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1.
Rev. Hosp. Ital. B. Aires (2004) ; 40(4): 199-207, dic. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1145501

ABSTRACT

La encefalitis límbica es una enfermedad infrecuente y potencialmente grave, que puede o no ser paraneoplásica y se caracteriza por déficit de la memoria reciente, alteraciones psiquiátricas y convulsiones. De origen autoinmunitario, está asociada a anticuerpos séricos e intratecales contra antígenos neuronales intracelulares y de superficie, con especial afectación de zonas límbicas. En este artículo se revisan aspectos históricos y epidemiológicos, patogenia, síndromes más frecuentes y mejor delimitados, histopatología y estudios complementarios. Se repasan también las dificultades del diagnóstico diferencial y la necesidad de descartar siempre un tumor subyacente. La detección de autoanticuerpos neuronales es importante para el diagnóstico, la planificación terapéutica y el pronóstico. La inmunoterapia y, si corresponde, el tratamiento de la neoplasia son cruciales para lograr una recuperación neurológica sustancial. La encefalitis límbica es una entidad probablemente subdiagnosticada, con un pronóstico más favorable si se trata de forma temprana. El actual conocimiento de su patogenia puede además aportar claridad para la mejor comprensión de otros síndromes neurológicos y psiquiátricos que puedan compartir mecanismos autoinmunitarios, como algunos trastornos psicóticos y epilepsias farmacorresistentes. (AU)


Limbic encephalitis is a rare and potentially serious disease, which may or may not be paraneoplastic and is characterized by recent memory deficits, psychiatric disturbances and seizures. Of autoimmune origin, it is associated with serum and intrathecal antibodies against intracellular and surface neuronal antigens, with special involvement of limbic areas. This article reviews historical and epidemiological aspects, pathogenesis, more frequent and better defined syndromes, histopathology and complementary studies. The difficulties of differential diagnosis and the need to always rule out an underlying tumor are also reviewed. Detection of neuronal autoantibodies is important for diagnosis, therapeutic planning and prognosis. Immunotherapy and, if appropriate, neoplasm treatment, are crucial to achieve substantial neurological recovery. Limbic encephalitis is probably an underdiagnosed entity, with a more favorable prognosis if treated early. The current knowledge of its pathogenesis may also provide clarity for a better understanding of other neurological and psychiatric syndromes that may share autoimmune mechanisms, such as some psychotic disorders and drug-resistant epilepsies. (AU)


Subject(s)
Humans , Autoantibodies/metabolism , Autoimmune Diseases/pathology , Paraneoplastic Syndromes, Nervous System/pathology , Limbic Encephalitis/pathology , Psychotic Disorders/diagnosis , Psychotic Disorders/etiology , Autoimmune Diseases/diagnosis , Autoimmune Diseases/etiology , Autoimmune Diseases/therapy , Review Literature as Topic , Paraneoplastic Syndromes, Nervous System/diagnosis , Paraneoplastic Syndromes, Nervous System/etiology , Paraneoplastic Syndromes, Nervous System/therapy , Limbic Encephalitis/diagnosis , Limbic Encephalitis/etiology , Limbic Encephalitis/history , Limbic Encephalitis/therapy , Epilepsy/diagnosis , Epilepsy/etiology
2.
Rev. bras. cir. plást ; 34(4): 567-570, oct.-dec. 2019. ilus
Article in English, Portuguese | LILACS | ID: biblio-1047930

ABSTRACT

O pioderma gangrenoso (PG) é doença inflamatória da pele, que pode se desenvolver espontaneamente, associado a certas doenças sistêmicas e neoplásicas, ou ao trauma cirúrgico, incluindo os das mamas. Há relatos cada vez mais frequentes, considerando o aumento desse procedimento nos dias atuais. A manifestação clínica das úlceras é característica e deve ser lembrada nas evoluções cicatriciais desfavoráveis com intensa reação inflamatória, perdas teciduais, secreção sanguinolenta e/ ou purulenta, fundo granuloso e bordas elevadas. Relatase o caso de paciente que teve pioderma gangrenoso após mamoplastia redutora. Respondeu ao corticosteroide sistêmico, e vem evoluindo sem recidivas até o momento.


Pyoderma gangrenosum (PG) is an inflammatory disease of the skin that may develop spontaneously. It is associated with certain systemic and neoplastic diseases, including those of the breasts. PG is also associated with surgical trauma. It has been increasingly reported, along with the increase in the incidence of reduction mammoplasty procedures. The clinical manifestation of ulcers is characteristic of PG and it should be considered in cases of poor healing with intense inflammatory reaction, tissue loss, bloody and/ or purulent secretion, granular background, and lesions with high edges. We describe a patient who developed PG after reduction mammoplasty. She has since responded to systemic corticosteroids and has had no relapse to date.


Subject(s)
Humans , Female , Middle Aged , History, 21st Century , Postoperative Complications , Skin Diseases , Autoimmune Diseases , Mammaplasty , Pyoderma Gangrenosum , Diagnosis, Differential , Postoperative Complications/surgery , Postoperative Complications/therapy , Skin Diseases/surgery , Skin Diseases/complications , Skin Diseases/therapy , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Surgical Procedures, Operative , Surgical Procedures, Operative/methods , Mammaplasty/methods , Pyoderma Gangrenosum/surgery , Pyoderma Gangrenosum/complications , Pyoderma Gangrenosum/therapy
3.
Rev. bras. enferm ; 72(4): 994-1000, Jul.-Aug. 2019. graf
Article in English | LILACS, BDENF | ID: biblio-1020533

ABSTRACT

ABSTRACT Objective: describe the development of a virtual learning object to provide information about autologous transplantation of hematopoietic stem cells to autoimmune diseases. Methods: methodological study of a website development, using the instructional design model that includes Analysis, Design, Development and Implementation. Results: the virtual object, available at http://www.transplantardai.com.br, was developed in a web platform, in the Hypertext Markup Language, using the software WebAcappella - Responsive Website Creator (Intuisphere, France 2016). The content was structured in the modules: History, Transplant, Autoimmune Diseases, Links, Guidelines, Speech Team and Doubts. The icons and menus were created in order to attract the user, facilitating the search for information and allowing maximum use of the resources available on the website. Conclusion: the methodology used allowed the development of the virtual learning object, which can be used as a tool to guide and disseminate knowledge about this treatment.


RESUMEN Objetivo: describir el desarrollo de un objeto de aprendizaje virtual para proporcionar información sobre el trasplante autólogo de células madre hematopoyéticas en las enfermedades autoinmunes. Métodos: estudio metodológico del desarrollo del sitio web, utilizando el modelo de diseño instruccional (Análisis, Diseño, Desarrollo e Implementación). Resultados: el objeto virtual, disponible en http://www.transplantardai.com.br, fue desarrollado en una plataforma web, en el lenguaje de marcación Hypertext Markup Language, utilizando el software WebAcappella - Responsive Website Creator (Intuisphere, Francia 2016). El contenido se estructuró en los módulos: Historia, Trasplante, Enfermedades Autoinmunes, Links, Guías, Habla Equipo y Dudas. Los iconos y menús fueron creados para atraer al usuario, facilitando la búsqueda de información y permitiendo el máximo aprovechamiento de los recursos disponibles en el sitio web. Conclusión: la metodología utilizada permitió el desarrollo del objeto de aprendizaje virtual, que puede ser utilizado como una herramienta para guiar y difundir el conocimiento sobre este tratamiento.


RESUMO Objetivo: descrever o desenvolvimento de um objeto virtual de aprendizagem para disponibilização de informações sobre transplante autólogo de células-tronco hematopoéticas para doenças autoimunes. Métodos: estudo metodológico de desenvolvimento de um website, empregando o modelo de design instrucional que envolve Análise, Design, Desenvolvimento e Implementação. Resultados: o objeto virtual, disponível no endereço eletrônico http://www.transplantardai.com.br, foi desenvolvido em plataforma web, na linguagem de marcação Hypertext Markup Language, utilizando-se o software WebAcappella - Responsive Website Creator (Intuisphere, França 2016). O conteúdo foi estruturado nos seguintes módulos: História, Transplante, Doenças Autoimunes, Links, Orientações, Fala Equipe e Dúvidas. Os ícones e menus foram criados de modo a atrair o usuário, facilitando a busca de informações e permitindo máximo uso dos recursos disponíveis no website. Conclusão: a metodologia empregada permitiu o desenvolvimento do objeto virtual de aprendizagem, que poderá ser utilizado como ferramenta para orientar e disseminar o conhecimento sobre esse tratamento.


Subject(s)
Humans , Autoimmune Diseases/therapy , Problem-Based Learning/methods , Hematopoietic Stem Cell Transplantation/instrumentation , Hematopoietic Stem Cell Transplantation/methods , Virtual Reality , Autoimmune Diseases/complications , Problem-Based Learning/standards , France
4.
Rev. cuba. reumatol ; 21(2): e89, mayo.-ago. 2019. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1093823

ABSTRACT

La melatonina es una hormona neuroendocrina pleiotrópica, producida principalmente por la glándula pineal que regula el ritmo circadiano, es antiinflamatoria, inmunomoduladora, neuroprotectora, antioxidante. Se realizó una revisión sobre el tema empleando artículos de libre acceso en la base de datos Pubmed en el período de enero del 2013 a septiembre del 2018 con el objetivo de describir el rol de esta biomolécula en algunas enfermedades autoinmunes y reumatológicas, así como en otros procesos inflamatorios agudos y crónicos. La melatonina ha demostrado acciones favorables cuando se administra en enfermedades como la esclerosis múltiple, diabetes mellitus tipo l, cáncer. No obstante, puede empeorar las crisis en la artritis reumatoide(AU)


Melatonin is a pleiotropic neuroendocrine hormone, produced mainly by the pineal gland that regulates the circadian rhythm, is anti-inflammatory, immunomodulatory, neuroprotective, antioxidant. A review on the subject was performed using articles of free access in the Pubmed database from January 2013 to September 2018 with the aim of describing the role of this biomolecule in some autoimmune and rheumatological diseases, as well as in other acute and chronic inflammatory processes. Melatonin has shown favorable actions when it is administered in diseases such as multiple sclerosis, diabetes mellitus type I, cancer. However, it can worsen crises in rheumatoid arthritis(AU)


Subject(s)
Humans , Arthritis, Rheumatoid , Autoimmune Diseases/therapy , Melatonin/therapeutic use , Melatonin/adverse effects
5.
An. bras. dermatol ; 94(4): 399-404, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038298

ABSTRACT

Abstract: Background: The Autoimmune Bullous Disease Quality of Life (ABQOL) and the Treatment of Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaires proved to be reliable tools that measure the disease and treatment burden. Objectives: We aimed to assess the ABQOL and TABQOL in the Arabic population. Methods: The English questionnaires were translated into the Arabic language by a certified translation agency. Eighty autoimmune bullous disease (AIBD) patients were included in this study. Patients were asked to answer 2 questionnaires. After 1 week the same patients were asked to answer the same questionnaires again. Results: The age of the patients ranged from 19 to 81 years (mean=46), 19 males, 61 females. The ABQOL ranged from 0-37 (mean=16.4±9.2). The TABQOL ranged from 2-43 (mean=21.5±9.4). Test-retest reliability was acceptable, Cronbach's alpha was 0.76 for ABQOL and 0.74 for TABQOL. There was no significant correlation between the age of the patients and ABQOL, r =-0.2, p value was 0.183. There was a significant negative correlation between the age of the patients and the TABQOL, r=-0.2, p value was 0.039. There was a significant negative correlation between the education of the patients and the TABQOL, r=-0.3, p value was 0.007. Study limitations: Small sample size of some AIBDs and patients with severe disease. Conclusion: Objective and valuable measurements such as ABQOL and TABQOL are now available to help physicians understand their patient's distress and should be used in every patient with AIBD. Younger and less educated patients appear to have more effects on their QOL from the treatments.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Quality of Life , Autoimmune Diseases/physiopathology , Autoimmune Diseases/therapy , Surveys and Questionnaires/standards , Skin Diseases, Vesiculobullous/physiopathology , Skin Diseases, Vesiculobullous/therapy , Time Factors , Tunisia , Severity of Illness Index , Cross-Sectional Studies , Multivariate Analysis , Reproducibility of Results , Skin Diseases, Vesiculobullous/immunology , Treatment Outcome , Egypt , Language
6.
Rev. chil. reumatol ; 35(4): 158-160, 2019. ilus
Article in Spanish | LILACS | ID: biblio-1282356

ABSTRACT

El mayor acceso a las terapias biológicas para el tratamiento de múltiples enfer-medades autoinmune trae consigo el mayor riesgo de padecer eventos adversos relacionados al uso de estos2,4. Presentamos un caso clínico de una paciente con diagnóstico de artritis reumatoide en tratamiento con ANTI TNF


The greater access to biological therapies for the treatment of multiple autoim-mune diseases brings with it the greatest risk of suffering adverse events related to the use of these (2,4). We present a clinical case of a patient diagnosed with rheumatoid arthritis in treatment with ANTI TNF


Subject(s)
Humans , Female , Middle Aged , Lupus Erythematosus, Cutaneous/etiology , Tumor Necrosis Factor Inhibitors/adverse effects , Arthritis, Rheumatoid/complications , Autoimmune Diseases/therapy
7.
Gastroenterol. latinoam ; 30(1): 13-20, 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1103775

ABSTRACT

Autoimmune gastritis (AIG) or chronic atrophic gastritis type A, is a chronic inflammatory disease that affects the body and fundus mucosa of the stomach. It is an underdiagnosed entity, whose clinical presentation has a broad spectrum, which may include asymptomatic patients; hematological manifestations such as iron deficiency anemia, vitamin B12 deficiency anemia (so called pernicious); non-specific digestive symptoms like dyspepsia; neurological and psychiatric manifestations. AIG is associated with other autoimmune diseases, mainly hypothyroidism ("Tyrogastric Syndrome") and type 1 diabetes. It is characterized by the development of anti-parietal cell and anti-intrinsic factor antibodies, decrease in pepsinogen I (PGI) level with low PGI/PGII ratio (< 3), and high level of gastrin. Endoscopic findings are not sufficient for the diagnosis of gastric atrophy. The use of the Sydney pathological report protocol and the OLGA/OLGIM system to evaluate the severity of gastritis have improved their diagnosis and the possibility to establish the risk of developing gastric neoplasms. The importance of its diagnosis and surveillance is based on the development of type 1 neuroendocrine gastric neoplasms, in addition to an increased risk of the incidence of gastric adenocarcinoma. Currently, an individualized endoscopic surveillance seems reasonable, with a minimum interval of 3 years.


La gastritis autoinmune (GAI) o gastritis crónica atrófica tipo A, es una enfermedad inflamatoria crónica que afecta la mucosa del cuerpo y fondo del estómago. La GAI es una entidad subdiagnosticada, cuya presentación clínica es de amplio espectro, puede incluir pacientes asintomáticos; manifestaciones hematológicas, tales como anemia ferropriva, anemia por déficit de vitamina B12 (anemia perniciosa); digestivas inespecíficas tipo dispepsia; neurológicas y psiquiátricas. La GAI está asociada a otras enfermedades autoinmunes, principalmente hipotiroidismo ("síndrome tirogástrico") y diabetes tipo 1. Se caracteriza por el desarrollo de anticuerpos anti células parietales y anti factor intrínseco, bajo nivel de pepsinógeno I (PGI) con una baja relación PGI/PGII (< 3), e hipergastrinemia. Los hallazgos endoscópicos no son suficientes para el diagnóstico de atrofia gástrica. El uso de protocolo de Sydney de reporte patológico y sistema OLGA/OLGIM para evaluar la severidad de gastritis han mejorado su diagnóstico y objetivado su riesgo de desarrollar neoplasias gástricas. La importancia de su diagnóstico y seguimiento está basada en el desarrollo de neoplasias gástricas neuroendocrinas tipo 1, además de un riesgo incrementado de la incidencia de adenocarcinoma gástrico, entre otros. Actualmente, parece razonable un seguimiento endoscópico individualizado, siendo un intervalo mínimo de 3 años.


Subject(s)
Humans , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Gastritis, Atrophic/diagnosis , Gastritis, Atrophic/immunology , Gastritis, Atrophic/therapy , Autoimmune Diseases/physiopathology , Vitamin B 12 , Autoimmunity , Chronic Disease , Helicobacter pylori , Gastritis, Atrophic/physiopathology , Anemia, Pernicious
8.
J. oral res. (Impresa) ; 7(9): 432-436, ene. 2, 2018. ilus
Article in English | LILACS | ID: biblio-1121164

ABSTRACT

Pemphigus is a chronic potentially fatal autoimmune disorder that causes blisters and erosions of the skin and oral mucous membrane. most of the cases present oral manifestations as the first clinical sign along with dermal lesions. only 0.5 to 3.2 of cases are reported each year per 1,000,000 population with oral manifestations without dermal participation, and is at times difficult to diagnose. we report a case of oral pemphigus vulgaris in a 20 year old female patient without dermal manifestations treated with oral mini pulse therapy. pénfigo oral tratado con terapia minipulse. resumen: el pénfigo es un trastorno autoinmune crónico potencialmente fatal que causa ampollas y erosiones de la piel y la membrana mucosa oral. la mayoría de los casos presentan manifestaciones orales como el primer signo clínico junto con lesiones dérmicas. solo se reportan de 0.5 a 3.2 casos cada año por cada 1,000,000 de personas con manifestaciones orales sin afectación de la piel, y algunas veces es difícil de diagnosticar. presentamos un caso de pénfigo vulgar oral en un paciente de 20 años, sin manifestaciones cutáneas tratadas con mini terapia del pulso oral.


Subject(s)
Humans , Female , Adult , Young Adult , Skin/pathology , Autoimmune Diseases/drug therapy , Pemphigus/diagnosis , Pemphigus/drug therapy , Mouth Mucosa/injuries , Autoimmune Diseases/therapy , Prednisolone/administration & dosage , Pemphigus/mortality , Pulse Therapy, Drug
9.
Rev. Assoc. Med. Bras. (1992) ; 63(12): 1090-1099, Dec. 2017. graf
Article in English | LILACS | ID: biblio-896334

ABSTRACT

Summary Previous studies have demonstrated the expression of the CD25 marker on the surface of naturally occurring T cells (Tregs) of mice, which have a self-reactive cellular profile. Recently, expression of other markers that aid in the identification of these cells has been detected in lymphocyte subtypes of individuals suffering of autoimmune and idiopathic diseases, including: CD25, CTLA-4 (cytotoxic T-lymphocyte antigen 4), HLA-DR (human leukocyte antigen) and Interleukin 10 (IL-10), opening new perspectives for a better understanding of an association between such receptors present on the cell surface and the prognosis of autoimmune diseases. The role of these molecules has already been described in the literature for the modulation of the inflammatory response in infectious and parasitic diseases. Thus, the function, phenotype and frequency of expression of the a-chain receptor of IL-2 (CD25) and IL-10 in lymphocyte subtypes were investigated. Murine models have been used to demonstrate a possible correlation between the expression of the CD25 marker (on the surface of CD4 lymphocytes) and the control of self-tolerance mechanisms. These studies provided support for the presentation of a review of the role of cells expressing IL-2, IL-10, HLA-DR and CTLA-4 receptors in the monitoring of immunosuppression in diseases classified as autoimmune, providing perspectives for understanding peripheral regulation mechanisms and the pathophysiology of these diseases in humans. In addition, a therapeutic approach based on the manipulation of the phenotype of these cells and ways of scintigraphically monitoring the manifestations of these diseases by labeling their receptors is discussed as a perspective. In this paper, we have included the description of experiments in ex vivo regulation of IL-10 and synthesis of thio-sugars and poly-sugars to produce radiopharmaceuticals for monitoring inflammation. These experiments may yield benefits for the treatment and prognosis of autoimmune diseases.


Resumo Estudos anteriores já haviam demonstrado a expressão do marcador CD25 na superfície de células T de ocorrência natural (Tregs) de camundongos, que apresentam perfil celular autorreativo. Recentemente, foi detectada, em subtipos de linfócitos de indivíduos acometidos por doenças autoimunes e de causa idiopática, a expressão de outros marcadores, que auxiliam na identificação dessas células, entre os quais: CD25, CTLA-4 (cytotoxic T-lymphocyte antigen 4), HLA-DR (human leucocyte antigen) e Interleucina 10 (IL-10), abrindo novas perspectivas para a melhor compreensão de uma associação entre esses receptores presentes na superfície celular e o prognóstico de doenças autoimunes. O papel dessas moléculas já havia sido descrito na literatura na modulação da resposta inflamatória em doenças infectoparasitárias. Dessa forma, foram investigados a função, o fenótipo e a frequência de expressão, do receptor de cadeia a da IL-2 (CD25) e de IL-10 em subtipos de linfócitos. O modelo murino tem sido utilizado para demonstrar uma possível correlação entre a expressão do marcador CD25 (na superfície de linfócitos CD4) e o controle dos mecanismos de autotolerância. Essas pesquisas forneceram suporte para apresentação de uma revisão sobre o papel das células que expressam os receptores de IL-2, IL-10, HLA-DR e CTLA-4 no monitoramento da imunossupressão, em doenças de classificação autoimune, abrindo perspectivas para o entendimento dos mecanismos de regulação periférica e sobre a fisiopatologia dessas doenças no ser humano. Além disso, é discutida como perspectiva uma abordagem terapêutica fundamentada na manipulação do fenótipo dessas células, bem como de modos de monitoramento cintilográfico das manifestações dessas doenças, por meio da marcação de seus receptores. Nestes, foram incluídas descrições das experiências em regulação ex-vivo de IL-10; de síntese de tioaçúcares e de poliaçúcares para produção de radiofármacos para monitoramento de inflamações. Essas experiências podem trazer benefícios na terapia e no prognóstico de doenças autoimunes.


Subject(s)
Humans , Animals , Autoimmune Diseases/diagnostic imaging , Autoimmunity/physiology , Interleukin-10/physiology , T-Lymphocytes, Regulatory/physiology , Prognosis , Autoimmune Diseases/immunology , Autoimmune Diseases/therapy , HLA-DR Antigens , Radionuclide Imaging , CD4 Antigens/immunology , Interleukin-10/immunology , Models, Animal , Interleukin-2 Receptor alpha Subunit/immunology , CTLA-4 Antigen , Immune Tolerance , Mice
10.
Rev. cuba. hematol. inmunol. hemoter ; 32(4): 455-469, oct.-dic. 2016. ilus
Article in Spanish | LILACS | ID: biblio-844897

ABSTRACT

Las evidencias epidemiológicas, clínicas e inmunológicas de estudios en humanos y los datos obtenidos de experimentos en modelos animales ofrecen un soporte creciente al criterio de que las infecciones por helmintos tienen un efecto protector contra entidades patológicas que transcurren con desregulación del sistema inmunitario, tales como enfermedades autoinmunes y algunas alteraciones inflamatorias idiopáticas. A partir de este precedente, el objetivo de este trabajo fue revisar y analizar lo publicado sobre helmintosis, regulación de las respuestas inmunitarias y eventos autoinmunes e inflamatorios. Los análisis realizados permiten concluir que la regulación de las respuestas inmunitarias del hospedero por los helmintos repercute en la frecuencia e intensidad de eventos autoinmunes e inflamatorios. En aras de una práctica médica de mejor calidad, las consecuencias clínicas y terapéuticas de esas repercusiones deben ser conocidas por los profesionales relacionados con el diagnóstico y tratamiento de enfermedades autoinmunes y alteraciones inflamatorias idiopáticas(AU)


Epidemiological, clinical and immunological evidence from human studies and data obtained from experiments in animal models offer increased support to the view that helminth infections have a protective effect against pathological entities that run with deregulation of the immune system, such as illness idiopathic autoimmune and inflammatory changes some. From this precedent, the objective of this study was to review and analyze the literature on helminth infections, regulation of immune responses and autoimmune and inflammatory events. Studies support the conclusion that regulation of immune responses by helminth hosts affects frequency and intensity of autoimmune and inflammatory events. In order to better quality medical practice, clinical and therapeutic implications of these impacts should be known by professionals in diagnosis and treatment of idiopathic autoimmune diseases and inflammatory disorders(AU)


Subject(s)
Humans , Male , Female , Autoimmune Diseases/therapy , Autoimmunity , Therapy with Helminths/methods
11.
Rev. méd. Chile ; 143(12): 1546-1551, dic. 2015. graf, tab
Article in Spanish | LILACS | ID: lil-774440

ABSTRACT

Background: The causes of acute decompensations of patients with systemic autoimmune diseases are not well known. Aim: To describe the causes for consultation in an emergency room of patients with systemic autoimmune diseases. Material and Methods: Review of medical records of patients with systemic autoimmune diseases, aged over 14 years, consulting in an emergency room of a general hospital during three months. Results: In the study period, 166 patients with systemic autoimmune diseases consulted in the emergency room, of a total of 18,153 consultations (0.9%). Patients with rheumatoid arthritis were those that consulted with higher frequency (37%) followed by patients with systemic lupus erythematosus (21%). The most common causes for consultation were cardiovascular diseases in 25%, followed by digestive disorders in 15%. The most common diagnosis was chest pain with suspected ischemic heart disease in 36%. No differences in cardiovascular risk factors were observed between those patients consulting for cardiovascular diseases and those consulting for other causes. Conclusions: The most common cause of consultation in the emergency room of patients with systemic autoimmune diseases is cardiovascular.


Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Autoimmune Diseases/therapy , Emergency Service, Hospital/statistics & numerical data , Autoimmune Diseases/classification , Chile , Retrospective Studies , Risk Factors , Tertiary Care Centers
12.
RELAMPA, Rev. Lat.-Am. Marcapasso Arritm ; 28(3): 123-125, jul.-set.2015. ilus
Article in Portuguese | LILACS | ID: lil-777956

ABSTRACT

A policondrite recidivante é uma doença rara, multissistêmica, de etiologia desconhecida, provavelmenteautoimune, que acomete estruturas cartilaginosas e tecidos ricos em proteoglicanos. Orelha, nariz, articulações e árvore traqueobrônquica são os locais mais afetados durante os surtos inflamatórios, ocasionando destruição tecidual, deformidades permanentes e complicações respiratórias. Menos comumente, afeta olhos, coração e vasos sanguíneos.O diagnóstico é essencialmente clínico e o tratamento envolve o uso de corticoides e imunossupressores. Relatamos um caso de policondrite recidivante, em que a manifestação do segundo surto da doença ocorreu por meio de bloqueio atrioventricular com recuperação da condução cardíaca após tratamento com corticoide...


The relapsing polychondritis is a rare, multisystem disease, whose etiology is unknown. It is probably autoimmune and affects cartilaginous structures and proteoglycan-rich tissues. The ear, nose, joints and tracheobronchial tree are the most affected sites during inflammatory outbreaks causing tissue destruction,permanent deformities and respiratory complications. Less commonly, it affects the eyes, heart and blood vessels. The diagnosis is essentially clinical and treatment involves the use of steroids and immunosuppressive agents.We report a case of relapsing polychondritis where the second outbreak of the disease was manifested by na atrioventricular block with recovery of cardiac conduction after treatment with steroids...


Subject(s)
Humans , Female , Adult , Atrioventricular Block/complications , Autoimmune Diseases/diagnosis , Autoimmune Diseases/therapy , Polychondritis, Relapsing/complications , Polychondritis, Relapsing/etiology , Heart Atria/abnormalities , Adrenal Cortex Hormones/therapeutic use , Prednisone/administration & dosage , Heart Ventricles/abnormalities
14.
Article in English | IMSEAR | ID: sea-162945

ABSTRACT

Gluten sensitivity is one of the prominent features of celiac disease (CD) which is an autoimmune disorder characterized by damaged lining of the small intestine. CD was known already to ancient Greeks as κοιλιακός (keeleeakoss) i.e. disease of the abdominal cavity hence celiac. Focus of this Commentary article is on rather complex definition of CD and its emerging new forms the example of which is non-celiac gluten sensitivity. It is becoming evident that to formulate more effective treatments, these associations and newly identified disease entities deserve attention from both academic and clinical communities.


Subject(s)
Autoimmune Diseases/therapy , Autoimmunity , Celiac Disease/classification , Celiac Disease/therapy , Diet, Gluten-Free/methods , Glutens , Humans , Transglutaminases
16.
Rev. bras. hematol. hemoter ; 35(1): 62-67, 2013.
Article in English | LILACS | ID: lil-670462

ABSTRACT

Although bone marrow is the main source, mesenchymal stem cells have already been isolated from various other tissues, such as the liver, pancreas, adipose tissue, peripheral blood and dental pulp. These plastic adherent cells are morphologically similar to fibroblasts and have a high proliferative potential. This special group of cells possesses two essential characteristics: self-renewal and differentiation, with appropriate stimuli, into various cell types. Mesenchymal stem cells are considered immunologically privileged, since they do not express costimulatory molecules, required for complete T cell activation, on their surface. Several studies have shown that these cells exert an immunosuppressive effect on cells from both innate and acquired immunity systems. Mesenchymal stem cells can regulate the immune response in vitro by inhibiting the maturation of dendritic cells, as well as by suppressing the proliferation and function of T and B lymphocytes and natural killer cells. These special properties of mesenchymal stem cells make them a promising strategy in the treatment of immune mediated disorders, such as graft-versus-host disease and autoimmune diseases, as well as in regenerative medicine. The understanding of immune regulation mechanisms of mesenchymal stem cells, and also those involved in the differentiation of these cells in various lineages is primordial for their successful and safe application in different areas of medicine.


Subject(s)
Humans , Autoimmune Diseases/therapy , Stem Cells , Cell Differentiation , Immunomodulation , Mesenchymal Stem Cells/immunology , Immune System
18.
Arq. neuropsiquiatr ; 70(4): 300-304, Apr. 2012. ilus, graf, tab
Article in English | LILACS | ID: lil-622592

ABSTRACT

The autoimmune encephalopathies are a group of conditions that are associated with autoantibodies against surface neuronal proteins, which are likely to mediate the disease. They are established as a frequent cause of encephalitis. Characteristic clinical features in individual patients often allow the specificity of the underlying antibody to be confidently predicted. Antibodies against the VGKC-complex, mainly LGI1(leucine-rich glioma-inactivated 1), CASPR2 (contactin-associated protein 2), and contactin-2, and NMDA (N-methyl, D-aspartate) -receptor are the most frequently established serological associations. In the minority of cases, an underlying tumour can be responsible. Early administration of immunotherapies, and tumour removal, where it is relevant, offer the greatest chance of improvement. Prolonged courses of immunotherapies may be required, and clinical improvements often correlate well with the antibody levels. In the present article, we have summarised recent developments in the clinical and laboratory findings within this rapidly expanding field.


As encefalopatias autoimunes constituem um grupo de condições associadas à presença, no soro, de anticorpos contra proteínas de superfície neuronais. Acredita-se que esses anticorpos sejam mediadores da ocorrência da doença, sendo reconhecidos atualmente como causas frequentes de encefalite. Apresentações clínicas características permitem, muitas vezes, predizer o grupo específico de anticorpos subjacentes. Anticorpos contra o complexo VGKF, especialmente LGI1 (leucine-rich glioma-inactivated1), CASPR2 (contactin-associated protein 2) e contactina-2, e contra o receptor NMDA(N-methyl, D-aspartate) são as associações sorológicas mais frequentemente estabelecidas. Na minoria dos casos, pode ser detectado um tumor subjacente. As maiores chances de melhora estão relacionadas à administração precoce de imunoterapia e à remoção do tumor, quando presente. A duração da imunoterapia pode se prolongada e a melhora se correlaciona, muitas vezes, com os níveis séricos de anticorpos. Neste artigo, estão resumidos os avanços recentes nos achados clínicos e laboratoriais neste campo que está em tão rápida expansão.


Subject(s)
Humans , Autoantibodies/immunology , Autoimmune Diseases/therapy , Encephalitis/therapy , Immunotherapy/methods , Autoimmune Diseases/immunology , /immunology , Encephalitis/classification , Encephalitis/immunology , Membrane Proteins/immunology , Nerve Tissue Proteins/immunology , Proteins/immunology , Receptors, N-Methyl-D-Aspartate/immunology
19.
Biol. Res ; 45(3): 269-277, 2012. ilus, graf
Article in English | LILACS | ID: lil-659284

ABSTRACT

Mesenchymal stem cells (MSCs) are now known to display not only stem cell multipotency, but also robust antiinflammatory and regenerative properties. After widespread in-vitro and in-vivo preclinical testing, autologous and allogeneic MSCs have been applied in a range of immune mediated conditions, including graft versus host disease, Crohn's disease, multiple sclerosis, refractory systemic lupus erythematosus and systemic sclerosis. Current data suggests that MSCs may not only replace diseased tissues, but also exert several trophic, regenerative and antiinflammatory effects. While the clinical outcome in case reports and phase I-II trials seems occasionally striking, these limited results point to the need to perform controlled multicenter trials. Future advances from stem cell science can be expected to pinpoint significant MSC subpopulations and/or stem cell markers for improved regenerative or immunoregulatory properties.


Subject(s)
Humans , Autoimmune Diseases/therapy , Mesenchymal Stem Cell Transplantation/methods , Clinical Trials as Topic , Mesenchymal Stem Cells/cytology , Mesenchymal Stem Cells/immunology
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