Cognitive Dysfunction Biomarkers in Patients With Rheumatoid Arthritis: A Systematic Review.

BACKGROUND/OBJECTIVES: During the last years, a growing number of studies have investigated the link between cognitive dysfunction and rheumatoid arthritis (RA), highlighting the potential pathogenic role of several clinical, psychological, and biological factors. We aimed to investigate serological and cerebrospinal fluid biomarkers in humans and its association with cognitive dysfunction in patients with RA. METHODS: We performed a systematic review using PRISMA (Preferred Reported Items for Systematic Reviews and Meta-analysis) protocol. A systematic search was conducted in the PubMed/MEDLINE, EMBASE, LILACS, Scopus, and Google Scholar databases from inception up to November 2021. The inclusion criteria for studies were defined based on the participants involved, type of exposure, type of comparison group, outcome of interest, and study design. RESULTS: Five original studies were included, which provided data from 428 participants. Among plasma proteins, SHH was increased and TTR was reduced in patients with mild cognitive impairment; anti-myelin basic protein and anti-myelin oligodendrocyte glycoprotein negatively correlated with memory, executive function, and attention. S100ß negatively correlated with memory and executive functions; some lymphocyte subpopulations positively correlated with attention, memory, and executive functions. Interleukin 2 [IL-2], IL-4, IL-6, and tumor necrosis factor α negatively correlated with memory and positively correlated with executive functions. Interleukin 1ß negatively correlated with global cognitive dysfunction and positively correlated with logical thinking. Interleukin 10 and brain-derived neurotrophic factor negatively correlated with memory. CONCLUSION: Despite the relative scarcity of studies on this subject and the heterogeneity of results, we identified possible biomarkers for cognitive deficits in the RA population. Further longitudinal studies are warranted to clarify these associations and the establishment of possible biomarkers for cognitive deficits in RA.

Lúpus eritematoso sistêmico e tuberculose renal: descrição de nove Casos / Systemic lupus erythematosus and renal tuberculosis: description of nine cases

OBJETIVO: O presente estudo tem por objetivo principal descrever uma série de nove casos de tuberculose (TB) renal em pacientes portadores de lúpus eritematoso sistêmico (LES) ocorridos em um período de seis anos em um hospital terciário do Nordeste brasileiro. MÉTODOS: Foram identificados nove pacientes portadoras de LES com baciloscopia e/ou cultura de urina positivas para Mycobacterium tuberculosis no período de outubro de 1998 a novembro de 2004, por intermédio dos registros do Serviço de Microbiologia do Hospital Universitário Walter Cantídio. Foram coletados dados demográficos, dados sobre o LES e sobre a TB renal das respectivas pacientes. RESULTADOS: Todas as pacientes eram do sexo feminino, com idade entre 19 e 58 anos. Quanto às características do LES, todas haviam tido nefrite lúpica em algum momento da evolução, das quais três haviam utilizado ciclofosfamida previamente à infecção. A dose média de prednisona antes do diagnóstico de TB renal variou entre 7, 5 e 20 mg/dia. O diagnóstico de TB renal foi feito por meio de cultura positiva em cinco pacientes e por intermédio de baciloscopia apenas em quatro pacientes. As manifestações laboratoriais mais freqüentes foram leucocitúria e hematúria. A recidiva da TB renal ocorreu em quatro pacientes. CONCLUSÃO: A ocorrência de TB renal em pacientes com LES deve ser suspeitada na presença de piúria estéril e/ou hematúria persistentes, em especial em populações de países em desenvolvimento.

OBJECTIVE: The main objective of the present study was to describe a series of nine cases of renal tuberculosis (TB) in patients diagnosed with systemic lupus erythematosus (SLE) over a period of six years at a tertiary-level hospital in Northeastern Brazil. METHODS: Nine SLE patients with renal TB confirmed by bacterioscopy (n=4) or urine culture (n=5) positive for M. tuberculosis between October 1998 and November 2004 were sampled from the records of the microbiology department of Hospital Universitário Walter Cantídio. Data were collected regarding demographics, SLE and renal TB. RESULTS: All patients were female, aged between 19 and 58 years and had a history of lupus nephritis. Three had been on cyclophosphamide therapy prior to TB infection. The average dose of prednisone administered before the diagnosis of renal TB ranged between 7.5 and 20 mg/day. The most common laboratory findings were leukocyturia and hematuria. Renal TB recurred in four patients. CONCLUSION: The occurrence of renal TB in SLE patients should be suspected in the presence of persistent sterile pyuria and/or hematuria, especially in developing countries.