CLAUDIA GIULI SANTI
Projetos de Pesquisa
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
10 resultados
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- Drug reaction with eosinophilia and systemic symptoms/drug-induced hypersensitivity syndrome: clinical features of 27 patients(2015) AVANCINI, J.; MARAGNO, L.; SANTI, C. G.; CRIADO, P. R.BackgroundDrug reaction with eosinophilia and systemic symptoms (DRESS) [also called drug-induced hypersensitivity syndrome (DIHS)] includes severe reactions to drugs that need to be promptly recognized by physicians. AimTo explore heterogeneity in the clinical presentation of DRESS/DIHS at a large academic hospital in Latin America, using the criteria defined by the European Registry of Severe Cutaneous Adverse Reactions (RegiSCAR) scoring system. MethodsA retrospective medical record review of 60 patients with diagnostic suspicion of DRESS/DIHS admitted to our hospital between July 2008 and April 2012 was performed, including demographic data, clinical features, laboratory findings and treatment. ResultsOf the 60 patients, 27 fulfilled the criteria for DRESS/DIHS. Maculopapular exanthema (85.1%), fever (96.2%) and hepatic involvement (85.1%) were the most common features. Anticonvulsants were the most common causal drugs (77.7%); Phenytoin was the most common individual drug (44.4%), followed by carbamazepine (29.6%). All patients were treated initially with prednisone 1mg/kg/day. Mortality rate was 4%. ConclusionThe major findings of this study (to our knowledge the largest collection of data on DRESS/DIHS in Latin America) include a positive statistical association between presence of atypical lymphocytes and higher levels of alanine aminotransferase (P<0.001) and reinforce the importance of anticonvulsants in the pathogenesis of this severe reaction.
bookPart Dermatoses potencialmente graves na emergência(2017) VASCONCELOS, Roberta; CRIADO, Paulo Ricardo; SANTI, Claudia Giuli- Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)/Drug-Induced Hypersensitivity Syndrome (DIHS): a review of current concepts(2012) CRIADO, Paulo Ricardo; CRIADO, Roberta Fachini Jardim; AVANCINI, Joao de Magalhaes; SANTI, Claudia GiuliThe Drug Reaction with Eosinophilia and Systemic Symptoms syndrome, also known as Drug Induced Hypersensitivity Syndrome presents clinically as an extensive mucocutaneous rash, accompanied by fever, lymphadenopathy, hepatitis, hematologic abnormalities with eosinophilia and atypical lymphocytes, and may involve other organs with eosinophilic infiltration, causing damage to several systems, especially to the kidneys, heart, lungs, and pancreas. Recognition of this syndrome is of paramount importance, since the mortality rate is about 10% to 20%, and a specific therapy may be necessary. The pathogenesis is related to specific drugs, especially the aromatic anticonvulsants, altered immune response, sequential reactivation of herpes virus and association with HLA alleles. Early recognition of the syndrome and withdrawal of the offending drug are the most important and essential steps in the treatment of affected patients. Corticosteroids are the basis of the treatment of the syndrome, which may be associated with intravenous immunoglobulin and, in selected cases, Ganciclovir. The article reviews the current concepts involving this important manifestation of adverse drug reaction.
bookPart Reações cutâneas medicamentosas(2013) VASCONCELOS, Roberta; CRIADO, Paulo Ricardo; SANTI, Claudia GiulibookPart Reações cutâneas medicamentosas(2017) VASCONCELOS, Roberta; CRIADO, Paulo Ricardo; SANTI, Claudia GiulibookPart Reações Cutâneas Medicamentosas(2016) VASCONCELOS, Roberta; CRIADO, Paulo Ricardo; SANTI, Claudia GiulibookPart Dermatoses potencialmente graves na emergência(2013) VASCONCELOS, Roberta; CRIADO, Paulo Ricardo; SANTI, Claudia Giuliarticle 74 Citação(ões) na Scopus Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS): A Complex Interaction of Drugs, Viruses and the Immune System(2012) CRIADO, Paulo R.; AVANCINI, Joao; SANTI, Claudia G.; MEDRADO, Ana T. Amoedo; RODRIGUES, Carlos E.; CARVALHO, Jozelio F. deThe DRESS syndrome (drug reaction with eosinophilia and systemic symptoms), also known as DIHS (drug-induced hypersensitivity syndrome), presents clinically as an extensive mucocutaneous rash, accompanied by fever, lymphadenopathy, hepatitis, hematologic abnormalities with eosinophilia and atypical lymphocytes, and may involve other organs with eosinophilic infiltration, producing damage in several systems, especially kidney, heart, lungs, and pancreas. The pathogenesis is related to specific drugs (especially the aromatic anticonvulsants), altered immune response, sequential reactivation of herpes virus, and association with some HLA alleles. Glucocorticoids are the basis for the treatment of the syndrome, which may be given with intravenous immunoglobulin and, in selected cases, ganciclovir. This article reviews current concepts regarding the interaction of drugs, viruses and immune responses during this complex adverse-drug reaction.bookPart Dermatoses Potencialmente Graves na Emergência(2016) VASCONCELOS, Roberta; CRIADO, Paulo Ricardo; SANTI, Claudia GiulibookPart Reações Cutâneas Adversas às Drogas(2013) MARUTA, Celina Wakisaka; SANTI, Claudia Giuli; CRIADO, Paulo Ricardo; REIS, Vitor Manoel Silva dos