scholarly journals INTERLEUKIN-17INHIBITION WITH SECUKINUMAB IMPROVES SUDOMOTOR DYSFUNCTION IN PSORIATIC ARTHRITIS

2018 ◽  
Vol 10 (3) ◽  
pp. 167
Author(s):  
Ashit Syngle ◽  
Inderjeet Verma ◽  
Sudeep Kaur ◽  
Tanya Syngle
Keyword(s):  
Monoclonal Antibody ◽  
Psoriatic Arthritis ◽  
Autonomic Neuropathy ◽  
Inflammatory Disease ◽  
Severe Disease ◽  
Specific Treatment ◽  
Treatment Recommendation ◽  
Joint Involvement ◽  
Distal Joint ◽  
Arthritis Mutilans

Psoriatic arthritis (PsA) is a relapsing inflammatory disease, most commonly a seronegative oligoarthritis found in patients with psoriasis, characterized by the absence of rheumatoid factor in serum, with differentiating features of distal joint involvement and in extreme cases of arthritis mutilans (which is a destructive form of PsA). Cardiovascular autonomic and peripheral sympathetic neuropathy occurs in PsA. However, there is no specific treatment recommendation for autonomic neuropathy (AN) in psoriatic diseases. Secukinumab, a recently approved therapeutic advancement for psoriasis and psoriatic arthritis, is an immunoglobulin G (IgG) 1k fully monoclonal antibody that selectively inhibits the effector function of interleukin (IL)-17A. Its effect on sudomotor dysfunction in PsA has not yet been reported. This is the first reported observation of improvement in peripheral sympathetic autonomic neuropathy with secukinumab in PsA. We report a case of a 52-year-old male with PsA on methotrexate 15 mg/week with severe disease activity treated with the addition of subcutaneous secukinumab 150 mg once a week for 5 w followed by once a month dose. We found significant improvement in sudomotor dysfunction after 4 and 8 w of treatment.

scholarly journals Nail Involvement in Patients with Psoriatic Arthritis in Northern Iran

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
O. Zargari ◽  
E. Kazemnezhad Leyli ◽  
S. Z. Azimi
Keyword(s):  
Psoriatic Arthritis ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Joint Involvement ◽  
Sectional Study ◽  
Northern Iran ◽  
Cross Sectional ◽  
The Relationship ◽  
Nail Involvement

Background. Psoriatic arthritis (PsA) results in an increased burden of psoriasis and impairs both quality of life and an individual’s functional capacity. The relationship between nail involvement and PsA in psoriasis is not fully characterized. Aim. To evaluate the frequency and characteristics of nail involvement in psoriatic patients and to assess the relationship with joint involvement. Methods. A total of 197 patients with moderate-to-severe psoriasis were consecutively invited to participate in this cross-sectional study. The patients are divided into two groups: those with and those without psoriatic arthritis. Results. 69.5% of psoriatic (137 out of 197) patients had nail involvement. The most common nail abnormality was onycholysis, followed by pitting and oil droplet changes. Nail involvement was more common in patients with psoriatic arthritis (82.1% versus 57.8%, p=0.001). Conclusion. Nail involvement is commonly associated with PsA. Onycholysis, splinter hemorrhage, and oil drop were significantly more common in the PsA group as opposed to patients with just skin findings. In general, psoriatic patients with arthritis had more severe disease.

scholarly journals Comorbidities in a Cohort of 66 Patients With Psoriatic Arthritis Mutilans—Results From the Nordic PAM Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Josephine Mistegård ◽  
Bjorn Gudbjornsson ◽  
Ulla Lindqvist ◽  
Leena Laasonen ◽  
Leif Ejstrup ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Functional Capacity ◽  
Bone Erosion ◽  
Joint Destruction ◽  
Median Number ◽  
Nordic Countries ◽  
Joint Involvement ◽  
Comorbid Conditions ◽  
Severe Phenotype ◽  
Arthritis Mutilans

Objective: Psoriatic arthritis mutilans (PAM) is the most severe phenotype of psoriatic arthritis due to excessive bone erosion causing joint destruction and decreased functional capacity. The aim of this study was to investigate the prevalence of comorbidities among patients with PAM and the association between comorbidities and joint involvement.Methods: A total of 66 patients aged ≥18 years from the Nordic countries with past or present psoriasis along with at least one mutilated joint were included in the present study.Results: The median number of comorbid conditions per patient was 1 [interquartile range (IQR) 0–2] and 16.7% reported three or more comorbidities. The most frequent comorbidity was hypertension (36.4%). The median number of mutilated joints per patient was 3 (IQR 1–8.3; range 1–38).Conclusion: Two thirds of the patients with PAM reported comorbid conditions and the most frequent was hypertension which affected more than a third of the patients. However, this study was unable to detect any association between comorbidities and the severity of PAM.

scholarly journals Prevalence and distribution of peripheral musculoskeletal manifestations in spondyloarthritis including psoriatic arthritis: results of the worldwide, cross-sectional ASAS-PerSpA study

RMD Open ◽  
2021 ◽  
Vol 7 (1) ◽  
pp. e001450
Author(s):  
Clementina López-Medina ◽  
Anna Molto ◽  
Joachim Sieper ◽  
Tuncay Duruöz ◽  
Uta Kiltz ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Latin American ◽  
Underlying Disease ◽  
Cross Sectional Study ◽  
Joint Disease ◽  
Joint Involvement ◽  
Cross Sectional ◽  
Small Joint ◽  
Musculoskeletal Manifestations ◽  
Inflammatory Bowel

ObjectivesTo characterise peripheral musculoskeletal involvement in patients with spondyloarthritis (SpA) including psoriatic arthritis (PsA), across the world.MethodsCross-sectional study with 24 participating countries. Patients with a diagnosis of axial SpA (axSpA), peripheral SpA (pSpA) or PsA according to their rheumatologist were included. The investigators were asked which diagnosis out of a list of six (axSpA, PsA, pSpA, inflammatory bowel disease-associated SpA, reactive arthritis or juvenile SpA (Juv-SpA)) fitted the patient best. Peripheral manifestations (ie, peripheral joint disease, enthesitis, dactylitis and root joint disease), their localisation and treatments were evaluated.ResultsA total of 4465 patients were included (61% men, mean age 44.5 years) from four geographic areas: Latin America (n=538), Europe plus North America (n=1677), Asia (n=975) and the Middle East plus North Africa (n=1275). Of those, 78% had ever suffered from at least one peripheral musculoskeletal manifestation; 57% had peripheral joint disease, 44% had enthesitis and 15% had dactylitis. Latin American had far more often peripheral joint disease (80%) than patients from other areas. Patients with PsA had predominantly upper limb and small joint involvement (52%).Hip and shoulder involvement was found in 34% of patients. The prevalence of enthesitis ranged between 41% in patients with axSpA and 65% in patients with Juv-SpA. Dactylitis was most frequent among patients with PsA (37%).ConclusionThese results suggest that all peripheral features can be found in all subtypes of SpA, and that differences are quantitative rather than qualitative. In a high proportion of patients, axial and peripheral manifestations coincided. These findings reconfirm SpA clinical subtypes are descendants of the same underlying disease, called SpA.

scholarly journals AB0806 DOES VITAMIN D INFLUENCE THE ACTIVITY OF THE DISEASE IN PATIENTS WITH PSORIATIC ARTHRITIS?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1704.1-1705
Author(s):  
L. Montolio-Chiva ◽  
A. V. Orenes Vera ◽  
M. Aguilar-Zamora ◽  
C. Vergara-Dangond ◽  
I. Vázquez-Gómez ◽  
...  
Keyword(s):  
Vitamin D ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Functional Capacity ◽  
Inverse Correlation ◽  
Hypovitaminosis D ◽  
Joint Involvement ◽  
Average Value ◽  
Vitamin D Levels

Background:Several studies have shown an inverse relationship between vitamin D levels (25OHD) and disease activity in patients with rheumatoid arthritis (RA). However, the existing data in patients with psoriatic arthritis (PsA) are poor, and they use the DAS28 index as a peripheral joint activity marker by extrapolation with RA.Objectives:To analyze the relationship between 25OHD levels, disease activity and functional capacity in patients with PsA.Methods:Transversal, observational, descriptive study. We included PsA patients with peripheral joint involvement. We collected demographic variables (gender, age), clinical variables [follow-up, received treatments, TJC (68), SJC (68), VAS] and analytical variables (25OHD, CRP, ESR). We usedDisease activity in psoriatic arthritis(DAPSA) score to measure disease activity, and theHealth assessment questionnaire(HAQ) to determine functional capacity. Levels of 25 OHD <20 ng/ml and between 20-30 ng/ml were considered deficient and insufficient, respectively. Statistical analysis was made with SPSS 22.0. The descriptive analysis results were expressed as percentage and mean ± SD. We used Pearson’s correlation to assess the association between quantitative variables and T test to compare means between dichotomous variables.Results:125 patients were included, the majority women (60.8%), with an average age of 55.4 (SD 12.2) years. The average follow-up was 75.5 (SD 68.3) months. 97.6% of patients had received DMARDs and 40.8% biologics, and almost half of the patients (42.7%) took calcium and 25OHD supplements. The average value of 25OHD was 27.1 (SD 12.1) ng/ml, with 30% of patients having 25OHD deficit and 63.3% insufficiency. The majority of patients had an acceptable disease control, with a mean DAPSA of 10.5 (SD 7,9); and mean of CRP, ESR, TJC and SJC was 6.1 (SD 3.7) mg/l, 10.2 (SD 9.9) mm/h, 1.3 (SD 2.5) and 0.7 (SD 2.1), respectively. The average value of HAQ was 0.6 (SD 0.7). We observed an inverse correlation between 25OHD levels and joint counts, TJC (p=0.02) and SJC (p=0.03). On the other hand, patients with hypovitaminosis D presented a tendency to get higher scores in DAPSA index (P=0.07). We do not observe any relationship between 25OHD and HAQ.Conclusion:As can be seen in our sample, low values of 25OHD are related to increased disease activity in patients with PsA.Disclosure of Interests:L Montolio-Chiva: None declared, Ana V Orenes Vera: None declared, Marta Aguilar-Zamora: None declared, C Vergara-Dangond: None declared, I Vázquez-Gómez: None declared, Eduardo Flores: None declared, A Sendra-García: None declared, À Martínez-Ferrer: None declared, Elia Valls-Pascual Grant/research support from: Roche, Novartis, and AbbVie, Speakers bureau: AbbVie, Lilly, Pfizer, MSD, Novartis, Janssen, Bristol Myers Squibb, UCB Pharma, D Ybáñez-García Speakers bureau: Lilly, Roche, Sanofi, V Núñez-Monje: None declared, I Torner-Hernández: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis

scholarly journals POS0239 ROOT JOINT INVOLVEMENT IN SPONDYLOARTHRITIS: A POST-HOC ANALYSIS FROM THE INTERNATIONAL ASAS-PERSPA STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 340.1-341
Author(s):  
N. Ziade ◽  
J. El-Hajj ◽  
J. Rassi ◽  
S. Hlais ◽  
C. López-Medina ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Positive Answer ◽  
Categorical Variables ◽  
Joint Involvement ◽  
Main Diagnosis ◽  
Post Hoc Analysis ◽  
Wall Distance ◽  
History Of ◽  
Axial Disease ◽  
Post Hoc

Background:In patients with spondyloarthritis (SpA), root joint diseases (RJD), i.e. hip or shoulder involvement, may be associated with a distinct disease phenotype compared to those with other affected joints. The ASAS-PerSpA study (PERipheral involvement in SPondyloArthritis) [1], offers a unique opportunity to study the phenotypes of patients with RJD in a global cohort.Objectives:Primary objective was to compare the clinical characteristics of SpA patients with and without RJD. Secondary objectives were to compare the prevalence of RJD across the different SpA subtypes and the different regions of the world, compare the severity of axial disease as well as the disease burden in SpA patients with and without RJD.Methods:This is a post-hoc analysis of the ASAS-PerSpA study, which included 4,465 patients with any subtype of SpA (axial SpA (axSpA), peripheral SpA (pSpA), psoriatic arthritis (PsA), inflammatory bowel disease associated SpA (IBD-SpA), reactive arthritis (ReA) and Juvenile SpA (Juv-SpA)) according to the rheumatologist’s diagnosis. RJD was defined as a positive answer by the investigator to the following question: “Do you consider that the patient has ever suffered from RJD (e.g. hip, shoulder) related to SpA?” In case of a positive answer, a potential specific treatment (e.g. Total Articular Replacement) was investigated. The patient’s characteristics were compared between those with and without RJD involvement, using Chi-2 or Fisher exact test for the categorical variables and t-test for the continuous variables. Two separate multivariable stepwise binary logistic regression analyses were conducted to identify factors associated with the dependent variables “hip involvement” and “shoulder involvement”.Results:RJD occurred in 1,503 patients (33.7%), with more prevalent hip (24.2%) than shoulder (13.2%) involvement. The prevalence of RJD as a group was the highest in Juv-SpA (52.7%), followed by pSpA (44.3%) and axSpA (33.9%). The highest prevalence of RJD was found in Asia and the lowest in Europe and North America. Among patients with hip involvement, 6.0% had a history of hip replacement (highest in the Middle East and North Africa and Latin America); among patients with shoulder involvement, 0.8% had a history of shoulder replacement. Hip had a distinct pattern of associations compared to shoulder involvement (Figure 1). Hip involvement was significantly associated with the SpA main diagnosis (highest in pSpA, lowest in PsA), younger age at first SpA symptom, lower prevalence of family history of psoriasis, positive HLA-B27, occiput-to-wall distance>0, and treatment with cs-DMARDs and b-DMARDs. Shoulder involvement was associated with the SpA main diagnosis (highest in Juv-SpA and pSpA, lowest in axSpA), older age at first SpA symptom, higher prevalence of enthesitis, dactylitis, tender joints count, IBD, occiput-to-wall distance>0, EQ5D score and treatment with cs-DMARDs.Conclusion:Hip involvement was more prevalent than shoulder involvement in patients with SpA, and had a distinct phenotype resembling axial disease whereas shoulder involvement was mostly associated with features of peripheral disease. Hip and shoulder involvement should be analyzed separately in future studies rather than under the RJD entity.References:[1]Lopez-medina, C. et al. Prevalence and Distribution of Peripheral Musculoskeletal Manifestations in Axial Spondyloarthritis, Peripheral Spondyloarthritis and Psoriatic Arthritis: Results of the International, Cross-sectional ASAS-PerSpA Study. RMD Open; 2021;7:e001450.Disclosure of Interests:None declared

scholarly journals AB0830 LIPID PROFILE IN PSORIATIC ARTHRITIS. FREQUENCY AND ASSOCIATION WITH DISEASE ACTIVITY.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1719.1-1720
Author(s):  
V. Savio ◽  
Y. Tissera ◽  
M. I. Quaglia ◽  
J. A. Albiero ◽  
C. G. Alonso ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Psoriatic Arthritis ◽  
Disease Activity ◽  
Lipid Profile ◽  
Activity Index ◽  
Laboratory Data ◽  
Disease Index ◽  
Interleukin 12 ◽  
Joint Involvement ◽  
Apo B

Background:Psoriatic arthritis (PsA) is a chronic inflammatory disease associated with higher risk of cardiovascular events and metabolic syndrome. The inflammation not only accelerates atherosclerosis, but also may influence cardiovascular (CV) risk factors such as lipid profile, blood pressure and insulin resistance. Lipid profile has previously been studied in PsA, however this association is still controversial.Objectives:To study the frequency of altered lipid profile in patients with PsA and its association with disease activity.Methods:We studied all the patients with diagnosis of PsA who consecutively attended to Rheumatology Unit at Cordoba Hospital from July 2018 to December 2019. PsA was diagnosed according CASPAR criteria. Clinical and laboratory data were collected. The activity of the disease was evaluated by PASI, MDA and DAPSA. Quantitative variables will be expressed in median and 1st and 3rd interquartile; qualitative variables expressed in frequency and percentage. Correlation analysis was calculated using Spearman’s rank correlation coefficient. P<0.05 was considered statistically significant.Results:42 PsA patients were included. Mean age was 56 years old (47.25-62.75) and 54.76% were female (n=23). 92.86% (n=39) of the patients had plaque Psoriasis and 87.8% (n=36) had peripheral joint involvement.Frequency of comorbidities in PsA are shown in Graphic 1. 31 (73.8%) of the patients were treated with topical therapy, 3 (7.14%) with phototherapy, 31 (73.8%) with Methotrexate and 17 (41.46%) with biologics and JAK inhibitor. Activity Disease Index and Lipid profile are shown in Table 1 and 2.There was not association between Apo B/Apo A coefficient with DAPSA (rho=0.013; p=0.940) and MDA (rho=-0.029; p=0.867).Conclusion:In spite of the presence of cardiovascular factors in the majority of PsA patients, lipid profile is not correlated with disease activity in this population.References:[1]Ahlehoff O, Gislason GH, Charlot M, et al. Psoriasis is associated with clinically significant cardiovascular risk: A Danish nationwide cohort study. J Intern Med 2011;270:147-57.[2]Mallbris, L., Ritchlin, C.T., Ståhle, M. “Metabolic disorders in patients with psoriasis and psoriatic arthritis.” Curr RheumatolRep.8(5): 355–363. 2006[3]Ng CY, Tzeng I-S, Liu S-H, Chang Y-C, Huang Y-H. Metabolic parameters in psoriatic patients treated with interleukin-12/23 blockade (Ustekinumab). J Dermatol 2018; 45:309–313[4]Kaur S, Kingo K, Zilmer M. Psoriasis and cardiovascular risk – do promising new biomarkers have clinical impact? Mediators Inflamm 2017; 2017: 7279818[5]Gentile M, Peluso R, Di Minno MN, et al. Association between small dense LDL and sub-clinical atherosclerosis in patients with psoriatic arthritis. ClinRheumatol 2016; 35: 2023-9.Graphic 1.Comorbidities in PsATable. 1.Activity Disease Index in PsAACTIVITY INDEXn=42DAPSA14.45 (9.72-23.92)DAPSA≤4 REMISSION3>4 y ≤14 low disease activity16>14 y ≤28 moderate disease activity17>28 high disease activity3cDAPSA14.00 (8.00-23.00)/41*MDA9 (25)/36PASI2.20 (0.20-6.80)/41**Expressed in median and interquartiles.Qualitative variables expressed in frequency and percentage.Table. 2.Lipid Profile in PsA patients.Cholesterol (mg/dl)194.5 (164.8-218.2)HDL (mg/dl)48.00 (37.00-57.00)LDL (mg/dl)114.5 (78.5-140.8)TG (mg/dl)139.50 (89.25-191.20)Expressed in median and interquartiles.Disclosure of Interests:None declared

scholarly journals AB0807 VITAMIN D ROLE IN VASCULAR DAMAGE PROGRESSION IN PATIENTS WITH PSORIATIC ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1705.2-1705
Author(s):  
L. Montolio-Chiva ◽  
M. Robustillo-Villarino ◽  
A. V. Orenes Vera ◽  
M. Aguilar-Zamora ◽  
C. Vergara-Dangond ◽  
...  
Keyword(s):  
Vitamin D ◽  
Psoriatic Arthritis ◽  
Vascular Damage ◽  
Atherogenic Index ◽  
Joint Involvement ◽  
Type I ◽  
Vascular Risk ◽  
Damage Progression ◽  
Atheromatous Plaques

Background:Psoriatic arthritis (PsA) is associated with insufficent levels of vitamin D (25OHD) and an increased cardiovascular risk. Several studies, have shown an inverse relationship between 25OHD levels and cardiovascular damage.Objectives:To study the relationship between 25OHD and vascular damage, as well as its possible influence on its progression, in patients with PsA.Methods:Pre-post longitudinal study with analytical components. PsA patients with peripheral joint involvement were included. Demographic (sex, age), clinical [follow-up time, DAPSA, current treatment, body mass index (BMI), classic vascular risk factors, vascular events] and analytical variables [atherogenic index, glomerular filtration (GF-MDRD), glycosylated hemoglobin (HbA1c), CRP, ESR, 25OHD] were collected. We considered deficient level of 25OHD <20 ng/ml and insufficient <30 ng/ml. Basal vascular risk was estimated through SCORE tool. Extracranial carotid artery was explored with an Esaote MyLab70XVG ultrasound with linear probe (7-12mHz) and an automated program that measures intima media thickness (IMT) by radiofrequency, and the presence of atheroma plaques was evaluated following Mannheim consensus. Pulse wave velocity (PWV) was measured through Mobil o graph® dispositive. IMT≥900 µ and PWV≥ 10m/s were considered as pathological values. We repeat vascular study 3 years later. Vascular damage progression was defined as the appearance of atheroma plaques during the follow-up and/or an increase in their number. Statistical analysis was performed using SPSS 22.0 program.Results:78 patients were included. Eighteen patients were excluded due to high vascular risk [previous event, diabetes type II or type I with target organ injury and/or GF-MDRD< 60 ml/min]. 57.5% were women with a mean age of 54.2 (SD 10.9) years. The mean follow-up time was 96.8 (SD 163.6) months and mean DAPSA was 10.2 (SD 8.3). 96.2% of patients had received DMARDs and 42.3% biologicals, and 42.3% took calcium and 25OHD supplements. Mean BMI was 27.5 (SD 4.7) kg/m2. 42.3% had tobacco exposure, 29.5% were hypertensive and 32% dyslipidemic. Mean SCORE was 1.6 (SD 1.8) and mean 25OHD was 27.6 (DSD 11.6) ng/ml. 28.2% patients had 25OHD deficit and 60.3 % insufficiency. At the beginning, 32.1 % of patients had atheromatous plaques with a number of plaques around 1.7 (SD 1.2), and 6.7% and 19.7% had a pathological IMT or PWV, respectively. Baseline, we had not observed any association between 25OHD and the presence of atheroma plaques, IMT or PWV. Three years later, we detected progression of vascular damage in 31.2% patients. In these patients, the existence of hypovitaminosis D was associate with the appearance of atheroma plaques (p=0.043). This association desappeared in the multivariate analysis, in which only the CRP influenced the appearance of atherome plaques (OR: 1.4, IC 95% 1.04-1.98, p=0.025).Conclusion:Low 25OHD levels are not related to vascular damage or influence a posible progression of it in our serie. As might be expected, the progression of vascular damage depends on the inflammatory load in these patients.Disclosure of Interests:L Montolio-Chiva: None declared, M Robustillo-Villarino: None declared, Ana V Orenes Vera: None declared, Marta Aguilar-Zamora: None declared, C Vergara-Dangond: None declared, I Vázquez-Gómez: None declared, Eduardo Flores: None declared, A Sendra-García: None declared, À Martínez-Ferrer: None declared, Elia Valls-Pascual Grant/research support from: Roche, Novartis, and AbbVie, Speakers bureau: AbbVie, Lilly, Pfizer, MSD, Novartis, Janssen, Bristol Myers Squibb, UCB Pharma, D Ybáñez-García Speakers bureau: Lilly, Roche, Sanofi, V Núñez-Monje: None declared, I Torner-Hernández: None declared, Juanjo J Alegre-Sancho Consultant of: UCB, Roche, Sanofi, Boehringer, Celltrion, Paid instructor for: GSK, Speakers bureau: MSD, GSK, Lilly, Sanofi, Roche, UCB, Actelion, Pfizer, Abbvie, Novartis

scholarly journals Animais Venenosos em Território Português: Abordagem Clínica de Picadas e Mordeduras

2021 ◽  
Vol 34 (11) ◽  
pp. 784
Author(s):  
Sofia R. Valdoleiros ◽  
Inês Correia Gonçalves ◽  
Carolina Silva ◽  
Diogo Guerra ◽  
Lino André Silva ◽  
...  
Keyword(s):  
Native Species ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Hospital Setting ◽  
Marine Species ◽  
Symptomatic Treatment ◽  
Thaumetopoea Pityocampa ◽  
Hermodice Carunculata ◽  
Spider Bites

There are many native species of animals with the potential to cause severe disease in Portugal. Of the four clinically relevant snake species, the vipers (Vipera latastei and Vipera seoanei) are the most concerning. They can cause severe disease and require in-hospital management, monitoring and specific treatment, including the administration of anti-snake venom serum. The Malpolon monspessulanus and Macroprotodon brevis snakes cause mostly localized clinical manifestations, which do not require specific treatment. Only a minority of the spider species in Portugal possess chelicerae (mouthparts of the Chelicerata, shaped as either articulated fangs or pincers, which may contain venom or be connected to the venom glands and are used for predation or capture of food) long enough to perforate the human skin. Nevertheless, Latrodectus tredecimguttatus and Loxosceles rufescens spider bites may require specialized treatment in a hospital setting, as well as careful active symptom surveillance. Diversely, the treatment for Scolopendra cingulata and Scolopendra oraniensis centipedes’ bites is merely symptomatic. The only existing scorpion species in Portugal is the Buthus ibericus; its sting typically causes local symptoms with intense pain, and its treatment consists essentially of analgesia. The insects of the Hymenoptera order, such as bees and wasps, have the ability to inject venom into the skin. Most people present only with local or regional inflammatory response, and symptomatic treatment is usually effective. Even so, individuals with hypersensitivity to bee venom may develop anaphylaxis. Several marine species in the Portuguese coast are venomous to humans, including weeverfish (Trachinidae family), stingrays (Dasyatis pastinaca, Taeniura grabata, Myliobatis aquila), red scorpion fish (Scorpaena scrofa), cnidaria (Pelagia noctiluca, Chrysaora hysoscella, Physalia physalis) and bearded fireworm (Hermodice carunculata); treatment is symptomatic. Contact with the larvae or bristles (chitinous structures with locomotor or tactile functions) of Thaumetopoea pityocampa (pine processionary) can cause cutaneous, ocular and, rarely, respiratory reactions; its management is also symptomatic.

Sign in / Sign up

Export Citation Format

Share Document