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2.
Muscle Nerve ; 61(1): 81-87, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31588577

RESUMO

INTRODUCTION: Myopathy associated with anti-mitochondrial antibody (AMA) has recently been characterized as a distinct type of idiopathic inflammatory myopathy. The purpose of this study is to evaluate the pattern of involvement in thigh muscles in AMA myopathy using MRI. METHODS: Six patients with AMA myopathy were identified and their muscle MRI findings evaluated. RESULTS: On thigh muscle MRI, all six patients showed high signal intensity with short-tau inversion recovery that reflected disease activity mostly in the adductor magnus, called a "cuneiform sign." Fatty degeneration was also prominent in the adductor magnus, as well as the semimembranosus muscles. DISCUSSION: These characteristic changes on MRI contrast with those of other inflammatory myopathies. From these observations, we concluded that the localization pattern of the inflammatory changes in muscle MRI can contribute to the diagnosis of AMA myopathy.


Assuntos
Autoanticorpos/imunologia , Doenças Autoimunes/complicações , Doenças Autoimunes/diagnóstico por imagem , Mitocôndrias Musculares/imunologia , Miopatias Mitocondriais/diagnóstico por imagem , Miopatias Mitocondriais/etiologia , Músculo Esquelético/diagnóstico por imagem , Coxa da Perna/diagnóstico por imagem , Tecido Adiposo/patologia , Adulto , Idoso , Atrofia , Feminino , Granuloma/patologia , Humanos , Hipertrofia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Coxa da Perna/patologia
3.
Rev Med Chil ; 147(6): 803-807, 2019 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-31859835

RESUMO

Pneumococcal meningitis produces several inflammatory disorders in susceptible subjects. A worsening of meningitis can occur on the fourth day of evolution in relation with the withdrawal of steroids. Other complications include the development of inflammatory signs in the post-acute stage of infection associated with disseminated vasculitis of the cerebral blood vessels and, even later, an autoimmune chronic meningitis. All these inflammatory complications are well controlled with the use of steroids. We report a 53-year-old woman with pneumococcal meningitis that had a good response to treatment with antibiotics and steroids. On the four day, after the steroids were discontinued, she complained of headache, became confused, and had an abnormal cerebrospinal fluid (CSF), report CT angiography showed signs of arteritis. She improved when the steroids were re-started. She was discharged in good condition but after slow tapering of the steroids over a four-month period she had a relapse of all her symptoms and had a gait disturbance. On readmission, she had an inflammatory CSF, there were no signs of infection and the cerebral MRI showed meningeal thickening with ventricular space enlargement. She improved again with steroids and she is now well on high-dose steroids but deteriorates each time the steroids are stopped. She experienced both acute and sub-acute inflammatory responses and finally developed a chronic meningitis responsive, and is dependent on steroids.


Assuntos
Doenças Autoimunes/microbiologia , Meningite Pneumocócica/complicações , Antibacterianos/uso terapêutico , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Líquido Cefalorraquidiano/microbiologia , Doença Crônica , Feminino , Humanos , Imagem por Ressonância Magnética , Meningite Pneumocócica/diagnóstico por imagem , Meningite Pneumocócica/tratamento farmacológico , Pessoa de Meia-Idade , Esteroides/uso terapêutico , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
4.
Arch. Soc. Esp. Oftalmol ; 94(11): 540-544, nov. 2019. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-187410

RESUMO

El objetivo fue presentar un caso de retinopatía autoinmune (AIR) no paraneoplásica con anticuerpos antirecoverina positivos. Una mujer de 28 años consultó por pérdida de la agudeza visual bilateral de 8 meses de evolución. El fondo de ojo presentó un patrón de coloración moteado desde el centro a la periferia, sin espículas pigmentarias. La angiografía mostró un patrón de áreas puntiformes, sin fuga de contraste. Se observó una reducción de las capas externas de la retina en la tomografía de coherencia óptica, mientras que el electrorretinograma mostró una ausencia de respuesta de los conos y los bastones en el ojo derecho, y una respuesta disminuida de los conos con ausencia de respuesta de los bastones en el ojo izquierdo. Se sospechó AIR, y se empezó tratamiento empírico con corticoides a la espera de los resultados del Western-blot, que posteriormente resultó positivo para recoverina, GAPDH, anti-alfa-enolasa y aldolasa. Mientras pudo ser tratada, la agudeza visual se mantuvo estable. Al retirarse el tratamiento, esta se redujo a amaurosis en el ojo derecho y movimiento de manos en el ojo izquierdo


The case is presented of a non-paraneoplastic autoimmune retinopathy (AIR) with positive anti-recoverin autoantibodies. A 28-year-old woman presented with a rapidly progressive bilateral visual loss of 8 months onset. Funduscopic examination revealed diffuse fine mottled atrophic changes in both eyes. Fluorescein angiographic studies showed a pattern of mottled areas of early hyperfluorescence without leakage of dye. In the ocular coherence tomography it was observed that was a loss of external layers. The electroretinogram showed absence of rod and cone responses in the right eye, and diminished cone response associated to absence of rod response in the left eye. AIR was suspected, and empirical corticosteroid treatment was started while waiting for Western-blot results, which was finally positive for recoverin, GAPDH, anti-alpha-enolase, and aldolase. The patient was able to be treated, and her visual acuity remained stable, but as soon as it was suspended, vision was completely lost in the right eye and reduced to hand movement in the left eye


Assuntos
Humanos , Feminino , Adulto , Anticorpos/análise , Doenças Autoimunes/imunologia , Recoverina/imunologia , Doenças Retinianas/imunologia , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Eletrorretinografia , Fundo de Olho , Glucocorticoides/uso terapêutico , Ácido Micofenólico/uso terapêutico , Prednisona/uso terapêutico , Doenças Retinianas/diagnóstico por imagem , Doenças Retinianas/tratamento farmacológico , Tomografia de Coerência Óptica , Acuidade Visual , Campos Visuais
5.
Sheng Wu Yi Xue Gong Cheng Xue Za Zhi ; 36(5): 755-762, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31631623

RESUMO

Autoimmune pancreatitis (AIP) is a unique subtype of chronic pancreatitis, which shares many clinical presentations with pancreatic ductal adenocarcinoma (PDA). The misdiagnosis of AIP often leads to unnecessary pancreatic resection. 18F-FDG positron emission tomography/ computed tomography (PET/CT) could provide comprehensive information on the morphology, density, and functional metabolism of the pancreas at the same time. It has been proved to be a promising modality for noninvasive differentiation between AIP and PDA. However, there is a lack of clinical analysis of PET/CT image texture features. Difficulty still remains in differentiating AIP and PDA based on commonly used diagnostic methods. Therefore, this paper studied the differentiation of AIP and PDA based on multi-modality texture features. We utilized multiple feature extraction algorithms to extract the texture features from CT and PET images at first. Then, the Fisher criterion and sequence forward floating selection algorithm (SFFS) combined with support vector machine (SVM) was employed to select the optimal multi-modality feature subset. Finally, the SVM classifier was used to differentiate AIP from PDA. The results prove that texture analysis of lesions helps to achieve accurate differentiation of AIP and PDA.


Assuntos
Adenocarcinoma/diagnóstico por imagem , Doenças Autoimunes/diagnóstico por imagem , Neoplasias Pancreáticas/diagnóstico por imagem , Pancreatite/diagnóstico por imagem , Algoritmos , Diagnóstico Diferencial , Fluordesoxiglucose F18 , Humanos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Máquina de Vetores de Suporte
6.
Sichuan Da Xue Xue Bao Yi Xue Ban ; 50(4): 471-477, 2019 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-31642221

RESUMO

OBJECTIVE: To determinethe diagnostic valuesand reliabilityof cardiac magnetic resonance tissue tracking (CMR-TT) derived two-dimensional(2D) and three-dimensional(3D) strains in assessing experimental autoimmunity myocarditis (EAM) in rats. METHODS: 20 Lewis rats were randomly divided into model and control groups. The animal model of autoimmune myocarditis was induced by injecting porcine cardiac myosin into the footpads of the rats.On day 35, all of the rats were examined using the 7.0T CMR cine scan. The cardiac function and global strain of the left ventricular of the rats were analyzed with specific cardiac post-processing. The rats were then sacrificed and myocardial samples were taken and stained with HE and Masson. The diagnostic values of the strain parameters were assessed by receiver operating characteristic (ROC) curves with the pathological results as diagnostic criteria.The reliability of the strain parameters were tested using interclass correlation coefficient (ICC), coefficients of variation (CV) and Bland-Altman. RESULTS: No abnormal pathological changes in myocardial cells were found in the control group. Myocarditis was successfully induced in all of the rats in the model group, showing myocardial fiber arrangement disorder, degeneration, necrosis, inflammatory cell infiltration and interstitial fibrosis. The ROC showed that 2D global strain parameters possessed higher diagnostic values than 3D strain parameters. The 2D had an area under the curve (AUC) of 0.96 in global circumferential strain (GCS), 0.95 in global radial strain (GRS), and 0.90 in global longitudinal strain (GLS), compared with 0.87 GCS, 0.85 GRS, and 0.77 GLS in the 3D, respectively.The reliability of the 2D strain parameters was high, except for inter-observer 2D GRS(ICC=0.893). The 3D strain parameters had lower reliability (ICCs:0.421-0.79) than the 2D strain parameters (ICCs:0.893-0.986). CONCLUSION: The diagnostic values of 2D strain parameters are higher than 3D strain parameters in diagnosing myocarditis.


Assuntos
Doenças Autoimunes/diagnóstico por imagem , Imagem Cinética por Ressonância Magnética , Miocardite/diagnóstico por imagem , Animais , Modelos Animais de Doenças , Distribuição Aleatória , Ratos , Ratos Endogâmicos Lew , Reprodutibilidade dos Testes , Suínos , Função Ventricular Esquerda
7.
N Engl J Med ; 381(10): 923-932, 2019 09 05.
Artigo em Inglês | MEDLINE | ID: mdl-31483963

RESUMO

BACKGROUND: Pulmonary alveolar proteinosis is a disease characterized by abnormal accumulation of surfactant in the alveoli. Most cases are autoimmune and are associated with an autoantibody against granulocyte-macrophage colony-stimulating factor (GM-CSF) that prevents clearing of pulmonary surfactant by alveolar macrophages. An open-label, phase 2 study showed some therapeutic efficacy of inhaled recombinant human GM-CSF in patients with severe pulmonary alveolar proteinosis; however, the efficacy in patients with mild-to-moderate disease remains unclear. METHODS: We conducted a double-blind, placebo-controlled trial of daily inhaled recombinant human GM-CSF (sargramostim), at a dose of 125 µg twice daily for 7 days, every other week for 24 weeks, or placebo in 64 patients with autoimmune pulmonary alveolar proteinosis who had a partial pressure of arterial oxygen (Pao2) while breathing ambient air of less than 70 mm Hg (or <75 mm Hg in symptomatic patients). Patients with severe pulmonary alveolar proteinosis (Pao2 <50 mm Hg) were excluded to avoid possible exacerbation of the disease in patients who were assigned to receive placebo. The primary end point was the change in the alveolar-arterial oxygen gradient between baseline and week 25. RESULTS: The change in the mean (±SD) alveolar-arterial oxygen gradient was significantly better in the GM-CSF group (33 patients) than in the placebo group (30 patients) (mean change from baseline, -4.50±9.03 mm Hg vs. 0.17±10.50 mm Hg; P = 0.02). The change between baseline and week 25 in the density of the lung field on computed tomography was also better in the GM-CSF group (between-group difference, -36.08 Hounsfield units; 95% confidence interval, -61.58 to -6.99, calculated with the use of the Mann-Whitney U test and the Hodges-Lehmann estimate of confidence intervals for pseudo-medians). Serious adverse events developed in 6 patients in the GM-CSF group and in 3 patients in the placebo group. CONCLUSIONS: In this randomized, controlled trial, inhaled recombinant human GM-CSF was associated with a modest salutary effect on the laboratory outcome of arterial oxygen tension, and no clinical benefits were noted. (Funded by the Japan Agency for Medical Research and Development and the Ministry of Health, Labor, and Welfare of Japan; PAGE ClinicalTrials.gov number, NCT02835742; Japan Medical Association Center for Clinical Trials number, JMA-IIA00205.).


Assuntos
Doenças Autoimunes/tratamento farmacológico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Fatores Imunológicos/uso terapêutico , Proteinose Alveolar Pulmonar/tratamento farmacológico , Administração por Inalação , Adulto , Idoso , Autoanticorpos/sangue , Doenças Autoimunes/diagnóstico por imagem , Método Duplo-Cego , Esquema de Medicação , Feminino , Fator Estimulador de Colônias de Granulócitos e Macrófagos/administração & dosagem , Fator Estimulador de Colônias de Granulócitos e Macrófagos/efeitos adversos , Fator Estimulador de Colônias de Granulócitos e Macrófagos/imunologia , Humanos , Fatores Imunológicos/administração & dosagem , Fatores Imunológicos/efeitos adversos , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Oxigênio/sangue , Proteinose Alveolar Pulmonar/diagnóstico por imagem , Proteinose Alveolar Pulmonar/imunologia , Capacidade de Difusão Pulmonar , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/uso terapêutico , Fumar/efeitos adversos , Tomografia Computadorizada por Raios X , Teste de Caminhada
8.
Transfus Apher Sci ; 58(4): 449-452, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31395426

RESUMO

Ghosal hematodiaphyseal dysplasia (GHDD) is an autosomal recessive inherited disorder associated with biallelic mutations in the TBXAS1 gene located on the chromosome 7q33-34, which encodes thromboxane-A-synthase. GHDD is characterized by defective hematopoiesis due to bone marrow fibrosis and metadiaphyseal dysplasia of long bones. The accurate diagnosis of this rare syndrome is critical since it reduces the need of blood transfusions by corticosteroid therapy, leading to a significant improvement in anemia and bone changes. The aim of this study is to report two adult siblings diagnosed as GHDD, who admitted with pancytopenia and treated with steroids treatment in adult hematology clinic.


Assuntos
Anemia Refratária , Anemia , Doenças Autoimunes , Cromossomos Humanos Par 7/genética , Mutação , Osteocondrodisplasias , Irmãos , Adulto , Anemia/diagnóstico por imagem , Anemia/tratamento farmacológico , Anemia/genética , Anemia Refratária/diagnóstico por imagem , Anemia Refratária/tratamento farmacológico , Anemia Refratária/genética , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/tratamento farmacológico , Doenças Autoimunes/genética , Humanos , Masculino , Osteocondrodisplasias/diagnóstico por imagem , Osteocondrodisplasias/tratamento farmacológico , Osteocondrodisplasias/genética
9.
PLoS One ; 14(7): e0219308, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31269074

RESUMO

In this study, we compared ultrasound (US) features between normal parotid parenchyma (NPP) and incidental diffuse parotid disease (DPD). From January 2008 to December 2017, 180 patients underwent neck US before parotid surgery at our hospital. From these, 82 were excluded because of the lack of histopathological data concerning the parotid parenchyma or inadequate US images. A single radiologist blinded to the clinicoserological data and histopathological results, retrospectively investigated all US features and categorizations for the parotid glands using a picture archiving and communication system. Retrospective histopathological analysis of the parotid parenchyma was performed by a single pathologist. On the basis of the histopathological analyses, the 98 patients were divided into NPP (n = 70) and DPD (n = 28) groups. Among US features, parenchymal echogenicity and echotexture showed statistically significant differences between the two groups (p < 0.0001), whereas the gland size, margin, and vascularity showed no significant differences (p > 0.05). The US-based categorization significantly differentiated between NPP and DPD (p < 0.0001), and receiver operating characteristic curve analysis revealed that US categorization based on ≥2 abnormal US features showed the best diagnostic performance for detecting DPD. Thus, US can aid in differentiating DPD from NPP.


Assuntos
Doenças Parotídeas/diagnóstico por imagem , Ultrassonografia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Autoimunes/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Curr Top Med Chem ; 19(16): 1445-1463, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31284861

RESUMO

Adenosine receptors (ARs) are a class of purinergic G-protein-coupled receptors (GPCRs). Extracellular adenosine is a pivotal regulation molecule that adjusts physiological function through the interaction with four ARs: A1R, A2AR, A2BR, and A3R. Alterations of ARs function and expression have been studied in neurological diseases (epilepsy, Alzheimer's disease, and Parkinson's disease), cardiovascular diseases, cancer, and inflammation and autoimmune diseases. A series of Positron Emission Tomography (PET) probes for imaging ARs have been developed. The PET imaging probes have provided valuable information for diagnosis and therapy of diseases related to alterations of ARs expression. This review presents a concise overview of various ARs-targeted radioligands for PET imaging in diseases. The most recent advances in PET imaging studies by using ARs-targeted probes are briefly summarized.


Assuntos
Doenças Autoimunes/metabolismo , Doenças Cardiovasculares/metabolismo , Inflamação/metabolismo , Doenças do Sistema Nervoso/metabolismo , Tomografia por Emissão de Pósitrons , Receptores Purinérgicos P1/análise , Animais , Doenças Autoimunes/diagnóstico por imagem , Doenças Cardiovasculares/diagnóstico por imagem , Humanos , Inflamação/diagnóstico por imagem , Sondas Moleculares/química , Doenças do Sistema Nervoso/diagnóstico por imagem
12.
Mult Scler Relat Disord ; 33: 70-74, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31158805

RESUMO

OBJECTIVES: To determine the differentiating features of autoimmune central nervous system (CNS) vasculitis and multiple sclerosis (MS) on susceptibility-weighted imaging (SWI). METHODS: Seventy-three patients (27 with autoimmune CNS vasculitis and 46 with MS) who underwent magnetic resonance imaging with SWI sequence were included. The features of lesions and distinct SWI findings were investigated in both diseases. RESULTS: On SWI, autoimmune CNS vasculitis presented with a higher prevalence of multiple microbleeds (48.1%), cortical superficial siderosis (70.4%), and tortuosity of the vascular route (59.3%) than were found in MS (p < 0.001, p < 0.001, and p = 0.001, respectively). Multivariable logistic analysis showed that multiple microbleeds and cortical superficial siderosis were associated with a much higher probability of a diagnosis of autoimmune CNS vasculitis than of MS (OR 19.09, 95% CI 1.13-321.18, p = 0.041; and OR 13.20, 95% CI 2.22-78.30, p = 0.005, respectively). The presence of more than eleven lesions was associated with a lower probability of a diagnosis of autoimmune CNS vasculitis than of MS (OR 0.14, 95% CI 0.03-0.73, p = 0.020). CONCLUSIONS: SWI may be a useful adjunct in distinguishing autoimmune CNS vasculitis from MS. The identification of multiple microbleeds and cortical superficial siderosis can point to a diagnosis of autoimmune CNS vasculitis.


Assuntos
Doenças Autoimunes/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Esclerose Múltipla/diagnóstico por imagem , Neuroimagem/métodos , Vasculite do Sistema Nervoso Central/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
13.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(5): 347-352, jun. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-180922

RESUMO

La capilaroscopia es una técnica de estudio que permite obtener imágenes directas in vivo de la microcirculación cutánea. Constituye un método accesible y no invasivo para analizar las anormalidades microvasculares, por lo que puede utilizarse en niños y adultos. En la actualidad se ha demostrado su utilidad en múltiples dolencias, principalmente en el fenómeno de Raynaud y otras enfermedades autoinmunes. La capilaroscopia se realiza en el lecho ungueal del segundo al quinto dedo de ambas manos con la finalidad de encontrar un patrón capilaroscópico específico. El patrón de normalidad se caracteriza por la presencia de 7-11 capilares por milímetro dispuestos en forma de «U» invertida. Los patrones patológicos muestran alteraciones morfológicas y estructurales como: ectasias, capilares gigantes, hemorragias patológicas, áreas avasculares y neoangiogénesis. En este artículo se presentan las bases de la capilaroscopia, incluyendo la técnica, las indicaciones, así como la utilidad diagnóstica y como factor pronóstico en enfermedades reumatológicas


Capillaroscopy produces in vivo images of skin microcirculation. It is a simple, noninvasive tool for analyzing microvascular abnormalities and, as such, can be used in both adults and children. Capillaroscopy has proven useful in many diseases, but it is of particular value in Raynaud phenomenon and other autoimmune diseases. The test is used to analyze capillaroscopic patterns in the nailfold bed of the second to fifth fingers of each hand. A normal capillaroscopic pattern is characterized by the presence of 7 to 11 capillaries in a hairpin shape. Pathologic patterns are characterized by morphologic and structural alterations, such as ectasias, giant capillaries, pathologic hemorrhages, avascular areas, and neoangiogenesis. In this article, we review the fundamentals of capillaroscopy, with an emphasis on the technique and its indications, diagnostic value, and use as a prognostic tool for rheumatologic disorders


Assuntos
Humanos , Angioscopia Microscópica , Doenças Reumáticas/diagnóstico por imagem , Angioscopia Microscópica/métodos , Microscopia Intravital , Microcirculação , Doenças Autoimunes/diagnóstico por imagem , Escleroderma Sistêmico , Unhas/irrigação sanguínea , Doença de Raynaud/diagnóstico por imagem
14.
EBioMedicine ; 43: 620-631, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31076346

RESUMO

BACKGROUND: Bone destruction is one of many severe complications that occurs in patients with rheumatoid arthritis (RA) and current therapies are unable to cure this manifestation. This study here aims to determine whether GMSC can directly inhibit osteoclast formation and eventually attenuate osteoclastogenesis and bone erosion in an inflammatory milieu. METHOD: GMSC were co-cultured with osteoclast precursors with or without CD39 inhibitor, CD73 inhibitor or adenosine receptors inhibitors pretreatment and osteoclast formation were evaluated in vitro. 2×10^6 GMSC per mouse were transferred to CIA mice and pathology scores, the frequency of osteoclasts, bone erosion in joints were assessed in vivo. FINDING: GMSC but not control cells, markedly suppressed human or mice osteoclastogenesis in vitro. GMSC treatment also resulted in a dramatically decreased level of NF-κB p65/p50 in osteoclasts in vitro. Infusion of GMSC to CIA significantly attenuated the severity of arthritis, pathology scores, frequency of osteoclasts, particularly bone erosion, as well as a decreased expression of RANKL in synovial tissues in vivo. Blockade of CD39/CD73 or adenosine receptors has significantly abrogated the suppressive ability of GMSC in vitro and therapeutic effect of GMSC on bone erosion during CIA in vivo. INTERPRETATION: GMSC inhibit osteoclast formation in vitro and in vivo partially via CD39-CD73-adenosine signals. Manipulation of GMSC may have a therapeutic implication on rheumatoid arthritis and other bone erosion related diseases. FUND: This study was supported by grants from the National Key R&D Program of China (2017YFA0105801 to F.H); the Zhujiang Innovative and Entrepreneurial Talent Team Award of Guangdong Province (2016 ZT 06S 252 to F·H) and National Institutes of Health (R01 AR059103, R61 AR073409 and NIH Star Award to S.G.Z).


Assuntos
Adenosina/metabolismo , Antígenos CD/metabolismo , Apirase/metabolismo , Gengiva/citologia , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/metabolismo , Osteogênese , Transdução de Sinais , Animais , Artrite Experimental , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/etiologia , Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/etiologia , Doenças Autoimunes/metabolismo , Doenças Autoimunes/patologia , Biomarcadores , Linhagem Celular , Feminino , Fibroblastos/metabolismo , Humanos , Camundongos , Osteoclastos/metabolismo , Tomografia Computadorizada por Raios X
15.
Eur J Clin Invest ; 49(8): e13132, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31125424

RESUMO

BACKGROUND: Experimental autoimmune myocarditis (EAM) is a common animal model for the investigation of the pathophysiology of myocarditis. Because of diverging findings from previous studies, we performed serial echocardiographic examinations throughout the course of the disease and investigated the dimensions of the murine heart and left ventricular (LV) systolic function. MATERIALS AND METHODS: Experimental autoimmune myocarditis was induced in male Balb/c mice by subcutaneous injection of a fragment of the α-myosin heavy chain (MyHC-α 614-629: Ac-SLKLMATLFSTYASAD). Transthoracic echocardiography was performed on days 0, 7 and 21 in healthy animals and mice with EAM. RESULTS: Experimental autoimmune myocarditis was associated with a reduction in LV systolic function and an increase in LV internal diameter in diastole (LVIDd) and systole (LVIDs) 7 days postimmunization. After 21 days, EAM led to a significant increase in LV-thickness (1.3-fold increase in LV anterior wall diameter in diastole [LVAWDd]), but there was no difference in LV systolic function between immunized animals and healthy controls. LV-thickness correlated well with the severity of myocarditis in the histopathological examination (LVAWDd: rs = 0.603, P = 0.003, LV anterior wall diameter in systole (LVAWDs): rs = 0.718, P < 0.0001). CONCLUSION: Our results indicate that EAM leads to an initial dilatation of the LV that is followed by ventricular "hypertrophy." On day 21, there was no significant difference in LV systolic function between immunized animals and controls. Furthermore, the ageing of the animals had a major impact on the echocardiographic parameters; therefore, the use of healthy age-matched controls seems warranted when echocardiography is performed in rodents.


Assuntos
Doenças Autoimunes/fisiopatologia , Miocardite/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Animais , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/patologia , Diástole , Modelos Animais de Doenças , Ecocardiografia , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Miocardite/diagnóstico por imagem , Miocardite/imunologia , Miocardite/patologia , Miocárdio/patologia , Sístole , Função Ventricular Esquerda
16.
Dig Dis ; 37(5): 416-421, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31079114

RESUMO

BACKGROUND: Diagnosis of pancreatic cancer (PC) in early stages is still challenging for gastroenterologists. The early detection of cancer is one of the utmost importance for the successful therapy of this malignancy. An accurate differential diagnosis of focal pancreatic lesions plays also an important role, whether it is differential diagnosis of chronic pancreatitis from PC or autoimmune pancreatitis (AIP) from PC. Raised serum immunoglobulin G4 (IgG4) levels to twice the normal value are considered one of significant diagnostic features of type 1 AIP. However, IgG4 can be increased also in patients with PC, but levels usually do not exceed twice the normal value. METHODS: In years 2012-2017, IgG4 serum levels were examined in 115 patients with histologically confirmed PC. Patients with PC and elevated IgG4 level (above 135 mg/dL) had tested their histological resection specimens or bioptic specimens from pancreatic lesion, with targeted detection of the presence of IgG4 and plasmocytes in the pancreatic tissue and changes characteristic for type 1 AIP. RESULTS: A plasmatic IgG4 level in 115 patients with diagnosed PC was higher than 135 mg/dL in 14 patients (12.2%). Out of them, 2 patients (1.7%) revealed a serum IgG4 level higher than double the normal value, that is, higher than 270.0 mg/dL (suggestive of AIP). One patient met histological criteria for diagnosis of AIP in the simultaneous presence of PC. CONCLUSION: Diagnosis of early cancer stages, particularly differentiating AIP from PC can be sometimes problematic. IgG4 levels can be slightly elevated also in case of PC. A targeted biopsy of the pancreas is the method of choice in cases suspected from a focal form of AIP and we recommend to prefer it over other modalities, such as, for example, response to steroid therapy.


Assuntos
Doenças Autoimunes/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Pancreatite Crônica/diagnóstico , Idoso , Doenças Autoimunes/sangue , Doenças Autoimunes/diagnóstico por imagem , Doenças Autoimunes/patologia , Doença Crônica , Diagnóstico Diferencial , Endossonografia , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Pancreatite Crônica/sangue , Pancreatite Crônica/diagnóstico por imagem , Pancreatite Crônica/patologia
17.
Int J Immunopathol Pharmacol ; 33: 2058738419843690, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30968726

RESUMO

Alemtuzumab, an anti-CD52 monoclonal antibody, is effective in the treatment of relapsing-remitting multiple sclerosis (RRMS). Common adverse effects include the development of autoimmune diseases, and Graves' disease is one of the most frequent presentations. We report here a case of alemtuzumab-induced thyroid disease in a female patient who showed a phase of thyrotoxicosis with positive anti-thyroglobulin (anti-Tg) and anti-thyroid peroxidase (TPO) antibodies, but a negative TSH receptor antibody, spontaneously followed by hypothyroidism. The aim is to illustrate the clinical presentation, evaluation over time, and the possibility to consider a conservative management up to the spontaneous resolution of the thyrotoxicosis. All these are intended to emphasize the importance of pretreatment screening and follow-up in the management of treatment with alemtuzumab.


Assuntos
Alemtuzumab/efeitos adversos , Antineoplásicos Imunológicos/efeitos adversos , Doenças Autoimunes/induzido quimicamente , Hipotireoidismo/induzido quimicamente , Esclerose Múltipla/tratamento farmacológico , Adulto , Doenças Autoimunes/diagnóstico por imagem , Feminino , Humanos , Hipotireoidismo/diagnóstico por imagem , Esclerose Múltipla/diagnóstico por imagem
18.
Neuroradiology ; 61(8): 853-860, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31028423

RESUMO

PURPOSE: Radiological hallmark of autoimmune limbic encephalitis (LE) is a hyperintense signal in MRI T2-weighted images of mesial temporal structures. We aimed to identify conventional magnetic resonance imaging (MRI) features that can help distinguish LE from temporal glioma. METHODS: Brain MRIs of 25 patients affected by antibody-positive autoimmune LE, 24 patients affected by temporal glioma (tumor group), and 5 negative controls were retrospectively blindly evaluated in random order. RESULTS: Ten brain MRIs from the LE group were correctly recognized; one additional patient with mesial temporal hyperintensity with anti-AK5 abs LE was wrongly diagnosed as having a tumor. The brain MRIs of the remaining 14 of the 25 patients with LE were judged negative or, in three cases, showed features not typical for LE. In the tumor group, all MRIs showed pathological alterations diagnosed as tumors in 22/24 cases and as LE in two (2/22, 9%). Unilateral lesions were more common in tumors than in neuroradiologically abnormal LE (96% vs. 18%, p < 0.001). T2/FLAIR hyperintensity of the parahippocampal gyrus was associated more with tumor than with LE (71% vs. 18%) (p = 0,009), as T2/FLAIR hyperintensity of extralimbic structures (p = 0.015), edema (p = 0.041), and mass effect (p = 0.015). Maintenance of gray/white matter distinction was strongly associated with LE (91% vs. 17%, p < 0.001). CONCLUSION: Conventional brain MRI is a fundamental tool in the differential diagnosis between LE and glioma. Bilateral involvement and maintenance of gray/white matter distinction at the cortical/subcortical interface are highly suggestive of LE.


Assuntos
Doenças Autoimunes/diagnóstico por imagem , Neoplasias Encefálicas/diagnóstico por imagem , Glioma/diagnóstico por imagem , Encefalite Límbica/diagnóstico por imagem , Imagem por Ressonância Magnética , Adulto , Idoso , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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