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Background and Aims:C-reactive protein (CRP) is commonly used as a biomarker for inflammation. Mild elevations of CRP have been seen in chronic autoimmune diseases like systemic lupus erythematosus (SLE), and CRP has been linked to an increased risk of cardiovascular events. Diet quality and certain dietary factors seem to influence CRP levels in healthy subjects. To date, the effect of diet on serum CRP in SLE has not been studied. Our aim was to investigate the relationship between dietary nutrients, antioxidant intake, and serum CRP in SLE.Design and Method:A cross-sectional study was conducted among 91 patients with SLE. High-sensitivity hsCRP values were determined using an immuno-turbidimetry assay in a Beckman Coulter analyzer (AU5800). Dietary intake of macro- and micronutrients was assessed through a 24-hr diet recall. Antioxidant nutrient intake was evaluated using the dietary antioxidant quality score (DAQs). Linear regression models were used to investigate the relationships between serum hsCRP levels, dietary nutrient intake, and DAQs.Results:The mean serum hsCRP level observed (3.76 ± 6.68 mg/L) was above the established normal range. However, participating SLE patients had low-quality diets, and we found no significant correlations between dietary intake of macro- or micronutrients or antioxidant nutrient intake (DAQs) and serum CRP levels.Conclusion:Our study reveals that participating SLE patients had a low-quality diet that did not influence inflammatory status measured using serum CRP levels. Further interventional studies with high-quality diets in this population are necessary to dissect the role of diet on CRP levels in SLE.

Sarcoidosis is a multisystemic disease which diagnosis depends on the presence of nonnecrotizing granulomas in the biopsy. However there are variants such as necrotizing sarcoidal granulomas or nodular sarcoidosis which have atypical findings and make difficult the differential diagnosis with other infectious processes. We describe a case of a man who develops granulomas with extensive necrosis in a systemic sarcoidosis that affected the lung and the central nervous system. This finding made us to make the diagnosis of tuberculosis and delay the specific treatment.

In recent years Internet has become an important tool for medical information search, not only for physicians but also for the patients. Little is known about Internet patient's use in Spain. Our objective was to study the frequency with which patients with different chronic autoimmune diseases cared in our unit use Internet as a source of medical information, and to identify the factors associated with its use.A survey was carried out on Internet use to patients cared in a teaching hospital Systemic Autoimmune Diseases unit along three consecutive weeks.Hundred thirty-eight patients completed the questionnaire. Eighty-seven (63%) were women. Fifty-four patients (39.1%) were older than 55 years. Mean disease progression was 34.2 +/- 39.2 months. 22% of the respondents were uneducated, 39% had elementary education level; 20% had average education level, and 20% had advanced education level. Forty-two patients (30.4%) used regularly Internet for any purpose. Factors associated to Internet use for medical purposes were regular Internet use (OR: 4.6; CI: 1.1-18.8;p = 0.03), and average or advanced educational degree (advanced education: OR: 22.9; CI: 2.6-202.7; p = 0.005; average education: OR: 8.5; CI: 1.2-59.6; p = 0.03). Eighty-one patients (58.7%) expressed their need of information on quality web pages.Many patients use Internet for medical purposes in our environment and even more consider to use it in the future. It is important to be aware of this fact and facilitate information about quality web pages for interested patients.

A significant proportion of our patients has described to have problems from tolerance to Dolquine, a new presentation of hydroxychloroquine recently marketed in Spain, compared to Plaquenil. The objective was to know the tolerability and the adverse effects of this new presentation.A cross-sectional multicenter study on 133 patients treated with Dolquine was conducted.Of the 133 patients (87% women; average age [AA]: 32.9 [15.4] years) who received Dolquine during an average period of 6.7 (1.4) months, 32 patients (24%) described to have more problems with this drug in comparison with other antimalarial. The adverse effects experienced were: bitter taste (62.4%), difficulty in swallowing the tablet (13.5%), dyspepsia (9.8%), nausea (7.5%), vomiting (1.5%), pruritus (1.5%), diarrhea (0.7%), and instability feeling (0.7%). The presence of gastrointestinal adverse effects was not related to the consumption of gastroerosive drugs, gastric protectors, or a high number of drugs. The attrition rate was 9.8%. Conclusions. Dolquine induces lower tolerance and more gastrointestinal adverse effects than Plaquenil, pointing out its bitter taste and the difficulty in swallowing it. Despite this higher intolerance there was not an increase in the attition rate from the antimalarial treatment in comparison to other series.