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[PMID]: 28370486 [Au] Autor: Sidana S; Rajkumar SV; Dispenzieri A; Lacy MQ; Gertz MA; Buadi FK; Hayman SR; Dingli D; Kapoor P; Gonsalves WI; Go RS; Hwa YL; Leung N; Fonder AL; Hobbs MA; Zeldenrust SR; Russell SJ; Lust JA; Kyle RA; Kumar SK [Ad] Endereço: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA. [Ti] Título: Clinical presentation and outcomes of patients with type 1 monoclonal cryoglobulinemia. [So] Source: Am J Hematol;92(7):668-673, 2017 Jul. [Is] ISSN: 1096-8652 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: We describe a series of 102 patients diagnosed from January 1, 1990 to December 31, 2015 with Type 1 monoclonal cryoglobulinemia (MoC). Symptoms were seen in 89 (87%) patients, including: cutaneous symptoms in 64 (63%) patients, with purpura (n = 43, 42%) and ulcers/gangrene (n = 35, 34%) being most common; neurological findings in 33 (32%) patients, most frequently sensory neuropathy (n = 24, 24%); vasomotor symptoms, mainly Raynaud's phenomenon in 25 (25%); arthralgias in 24 (24%); and renal manifestations, primarily glomerulonephritis in 14 (14%) patients. An underlying lymphoproliferative disorder was identified in 94 (92%) subjects; MGUS-39, myeloma-20, lymphoplasmacytic lymphoma-21 and others-14. Treatment was initiated in 73 (72%) patients, primarily for cryoglobulinemia-related symptoms in 57. Treatment regimens consisted of: steroids ± alkylating agents in 29 (40%), novel myeloma therapies in 16 (22%), rituximab with alkylating agents in 12 (16%) and rituximab ± steroids in 11 (15%) patients; 22 patients received plasmapheresis. Six patients underwent autologous stem cell transplant. Cryocrit at treatment initiation, change in cryocrit and time to nadir cryocrit were predictive of symptom improvement. Treatment directed toward the underlying clonal disorder resulted in improvement (n = 47) or stabilization (n = 16) of symptoms in the majority of patients and disappearance of cryoglobulin in over one-half. [Mh] Termos MeSH primário: Crioglobulinemia/diagnóstico Crioglobulinemia/terapia Fenótipo [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico Biópsia Terapia Combinada Crioglobulinemia/mortalidade Crioglobulinas Diagnóstico Diferencial Feminino Transplante de Células-Tronco Hematopoéticas/métodos Seres Humanos Imunoglobulina G/sangue Imunoglobulina M/sangue Estimativa de Kaplan-Meier Masculino Meia-Idade Transplante Autólogo Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Cryoglobulins); 0 (Immunoglobulin G); 0 (Immunoglobulin M) [Em] Mês de entrada: 1707 [Cu] Atualização por classe: 170903 [Lr] Data última revisão: 170903 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170404 [St] Status: MEDLINE [do] DOI: 10.1002/ajh.24745

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[PMID]: 28288791 [Au] Autor: Saadoun D; Pol S; Ferfar Y; Alric L; Hezode C; Si Ahmed SN; de Saint Martin L; Comarmond C; Bouyer AS; Musset L; Poynard T; Resche Rigon M; Cacoub P [Ad] Endereço: Sorbonne Universités, Université Pierre et Marie Curie University of Paris 06, Unité Médicale de Recherche 7211, Inflammation-Immunopathology-Biotherapy Department (Département Hospitalo Universitaire Inflammation, Immunopathology and Biotherapy), Paris, France; INSERM, Unité Médicale de Recherche_S [Ti] Título: Efficacy and Safety of Sofosbuvir Plus Daclatasvir for Treatment of HCV-Associated Cryoglobulinemia Vasculitis. [So] Source: Gastroenterology;153(1):49-52.e5, 2017 Jul. [Is] ISSN: 1528-0012 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Circulating mixed cryoglobulins are detected in 40%-60% of patients with hepatitis C virus (HCV) infection, and overt cryoglobulinemia vasculitis (CryoVas) develops in approximately 15% of patients. Remission of vasculitis has been associated with viral clearance, but few studies have reported the effectiveness of direct-acting antiviral drugs in these patients. We performed an open-label, prospective, multicenter study of the effectiveness and tolerance of an all-oral, interferon- and ribavirin-free regimen of sofosbuvir plus daclatasvir in patients with HCV-associated CryoVas. Forty-one consecutive patients with active HCV-associated CryoVas (median age, 56 y; 53.6% women) were recruited from hospitals in Paris, France, from 2014 through 2016. They received sofosbuvir (400 mg/day) plus daclatasvir (60 mg/day) for 12 weeks (n = 32) or 24 weeks (n = 9), and were evaluated every 4 weeks until week 24 and at week 36. Blood samples were analyzed for complete blood count, serum chemistry profile, level of alanine aminotransferase, rheumatoid factor activity, C4 fraction of complement, and cryoglobulin; peripheral blood mononuclear cells were isolated for flow cytometry analysis. Thirty-seven patients (90.2%) had a complete clinical response (defined by improvement of all the affected organs involved at baseline and no clinical relapse) after a median time of 12 weeks of therapy; all had a sustained virologic response (no detectable serum HCV RNA 12 weeks after the end of antiviral therapy). Patients' mean cryoglobulin level decreased from 0.56 ± 0.18 at baseline to 0.21 ± 0.14 g/L at week 36, and no cryoglobulin was detected in 50% of patients at this time point. After antiviral therapy, patients had increased numbers of T-regulatory cells, IgM+CD21-/low-memory B cells, CD4+CXCR5+ interleukin 21+ cells, and T-helper 17 cells, compared with before therapy. After a median follow-up period of 26 months (interquartile range, 20-30 mo), no patients had a serious adverse event or relapse of vasculitis. [Mh] Termos MeSH primário: Antivirais/uso terapêutico Crioglobulinemia/tratamento farmacológico Crioglobulinas/metabolismo Hepatite C/tratamento farmacológico Imidazóis/uso terapêutico Sofosbuvir/uso terapêutico Vasculite/tratamento farmacológico [Mh] Termos MeSH secundário: Antivirais/efeitos adversos Linfócitos B/química Linfócitos T CD4-Positivos/química Crioglobulinemia/sangue Crioglobulinemia/virologia Quimioterapia Combinada Feminino Hepatite C/sangue Hepatite C/complicações Seres Humanos Imidazóis/efeitos adversos Imunoglobulina M/análise Interleucinas/análise Contagem de Linfócitos Masculino Meia-Idade Estudos Prospectivos Receptores CXCR5/análise Receptores de Complemento 3d/análise Sofosbuvir/efeitos adversos Resposta Viral Sustentada Linfócitos T Reguladores Células Th17 Vasculite/sangue Vasculite/virologia [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Nm] Nome de substância: 0 (Antiviral Agents); 0 (BMS-790052); 0 (CXCR5 protein, human); 0 (Cryoglobulins); 0 (Imidazoles); 0 (Immunoglobulin M); 0 (Interleukins); 0 (Receptors, CXCR5); 0 (Receptors, Complement 3d); 0 (interleukin-21); WJ6CA3ZU8B (Sofosbuvir) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170906 [Lr] Data última revisão: 170906 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170315 [St] Status: MEDLINE

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[PMID]: 28266038 [Au] Autor: Wilen CB; Booth GS; Grossman BJ; Lane WJ; Szklarski PC; Jackups R [Ad] Endereço: Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri. [Ti] Título: Using direct antiglobulin test results to reduce unnecessary cold agglutinin testing. [So] Source: Transfusion;57(6):1480-1484, 2017 Jun. [Is] ISSN: 1537-2995 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Cold agglutinin disease (CAD) is a rare autoimmune hemolytic anemia mediated by autoantibodies that preferentially react at 4°C. Laboratory testing for cold-reactive autoantibodies is laborious and may not be ordered judiciously, particularly in patients with a negative direct antiglobulin test (DAT). We sought to determine whether a negative DAT using anti-human complement (anti-C3) rules out elevated cold agglutinin (CA) titers and the diagnosis of CAD. STUDY DESIGN AND METHODS: We performed a retrospective study of patients with a CA test performed at three major academic medical centers: Barnes-Jewish Hospital (2003-2014), Vanderbilt University Medical Center (2007-2009), and Massachusetts General Hospital (2009-2014). RESULTS: This study included 801 patients, of whom 51% (n = 410) had a DAT within the 7 days before CA testing. A total of 98% of patients with a negative DAT using anti-C3 had a negative CA titer (<64). Only five subjects had a negative DAT using anti-C3 and an elevated CA titer. CONCLUSIONS: Overutilization of CA testing could be reduced by establishing laboratory acceptance criteria based on a positive DAT using anti-C3. Such acceptance criteria would have reduced CA testing by 68% for those with an available DAT result. [Mh] Termos MeSH primário: Teste de Coombs [Mh] Termos MeSH secundário: Anemia Hemolítica Autoimune/diagnóstico Anemia Hemolítica Autoimune/imunologia Autoanticorpos/análise Autoanticorpos/imunologia Crioglobulinas/análise Crioglobulinas/imunologia Seres Humanos Estudos Retrospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Autoantibodies); 0 (Cryoglobulins); 0 (cold agglutinins) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170919 [Lr] Data última revisão: 170919 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170308 [St] Status: MEDLINE [do] DOI: 10.1111/trf.14059

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[PMID]: 27940588 [Au] Autor: Jasiek M; Karras A; Le Guern V; Krastinova E; Mesbah R; Faguer S; Jourde-Chiche N; Fauchais AL; Chiche L; Dernis E; Moulis G; Fraison JB; Lazaro E; Jullien P; Hachulla E; Le Quellec A; Rémy P; Hummel A; Costedoat-Chalumeau N; Ronco P; Vanhille P; Meas-Yedid V; Cordonnier C; Ferlicot S; Daniel L; Seror R; Mariette X; Thervet E; François H; Terrier B [Ad] Endereço: Department of Nephrology, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Le Kremlin-Bicêtre. [Ti] Título: A multicentre study of 95 biopsy-proven cases of renal disease in primary Sjögren's syndrome. [So] Source: Rheumatology (Oxford);56(3):362-370, 2017 Mar 01. [Is] ISSN: 1462-0332 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: Objective.: Renal involvement is a rare event during primary SS (pSS). We aimed to describe the clinico-biological and histopathological characteristics of pSS-related nephropathy and its response to treatment. Methods.: We conducted a French nationwide, retrospective, multicentre study including pSS patients fulfilling American-European Consensus Group criteria or enlarged American-European Consensus Group criteria, and with biopsy-proven renal involvement. Results.: A total of 95 patients were included (median age 49 years). An estimated glomerular filtration rate (eGFR) of <60 ml/min was found in 82/95 patients (86.3%). Renal biopsy demonstrated tubulointerstitial nephritis (TIN) in 93 patients (97.9%), and frequent (75%) plasma cell infiltrates. Glomerular lesions were found in 22 patients (23.2%), mainly related to cryoglobulin. The presence of anti-SSA (76.8%) and anti-SSB (53.8%) antibodies was particularly frequent among patients with TIN and was associated with a worse renal prognosis. Eighty-one patients (85.3%) were treated, with CSs in 80 (98.8%) and immunosuppressive agents (mostly rituximab) in 21 cases (25.9%). Despite marked interstitial fibrosis at initial biopsy, kidney function improved significantly during the 12-month period following diagnosis (final eGFR 49.9 vs 39.8 ml/min/1.73 m 2 at baseline, P < 0.001). No proven benefit of immunosuppressive agents over steroid therapy alone was found in this study. Conclusion.: Renal involvement of pSS is mostly due to TIN with marked T, B and especially plasma cell infiltration. Renal dysfunction is usually isolated but can be severe. Use of CSs can improve the eGFR, but further studies are needed to define the best therapeutic strategy in this disease. [Mh] Termos MeSH primário: Nefrite Intersticial/epidemiologia Insuficiência Renal/epidemiologia Síndrome de Sjogren/epidemiologia [Mh] Termos MeSH secundário: Adolescente Corticosteroides/uso terapêutico Adulto Idoso Idoso de 80 Anos ou mais Anticorpos Antinucleares/imunologia Linfócitos B/patologia Biópsia Crioglobulinas Feminino França Seres Humanos Imunossupressores/uso terapêutico Glomérulos Renais/patologia Masculino Meia-Idade Nefrite Intersticial/tratamento farmacológico Nefrite Intersticial/imunologia Nefrite Intersticial/patologia Plasmócitos/patologia Insuficiência Renal/tratamento farmacológico Insuficiência Renal/imunologia Insuficiência Renal/patologia Estudos Retrospectivos Rituximab/uso terapêutico Síndrome de Sjogren/tratamento farmacológico Síndrome de Sjogren/imunologia Linfócitos T/patologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; MULTICENTER STUDY [Nm] Nome de substância: 0 (Adrenal Cortex Hormones); 0 (Antibodies, Antinuclear); 0 (Cryoglobulins); 0 (Immunosuppressive Agents); 0 (SS-A antibodies); 0 (SS-B antibodies); 4F4X42SYQ6 (Rituximab) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 170620 [Lr] Data última revisão: 170620 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 161213 [St] Status: MEDLINE [do] DOI: 10.1093/rheumatology/kew376

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[PMID]: 27866967 [Au] Autor: Sethi S; Yachoui R; Murray DL; Radhakrishnan J; Alexander MP [Ad] Endereço: Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN. [Ti] Título: Cryofibrinogen-Associated Glomerulonephritis. [So] Source: Am J Kidney Dis;69(2):302-308, 2017 Feb. [Is] ISSN: 1523-6838 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Cryofibrinogen is an under-recognized cryoprotein. Cryofibrinogen is a cryoprecipitate that develops following plasma refrigeration, but does not occur in cold serum. People with cryofibrinogenemia may be asymptomatic, but this cryoprotein can be associated with thromboembolic disease, particularly affecting the skin. Kidney manifestations are relatively uncommon, but are likely underestimated. We describe clinical features and kidney biopsy results in 2 patients with cryofibrinogen-related kidney disease. Both patients presented with proteinuria and hematuria. One had significant cutaneous ulcers and palpable purpura. Kidney biopsy in both cases showed membranoproliferative glomerulonephritis with no immunoglobulin deposition. Weak segmental capillary wall fibrinogen staining was noted in glomeruli. Immunofluorescence studies following pronase digestion failed to reveal masked immunoglobulin deposits. Ultrastructural studies were distinctive and characterized by organized deposits of large-bore with multilayered tubular structures and fine fibrillary structures in a matrix. To confirm the composition of deposits, we extracted the cryoprecipitate from plasma of a patient and performed ultrastructural studies, which showed identical ultrastructural characteristics to those seen on the kidney biopsy. We also performed proteomic analysis of the cryoprecipitate that confirmed the presence of fibrinogen. Subsequent laboratory evaluation was positive for cryofibrinogen in both patients on multiple occasions. Appropriate therapy was instituted in both patients, which included prednisone, immunosuppressive therapy, and avoidance of cold exposure. In summary, we present clinical, kidney biopsy, and laboratory findings and the treatment and follow-up of cryofibrinogen-associated glomerulonephritis. Awareness of this entity will result in accurate diagnoses, appropriate investigation, and treatment. [Mh] Termos MeSH primário: Crioglobulinas/análise Fibrinogênios Anormais/análise Glomerulonefrite Membranoproliferativa/etiologia [Mh] Termos MeSH secundário: Idoso Glomerulonefrite Membranoproliferativa/sangue Glomerulonefrite Membranoproliferativa/patologia Seres Humanos Masculino Microscopia Eletrônica [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Cryoglobulins); 0 (Fibrinogens, Abnormal); 0 (cryofibrinogen) [Em] Mês de entrada: 1705 [Cu] Atualização por classe: 170531 [Lr] Data última revisão: 170531 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161122 [St] Status: MEDLINE

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[PMID]: 27799164 [Au] Autor: Muchtar E; Magen H; Gertz MA [Ad] Endereço: Division of Hematology, Mayo Clinic, Rochester, MN; and. [Ti] Título: How I treat cryoglobulinemia. [So] Source: Blood;129(3):289-298, 2017 Jan 19. [Is] ISSN: 1528-0020 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Cryoglobulinemia is a distinct entity characterized by the presence of cryoglobulins in the serum. Cryoglobulins differ in their composition, which has an impact on the clinical presentation and the underlying disease that triggers cryoglobulin formation. Cryoglobulinemia is categorized into two main subgroups: type I, which is seen exclusively in clonal hematologic diseases, and type II/III, which is called mixed cryoglobulinemia and is seen in hepatitis C virus infection and systemic diseases such as B-cell lineage hematologic malignancies and connective tissue disorders. Clinical presentation is broad and varies between types but includes arthralgia, purpura, skin ulcers, glomerulonephritis, and peripheral neuropathy. Life-threatening manifestations can develop in a small proportion of patients. A full evaluation for the underlying cause is required, because each type requires a different kind of treatment, which should be tailored on the basis of disease severity, underlying disease, and prior therapies. Relapses can be frequent and can result in significant morbidity and cumulative organ impairment. We explore the spectrum of this heterogeneous disease by discussing the disease characteristics of 5 different patients. [Mh] Termos MeSH primário: Crioglobulinemia/classificação Crioglobulinemia/etiologia [Mh] Termos MeSH secundário: Adulto Doenças do Tecido Conjuntivo/complicações Crioglobulinemia/patologia Crioglobulinemia/terapia Crioglobulinas Feminino Hepatite C/complicações Seres Humanos Leucemia de Células B/complicações Linfoma de Células B/complicações Masculino Meia-Idade Recidiva [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Cryoglobulins) [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170823 [Lr] Data última revisão: 170823 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 161102 [St] Status: MEDLINE [do] DOI: 10.1182/blood-2016-09-719773

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[PMID]: 27608500 [Au] Autor: Lasso de la Vega M; Villarreal IM; López Moya J; García-Berrocal JR [Ad] Endereço: a ENT Department , 'Severo Ochoa' University Hospital , Leganes , Madrid , Spain. [Ti] Título: Extended high frequency audiometry can diagnose sub-clinic involvement in a seemingly normal hearing systemic lupus erythematosus population. [So] Source: Acta Otolaryngol;137(2):161-166, 2017 Feb. [Is] ISSN: 1651-2251 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: CONCLUSIONS: Sensorineural hearing loss must be considered within the clinical picture of systemic lupus erythematosus. The results confirm the usefulness of extended high-frequency audiometry in the audiologic testing of these patients, enabling the possibility of modifying or applying a preventive treatment for a possible hearing loss. OBJECTIVES: Hearing involvement is usually under-diagnosed with routine auditory examination. This study proposes the use of extended high-frequency audiometry to achieve a correct detection of a possible asymptomatic hypoacusis in early stages of the disease. The aim of this study is to analyze the hearing levels in extended high-frequencies in these patients and to correlate the hearing loss with the severity of the disease and the immunological parameters. METHODS: A descriptive cross-sectional study was performed. Fifty-five patients with systemic lupus erythematosus were included in the study. The control group consisted of 71 patients paired by age and sex with the study population. Both a pure tone audiometry and an extended high-frequency audiometry (8-18 KHz) were performed. RESULTS: In total, 70% were diagnosed with sensorineural hearing loss with extended high-frequency audiometry, overcoming the results obtained with pure tone audiometry (30.9%). Statistically significant correlations were found within the patients regarding sensorineural hearing loss related with age, disease activity and cryoglobulinemia. [Mh] Termos MeSH primário: Audiometria de Tons Puros/métodos Perda Auditiva Neurossensorial/etiologia Lúpus Eritematoso Sistêmico/complicações [Mh] Termos MeSH secundário: Adulto Estudos de Casos e Controles Estudos Transversais Crioglobulinas/metabolismo Feminino Perda Auditiva Neurossensorial/sangue Seres Humanos Lúpus Eritematoso Sistêmico/sangue Lúpus Eritematoso Sistêmico/imunologia Masculino Meia-Idade Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Cryoglobulins) [Em] Mês de entrada: 1703 [Cu] Atualização por classe: 170306 [Lr] Data última revisão: 170306 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160910 [St] Status: MEDLINE [do] DOI: 10.1080/00016489.2016.1219049

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[PMID]: 27258205 [Au] Autor: Papp J; Sandor B; Toth A; Biro K; Rabai M; Botor D; Kovacs D; Csernus Z; Toth K; Kesmarky G [Ad] Endereço: 1st Department of Medicine, University of Pecs, School of Medicine, Pecs, Hungary. [Ti] Título: Altered microrheological parameters in Raynaud's phenomenon. [So] Source: Clin Hemorheol Microcirc;65(1):23-29, 2017. [Is] ISSN: 1875-8622 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: Raynaud's phenomenon is an episodic, painful attack of the acral parts caused by local diminished blood supply. The aim of our study was to examine hemorheological parameters, cold agglutinins, cryoglobulins and their relationship in patients suffering from Raynaud's phenomenon.Blood was taken from 74 patients (mean age: 48 years, female/male: 56/18). Cold agglutinins and cryoglobulins were determined. Hemorheological parameters were also measured such as hematocrit, plasma and whole blood viscosity, red blood cell aggregation and deformability. Results were compared to a group of 58 healthy controls (mean age: 31.5 years, female/male: 24/34).Cold agglutinins were positive in 70%, cryoglobulins in 43% of patients. When compared to healthy controls, increased red blood cell aggregation (64.54  ±  8.93 vs. 61.11  ±  7.05) and decreased red blood cell deformability (0.669  ±  0.002 vs. 0.681  ±  0.001) was observed in Raynaud's patients (p < 0.05), but there were no differences in hematocrit (43.27% ± 3.85 vs. 44.10% ± 3.70), plasma (1.27 mPas ± 0.08 vs. 1.24 mPas ± 0.09) and whole blood viscosity (4.12 mPas ± 0.52 vs. 4.26 mPas ± 0.46). No differences were found between the hemorheological profile of cold agglutinin/cryoglobulin positive and negative patients. Also primary and secondary Raynaud's patients had similar rheological profile.Erythrocyte aggregation and deformability seems to be unfavorable in Raynaud's patients that can play a role in the disturbance of the microcirculation. [Mh] Termos MeSH primário: Doença de Raynaud/sangue Reologia [Mh] Termos MeSH secundário: Crioglobulinas Agregação Eritrocítica Deformação Eritrocítica Feminino Seres Humanos Masculino Meia-Idade [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Cryoglobulins); 0 (cold agglutinins) [Em] Mês de entrada: 1704 [Cu] Atualização por classe: 170426 [Lr] Data última revisão: 170426 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 160604 [St] Status: MEDLINE [do] DOI: 10.3233/CH-162069

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[PMID]: 27938559 [Au] Autor: Fan XH; Deng ZH; Xu XY [Ad] Endereço: Department of Gastroenterology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province 030001, China. [Ti] Título: [Serum CXCL-10 level in chronic hepatitis C patients with cryoglobulinemia and its influence on antiviral therapy]. [So] Source: Zhonghua Gan Zang Bing Za Zhi;24(10):744-748, 2016 Oct 20. [Is] ISSN: 1007-3418 [Cp] País de publicação: China [La] Idioma: chi [Ab] Resumo: To investigate the serum CXCL-10 level in chronic hepatitis C (CHC) patients with cryoglobulinemia and its influence on the effect of antiviral therapy. A total of 50 CHC patients were enrolled in the study. Cryoprecipitation was used to determine the nature of cryoglobulins in serum before treatment, and ELISA was used to measure the serum CXCL-10 level. The hepatitis C virus (HCV) genotype was detected, and serum HCV RNA level was measured at baseline, 4, 12, and 24 weeks of treatment, the end of treatment, and 24 weeks after treatment.. Compared with the cryoglobulin-negative patients, the cryoglobulin-positive patients had significantly higher baseline levels of HCV RNA [(6.28±0.79) log10 copies/ml vs (5.48±1.20) log10 copies/ml, = 0.009] and CXCL-10 (541.67±224.07 pg/ml vs 394.39±179.71 pg/ml, = 0.015). After the treatment with pegylated interferon-α-2a and ribavirin, the cryoglobulin-positive patients had a significantly lower proportion of individuals who achieved rapid virological response compared with the cryoglobulin-negative patients (33.3% vs 82.6%, < 0.001). The cryoglobulin-positive patients had a significantly lower rate of sustained virologic response than the cryoglobulin-negative patients (33.3% vs 78.3%, = 0.001). The patients with cryoglobulinemia have higher serum levels of HCV RNA and CXCL-10 and poor outcomes compared with those without cryoglobulinemia. [Mh] Termos MeSH primário: Antivirais/uso terapêutico Quimiocina CXCL10/sangue Crioglobulinemia Crioglobulinas/análise Hepacivirus/imunologia Hepatite C Crônica/tratamento farmacológico Interferon-alfa/uso terapêutico Polietilenoglicóis/uso terapêutico Ribavirina/uso terapêutico [Mh] Termos MeSH secundário: Adulto Antivirais/administração & dosagem Estudos de Casos e Controles Ensaio de Imunoadsorção Enzimática Feminino Hepacivirus/genética Hepatite C Crônica/sangue Hepatite C Crônica/virologia Seres Humanos Interferon-alfa/administração & dosagem Masculino Meia-Idade Polietilenoglicóis/administração & dosagem RNA Viral/sangue Proteínas Recombinantes/administração & dosagem Proteínas Recombinantes/uso terapêutico Ribavirina/administração & dosagem Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antiviral Agents); 0 (CXCL10 protein, human); 0 (Chemokine CXCL10); 0 (Cryoglobulins); 0 (Interferon-alpha); 0 (RNA, Viral); 0 (Recombinant Proteins); 30IQX730WE (Polyethylene Glycols); 49717AWG6K (Ribavirin); Q46947FE7K (peginterferon alfa-2a) [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170925 [Lr] Data última revisão: 170925 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 161213 [St] Status: MEDLINE [do] DOI: 10.3760/cma.j.issn.1007-3418.2016.10.006

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[PMID]: 27298398 [Au] Autor: Sapatnekar S; Figueroa PI [Ad] Endereço: From the Section of Transfusion Medicine, Department of Laboratory Medicine, Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH. sapatns@ccf.org. [Ti] Título: Cold Antibodies in Cardiovascular Surgery: Is Preoperative Screening Necessary? [So] Source: Am J Clin Pathol;145(6):789-95, 2016 Jun. [Is] ISSN: 1943-7722 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: OBJECTIVES: Cold antibodies (CAs) are rarely significant for transfusion, but they can cause complications under the hypothermic conditions of cardiovascular surgery. The purpose of this study was to determine the incidence of such complications. METHODS: Patients with CAs who underwent cardiovascular surgery were identified, and their records were reviewed for intraoperative complications attributable to CAs. RESULTS: Over 14.5 years, of the 47,373 patients who underwent cardiovascular surgery, 99 had CAs before or within 30 days after surgery. Ninety-seven patients had hypothermic surgery, and intraoperative agglutination was noted in four; two of these cases were never reported to the transfusion service. CONCLUSIONS: The incidence of intraoperative complications among our patients with CAs was only 4%; therefore, the use of special testing protocols for the preoperative identification of CAs is neither necessary nor justified. Patient risk is best managed by preoperative clinical evaluation for potentially pathogenic CAs and intraoperative vigilance for agglutination. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos Cardiovasculares/efeitos adversos Hemaglutinação Complicações Intraoperatórias/epidemiologia Complicações Intraoperatórias/etiologia [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Crioglobulinas/efeitos adversos Feminino Seres Humanos Hipotermia Induzida/efeitos adversos Masculino Meia-Idade [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Nm] Nome de substância: 0 (Cryoglobulins); 0 (cold agglutinins) [Em] Mês de entrada: 1702 [Cu] Atualização por classe: 170817 [Lr] Data última revisão: 170817 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 160615 [St] Status: MEDLINE [do] DOI: 10.1093/ajcp/aqw054

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