Idiopathic inflammatory demyelinating disorders of the central nervous system in children.

Idiopathic inflammatory demyelinating disorders of the central nervous system usually present with a typical morphologic pattern in adults, with multiple sclerosis as the predominant disorder. However, the variety of disorders in children has an odd range of features that have piqued the interest of researchers. Information concerning this group of diseases, both in vivo and in different age groups, has particularly progressed with the advent of magnetic resonance imaging in the last few decades. In this article, we provide an overview of the applicability of imaging for idiopathic inflammatory demyelinating disorders of the central nervous system in children. In addition to pediatric multiple sclerosis, this review addresses other related disorders, such as acute disseminated encephalomyelitis, pediatric neuromyelitis optica, recurrent optic neuritis, and relapsing transverse myelitis.

Prevalência de alterações no exame citológico do colo do útero em pacientes com lúpus eritematoso sistêmico / Prevalence of abnormal pap smears in patients with systemic lupus erythematosus

INTRODUÇÃO: estudos sugerem que mulheres com lúpus eritematoso sistêmico (LES) apresentam maior taxa de anormalidades no exame citológico do esfregaço cervical quando comparadas com a população geral. OBJETIVO: estudar a prevalência de anormalidades no exame citológico de Papanicolaou de pacientes com LES, procurando correlacionar o seu aparecimento com tempo de doença, uso de medicamentos imunossupressores e perfil de auto-anticorpos. MÉTODO: foram analisados 76 exames citológicos de pacientes do sexo feminino, portadoras de LES, e de 80 mulheres saudáveis. Nas pacientes com lúpus, foram verificados: tempo de doença, uso de anticoncepcionais, uso anterior de citostáticos (ciclofosfamida, azatioprina e metotrexato), antimaláricos e presença dos anticorpos anti-RO, anti-LA, anti-DNA. RESULTADO: a prevalência de alterações do Papanicolaou foi maior no grupo das pacientes com LES quando comparada com controles (9,4 por cento versus 1,2 por cento, p = 0,03). Não se encontrou associação entre o aparecimento de Papanicolaou alterado e o uso de ciclofosfamida (p = 1,0), metotrexato (p = 0,58), azatioprina (p = 1,0), antimaláricos (p = 0,051), tempo de doença (p = 0,85), exposição, nem com perfil de auto-anticorpos estudado. CONCLUSÃO: existe maior prevalência de alterações do exame citológico de esfregaço vaginal em pacientes com LES na população estudada, a qual não depende do tempo da doença, uso de agentes imunossupressores e presença de anti-RO, anti-LA ou anti-DNA.

BACKGROUND: studies have suggested that patients with systemic lupus erythematosus (SLE) have increased risk of developing abnormal results in Pap smears, when compared to the general population. OBJECT: to check the prevalence of abnormal Pap smears in patients with SLE compared to the general population relating it with disease duration, use of immunosuppressive and antimalarial agents and autoantibody profile. METHOD: we studied Pap smears of 76 patients with SLE and 80 healthy controls. In patients with SLE we assessed disease duration, use of cyclophosphamide, methotrexate, azathioprine, antimalarials and the presence of anti-RO, anti-LA and anti-DNA. RESULT: the prevalence of abnormal Pap smears was higher in the SLE group than controls (9.4 percent versus 1.2 percent, p = 0.03). No relationship was found between abnormal Pap smears and cyclophosphamide (p = 1.0), methotrexate (p = 0.58), azathioprine (p = 1.0) or antimalarial use (p = 0.051), disease duration (p = 0.85), neither with any of the studied auto antibodies. CONCLUSION: there is a higher prevalence of abnormal Pap smears in the studied SLE population than in normal people that is independent of the duration of the disease, use of immunosupressive medication or presence of autoantibodies.