0 => "Rituximab"
            1 => "Eosinophilic granulomatosis with polyangiitis"
            2 => "Anti-neutrophil cytoplasmic antibody-associated vasculitis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Algunos pacientes con granulomatosis eosinof&#237;lica con poliangitis &#40;EGPA&#41; y factores de mal pron&#243;stico son refractarios o presentan efectos adversos al tratamiento de inducci&#243;n &#40;glucocorticoides &#91;GC&#93; y ciclofosfamida &#91;CF&#93;&#41;&#44; o recaen durante el mantenimiento &#40;GC y azatioprina&#41;&#44; haciendo necesaria la b&#250;squeda de alternativas terap&#233;uticas&#46; En ensayos cl&#237;nicos&#44; el rituximab &#40;RTX&#41; demostr&#243; ser eficaz para el tratamiento de las vasculitis asociadas al ANCA&#59; sin embargo&#44; los pacientes con EGPA no fueron incluidos&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Revisar y analizar la bibliograf&#237;a sobre la uso de RTX para el tratamiento de la EGPA&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La b&#250;squeda se realiz&#243; en MEDLINE y LILACS &#40;1965 y 1986&#44; respectivamente&#44; hasta febrero del 2014&#41;&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; a 27 pacientes&#46; La indicaci&#243;n de RTX fue por enfermedad refractaria &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; reca&#237;da &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; y nuevo diagn&#243;stico &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; Los &#243;rganos afectados fueron los pulmones&#44; el sistema nervioso perif&#233;rico&#44; el ri&#241;&#243;n y los ojos&#46; Se observ&#243; remisi&#243;n en 16 y respuesta en 8 pacientes&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El RTX fue eficaz y bien tolerado para el tratamiento de la EGPA&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Antecedentes"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivo"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todos"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The general consensus is that for patients with EGPA with poor prognosis&#44; intensive therapy with both GC and CF is indicated&#46; The maintenance of remission is made with GC and AZA&#46; A considerable number of patients with EGPA are refractory to first line therapy&#44; experience dose-limiting side effects or relapse&#46; In clinical trials&#44; RTX was effective for the treatment of ANCA-associated vasculitis&#46; However&#44; patients with a diagnosis of EGPA were not included&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objective</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">to review and analyze the published literature regarding the use of RTX in the treatment of EGPA&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The literature search was performed in MEDLINE and LILACS from 1965 and 1986 respectively until february 2014&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">27 patients were included&#46; RTX treatment was due to refractory disease &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&#44; relapse &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>5&#41; and with newly diagnosed &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#41;&#46; The affected organs were the lungs&#44; peripheral nervous system&#44; kidney and the eyes&#46; Sixteen patients had clinical remission and 8 patients had clinical response&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">RTX was effective and well tolerated for the treatment of EGPA&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objective"
          ]
          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">AZA&#58; azatioprina&#59; CF&#58; ciclofosfamida&#59; CSP&#58; ciclosporina&#59; Dn&#58; nuevo diagn&#243;stico&#59; F&#58; femenino&#59; Ig&#58; inmunoglobulina&#59; M&#58; masculino&#59; MFM&#58; micofenolato mofetilo&#59; MP&#58; metilprednisolona&#59; MTX&#58; metotrexate&#59;NC&#58; no corresponde&#59; NR&#58; no reportado&#59; PF&#58; plasmaf&#233;resis&#59; PS&#58; prednisona&#59; Rc&#58; reca&#237;da&#59; Rf&#58; refractaria&#59; RP&#58; respuesta&#59; RS&#58; remisi&#243;n&#59; SNC&#58; sistema nervioso central&#59; SNP&#58; sistema nervioso perif&#233;rico&#59; RTX&#58; rituximab&#59; VAS&#58; v&#237;as a&#233;reas superiores&#46;</p>"
          "tablatextoimagen" => array:1 [
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              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Paciente&#47;cita&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">Edad&#47;sexo&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">Estado&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">&#211;rganos afectados&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">Tratamientos <span class="elsevierStyleBold">previos</span> y concomitantes&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">Tiempo seguimiento&#40;meses&#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">N&#46;&#176; de ciclosde RTX e indicaci&#243;n&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">Resultado&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">Eventos adversos&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">1<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">49&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Piel&#44; pulm&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Neumon&#237;a&#44; herpes z&#243;ster&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">2<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">37&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; SNP&#44; VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; Ig&#44; MFM&#44; alentuzumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">18&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;reca&#237;da&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">3<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; VAS&#44; SNP&#44; articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; AZA&#44; MFM&#44; INF alentuzumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Infecci&#243;n respiratoria&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">4<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">40&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Piel&#44; ri&#241;&#243;n&#44; ojo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS&#44; CF</span>&#44; PF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">5<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">66&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; coraz&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS</span>&#44; Ig&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">6<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">60&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; articular&#44; piel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS</span>&#44; CF&#44; Ig&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">7<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; pulm&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PS&#44; AZA&#44; MTX&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Broncoespasmo&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">8<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">33&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PS&#44; CF&#44; MFM&#44; AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Broncoespasmo&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">9<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">46&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; <span class="elsevierStyleBold">MFM</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">10<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">50&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; o&#237;do&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; AZA&#44; <span class="elsevierStyleBold">MTX</span>&#44; CSP&#44; infliximab&#44; anakinra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">11<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; VAS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">12<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">35&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; articular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&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;reca&#237;da&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">13<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&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;reca&#237;da&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">14<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">54&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dn&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&#44; pulm&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">15<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">64&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Dn&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&#44; m&#250;sculo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">16<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">59&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF</span>&#44; AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">17<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">44&#47;F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">SNP&#44; s&#237;ndrome febril&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; <span class="elsevierStyleBold">PS</span>&#44; Ig&#44; CF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">18<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">70&#47;M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">MP&#44; CF&#44; PF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">19<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">20<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&#44; SNP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">21<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">F&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; SNP&#44; SNC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; MTX&#44; <span class="elsevierStyleBold">AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">22<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&#44; SNC&#44; piel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">23<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA&#44;</span> AZA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Seminoma&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">24<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; SNP&#44; piel&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS</span>&#44; CF&#44; <span class="elsevierStyleBold">MFM</span>&#44; MTX&#44; LF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&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;profilaxis&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">25<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; coraz&#243;n&#44; piel&#44; SNP&#44; SNC&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; AZA</span>&#44; CF&#44; MTX&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">26<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rf&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; SNP&#44; ri&#241;&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; CF&#44; AZA</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">27<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">M&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Rc&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Pulm&#243;n&#44; ojo&#44; o&#237;do&#44; SNP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleBold">PS&#44; MTX</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">RS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">NR&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">Caracter&#237;sticas generales de los 27 pacientes con EGPA tratados con RTX hasta febrero del a&#241;o 2014</p>"
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                  \t\t\t\t</th><th class="td" title="table-head  " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Pacientes estudiados&#47;totalPrevio rituximab&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">Pacientes estudiados&#47;totalPosterior rituximab&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">ANCA&#47;especificidad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">24&#47;27C &#40;&#43;&#41;&#58; 12&#37;P &#40;&#43;&#41;&#58; 46&#37;C y P &#40;&#8211;&#41;&#58; 42&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">10&#47;27C &#40;&#43;&#41;&#58; 0&#37;P &#40;&#43;&#41;&#58; 10&#37;C y P &#40;&#8211;&#41;&#58; 90&#37;&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">Recuento de eosin&#243;filos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Casos analizados<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9-21</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">48&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Dubrau et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&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;NR&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry  " align="left" valign="top">Hot et al&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">30 &#40;16&#47;14&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Refractaria o reca&#237;da&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Remisi&#243;n&#58; 26 &#40;88&#41;Respuesta&#58; 2 &#40;6&#41;No respuesta&#58; 2 &#40;6&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Detalle de la respuesta al tratamiento con RTX en EGPA de los casos analizados y de 2 series recientes comunicadas en forma de res&#250;menes</p>"
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    ]
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                      "Revista" => array:6 [
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                      "titulo" => "EULAR recommendations for the management of primary small and medium vessel vasculitis"
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                          "etal" => true
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                      "titulo" => "Long-term outcome of 118 patients with eosinophilic granulomatosis with polyangiitis &#40;Churg-Strauss syndrome&#41; enrolled in two prospective trials"
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                          "autores" => array:6 [
                            0 => "M&#46; Samson"
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                0 => array:2 [
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                    0 => array:2 [
                      "titulo" => "A multicenter survey of rituximab therapy for refractory antineutrophil cytoplasmic antibody-associated vasculitis"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46;B&#46; Jones"
                            1 => "A&#46;J&#46; Ferraro"
                            2 => "A&#46;N&#46; Chaudhry"
                            3 => "P&#46; Brogan"
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                          ]
                        ]
                      ]
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Información del artículo
ISSN: 1699258X
Idioma original: Español
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