ABSTRACT
OBJECTIVE: Tumor necrosis factor-alpha (TNF-α) is an important inflammatory cytokine. 99mTc-anti-TNF-α antibody scintigraphy has proven to be a viable alternative to MRI in specific cases. The objective of this study was to evaluate the performance of scintigraphy with 99mTc-anti-TNF-α in the identification of inflammatory foci in individuals diagnosed with rheumatoid arthritis using MRI as the gold standard. METHODS: This cross-sectional, descriptive and analytical-qualitative clinical study compared the performance of 99mTc-anti-TNF-α scintigraphy with that of MRI with intravenous administration of gadolinium (used as the gold standard) and a clinical examination (Disease Activity Score 28) in 220 joints of 20 patients with a diagnosis of rheumatoid arthritis and one healthy control. RESULTS: The concordance of scintigraphy with MRI in individuals with a diagnosis of rheumatoid arthritis was 79%. The accuracy, sensitivity and specificity of scintigraphy for distinguishing between inflammatory and noninflammatory sites were 92, 89, and 93%, respectively. No adverse reactions to the examinations were reported. CONCLUSIONS: Scintigraphy with 99mTc-anti-TNF-α was well-tolerated and had a good ability to distinguish between inflammatory and noninflammatory lesions in patients with rheumatoid arthritis.
Subject(s)
Arthritis, Rheumatoid/diagnostic imaging , Organotechnetium Compounds , Tumor Necrosis Factor-alpha/immunology , Arthritis, Rheumatoid/immunology , Cross-Sectional Studies , Female , Humans , Inflammation/immunology , Male , Middle Aged , Radionuclide Imaging , Sensitivity and Specificity , Young AdultABSTRACT
OBJETIVO: avaliar o impacto da nefrite lúpica e suas complicacões nos resultados gestacionais. MÉTODOS: avaliamos retrospectivamente 76 gestacões em 63 pacientes com lúpus eritematoso sistêmico (LES). RESULTADOS: a hipertensão arterial estava presente como complicacão clínica em 23 (30 por cento) gestacões. Vinte e sete (36 por cento) gestacões ocorreram em 19 pacientes com nefrite. Encontramos um número significativamente mais elevado de óbitos fetais quando avaliamos todas as pacientes com nefrite em comparacão com aquelas sem nefrite (37 por cento e 12,2 por cento, respectivamente [p=0,019]). CONCLUSÕES: além da atividade de nefrite e do diagnóstico de nefrite propriamente dito, tiveram relacão com pior sobrevida fetal a associacão da síndrome do anticorpo antifosfolipídeo ou deteccão de um dos anticorpos relacionados, a presenca HAS e insuficiência renal (mesmo em suas fases iniciais).
