RESUMO
INTRODUCTION: Systemic lupus erythematosus (SLE) patients have a higher infection rate than the general population. The role of influenza vaccination in SLE patients has been a matter of discussion due to the risk of disease exacerbation and to the influence of the disease and its treatment on vaccine efficacy. OBJECTIVE: To study safety and efficiency of influenza vaccination in SLE patients. METHODS: We studied 47 SLE patients and 27 healthy controls for influenza hemagglutinin titers before and 6 weeks after immunization. SLE patients were scored for disease activity by SLEDAI before and after receiving the vaccine. We also studied antibody titers in SLE patients according to the use of glucocorticoid, methotrexate and azathioprine. RESULTS: Seroprotection after vaccination was equal in SLE patients and healthy controls although seroconvertion was lower in SLE patients for one of the three antigens tested. No significant increase in SLEDAI was observed. Medications such as methotrexate and azathioprine did not change the mean titers of antibody response but glucocorticoids did affect the response to one of the antigens. CONCLUSIONS: Although immune response to influenza vaccine in SLE patients may be diminished it is safe and effective.
Assuntos
Vacinas contra Influenza , Influenza Humana/prevenção & controle , Lúpus Eritematoso Sistêmico , Adulto , Anticorpos Antivirais/sangue , Feminino , Humanos , Vacinas contra Influenza/efeitos adversos , Vacinas contra Influenza/imunologia , Lúpus Eritematoso Sistêmico/sangue , Masculino , Pessoa de Meia-Idade , Orthomyxoviridae/imunologia , Adulto JovemRESUMO
Crianças com a forma poliarticular da artrite idiopática juvenil (AIJ), ao entrarem na idade adulta, têm um quadro similar ao de pacientes com artrite reumatoide (AR) de início no adulto. No presente estudo comparam-se características clínicas e imunológicas desses dois grupos de pacientes. Para isso, foram estudados vinte adultos com AIJ poliarticular e cinquenta pacientes com AR (pareados para sexo e tempo de duração de doença), para presença de autoanticorpos, nódulos subcutâneos, síndrome de Sjõgren secundária, hipotireoidismo e para a determinação de índices funcionais e antropométricos. Encontraram-se, nesses dois grupos, características similares, exceto pela presença de fator reumatoide (menor no grupo de AIJ poliarticular; P = 0,026) e menor IMC nos pacientes com AIJ poliarticular (P < 0,001).
When children with polyarticular juvenile idiopathic arthritis (JIA) reach adulthood, they have a condition similar to that of patients with adult onset rheumatoid arthritis (RA). In the present study, the clinical and immunological characteristics of these two groups of patients are compared. The presence of autoantibodies, subcutaneous nodules, secondary Sjõgren syndrome, and hypothyroidism, was determined in 20 adult patients with polyarticular JIA and in 50 patients with RA (paired for gender and duration of the disease), as well as the determination of functional and anthropometric indexes. Both groups had similar characteristics, except for the presence of rheumatoid factor (lower in the polyarticular JIA group; P = 0.026) and lower BMI in patients with polyarticular JIA (P < 0.001).
Assuntos
Humanos , Adulto , Artrite Juvenil , Artrite Reumatoide , Evolução Biológica , Doenças Reumáticas , Fator ReumatoideRESUMO
Pacientes com Mal de Hansen (MH) podem se apresentar com quadro clínico e laboratorial sugestivo de doenças reumáticas, o que exige um exercício cuidadoso de diagnósticos diferenciais. Descreve-se aqui o caso de uma jovem com MH que se apresentou com lesões cutâneas sugestivas de vasculite, obstrução de vasos fibulares, FAN e anticorpos antifosfolípides positivos sem muitos estigmas da doença cutânea, ilustrando essa dificuldade.
Patients with Hansen's disease (HD) may present themselves with clinical and laboratorial features that resemble rheumatic disorders. This requires a careful exercise of differential diagnosis. We describe here a case of a young woman with HD that presented with vasculitic like lesions, fibular vessels obstruction, ANA and antiphospholipid antibodies without typical signs of cutaneous disease, illustrating this clinical difficulty.