Manifestações articulares em pacientes com doença de Crohn e retocolite ulcerativa

Lanna, Cristina Costa Duarte; Ferrari, Maria de Lourdes Abreu; Carvalho, Marcos Alberto de; Cunha, Aloísio Sales da

doi:10.1590/s0482-50042006000700008

Cited by 9 publications

(6 citation statements)

References 48 publications

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“…As DII podem apresentar manifestações extraintestinais, como as osteomusculares, dermatológicas e oftalmológicas, que podem preceder, acompanhar ou suceder a doença intestinal (8) . As complicações do curso da doença devem-se especialmente aos fenótipos estenosante e fistulizante, como pode ser observado na DC, assim como à presença de displasias na evolução da RCU e na DC quando há comprometimento colônico (9) .…”

Section: Introductionunclassified

Perfil de imunização em pacientes com Doença Inflamatória Intestinal / Immunization profile in patients with inflammatory bowel disease

Filetti¹,

Aride²,

Gonçalves³

et al. 2022

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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Introdução: Doença de Crohn e retocolite ulcerativa são as formas mais comuns de doenças inflamatórias intestinais (DII), que se caracterizam por condições inflamatórias crônicas devidas à ativação imune inadequada. Pela heterogeneidade clínica das DII, torna-se imperativo ressaltar as peculiaridades quanto à vacinação nesses pacientes em razão da imunossupressão decorrente dos esquemas terapêuticos instituídos, verificando-sequais vacinas são preconizadas ou contraindicadas. Objetivo: Avaliar a imunização dos pacientes com DII e conscientizá-los, assim como os médicos, sobre a importância do cumprimento do calendário vacinal. Material e Método: Estudo transversal descritivo elaborado com base em coleta de dados feita por meio de questionários aplicados durante as consultas ou telefonemas acerca do status vacinal dos pacientes portadores de DII atendidos nos ambulatórios de DII, em Hospital filantrópico de Vitória/ES. A comprovação da vacinação foi feita diretamente pelo cartão, por fotos dos cartões via telefone, ou pelo prontuário do paciente. Resultados: O nível de imunossupressão depende da intensidade, duração e tipo de tratamento, influenciando diretamente na resposta vacinal e no risco e benefício de cada vacina, principalmente as de vírus vivos ou organismos vivos atenuados. Por outro lado, vacinas com organismos inativados sempre devem ser administradas. No estudo, entre os imunizantesanalisados, identificou-se que aquele contra o papilomavírus humano apresentou maior porcentagem de ausência (92%), e aquele contra hepatite B obteve maior porcentagem de esquemas completos (84,1%). Conclusão: As principais causas observadas de esquemas incompletos foram: ausência de direcionamento médico; ausência dos imunizantes nos centros de saúde; e negligência pessoal, apesar das informações fornecidas sobre a necessidade de vacinação. Assim, evidenciou-se a importância da relação médico-paciente, a necessidade de os profissionais de saúde atuarem na manutenção do cartão vacinal completo, bem como a de os pacientes se comprometerem a completar as vacinas. As informações obtidas servirão como base para futuras pesquisas, favorecendo as evidências de imunização em pacientes com DII. Palavras-chave: Doença de Crohn, Colite ulcerativa, Imunização, Cobertura Vacinal ABSTRACT: Introduction: Crohn’s Ddisease and Uulcerative Ccolitis are the most common forms of Iinflammatory Bbowel Ddisease (IBD’s), which are characterized by chronic inflammatory conditions due to inadequate immune activation. Due to the clinical heterogeneity of IBDs, it is imperative to emphasize the peculiarities regarding vaccination in these patients due to immunosuppression resulting from the therapeutic regimens instituted, verifying which vaccines are recommended or contraindicated. Objective: The aim of this study was to evaluate the immunization of patients with IBD’s and make them, as well as doctors, aware of the importance of complying with the vaccination schedule. Materials and Methods: This is a descriptive cross-sectional study prepared from the data collection collected through the questionnaires applied during consultations or through phone calls, about the immunization status of patients with IBD, who were treated at the IBD outpatient clinics, in the Hhospital philanthropic of Vitória, - ES. Proof of vaccination was made directly by the card, by photos of the cards via telephone, or by the patient’s medical record. Results: The level of immunosuppression depends on the intensity, duration, and type of treatment, directly influencing the vaccine response and the risk and benefit of each vaccine, especially those involving live viruses or live attenuated organisms. On the other handcontrary, vaccines with inactivated organisms should always be administered. In the this study, among the immunizations analyzed, it was identified that the one against Hhuman Ppapilloma Vvirus had the highest percentage of absence (92%), and the one against hepatitis B had the highest percentage of complete regimens (84.1%). Conclusion: The main observed causes of incomplete schedules wereincluded: lack of medical guidance; absence of immunizations in health centers; and personal negligence, despite being informed about the need for vaccination. Thus, the importance of the doctor-patient relationship was highlighted, as well as the need for health professionals to act in the maintenance of the complete vaccination card, in addition to the patients’ committing commitment to complete the vaccination schedulevaccines. The information obtained will serve as a basis for future research, favoring evidence of immunization in patients with IBD. Keywords: Crohn Disease, Colitis, ulcerative, Imunization, Vaccination coverage

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Section: Introductionunclassified

Perfil de imunização em pacientes com Doença Inflamatória Intestinal / Immunization profile in patients with inflammatory bowel disease

Filetti¹,

Aride²,

Gonçalves³

et al. 2022

Arq Med Hosp Fac Cienc Med Santa Casa São Paulo

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“…Such involvement requires the differential diagnosis with RA, especially in the presence of positive RF. [2][3][4] The differential diagnosis between arthropathy secondary to infl ammatory bowel disease, also called enteropathic arthropathy, and the occurrence of joint manifestations related to other pathologies concomitant with UC is sometimes challenging.…”

Section: Introductionmentioning

confidence: 99%

Retocolite ulcerativa e artrite reumatoide: uma rara associação - relato de caso

Cruz¹,

Yamaguchi

Ribeiro

et al. 2012

Rev. Bras. Reumatol.

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Ulcerative colitis is an autoimmune disorder of unknown etiology. Although the large intestine is the major focus of autoimmunity, resulting in chronic diarrhea, that is actually a systemic disease, with numerous extraintestinal manifestations, such as articular involvement. The frequent association of a number of autoimmune diseases in the same patient has been described. However, the coexistence of ulcerative colitis and rheumatoid arthritis is rare. The authors report a case of ulcerative colitis associated with rheumatoid arthritis, in which colitis occurred 12 years before the onset of infl ammatory arthropathy.

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“…Among these, sacroiliitis and ankylosing spondylitis [8][9][10] are common for CD, and much more frequent than it is observed in practice, since early changes that cannot always be shown by imaging resources can be asymptomatic, thus going unnoticed 10,11 . articular manifestations stand out due to pain of varied intensity, according to the extension of the inflammatory process, with the risk to lose mobility or even the articular function 11 .…”

Section: Introductionmentioning

confidence: 99%

Crohn's Disease: current state of biological therapy

Júnior¹

2011

J. Coloproctol. (Rio J.)

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The inflammatory bowel diseases (IBD) are defined as nonspecific chronic intestinal inflammations with possible systemic involvement. IBD have unknown etiology. The inflammatory process is complex and heterogeneous, both as to the characterization of the disease that affects the digestive tract, without an intelligible pattern of revelation and balance, and in its different systemic damages when including the extensive and severe extraintestinal symptoms. Aparently, the natural history of the disease is irregular in relation to the offending agent system and the attacked system, both in the intestinal and extraintestinal teguments. Isolated aspects showing irregularity in this balance gives us the notion that IBD, especially Crohn's disease, can be caused by the stimulation of an immune response caused by damaging agents (intestinal bacteria), but mediated by inadequate genetic factors, whose expressions determine different individual susceptibilities. These observations have been shown in genetic studies that emphasize the importance of pathological interaction between host and bacteria subsidized by a genomic region that contains genes producing proteins (NOD2 -nucleotide-binding oligomerization domain containing 2) participating in an enhanced defense response by the tissue. Increased numbers and the activation of these cells in the intestinal mucosa elevate local levels of tumor necrosis factor α (TNF-α), interleukin-1β, interferon-γ, and cytokines of the interleukin-23-Th17 pathway. So, it can be assumed that the susceptibility, which is a result of genetic alterations, is connected to an exaggerated response in the pro-inflammatory phase because of a dysfunction in the intestinal immune system. The identification of tumor necrosis factor (TNF-α) as the active element in the pro-inflammatory inadequate response gave rise to the heightened production of biological substances that could block TNF-α, at different levels, opening a large field of view to new treatment of IBD.

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Manifestações articulares em pacientes com doença de Crohn e retocolite ulcerativa

Cited by 9 publications

References 48 publications

Perfil de imunização em pacientes com Doença Inflamatória Intestinal / Immunization profile in patients with inflammatory bowel disease

Perfil de imunização em pacientes com Doença Inflamatória Intestinal / Immunization profile in patients with inflammatory bowel disease

Retocolite ulcerativa e artrite reumatoide: uma rara associação - relato de caso

Crohn's Disease: current state of biological therapy

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