Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 698
Filter
1.
Rev. Soc. Argent. Diabetes ; 56(suple. 2): 15-18, may. - ago. 2022. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1396180

ABSTRACT

La diabetes mellitus (DM) es una enfermedad heterogénea que presenta fenotipos clínicos diversos, todos con hiperglucemia. Históricamente se han utilizado cuatro factores para identificar esta diversidad: la edad de inicio, la gravedad de la enfermedad o grado de pérdida de la función de la célula beta, el grado de resistencia a la insulina y la presencia de autoanticuerpos asociados a la enfermedad. Actualmente, los parámetros empleados para clasificar los diferentes tipos de DM dificultan el diagnóstico y tratamiento de los pacientes. Las distintas presentaciones clínicas requieren una clasificación diagnóstica más eficaz para un abordaje terapéutico más preciso, valiéndose del avance de la inmunogenética y la bioquímica clínica. Esta guía está orientada a clasificar con precisión las presentaciones clínicas que a menudo generan incertidumbre dentro de los dos tipos principales de DM.


Diabetes mellitus (DM) is a heterogeneous disease, with diverse clinical phenotypes, all with hyperglycemia. Historically, four factors have been used to identify this diversity: the age at onset, the severity of the disease, that is, the degree of loss of beta cell function and insulin resistance, and the presence of circulating autoantibodies. Currently, the parameters used to classify the different types of DM make it difficult to diagnose and treat patients. The different clinical manifestations require an accurate diagnosis to achieve an effective therapeutic approach through the use of immunogenetics and clinical biochemistry. This practical guide aims to accurately classify the often uncertain clinical presentations within the two main types of diabetes.


Subject(s)
Diabetes Mellitus , Autoantibodies , Autoimmunity , Genetics
2.
Rev. colomb. gastroenterol ; 37(2): 220-224, Jan.-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1394953

ABSTRACT

Abstract Autoimmune gastritis is an underdiagnosed disease in the pediatric population due to the absence of specific signs and symptoms and late clinical manifestations. Iron deficiency anemia has recently been identified as an early hematological manifestation, allowing an early diagnostic approach. We present the case of a Colombian teenager, with no history of autoimmunity, with refractory iron deficiency. He underwent extension studies; biopsies and serology compatible with autoimmune gastritis were documented, requiring parenteral iron in its evolution. This pathology is underdiagnosed in our context since early diagnosis requires a high index of suspicion to prevent associated complications.


Resumen La gastritis autoinmune es una enfermedad subdiagnosticada en la población pediátrica. Lo anterior se debe a la ausencia de signos y síntomas específicos y manifestaciones clínicas tardías. Recientemente se ha identificado la anemia ferropénica como una manifestación hematológica precoz, lo que permite un enfoque diagnóstico temprano. Se presenta el caso de un adolescente colombiano, sin antecedentes de autoinmunidad, con ferropenia refractaria, en el que se realizaron estudios de extensión y se documentaron biopsias y serología compatible con gastritis autoinmune, con requerimiento de hierro parenteral en su evolución. Esta patología es subdiagnosticada en nuestro medio, ya que el diagnóstico temprano requiere un alto índice de sospecha, lo que permite la prevención de las complicaciones asociadas.


Subject(s)
Humans , Male , Adolescent , Adolescent , Anemia, Iron-Deficiency , Gastritis , Pathology , Population , Signs and Symptoms , Autoimmunity , Early Diagnosis
4.
repert. med. cir ; 31(1): 79-83, 2022. tab.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1367068

ABSTRACT

Introducción: Constantin von Economo reportó en 1917 múltiples casos de manifestaciones neurológicas secundarias a la pandemia de la gripe española, clasificándolos en tres grandes grupos: forma somnolienta-oftalmopléjica, mutismo y la hipercinética, con secuelas similares a la enfermedad de Parkinson. Objetivo: presentar un caso de reciente aparición de patología rara en Cali, Colombia con manejo adecuado en unidad de cuidados intensivos (UCI). Presentación del caso: paciente de 9 años con disminución de la fuerza en extremidades, disartria y somnolencia, que inició deterioro neurológico progresivo requiriendo manejo en UCI. El equipo multidisciplinario diagnosticó encefalitis letárgica e iniciaron manejo con plasmaféresis e inmunosupresión con mejoría significativa. Discusión y conclusiones: como la prevalencia es escasa, el diagnóstico exige un alto índice de sospecha como la ocurrencia de un cuadro infeccioso previo al inicio de los síntomas, ya que se considera una reacción autoinmune cruzada contra antígenos de la sustancia nigra. En algunos casos hay alteraciones en los estudios imagenológicos o en citoquímico de líquido cefalorraquídeo. El manejo con pulsos de metilprednisolona y filtración de plasma con plasmaféresis brinda mejoría significativa con disminución de las secuelas a futuro.


Introduction: In 1917, Constantin von Economo reported multiple cases of neurological manifestations secondary to the Spanish flu pandemic. He classified them into three main clinical forms: somnolent-ophthalmoplegic, mutism and hyperkinetic, causing sequelae resembling Parkinson ́s disease. Objective: to present a case of a recent appearance rare disease entity, in Cali Colombia, receiving appropriate management in the Intensive Care Unit (ICU). Case presentation: 9-year-old patient presenting with limb muscle weakness, dysarthria and somnolence, evidencing progressive neurological deterioration requiring admission to the ICU for management. A diagnosis of encephalitis lethargica (EL) was made by the attending multidisciplinary team and management with plasmapheresis and immunosuppression was started, obtaining significant improvement. Discussion and conclusions: as the prevalence is low, the diagnosis requires a high level of suspicion in cases presenting with infectious conditions prior to the development of symptoms, since it is considered an autoimmune cross-reaction against substantia nigra antigens. Alterations in brain imaging or in cerebrospinal fluid cytometry may be found in some cases. Management with methylprednisolone pulse therapy and filtration plasmapheresis provides significant improvement with a decrease in future sequelae.


Subject(s)
Humans , Female , Child , Parkinson Disease, Postencephalitic , Encephalitis, St. Louis , Fever , Autoimmunity , Influenza, Human
5.
Arq. Asma, Alerg. Imunol ; 5(4): 422-425, out.dez.2021. ilus
Article in English, Portuguese | LILACS | ID: biblio-1399807

ABSTRACT

A reativação da BCG pode ocorrer em diversos contextos: associada a quadros infecciosos, imunossupressão, autoimunidade e pós-vacinações. Além disso, especialmente em crianças abaixo de 5 anos de idade, deve ser valorizada como um achando presente em cerca de 50% dos casos de Doença de Kawasaki. Neste artigo, relatamos o primeiro caso publicado na literatura de uma paciente adulta jovem, a qual manifestou uma reativação de BCG após receber a primeira dose de vacina contra COVID-19 (AztraZeneca/Oxford/Biomanguinhos). Dentro das primeiras 24h após a administração da vacina, a paciente desenvolveu febre alta, sudorese, dor local, mialgia difusa e cefaleia. Após dois dias, iniciou eritema e enduração no local da cicatriz da vacina BCG. Ela tem como comorbidade a urticária crônica espontânea, porém estava assintomática sem crises há mais de 1 ano. Tem como antecedente familiar relevante o óbito materno por síndrome complexa de sobreposição de autoimunidade (lúpus eritematoso sistêmico, síndrome de Sjögren e síndrome do anticorpo antifosfolípide). Após ser medicada com anti-inflamatórios não esteroides (AINE) e corticoterapia tópica de moderada potência por 3 dias, houve resolução completa da reativação da BCG. A paciente, após 3 meses, recebeu a segunda dose da vacina e não manifestou nenhum sintoma. Acredita-se que a reativação da BCG ocorra devido a um mecanismo de reação cruzada entre HSP do indivíduo, elicitadas como mediadores da imunidade inata frente à inflamação vacinal, com alguns epítopos do M. bovis. Recomendase que seja investigada alguma condição imunossupressora ou autoimune nos pacientes que manifestem reativação da BCG, principalmente em adultos, na qual a doença de Kawasaki é bastante rara. As vacinas, incluindo as contra COVID-19, também podem desencadear o surgimento deste fenômeno imunológico ainda pouco compreendido.


BCG reactivation can occur in different contexts: associated with infectious conditions, immunosuppression, autoimmunity and post-vaccinations. Also, especially in children below of 5 years of age, should be valued as a finding present in about 50% of cases of Kawasaki disease. In this article, we report the first case published in the literature of a young adult patient, who manifested a reactivation of BCG after receiving the first dose of vaccine against COVID-19 (AztraZeneca/Oxford/Biomanguinhos). Within the first 24 hours after the administration of the vaccine, the patient developed high fever, sweating, local pain, diffuse myalgia and headache. After 2 days, erythema and induration at the site of the BCG vaccine scar began. she has how comorbidity to chronic spontaneous urticaria, but she was asymptomatic without crises for more than 1 year. The relevant family history is maternal death due to the complex syndrome of autoimmunity overlap (systemic lupus erythematosus, Sjögrens syndrome, and anti-phospholipid antibody). After being medicated with NSAID and moderate topical corticosteroid therapy potency for 3 days, there was complete resolution of BCG reactivation. The patient, after 3 months, received the 2nd dose of the vaccine and had no symptoms. It is believed that the reactivation of BCG occurs due to a cross-reaction mechanism between the individuals HSP, elicited as mediators of innate immunity against vaccine inflammation, with some epitopes of M. bovis. It is recommended that any immunosuppressive or autoimmune condition be investigated in patients that manifest BCG reactivation, especially in adults, in which Kawasaki disease is quite rare. Vaccines, including those against COVID-19, can also trigger of this immunological phenomenon still poorly understood.


Subject(s)
Humans , Female , Young Adult , BCG Vaccine , Autoimmunity , Cicatrix , COVID-19 , ChAdOx1 nCoV-19 , Pain , Signs and Symptoms , Sjogren's Syndrome , Anti-Inflammatory Agents, Non-Steroidal , Antiphospholipid Syndrome , Adrenal Cortex Hormones , Erythema , Fever , Chronic Urticaria , COVID-19 Vaccines , Headache , Lupus Erythematosus, Systemic , Mucocutaneous Lymph Node Syndrome , Mycobacterium bovis
6.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 396-401, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1350809

ABSTRACT

ABSTRACT CD28 null T helper (Th) cells are rare in healthy individuals, but they are increased in various inflammatory and immune-mediated diseases. In this study, we determined the size of the CD4+/CD28 null T lymphocyte compartment in the peripheral blood of 40 autoimmune hemolytic anemia (AIHA) patients (idiopathic and secondary) and 20 healthy control subjects, using tri-color flow cytometry. The frequency and absolute count of CD4+/CD28 null T helper (Th) cells was significantly higher in idiopathic AIHA patients, compared to healthy controls (p = 0.001 and 0.001, respectively) and to patients with secondary AIHA (p = 0.04 and 0.01, respectively). The percentage of CD4+/CD28 null Th cells was also negatively correlated to the hemoglobin (Hb) level (p = 0.03). These findings demonstrate, for the first time, the expansion of this phenotypically-defined population of T lymphocytes in patients with idiopathic AIHA and indicate that it likely plays an etiological role in the development of this disease. However, establishing the use of this marker for diagnosis or monitoring treatment of such patients needs further studies.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , T-Lymphocytes, Helper-Inducer , Anemia, Hemolytic, Autoimmune , T-Lymphocytes , CD4 Antigens , Autoimmunity , CD28 Antigens , Th1 Cells , Flow Cytometry
7.
Arq. Asma, Alerg. Imunol ; 5(2): 142-150, abr.jun.2021. ilus
Article in Portuguese | LILACS | ID: biblio-1398835

ABSTRACT

Introdução: As reações cutâneas graves a medicamentos (RCGM) compreendem um grupo de doenças caracterizadas por hipersensibilidade tardia a um ou vários tipos de fármacos. Por ser uma doença potencialmente fatal, o diagnóstico precoce, bem como o início do tratamento, são de suma importância. Objetivo: Analisar a evolução das RCGM em pacientes pediátricos acompanhados em dois hospitais da cidade de São Paulo, SP. Método: Trata-se de um estudo retrospectivo baseado na análise de prontuários de pacientes atendidos no período de 2002 a 2018 em dois hospitais da capital paulista. Resultados: Não houve diferença entre os sexos, prevaleceu a faixa etária dos adolescentes, e os medicamentos mais implicados com o desenvolvimento das lesões cutâneas foram os anticonvulsivantes, sendo os principais a carbamazepina e fenitoína, sem diferença entre eles, seguidos dos antibióticos betalactâmicos. No tratamento, todos os pacientes fizeram uso de corticoides sistêmicos e anti-histamínicos, sendo que oito pacientes também receberam imunoglobulina intravenosa e um recebeu ciclosporina. A taxa de mortalidade foi baixa e, em relação às complicações e sequelas, a autoimunidade foi a mais encontrada. Conclusão: Os casos de RCGM são eventos raros na faixa etária pediátrica, todavia de alta morbimortalidade e risco de sequelas. O diagnóstico e tratamento precoces contribuem para um melhor prognóstico, sendo de suma importância a identificação da medicação associada, bem como a retirada da mesma.


Background: Severe cutaneous adverse reactions (SCARs) comprise a group of diseases characterized by late hypersensitivity to one or more types of drugs. Because they are potentially fatal, early diagnosis and initiation of treatment are of paramount importance. Objective: To analyze the evolution of SCARs in pediatric patients followed up in two hospitals in São Paulo, SP, Brazil. Methods: This is a retrospective study based on the analysis of medical records of patients treated between 2002 and 2018 in two hospitals in the state capital. Results: There was no difference between sexes, and the age group of adolescents prevailed. Anticonvulsants were the drugs most implicated in the development of skin lesions, especially carbamazepine and phenytoin, with no difference between them, followed by betalactam antibiotics. During treatment, all patients used systemic corticosteroids and antihistamines; eight patients also received intravenous immunoglobulin and one received cyclosporine. The mortality rate was low, and regarding complications and sequelae, autoimmunity was the most commonly found. Conclusion: Cases of SCAR are rare events in the pediatric age group, but morbidity, mortality, and risk of sequelae are high. Early diagnosis and treatment contribute to a better prognosis, and identification of the associated medication as well as its withdrawal are extremely important.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Carbamazepine , Autoimmunity , Drug Hypersensitivity , Drug-Related Side Effects and Adverse Reactions , Anti-Bacterial Agents , Therapeutics , Pharmaceutical Preparations , Medical Records , Risk , Retrospective Studies , Immunoglobulins, Intravenous , Early Diagnosis , Histamine Antagonists , Anticonvulsants
9.
J. pediatr. (Rio J.) ; 97(supl.1): 24-33, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1250231

ABSTRACT

Abstract Objectives: Classical immunodeficiencies are mainly characterized by infectious conditions. In recent years, manifestations related to allergy, inflammation, autoimmunity, lymphoproliferation, and malignancies related to this group of diseases have been described. The text intends to make an update on the non-infectious manifestations of the primary defects of the immune system. Source of data: Searches were carried out in the PubMed database for review articles published in the last five years, in English, French, or Spanish, using the terms "allergy," "inflammation," "autoimmunity," "lymphoproliferation," "cancer," AND "immunodeficiency" or "primary immunodeficiency" or "inborn errors of immunity" NOT "HIV". Synthesis of data: Non-infectious manifestations characterize the primary defects in which there is dysregulation of the immune system. The most common manifestations of autoimmunity in this group of diseases are autoimmune cytopenias. Exacerbated inflammatory processes, benign lymphoproliferation, and propensity to malignancy of the lymphoreticular system are related to several diseases in this group. Severe manifestations of atopy or food allergy characterize some immunodeficiencies. Disorders of inborn immunity of the autoinflammatory type are characterized by an aseptic inflammatory process in the absence of autoimmunity, with fever and recurrent manifestations in different organs. Conclusions: Not only infectious conditions should raise the suspicion of immunodeficiencies, but also manifestations of allergy, inflammation, autoimmunity, lymphoproliferation, or cancer, especially if they are recurrent, associated to each other, affecting young patients, or in severe and/or difficult to treat conditions.


Subject(s)
Humans , Immunologic Deficiency Syndromes , Neoplasms/etiology , Autoimmunity , Inflammation
10.
Rev. chil. neuro-psiquiatr ; 59(1): 56-65, mar. 2021. ilus, tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1388378

ABSTRACT

INTRODUCCIÓN: La epilepsia es un desorden neurológico crónico caracterizado por crisis convulsivas recurrentes, y constituye uno de los trastornos neurológicos con mayor prevalencia global. Una de las etiologías que ha cobrado mayor relevancia en el último tiempo es la autoinmunidad, la que ha venido a dar explicación a muchos casos de epilepsia idiopática o refractaria a tratamientos convencionales. MÉTODOS: Se realizó una búsqueda avanzada asociada a filtros en la plataforma PubMed con los términos "epilepsy" y "autoimmunity". Se seleccionaron 17 artículos de un total de 98 publicados desde el año 2010 en adelante, y que aportaban mas datos desde la fisiopatología. RESULTADOS: En base a la literatura, se describen los principales mecanismos de autoinmunidad que generan epilepsia entre los destacan generación de auto-anticuerpos, desregulación del perfil de citoquinas y pérdida del control de linfocitos T autorreactivos, fenómenos que redundan en neuroinflamación y que se originan en el contexto de infecciones, síndromes paraneoplásicos, autoinmunidad materna transferida a hijos, encefalitis autoinmune, entre otras. CONCLUSIONES: En los últimos años ha habido grandes avances en la comprensión de la epilepsia autoinmune, sin embargo, aún queda mucho por comprender. Pese a lo prometedor que es el descubrimiento de anticuerpos, existen muchos casos de epilepsia con seronegatividad, o casos con la presencia de anticuerpos, pero no la epilepsia autoinmune. Cabe destacar que se debe precisar mecanismos diagnósticos eficaces y específicos que permitan generar protocolos terapéuticos atingentes y resolutivos.


Epilepsy is a neurological chronic disorder which is characterized by recurrent seizures and constitutes one of the most prevalent neurological disorders worldwide. One of the etiologies that has gained a lot of strength is autoimmunity, which has explained a lot of cases of idiopathic epilepsy or epilepsies refractory to common treatment. METHODS: An advanced search was made in the PubMed platform using filters with the terms "epilepsy" and "autoimmunity", showing 98 publications from 2010 onwards, leaving only 17 selected articles because of their pathophysiological information. RESULTS: Based on the literature, we described the main mechanisms of autoimmunity as a cause of epilepsy, standing out the ones related to auto-antibodies production, cytokines disregulation and autoreactive T lymphocytes control alteration, phenomenons related to neuroinflammation that arise from the context of infections, paraneoplastic syndromes, maternal autoimmunity transmitted to their babies, autoimmune encephalitis, etc. CONCLUSIONS: Great advances has been made on the understanding of autoimmune epilepsy in the last years, but despite this there's a lot that we need to comprehend. Although how promising was the discovery of antibodies there's still a lot of seronegative cases or cases with antibodies but without the epilepsy. It is worth mentioning that it becomes necessary to establish efficient and specific diagnostic mechanisms that allow us to create suitable and resolutive therapeutic protocols.


Subject(s)
Humans , Autoimmunity , Epilepsy/immunology , Seizures/immunology , Epilepsy/etiology , Antibodies
11.
Infectio ; 25(1): 59-62, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1154404

ABSTRACT

Resumen La neumonía en el paciente inmunocomprometido es un reto diagnóstico al cual el clínico se enfrenta cada vez con más frecuencia , al momento de hablar de infiltrados en vidrio esmerilado es menester tener siempre en cuenta la posibilidad de neumonía por Pneumocystis Jirovecii, que por mucho tiempo se pensó como una enfermedad propia del huésped inmunosuprimido con VIH, a través del tiempo se ha manifestado en pacientes con trasplantes de órgano sólido y de precursores hematopoyéticos, asociado a autoinmunidad, al uso crónico de corticoesteroides y más recientemente al uso de terapia biológicas. La descripción de esta enfermedad y sus métodos diagnósticos en huéspedes inmunosuprimidos no VIH no es del todo claro, sabemos que el tratamiento de elección en estos casos es el trimetropin-sulfametoxazol (TMP-SMX) el cual no cuenta con evidencia de alta calidad al momento de plantear una dosis ni un tiempo de duración establecidos. Presentamos el caso de un paciente con diagnóstico de glomerulonefritis por enfermedad de cambios mínimos corticodependiente y quien desarrolló neumonía por Pneumocystis Jirovecii confirmada por histopatología quien recibió tratamiento y tuvo un desenlace positivo.


Abstract The pneumonia in the immunocompromised patient is a diagnostic challenge that the clinician faces more and more frequently, every time we talk about ground glass infiltrates it is necessary to always take into account the possibility of pneumonia due to Neumocystis Jirovecii, which for a long time was thought as a disease of the immunosuppressed host with HIV, but that across the time it has manifested itself in patients with solid organ transplants and hematopoietic precursors, associated with autoimmunity, the chronic use of corticosteroids and more recently the use of biological therapy. The description of this disease and the diagnostic methods in non-HIV immunosuppressed hosts is not entirely clear, we know that the treatment of choice in these cases is trimethropin-sulfamethoxazole (TMP-SMX), which does not have high-quality evidence at the time of a dose or a time of established duration. We present the case of a patient diagnosed with glomerulonephritis due to corticodependent minimal change disease and who suffers from pneumocystis Jirovecii pneumonia confirmed by histopathology, which received treatment and had a positive outcome


Subject(s)
Humans , Male , Adolescent , Pneumonia, Pneumocystis , Pneumonia , Autoimmunity , HIV , Immunocompromised Host , Adrenal Cortex Hormones , Glass
12.
Rev. cuba. invest. bioméd ; 40(1): e842, ene.-mar. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289454

ABSTRACT

Introducción: La etiología de las enfermedades autoinmunes aún se desconoce, aunque se plantean diferentes causas. Objetivo: Describir el rol de factores como las hormonas, alimentación, estrés, enfermedades infecciosas y cáncer en las enfermedades autoinmunes. Métodos: Se realizó una revisión bibliográfica empleando Google Académico y artículos de libre acceso en la base de datos PubMed y SciELO, publicados entre enero del 2014 y junio del 2020. Se consultó la bibliografía nacional e internacional relevante y actualizada, con un total de 51 referencias, de estas, tres libros básicos de la especialidad de Inmunología y 48 artículos (12 en idioma español y 36 en inglés). Se utilizaron los términos de búsqueda según los descriptores del DeCS y MeSH. Resultados: Las hormonas femeninas incrementan el riesgo de las enfermedades autoinmunes. Un desbalance en la neurohormona melatonina puede generar linfocitos autorreactivos. El estrés puede mantener respuestas inflamatorias crónicas que causen daño tisular. Una adecuada alimentación permite que los comensales de la microbiota intestinal mantengan la homeostasis del sistema inmune. Las infecciones en ocasiones desarrollan respuestas autoinmunitarias. La causalidad entre el cáncer y la autoinmunidad es bidireccional producto de procesos inflamatorios. Conclusiones: Las enfermedades autoinmunes son más frecuentes en las mujeres. Una alimentación adecuada permite que la microbiota intestinal no se altere y que mantenga la homeostasis inmunológica. Situaciones de estrés e infecciones pueden iniciar respuestas autoinmunes. El cáncer puede favorecer el desarrollo de manifestaciones autoinmunes, y estas últimas por el predominio inflamatorio, favorecen la tumorogénesis(AU)


Introduction: The etiology of autoimmune diseases is still unknown, though several causes have been suggested. Objective: Describe the role of hormones, eating, stress, infectious diseases and cancer in immune diseases. Methods: A bibliographic review was conducted using Google Scholar and open access papers published in the databases Pubmed and SciELO from January 2014 to June 2020. Relevant updated national and international bibliography was consulted, for a total 51 references: three basic books from the specialty of immunology and 48 papers (12 in Spanish and 36 in English). The search terms used were obtained from the descriptors DeCS and MeSH. Results: Feminine hormones increase the risk of autoimmune diseases. Imbalance in the neurohormone melatonin may generate autoreactive lymphocytes. Stress may maintain chronic inflammatory responses causing tissue damage. Appropriate eating habits allow gut microbiota commensals to maintain the homeostasis of the immune system. Infections occasionally develop autoimmune responses. Causality between cancer and autoimmunity is bidirectional, due to the presence of inflammatory processes. Conclusions: Autoimmune diseases are more common among women. Appropriate eating habits prevent alterations of the gut microbiota, allowing it to maintain immune homeostasis. Stress situations and infections may trigger autoimmune responses. Cancer may foster the development of autoimmune manifestations, and these, due to the inflammatory predominance, may foster tumorigenesis(AU)


Subject(s)
Humans , Autoimmune Diseases , Autoimmunity , Eating , Allergy and Immunology , Gastrointestinal Microbiome , Immune System , Immune System Diseases , Neurotransmitter Agents
13.
Cienc. tecnol. salud ; 8(1): 104-117, 2021. il 27 c
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1352998

ABSTRACT

La autoinmunidad es la consecuencia de la pérdida de control y regulación de la respuesta inmune. Se re-porta que ocurre entre 5 y 9% de patologías a nivel mundial. A las enfermedades con esta anomalía se les denomina autoinmunes y se clasifican de acuerdo con el órgano o sistema afectado. Las reumáticas involucran al tejido conectivo y las articulaciones. Los factores asociados a su aparición incluyen: edad, género, medioam-biente y genéticos. La susceptibilidad genética indica la presencia de uno o varios genes asociados al desarrollo de determinada enfermedad, cuya expresión podría ser el producto de la migración, selección, recombinación y adaptación de genes entre las poblaciones, lo que explica la variación fenotípica y la expresión clínica resultan-te. Los estudios de asociación del genoma completo (GWAS por sus siglas en inglés) han permitido identificar múltiples genes involucrados con enfermedades reumáticas, destacan el lupus eritematoso sistémico y artritis reumatoide, asociadas con más de 60 alelos, y otras como la espondilitis anquilosante, en donde la asociación ha sido primordialmente con un gen y sus polimorfismos. Esta revisión tiene como objetivo informar el estado de la susceptibilidad determinada genéticamente para estas enfermedades y el impacto que tiene sobre la expresión clínica. Se realizó una búsqueda en PubMed y la base de datos de la biblioteca Cochrane, se incluyeron artículos relacionados con las palabras clave propuestas desde el 2000. La revisión identifica genes y la asociación con estas enfermedades, expone la diversidad existente y justifica continuar la búsqueda de genes en todas las poblaciones.


Autoimmunity is the consequence of the loss of control and regulation of the immune response. It is reported that between 5 and 9% of pathologies occur worldwide. Diseases with this abnormality are called autoimmune and are classified according to the organ or system affected. Rheumatic diseases involve connective tissue and joints. Factors associated with its appearance include age, gender, environment, and genetics. Genetic suscepti-bility indicates the presence of one or more genes associated with the development of a certain disease, whose expression could be the product of migration, selection, recombination and adaptation of genes between popu-lations, which explains the phenotypic variation and the resulting clinical expression. Genome wide association studies (GWAS) have allowed the identification of multiple genes involved with rheumatic diseases, including systemic lupus erythematosus and rheumatoid arthritis, associated with more than 60 alleles, and others such as ankylosing spondylitis, where the association has been primarily with a gene and its polymorphisms. This review aims to report the status of genetically determined susceptibility to these diseases and the impact it has on clinical expression. A search was carried out in PubMed and the Cochrane library database, articles related to the proposed keywords from the year 2000 were included. The review identifies genes and the association with these diseases, exposes the existing diversity and justifies continuing the search for genes in all populations.


Subject(s)
Humans , Arthritis, Rheumatoid/genetics , Genetic Predisposition to Disease , Lupus Erythematosus, Systemic/genetics , Autoimmunity/immunology , Genome-Wide Association Study
14.
Arch. endocrinol. metab. (Online) ; 65(5): 562-569, 2021. tab
Article in English | LILACS | ID: biblio-1345194

ABSTRACT

ABSTRACT Objective: People with Down's syndrome (DS) have a higher risk of developing type 1 diabetes mellitus (T1D) and may have specific clinical features compared to T1D patients without DS. This study evaluated the clinical and laboratory aspects of T1D in children and adolescents with DS in an admixed population. Subjects and methods: A case-control study comparing patients with T1D and DS (T1D+DS) to patients with T1D without DS (T1D controls) from two tertiary academic Hospitals in São Paulo, Brazil. Results: The sample consisted of 9 patients with T1D+DS and 18 T1D age and sex-matched controls. Anti-glutamic acid decarboxylase 65 antibodies were positive in 7/7 of the 9 T1D+DS patients, confirming the presence of diabetes autoimmunity in this group. Mean age at diagnosis of T1D was 4.9 ± 3.9 years in the T1D+DS group and 6.4 years ± 3 in the T1D control group; early diagnosis (<2 years old) occurred in three T1D+DS patients but only in one T1D control patients, both suggesting lower age of diagnosis in T1D+DS group, although without statistical significance (p = 0.282 and p = 0.093, respectively). The T1D+DS group presented lower total insulin dose (0.7 IU/kg/day ± 0.2) and HbA1c (7.2% ± 0.6) than the control group (1.0 IU/kg/day ± 0.3 and 9.1% ± 0.7, respectively) (p = 0.022 and p = 0.047, respectively). Conclusion: We confirmed the autoimmune etiology of diabetes in people with DS in this admixed population. T1D+DS patients developed diabetes earlier and achieved better metabolic control with a lower insulin dose than T1D controls. These findings are in agreement with previous studies in Caucasian populations.


Subject(s)
Humans , Child, Preschool , Child , Adolescent , Down Syndrome/complications , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/epidemiology , Brazil/epidemiology , Autoimmunity , Case-Control Studies
15.
Adv Rheumatol ; 61: 8, 2021. tab, graf
Article in English | LILACS | ID: biblio-1152738

ABSTRACT

Abstract Background: Sjögren's Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren's versus healthy people or patients with non-Sjögren's sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren's syndrome in comparison to controls (healthy and non-Sjögren's sicca patients). Methods: A systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively. Results: Thirty-two articles were included (20 were case-control studies,6 were cross-sectional,2 prospective cohort,2 retrospective cohort, and2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren's group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, −0.24 to −0.13; chi2-P-value <0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly3 or 4. The quality of evidence was met (97% of items valued). Conclusion: For the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren's syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis. (AU)


Subject(s)
Humans , Salivary Glands/metabolism , Xerostomia/metabolism , Sjogren's Syndrome/physiopathology , Autoimmunity
16.
Hepatología ; 2(2): 355-371, 2021. ilus, tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1396510

ABSTRACT

Introducción. Las enfermedades autoinmunes del hígado son un grupo de patologías caracterizadas por una respuesta autoinmune contra los hepatocitos y/o el epitelio biliar. Sus manifestaciones clínicas son variadas, con alteraciones en las pruebas de función hepática y presencia de autoanticuerpos. Metodología. Estudio observacional descriptivo con 101 pacientes atendidos en el Hospital Universitario de La Samaritana de Bogotá D.C., entre enero a diciembre de 2019, con los diagnósticos de hepatitis autoinmune, colangitis biliar primaria, colangitis esclerosante primaria y síndrome de sobreposición. Se evaluaron los parámetros clínicos y de laboratorio, con el fin de caracterizar su frecuencia en estas patologías, debido a la importancia de un diagnóstico precoz. Resultados. Se encontraron 54 casos de hepatitis autoinmune, 19 casos de colangitis biliar primaria, 4 casos de colangitis esclerosante primaria y 24 casos de síndrome de sobreposición. El 81% fueron mujeres y la edad promedio fue de 55 años. El 39% de los pacientes tenían cirrosis. En general, los resultados se ajustaron a lo descrito internacionalmente, como es el predominio en mujeres y la comorbilidad autoinmune. Conclusión. Los hallazgos indican que cualquier alteración del perfil bioquímico hepático debe ser considerado, y se debe descartar la presencia de hepatopatías autoinmunes para diagnosticarlas de manera precoz, evitando que lleguen a cirrosis y sus complicaciones, con la necesidad de un trasplante hepático como única alternativa terapéutica.


Introduction. Autoimmune liver diseases are a group of pathologies characterized by an autoimmune response against hepatocytes and/or the biliary epithelium. Their clinical manifestations are varied, with alterations in liver function tests and the presence of autoantibodies. Methodology. Descriptive study with 101 patients who attended at the Hospital Universitario de La Samaritana in Bogota D.C., between January and December 2019, with the diagnoses of autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis and overlap syndrome. Clinical and laboratory parameters were evaluated in order to characterize their frequency in these pathologies, due to the importance of an early diagnosis. Results. There were 54 cases of autoimmune hepatitis, 19 cases of primary biliary cholangitis, 4 cases of primary sclerosing cholangitis, and 24 cases of overlap syndrome. Of all patients, 81% were women, the average age was 55 years, and 39% had cirrhosis. In general, the findings were consistent with what has been described worldwide, such as a higher prevalence in women and autoimmune comorbidity. Conclusion. The findings indicate that any alteration in the liver biochemical profile should be considered to rule out an autoimmune liver disease for an early diagnosis, avoiding the possibility of cirrhosis and its complications, with the need for a liver transplant as the only therapeutic alternative.


Subject(s)
Humans , Adult , Middle Aged , Aged , Aged, 80 and over , Autoimmunity , Autoantibodies , Cholangitis, Sclerosing , Hepatitis, Autoimmune , Transaminases , Liver Cirrhosis, Biliary , Liver Diseases
17.
Alger. J. health sci. (Online. Oran) ; 3(3): 49-58, 2021. Tables, figures
Article in English | AIM | ID: biblio-1292603

ABSTRACT

Les produits d?origine naturelle sont considérés comme une source précieuse de substances médicamenteuses et constituent une grande diversité structurelle et fonctionnelle. Les venins, de par les propriétés de leurs composés représentent pour l?animal venimeux un moyen de défense contre des prédateurs et d?immobilisation de leurs proies. Ces venins sont responsables des effets néfastes induits lors d?une envenimation en induisant une stimulation du système nerveux autonome par des peptides toxiques, une libération massive des neurotransmetteurs et une réponse inflammatoire systémique excessive. Ces processus sont à l?origine des dommages tissulaires et d?une défaillance multiviscérale. Par ailleurs, certains des composants des venins représentent un potentiel pharmacologique d?intérêt dans le développement de nouveaux médicaments pouvant être utilisés dans plusieurs pathologies telles que la COVID-19. La COVID-19 est une maladie infectieuse transmissible. Lors d?une infection, le virus SARS-CoV-2 induit une réaction immunitaire inadaptée associée à un orage cytokinique et à une coagulopathie, responsables d?un syndrome de détresse respiratoire dans les cas les plus graves. La pandémie de la COVID-19 a causé à travers le monde et ce depuis fin 2019, une crise sanitaire sans précédent et d'énormes pertes économiques. Dans cette revue bibliographique, les principales avancées scientifiques concernant essentiellement la réponse immunitaire et les mécanismes immunopathologiques induits lors d?une infection avec le SARS-CoV-2 seront décrites. Le rôle bénéfique des biomolécules isolées à partir des venins sera également rapporté pour une éventuelle utilisation de nouvelles biomolécules contre la COVID-19.


Natural products are considered as an excellent source of novel drugs and continue to provide greater structural and functional diversity. Venoms, by the properties of their compounds, are used by venomous animal for their defense against predators and to immobilize the prey. These venoms are responsible for the harmful effects induced during envenomation by inducing stimulation of the autonomic nervous system by toxic peptides, massive release of neurotransmitters and an excessive systemic inflammatory response. These processes cause tissue damage and multiple organ failure. However, some of the components of the venoms represent a valuable pharmacological potential in the development of new drugs that can be used in several pathologies such as COVID-19. The infectious, COVID-19 disease, caused by SARS-CoV-2, can lead to an inappropriate immune response, consequently causing cytokine storm and coagulopathy, responsible for respiratory distress syndrome in the most severe cases. Since its onset, the COVID-19 pandemic has spread over the world; it has not only impacted human health, but also the individual behavior, the functioning of society and the economy of all countries. This review provides an overview of the current evidence regarding immune response and the immune-pathological mechanisms involved during infection with SARS-CoV-2. The beneficial role of biomolecules isolated from venoms will be also presented as potential candidate molecules against COVID-19.


Subject(s)
Scorpion Venoms , Therapeutics , COVID-19 , Autoimmunity , SARS-CoV-2
18.
Rev. argent. reumatolg. (En línea) ; 31(4): 7-7, dic. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1288204

ABSTRACT

La búsqueda constante para mejorar la calidad de vida de la población nos conduce a la obtención de medicamentos para así prevenir y tratar mejor las enfermedades. En esa búsqueda, sustancias ya conocidas por otras propiedades, adquieren relevancia cuando puede demostrarse su efectividad para mejorar la evolución de algunas patologías. Con motivo de la promulgación de la Ley de Uso Medicinal de la Planta de Cannabis y su actual reglamentación, la problemática en el uso de los derivados de la misma en el tratamiento de afecciones médicas dolo- rosas y enfermedades autoinmunes adquiere particular importancia. En ese sentido es oportuno que las sociedades médicas en general y en este caso, la Sociedad Argentina de Reumatología en particular, dé lugar a un espacio de publicación y discusión de este tema. En esta edición, Scublinsky D et al publican un estudio realizado sobre la conducta de los médicos frente a la prescripción de cannabis terapéutico. Resulta de interés saber lo que piensan los médicos por ser los efectores directos de la Salud y a quienes más escuchan los pacientes. También en esta edición se presenta una puesta al día del tema con la evidencia disponible y la discusión del tema, que resulta interesante su lectura.


Subject(s)
Cannabis , Pain , Autoimmunity
19.
Rev. colomb. reumatol ; 27(supl.2): 58-66, oct.-dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1341340

ABSTRACT

RESUMEN La poliautoinmunidad se define como la presencia de más de una enfermedad autoinmune (EA) bien caracterizada en un mismo paciente. Es una condición frecuente en pacientes con síndrome de Sjögren (SS) y sigue un patrón de agrupamiento. Las EA más frecuentes observadas en el SS son la enfermedad tiroidea autoinmune, la artritis reumatoide y el lupus eritematoso sistémico. El estudio de este fenómeno aporta claves importantes para entender los mecanismos comunes de las EA.


ABSTRACT Multiple autoimmunity is defined as the presence of more than one well-defined autoimmune disease (AD) in a single patient. Multiple autoimmunity is a frequent condition in Sjögren's syndrome (SS) and follows a grouping pattern. The most frequent ADs observed in SS are autoimmune thyroid disease, rheumatoid arthritis, and systemic lupus erythematosus. The study of multiple autoimmunity provides important clues for elucidating the common mechanisms of ADs.


Subject(s)
Humans , Sjogren's Syndrome , Autoimmunity , Autoimmune Diseases , Thyroid Diseases , Lupus Erythematosus, Systemic
20.
Rev. cuba. endocrinol ; 31(3): e206, sept.-dic. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156395

ABSTRACT

La diabetes insípida es el resultado de una secreción o acción reducidas de la hormona vasopresina, expresada clínicamente por un cuadro de poliuria-polidipsia. Los arbovirus pueden tener afinidad por el sistema nervioso y se ha demostrado que el Zika desencadena un trastorno autoinmune que ataca a las células nerviosas, lo que puede traer como consecuencia una diabetes insípida central. En la literatura médica nacional e internacional revisada no se reportan casos anteriores donde se vincule la diabetes insípida con el virus del Zika. Se presenta un caso a propósito de esta asociación: paciente femenina de 53 años, diagnosticada con infección por el virus del Zika dos semanas antes de comenzar con los síntomas sugestivos de diabetes insípida. El potencial neurotrópico del virus, así como los resultados en la resonancia magnética nuclear y la determinación de marcadores de autoinmunidad anti-ADNdc positivos, son elementos que apoyan la hipótesis de que la paciente presentó una posible hipofisitis autoinmune, como respuesta inflamatoria post-infección, desarrollando diabetes insípida central transitoria(AU)


Diabetes insipidus is the result of reduced secretion or action of the vasopressin hormone, which is clinically expressed by a polyuria-polydipsia picture. Arboviruses can have a nervous system affinity and Zika has been shown to trigger an autoimmune disorder that attacks nerve cells, which can result in central diabetes insipidus. The reviewed national and international medical literatures does not report previous cases linking diabetes insipidus with Zika virus. It is presented a case about this association: 53-year-old female patient diagnosed with Zika virus infection two weeks before starting symptoms suggestive of diabetes insipidus. The neurotropic potential of the virus, as well as the results in nuclear MRI and the determination of positive anti-ADNdc autoimmunity markers are elements that support the hypothesis that the patient had a possible autoimmune hypophysis, as a post-infection inflammatory response, developing transient central diabetes insipidus(AU)


Subject(s)
Humans , Female , Middle Aged , Autoimmunity , Diabetes Insipidus/etiology , Zika Virus Infection/diagnosis , Arboviruses/immunology , Review Literature as Topic , Magnetic Resonance Spectroscopy/methods
SELECTION OF CITATIONS
SEARCH DETAIL