RESUMO
OBJECTIVE: To investigate the effect of a single oral dose of 200,000 IU of vitamin D3 on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19. METHODS: This is a post-hoc, exploratory analysis from a double-blind, placebo-controlled, randomized clinical trial performed in two centers in Sao Paulo, Brazil. Hospitalized patients with COVID-19 were randomly assigned to receive either vitamin D3 (n = 97) or placebo (n = 97). In this post-hoc analysis, the endpoints were titers and frequency of anti-ß2-Glycoprotein-I (aß2-GP) and Anticardiolipin (aCL) antibodies [Immunoglobulin G, M and A (IgG, IgM and IgA)]. RESULTS: Overall mean (SD) age was 55.3 (13.9) years, Body Mass Index (BMI) was 32.2 (7.1 kg/m2), and 106 participants (54.6 %) were male. There was a significant group by time interaction (p = 0.046) for frequency of aCL IgG, with increased values from baseline to discharge in the placebo group [n (%), from 13 (13.4) to 25 (25.8)] compared to the vitamin D3 [from 25 (25.8) to 29 (29.9)]. However, the frequency of aCL IgG did not change between the groups on discharge. No significant differences between vitamin D3 and placebo groups were found for any other autoantibodies. CONCLUSION: These findings do not support the use of a single oral dose of 200,000 IU of vitamin D3 to modulate autoantibodies in hospitalized patients with moderate to severe COVID-19.
Assuntos
Anticorpos Antifosfolipídeos , COVID-19 , Colecalciferol , Humanos , Masculino , Colecalciferol/uso terapêutico , Colecalciferol/administração & dosagem , Feminino , Pessoa de Meia-Idade , Método Duplo-Cego , COVID-19/imunologia , Anticorpos Antifosfolipídeos/sangue , Idoso , Adulto , Índice de Gravidade de Doença , Hospitalização/estatística & dados numéricos , SARS-CoV-2/imunologia , Tratamento Farmacológico da COVID-19 , Vitaminas/uso terapêutico , Vitaminas/administração & dosagem , Anticorpos Anticardiolipina/sangue , Brasil , Imunoglobulina G/sangue , beta 2-Glicoproteína I/imunologia , Resultado do TratamentoRESUMO
Abstract Objective: To investigate the effect of a single oral dose of 200,000 IU of vitamin D3 on antiphospholipid antibodies in hospitalized patients with moderate to severe COVID-19. Methods: This is a post-hoc, exploratory analysis from a double-blind, placebo-controlled, randomized clinical trial performed in two centers in São Paulo, Brazil. Hospitalized patients with COVID-19 were randomly assigned to receive either vitamin D3 (n = 97) or placebo (n = 97). In this post-hoc analysis, the endpoints were titers and frequency of anti-β2-Glycoprotein-I (aβ2-GP) and Anticardiolipin (aCL) antibodies [Immunoglobulin G, M and A (IgG, IgM and IgA)]. Results: Overall mean (SD) age was 55.3 (13.9) years, Body Mass Index (BMI) was 32.2 (7.1 kg/m²), and 106 participants (54.6 %) were male. There was a significant group by time interaction (p = 0.046) for frequency of aCL IgG, with increased values from baseline to discharge in the placebo group [n (%), from 13 (13.4) to 25 (25.8)] compared to the vitamin D3 [from 25 (25.8) to 29 (29.9)]. However, the frequency of aCL IgG did not change between the groups on discharge. No significant differences between vitamin D3 and placebo groups were found for any other autoantibodies. Conclusion: These findings do not support the use of a single oral dose of 200,000 IU of vitamin D3 to modulate autoantibodies in hospitalized patients with moderate to severe COVID-19.
RESUMO
Hepatitis E in industrialized countries is mainly associated with genotype 3 hepatitis E virus (HEV) and normally causes a sporadic self-limiting disease in immunocompetent individuals. Unlike genotype 3, genotypes 1 and 2 circulate in developing countries, produce severe disease and occur in the epidemic form. Hepatitis E occurring in travellers returning from endemic areas in developing countries is not a novel epidemiological occurrence, however the vast majority of cases remain to be genetically studied. The present study describes two cases of severe acute hepatitis E that required hospitalization for 6 and 9 days in two individuals of Indian nationality that had recently migrated to Portugal to work. The retrieved HEV sequences both belonged to genotype 1 and had a high degree of nucleotide sequence identity, clustering with strains isolated in India and Nepal, in 2013 and 2014. Confirmed HEV genotypes of increased pathogenicity like genotype 1 are being introduced into otherwise naïve populations of industrialized countries such as European countries with consequences difficult to predict. As far as we know the present study is the first in Portugal to describe and genetically characterize imported cases of hepatitis E infection caused by HEV genotype 1.
Assuntos
DNA Viral/genética , Vírus da Hepatite E/genética , Hepatite E/virologia , Adulto , Emigrantes e Imigrantes , Emigração e Imigração , Genótipo , Hepatite E/diagnóstico , Hepatite E/terapia , Vírus da Hepatite E/patogenicidade , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Portugal , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
OBJECTIVES: To determine the possible association of serum 25-hydroxyvitamin D (25OHD) levels with disease activity and respiratory infection in granulomatosis with polyangiitis patients during two different periods: winter/spring and summer/autumn. METHODS: Thirty-two granulomatosis with polyangiitis patients were evaluated in the winter/spring, and the same patients (except 5) were evaluated in summer/autumn (n=27). The 25OHD levels were measured by radioimmunoassay. Disease activity was assessed by the Birmingham Vasculitis Activity Score Modified for Wegener's Granulomatosis (BVAS/WG) and antineutrophil cytoplasmic antibody (ANCA) positivity. Respiratory infection was defined according the Centers for Disease Control and Prevention criteria. RESULTS: 25OHD levels were lower among patients in winter/spring than in summer/autumn (32.31±13.10 vs. 38.98±10.97 ng/mL, p=0.04). Seven patients met the criteria for respiratory infection: 5 in winter/spring and 2 in summer/autumn. Patients with respiratory infection presented lower 25OHD levels than those without infection (25.15±11.70 vs. 36.73±12.08 ng/mL, p=0.02). A higher frequency of low vitamin D levels (25OHD<20 ng/mL) was observed in patients with respiratory infection (37.5% vs. 7.8, p=0.04). Serum 25OHD levels were comparable between patients with (BVAS/WG≥1 plus positive ANCA) and without disease activity (BVAS/WG=0 plus negative ANCA) (35.40±11.48 vs. 35.34±13.13 ng/mL, p=0.98). CONCLUSIONS: Lower 25OHD levels were associated with respiratory infection but not disease activity in granulomatosis with polyangiitis patients. Our data suggest that hypovitaminosis D could be an important risk factor for respiratory infection in granulomatosis with polyangiitis patients.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Infecções Respiratórias/sangue , Estações do Ano , Vitamina D/análogos & derivados , Granulomatose com Poliangiite/sangue , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/etiologia , Vitamina D/sangue , Prednisona/uso terapêutico , Biomarcadores/sangue , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/tratamento farmacológico , Rituximab/uso terapêutico , Imunossupressores/uso terapêuticoRESUMO
OBJECTIVES: To determine the possible association of serum 25-hydroxyvitamin D (25OHD) levels with disease activity and respiratory infection in granulomatosis with polyangiitis patients during two different periods: winter/spring and summer/autumn. METHODS: Thirty-two granulomatosis with polyangiitis patients were evaluated in the winter/spring, and the same patients (except 5) were evaluated in summer/autumn (n=27). The 25OHD levels were measured by radioimmunoassay. Disease activity was assessed by the Birmingham Vasculitis Activity Score Modified for Wegener's Granulomatosis (BVAS/WG) and antineutrophil cytoplasmic antibody (ANCA) positivity. Respiratory infection was defined according the Centers for Disease Control and Prevention criteria. RESULTS: 25OHD levels were lower among patients in winter/spring than in summer/autumn (32.31±13.10 vs. 38.98±10.97 ng/mL, p=0.04). Seven patients met the criteria for respiratory infection: 5 in winter/spring and 2 in summer/autumn. Patients with respiratory infection presented lower 25OHD levels than those without infection (25.15±11.70 vs. 36.73±12.08 ng/mL, p=0.02). A higher frequency of low vitamin D levels (25OHD<20 ng/mL) was observed in patients with respiratory infection (37.5% vs. 7.8, p=0.04). Serum 25OHD levels were comparable between patients with (BVAS/WG≥1 plus positive ANCA) and without disease activity (BVAS/WG=0 plus negative ANCA) (35.40±11.48 vs. 35.34±13.13 ng/mL, p=0.98). CONCLUSIONS: Lower 25OHD levels were associated with respiratory infection but not disease activity in granulomatosis with polyangiitis patients. Our data suggest that hypovitaminosis D could be an important risk factor for respiratory infection in granulomatosis with polyangiitis patients.
Assuntos
Granulomatose com Poliangiite/sangue , Infecções Respiratórias/sangue , Estações do Ano , Vitamina D/análogos & derivados , Adulto , Biomarcadores/sangue , Feminino , Granulomatose com Poliangiite/complicações , Granulomatose com Poliangiite/tratamento farmacológico , Humanos , Imunossupressores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/etiologia , Rituximab/uso terapêutico , Vitamina D/sangueRESUMO
Previous studies have shown a relationship between osteoporosis and increased mortality risk. However, none of these studies performed a concomitant evaluation of the parathyroid hormone (PTH)-calcium-vitamin D axis and bone mass to accurately determine the contribution of each of these parameters to survival in older subjects. Thus, we sought to investigate the association between bone parameters and mortality in a longitudinal, prospective, population-based cohort of 839 elderly subjects. Clinical data (including history of fractures and cardiovascular events) were assessed using a specific questionnaire. Laboratory exams, including serum 25OHD and PTH, were also performed. Bone mineral density (BMD) at the lumbar spine and hip were evaluated using DXA. All analyses were performed at baseline (2005 to 2007). Mortality was recorded during follow-up. Multivariate Cox proportional regression was used to compute hazard ratios for all-cause and cardiovascular mortality. Over a mean 4.06 ± 1.07 years, there were 132 (15.7%) deaths. These individuals were compared to 707 subjects who were alive at the end of the coverage period for mortality data collection. In a multivariate Cox proportional hazards model, age (HR 1.32; 95% CI, 1.13 to 1.55; p = 0.001, for each 5-year increase), male gender (HR 1.90; 95% CI, 1.30 to 2.79; p = 0.001), recurrent falls (more than two in the previous year; HR 1.65; 95% CI, 1.06 to 2.56; p = 0.026), diabetes mellitus (HR 2.17; 95% CI, 1.46 to 3.21; p < 0.001), low physical activity score (HR 1.78; 95% CI, 1.14 to 2.79; p = 0.011), prior cardiovascular event (HR 1.76; 95% CI, 1.18 to 2.63; p = 0.006), total hip BMD (HR 1.41; 95% CI, 1.15 to 1.72; p = 0.001, per each 1 SD decrease), and intact PTH (iPTH) (HR 1.06; 95% CI, 1.04 to 1.08; p < 0.001, per each 10 pg/mL increase) were independently associated with all-cause mortality. The subjects in the highest quartile of PTH (>49 pg/mL) were at a higher risk of cardiovascular death (HR 3.09; 95% CI, 1.36 to 6.99; p = 0.007) compared with the subjects in the lowest quartile (<26 pg/mL). Low BMD and higher PTH were significantly associated with mortality in community-dwelling older adults. These findings support the notion that careful screening of these bone parameters might lead to better management of older patients and improve outcomes in this population. © 2016 American Society for Bone and Mineral Research.
Assuntos
Densidade Óssea , Mortalidade , Hormônio Paratireóideo/sangue , Acidentes por Quedas/mortalidade , Idoso , Idoso de 80 Anos ou mais , Brasil/epidemiologia , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/mortalidade , Feminino , Seguimentos , Humanos , Masculino , Vitamina D/sangueRESUMO
OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with increased risk for cardiovascular disease. We sought to evaluate the effects of insulin resistance (IR) on myocardial microcirculation and peripheral artery function in patients with PCOS. METHODS: We studied 55 women (28 with PCOS without IR, 18 with PCOS and IR and 11 normal controls) who underwent laboratorial analysis, high-resolution vascular ultrasound and real time myocardial contrast echocardiography (RTMCE). Intima-media thickness (IMT) and brachial artery flow-mediated dilation (FMD) were evaluated by vascular ultrasound. The replenishment velocity (ß), plateau of acoustic intensity (A) and myocardial blood flow reserve (MBFR) were determined by quantitative dipyridamole stress RTMCE. RESULTS: ß reserve in group PCOS + IR was lower than control (2.34 ± 0.55 vs. 3.60 ± 0.6; P < 0.001) and than PCOS without IR (2.34 ± 0.55 vs. 3.17 ± 0.65; P < 0.001). MBFR in patients with PCOS without IR did not differ from those of control (4.59 ± 1.59 vs. 5.30 ± 1.64; P = 0.22) or from patients with PCOS + IR (4.59 ± 1.59 vs. 3.70 ± 1.47; P = 0.07). When comparing with control group, patients with PCOS + IR had lower MBFR (5.30 ± 1.64 vs. 3.70 ± 1.47; P = 0.01). No significant differences were found between control, PCOS without IR and PCOS + IR for FMD (0.18 ± 0.05, 0.15 ± 0.04 and 0.13 ± 0.07; P =NS) or IMT (0.48 ± 0.05, 0.47 ± 0.05 and 0.49 ± 0.07; P = NS). CONCLUSION: Women with PCOS and IR had depressed ß and MBFR as demonstrated by quantitative RTMCE, but no alteration in endothelial dysfunction or IMT. PCOS without IR showed isolated depression in ß reserve, probably an earlier marker of myocardial flow abnormality.
Assuntos
Artéria Braquial/fisiopatologia , Doença da Artéria Coronariana/fisiopatologia , Circulação Coronária , Resistência à Insulina , Síndrome do Ovário Policístico/fisiopatologia , Adulto , Velocidade do Fluxo Sanguíneo , Artéria Braquial/diagnóstico por imagem , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Síndrome do Ovário Policístico/diagnóstico por imagem , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , UltrassonografiaRESUMO
OBJECTIVES: The aim of this study was to investigate the HLA-G serum levels in Primary Antiphospholipid Syndrome (PAPS) patients, its impact on clinical and laboratory findings, and heparin treatment. METHODS: Forty-four PAPS patients were age and gender matched with 43 controls. HLA-G serum levels were measured using an enzyme-linked immunosorbent assay (ELISA). RESULTS: An increase in soluble HLA-G levels was found in patients compared to controls (3.35 (0-22.9) versus 1.1 (0-14), P = 0.017). There were no significant differences in HLA-G levels between patients with and without obstetric events, arterial thrombosis, venous thrombosis, or stroke. Sixty-six percent of patients were being treated with heparin. Interestingly, patients treated with heparin had higher HLA-G levels than ones who were not treated with this medication (5 (0-22.9) versus 1.8 (0-16) ng/mL, P = 0.038). Furthermore, patients on heparin who experienced obstetric events had a trend to increased HLA-G levels compared to patients who were not on heparin and did not have obstetric events (5.8 (0-22.9) versus 2 (0-15.2) ng/mL, P = 0.05). CONCLUSION: This is the first study to demonstrate that serum HLA-G levels are increased in APS patients. We also demonstrated that heparin increases HLA-G levels and may increase tolerance towards autoantigens.
Assuntos
Síndrome Antifosfolipídica/diagnóstico , Síndrome Antifosfolipídica/imunologia , Antígenos HLA-G/biossíntese , Adulto , Síndrome Antifosfolipídica/tratamento farmacológico , Ensaio de Imunoadsorção Enzimática , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/imunologia , Antígenos HLA-G/sangue , Antígenos HLA-G/genética , Heparina/uso terapêutico , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A infertilidade pode ser definida como a incapacidade de se conseguir uma gravidez dentro de um determinado período ou a falha repetida em levar uma gravidez a termo. Os fatores mais comuns associados com o abortamento habitual são de ordem genética, hormonal ou anatômica. O aumento da heterocromatina encontrado nos cromossomos humanos autossomos 1, 9, 16 e no cromossomo sexual Y tem sido comumente definido como sendo uma variação da normalidade. Todavia, têm-se alguns relatos da frequência aumentada dessas alterações em pais de crianças com anomalias cromossômicas, casais com abortos recorrentes e em conceptos cromossomicamente anormais. Sabe-se que os genes responsáveis pela fertilidade e viabilidade são encontrados presentes na heterocromatina, sugerindo que tais variantes não podem ser ignoradas.(AU)
Infertility can be defined as the inability to achieve pregnancy within certain time frame, or the repetitive failure to carry pregnancy through completion. The most common factors associated with habitual abortion have a genetic, hormonal, or anatomical cause. The increase found in heterochromatin at chromosomes 1, 9 and 16 as well as in the sex chromosome Y has been implicated as a variation of normality. However, some reports have highlighted cases of children having chromosomal abnormalities from parents carrying a higher alteration frequency, cases of repetitive abortions, and also some chromosomal abnormal conceptions. It is known that genes for fertility and viability are now thought to reside in heterochromatin, which suggests that variants should not be ignored.(AU)
Assuntos
Humanos , Feminino , Gravidez , Heterocromatina/genética , Cromossomos , Aborto , Infertilidade Feminina , Literatura de Revisão como Assunto , Bases de Dados Bibliográficas , CitogenéticaRESUMO
The aim of this study was to evaluate the frequency of thyroid dysfunction and thyroid antibodies in patients with juvenile onset Systemic Lupus Erythematosus (JOSLE) and its association with clinical and immunological features. Seventy-seven patients with JOSLE, 64 females, median age 19 years, were consecutively enrolled from March to December 2007. Clinical data related to thyroid dysfunction and lupus were obtained by chart review and patient interview. Serum levels of TSH, free T4, anti-thyroglobulin (TgAb), anti-thyroperoxidase (TPOAb), TRAb and lupus related autoantibodies were analyzed by standard techniques. Nine patients were diagnosed as hypothyroidism and 4 hyperthyroidism. 28% JOSLE patients had moderate/high titer of thyroid antibodies: 23% TgAb, 2.6% TPOAb and 3.9% TRAb. JOSLE patients with positive thyroid autoantibodies had higher frequency of anti-U1RNP antibodies than patients without these antibodies (40.9 vs. 14.5%, OR:0.25, CI:0.08-0.76, p = 0.017). Furthermore, renal/neurological/hematological involvement was less frequently observed in patients with hypothyroidism (55.6 vs. 87.5%, OR:0.18, CI:0.04-0.81, p = 0.035) and with thyroid antibodies (68.4 vs. 90.9%, OR:0.22, CI:0.06-0.82, p = 0.027) than in patients without these alterations. No association with PTPN22 polymorphism was found. In conclusion, JOSLE patients have high prevalence of subclinical hypothyroidism. The novel association of anti-thyroid antibodies with anti-U1RNP antibodies in JOSLE seems to identify a subgroup of patients with less life-threatening organ involvement.
Assuntos
Autoanticorpos/sangue , Lúpus Eritematoso Sistêmico/complicações , Doenças da Glândula Tireoide/imunologia , Adolescente , Adulto , Autoantígenos/imunologia , Criança , Feminino , Genótipo , Humanos , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Lúpus Eritematoso Sistêmico/genética , Masculino , Polimorfismo de Nucleotídeo Único/genética , Proteína Tirosina Fosfatase não Receptora Tipo 22/genética , Proteína Tirosina Fosfatase não Receptora Tipo 22/imunologia , Proteína Tirosina Fosfatase não Receptora Tipo 22/metabolismo , Receptores da Tireotropina/imunologia , Ribonucleoproteína Nuclear Pequena U1/sangue , Doenças da Glândula Tireoide/genética , Tireotropina/sangue , Tiroxina/sangue , Adulto JovemRESUMO
OBJECTIVE: To evaluate interleukin (IL)-12 and IL-18 levels in the serum and peritoneal fluid of women with and without endometriosis. DESIGN: Cross-sectional survey. SETTING: University hospital. PATIENTS: Interleukin-12 and IL-18 levels were compared in 105 patients submitted to laparoscopy because of symptoms suggestive of endometriosis (pain and/or infertility). The disease was confirmed in 72 patients (study group), while in 33 patients findings were not compatible with endometriosis (control group). INTEVENTION(S): Blood sample and peritoneal fluid were obtained from patients during videolaparoscopy. MAIN OUTCOME MEASURE(S): The levels of IL-12 and IL-18 in peripheral blood and peritoneal fluid were determined and compared with the stage and site of the disease and histologic classification. RESULT(S): IL-12 levels measured in peritoneal fluid were higher in patients with endometriosis compared with the control group. A significant increase in IL-12 levels was found when the more advanced stages of the disease were compared with the initial stages. No statistically significant differences were found in IL-18 levels, either in serum or in peritoneal fluid samples. CONCLUSION(S): Patients with severe endometriosis have higher IL-12 levels irrespective of IL-18 levels, suggesting that in this disease an alternative pathway is involved in induction of the Th1 immune response.
Assuntos
Líquido Ascítico/imunologia , Endometriose/imunologia , Interleucina-12/análise , Interleucina-18/análise , Adolescente , Adulto , Biomarcadores/análise , Estudos de Casos e Controles , Estudos Transversais , Endometriose/patologia , Feminino , Humanos , Interleucina-12/sangue , Interleucina-18/sangue , Laparoscopia , Projetos Piloto , Índice de Gravidade de Doença , Regulação para Cima , Cirurgia Vídeoassistida , Adulto JovemRESUMO
Objetivo: avaliar homens de casais com infertilidade sem causa conhecida quanto à presença de danos no DNA espermático utilizando o Teste da Estrutura da Cromatina Espermática. Material e Métodos: foram analisadas 57 amostras do sêmen ejaculado quantificando-se IFD (índice de fragmentação do DNA) e CDE (coloração do DNA elevada). Resultados: levando-se em conta os valores de corte de 30% para IFD e 15% para CDE, 37% dos homens analisados têm danos no DNA espermático. Observando-se apenas o IFD maior que 30%, 19% dos homens são afetados, enquanto 14% são afetados observando-se apenas CDE maior que 15% e 4% apresentam os dois índices alterados. Conclusão: de acordo com os resultados obtidos, análise seminal convencional sem o complemento do teste da estrutura da cromatina espermática tem sua utilidade limitada.
Assuntos
Humanos , Masculino , Cromatina , Fragmentação do DNA , Infertilidade Masculina , Capacitação Espermática , SêmenRESUMO
Os autores mostram a frequência de alguns marcadores tumorais em pacientes com lúpus eritematoso sistêmico (LES) e esclerose sistêmica (ES). Foram estudados dez pacientes do sexo feminino com LES com média de idade de 31 anos e dez pacientes (oito mulheres) com ES cuja média de idade era de 54 anos. Efetuou-se a dosagem quantitativa de oito marcadores tumorais (antígeno carcinoembriônico, alfafetoproteína, gonadotrofina coriônica, CA 15-3, CA 19-9, CA 72-4, CA 125 e enolase específica de neurônio) utilizando-se ensaio de quimiluminescência em fase sólida com dois anticorpos (mono e policlonal). Observou-se que quatro pacientes com LES (40 por cento) apresentavam níveis séricos elevados de algum marcador tumoral; dois destes tinham mais do que um marcador em níveis elevados (CA 19-9 e CA 125. Nenhum dos marcadores pesquisados se destacou individualmente nos pacientes com LES. Cinco pacientes com ES (50 por cento) tinham níveis elevados de enolase específica de neurônio (NSE) e os demais marcadores tumorais apresentaram-se em níveis séricos dentro da normalidade. Comparando-se a dosagem de cada marcador tumoral nos pacientes com LES e ES, encontraram-se níveis séricos de NSE significantemente maiores nos pacientes com ES (P<0,05). Em síntese. encontrou-se frequência significativamente alta de valores anormais de marcadores tumorais no LES e ES, chamando a atenção os níveis séricos de NSE em alguns pacientes na faixa dos observados em neoplasias. O acompanhamento prospectivo desses pacientes e a ampliação do âmbito deste estudo são desejáveis para o entendimento do significado clínico e biológico desses achados.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Lúpus Eritematoso Sistêmico , Biomarcadores Tumorais , Fosfopiruvato Hidratase , Escleroderma Sistêmico , Antígeno Carcinoembrionário , Gonadotropina CoriônicaRESUMO
In this retrospective study, 47 patients with clinical diagnosis of central nervous system metastases of breast cancer were evaluated by computerized tomography (CT), magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) examination. The patients were divided in 2 groups: 1, without leptomeningeal neoplasm and 2, with leptomeningeal neoplasm. In the group 2, the time interval between the primary disease and the central nervous system metastasis as well as the survival time were shorter than in group 1 (40 and 4.3 months in group 2 versus 57 and 10 months respectively, in group 1). In both groups the most common neurological symptons and signs were intracranial hypertension and motor deficits. The most sensitive diagnostic methods were CT and MRI in group 1, and the CSF examination in group 2. The use of the tumor markers CEA and CA-15.3 in the routine examination of CSF showed promissing results, mainly in leptomeningeal forms.
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Neoplasias da Mama/patologia , Neoplasias do Sistema Nervoso Central/secundário , Cistos Aracnóideos/diagnóstico , Biomarcadores Tumorais/líquido cefalorraquidiano , Neoplasias do Sistema Nervoso Central/líquido cefalorraquidiano , Neoplasias do Sistema Nervoso Central/diagnóstico , Neoplasias Meníngeas/diagnóstico , Estudos RetrospectivosRESUMO
Os autores estudaram os anticorpos anticardiolipina (aCL) em pacientes com vasculites. Esses anticorpos foram detectados em seis de 15 pacientes com vasculite reumatóide, três de 29 com poliarterite nodosa, dois de nove com síndrome de Behcet, dois de quatro com arterite de células gigantes, um de seis com vasculite de Churg-Strauss e nenhum dos pacientes com granulomatose de Wegener ou púrpura de Henoch-Schönlein. Os autores discutem os possíveis mecanismos patogênicos desses anticorpos
Assuntos
Humanos , Anticorpos Anticardiolipina/análise , Vasculite/imunologiaRESUMO
In an attempt to find a serological marker for neuropsychiatric manifestations (NPM) of SLE sera from 66 patients (classified in three groups, according to their NPM - defined, probable and without NPM) were analysed by ELISA for IgG and antigalactocerebrosides antibodies. A strong correlation was found between IgM antigangliosides and antigalactocerebrosides antibodies and NPM, but not with IgG class. IgM and IgG antibodies anticardiolipin were not correlated with BPM in this study. Both IgM antigangliosides and seven patients with definid NPM but clinically inactive. The analysis of these autoantibodies showed an important role predictive for NPM in SLE; the negative test decreases the chance of the NPM