Prevalência de deficiência de IgA em pacientes adultos com lúpus eritematoso sistêmico e estudo de sua associação com perfil clínico e de autoanticorpos

Mantovani, A; Monclaro, Mariel Perini; Skare, Thelma L.

doi:10.1590/s0482-50042010000300007

Cited by 16 publications

(2 citation statements)

References 15 publications

(30 reference statements)

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“…Many of these individuals have no apparent disease, whereas selected patients suffer from recurrent mucosal infections, allergies and autoimmune diseases [2,3,4]. Furthermore, unexplained coincidences between SIgAD and systemic autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis, celiac disease, hemolytic anemia, thyroiditis, type 1 diabetes mellitus, juvenile rheumatoid arthritis and autoimmune glomerulonephritis were reported [5,6,7,8,9]. …”

Section: Introductionmentioning

confidence: 99%

Evaluation of Natural Regulatory T Cells in Subjects with Selective IgA Deficiency: From Senior Idea to Novel Opportunities

Soheili

Abolhassani²,

Arandi³

et al. 2012

Int Arch Allergy Immunol

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Background: Selective IgA deficiency (SIgAD) is the most common primary immunodeficiency disorder, which is characterized by significantly decreased serum levels of IgA. Abnormalities of CD4+CD25^highforkhead box P3 (FoxP3)+ regulatory T cells (T_reg) have been shown in association with autoimmune and inflammatory disorders. Methods: In order to evaluate the relationship between autoimmunity and T_reg in SIgAD, we studied 26 IgA-deficient patients (aged 4–17 years) with serum IgA levels <7 mg/dl, 26 age- and sex-matched healthy controls and 26 age- and sex matched idiopathic thrombocytopenic purpura cases with normal immune system. T_reg were determined by flow cytometry using T_reg markers, including CD4, CD25 and FoxP3. Results: The mean percentage of CD4, CD25+FoxP3+ T_reg from all CD4+ cells was 4.08 ± 0.86 in healthy controls, which was significantly higher than in SIgAD patients (2.93 ± 1.3; p = 0.003). We set a cutoff point (2.36%) for T_reg, which was two standard deviations lower than the mean of normal controls. According to this cutoff point and in order to assess the role of T_reg in clinical SIgAD manifestation, we classified patients into two groups: 16 patients in G1 with T_reg <2.36% and 10 patients in G2 with T_reg >2.36%. Autoimmunity was recorded in 9 patients (53.3%) of G1 and only 1 patient of G2, respectively (p = 0.034). Although a defect in class switching recombination was observed in 40% of the patients in G1, none of the G2 patients had such a defect (p = 0.028). Conclusion: This study showed decreased proportions of T_reg in SIgAD patients, particularly in those with signs of chronic inflammation.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Natural Regulatory T Cells in Subjects with Selective IgA Deficiency: From Senior Idea to Novel Opportunities

Soheili

Abolhassani²,

Arandi³

et al. 2012

Int Arch Allergy Immunol

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“…The most common conditions were thrombocytopenia in 18 patients, hemolytic anemia in 12, rheumatoid arthritis in 5, and juvenile rheumatoid arthritis in 4 [50, 51]. Results from another study of 189 patients with systemic lupus erythematosus (SLE) indicated that 6 % had IgA deficiency [52]. …”

Section: Methodsmentioning

confidence: 99%

Attending to Warning Signs of Primary Immunodeficiency Diseases Across the Range of Clinical Practice

et al. 2013

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PurposePatients with primary immunodeficiency diseases (PIDD) may present with recurrent infections affecting different organs, organ-specific inflammation/autoimmunity, and also increased cancer risk, particularly hematopoietic malignancies. The diversity of PIDD and the wide age range over which these clinical occurrences become apparent often make the identification of patients difficult for physicians other than immunologists. The aim of this report is to develop a tool for educative programs targeted to specialists and applied by clinical immunologists.MethodsConsidering the data from national surveys and clinical reports of experiences with specific PIDD patients, an evidence-based list of symptoms, signs, and corresponding laboratory tests were elaborated to help physicians other than immunologists look for PIDD.ResultsTables including main clinical manifestations, restricted immunological evaluation, and possible related diagnosis were organized for general practitioners and 5 specialties. Tables include information on specific warning signs of PIDD for pulmonologists, gastroenterologists, dermatologists, hematologists, and infectious disease specialists.ConclusionsThis report provides clinical immunologists with an instrument they can use to introduce specialists in other areas of medicine to the warning signs of PIDD and increase early diagnosis. Educational programs should be developed attending the needs of each specialty.

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Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long‐Term Effects on Serum Immunoglobulins

Reddy

Martinez

Isenberg

et al. 2017

Arthritis Care & Research

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ObjectiveB cell–depletion therapy based on rituximab is a therapeutic option for refractory disease in patients with systemic lupus erythematosus (SLE). The aim of this observational study was to document long‐term effects on B cell function by following serum immunoglobulin levels in patients with SLE treated with rituximab in routine clinical practice.MethodsWe included 57 consecutive patients with SLE treated with rituximab and concomitant/sequential immunosuppressants and measured serum total IgG, IgM, and IgA and IgG anti‐dsDNA antibodies, over a median of 48 months most recent followup. Flow cytometry was used prospectively to assess B cell phenotypes in 17 of 57 patients.ResultsTwelve patients (21%) had persistent IgM hypogammaglobulinemia (<0.4 gm/liter), and 4 of 57 (5%) had low IgG (<7 gm/liter) at the most recent followup (range 12–144 months). This was not associated with serious adverse events or high anti–double‐stranded DNA (anti‐dsDNA) antibodies (>1,000 IU/ml; normal <50 IU/ml). Factors predictive of low serum IgM included baseline serum IgM ≤0.8 gm/liter (receiver operator curve analysis) and subsequent therapy with mycophenolate mofetil (MMF; odds ratio 6.8, compared with other immunosuppressants). In patients maintaining normal IgM levels (9 of 17), the frequency of circulating IgD+CD27+ B cells was significantly higher (P = 0.05). At 12 months after rituximab, 7 of 30 SLE patients with baseline anti‐dsDNA ≤1,000 IU/ml had lost seropositivity.ConclusionLower baseline serum IgM levels and sequential therapy with MMF were predictive of IgM hypogammaglobulinemia after rituximab in SLE, but this was not associated with higher levels of anti‐dsDNA antibodies or an increased risk of infections. This provides useful directions for clinicians regarding rituximab and sequential immunosuppressive treatment for patients with SLE.

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Prevalência de deficiência de IgA em pacientes adultos com lúpus eritematoso sistêmico e estudo de sua associação com perfil clínico e de autoanticorpos

Cited by 16 publications

References 15 publications

Evaluation of Natural Regulatory T Cells in Subjects with Selective IgA Deficiency: From Senior Idea to Novel Opportunities

Evaluation of Natural Regulatory T Cells in Subjects with Selective IgA Deficiency: From Senior Idea to Novel Opportunities

Attending to Warning Signs of Primary Immunodeficiency Diseases Across the Range of Clinical Practice

Pragmatic Treatment of Patients With Systemic Lupus Erythematosus With Rituximab: Long‐Term Effects on Serum Immunoglobulins

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