RESUMO

The loss of estrogen with menopause is associated with an increase in central fat. The objective of this study was to evaluate the effects of menopause hormone therapy (HT) on body composition and metabolic parameters in postmenopausal women. A prospective study was conducted among postmenopausal women from the Climacteric clinic, Universidade Federal de São Paulo. Thirty-two participants, median age 51 years, were included. Sixteen women were eligible to receive a low-dose continuous combined HT, containing 1 mg of E2 plus 0.125 mg of trimegestone for 6 months. The other 16 women remained in the control group. In the HT group, significant decreases from baseline were evident for the total cholesterol (TC) (p < 0.05) and LDL levels (p < 0.05). The HDL significantly decreased (p < 0.05). However, the TC/HDL ratio also decreased (p = 0.05). The parameters of body composition, after 6 months of HT, were maintained. In the control group, body mass index levels increased from baseline, however, with nonstatistically significant differences (p = 0.06). Analyzing the body composition showed a significant increase in the trunk body fat (p = 0.04), trunk region fat (p = 0.04), and total region fat (p = 0.03) after 6 months. In conclusion, the present study provides evidence that HT can stunt the increase in total body fat and prevent the shift from a more central fat distribution observed in early postmenopausal period.

RESUMO

El pénfigo paraneoplásico es una dermatosis ampollar autoimmune asociada a un proceso neoplásico, conocido previamente o no. Se presenta con mayor frecuencia en hombres, entre los 45 y 70 años, pero también puede manifestarse en niños. La clínica es polimorfa. Existen 5 variantes posibles: pénfigo símil, penfigoide ampollar símil, eritema multiforme símil, enfermedad de injerto contra huésped símil y liquen plano símil. Todas ellas comparten una característica en común: la estomatitis severa, dolorosa, progresiva y refractaria a los tratamientos convencionales, que obliga a descartar esta enfermedad. Si bien los antígenos involucrados en su fisiopatogenia son múltiples, la detección de anticuerpos Ig G anti envoplaquina y anti periplaquina constituye el método de diagnóstico más específico. En la actualidad se utilizan los criterios de diagnóstico de Camisa y Helm, que se basan en hallazgos clínicos (erupción mucocutánea polimorfa), histológicos (acantolisis) e inmunohistoquímicos (inmunofluorescencia directa, indirecta e inmunoprecipitación positivas). El abordaje de esta enfermedad debe considerar dos aspectos: el tratamiento del pénfigo en sí y el de la neoplasia asociada, que puede ser benigna (raro) o maligna (con mayor frecuencia). El pronóstico es severo (mortalidad del 75-90%) y en la mayoría de los casos la causa de muerte depende de las complicaciones de la enfermedad, como sepsis y bronquiolitis obliterante. Se presenta un paciente varón de 67 años con PPN asociado a Leucemia Linfocítica Crónica que respondió satisfactoriamente al tratamiento instaurado (meprednisona + quimioterapia con fludarabina, ciclofosfamida y rituximab) y no presentó recidiva a más de 2 años de seguimiento interdisciplinario.

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Paraneoplastic pemphigus is an autoimmune blistering disease associated with neoplasms, previously known or not. It occurs most often in men, between 45-70 years, but can also manifest in children. The clinic is polymorphic. There are 5 possible variants: pemphigus-like, bullous pemphigoid-like, erythema multiforme-like, graft versus host disease-like and lichen planus-like. All of them share a common characteristic: a severe, painful, progressive and refractory to conventional treatments stomatitis, which forces us to rule out this disease. Although the antigens involved in its physiopathogenesis are multiple, the detection of anti-envoplakin and anti-periplakin IgG antibodies constitutes the most specific diagnostic method. At present, the diagnostic criteria of Camisa and Helm are used, which are based on clinical (polymorphic mucocutaneous eruption), histological (acantholysis) and immunohistochemical findings (direct and indirect immunofluorescence and immunoprecipitation positive). The approach to this disease must consider two aspects: treatment of the pemphigus as well as the associated neoplasm, which can be benign (rare) or malignant (more frequently). The prognosis is severe (mortality of 75-90%) and in most cases the cause of death depends on the complications of the disease, such as sepsis and bronchiolitis obliterans. We present a 67-year-old male patient with PPN associated with Chronic Lymphocytic Leukemia who responded satisfactorily to the established therapy (meprednisone + chemotherapy with fludarabine, cyclophosphamide and rituximab) and did not present recurrence after more than two years of interdisciplinary follow-up.

Assuntos

Humanos , Masculino , Idoso , Imunoglobulina G , Pênfigo/terapia , Plaquinas , Neoplasias/mortalidade , Neoplasias/terapia

RESUMO

Periodontal disease (PD) is a chronic inflammatory and alveolar bone destructive disease triggered by oral biofilm-producing microorganisms, such as Aggregatibacter actinomycetemcomitans. The levels of the phospholipid platelet-activating factor (PAF) in the saliva, gingival crevicular fluid, and periodontal tissues are significantly increased during inflammatory conditions, such as PD, but the exact mechanism that links PAF to alveolar bone resorption is not well understood. In the current study, alveolar bone resorption was induced by experimental PD through the oral inoculation of A. actinomycetemcomitans in wild-type (WT) and PAF receptor knockout (Pafr(-/-)) mice. In vitro experiments using A. actinomycetemcomitans lipopolysaccharide (LPS)-stimulated RAW 264.7 cells treated with a PAF receptor antagonist (UK74505) were also performed. The expression of lyso-PAF acetyltransferase in periodontal tissues was significantly increased 3 h after A. actinomycetemcomitans LPS injection in mice. WT and Pafr(-/-) mice that were subjected to oral inoculation of A. actinomycetemcomitans presented neutrophil accumulation and increased levels of CXCL-1 and tumor necrosis factor alpha (TNF-α) in periodontal tissues. However, Pafr(-/-) mice presented less alveolar bone loss than WT mice. The in vitro blockade of the PAF receptor impaired the resorptive activity of A. actinomycetemcomitans LPS-activated osteoclasts. In conclusion, this study shows for the first time that the blockade of PAF receptor may contribute to the progression of PD triggered by A. actinomycetemcomitans by directly affecting the differentiation and activity of osteoclasts.

Assuntos

Infecções por Pasteurellaceae/patologia , Pasteurellaceae/patogenicidade , Doenças Periodontais/patologia , Glicoproteínas da Membrana de Plaquetas/antagonistas & inibidores , Receptores Acoplados a Proteínas G/antagonistas & inibidores , Perda do Osso Alveolar/patologia , Animais , Reabsorção Óssea , Linhagem Celular , Citocinas/metabolismo , Modelos Animais de Doenças , Endotoxinas/imunologia , Gengiva/imunologia , Gengiva/patologia , Lipopolissacarídeos/imunologia , Macrófagos/imunologia , Macrófagos/microbiologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Neutrófilos/imunologia , Osteoclastos/metabolismo , Infecções por Pasteurellaceae/microbiologia , Doenças Periodontais/microbiologia , Glicoproteínas da Membrana de Plaquetas/deficiência , Receptores Acoplados a Proteínas G/deficiência

RESUMO

Periodontal disease (PD) is a chronic inflammatory and alveolar bone destructive disease triggered by microorganisms from the oral biofilm. Oral inoculation of mice with the periodontopathogen Aggregatibacter actinomycetemcomitans (Aa) induces marked alveolar bone loss and local production of inflammatory mediators, including Macrophage Migration Inhibitory Factor (MIF). The role of MIF for alveolar bone resorption during PD is not known. In the present study, experimental PD was induced in BALB/c wild-type mice (WT) and MIF knockout mice (MIF⁻/⁻) through oral inoculation of Aa. Despite enhanced number of bacteria, MIF⁻/⁻ mice had reduced infiltration of TRAP-positive cells and reduced alveolar bone loss. This was associated with decreased neutrophil accumulation and increased levels of IL-10 in periodontal tissues. TNF-α production was similar in both groups. In vitro, LPS from Aa enhanced osteoclastic activity in a MIF-dependent manner. In conclusion, MIF has role in controlling bacterial growth in the context of PD but contributes more significantly to the progression of bone loss during PD by directly affecting differentiation and activity of osteoclasts.

Assuntos

Perda do Osso Alveolar/patologia , Oxirredutases Intramoleculares/metabolismo , Fatores Inibidores da Migração de Macrófagos/metabolismo , Osteoclastos/metabolismo , Infecções por Pasteurellaceae/patologia , Pasteurellaceae/fisiologia , Doenças Periodontais/patologia , Perda do Osso Alveolar/microbiologia , Animais , Diferenciação Celular , Modelos Animais de Doenças , Progressão da Doença , Mediadores da Inflamação/metabolismo , Interleucina-10/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Knockout , Neutrófilos/metabolismo , Osteoclastos/patologia , Pasteurellaceae/crescimento & desenvolvimento , Infecções por Pasteurellaceae/microbiologia , Doenças Periodontais/microbiologia , Fator de Necrose Tumoral alfa/metabolismo

RESUMO

OBJECTIVE: To evaluate the positive predictive value of detectable Tg during T4 therapy (Tg on T4) in patients with thyroid cancer after total thyroidectomy and remnant ablation, discussing the work-up in this situation and the empirical indication of 131I. PATIENTS AND METHODS: Initially, 234 low-risk patients [tumor < 5cm, completely resected, no extensive extrathyroid invasion (pT4)] submitted to total thyroidectomy and ablation with 131I (3.7-5.5 GBq) who presented no ectopic uptake on RxWBS were studied. Of these, 23 patients with detectable Tg on T4 (> 1ng/ml) during the first year after initial therapy were selected. RESULTS: Metastases were detected by neck US in 7 patients, by chest CT in 2 and by US and CT in 3. Four of five patients with lung metastases upon CT had a positive RxWBS. Eleven patients with negative US and CT received a new 131I dose (without DxWBS), and RxWBS showed ectopic uptake in 3 patients. Among the patients with negative RxWBS, 7 remained free of apparent disease and Tg was declining (5 with undetectable Tg on T4 at the end of the study). One patient presented an increase in Tg and FDG-PET was positive for lymph node and bone metastases. CONCLUSIONS: All patients with Tg on T4 > 5ng/ml presented apparent disease. In these cases, even when US and CT are negative, the administration of a therapeutic dose of 131I (without DxWBS) and FDG-PET are recommended. Among patients with detectable Tg on T4

Assuntos

Carcinoma/terapia , Radioisótopos do Iodo/uso terapêutico , Tireoglobulina/análise , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia , Tiroxina/uso terapêutico , Adolescente , Adulto , Idoso , Biomarcadores Tumorais/análise , Carcinoma/diagnóstico , Carcinoma/radioterapia , Feminino , Humanos , Neoplasias Pulmonares/secundário , Linfonodos/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/terapia , Valor Preditivo dos Testes , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/radioterapia , Tiroxina/análise , Tomografia Computadorizada por Raios X , Ultrassonografia

RESUMO

OBJECTIVE: To evaluate the positive predictive value of detectable Tg during T4 therapy (Tg on T4) in patients with thyroid cancer after total thyroidectomy and remnant ablation, discussing the work-up in this situation and the empirical indication of 131I. PATIENTS AND METHODS: Initially, 234 low-risk patients [tumor < 5cm, completely resected, no extensive extrathyroid invasion (pT4)] submitted to total thyroidectomy and ablation with 131I (3.7­5.5 GBq) who presented no ectopic uptake on RxWBS were studied. Of these, 23 patients with detectable Tg on T4 (> 1ng/ml) during the first year after initial therapy were selected. RESULTS: Metastases were detected by neck US in 7 patients, by chest CT in 2 and by US and CT in 3. Four of five patients with lung metastases upon CT had a positive RxWBS. Eleven patients with negative US and CT received a new 131I dose (without DxWBS), and RxWBS showed ectopic uptake in 3 patients. Among the patients with negative RxWBS, 7 remained free of apparent disease and Tg was declining (5 with undetectable Tg on T4 at the end of the study). One patient presented an increase in Tg and FDG-PET was positive for lymph node and bone metastases. CONCLUSIONS: All patients with Tg on T4 > 5ng/ml presented apparent disease. In these cases, even when US and CT are negative, the administration of a therapeutic dose of 131I (without DxWBS) and FDG-PET are recommended. Among patients with detectable Tg on T4 < 5ng/ml and negative US and CT, only 12 percent presented ectopic uptake on RxWBS. These cases could be followed up by monitoring Tg on T4, and RxWBS and FDG-PET should only be performed if this marker does not decrease after 1­2 years.

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OBJETIVO: Avaliar o valor preditivo positivo da Tg detectável durante terapia com T4 (Tg sob T4) em pacientes com câncer de tireóide após tireoidectomia total e ablação dos remanescentes, discutindo o manuseio dessa situação e a indicação empírica de 131I. PACIENTES E MÉTODOS: Inicialmente, foram estudados 234 pacientes de baixo risco [tumor < 5cm, completamente ressecado, sem invasão extratireoideana extensa (pT4)] submetidos à tireoidectomia total e ablação com 131I (3,7­5,5 GBq) que não apresentaram captação ectópica com RxWBS. Desses, foram selecionados 23 pacientes com Tg detectável com T4 (> 1ng/ml) durante o primeiro ano após a terapia inicial. RESULTADOS: Metástases foram detectadas em 7 pacientes pelo US cervical, em 2 pela TC de tórax e em 3 pela US e TC. Quatro de 5 pacientes com metástases pulmonares à TC tiveram um RxWBS positivo; 11 pacientes com US e TC negativos receberam uma nova dose de 131I (sem DxWBS), e a RxWBS mostrou captação ectópica em 3 pacientes. Entre os pacientes com RxWBS negativo, 7 permaneceram livres de doença aparente e a Tg estava em declínio (5 com Tg indetectável sob T4 ao final do estudo). Um paciente apresentou aumento da Tg e o FDG-PET foi positivo para linfonodos e metástases ósseas. CONCLUSÕES: Todos os patients com Tg sob T4 > 5ng/ml apresentaram doença aparente. Nesses casos, mesmo quando a US e a TC são negativos, é recomendada a administração de dose terapêutica de 131I (sem DxWBS) e FDG-PET. Em pacientes com Tg detectável sob T4 < 5ng/ml, mas US e TC negativos, apenas 12 por cento apresentaram captação ectópica com a RxWBS. Estes casos podem ser seguidos pelo monitoramento da Tg sob T4, e RxWBS e FDG-PET devem ser feitos apenas se esse marcador não diminuir.

Assuntos

Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Carcinoma/terapia , Radioisótopos do Iodo/uso terapêutico , Tireoidectomia , Tireoglobulina/análise , Neoplasias da Glândula Tireoide/terapia , Tiroxina/uso terapêutico , Carcinoma/diagnóstico , Carcinoma/radioterapia , Neoplasias Pulmonares/secundário , Linfonodos , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/terapia , Valor Preditivo dos Testes , Tomografia Computadorizada por Raios X , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/radioterapia , Tiroxina/análise , Biomarcadores Tumorais/análise

RESUMO

This study evaluated the positive predictive value (PPV) of detectable stimulated thyroglobulin during the first year after treatment of thyroid carcinoma (Tg-1) and the value of comparison with Tg-ablation and measured after 24 months (Tg-2). Forty-two consecutive patients undergoing total thyroidectomy and ablation with detectable Tg-1 (>1ng/mL) were selected. The patients had well-differentiated tumors, which were completely resected, and there was no ectopic uptake on whole body scan after 3.7-5.5GBq I(131). Imaging methods during follow-up revealed metastases in 10 patients (24%) (15% if Tg-1 10 ng=mL). Tg-ablation (cutoff of 10 ng/mL) presented a negative predictive value (NPV) of 91% and PPV of 42%. Comparing Tg-ablation with Tg-1, the PPV of an increase was 100%, whereas the NPV of a decrease was 88%. Thirty-six patients presented negative imaging results upon first assessment and Tg-1 was compared to Tg-2. Metastases were detected in all patients who presented an increase in Tg (n=4), whereas patients without variation (n=4) or with a decrease (n=28) showed no apparent disease. Among disease-free patients (n=32), 50% presented undetectable Tg and 40% showed a >50% decrease after 2 years. In conclusion, most patients with detectable stimulated Tg during the first year after therapy had no metastases, and evaluation of the slope of Tg helped discriminate cases with apparent disease.

Assuntos

Tireoglobulina/sangue , Neoplasias da Glândula Tireoide/radioterapia , Neoplasias da Glândula Tireoide/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/sangue , Criança , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Radioisótopos do Iodo/uso terapêutico , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Neoplasias da Glândula Tireoide/secundário , Tireoidectomia , Tireotropina/sangue , Tiroxina/sangue

RESUMO

El granuloma naular elastolítico de células gigantes (GAECG) es una dermatosis granulomatosa benigna, poco frecuente, crónica y de etiología desconocida, localizada en áreas fotoexpuestas. La histopatología demuestra la presencia de células gigantes con elastólisis y elastofagocitosis. Describimos dos casos de GAECG y se realiza un revisión de esta patología, diagnósticos diferenciales y posibilidades terapéuticas.

Assuntos

Humanos , Granuloma Anular/diagnóstico , Granuloma Anular/fisiopatologia

RESUMO

Among bullous diseases, pemphigus vulgaris (PV) is a classical variety of this type of skin disorders. To establish the real prevalence of thyroid abnormalities in such a disease, a prospective study was developed. For this reason, thyroid evaluation was performed in 15 consecutive patients who attended the Dermatology Clinic for PV and in a group of 15 healthy volunteers (Control Group) matched by age and gender. Thyroid function was evaluated by measuring T3, T4 and TSH. The presence or absence of goiter was searched by palpation, while thyroid autoimmunity was investigated through the assay of thyroperoxidase antibodies (TPO-Ab). In each group there were 9 women and 6 men, aging 25-65 years (mean = 48.3 y) in the PV Group, and 25-69 years (mean = 45.4 y) in the Control Group. It was found that 7 patients (46.6%) of the PV Group and 1 subject (6.7%) of the Control Group (p < 0.015) disclosed thyroidal alterations. Positive titers of TPO-Ab were observed in 6 patients with PV and in one volunteer. Goiter and subclinical hypothyroidism were found in one PV patient with negative TPO-Ab. Out of the total 7 cases with positive TPO-Ab, only a PV patient had an overt Hashimoto's thyroiditis. All other cases had only the presence of thyroid auto-antibodies without clinical evidences of chronic thyroiditis. It is concluded that PV is highly associated with primary thyroid disorders, mainly with positive titers of TPO-Ab, although most patients do not present overt clinical thyroid disease.

Assuntos

Autoimunidade , Pênfigo/imunologia , Doenças da Glândula Tireoide/imunologia , Adulto , Fatores Etários , Idoso , Argentina/epidemiologia , Autoantígenos/imunologia , Métodos Epidemiológicos , Feminino , Humanos , Ensaio Imunorradiométrico , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Masculino , Pessoa de Meia-Idade , Pênfigo/epidemiologia , Fatores Sexuais , Doenças da Glândula Tireoide/epidemiologia , Testes de Função Tireóidea , Tireotropina/imunologia

RESUMO

Introducción. Los pénfigos representan un grupo de enfermedades autoinmunes caracterizadas por la formación de ampollas. Dentro de este grupo, el pénfigo vulgar es la forma clínica más frecuente. Por otro lado, la patología tiroidea tiene elevada prevalencia en la práctica médica y está asociada con un amplio rango de trastornos cutáneos. Hay publicaciones aisladas de la asociación entre patología tiroidea y pénfigo vulgar. Por esta razón, se decidió establecer la prevalencia de disfunción tiroidea primaria y autoinmunidad tiroidea en pacientes con pénfigo vulgar. Objetivos. (i) Determinar la prevalencia de disfunción tiroidea primaria y autoinmunidad tiroidea en pacientes con pénfigo vulgar. (ii) Relacionar los hallazgos con lo referido en la bibliografía. Material y métodos. Se efectuó un estudio observacional, transversal, prospectivo y controlado, entre marzo del 2002 y marzo del 2004, en 28 pacientes con diagnóstico de pénfigo vulgar que concurrieron a la Sección Ampollares de la División Dermatología y fueron evaluados posteriormente por endocrinólogos de la División Endocrinología, en el Hospital de Clínicas José de San Martín. La evaluación tiroidea fue realizada en 28 pacientes consecutivos con pénfigo vulgar y 40 voluntarios sanos (controles) apareados por sexo y edad, y consistió en palpación tiroidea, prueba de funcionalidad tiroidea mediante dosaje en sangre de las hormonas T3, T4, TSH, y prueba de autoinmunidad tiroidea mediante dosaje en sangre de anticuerpos antiperoxidasa...(AU)

Assuntos

Masculino , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Pênfigo/imunologia , Tireoidite Autoimune/complicações , Pênfigo/complicações , Doenças Autoimunes/complicações , Tireoidite Autoimune/diagnóstico , Glândula Tireoide/imunologia

RESUMO

Introducción. Los pénfigos representan un grupo de enfermedades autoinmunes caracterizadas por la formación de ampollas. Dentro de este grupo, el pénfigo vulgar es la forma clínica más frecuente. Por otro lado, la patología tiroidea tiene elevada prevalencia en la práctica médica y está asociada con un amplio rango de trastornos cutáneos. Hay publicaciones aisladas de la asociación entre patología tiroidea y pénfigo vulgar. Por esta razón, se decidió establecer la prevalencia de disfunción tiroidea primaria y autoinmunidad tiroidea en pacientes con pénfigo vulgar. Objetivos. (i) Determinar la prevalencia de disfunción tiroidea primaria y autoinmunidad tiroidea en pacientes con pénfigo vulgar. (ii) Relacionar los hallazgos con lo referido en la bibliografía. Material y métodos. Se efectuó un estudio observacional, transversal, prospectivo y controlado, entre marzo del 2002 y marzo del 2004, en 28 pacientes con diagnóstico de pénfigo vulgar que concurrieron a la Sección Ampollares de la División Dermatología y fueron evaluados posteriormente por endocrinólogos de la División Endocrinología, en el Hospital de Clínicas José de San Martín. La evaluación tiroidea fue realizada en 28 pacientes consecutivos con pénfigo vulgar y 40 voluntarios sanos (controles) apareados por sexo y edad, y consistió en palpación tiroidea, prueba de funcionalidad tiroidea mediante dosaje en sangre de las hormonas T3, T4, TSH, y prueba de autoinmunidad tiroidea mediante dosaje en sangre de anticuerpos antiperoxidasa...

Assuntos

Masculino , Adulto , Humanos , Feminino , Pessoa de Meia-Idade , Pênfigo/imunologia , Tireoidite Autoimune , Doenças Autoimunes , Glândula Tireoide/imunologia , Pênfigo/complicações , Tireoidite Autoimune

RESUMO

Among bullous diseases, pemphigus vulgaris (PV) is a classical variety of this type of skin disorders. To establish the real prevalence of thyroid abnormalities in such a disease, a prospective study was developed. For this reason, thyroid evaluation was performed in 15 consecutive patients who attended the Dermatology Clinic for PV and in a group of 15 healthy volunteers (Control Group) matched by age and gender. Thyroid function was evaluated by measuring T3, T4 and TSH. The presence or absence of goiter was searched by palpation, while thyroid autoimmunity was investigated through the assay of thyroperoxidase antibodies (TPO-Ab). In each group there were 9 women and 6 men, aging 25-65 years (mean = 48.3 y) in the PV Group, and 25-69 years (mean = 45.4 y) in the Control Group. It was found that 7 patients (46.6

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) of the PV Group and 1 subject (6.7

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) of the Control Group (p < 0.015) disclosed thyroidal alterations. Positive titers of TPO-Ab were observed in 6 patients with PV and in one volunteer. Goiter and subclinical hypothyroidism were found in one PV patient with negative TPO-Ab. Out of the total 7 cases with positive TPO-Ab, only a PV patient had an overt Hashimotos thyroiditis. All other cases had only the presence of thyroid auto-antibodies without clinical evidences of chronic thyroiditis. It is concluded that PV is highly associated with primary thyroid disorders, mainly with positive titers of TPO-Ab, although most patients do not present overt clinical thyroid disease.

RESUMO

BACKGROUND: Pemphigus is a group of chronic blistering autoimmune diseases of which pemphigus vulgaris (PV) is the more frequent clinical form. The association of PV with the HLA serotypes suggests that there is a genetic predisposition to the disease. OBJECTIVES: To determine the frequency of class I and class II HLA antigens and the allelic variants of the class II HLA antigens, DR and DQ, in patients with PV and to determine the relative risk. METHODS: An observational, prospective, transverse, and controlled study carried out between 1995 and 1999. Forty-seven patients with a diagnosis of PV and a control sampling of 199 unselected individuals from the same ethnic group were included. The HLA alleles were determined by polymerase chain reaction. RESULTS: No significant associations were detected between HLA A, B, or C and our patients. The DR and DQ molecular alleles positively associated with PV were two different haplotypes: DRb1* 0402/DQb1* 0302 and DRb1* 1401/DQb1* 0503. CONCLUSIONS: In patients with the haplotype DRb1* 0402/DQb1* 0302 the affectation of 10%-30% of the corporal surface prevailed (ACS). In patients with DRb1* 1401/DRQb1* 0503, involvement of <10% of the ACS prevailed.

Assuntos

Alelos , Antígenos HLA/genética , Antígenos de Histocompatibilidade Classe II/genética , Pênfigo/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Antígenos HLA/sangue , Haplótipos , Antígenos de Histocompatibilidade Classe II/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Pênfigo/sangue

RESUMO

El pénfigo vulgar (PV) es una enfermedad cutaneomucosa que se caracteriza por la presencia de autoanticuerpos dirigidos contra la desmogléína 3, causando acantolisis y formación de ampollas. En el presente estudio se analiza la asociación de los antígenos HLA DR y HLA DQ en 30 pacientes caucásicos argentinos que padecen esta enfermedad comparada con una población control (N = 199) del mismo grupo étnico. La técnica utilizada fue PCR SSO. Los resultados muestran una asociación con HLA DR 4 (RR = 3.80, P = 0.001) y HLA DR 14 (RR = 5.97, P = 0.0001). En el caso de los subtipos moleculares DrBeta1 y DQBeta1, los que están positivamente asociados con PV pertencen a 2 alelos diferentes, tal como en otras poblaciones. El primero es DRBeta1 0402 (RR = 44.70, P = 10.7) y DQBeta1 0302 (RR = 71.82, P = 10.7) y el segundo es DRBeta1 1401 (RR = 117.94, P = 10.7) y DQBeta1 0503 (RR = 86.95, P = 10.7).

Assuntos

Humanos , Antígenos HLA-DQ/sangue , Antígenos HLA-DR/sangue , Pênfigo/genética , Pênfigo/imunologia , Reação em Cadeia da Polimerase/métodos , Alelos , Estudos Prospectivos , Risco

RESUMO

El pénfigo vulgar (PV) es una enfermedad cutaneomucosa que se caracteriza por la presencia de autoanticuerpos dirigidos contra la desmogléína 3, causando acantolisis y formación de ampollas. En el presente estudio se analiza la asociación de los antígenos HLA DR y HLA DQ en 30 pacientes caucásicos argentinos que padecen esta enfermedad comparada con una población control (N = 199) del mismo grupo étnico. La técnica utilizada fue PCR SSO. Los resultados muestran una asociación con HLA DR 4 (RR = 3.80, P = 0.001) y HLA DR 14 (RR = 5.97, P = 0.0001). En el caso de los subtipos moleculares DrBeta1 y DQBeta1, los que están positivamente asociados con PV pertencen a 2 alelos diferentes, tal como en otras poblaciones. El primero es DRBeta1 0402 (RR = 44.70, P = 10.7) y DQBeta1 0302 (RR = 71.82, P = 10.7) y el segundo es DRBeta1 1401 (RR = 117.94, P = 10.7) y DQBeta1 0503 (RR = 86.95, P = 10.7). (AU)

Assuntos

Estudo Comparativo , Humanos , Antígenos HLA-DQ/sangue , Reação em Cadeia da Polimerase/métodos , Antígenos HLA-DR/sangue , Pênfigo/imunologia , Pênfigo/genética , Estudos Prospectivos , Risco , Alelos

Assuntos

Humanos , Gravidez , Dermatologia , Plasmaferese/história , Plasmaferese/métodos , Artrite Psoriásica/sangue , Artrite Psoriásica/terapia , Pênfigo/sangue , Pênfigo/terapia , Urticária/sangue , Urticária/terapia

Assuntos

Humanos , Gravidez , Plasmaferese/história , Plasmaferese/métodos , Dermatologia , Artrite Psoriásica/sangue , Artrite Psoriásica/terapia , Urticária/sangue , Urticária/terapia , Pênfigo/sangue , Pênfigo/terapia

RESUMO

Se presentan tres casos de siringomas eruptivos (tipo Jacquet-Darier). En dos de ellos las lesiones aparecieron en brotes sucesivos en la infancia y en el tercero lo hicieron a una edad más tardía. En todos los casos la histología muestra un cuadro característico de siringomas. Se revisan las características clínicas, histopatológicas, diagnósticos diferenciales y tratamiento de una patología poco común en la práctica diaria

Assuntos

Humanos , Masculino , Feminino , Adolescente , Adulto , Siringoma/diagnóstico , Isotretinoína/uso terapêutico , Siringoma/tratamento farmacológico , Siringoma/patologia , Tretinoína/uso terapêutico

RESUMO

Se presentan tres casos de siringomas eruptivos (tipo Jacquet-Darier). En dos de ellos las lesiones aparecieron en brotes sucesivos en la infancia y en el tercero lo hicieron a una edad más tardía. En todos los casos la histología muestra un cuadro característico de siringomas. Se revisan las características clínicas, histopatológicas, diagnósticos diferenciales y tratamiento de una patología poco común en la práctica diaria (AU)

Assuntos

Humanos , Masculino , Feminino , Adolescente , Adulto , Siringoma/diagnóstico , Siringoma/patologia , Siringoma/tratamento farmacológico , Isotretinoína/uso terapêutico , Tretinoína/uso terapêutico