Publications by authors named "Cristina Costa Duarte Lanna"

19 Publications

  • Page 1 of 1

Neurotrophic factors in systemic lupus erythematosus: markers of disease activity.

Clin Exp Rheumatol 2021 Jun 8. Epub 2021 Jun 8.

Department of Locomotor System, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

View Article and Find Full Text PDF

Download full-text PDF

Source
June 2021

Cosmetic camouflage improves health-related quality of life in women with systemic lupus erythematosus and permanent skin damage: A controlled intervention study.

Lupus 2020 Oct 5;29(11):1438-1448. Epub 2020 Aug 5.

Department of Locomotor Apparatus, School of Medicine, Universidade Federal of Minas Gerais-UFMG, Belo Horizonte, Brazil.

Objective: To investigate the effect of cosmetic camouflage in health-related quality of life (HRQoL) in women with systemic lupus erythematosus (SLE) and permanent facial skin damage.

Methods: This is a randomized controlled clinical trial (Universal Trial Number: U1111-1210-2554e) with SLE women from outpatients using ACR/1997 and/or SLICC/2012 criteria, aged over 18 years old, with modified SLEDAI 2k < 4 and permanent facial skin damage, recruited in two tertiary centers to use cosmetic camouflage (n = 36) or no intervention (n = 20). Endpoints were score variations in SLE Quality of Life (SLEQoL) (total and each domain), Dermatology Life Quality Index (DLQI), Rosenberg self-esteem scale and Hospital Anxiety and Depression Scale (HADS), after daily use of cosmetic camouflage for 12 +/-2 weeks (Phase I), "as needed" use of cosmetic camouflage for another 12 +/-2 weeks (Phase II), and during total follow up (24 +/-2 weeks). Univariate and multivariate linear regressions were conducted by protocol analysis.

Results: Both groups were similar at baseline regarding age, disease duration, socio-demographic, clinical, laboratory and treatment characteristics. The comparison of score variations between intervention and control groups showed an independent HRQoL improvement in total SLEQoL score after using cosmetic camouflage in Phase I [β -27.56 (CI 95% -47.86 to -7.27) p = 0.009] and total follow up [β -28.04 (CI 95% -48.65 to -7.44) p = 0.09], specifically in mood, self-image and physical functioning domains. Also, there was an improvement in DLQI scores during Phase I [β -7.65 (CI 95% -12.31 to -3.00) p = 0.002] and total follow up [β -8.97(CI95% -12.99 to -4.94) p < 0.001). Scores for depression [β -1.92 (CI 95% -3.67 to -0.16) p = 0.033], anxiety [β -2.87 (CI 95% -5.67 to -0.07] p = 0.045] and self-esteem [β 2.79 (CI 95% 0.13 to 5.46) p = 0.041] improved considering the total follow up. No significant changes occurred in the control group scores.

Conclusion: The use of cosmetic camouflage improved the HRQoL in female SLE patients with permanent facial skin damage.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0961203320947802DOI Listing
October 2020

Recognition and control of hypertension, diabetes, and dyslipidemia in patients with systemic lupus erythematosus.

Clin Rheumatol 2018 Oct 12;37(10):2693-2698. Epub 2018 Jun 12.

Hospital das Clínicas e Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais, 30130-100, Brazil.

Systemic lupus erythematosus (SLE) patients have a high risk for cardiovascular events, but few studies have evaluated the recognition and none have evaluated the control of cardiovascular risk factors (RF) in SLE patients. The study aims to describe the recognition and control frequencies of systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM) in SLE patients. Of the female patients with SLE, 137 answered a questionnaire focused on general knowledge of the RF for coronary artery disease (CAD) and on recognition of the risk factors that they possess. The patient's information collected on a structured medical record was reviewed to evaluate the RF control. The mean age was 29.1 (9.6) years. Seventy patients had SAH; 85.7% recognized their condition and 71.4% had desirable blood pressure (BP) control (< 140 × 90 mmHg). From a group of 63 patients with dyslipidemia, 68.3% recognized that they had dyslipidemia and 69.8% had desirable LDL-cholesterol (< 130 mg/dL). Sixteen patients had DM; 87.5% admitted being diabetic and 50.0% had desirable glycemic control (HbA1C < 7%). Most patients were aware of presenting SAH, DM, or dyslipidemia, and the recognition frequency was higher in comparison to general population. The SAH and dyslipidemia control frequencies were higher than that described for the general population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10067-018-4169-0DOI Listing
October 2018

Recognition and control of hypertension, diabetes, and dyslipidemia in patients with rheumatoid arthritis.

Rheumatol Int 2018 Aug 15;38(8):1437-1442. Epub 2018 Jun 15.

Hospital das Clínicas e Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Av. Professor Alfredo Balena, 190, Belo Horizonte, Minas Gerais, 30130-100, Brazil.

Absolute cardiovascular risk of an individual with rheumatoid arthritis (RA) is greater when compared to the general population, and several factors have proven to be important for the development of coronary artery disease (CAD) in these patients, including factors related to the underlying disease, such as the systemic inflammatory response, drugs used in its treatment, and a higher prevalence of traditional risk factors for CAD. Our aim is to describe the recognition and control frequencies of systemic arterial hypertension (SAH), dyslipidemia, and diabetes mellitus (DM) in RA patients. Patients with RA answered a questionnaire focused on their general knowledge of the risk factors for CAD, as well as on the recognition of the risk factors that they possess. The patient's information, collected from a structured medical record, was reviewed to evaluate the control of risk factors. Hundred and thirty-four patients were included in the study. One patient was excluded due to the impossibility of reviewing her medical records. Therefore, 133 patients remained in the study. Patients had a mean (SD) age of 57.3 (12.9) years. SAH was diagnosed in 88 subjects, with a recognition frequency of 89.8%, and 63.3% had desirable blood pressure control. Seventy-two patients were diagnosed with dyslipidemia; 68.1% recognized that they had dyslipidemia and 69.4% achieved desirable LDL-c control. Twenty-two patients had DM; 90.9% admitted being diabetic and 40.9% had desirable glycemic control. The frequencies of the CAD risk factor recognition and control were high in comparison to those described for the general population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00296-018-4084-3DOI Listing
August 2018

Omega-3 fatty acids, inflammatory status and biochemical markers of patients with systemic lupus erythematosus: a pilot study.

Rev Bras Reumatol Engl Ed 2017 Nov - Dec;57(6):526-534. Epub 2016 Oct 22.

Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento do Aparelho Locomotor, Belo Horizonte, MG, Brazil. Electronic address:

Background: Studies have shown that omega-3 fatty acids reduce the concentrations of eicosanoids, cytokines, chemokines, C-reactive protein (CRP) and other inflammatory mediators.

Objective: 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).

Methods: Experimental clinical study (clinical trial: NCT02524795); 49 women with SLE (ACR1982/1997) were randomized: 22 to the omega-3 group (daily intake of 1080mg EPA+200mg 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 [ΔV=pre-treatment (T0)-post-treatment (T1) concentrations] between groups. p<0.05 was considered significant.

Results: The median (interquartile range - IQR) of age was 37 (29-48) years old, of disease duration was 7 (4-13) years, and of SLEDAI-2K 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.

Conclusions: 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rbre.2016.09.014DOI Listing
August 2019

Anti-CCP antibodies are not a marker of severity in established rheumatoid arthritis: a magnetic resonance imaging study.

Rev Bras Reumatol Engl Ed 2017 Jan - Feb;57(1):15-22. Epub 2015 Dec 2.

Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento do Aparelho Locomotor, Belo Horizonte, MG, Brazil.

Introduction: The presence of anti-CCP is an important prognostic tool of rheumatoid arthritis (RA). But research is still ongoing on its relationship with disease activity and functional capacity.

Objectives: To study the relationship between anti-CCP and disease activity, functional capacity and structural damage indexes, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in cases of established RA.

Methods: Cross-sectional study with RA patients with 1-10 disease duration. Participants underwent clinical evaluation with anti-CCP. Disease activity was assessed using the Clinical Disease Activity Index (CDAI), and functional capacity through the Health Assessment Questionnaire (HAQ). CR analysis was carried out by the Sharp van der Heijde index (SvdH), and MRI analysis by RAMRIS (Rheumatoid Arthritis Magnetic Resonance Image Scoring).

Results: We evaluated 56 patients, with a median (IqR) age of 55 (47.5-60) years; 50 (89.3%) participants were female and 37 (66.1%) were positive for anti-CCP. Medians (IqR) of CDAI, HAQ, SvdH and RAMRIS were 14.75 (5.42-24.97) 1.06 (0.28-1.75), 2 (0-8) and 15 (7-35), respectively. There was no association between anti-CCP and CDAI, HAQ and SvdH and RAMRIS scores.

Conclusion: Our results have not established an association of anti-CCP with the severity of disease. To date, we cannot corroborate anti-CCP as a prognostic tool in patients with established RA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rbre.2015.07.018DOI Listing
September 2019

Anti-CCP antibodies are not a marker of severity in established rheumatoid arthritis: a magnetic resonance imaging study.

Rev Bras Reumatol 2015 Sep 14. Epub 2015 Sep 14.

Departamento do Aparelho Locomotor, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brasil.

Introduction: The presence of anti-CCP is an important prognostic tool of rheumatoid arthritis (RA). But research is still ongoing on its relationship with disease activity and functional capacity.

Objectives: To study the relationship between anti-CCP and disease activity, functional capacity and structural damage indexes, by means of conventional radiography (CR) and magnetic resonance imaging (MRI), in cases of established RA.

Methods: Cross-sectional study with RA patients with 1-10 years of disease duration. Participants underwent clinical evaluation with anti-CCP. Disease activity was assessed using the Clinical Disease Activity Index (CDAI), and functional capacity through the Health Assessment Questionnaire (HAQ). CR analysis was carried out by the Sharp van der Heijde index (SvdH), and MRI analysis by RAMRIS (Rheumatoid Arthritis Magnetic Resonance Image Scoring).

Results: We evaluated 56 patients, with a median (IqR) age of 55 (47.5-60.0) years; 50 (89.3%) participants were female and 37 (66.1%) were positive for anti-CCP. Medians (IqR) of CDAI, HAQ, SvdH and RAMRIS were 14.75 (5.42-24.97) 1.06 (0.28-1.75), 2 (0-8) and 15 (7-35), respectively. There was no association between anti-CCP and CDAI, HAQ and SvdH and RAMRIS scores.

Conclusion: Our results have not established an association of anti-CCP with the severity of disease. To date, we cannot corroborate anti-CCP as a prognostic tool in patients with established RA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rbr.2015.07.009DOI Listing
September 2015

[Consensus of the Brazilian Society of Rheumatology for the diagnosis, management and treatment of lupus nephritis].

Rev Bras Reumatol 2015 Jan-Feb;55(1):1-21. Epub 2014 Nov 1.

Disciplina de Reumatologia, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

Objective: To develop recommendations for the diagnosis, management and treatment of lupus nephritis in Brazil.

Method: Extensive literature review with a selection of papers based on the strength of scientific evidence and opinion of the Commission on Systemic Lupus Erythematosus members, Brazilian Society of Rheumatology.

Results And Conclusions: 1) Renal biopsy should be performed whenever possible and if this procedure is indicated; and, when the procedure is not possible, the treatment should be guided with the inference of histologic class. 2) Ideally, measures and precautions should be implemented before starting treatment, with emphasis on attention to the risk of infection. 3) Risks and benefits of treatment should be shared with the patient and his/her family. 4) The use of hydroxychloroquine (preferably) or chloroquine diphosphate is recommended for all patients (unless contraindicated) during induction and maintenance phases. 5) The evaluation of the effectiveness of treatment should be made with objective criteria of response (complete remission/partial remission/refractoriness). 6) ACE inhibitors and/or ARBs are recommended as antiproteinuric agents for all patients (unless contraindicated). 7) The identification of clinical and/or laboratory signs suggestive of proliferative or membranous glomerulonephritis should indicate an immediate implementation of specific therapy, including steroids and an immunosuppressive agent, even though histological confirmation is not possible. 8) Immunosuppressives must be used during at least 36 months, but these medications can be kept for longer periods. Its discontinuation should only be done when the patient achieve and maintain a sustained and complete remission. 9) Lupus nephritis should be considered as refractory when a full or partial remission is not achieved after 12 months of an appropriate treatment, when a new renal biopsy should be considered to assist in identifying the cause of refractoriness and in the therapeutic decision.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rbr.2014.09.008DOI Listing
March 2017

[Polyunsaturated omega-3 fatty acids and systemic lupus erythematosus: what do we know?].

Rev Bras Reumatol 2014 Nov-Dec;54(6):459-66. Epub 2014 Sep 28.

Departamento do Aparelho Locomotor, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.

Various studies have demonstrated the impact of omega-3 fatty acids on the concentration of C reactive protein (CRP), pro-inflammatory eicosanoids, cytokines, chemokines and other inflammatory mediators. Therefore, the supplementation of these types of lipids may represent additional option treatment for chronic systemic diseases, such as Systemic Lupus Erythematous and other rheumatic diseases. The role of these lipids has not been well established, yet. However, it seems there is a direct relationship between its intake and the decrease of the disease clinical manifestations as well as of the inflammatory status of the patients. Thus, the aim of this manuscript is to present a thorough review on the effects of omega-3 fatty acids in patients with SLE. Bibliographic data set as the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) were searched using as key words: systemic lupus erythematous (SLE), polyunsaturated fatty acids omega-3, eicosapentanoic acid (EPA), docosahexanoic acid (DHA), antioxidants and diet. Manuscripts published up to September 2013 were included. There were 43 articles related to the topic, however only 15 pertained human studies, with three review articles and 12 clinical studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rbr.2013.12.002DOI Listing
December 2016

Nutritional status and food intake in patients with systemic lupus erythematosus.

Nutrition 2012 Nov-Dec;28(11-12):1098-103. Epub 2012 Aug 14.

School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Objective: Systemic inflammation, therapy with corticosteroids, and reduced physical activity may increase the predisposition to accumulate body fat in patients with systemic lupus erythematosus (SLE). The aim of this study was to assess the nutritional status and food intake of patients with SLE.

Methods: One hundred seventy women with SLE were evaluated consecutively in a cross-sectional study. Nutritional status was assessed by subjective global assessment and body mass index. Food intake was assessed by a 24-h recall and a semiquantitative food frequency questionnaire. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS), considering P < 0.05 as significant.

Results: The mean ± SD age of the patients was 39.14 ± 9.98 y, and the duration of the disease was 9.94 ± 6.18 y. Approximately 91.8% patients were classified as being well nourished; 6.5% were classified as suspected or moderately malnourished, and 1.8% were classified as severely malnourished. In terms of body mass index, malnutrition was found in 1.2% of the patients, normal weight in 35.9%, overweight in 35.3%, and obesity in 27.7%. Most patients reported food consumption below the estimated needs for energy. Calcium was the nutrient with the most inadequate intake. Low consumption of fruits, vegetables, and dairy products and a high consumption of oils and fats were reported.

Conclusion: The results showed that patients with SLE have inadequate nutritional status and food intake.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2012.01.015DOI Listing
March 2013

Excess weight and associated risk factors in patients with systemic lupus erythematosus.

Rheumatol Int 2013 Mar 22;33(3):681-8. Epub 2012 Apr 22.

Department of Locomotor System, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

The objective of this study is to determine the socio-demographic, clinical and laboratory characteristics of outpatients with SLE who present with excess weight as well as to assess the immunosuppressive therapy used. One hundred and seventy women with SLE were evaluated consecutively in a transversal study. The relationship between excess weight and the patients' characteristics was evaluated using univariate and multivariate Poisson regression analysis. Of the 170 patients evaluated, 109 presented with excess weight, two were malnourished and 59 were classified as eutrophic. Age and disease duration of those with excess weight were 42.4 ± 8.7 and 10.4 ± 6.2 years, respectively. Risk factors associated with excess weight were the following: age ≥40 years, <8 years of education, lack of occupation, damage index ≥1, systemic high blood pressure, diabetes mellitus and triglycerides ≥150 mg/dL levels. The use of antimalarial therapy and steroids was associated with a lower frequency of excess weight. Age ≥40 years and the non-usage of methotrexate were the variables independently associated with excess weight in the multivariate analysis. Patients with SLE who have excess weight present distinct clinical-laboratory findings, socio-demographic characteristics and treatment options when compared to normal weight patients. Prospective studies should assess whether these characteristics will interfere with the outcome or prognosis of lupus.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00296-012-2402-8DOI Listing
March 2013

Causes and predictors of death in Brazilian lupus patients.

Rheumatol Int 2013 Feb 30;33(2):467-73. Epub 2012 Mar 30.

Hospital das Clínicas, Belo Horizonte, Minas Gerais, Brazil.

The objective of this study is to determine the causes and predictors of death in systemic lupus erythematosus (SLE) patients. Causes of death were defined based on death certificates, medical records, and information collected from doctors and relatives. Possible variables predicting mortality were assessed by Kaplan-Meier and Cox regression methods. The multivariate model was validated using the bootstrap method, and the hazard ratios were adjusted according to the shrinkage coefficient. One hundred eighty-one patients were included, and two patients were lost to follow-up. The median (IR) age at T (0) and disease duration of the 179 patients were 26.7 (21.8-34.6) and 8.2 (4.3-12.4) years, respectively. After a median (IR) follow-up of 3.3 (3.1-3.5) years, 13 (7.3 %) patients died due to end-organ failure (5), infection (5), disease activity (1), and atherosclerotic cardiovascular disease (CVD) (1). The cause of mesenteric ischemia in one patient could not be determined. Predictors of mortality collected at T(0) were the following: nephritis, chronic kidney disease, antiphospholipid syndrome (APS), higher modified SLEDAI-2k, higher damage index score, intravenous cyclophosphamide use, higher daily dose of prednisone, and higher systolic blood pressure. Independent predictors of mortality were higher damage index score (HR: 1.40; 95 % CI: 1.08-1.82), cyclophosphamide use (HR: 3.80; 95 % CI: 1.13-12.77), and APS diagnosis (HR: 3.82; 95 % CI: 1.07-13.59). This paper presents a high frequency of late mortality in lupus patients due to the SLE itself and infection. This result is not in agreement with the initial proposed bimodal pattern of lupus mortality, nor is it in agreement with the high frequency of CVD as a cause of death in developed countries. The most important predictors of death were related to the lupus itself.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00296-012-2372-xDOI Listing
February 2013

Assessment of nutritional status and physical activity in systemic lupus erythematosus patients.

Rev Bras Reumatol 2010 Nov-Dec;50(6):631-8

HC-UFMG, Brazil.

Introduction: Patients with systemic lupus erythematosus (SLE) may present nutritional changes triggered by disease or treatment, and these conditions may interfere with prognosis.

Objective: Assess the nutritional status, physical activity and associated factors in patients with SLE under treatment at the Service of Rheumatology of Hospital das Clínicas/Universidade Federal de Minas Gerais.

Methods: A cross-sectional study evaluating the nutritional status, clinical laboratory findings, sociodemographic, and treatment characteristics of 170 SLE female patients.

Results: Patients aged between 18 and 60 years were included. The mean (SD) age of patients and duration of SLE was 39.1 (10.0) and 9.9 (6.2) years, respectively. Two (1.2%) patients were classified as grade I underweight, 59 (34.7%) eutrophic, 61 (35.9%) as overweight, 37 (21.8%) as grade I obesity, seven (4,1%) as grade II obesity, and four (2,4%) as grade III obesity. Overweight and obesity were significantly associated with older age, lower education, higher SLE damage index, higher serum concentration of complement, higher incidence of hypertension and diabetes mellitus, presence of ovarian failure, and less frequent use of antimalarials Regarding physical activity, 39 patients (22.9%) were classified as inactive, 100 (58.8%) insufficiently active, and 31 (18.2%) active. Of the latter, 13 (43.3%) were in the eutrophic group.

Conclusion: Excess weight was high in this population and associated with some traditional risk factors for cardiovascular disease and SLE poor prognosis. Therefore, encouraging weight control must be part of the main goals in treating SLE patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
June 2011

Prevalence of serological markers for celiac disease (IgA and IgG class antigliadin antibodies and IgA class antiendomysium antibodies) in patients with autoimmune rheumatologic diseases in Belo Horizonte, MG, Brazil.

Arq Gastroenterol 2010 Jul-Sep;47(3):250-6

Department of Internal Medicine, Medical School of the Federal University of Minas Gerais, Belo Horizonte, MG, Brazil.

Context: Patients with autoimmune rheumatologic conditions and celiac disease tend to have a variety of autoantibodies, many of which have no clear pathogenic role. The literature contains frequent reports of celiac disease being more prevalent in patients with rheumatologic diseases, although this remains controversial.

Objectives: To investigate the prevalence of positive serum tests for celiac disease, particularly IgA and IgG antigliadin (AGA) antibodies and IgA antiendomysium antibodies (EmA) in patients with autoimmune rheumatologic diseases. A second aim was to correlate positive serum tests with prednisone and immunosuppressant medication.

Methods: A total of 190 adults and pediatric patients with a variety of autoimmune rheumatologic diseases (systemic lupus erythematosus, rheumatoid arthritis, juvenile rheumatoid arthritis and spondyloarthrophathies) were evaluated and tested for IgA and IgG antigliadin-antibodies and IgA antiendomysium antibodies. Patients with positive serum tests underwent endoscopic duodenal biopsies for pathology studies.

Results: There were four positive sera (2.1%) for AGA IgA, all of which tested negative for AGA IgG and EmA. Three sera (1.6%) tested positive for AGA IgG; all were negative for AGA IgA and EmA. The EmA test at a 1:2.5 serum dilution tested positive in 94 patients (49.5%); at a 1:5 serum dilution it was positive in 41 patients (21.6%). Eleven subjects tested positive for EmA at 1:40 dilution; and all of these tested negative for IgA tissue antitransglutaminase (tTG) antibodies. Nine of the 11 EmA-positive patients and all 7 patients with positive antigliadin antibodies tests underwent duodenal endoscopic biopsies, and no significant changes were demonstrated in their duodenal mucosa. A positive EmA was associated with elevated optical density AGA IgA readings; however, there was no relationship between positive EmA and AGA IgG optical density readings. Prednisone and immunosuppressant use were unrelated to AGA IgA optical density readings or AGA IgG readings. These drugs were associated with fewer positive EmA tests.

Conclusions: Positive AGAA, AGAG or EmA results are probably nonspecific for the presence of celiac disease among autoimmune rheumatologic disease patients. The intake of prednisone and immunosuprressant drugs seems to reduce the prevalence of IgA EmA, but it does not interfere with antigliadin antibodies tests.Further studies are required to estimate more accurately the prevalence of this disease in rheumatologic patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0004-28032010000300008DOI Listing
October 2011

A cross-sectional study of 130 Brazilian patients with Crohn's disease and ulcerative colitis: analysis of articular and ophthalmologic manifestations.

Clin Rheumatol 2008 Apr 21;27(4):503-9. Epub 2007 Dec 21.

Unit of Rheumatology, Department of Locomotor System, Federal University of Minas Gerais, Belo Horizonte, Brazil.

This is a cross-sectional study that analyzed the pattern and frequency of articular and ophthalmologic manifestations in patients with Crohn's disease (CD) and ulcerative colitis (UC), with or without signs of active bowel inflammation. One hundred and thirty consecutive patients with CD (n = 71) and UC (n = 59) were examined. Simple X-rays of lumbar spine, sacroiliac joints, and calcaneal bone were performed and human leukocyte antigen (HLA)-B27 was typed. Joint manifestations occurred in 41 (31.5%) patients, 27 (38%) with CD and 14 (23.7%) with UC. Peripheral involvement occurred in 22 patients, axial involvement in five, and mixed involvement in 14. The most frequently involved joints were knees (56.1%), ankles (29.3%), and hips (29.3%), while the predominant pattern was oligoarticular (84.6%) and asymmetrical (65.6%). Enthesitis was identified in seven (5.4%) patients and inflammatory lumbar pain in 13 (10%). Eight of these patients fulfilled the diagnostic criteria for ankylosing spondylitis (6.2%). Radiographic sacroiliitis occurred in 12 patients (9.2%). Ocular abnormalities were present in six patients (6.2%), and HLA-B27 was positive in five (5.8%). In conclusion, the articular manifestations in the present study were predominantly oligoarticular and asymmetric, with a low frequency of ophthalmologic involvement and positive HLA-B27.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10067-007-0797-5DOI Listing
April 2008

Increased expression of 2'5'oligoadenylate synthetase and double-stranded RNA dependent protein kinase messenger RNAs on affected skin of systemic sclerosis patients.

Arch Dermatol Res 2007 Aug 1;299(5-6):259-62. Epub 2007 Jun 1.

Laboratório de Vírus, Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.

Scleroderma or systemic sclerosis (SSc) is an autoimmune disorder of unknown aetiology characterized by excessive collagen synthesis and subsequent deposition on the skin and various internal organs. Interferons (IFNs) are well-known immunomodulators and inhibitors of collagen production. However, IFN therapy has been implicated in the development or exacerbation of several autoimmune diseases, including SSc. We analyzed the expression of several interferon-stimulated genes (ISGs) in affected skin of SSc patients (skin tissue and cultured skin fibroblasts). A set of ISGs (PKR, 2'5'OAS, MxA, and 6-16) was analyzed by real-time PCR using RNA extracted from cultured skin fibroblasts and skin tissue of normal individuals and SSc patients. Both normal and SSc affected skin cultured fibroblasts were sensitive to the IFN treatment and presented similar levels of all ISGs tested. However, PKR and 2'5'OAS mRNA expression levels were significantly higher in the affected skin tissue of SSc patients when compared to normal controls. These data suggest that the IFN system plays a role in the pathogenesis of SSc.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00403-007-0737-xDOI Listing
August 2007

Libman-Sacks endocarditis and oral anticoagulation.

Arq Bras Cardiol 2004 Apr;82(4):378-83

Serviço de Reumatologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

The patient is a 34-year-old female with systemic lupus erythematosus and secondary antiphospholipid antibody syndrome, who evolved with convulsive crises, partially controlled with an anticonvulsant, and auscultation of a cardiac murmur, whose investigation showed the presence of a mitral valve vegetation. Once the diagnosis of Libman-Sacks endocarditis was established, therapy with warfarin sodium was initiated, and, after 6 months of oral anticoagulation, the patient had total control of the convulsive crises and the valvular vegetation disappeared on echocardiography. This study discusses the occurrence of Libman-Sacks endocarditis in systemic lupus erythematosus, its association with antiphospholipid antibody syndrome, and the anticoagulant therapy. A literature review is also provided.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/s0066-782x2004000400009DOI Listing
April 2004

Subclinical rheumatic valvitis: a long-term follow-up.

Cardiol Young 2003 Oct;13(5):431-8

Division of Paediatric Cardiology, Department of Paediatrics, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.

In order prospectively to investigate the frequency and evolution of subclinical valvitis, we selected 40 consecutive patients suffering their initial attack of rheumatic fever, seen in our clinic from 1992 to 1994, and followed-up until 2001, with a mean period of follow-up of 8.1 years, and a standard deviation of 0.6 year. We also assembled a matched control group of 37 healthy children and adolescents. We discovered a murmur of mitral regurgitation in 28 (70.0%) of the patients. In 3 (7.5%) of these patients, there was also a murmur of aortic regurgitation. In the group of 28 symptomatic patients, Doppler echocardiography showed mitral regurgitation in all, and aortic regurgitation in 17. In the group of 12 patients without clinical evidence of cardiac involvement, Doppler echocardiography identified mitral regurgitation in 2, isolated in one and associated with aortic regurgitation in the other. Thus, the frequency of subclinical valvitis was 16.7%. In patients with subclinical valvitis only the aortic regurgitation regressed during the period of follow-up. In the group of 28 symptomatic patients, mitral regurgitation disappeared in 6 (21.4%), aortic regurgitation in 7 of the 17 having this feature (41.2%), while 2 patients (7.1%) developed mitral stenosis. The sensitivity and specificity of cardiac auscultation were, respectively, 93.3%, with 95% confidence intervals between 72.3% and 97.4%, and 100%, with 95% confidence intervals between 65.5% and 100%, for the diagnosis of mitral regurgitation, and 16.7%, with 95% confidence intervals between 4.4% and 42.3%, and 100%, with 95% confidence intervals between 81.5% and 100%, for that of aortic regurgitation. We conclude that the Doppler echocardiogram is an important means of diagnosing and assessing the evolution of subclinical rheumatic valvar lesions, which are not always transient. We suggest that Doppler echocardiography should be performed in all patients with acute rheumatic fever. Subclinical valvitis should be considered as mild carditis, provided that strict criterions are observed in the differential diagnosis from physiological regurgitation, and Doppler echocardiographic findings are analyzed in the context of the other manifestations of the disease.
View Article and Find Full Text PDF

Download full-text PDF

Source
October 2003

Protease nexin-1 messenger RNA levels are not affected by serum or interferon beta in cultured systemic sclerosis fibroblasts.

Arch Dermatol Res 2002 Jan;293(11):584-9

Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.

The aim of the present study was to analyze the effect of serum and human recombinant beta interferon (rIFNbeta) treatment on PN-1 mRNA levels in cultured dermal fibroblasts obtained from the skin of healthy donors and from lesional skin of systemic sclerosis (SSc) patients with the limited (CREST syndrome) or the diffuse form of SSc. Total RNA was isolated from fibroblasts derived from the skin of healthy individuals and from lesional skin of patients with CREST syndrome and the diffuse form of SSc cultured under different conditions (1% or 10% serum-supplemented medium) and treated with 500 IU/ml of rIFNbeta. PN-1 gene expression was assessed by Northern blot analysis. We detected variable PN-1 mRNA levels in normal control fibroblasts as well as in SSc fibroblasts under the different culture conditions (1% or 10% serum-supplemented medium). Accumulated PN-1 mRNA levels found in normal cultured fibroblasts were similar to or even higher than in SSc fibroblasts. PN-1 messenger levels were not significantly altered by IFNbeta treatment in normal or SSc cultured fibroblasts despite the presence of an IFN-stimulated responsive element (ISRE) in the promoter of the PN-1 gene. Our findings suggest that PN-1 expression in SSc fibroblasts at the mRNA level requires further investigation in a large number of SSc patients to better characterize the role of this serpin in the pathogenesis of SSc. We conclude that the transcriptional regulation of PN-1 is not associated with IFNbeta, an antifibrotic cytokine naturally produced by fibroblasts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00403-001-0281-zDOI Listing
January 2002