Revista Brasileira De Reumatologia最新文献

{"title":"Vasculite digital inicial em uma grande coorte multicêntrica de pacientes com lúpus eritematoso sistêmico de início na infância","authors":"Ana Paula Sakamoto ,&nbsp;Clovis Artur Silva ,&nbsp;Marco Felipe Castro da Silva ,&nbsp;Anandreia Simões Lopes ,&nbsp;Gleice Clemente Souza Russo ,&nbsp;Adriana Maluf Elias Sallum ,&nbsp;Katia Kozu ,&nbsp;Eloisa Bonfá ,&nbsp;Claudia Saad‐Magalhães ,&nbsp;Rosa Maria Rodrigues Pereira ,&nbsp;Claudio Arnaldo Len ,&nbsp;Maria Teresa Terreri","doi":"10.1016/j.rbr.2017.05.008","DOIUrl":"10.1016/j.rbr.2017.05.008","url":null,"abstract":"<div><h3>Objectives</h3><p>To assess clinical digital vasculitis (DV) as an initial manifestation of childhood‐onset systemic lupus erythematosus (cSLE) within a large population.</p></div><div><h3>Methods</h3><p>Multicenter cross‐sectional study including 852 cSLE patients (ACR criteria) followed in ten Pediatric Rheumatology centers in São Paulo State, Brazil.</p></div><div><h3>Results</h3><p>DV was observed in 25/852 (3%) cSLE patients. Periungual hemorrhage was diagnosed in 12 (48%), periungual infarction in 7 (28%), tip finger ulceration in 4 (16%), painful nodules in 1 (4%) and gangrene in 1 (4%). A poor outcome, with digital resorption, occurred in 5 (20%). Comparison of patients with and without DV revealed higher frequency of malar rash (80% vs. 53%, p<!--> <!-->=<!--> <!-->0.008), discoid rash (16% vs. 4%, p<!--> <!-->=<!--> <!-->0.017), photosensitivity (76% vs. 45%, p<!--> <!-->=<!--> <!-->0.002) and other cutaneous vasculitides (80% vs. 19%, p<!--> <!-->&lt;<!--> <!-->0.0001), whereas the frequency of overall constitutional features (32% vs. 61%, p<!--> <!-->=<!--> <!-->0.003), fever (32% vs. 56%, p<!--> <!-->=<!--> <!-->0.020) and hepatomegaly (4% vs. 23%, p<!--> <!-->=<!--> <!-->0.026) were lower in these patients. Frequency of female gender, severe multi‐organ involvement, autoantibodies profile and low complement were alike in both groups (p<!--> <!-->&gt;<!--> <!-->0.05). SLEDAI‐2<!--> <!-->K median, DV descriptor excluded, was significantly lower in patients with DV compared to those without this manifestation [10(0‐28) vs. 14(0‐58), p<!--> <!-->=<!--> <!-->0.004]. Visceral vasculitis or death were not observed in this cSLE cohort. The frequency of cyclophosphamide use (0% vs. 18%, p<!--> <!-->=<!--> <!-->0.014) was significantly lower in the DV group.</p></div><div><h3>Conclusion</h3><p>Our large multicenter study identified clinical DV as one of the rare initial manifestation of active cSLE associated with a mild multisystemic disease, in spite of digital resorption in some of these patients.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 583-589"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2017.05.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44600736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome nefrótica como a primeira manifestação da esclerodermia sistêmica juvenil","authors":"Saulo B. Couto ,&nbsp;Adriana M. Sallum ,&nbsp;Luciana S. Henriques ,&nbsp;Denise M. Malheiros ,&nbsp;Clovis A. Silva ,&nbsp;Maria H. Vaisbich","doi":"10.1016/j.rbr.2014.08.005","DOIUrl":"10.1016/j.rbr.2014.08.005","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 613-615"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2014.08.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32851522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redução da ativação e do recrutamento de linfócito CD3 com o uso de anticorpo anti‐TNF‐alfa: avaliação da resposta clínica e cintilográfica com 99mTc‐OKT3 em paciente com artrite idiopática juvenil","authors":"Flavia Paiva Proença Lobo Lopes ,&nbsp;Sergio Augusto Lopes de Souza ,&nbsp;Blanca Elena Rios Gomes Bica ,&nbsp;Lea Mirian Barbosa da Fonseca ,&nbsp;Mario Newton Leitão de Azevedo ,&nbsp;Bianca Gutfilen","doi":"10.1016/j.rbr.2015.03.007","DOIUrl":"10.1016/j.rbr.2015.03.007","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 616-619"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2015.03.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33904374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A hepcidina‐25 dá uma indicação da eficácia terapêutica do tocilizumab na artrite reumatoide – Relação entre a atividade da doença na artrite reumatoide e a anemia","authors":"Satoshi Suzuki ,&nbsp;Souichiro Nakano ,&nbsp;Seiichiro Ando ,&nbsp;Ran Matsudaira ,&nbsp;Yoshinori Kanai ,&nbsp;Kenjiro Yamanaka ,&nbsp;Yoshinari Takasaki","doi":"10.1016/j.rbr.2016.07.004","DOIUrl":"10.1016/j.rbr.2016.07.004","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 637-640"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.07.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55036161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ácidos graxos ômega‐3, estado inflamatório e marcadores bioquímicos de pacientes com lúpus eritematoso sistêmico: estudo piloto","authors":"Mariane Curado Borges ,&nbsp;Fabiana de Miranda Moura dos Santos ,&nbsp;Rosa Weiss Telles ,&nbsp;Marcus Vinícius Melo de Andrade ,&nbsp;Maria Isabel Toulson Davisson Correia ,&nbsp;Cristina Costa Duarte Lanna","doi":"10.1016/j.rbr.2016.08.002","DOIUrl":"10.1016/j.rbr.2016.08.002","url":null,"abstract":"<div><h3>Background</h3><p>Studies have shown that omega‐3 fatty acids reduce the concentrations of eicosanoids, cytokines, chemokines, C‐reactive protein (CRP) and other inflammatory mediators.</p></div><div><h3>Objective</h3><p>To investigate the effects of omega‐3 fatty acids on circulating levels of inflammatory mediators and biochemical markers in women with systemic lupus erythematosus (SLE).</p></div><div><h3>Methods</h3><p>Experimental clinical study (clinical trial: NCT02524795); 49 women with SLE (ACR1982/1997) were randomized: 22 to the omega‐3 group (daily intake of 1080<!--> <!-->mg EPA<!--> <!-->+<!--> <!-->200<!--> <!-->mg DHA, for 12 weeks) and 27 to the control group. The inflammatory mediators and biochemical markers at T0 and T1 in omega‐3 group were compared using Wilcoxon test. U‐Mann‐Whitney test was used to compare variations of measured variables [Δ<span>V</span> <!-->=<!--> <!-->pre‐treatment (T0) <em>minus</em> post‐treatment (T1) concentrations] between groups. p<!--> <!-->&lt;<!--> <!-->0.05 was considered significant.</p></div><div><h3>Results</h3><p>The median (interquartile range ‐ IQR) of age was 37 (29‐48) years old, of disease duration was 7 (4‐13) years, and of SLEDAI‐2<!--> <!-->K was 1 (0‐2). The median (IQR) of variation in CRP levels between the two groups showed a decrease in omega‐3 group while there was an increase in control group (p<!--> <!-->=<!--> <!-->0.008). The serum concentrations of IL‐6 and IL‐10, leptin and adiponectin did not change after a 12 week treatment.</p></div><div><h3>Conclusions</h3><p>Supplementation with omega‐3 had no impact on serum concentrations of IL‐6, IL‐10, leptin and adiponectin in women with SLE and low disease activity. There was a significant decrease of CRP levels as well as evidence that omega‐3 may impact total and LDL‐cholesterol</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 526-534"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.08.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55036242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nomes de cientistas usados na classificação das vasculites","authors":"Gokhan Sargin,&nbsp;Taskin Senturk","doi":"10.1016/j.rbr.2016.05.001","DOIUrl":"10.1016/j.rbr.2016.05.001","url":null,"abstract":"<div><p>The first International Chapel Hill Consensus Conference (CHHC) was held in 1994. There have been suggestions about the nomenclature of systemic vasculitis. Important categories were added to the classification of vasculitis, and many changes were made for disease names in the second CHHC 2012, which were not included in the CHCC 1994. The new nomenclature was introduced instead of being referred to by many names such as Churg‐Strauss and Wegener”s. New categories such as Behçet”s and Cogan etc. were also added. These people are honored by the classification. They contribute to science through their case studies, scientific articles, and observations. This article reviews only eponyms present in the current classification of vasculitis. The aim of this paper is to give information about scientists mentioned in the classification of vasculitis.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 605-609"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.05.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47092879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anormalidades esofágicas na esclerodermia localizada juvenil: associação com outras manifestações extracutâneas?","authors":"Clarissa C.M. Valões ,&nbsp;Glaucia V. Novak ,&nbsp;Juliana B. Brunelli ,&nbsp;Katia T. Kozu ,&nbsp;Ricardo K. Toma ,&nbsp;Clovis A. Silva","doi":"10.1016/j.rbr.2016.07.005","DOIUrl":"10.1016/j.rbr.2016.07.005","url":null,"abstract":"<div><h3>Objective</h3><p>To assess esophageal involvement (EI) in juvenile localized scleroderma (JLS) population and the possible association between this gastrointestinal manifestation and demographic data, clinical features, laboratory exams, treatments and outcomes.</p></div><div><h3>Methods</h3><p>For a period of 31 years, 5,881 patients with rheumatic diseases were followed in our Pediatric Rheumatology Division. EI was defined by the presence of symptoms (solid/liquid dysphagia, heartburn, esophageal regurgitation, nausea/vomiting and epigastralgia) and confirmed by at least one EI exam abnormality: barium contrast radiography, upper gastrointestinal endoscopy and 24‐hour esophageal pH‐monitoring.</p></div><div><h3>Results</h3><p>JLS was observed in 56/5881 patients (0.9%), mainly linear morphea subtype. EI was observed in 23/56(41%) of JLS patients. Eight(35%) of 23 EI patients with JLS were symptomatic and presented heartburn(5/8), solid and liquid dysphagia(3/8), nausea and epigastralgia(1/8). The frequency of any cumulative extracutaneous manifestations (calcinosis, arthritis/arthralgia, central nervous system, interstitial pneumonitis, mesangial nephritis and/or arrhythmia) was significantly higher in JLS patients with EI compared to those without this complication (56% vs. 24%, p<!--> <!-->=<!--> <!-->0.024). No differences were evidenced in demographic data, JLS subtypes and in each extracutaneous manifestation in both groups (p<!--> <!-->&gt;<!--> <!-->0.05). The frequency of methotrexate use was significantly higher in JLS patients with EI compared to those without (52% vs. 12%, p<!--> <!-->=<!--> <!-->0.002). Autoantibody profile (antinuclear antibodies, anti‐SCL‐70, rheumatoid factor, anticentromere, anti‐cardiolipin, anti‐Ro/SSA and anti‐La/SSB) was similar in both groups (p<!--> <!-->&gt;<!--> <!-->0.05).</p></div><div><h3>Conclusions</h3><p>Our study demonstrated that EI was frequently observed in JLS patients, mainly in asymptomatic patients with linear subtype. EI occurred in JLS patients with other extracutaneous manifestations and required methotrexate therapy.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 521-525"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.07.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41577365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinantes da qualidade de vida na doença de Paget óssea","authors":"Gláucio Ricardo Werner de Castro ,&nbsp;Silvania Ana Fernandes de Castro ,&nbsp;Ivanio Alves Pereira ,&nbsp;Adriana Fontes Zimmermann ,&nbsp;Maria Amazile Toscano ,&nbsp;Fabricio Souza Neves ,&nbsp;Maria Aparecida Scottini ,&nbsp;Juliane Paupitz ,&nbsp;Julia Salvan da Rosa ,&nbsp;Ziliani Buss ,&nbsp;Tânia Silvia Fröde","doi":"10.1016/j.rbr.2017.04.005","DOIUrl":"10.1016/j.rbr.2017.04.005","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the parameters associated with quality of life in patients with Paget's disease of bone (PDB).</p></div><div><h3>Methods</h3><p>Patients with PDB were evaluated with SF‐36 and WHOQOL‐bref questionnaires. Patients with other diseases that could cause significant impairment of their quality of life were excluded. We searched for correlations between the results and: age, time from diagnosis, type of involvement, pain related to PDB, limitation to daily activities, deformities, bone specific alkaline phosphatase, the extent of involvement and treatment.</p></div><div><h3>Results</h3><p>Fifty patients were included. Results of the SF‐36 total score and its domains, physical and mental health, were significantly correlated with bone pain and deformities. Marital status was significantly correlated with the SF‐36 total score and Mental Health domain. BAP levels and disease extension were significantly correlated to SF‐36 Physical Health Domain. After multivariate analysis, the only parameters that remained significantly associated with the SF‐36 total score and to its Mental Health and Physical Health domains were pain and marital status.</p><p>The whoqol‐bref total score was significantly associated with pain, physical impairment and deformities. WHOQOL‐bref Domain 1 (physical) score was significantly associated with marital status, pain and deformities, while Domain 2 (psychological) score was associated with marital status, physical impairment and kind of involvement. After multivariate analysis, the presence of pain, deformities, and marital status were significantly associated with results of the WHOQOL‐bref total score and its Domain 1. WHOQOL‐bref domain 2 results were significantly predicted by pain and marital status.</p></div><div><h3>Conclusion</h3><p>The main disease‐related factor associated with SF‐36 results in PDB patients was bone pain, while bone pain and deformities were associated with WHOQOL‐bref.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 566-573"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2017.04.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45842403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rotina de administração de ciclofosfamida em doenças autoimunes reumáticas: uma revisão","authors":"Kaian Amorim Teles ,&nbsp;Patrícia Medeiros‐Souza ,&nbsp;Francisco Aires Correa Lima ,&nbsp;Bruno Gedeon de Araújo ,&nbsp;Rodrigo Aires Correa Lima","doi":"10.1016/j.rbr.2016.04.009","DOIUrl":"10.1016/j.rbr.2016.04.009","url":null,"abstract":"<div><p>Cyclophosphamide (CPM) is an alkylating agent widely used for the treatment of malignant neoplasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeutic guidelines for the patient. The routine is schematized in three phases: pre‐chemotherapy (pre‐ChT), administration of cyclophosphamide, and post‐chemotherapy (post‐ChT), taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare–but serious–side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post‐chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system.</p></div>","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 596-604"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.04.009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"55035943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hanseníase que simula esclerose sistêmica: relato de caso","authors":"Bruna Burko Rocha Chu ,&nbsp;Giorgina Falcão Brandão Côrtes Gobbo ,&nbsp;Rafaela Copês ,&nbsp;Glênio Gutjahr ,&nbsp;Erick Cavalcanti Cossa ,&nbsp;Eduardo dos Santos Paiva","doi":"10.1016/j.rbr.2016.08.001","DOIUrl":"10.1016/j.rbr.2016.08.001","url":null,"abstract":"","PeriodicalId":48991,"journal":{"name":"Revista Brasileira De Reumatologia","volume":"57 6","pages":"Pages 630-632"},"PeriodicalIF":0.0,"publicationDate":"2017-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rbr.2016.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47102180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}