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[PMID]:29238021
[Au] Autor:Kiboshi T; Isoda K; Furukawa K; Wakahara T; Otani K; Ueda K; Konma J; Teramura K; Ueno N; Fujiwara H; Shoda T
[Ad] Endereço:Department of Rheumatology, Yodogawa Christian Hospital.
[Ti] Título:[Granulomatosis with Polyangiitis Complicated with Gastrointestinal Perforation: A Case Report and Review of Literature].
[So] Source:Nihon Rinsho Meneki Gakkai Kaishi;40(5):382-386, 2017.
[Is] ISSN:1349-7413
[Cp] País de publicação:Japan
[La] Idioma:jpn
[Ab] Resumo:  A 51-year-old man was detected nasal bleeding, multiple pulmonary nodule and mass, urinalysis abnormality, renal involvement and high titer of proteinase 3-anti-neutrophil cytoplasmic antibody (PR3-ANCA), and was suspected of granulomatosis with polyangiitis and initiated with steroid pulse therapy. On the day after the start of steroid pulse therapy, generalized peritonitis due to ileal perforation occurred, and emergency ileectomy and peritonitis surgery were performed. Induction therapy with steroid pulse therapy, plasma exchange and intravenous cyclophosphamide therapy (IVCY) and maintenance therapy with glucocorticoid and azathioprine led to good therapeutic outcomes. Gastrointestinal perforation in GPA is a rare complication, and we examined the clinical features, treatment contents, and prognosis of GPA with gastrointestinal perforation from this case and previous reports. Lung involvements were complicated in all reported cases. Gastrointestinal perforations in GPA were frequent in the small intestine, occurred just before and immediately after the start of treatment, and were severe involvement with poor prognosis because of the high mortality rate (46.7%). The frequency of ear, nose and upper respiratory tract lesions in the surviving group was significantly higher than in the dead group (survival 87.5%, death 28.3%, P = 0.041). IVCY were more frequently used in the surviving group (62.5%) than the death group (16.7%), but it was not significantly. GPA complicated with gastrointestinal perforation is a severe condition with poor prognosis, but there is a possibility to improve prognosis by early diagnosis and early initiation of strong treatment.
[Mh] Termos MeSH primário: Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/terapia
Íleo
Perfuração Intestinal/etiologia
Troca Plasmática
[Mh] Termos MeSH secundário: Anticorpos Anticitoplasma de Neutrófilos/sangue
Azatioprina/administração & dosagem
Biomarcadores/sangue
Ciclofosfamida/administração & dosagem
Diagnóstico Precoce
Granulomatose com Poliangiite/diagnóstico
Seres Humanos
Perfuração Intestinal/cirurgia
Masculino
Metilprednisolona/administração & dosagem
Meia-Idade
Mieloblastina/imunologia
Prognóstico
Pulsoterapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic); 0 (Biomarkers); 8N3DW7272P (Cyclophosphamide); EC 3.4.21.76 (Myeloblastin); MRK240IY2L (Azathioprine); X4W7ZR7023 (Methylprednisolone)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180112
[Lr] Data última revisão:
180112
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.2177/jsci.40.382


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[PMID]:28745688
[Au] Autor:Milovanov YS; Kozlovskaya LV; Milovanova LY; Markina MM; Kozlov VV; Taranova MV; Fomin VV
[Ad] Endereço:I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
[Ti] Título:[Risk factors for anemia in the early stages of chronic kidney disease].
[Ti] Título:Faktory riska razvitiia anemii na rannikh stadiiakh khronicheskoi bolezni pochek..
[So] Source:Ter Arkh;89(6):41-47, 2017.
[Is] ISSN:0040-3660
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:AIM: To identify the early markers of anemia in chronic kidney disease (CKD) in patients with chronic glomerulonephritis (CGN) and glomerulonephritis (GN) in systemic diseases. SUBJECTS AND METHODS: Seventy-nine patients with some male preponderance who were aged 21 to 65 years (45.3±11.1 years) and had CKD (CGN and GN) in systemic diseases (systemic lupus erythematosus and Wegener's granulomatosis) in the early stages (Stages I-II) of CKD were examined. GN was diagnosed by a lifetime renal biopsy. Systemic diseases were diagnosed according to the criteria for each nosological entity. The stages of CKD were defined according to the 2012 Kidney Disease: Improving Global Outcomes (KDIGO) criteria; the glomerular filtration rate (GFR) was calculated using the CKD EPI equation (2012). According to the presence or absence of anemia, all the patients included in the study were divided into 2 groups: 1) 43 (54.4%) anemic patients; 2) 36 (45.6%) non-anemic patients (a control group). In addition to general clinical examination adopted for a nephrology department, special studies, such as determination of the serum levels of hepcidin, interferon-γ (IFN-γ), soluble Klotho protein (s-Klotho), as well as iron, ferritin, and transferrin saturation (TSAT) ratio, were performed to solve the set tasks. RESULTS: Forty-three anemic patients who had a hemoglobin level of 110 (100; 119) g/l and 36 control patients who had the similar values were noted to have statistically significantly (p<0.001) higher levels of IFN-γ (11 (10; 14) and 0.2 (0.09; 0.6) ng/ml), hepcidin (26 (25; 27) and 5.1 (3.8; 5.9) ng/ml) and C-reactive protein (1.5 (1.1; 2.1) and 0.3 (0.2; 0.6) mg/dl), and lower levels of s-Klotho protein (12 (10; 18) pg/ml) and TSAT (18 (14; 19)%. Forty-three patients with anemia were also found to have a statistically significantly (p<0.01) lower GFR (65 (62; 87) and 80.5 (62; 90) ml/min) and higher systolic blood pressure (145 (125; 160) and 120 (115; 16) mm Hg) as compared with those in 36 control patients. At the same time, the compared groups displayed no statistically significant differences in serum ferritin levels (123 (110; 150) and 115 (100; 140) µg/l). Among 43 CKD patients with anemia, its detection rate in the presence of systemic diseases was 3.2 times higher than that in CGN patients (41.7 and 12.7%). ROC analysis revealed that in the CKD patients with CGN and GN, the serum hepcidin level ≥ 25 ng/ml, with the sensitivity and specificity being of 89.7% and 74%, respectively (p > 0.001), was associated with the development of anemia. Moreover, the hemoglobin level of<120 g/ l was found to have an independent impact on the risk of reducing serum s-Klotho production. CONCLUSION: In Stage I-II CKD patients with CGN and GN in the presence of systemic diseases, elevated serum hepcidin levels should be regarded as a predictor for anemia of chronic disease (ACD). Herewith, the decrease in hemoglobin levels <120 g/l is associated with the reduced production of the nephroprotective factor s-Klotho. The treatment of ACD for Stages I-II CKD should encompass intravenous administration of iron in order to increase its content and availability for erythropoiesis.
[Mh] Termos MeSH primário: Anemia/sangue
Glomerulonefrite/sangue
Granulomatose com Poliangiite/sangue
Lúpus Eritematoso Sistêmico/sangue
Insuficiência Renal Crônica/sangue
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Glomerulonefrite/etiologia
Granulomatose com Poliangiite/complicações
Seres Humanos
Lúpus Eritematoso Sistêmico/complicações
Masculino
Meia-Idade
Insuficiência Renal Crônica/etiologia
Fatores de Risco
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171129
[Lr] Data última revisão:
171129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.17116/terarkh201789641-47


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[PMID]:29045211
[Au] Autor:Palamara K; Nagarur A; Fintelmann FJ; Kohler MJ; Cortazar FB
[Ad] Endereço:From the Departments of Medicine (K.P., A.N., M.J.K., F.B.C.) and Radiology (F.J.F.), Massachusetts General Hospital, and the Departments of Medicine (K.P., A.N., M.J.K., F.B.C.) and Radiology (F.J.F.), Harvard Medical School - both in Boston.
[Ti] Título:Case 32-2017. A 64-Year-Old Man with Dyspnea, Wheezing, Headache, Cough, and Night Sweats.
[So] Source:N Engl J Med;377(16):1569-1578, 2017 10 19.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Anticitoplasma de Neutrófilos/sangue
Granulomatose com Poliangiite/diagnóstico
Peroxidase/imunologia
[Mh] Termos MeSH secundário: Tosse/etiologia
Diagnóstico Diferencial
Dispneia/etiologia
Eosinofilia/etiologia
Fibromialgia/complicações
Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/tratamento farmacológico
Cefaleia/etiologia
Seres Humanos
Imunossupressores/uso terapêutico
Pulmão/diagnóstico por imagem
Pulmão/patologia
Masculino
Meia-Idade
Sons Respiratórios/etiologia
Sudorese
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic); 0 (Immunosuppressive Agents); EC 1.11.1.7 (Peroxidase)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171026
[Lr] Data última revisão:
171026
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1703513


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[PMID]:29016646
[Au] Autor:Maritati F; Alberici F; Oliva E; Urban ML; Palmisano A; Santarsia F; Andrulli S; Pavone L; Pesci A; Grasselli C; Santi R; Tumiati B; Manenti L; Buzio C; Vaglio A
[Ad] Endereço:Nephrology Unit, University Hospital of Parma, Italy.
[Ti] Título:Methotrexate versus cyclophosphamide for remission maintenance in ANCA-associated vasculitis: A randomised trial.
[So] Source:PLoS One;12(10):e0185880, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The treatment of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is based on remission-induction and remission-maintenance. Methotrexate is a widely used immunosuppressant but only a few studies explored its role for maintenance in AAV. This trial investigated the efficacy and safety of methotrexate as maintenance therapy for AAV. METHODS: In this single-centre, open-label, randomised trial we compared methotrexate and cyclophosphamide for maintenance in AAV. We enrolled patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA), the latter with poor-prognosis factors and/or peripheral neuropathy. Remission was induced with cyclophosphamide. At remission, the patients were randomised to receive methotrexate or to continue with cyclophosphamide for 12 months; after treatment, they were followed for another 12 months. The primary end-point was relapse; secondary end-points included renal outcomes and treatment-related toxicity. RESULTS: Of the 94 enrolled patients, 23 were excluded during remission-induction or did not achieve remission; the remaining 71 were randomised to cyclophosphamide (n = 33) or methotrexate (n = 38). Relapse frequencies at months 12 and 24 after randomisation were not different between the two groups (p = 1.00 and 1.00). Relapse-free survival was also comparable (log-rank test p = 0.99). No differences in relapses were detected between the two treatments when GPA+MPA and EGPA were analysed separately. There were no differences in eGFR at months 12 and 24; proteinuria declined significantly (from diagnosis to month 24) only in the cyclophosphamide group (p = 0.0007). No significant differences in adverse event frequencies were observed. CONCLUSIONS: MTX may be effective and safe for remission-maintenance in AAV. TRIAL REGISTRATION: clinicaltrials.gov NCT00751517.
[Mh] Termos MeSH primário: Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/tratamento farmacológico
Síndrome de Churg-Strauss/tratamento farmacológico
Ciclofosfamida/uso terapêutico
Granulomatose com Poliangiite/tratamento farmacológico
Imunossupressores/uso terapêutico
Metotrexato/uso terapêutico
Poliangiite Microscópica/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/complicações
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/imunologia
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/mortalidade
Anticorpos Anticitoplasma de Neutrófilos/sangue
Síndrome de Churg-Strauss/complicações
Síndrome de Churg-Strauss/imunologia
Síndrome de Churg-Strauss/mortalidade
Feminino
Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/imunologia
Granulomatose com Poliangiite/mortalidade
Seres Humanos
Masculino
Poliangiite Microscópica/complicações
Poliangiite Microscópica/imunologia
Poliangiite Microscópica/mortalidade
Meia-Idade
Segurança do Paciente
Seleção de Pacientes
Doenças do Sistema Nervoso Periférico/complicações
Doenças do Sistema Nervoso Periférico/tratamento farmacológico
Doenças do Sistema Nervoso Periférico/imunologia
Doenças do Sistema Nervoso Periférico/mortalidade
Proteinúria/complicações
Proteinúria/tratamento farmacológico
Proteinúria/imunologia
Proteinúria/mortalidade
Distribuição Aleatória
Recidiva
Indução de Remissão
Análise de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic); 0 (Immunosuppressive Agents); 8N3DW7272P (Cyclophosphamide); YL5FZ2Y5U1 (Methotrexate)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0185880


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[PMID]:28977502
[Au] Autor:de Joode AAE; Sanders JSF; Puéchal X; Guillevin LP; Hiemstra TF; Flossmann O; Rasmussen N; Westman K; Jayne DR; Stegeman CA
[Ad] Endereço:Department of Internal Medicine and Nephrology, University Medical Center Groningen, Groningen, the Netherlands.
[Ti] Título:Long term azathioprine maintenance therapy in ANCA-associated vasculitis: combined results of long-term follow-up data.
[So] Source:Rheumatology (Oxford);56(11):1894-1901, 2017 Nov 01.
[Is] ISSN:1462-0332
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective: We studied whether in ANCA-associated vasculitis patients, duration of AZA maintenance influenced relapse rate during long-term follow-up. Methods: Three hundred and eighty newly diagnosed ANCA-associated vasculitis patients from six European multicentre studies treated with AZA maintenance were included; 58% were male, median age at diagnosis 59.4 years (interquartile range: 48.3-68.2 years); granulomatosis with polyangiitis, n = 236; microscopic polyangiitis, n = 132; or renal limited vasculitis, n = 12. Patients were grouped according to the duration of AZA maintenance after remission induction: ⩽18 months, ⩽24 months, ⩽36 months, ⩽48 months or > 48 months. Primary outcome was relapse-free survival at 60 months. Results: During follow-up, 84 first relapses occurred during AZA-maintenance therapy (1 relapse per 117 patient months) and 71 after withdrawal of AZA (1 relapse/113 months). During the first 12 months after withdrawal, 20 relapses occurred (1 relapse/119 months) and 29 relapses >12 months after withdrawal (1 relapse/186 months). Relapse-free survival at 60 months was 65.3% for patients receiving AZA maintenance >18 months after diagnosis vs 55% for those who discontinued maintenance ⩽18 months (P = 0.11). Relapse-free survival was associated with induction therapy (i.v. vs oral) and ANCA specificity (PR3-ANCA vs MPO-ANCA/negative). Conclusion: Post hoc analysis of combined trial data suggest that stopping AZA maintenance therapy does not lead to a significant increase in relapse rate and AZA maintenance for more than 18 months after diagnosis does not significantly influence relapse-free survival. ANCA specificity has more effect on relapse-free survival than duration of maintenance therapy and should be used to tailor therapy individually.
[Mh] Termos MeSH primário: Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/tratamento farmacológico
Azatioprina/uso terapêutico
Imunossupressores/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Vasculite Associada a Anticorpo Anticitoplasma de Neutrófilos/imunologia
Anticorpos Anticitoplasma de Neutrófilos/imunologia
Intervalo Livre de Doença
Feminino
Seguimentos
Granulomatose com Poliangiite/tratamento farmacológico
Granulomatose com Poliangiite/imunologia
Seres Humanos
Nefropatias/tratamento farmacológico
Nefropatias/imunologia
Quimioterapia de Manutenção
Masculino
Poliangiite Microscópica/tratamento farmacológico
Poliangiite Microscópica/imunologia
Meia-Idade
Mieloblastina/imunologia
Peroxidase/imunologia
Recidiva
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic); 0 (Immunosuppressive Agents); EC 1.11.1.7 (Peroxidase); EC 3.4.21.76 (Myeloblastin); MRK240IY2L (Azathioprine)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171005
[St] Status:MEDLINE
[do] DOI:10.1093/rheumatology/kex281


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[PMID]:28973595
[Au] Autor:Miceli MH; Kauffman CA
[Ad] Endereço:Division of Infectious Diseases, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
[Ti] Título:Aspergillus Galactomannan for Diagnosing Invasive Aspergillosis.
[So] Source:JAMA;318(12):1175-1176, 2017 Sep 26.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Aspergillus fumigatus
Líquido da Lavagem Broncoalveolar/química
Hospedeiro Imunocomprometido
Técnicas Imunoenzimáticas
Aspergilose Pulmonar Invasiva/diagnóstico
Mananas/análise
[Mh] Termos MeSH secundário: Idoso
Aspergillus fumigatus/isolamento & purificação
Biópsia
Líquido da Lavagem Broncoalveolar/microbiologia
Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/tratamento farmacológico
Seres Humanos
Masculino
Mananas/sangue
Sensibilidade e Especificidade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Mannans); 11078-30-1 (galactomannan)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171004
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.10661


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[PMID]:28905856
[Au] Autor:Bossuyt X; Cohen Tervaert JW; Arimura Y; Blockmans D; Flores-Suárez LF; Guillevin L; Hellmich B; Jayne D; Jennette JC; Kallenberg CGM; Moiseev S; Novikov P; Radice A; Savige JA; Sinico RA; Specks U; van Paassen P; Zhao MH; Rasmussen N; Damoiseaux J; Csernok E
[Ad] Endereço:Department of Microbiology and Immunology, University of Leuven and Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Herestraat 49, 3000 Leuven, Belgium.
[Ti] Título:Position paper: Revised 2017 international consensus on testing of ANCAs in granulomatosis with polyangiitis and microscopic polyangiitis.
[So] Source:Nat Rev Rheumatol;13(11):683-692, 2017 Nov.
[Is] ISSN:1759-4804
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Anti-neutrophil cytoplasmic antibodies (ANCAs) are valuable laboratory markers used for the diagnosis of well-defined types of small-vessel vasculitis, including granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). According to the 1999 international consensus on ANCA testing, indirect immunofluorescence (IIF) should be used to screen for ANCAs, and samples containing ANCAs should then be tested by immunoassays for proteinase 3 (PR3)-ANCAs and myeloperoxidase (MPO)-ANCAs. The distinction between PR3-ANCAs and MPO-ANCAs has important clinical and pathogenic implications. As dependable immunoassays for PR3-ANCAs and MPO-ANCAs have become broadly available, there is increasing international agreement that high-quality immunoassays are the preferred screening method for the diagnosis of ANCA-associated vasculitis. The present Consensus Statement proposes that high-quality immunoassays can be used as the primary screening method for patients suspected of having the ANCA-associated vaculitides GPA and MPA without the categorical need for IIF, and presents and discusses evidence to support this recommendation.
[Mh] Termos MeSH primário: Anticorpos Anticitoplasma de Neutrófilos/imunologia
Consenso
Granulomatose com Poliangiite/imunologia
Poliangiite Microscópica/imunologia
[Mh] Termos MeSH secundário: Granulomatose com Poliangiite/diagnóstico
Seres Humanos
Poliangiite Microscópica/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1038/nrrheum.2017.140


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[PMID]:28817388
[Au] Autor:Papaliodis GN
[Ad] Endereço:Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
[Ti] Título:Ophthalmologic manifestations of systemic vasculitis.
[So] Source:Curr Opin Ophthalmol;28(6):613-616, 2017 Nov.
[Is] ISSN:1531-7021
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: To review the systemic vasculitides and associated ocular manifestations with emphasis on publications within the last 12 months. RECENT FINDINGS: There are multiple case reports demonstrating atypical ocular manifestations of systemic vasculitis. Often the eye findings are the initial presentation of the disorder and require a high degree of clinical suspicion to evaluate further as these conditions can compromise vision but some may also be life threatening. SUMMARY: The systemic vasculitides are a heterogenous group of rare disorders with inflammation of blood vessels as a common feature. This review will provide a synopsis of the diseases with associated ocular manifestations. The implication for clinicians is to highlight recent case reports/series demonstrating the pathology.
[Mh] Termos MeSH primário: Oftalmopatias/etiologia
Vasculite Sistêmica/complicações
[Mh] Termos MeSH secundário: Oftalmopatias/diagnóstico
Arterite de Células Gigantes/diagnóstico
Arterite de Células Gigantes/etiologia
Granulomatose com Poliangiite/diagnóstico
Granulomatose com Poliangiite/etiologia
Seres Humanos
Vasculite Retiniana/diagnóstico
Vasculite Retiniana/etiologia
Vasculite Sistêmica/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170818
[St] Status:MEDLINE
[do] DOI:10.1097/ICU.0000000000000422


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[PMID]:28771641
[Au] Autor:Land J; Abdulahad WH; Arends S; Sanders JF; Stegeman CA; Heeringa P; Rutgers A
[Ad] Endereço:Department of Rheumatology and Clinical Immunology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
[Ti] Título:Prospective monitoring of in vitro produced PR3-ANCA does not improve relapse prediction in granulomatosis with polyangiitis.
[So] Source:PLoS One;12(8):e0182549, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Patients with granulomatosis with polyangiitis (GPA) are prone to disease relapse. Currently, no good biomarkers are available to predict relapses in individual patients. This study aimed to determine whether patients at risk for relapse can be distinguished based on increased in vitro autoantibody production. METHODS: Eighty-four proteinase 3 (PR3) anti-neutrophil cytoplasmic antibody (ANCA) positive GPA outpatients were prospectively monitored for up to two years and 32 healthy controls were included. At periodic intervals peripheral blood mononuclear cells were isolated, cultured and in vitro production of total and PR3-ANCA-specific IgG was determined. Moreover, serum ANCA titers were measured by indirect immunofluorescence. RESULTS: Sixteen patients (21%) relapsed during the follow-up period. At time of inclusion no significant differences were present for ANCA production between relapsing and non-relapsing patients. Samples before relapse exhibited increased serum ANCA titers and in vitro PR3-ANCA IgG levels compared with inclusion samples from non-relapsing patients. When evaluating changes over time, increasing serum ANCA titers were observed prior to relapse compared to a 1-year follow-up from non-relapsing patients. No significant change in in vitro PR3-ANCA levels occurred prior to relapse, compared to non-relapse patients. CONCLUSIONS: While differences were observed for the serum ANCA titer in relapsing and non-relapsing patients, monitoring in vitro PR3-ANCA IgG production does not improve relapse prediction in GPA patients.
[Mh] Termos MeSH primário: Anticorpos Anticitoplasma de Neutrófilos/sangue
Granulomatose com Poliangiite/diagnóstico
Granulomatose com Poliangiite/epidemiologia
Mieloblastina/imunologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Diagnóstico Precoce
Feminino
Granulomatose com Poliangiite/metabolismo
Seres Humanos
Masculino
Meia-Idade
Vigilância da População
Estudos Prospectivos
Recidiva
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Antineutrophil Cytoplasmic); EC 3.4.21.76 (Myeloblastin)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0182549


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[PMID]:28767340
[Au] Autor:Divakaran S; Dellaripa P; Kobzik L; Levy B; Loscalzo J
[Ad] Endereço:From the Departments of Medicine and Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston.
[Ti] Título:All That Wheezes….
[So] Source:N Engl J Med;377(5):477-484, 2017 08 03.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Granuloma Eosinófilo/diagnóstico
Granulomatose com Poliangiite/diagnóstico
Pulmão/patologia
Sons Respiratórios/etiologia
[Mh] Termos MeSH secundário: Asma/diagnóstico
Asma/tratamento farmacológico
Tosse/etiologia
Diagnóstico Diferencial
Granuloma Eosinófilo/complicações
Granuloma Eosinófilo/tratamento farmacológico
Feminino
Glucocorticoides/uso terapêutico
Granulomatose com Poliangiite/complicações
Granulomatose com Poliangiite/tratamento farmacológico
Seres Humanos
Imunoglobulina E/sangue
Pulmão/diagnóstico por imagem
Prednisona/uso terapêutico
Testes de Função Respiratória
Tomografia Computadorizada por Raios X
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Glucocorticoids); 37341-29-0 (Immunoglobulin E); VB0R961HZT (Prednisone)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcps1607526



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