{"id":295,"date":"2025-03-26T13:14:38","date_gmt":"2025-03-26T12:14:38","guid":{"rendered":"https:\/\/www.neuromuscularbcn.org\/?page_id=295"},"modified":"2025-04-29T10:44:27","modified_gmt":"2025-04-29T08:44:27","slug":"consultes-monografiques-enmr-inmunomediadas","status":"publish","type":"page","link":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/","title":{"rendered":"Consultes monogr\u00e0fiques ENMR inmunomediadas"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container has-pattern-background has-mask-background nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:1422.72px;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column cnt_PagGen_Content_col\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:0px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\" data-scroll-devices=\"small-visibility,medium-visibility,large-visibility\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-tabs fusion-tabs-1 classic nav-is-justified cnt_pestanas horizontal-tabs icon-position-left mobile-mode-carousel mobile-sticky-tabs\" style=\"--awb-title-border-radius-top-left:0px;--awb-title-border-radius-top-right:0px;--awb-title-border-radius-bottom-right:0px;--awb-title-border-radius-bottom-left:0px;--awb-alignment:start;--awb-inactive-color:var(--awb-color2);--awb-background-color:var(--awb-color1);--awb-border-color:var(--awb-color3);--awb-active-border-color:var(--awb-color5);\"><div class=\"nav\"><ul class=\"nav-tabs nav-justified\" role=\"tablist\"><li class=\"active\" role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-feaf70e7d1a738a04ad\" aria-selected=\"true\" id=\"fusion-tab-miast\u00e8niagravis\" href=\"#tab-feaf70e7d1a738a04ad\"><h4 class=\"fusion-tab-heading\">Miast\u00e8nia Gravis<\/h4><\/a><\/li><li role=\"presentation\"><a class=\"tab-link\" data-toggle=\"tab\" role=\"tab\" aria-controls=\"tab-08c4aeb42031cf213c6\" aria-selected=\"false\" tabindex=\"-1\" id=\"fusion-tab-neuropatiesimmunomediades\" href=\"#tab-08c4aeb42031cf213c6\"><h4 class=\"fusion-tab-heading\">Neuropaties immunomediades<\/h4><\/a><\/li><\/ul><\/div><div class=\"tab-content\"><div class=\"tab-pane fade fusion-clearfix in active\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-miast\u00e8niagravis\" id=\"tab-feaf70e7d1a738a04ad\">\n<h4 class=\"anclaje_btn_cab\">Miast\u00e8nia Gravis<\/h4>\n<p><img decoding=\"async\" class=\"wp-image-2647 alignleft\" src=\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg\" alt=\"\" width=\"569\" height=\"214\" srcset=\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1-200x75.jpg 200w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1-300x113.jpg 300w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1-400x151.jpg 400w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1-600x226.jpg 600w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg 768w\" sizes=\"(max-width: 569px) 100vw, 569px\" \/><\/p>\n<p>Aquesta consulta monogr\u00e0fica la realitza la Dra. Illa els dilluns amb un neur\u00f2leg postMIR en formaci\u00f3 neuromuscular i un resident del servei de neurologia de l\u2019Hospital de Sant Pau o d\u2019un hospitals d\u2019altres comunitats. Aquesta formaci\u00f3 t\u00e9 l\u2019objectiu d\u2019aprendre tant el diagn\u00f2stic com el maneig i el tractament d\u2019aquesta malaltia poc freq\u00fcent i en especial aquells casos que s\u00f3n resistents a les ter\u00e0pies habituals.<\/p>\n<p>Una de les caracter\u00edstiques de la consulta monogr\u00e0fica \u00e9s la protocol\u00b7litzaci\u00f3 de l\u2019exploraci\u00f3, amb la utilitzaci\u00f3 d\u2019una escala de fatigabilitat i la monitoritzaci\u00f3 dels nivells d\u2019anticossos anti-receptor d\u2019acetilcolina o anti-Musk en el seguiment dels pacients. D\u2019aquesta manera \u00e9s possible realitzar estudis amb una metodologia adequada sobre estrat\u00e8gies diagn\u00f2stiques i terap\u00e8utiques.<\/p>\n<p>Des de el 1977 es realitza la consulta especialitzada en MG, el Dr. Pradas ,adjunt de neurologia, el Dr. Rodr\u00edguez de la Serna, adjunt de Medicina Interna i els Drs. Blesa i Illa, residents de neurologia, a l\u2019any 1977 van desenvolupar un programa per realitzar la timectomia i el tractament immunosupressor a pacients amb MG. Es va desenvolupar no nom\u00e9s un protocol de diagn\u00f2stic i tractament si no que es va realitzar un protocol de tractament a pacients aguts de la UCI. Una caracter\u00edstica d\u2019aquest protocol va ser que els pacients ingressaven al servei de neurologia, un cop realitzada la timectomia, per que el seguiment post-operatori estigues sota la nostra supervisi\u00f3. S\u2019ha desenvolupat tamb\u00e9 un protocol de tractaments immunomoduladors (Igev o plasmaf\u00e8resis) a l\u2019Hospital de dia que tamb\u00e9 est\u00e0 supervisat per la unitat de malalties neuromusculars.<\/p>\n<p>Juntament amb el Dr. Ju\u00e1rez del servei d\u2019immunologia es va posar en marxa la determinaci\u00f3 dels anticossos antireceptor d\u2019acetilcolina (AcRACh). El desenvolupament de la t\u00e8cnica i la correlaci\u00f3 dels anticossos amb els subgrups de pacients amb MG va ser el tema de la tesis doctoral de la Dra. Illa. Posteriorment al 2004, es va posar a punt la t\u00e8cnica de detecci\u00f3 dels anticossos anti-MusK pel diagn\u00f2stic d\u2019un subgrup concret de MG. Vam ser i som pioners a Espanya en la determinaci\u00f3 d\u2019ambd\u00f3s anticossos, en el diagn\u00f2stic d\u2019aquests pacients i en el seu tractament. El n\u00famero de determinacions que es fan actualment \u00e9s de 330-360 per cada un d\u2019aquests anticossos, procedents de diversos centres d\u2019Espanya.<\/p>\n<p>L\u2019experi\u00e8ncia en Miast\u00e8nia Gravis ha estat presentat en diversos congressos i publicada en diferents articles, que van fer que la Dra. Illa particip\u00e9s en l\u2019elaboraci\u00f3 de les guies europees de tractament de la Miast\u00e8nia Gravis \u201cGuidelines for treatment of autoimmune neuromuscular transmission disorders \u201c. Skeie GO, Apostolski S, Evoli A, Gilhus NE, Illa I, Harms L, Hilton-Jones D, Melms A, Verschuuren J, Horge HW; European Federation of Neurological Societies. Eur J Neurol. 2010 Jul;17(7):893-902. Actualment la Dra. Illa participa en l\u2019elaboraci\u00f3 de la guia internacional de diagn\u00f2stic i tractament de la MG, sota la direcci\u00f3 del Dr. Donald Sanders. Aquesta guia conte amb la participaci\u00f3 d\u2019experts d\u2019Europa, Estats Units, Australi\u00e0 i Jap\u00f3, seguint amb el proc\u00e9s Delphi publicat al 2015.<\/p>\n<p>En quant a tractament de la MG precisament la monitoritzaci\u00f3 de la fatigabilitat i la determinaci\u00f3 dels anticossos ens ha permet publicar la nostra experi\u00e8ncia en diversos articles i revisions: Treatment<\/p>\n<p>strategies for myasthenia gravis: an update\u201d. Expert Opin Pharmacother. 2012 Sep;13(13):1873- 83. Al gener del 2012 vam publicar a la revista Neurology, una de les revistes amb m\u00e9s prestigi en neurologia cl\u00ednica, la nostra experi\u00e8ncia en el tractament amb Rituximab de pacients amb miast\u00e8nia resistent a altres f\u00e0rmacs: \u201c<em>Long-lasting treatment effect of rituximab in MuSK myasthenia\u201d. Neurology. 2012 Jan 17;78(3):189-93<\/em>. Els resultats mostrats en aquesta publicaci\u00f3 han fet que aquest article hagi estat qualificat amb una alta qualitat docent, convertint-se en referent d\u2019algoritmes de tractament de la miast\u00e8nia resistent a altres tractaments immunosupressors, motiu pel qual ens van convidar a publicar la nostre experi\u00e8ncia:\u00a0<em>\u201cMyasthenia gravis and the neuromuscular junction\u201d. Curr Opin Neurol. 2013<\/em>.<\/p>\n<p>La UMNM ha publicat 23 articles sobre Miast\u00e8nia Gravis sobre aspectes cl\u00ednics, immunopatog\u00e8nia, resposta al tractament, nous ant\u00edgens i guies cl\u00edniques internacionals. En col\u00b7laboraci\u00f3 amb un hospital de la comarca d\u2019Osona hem pogut realitzar estudis epidemiol\u00f2gics que demostren una clara tend\u00e8ncia a augmentar la incid\u00e8ncia i prevalen\u00e7a de la miast\u00e8nia a la poblaci\u00f3 de m\u00e9s de 70 anys.<\/p>\n<p>Per \u00faltim destacar la publicaci\u00f3 d\u2019un article sobre episodis greus i crisis miast\u00e8niques, aquest article ha estat possible gr\u00e0cies a l\u2019exist\u00e8ncia d\u2019un registre de malalties neuromusculars espanyol\u00a0<strong><em>\u201cMyasthenia gravis: descriptive analysis of life-threatening events in a recent nationwide registry\u201d.<\/em><\/strong><\/p>\n<\/div><div class=\"tab-pane fade fusion-clearfix\" role=\"tabpanel\" tabindex=\"0\" aria-labelledby=\"fusion-tab-neuropatiesimmunomediades\" id=\"tab-08c4aeb42031cf213c6\">\n<h4 class=\"anclaje_btn_cab\">Neuropaties immunomediades (CIDP, NMM, S. Guillain-Barr\u00e9)<\/h4>\n<h4 class=\"anclaje_btn_cab\"><\/h4>\n<p><img decoding=\"async\" class=\"wp-image-2650 alignleft\" src=\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1.jpg\" alt=\"\" width=\"722\" height=\"148\" srcset=\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1-200x41.jpg 200w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1-300x62.jpg 300w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1-400x82.jpg 400w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1-600x123.jpg 600w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1-768x158.jpg 768w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1-800x164.jpg 800w, https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/slider1-1024x210-1.jpg 1024w\" sizes=\"(max-width: 722px) 100vw, 722px\" \/><\/p>\n<p>Aquesta consulta es realitzen els doctors Illa, Rojas i Querol els dimarts i\/o els dimecres. Els pacients d\u2019aquestes consultes tenen neuropaties tipus CIDP i neuropatia motora multifocal principalment. Aquestes s\u00f3n patologies minorit\u00e0ries per\u00f2 molt important d\u2019identificar-les per que s\u00f3n tractables. El diagn\u00f2stic i seguiment d\u2019aquesta patologia \u00e9s molt complexa i requereix neur\u00f2legs experts. \u00c9s essencial pel diagn\u00f2stic i diagn\u00f2stic diferencial la realitzaci\u00f3 d\u2019estudis neurofisiol\u00f2gics, que es recomana que es facin de forma protocol\u00b7litzada (INCAT, PERINOMS).\u00a0 A m\u00e9s de les t\u00e8cniques diagn\u00f2stiques, s\u2019ha de fer el seguiment i quantificar l\u2019evoluci\u00f3 de la resposta al tractament que en aquests casos es realitza amb Igev i\/o f\u00e0rmacs immunosupressors.<\/p>\n<p>La UMNM-HSCSP t\u00e9 inter\u00e8s en les neuropaties immunomediades des de l\u2019any 1990, quan la Dra. Illa va aprendre, durant la seva estada al NIH, la valoraci\u00f3 cl\u00ednica d\u2019aquests pacients i a realitzar la determinaci\u00f3 dels anticossos antigangli\u00f2sids d\u2019aquestes neuropaties. Aquesta t\u00e8cnica va ser validada pel nostre centre pel Dr. E. Gallardo\u00a0 a Glasgow, sota la supervisi\u00f3 del Dr. H. Willison amb un estudi inter-laboratoris de validaci\u00f3.<\/p>\n<p>La UMNM va participar en un estudi europeu, denominat INCAT (Inflammatory Neuropathies, Cause and Treatment) que va desenvolupar un protocol d\u2019avaluaci\u00f3 dels pacients amb CIDP. Es va validar una escala de valoraci\u00f3 del d\u00e8ficit neurol\u00f2gic \u00e0mpliament utilitzada pels experts Hughes R, Bensa S, Willison H, Van den Bergh P, Comi G, Illa I, Nobile-Orazio E, van Doorn P, Dalakas M, Bojar M, Swan A;\u00a0<em>Inflammatory Neuropathy Cause and Treatment (INCAT) Group. Ann Neurol. 2001 Aug;50(2):195-201<\/em>.<\/p>\n<p>Tradicionalment participem a projectes internacionals que tenen l\u2019objectiu de desenvolupar protocols d\u2019avaluaci\u00f3 del d\u00e8ficit motor o sensitiu en les neuropaties immunomediades. Un d\u2019ells, PERINOMS, ha desenvolupat una s\u00e8rie d\u2019escales\u00a0 que estem intentant implantar a la consulta monogr\u00e0fica de les neuropaties inflamat\u00f2ries.<\/p>\n<p>El nostre inter\u00e8s en la quantificaci\u00f3 del d\u00e8ficit deriva de la seva import\u00e0ncia per objectivar el millor possible la resposta al tractament que apliquem als malalts, majorit\u00e0riament immunoglobulines endovenoses i f\u00e0rmacs immunosupressors.<\/p>\n<p>A m\u00e9s participem en un estudi acad\u00e8mic internacional sobre S\u00edndrome de Guillain- Barr\u00e9, en el que tot pacient diagnosticat i tractat d\u2019aquesta malaltia a Espanya que accepta participar es registra en una base de dades (projecte IGOS). Actualment hi ha mes de 800 pacients i l\u2019objectiu \u00e9s arribar als 1000 pacients. Amb les dades recollides de cada pacient es pret\u00e9n trobar factors pron\u00f2stics de recuperaci\u00f3, factor desencadenants i resposta al tractament entre altres.<\/p>\n<p>En quant als anticossos, tenim una gran experi\u00e8ncia en els anticossos antigangli\u00f2sids, ja que hem pogut contribuir a demostrar que aquesta prova \u00e9s \u00fatil per establir un diagn\u00f2stic prec\u00eds del S\u00edndrome de Guillain- Barr\u00e9 a m\u00e9s de diferents subtipus de neuropaties cr\u00f2niques disimmunes (motores, sensitives) i per establir el seu pron\u00f2stic. \u00c9s per aquest motiu que hi ha un n\u00famero considerable d\u2019estudis anualment derivats al nostre centre, unes 300 proves de mitja. L\u2019estudi es realitza en el servei d\u2019immunologia i la interpretaci\u00f3 del significat del resultat la realitza el Dr. Rojas de la UMNM en col\u00b7laboraci\u00f3 amb l\u2019esmenat servei.<\/p>\n<p>Gr\u00e0cies als treballs d\u2019investigaci\u00f3 que realitza actualment el Dr. Querol en la recerca de nous ant\u00edgens en la CIDP disposem ja de dos nous biomarcadors , CNTN-1 i NF-155 que tenen una repercussi\u00f3 cl\u00ednica important i que augmenten el perfil d\u2019anticossos en les neuropaties inflamat\u00f2ries. La seva determinaci\u00f3 positiva implica un pron\u00f2stic m\u00e9s greu i falta de resposta a les Igev. Precisament per aquest motiu, hem realitzat un protocol de tractament amb Rituximab en aquests pacients que estem avaluant ara.<\/p>\n<p>Fruit d\u2019aquest treball continuat de la unitat, hem publicat m\u00e9s de 15 treballs de diferents aspectes tant cl\u00ednics com de correlaci\u00f3 fenotip i marcat immunol\u00f2gic i terap\u00e8utic en les diferents neuropaties immunomediades.<\/p>\n<p>Precisament per la nostra experi\u00e8ncia en neuropaties immunomediades hem participat en l\u2019elaboraci\u00f3 de les guies europees de diagn\u00f2stic i tractament de les neuropaties disimmunes publicades al 2006 i una revisi\u00f3 publica al 2010).<\/p>\n<p>Finalment, ressaltar que la nostre unitat \u00e9s centre de refer\u00e8ncia per neuropaties inflamat\u00f2ries per la GBS-CISP Foundation americana (<strong><a href=\"http:\/\/www.gbs-cidp.org\/get-support\/centers-of-excellence\/\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/www.gbs-cidp.org\/get-support\/centers-of-excellence\/<\/a><\/strong>)<strong>.<\/strong><\/p>\n<\/div><\/div><\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"parent":275,"menu_order":4,"comment_status":"closed","ping_status":"closed","template":"100-width.php","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-295","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Consultes monogr\u00e0fiques ENMR inmunomediadas - Neuromuscular BCN<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Consultes monogr\u00e0fiques ENMR inmunomediadas - Neuromuscular BCN\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/\" \/>\n<meta property=\"og:site_name\" content=\"Neuromuscular BCN\" \/>\n<meta property=\"article:modified_time\" content=\"2025-04-29T08:44:27+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:site\" content=\"@NMDSantPau\" \/>\n<meta name=\"twitter:label1\" content=\"Temps estimat de lectura\" \/>\n\t<meta name=\"twitter:data1\" content=\"14 minuts\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/\",\"url\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/\",\"name\":\"Consultes monogr\u00e0fiques ENMR inmunomediadas - Neuromuscular BCN\",\"isPartOf\":{\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#primaryimage\"},\"image\":{\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#primaryimage\"},\"thumbnailUrl\":\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg\",\"datePublished\":\"2025-03-26T12:14:38+00:00\",\"dateModified\":\"2025-04-29T08:44:27+00:00\",\"breadcrumb\":{\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#breadcrumb\"},\"inLanguage\":\"ca\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"ca\",\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#primaryimage\",\"url\":\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg\",\"contentUrl\":\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Portada\",\"item\":\"https:\/\/www.neuromuscularbcn.org\/ca\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"Consultes monogr\u00e0fiques ENMR inmunomediadas\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/#website\",\"url\":\"https:\/\/www.neuromuscularbcn.org\/ca\/\",\"name\":\"Neuromuscular BCN\",\"description\":\"Neuromuscular BCN - Unidad Neuromuscular del hospital de Sant Pau\",\"publisher\":{\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/#organization\"},\"alternateName\":\"Neuromuscular BCN - Unidad Neuromuscular del hospital de Sant Pau\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/www.neuromuscularbcn.org\/ca\/?s={search_term_string}\"},\"query-input\":{\"@type\":\"PropertyValueSpecification\",\"valueRequired\":true,\"valueName\":\"search_term_string\"}}],\"inLanguage\":\"ca\"},{\"@type\":\"Organization\",\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/#organization\",\"name\":\"Neuromuscular BCN - Sant Pau\",\"url\":\"https:\/\/www.neuromuscularbcn.org\/ca\/\",\"logo\":{\"@type\":\"ImageObject\",\"inLanguage\":\"ca\",\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/#\/schema\/logo\/image\/\",\"url\":\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/06\/cropped-favicon_logotip.png\",\"contentUrl\":\"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/06\/cropped-favicon_logotip.png\",\"width\":512,\"height\":512,\"caption\":\"Neuromuscular BCN - Sant Pau\"},\"image\":{\"@id\":\"https:\/\/www.neuromuscularbcn.org\/ca\/#\/schema\/logo\/image\/\"},\"sameAs\":[\"https:\/\/x.com\/NMDSantPau\"]}]}<\/script>\n<!-- \/ Yoast SEO plugin. -->","yoast_head_json":{"title":"Consultes monogr\u00e0fiques ENMR inmunomediadas - Neuromuscular BCN","robots":{"index":"index","follow":"follow","max-snippet":"max-snippet:-1","max-image-preview":"max-image-preview:large","max-video-preview":"max-video-preview:-1"},"canonical":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/","og_locale":"ca_ES","og_type":"article","og_title":"Consultes monogr\u00e0fiques ENMR inmunomediadas - Neuromuscular BCN","og_url":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/","og_site_name":"Neuromuscular BCN","article_modified_time":"2025-04-29T08:44:27+00:00","og_image":[{"url":"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg","type":"","width":"","height":""}],"twitter_card":"summary_large_image","twitter_site":"@NMDSantPau","twitter_misc":{"Temps estimat de lectura":"14 minuts"},"schema":{"@context":"https:\/\/schema.org","@graph":[{"@type":"WebPage","@id":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/","url":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/","name":"Consultes monogr\u00e0fiques ENMR inmunomediadas - Neuromuscular BCN","isPartOf":{"@id":"https:\/\/www.neuromuscularbcn.org\/ca\/#website"},"primaryImageOfPage":{"@id":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#primaryimage"},"image":{"@id":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#primaryimage"},"thumbnailUrl":"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg","datePublished":"2025-03-26T12:14:38+00:00","dateModified":"2025-04-29T08:44:27+00:00","breadcrumb":{"@id":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#breadcrumb"},"inLanguage":"ca","potentialAction":[{"@type":"ReadAction","target":["https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/"]}]},{"@type":"ImageObject","inLanguage":"ca","@id":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#primaryimage","url":"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg","contentUrl":"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/04\/Consulta-monografica-768x289-1.jpg"},{"@type":"BreadcrumbList","@id":"https:\/\/www.neuromuscularbcn.org\/ca\/assistencia\/consultes-monografiques-enmr-inmunomediadas\/#breadcrumb","itemListElement":[{"@type":"ListItem","position":1,"name":"Portada","item":"https:\/\/www.neuromuscularbcn.org\/ca\/"},{"@type":"ListItem","position":2,"name":"Consultes monogr\u00e0fiques ENMR inmunomediadas"}]},{"@type":"WebSite","@id":"https:\/\/www.neuromuscularbcn.org\/ca\/#website","url":"https:\/\/www.neuromuscularbcn.org\/ca\/","name":"Neuromuscular BCN","description":"Neuromuscular BCN - Unidad Neuromuscular del hospital de Sant Pau","publisher":{"@id":"https:\/\/www.neuromuscularbcn.org\/ca\/#organization"},"alternateName":"Neuromuscular BCN - Unidad Neuromuscular del hospital de Sant Pau","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.neuromuscularbcn.org\/ca\/?s={search_term_string}"},"query-input":{"@type":"PropertyValueSpecification","valueRequired":true,"valueName":"search_term_string"}}],"inLanguage":"ca"},{"@type":"Organization","@id":"https:\/\/www.neuromuscularbcn.org\/ca\/#organization","name":"Neuromuscular BCN - Sant Pau","url":"https:\/\/www.neuromuscularbcn.org\/ca\/","logo":{"@type":"ImageObject","inLanguage":"ca","@id":"https:\/\/www.neuromuscularbcn.org\/ca\/#\/schema\/logo\/image\/","url":"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/06\/cropped-favicon_logotip.png","contentUrl":"https:\/\/www.neuromuscularbcn.org\/wp-content\/uploads\/2025\/06\/cropped-favicon_logotip.png","width":512,"height":512,"caption":"Neuromuscular BCN - Sant Pau"},"image":{"@id":"https:\/\/www.neuromuscularbcn.org\/ca\/#\/schema\/logo\/image\/"},"sameAs":["https:\/\/x.com\/NMDSantPau"]}]}},"_links":{"self":[{"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/pages\/295","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/comments?post=295"}],"version-history":[{"count":4,"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/pages\/295\/revisions"}],"predecessor-version":[{"id":3070,"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/pages\/295\/revisions\/3070"}],"up":[{"embeddable":true,"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/pages\/275"}],"wp:attachment":[{"href":"https:\/\/www.neuromuscularbcn.org\/ca\/wp-json\/wp\/v2\/media?parent=295"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}