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[PMID]:29301743
[Au] Autor:Dowlatshahi EA; Diercks G; van Doorn M
[Ad] Endereço:Erasmus Medical Centre, Rotterdam, Netherlands emmilia.dowlat@gmail.com.
[Ti] Título:Blisters in disguise.
[So] Source:BMJ;360:j5364, 2018 01 04.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Vesícula/imunologia
Vesícula/patologia
Pênfigo/imunologia
Pênfigo/patologia
Pele/patologia
[Mh] Termos MeSH secundário: Corticosteroides/administração & dosagem
Corticosteroides/uso terapêutico
Idoso
Vesícula/tratamento farmacológico
Vesícula/epidemiologia
Desmogleínas/imunologia
Diagnóstico Diferencial
Ensaio de Imunoadsorção Enzimática/métodos
Técnica Direta de Fluorescência para Anticorpo/métodos
Seres Humanos
Fatores Imunológicos/administração & dosagem
Fatores Imunológicos/uso terapêutico
Imunossupressores/administração & dosagem
Imunossupressores/uso terapêutico
Incidência
Masculino
Pênfigo/tratamento farmacológico
Pênfigo/epidemiologia
Rituximab/administração & dosagem
Rituximab/uso terapêutico
Pele/imunologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Desmogleins); 0 (Immunologic Factors); 0 (Immunosuppressive Agents); 4F4X42SYQ6 (Rituximab)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j5364


  2 / 2924 MEDLINE  
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[PMID]:27774621
[Au] Autor:Schulz U; Reil A; Kiefel V; Bux J; Moog R
[Ad] Endereço:DRK Blood Service North-East, Cottbus, Germany.
[Ti] Título:Evaluation of a new microbeads assay for granulocyte antibody detection.
[So] Source:Transfusion;57(1):70-81, 2017 01.
[Is] ISSN:1537-2995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To reduce the risk of transfusion-associated acute lung injury (TRALI), a high number of plasma donors were tested for human leukocyte antigen (HLA) and human neutrophil antigen (HNA) antibodies. For HNA antibody detection, the gold standard is a combination of the granulocyte immunofluorescence test (GIFT) and the granulocyte agglutination test (GAT). However, these tests are not suitable for a high-throughput of samples. STUDY DESIGN AND METHODS: To evaluate the new generation of the LABScreen MULTI assay (One Lambda, Inc.), which has special new beads for all the known HNA specificities, including HNA-3a, 97 sera samples containing well-defined HNA antibodies were used. For background testing, we used 91 samples from plasma donors previously identified by GAT, GIFT, and the monoclonal antibody-specific immobilization of granulocyte antigens (MAIGA) assay. RESULTS: Compared with previous tests, the new LABScreen MULTI assay was highly specific for the HNA-1a, HNA-1b, HNA-2, and HNA-3a antibody specificities required to prevent TRALI. Ninety-eight percent of the HNA-1a, HNA-1b, and HNA-2 antibodies could be detected as true positive; and 90% of the HNA-3a antibodies were recognized correctly as positive. False-positive reactions were identified in 5.5% of samples that previously tested negative. CONCLUSION: The detection of HNA-3a antibody specificities could be integrated into the new LABScreen MULTI assay; however, we detected only 90%. In addition, we detected further HNA antibodies, such as HNA-1c, HNA-1d, and some HNA-3b and HNA-4a antibodies. The new generation of LABScreen MULTI is a great step toward feasible high-throughput testing for HNA antibodies. Nevertheless, GIFT and GAT remain the gold-standard methods for the differentiation of rare and currently unknown HNA specificities.
[Mh] Termos MeSH primário: Autoanticorpos/sangue
Isoantígenos/sangue
Microesferas
[Mh] Termos MeSH secundário: Lesão Pulmonar Aguda/sangue
Lesão Pulmonar Aguda/etiologia
Lesão Pulmonar Aguda/prevenção & controle
Testes de Aglutinação/métodos
Anticorpos Monoclonais/química
Feminino
Técnica Direta de Fluorescência para Anticorpo/métodos
Seres Humanos
Masculino
Reação Transfusional
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Autoantibodies); 0 (Isoantigens)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13878


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[PMID]:27772619
[Au] Autor:Abad CL; Razonable RR
[Ad] Endereço:Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN.
[Ti] Título:α Herpes Virus Infections Among Renal Transplant Recipients.
[So] Source:Semin Nephrol;36(5):344-350, 2016 09.
[Is] ISSN:1558-4488
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The α herpes viruses HSV-1, HSV-2, and VZV often reactivate in the setting of immune suppression after solid organ transplantation. Oral or genital mucocutaneous disease is the most common clinical manifestation of HSV disease while VZV manifests as varicella (or chickenpox) or reactivation herpes zoster, characterized by a diffuse rash, or a painful unilateral vesicular eruption in a dermatomal distribution, respectively. The diagnosis of HSV and VZV is primarily based on history and clinical presentation, although diagnostic tests may be necessary for atypical presentations of disease. Treatment usually involves oral or intravenous antiviral therapy, depending on severity of illness.
[Mh] Termos MeSH primário: Varicela/induzido quimicamente
Rejeição de Enxerto/prevenção & controle
Herpes Simples/induzido quimicamente
Herpes Zoster/induzido quimicamente
Imunossupressores/efeitos adversos
Falência Renal Crônica/cirurgia
Transplante de Rim
[Mh] Termos MeSH secundário: Antivirais/uso terapêutico
Varicela/diagnóstico
Varicela/tratamento farmacológico
Varicela/prevenção & controle
Vacina contra Varicela/uso terapêutico
Técnicas de Cultura
Técnica Direta de Fluorescência para Anticorpo
Herpes Simples/diagnóstico
Herpes Simples/tratamento farmacológico
Herpes Zoster/diagnóstico
Herpes Zoster/tratamento farmacológico
Herpes Zoster/prevenção & controle
Herpesvirus Humano 1
Herpesvirus Humano 2
Herpesvirus Humano 3
Seres Humanos
Reação em Cadeia da Polimerase
Testes Sorológicos
Ativação Viral
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antiviral Agents); 0 (Chickenpox Vaccine); 0 (Immunosuppressive Agents)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE


  4 / 2924 MEDLINE  
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[PMID]:28463665
[Au] Autor:Cristovam E; Almeida D; Caldeira D; Ferreira JJ; Marques T
[Ad] Endereço:1​Laboratory of Microbiology and Molecular Biology, Centro Hospitalar de Lisboa Ocidental, Rua da Junqueira, 126, 1349-019 Lisbon, Portugal.
[Ti] Título:Accuracy of diagnostic tests for Legionnaires' disease: a systematic review.
[So] Source:J Med Microbiol;66(4):485-489, 2017 Apr.
[Is] ISSN:1473-5644
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Rapid and effective diagnosis of Legionnaires' disease (LD) cases is extremely important so that timely and appropriate therapy can be provided, thereby lowering the morbidity and mortality rates and reducing the health and economic costs associated with this disease. METHODOLOGY: Diagnosis is established solely by microbiological tests. There are several methods available, each with different performance, sensitivity and specificity characteristics, and further understanding is required. Our objective was to assess the accuracy of urinary antigen detection, direct fluorescent antibody (DFA) staining, serological testing and the polymerase chain reaction (PCR) method versus culture analysis (the reference standard) in patients suspected of being infected with Legionella or patients with laboratory-confirmed LD. We performed a MEDLINE search in November 2014. Two authors independently assessed the trials and extracted data. Pooled analysis was performed through Meta-DiSc version 1.4. RESULT: The inclusion criteria were met by 11 studies. All the studies evaluated PCR and DFA tests to detect Legionella in clinical specimens, comparing them to culture techniques, and were included in the meta-analysis. The pooled sensitivity and specificity for PCR were 83 % [95 % confidence interval (CI): 79-87 %] and 90 % (95 % CI: 88-92 %), respectively. DFA was evaluated in one study and the sensitivity and specificity of this test were 67 % (95 % CI: 30-93 %) and 100 % (95 % CI: 91-100 %), respectively. PCR had high sensitivity and specificity for early diagnosis of LD. CONCLUSION: Culture analysis is deemed necessary for epidemiological studies, molecular strain typing and antibiotic sensibility evaluations; however, the performance of PCR in recent studies calls for additional, well-designed studies in order to achieve the best standard test, which will enable optimization of the Legionella infection diagnostic.
[Mh] Termos MeSH primário: Testes Diagnósticos de Rotina/métodos
Técnica Direta de Fluorescência para Anticorpo/métodos
Doença dos Legionários/diagnóstico
Reação em Cadeia da Polimerase/métodos
[Mh] Termos MeSH secundário: Antígenos de Bactérias/análise
Seres Humanos
Doença dos Legionários/microbiologia
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antigens, Bacterial)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1099/jmm.0.000454


  5 / 2924 MEDLINE  
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[PMID]:29241772
[Au] Autor:St John J; Vedak P; Garza-Mayers AC; Hoang MP; Nigwekar SU; Kroshinsky D
[Ad] Endereço:Department of Dermatology, Massachusetts General Hospital, Harvard University, Boston, Massachusetts.
[Ti] Título:Location of skin lesions in Henoch-Schönlein purpura and its association with significant renal involvement.
[So] Source:J Am Acad Dermatol;78(1):115-120, 2018 Jan.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Henoch-Schönlein purpura (HSP) is a small vessel IgA-predominant vasculitis. OBJECTIVE: To describe adult patients with HSP and determine if the distribution of skin lesions (ie, purpura above the waist or purpura below the waist only), is a predictor of significant renal involvement at the time of the skin biopsy and the months following. METHODS: A retrospective study on renal function from 72 adult patients with skin-biopsy proven HSP. Longitudinal renal data were analyzed after HSP diagnosis by using baseline renal function for comparison. RESULTS: Statistical analysis adjusted for sex, age, and baseline creatinine revealed a trend between HSP lesions only on the upper and lower extremities and long-term renal involvement (4.767, P = .067). Moreover, in another analysis adjusted for age and baseline creatinine, lesions located only on the upper and lower extremities significantly increased the odds of having long-term significant renal involvement (6.55, P = .049) in men. LIMITATIONS: This retrospective study used patient information that was subject to selection bias. CONCLUSION: In patients with HSP, skin lesion distribution on the extremities might be predictive of significant long-term renal involvement and might be critical for risk stratification and development of personalized diagnostics and therapeutics.
[Mh] Termos MeSH primário: Nefropatias/etiologia
Nefropatias/patologia
Púrpura de Schoenlein-Henoch/complicações
Púrpura de Schoenlein-Henoch/patologia
[Mh] Termos MeSH secundário: Abdome/fisiopatologia
Centros Médicos Acadêmicos
Adulto
Fatores Etários
Biópsia por Agulha
Estudos de Coortes
Bases de Dados Factuais
Feminino
Técnica Direta de Fluorescência para Anticorpo/métodos
Seguimentos
Seres Humanos
Imuno-Histoquímica
Testes de Função Renal
Estudos Longitudinais
Extremidade Inferior/fisiopatologia
Masculino
Meia-Idade
Valor Preditivo dos Testes
Estudos Retrospectivos
Medição de Risco
Índice de Gravidade de Doença
Fatores Sexuais
Extremidade Superior/fisiopatologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171229
[Lr] Data última revisão:
171229
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE


  6 / 2924 MEDLINE  
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[PMID]:28860044
[Au] Autor:Labowsky MT; Stinnett SS; Liss J; Daluvoy M; Hall RP; Shieh C
[Ad] Endereço:Duke University School of Medicine, Durham, North Carolina. Electronic address: marytlabowsky@gmail.com.
[Ti] Título:Clinical Implications of Direct Immunofluorescence Findings in Patients With Ocular Mucous Membrane Pemphigoid.
[So] Source:Am J Ophthalmol;183:48-55, 2017 Nov.
[Is] ISSN:1879-1891
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To examine the clinical implications of positive or negative direct immunofluorescence biopsies (DIF) in patients with clinically typical ocular mucous membrane pemphigoid (MMP). DESIGN: Retrospective cohort study. METHODS: The study population was patients with clinically typical ocular MMP disease with documented DIF results who were followed for at least 1 year at the Duke University multidisciplinary ocular MMP clinic. Data were collected by chart review and included patient demographics, clinical examination findings, and history of autoimmune disease and/or malignancy, as well as topical, systemic, and surgical treatments received. Main outcome measures included MMP Disease Area Index, Foster stages, proportion legally blind, duration of follow-up, and use of systemic immunosuppression and ocular procedures in treatment. RESULTS: In multivariable analysis restricted to 55 patients, patients with negative and positive biopsies were similar in the outcome measures; however, positive-biopsy patients were more likely to be treated with systemic immunosuppression and were followed for longer at our clinic. Patients with isolated ocular disease were also more likely to have negative biopsies compared to those who also had extraocular disease. Patients who had conjunctival biopsies were more likely to have a negative direct immunofluorescence result than patients with biopsies from other sites. CONCLUSIONS: We encourage clinicians and patients to consider treatment with systemic immunosuppression even in the absence of diagnosis confirmation by DIF. Furthermore, this study supports current standard of care to pursue a nonocular biopsy of normal-appearing, perilesional skin or oral mucosa when possible.
[Mh] Termos MeSH primário: Autoanticorpos/análise
Túnica Conjuntiva/patologia
Doenças da Túnica Conjuntiva/diagnóstico
Técnica Direta de Fluorescência para Anticorpo/métodos
Penfigoide Mucomembranoso Benigno/diagnóstico
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Autoanticorpos/imunologia
Membrana Basal/patologia
Biópsia
Doenças da Túnica Conjuntiva/imunologia
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Penfigoide Mucomembranoso Benigno/imunologia
Reprodutibilidade dos Testes
Estudos Retrospectivos
Índice de Gravidade de Doença
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE


  7 / 2924 MEDLINE  
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[PMID]:28722591
[Au] Autor:Bennett MD; Abdad MY; Stenos J
[Ad] Endereço:Murdoch University, Western Australia, Australia.
[Ti] Título:Serological Evidence of spp. in Western Australian Dogs.
[So] Source:Am J Trop Med Hyg;97(2):407-412, 2017 Aug.
[Is] ISSN:1476-1645
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:It has been claimed that dogs can be useful sentinels for public health monitoring of vector-borne infectious diseases, including spp. We used 153 canine blood samples opportunistically collected at Murdoch University Veterinary Hospital and 156 canine sera collected from Aboriginal communities in northwest Western Australia to test for evidence of spp. exposure, using microimmunofluorescence (MIF) in the latter case, and both MIF and polymerase chain reaction (PCR) in the former. Conventional and real-time PCR failed to amplify any spp. DNA. The seroprevalence for spotted fever group/transitional group spp. in Western Australian dogs was 17.3% (54/312), and for typhus group (TG) spp., 18.4% (57/310), with a cut-off titer of 1:128. Young dogs (≤ 2 years) from Aboriginal communities had significantly lower seropositivity to TG spp. compared with all other groups, and young Perth dogs had a significantly higher seropositivity to TG spp. than all Aboriginal community dogs.
[Mh] Termos MeSH primário: Anticorpos Antibacterianos/sangue
Doenças do Cão/epidemiologia
Doenças do Cão/microbiologia
Infecções por Rickettsia/sangue
[Mh] Termos MeSH secundário: Fatores Etários
Animais
Austrália/epidemiologia
Doenças do Cão/sangue
Cães
Técnica Direta de Fluorescência para Anticorpo
Reação em Cadeia da Polimerase em Tempo Real
Estudos Soroepidemiológicos
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Bacterial)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170720
[St] Status:MEDLINE
[do] DOI:10.4269/ajtmh.16-0998


  8 / 2924 MEDLINE  
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[PMID]:28683092
[Au] Autor:Moodley B; Tempia S; Frean JA
[Ad] Endereço:Centre for Emerging, Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg, South Africa.
[Ti] Título:Comparison of quantitative real-time PCR and direct immunofluorescence for the detection of Pneumocystis jirovecii.
[So] Source:PLoS One;12(7):e0180589, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Pneumocystis pneumonia (PCP) is a serious risk for HIV-positive patients. Asymptomatic infection or colonisation with P. jirovecii has been shown to occur frequently. PCR assays frequently identify such cases, due to their high sensitivity. Quantitative real-time PCR (qPCR) gene copy number cut-off values have been suggested to differentiate colonisation and infection; these need to be standardised for routine use. We compared the results of qPCR with an immunofluorescence assay (IFA) to determine a specific cut-off value. METHODS: From March 2005 through June 2009, induced sputum specimens were collected from adult patients who were clinically suspected of having PCP, at the Chris Hani Baragwanath Hospital in Gauteng, South Africa. Laboratory diagnosis of PCP was done by a conventional direct IFA and a qPCR assay. A receiver operating characteristic (ROC) analysis was performed to determine a suitable copy number cut-off value. RESULTS: P. jirovecii was identified in 51% (156/305) and 67% (204/305) of specimens using IFA and qPCR, respectively. The cut-off value for the qPCR that best predicted the IFA results was 78 copies/5 µl (area under ROC curve 0.92). The sensitivity and specificity of qPCR using this cut-off was 94.6% and 89.1%, respectively, compared with the IFA. DISCUSSION: The results of the ROC curve analysis indicate an excellent predictive value of the qPCR using the proposed cut-off. However, the IFA test is an imperfect gold standard and so this cut-off should not be used in isolation; clinical data should also contribute to the interpretation of the qPCR result.
[Mh] Termos MeSH primário: Técnica Direta de Fluorescência para Anticorpo/métodos
Pneumocystis carinii/isolamento & purificação
Reação em Cadeia da Polimerase em Tempo Real/métodos
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Pneumocystis carinii/genética
Pneumonia por Pneumocystis/diagnóstico
Pneumonia por Pneumocystis/microbiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0180589


  9 / 2924 MEDLINE  
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[PMID]:28676329
[Au] Autor:Shimanovich I; Nitz JM; Zillikens D
[Ad] Endereço:Department of Dermatology, University of Lübeck, Lübeck, Germany. Electronic address: iakov.shimanovich@uksh.de.
[Ti] Título:Multiple and repeated sampling increases the sensitivity of direct immunofluorescence testing for the diagnosis of mucous membrane pemphigoid.
[So] Source:J Am Acad Dermatol;77(4):700-705.e3, 2017 Oct.
[Is] ISSN:1097-6787
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Mucous membrane pemphigoid (MMP) is an autoimmune disease characterized by the predominant blistering of mucosal surfaces and the linear deposition of complement, IgG, or IgA along the basement membrane detected by direct immunofluorescence (DIF) test. OBJECTIVE: To assess the impact of multiple and repeated DIF sampling on establishing the diagnosis of MMP. METHODS: We reviewed the results of DIF studies in 136 nonlesional biopsies from 78 patients who were immunologically confirmed to have MMP. RESULTS: Thirty-six of 52 patients (69%) who underwent only 1 biopsy at the first workup were positive. In 13 cases, the initial single biopsy was negative, and later biopsies were positive. Twenty-two of 26 patients (85%) who underwent multiple biopsies at the initial workup showed ≥1 positive DIF test result. Simultaneously obtained biopsies yielded discordant positive and negative findings in 11 patients. Overall, 74 of 78 patients (95%) had ≥1 positive result by DIF test. In the remaining 4 cases, the diagnosis was confirmed by the detection of circulating autoantibodies against BP180. LIMITATIONS: This is a retrospective, single-center study. CONCLUSION: Our data demonstrate that multiple and repeated biopsies increase the sensitivity of the DIF test for MMP diagnosis. Negative DIF test findings in cases clinically suggestive of MMP should prompt repeat biopsies.
[Mh] Termos MeSH primário: Membrana Basal/patologia
Proteínas do Sistema Complemento/análise
Imunoglobulina A/análise
Imunoglobulina G/análise
Penfigoide Mucomembranoso Benigno/diagnóstico
Penfigoide Mucomembranoso Benigno/patologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Autoanticorpos/sangue
Autoantígenos/imunologia
Membrana Basal/química
Biópsia
Moléculas de Adesão Celular/imunologia
Feminino
Técnica Direta de Fluorescência para Anticorpo
Seres Humanos
Masculino
Meia-Idade
Colágenos não Fibrilares/imunologia
Penfigoide Mucomembranoso Benigno/sangue
Estudos Retrospectivos
Sensibilidade e Especificidade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Autoantibodies); 0 (Autoantigens); 0 (Cell Adhesion Molecules); 0 (Immunoglobulin A); 0 (Immunoglobulin G); 0 (Non-Fibrillar Collagens); 0 (collagen type XVII); 0 (kalinin); 9007-36-7 (Complement System Proteins)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170927
[Lr] Data última revisão:
170927
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE


  10 / 2924 MEDLINE  
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[PMID]:28533859
[Au] Autor:Aounallah A; Jrad M; Ksiaa M; Mokni S; Saidi W; Boussofara L; Sriha B; Denguezli M; Ghariani N; Belajouza C; Nouira R
[Ad] Endereço:Université de Sousse, Tunisie.
[Ti] Título:[A particular type of cicatricial Pemphigoid with unique IgA deposit].
[Ti] Título:Forme particulière de Pemphigoide cicatricielle à dépôt unique d'IgA..
[So] Source:Pan Afr Med J;26:136, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Cicatricial Pemphigoid is a subepithelial bullous dermatosis which essentially involves the mucous membranes with cicatricial evolution We report the case of a 66-year old patient hospitalized with erosive gingivitis associated with dysphagia, dyspnea and blurred vision. Dermatologic examination showed erosive lesions involving the palate and the pharynx. Ophthalmologic examination showed symblepharons, ectropion and bilateral cataract. Gingival biopsy revealed a necrotic detachment of the buccal epithelium. Direct immunofluorescence showed linear IgA deposit at the dermo-epidermal junction. Indirect immunofluorescence test was negative. The diagnosis of cicatricial pemphigoid was confirmed. Esophagogastroduodenoscopy objectified double stenosis of the esophagus. Nasopharyngeal and bronchial endoscopy showed ulceration of the epiglottis, hypopharynx, pharynx and bronchial tree. The patient was treated with Solumedrol bolus corresponding to 0.5mg/kg/day prednisone associated with 100mg/day disulone. The patient showed a favorable early clinical outcome complicated because of the aggravation of dysphagia and esophageal stenosis after 2 months. Our case study is singular due to the occurrence of a cicatricial pemphigoid in a male patient with a serious clinical picture due to lesions extending to conjunctival, oral, nasal, esophageal and bronchial mucous membranes associated with direct immunofluorescence only showing IgA deposit.
[Mh] Termos MeSH primário: Dapsona/administração & dosagem
Imunoglobulina A/imunologia
Hemissuccinato de Metilprednisolona/administração & dosagem
Penfigoide Mucomembranoso Benigno/fisiopatologia
[Mh] Termos MeSH secundário: Idoso
Transtornos de Deglutição/etiologia
Endoscopia do Sistema Digestório
Estenose Esofágica/etiologia
Técnica Direta de Fluorescência para Anticorpo
Seres Humanos
Masculino
Penfigoide Mucomembranoso Benigno/diagnóstico
Penfigoide Mucomembranoso Benigno/imunologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Immunoglobulin A); 5GMR90S4KN (Methylprednisolone Hemisuccinate); 8W5C518302 (Dapsone)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170613
[Lr] Data última revisão:
170613
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170524
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.26.136.9702



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