ELOISA SILVA DUTRA DE OLIVEIRA BONFA

(Fonte: Lattes)
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Lattes
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Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina

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  • conferenceObject
    OBSERVATIONAL STUDY OF SWITCHING ANTI-TNF AGENTS IN ANKYLOSING SPONDYLITIS: EFFECTIVENESS AND PREDICTORS
    (2014) SAAD, C. G. S.; SHIMABUCO, A. Y.; RIBEIRO, A. C. M.; MORAES, J. C. B.; SAMPAIO-BARROS, P. D.; GOLDENSTEIN-SCHAINBERG, C.; GONCALVES, C.; BONFA, E.
  • article 22 Citação(ões) na Scopus
    Dyslipidaemia in juvenile dermatomyositis: the role of disease activity
    (2013) KOZU, K. T.; SILVA, C. A.; BONFA, E.; SALLUM, A. M.; PEREIRA, R. M. R.; VIANA, V. S.; BORBA, E.; CAMPOS, L. M.
    Objective To evaluate the presence of dyslipidaemia in JDM and its possible risk factors. Methods Twenty-five JDM patients were compared to 25 healthy controls according to demographic data, body composition, fasting lipoproteins, glycaemia, insulin, antibodies and muscle enzymes. JDM scores were assessed: CMAS, MMT, DAS, MYOACT and MYTAX. Results Abnormal lipid profile was found in nine patients and four controls (36% vs. 16%, p=0.196). TDM patients demonstrated significant higher levels of triglycerides (TG) [80(31-340) vs. 61(19-182) mgldL, p=0.011 j and higher frequency of abnormal levels of high density lipoproteins (HDL) (28% vs. 4%, p=0.04) when compared to controls. JDM patients with dyslipidaemia demonstrated significant lower median of HDL levels 129(0-49) vs. 50(39-72) mgldL, p=0.0005, higher frequency of low HDL levels (77% vs. 0%, p=0.0001),.higher TG levels [128(31-340) vs. 69(46-138) mgldL, p=0.011), and also a higher frequency of increased levels of TG (44% vs. 0%, p=0.01), and TC (33% vs. 0%, p=0.03) when compared to those without this condition. Positive anti-LPL antibody was detected in just one JDM patient with abnormal lipid profile. JDM with dyslipidaemia had higher ESR (26 vs. I 4.5mmllsthour, p=0.006), CRP (2.1 vs. 0.4mgldL, p=0.01), DAS (6 vs. 2, p=0.008), MYOACT(0.13 vs. 0.01, p=0.012), MYTAX(0.06vs.0,p=0.018), and lower scores of CMAS (47 vs. 52, p=0.024) and MMT (78 vs. 80, p=0.001) compared to JDM without dyslipidaemia. Positive correlations were detected between TG levels and CRP (7-.19.697, p=0.001), DAS (r-0.610, p=0.001), MYOACT (r=0.661, p=0.001),114YTAX (r-0.511, p=0.008), and negative correlations with CMAS (r=-0.506, p=0.009) and MMT (r=-0.535, p=0.005). No differences were found between these groups regarding body composition, lipodystrophy, anti-LPL antibodies, and treatment except by higher frequency of cyclosporine current use in patients with dys.lipidaemia (33% vs. 0%, p=0.03). Conclusions Dyslipidaemia in JDM patients was characterised by increased levels of TG and low levels of HDL. Disease activity and cyclosporine use were the mainly factors associated to these abnormalities.
  • conferenceObject
  • conferenceObject
    CLINICAL AND SEROLOGICAL COMPARATIVE ANALYSIS OF SYSTEMIC SCLEROSIS WITH OR WITHOUT OVERLAP SYNDROMES IN A LARGE BRAZILIAN COHORT
    (2014) SILVA, C. M.; PASOTO, S. G.; VIANA, V. S.; SEGURO, L. P. C.; ANDRADE, D. C. O.; BONFA, E.; SAMPAIO-BARROS, P. D.
  • conferenceObject
    Digital vasculitis survey in 852 childhood-onset systemic lupus erythematosus patients: a multicenter cohort study
    (2015) SAKAMOTO, A. P.; SILVA, C. A.; SILVA, M. F. C.; LOPES, A. S.; FRAGA, M. M.; BONFA, E.; MAGALHAES, C. S.; PEREIRA, R. M. R.; LEN, C. A.; TERRERI, M. T.
  • conferenceObject
    INFLUENCE OF SULFASALAZINE COMEDICATION IN SWITCHING AND RESPONSE TO ANTI-TUMORAL NECROSIS FACTOR IN ANKYLOSING SPONDYLITIS
    (2016) SHIMABUCO, A. Y.; GONCALVES, C. R.; MORAES, J. C. B.; WAISBERG, M. G.; RIBEIRO, A. C. M.; SAMPAIO-BARROS, P. D.; GOLDENSTEIN-SCHAINBERG, C.; BONFA, E.; SAAD, C. G. S.
  • article 17 Citação(ões) na Scopus
    Reduction of ovarian reserve in adult patients with dermatomyositis
    (2015) SOUZA, F. H. C. de; SHINJO, S. K.; YAMAKAMI, L. Y. S.; VIANA, V. S. T.; BARACAT, E. C.; BONFA, E.; SILVA, C. A.
    Objective To assess ovarian reserve markers and anti-corpus luteum (anti-CoL) antibodies in dermatomyositis (DM) patients. Methods Forty female DM patients were invited to participate. Exclusion criteria included hormonal contraceptive use within the last six months, neoplasia associations, overlapped systemic autoimmune diseases, current pregnancy, gynaecological surgery and individual choice not to participate. The final experimental group for this cross-sectional study included 16 DM patients and 23 healthy controls, each of whom was evaluated during the early follicular phase of the menstrual cycle. Values for IgG anti-CoL (via immunoblotting), follicle stimulating hormone (FSH), estradiol, inhibin B, anti-Mullerian hormone (AMH) serum levels (via ELISA) and sonographic antral follicle count (AFC) were determined. Results DM patients and controls were of comparable mean age (p>0.05). The mean age of DM onset was 29.1 +/- 4.7 years, with disease duration of 5.6 +/- 3.2 years. Menstrual cycle characteristics, comorbidity and lifestyle were similar amongst patients in both groups (p>0.05). AMH values of <= lng/mL (p=0.027) and AFC values (p=0.017) were significantly reduced in DM patients relative to the control group, whereas serum estradiol levels (p<0.001) were higher in DM patients compared to controls. In contrast, serum FSH and inhibin B levels, ovarian volumes, and anti-CoL antibody frequency were similar in both groups. Differences in AFC and estradiol were determined to be significant following Bonferroni correction for multiple testing. Conclusion We identified a diminished ovarian reserve in DM patients of reproductive age. Further studies are necessary to assess the idiopathic inflammatory myopathy-related factors involved in the ovarian impairment of this patient population.
  • conferenceObject
    TESTICULAR SERTOLI CELL FUNCTION IN ANKYLOSING SPONDYLITIS: THE POSSIBLE EFFECT OF TNF BLOCKAGE
    (2012) SAAD, C. G. S.; ALMEIDA, B. P. de; SOUZA, F. H. C.; MORAES, J. C. B.; NUKUMIZU, L. A.; SAMPAIO-FARROS, P. D.; VIANA, V. S. T.; BONFA, E.; SILVA, C. A.
    Introduction: Inhibin B is an important testicular Sertoli cell function marker allowing a global evaluation of testicular tissue. However there are no data regarding this cell function in ankylosing spondylitis (AS) patients.in this hormone production. Materials and Methods: 20 consecutive male AS patients and 24 healthy controls were evaluated. At study entry, AS patients were not receiving sulfasalazine/methotrexate and they never used biological/cytotoxic agents. Serum dimeric inhibin B levels were measured by a double-antibody ELISA. Demographic, disease parameters and urologic evaluation were systematically performed. The latter included testicular Döppler ultrasound, hormone profile and semen analysis. Ten of these patients received anti-TNF treatment and they were re-evaluated for inhibin B and disease parameters at 6 months(6M). Four of them also repeated sperm analysis. Results: At study entry, the median of current and spermarche age were similar in AS patients and controls [33(17-53) vs. 28.5(15-54) years, p=0.175; 13(9-18) vs. 12(11-15)years, p=0.358; respectively]. The median of inhibin B [68(23-265) vs. 112.9(47.8-231.9)pg/mL, p=0.111], FSH levels and the other hormones were comparable in both groups (p>0.05). All patients and controls had normal sperm motility and concentration with two AS patients presenting borderline low inhibin B levels. Further analysis at 6M of the 10 patients referred for anti-TNF therapy, including one with borderline inhibin B, revealed that median inhibin B levels remained largely stable [126.5(24-316) vs. 116.5(28-265)pg/mL, p=0.431]. Sperm motility/concentration were preserved in the four patients that performed this analysis after anti-TNF. Conclusions: This is the first study to demonstrate, through a specific marker, a normal testicular Sertoli cell function associated with preserved sperm quality in AS patients. We further identified that anti-TNF drugs do not seem to have a deleterious effect in inhibin B production reinforcing its safety for testicular function in this disease.
  • conferenceObject
    LATENT TUBERCULOSIS SCREENING AND TREATMENT IN ANKYLOSING SPONDYLITIS PATIENTS UNDER ANTI-TNF THERAPY IN ENDEMIC AREA
    (2016) MORAES, J. C. B.; SAAD, C. G. S.; MIOSSI, R.; BONFIGLIOLI, K. R.; RIBEIRO, A. C. M.; BONFA, E.
  • article 13 Citação(ões) na Scopus
    Long-term evaluation of cardiac function in juvenile idiopathic arthritis under anti-TNF therapy
    (2014) LIANZA, A. C.; AIKAWA, N. E.; MORAES, J. C. B.; LEAL, G. N.; MORHY, S. S.; ANDRADE, J. L.; BONFA, E.; SILVA, C. A.
    Objective This paper aims to perform global assessment of long-term cardiac function in juvenile idiopathic arthritis (JIA) patients under TNF blockage therapy. Methods Twenty-five polyarticular-course JIA patients pre-anti-TNF and 22 healthy controls underwent conventional/tissue Doppler echocardiography and cardiac biomarkers measurements (N-terminal pro-brain natriuretic peptide [NT-pro-BNP] and troponin T) at baseline (BL). Twenty-one JIA patients completed six evaluations during two consecutive years. Clinical/laboratorial evaluations were assessed before and during TNF blockage therapy. Results JIA patients and controls were comparable regarding current age (p=0.898) and female gender (p=0.38). At BL isoyolumetric relaxation time of left ventricle (p=0.03), ventricular septum (VS), E' wave (p=0.014) and VS S wave velocity (p=0.03) were significantly reduced in JIA patients compared to controls. Frequencies of elevated NT-pro-BNP and troponin T levels were similar in JIA and controls (p=0.297 and p=0.756) and levels remained within normal range throughout the study, except for one patient with mild troponin T elevation. During TNF blockage therapy, none of the 21 participants had heart failure, ejection fraction or other parameters alterations in conventional and tissue Doppler. Only one had mild pulmonary hypertension. Further analysis revealed that JIA patients with elevated levels of NT-pro-BNP at BL had significantly more active joints (p=0.025) and higher ESR (p=0.034). Conclusion Long-term TNF blockage safety was demonstrated in JIA patients in spite of the observed subclinical diastolic involvement. Elevated cardiac biomarker in these patients was associated with inflammatory parameters reinforcing the need for a careful interpretation of this finding in patients with active disease.