FABIO EIJI ARIMURA
Projetos de Pesquisa
Unidades Organizacionais
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
LIM/09 - Laboratório de Pneumologia, Hospital das Clínicas, Faculdade de Medicina
4 resultados
Resultados de Busca
Agora exibindo 1 - 4 de 4
- Baseline Characteristics and Progression of a Spectrum of Interstitial Lung Abnormalities and Disease in Rheumatoid Arthritis(2020) KAWANO-DOURADO, Leticia; DOYLE, Tracy J.; BONFIGLIOLI, Karina; SAWAMURA, Marcio V. Y.; NAKAGAWA, Renato H.; ARIMURA, Fabio E.; LEE, Hye J.; RANGEL, Diana Arrais de Souza; BUENO, Cleonice; CARVALHO, Carlos R. R.; SABBAG, Maria Laura; MOLINA, Camila; ROSAS, Ivan O.; KAIRALLA, Ronaldo A.BACKGROUND Interstitial lung abnormalities (ILA) and interstitial lung disease (ILD) are seen in up to 60% of individuals with rheumatoid arthritis (RA), some of which will progress to have a significant impact on morbidity and mortality rates. Better characterization of progressive interstitial changes and identification of risk factors that are associated with progression may enable earlier intervention and improved outcomes. RESEARCH QUESTION. What are baseline characteristics associated with RA-ILD progression? STUDY DESIGN AND METHOD! We performed a retrospective study in which all clinically indicated CT chest scans in adult individuals with RA from 2014 to 2016 were evaluated for interstitial changes, and the data were further subdivided into ILA and ILD based on clinical record review. Progression was determined visually and subsequently semiquantified. RESULTS. Those individuals with a spectrum of interstitial changes (64 of 293) were older male smokers and less likely to be receiving biologics/small molecule disease-modifying antirheumatic drugs. Of 44% of the individuals with ILA, 46% had had chest CT scans performed for nonpulmonary indications. Of the 56 individuals with ILA/ILD with sequential CT scans, 38% had evidence of radiologic progression over 4.4 years; 29% of of individuals with ILA progressed. Risk factors for progressive ILA/ILD included a subpleural distribution and higher baseline involvement. INTERPRETATION. Of 293 individuals with RA with clinically indicated CT scans, interstitial changes were observed in 22%, one-half of whom had had a respiratory complaint at the time of imaging; radiologic progression was seen in 38%. Of individuals with progressive ILA, one-half had had baseline CT scans performed for nonpulmonary indications. Subpleural distribution and higher baseline ILA/ILD extent were risk factors associated with progression. Prospective longi- tudinal studies of RA-ILA are necessary.
- Concentration of Serum Vascular Endothelial Growth Factor (VEGF-D) and Its Correlation with Functional and Clinical Parameters in Patients with Lymphangioleiomyomatosis from a Brazilian Reference Center(2019) AMARAL, Alexandre Franco; OLIVEIRA, Martina Rodrigues de; DIAS, Olivia Meira; ARIMURA, Fabio Eiji; FREITAS, Carolina Salim Goncalves; ACENCIO, Milena Marques Pagliarelli; ALVARENGA, Vanessa Adelia de; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno Guedes; SCLEROSIS, Tuberous; BALBO, Bruno Eduardo Pedroso; WATANABE, Elieser Hitoshi; SAMORANO, Luciana Paula; ONUCHIC, Luiz Fernando; RIVITTI-MACHADO, Maria Cecilia da Matta; MANREZA, Maria Luiza Giraldes de; CORDEIRO, Mauricio Dener; TAKAHASHI, Patricia; OLIVEIRA, Zilda Najjar Prado deIntroductionSerum vascular endothelial growth factor-D (VEGF-D) is a lymphangiogenic growth factor that is considered a valuable tool in the diagnosis of lymphangioleiomyomatosis (LAM). Previous studies have reported a wide variability in VEGF-D serum levels in LAM patients and it seems to be associated with pulmonary impairment and lymphatic involvement.MethodsWe conducted a cross-sectional study from 2009 to 2017 that evaluated VEGF-D serum levels in a cohort of LAM patients who were never treated with mTOR inhibitors and compared them to healthy age-matched volunteers. Clinical and functional parameters were assessed and correlated with their respective serum VEGF-D levels.ResultsOne hundred and four patients were included in the analysis. Serum VEGF-D levels were higher in LAM patients compared to healthy controls: 796 (404-1588) versus 162 (117-232)pg/mL, respectively (p<0.001). Patients with tuberous sclerosis complex-LAM, TSC-LAM (20%), had higher levels of VEGF-D when compared to patients with sporadic LAM (80%) [1005 (641-2732) vs. 772 (370-1383), p=0.05]. Serum VEGF-D levels were weakly correlated with DLCO (r=-0.26, p=0.001) and lymphatic involvement was more frequent in those with serum VEGF-D levels equal or above 800pg/mL (35% vs. 13%, p=0.02).ConclusionsIn LAM, serum VEGF-D is weakly associated with lung function impairment and strongly associated with lymphatic involvement. VEGF-D is validated for use in Brazilian patients with LAM whose characteristics must be accounted for when evaluating their serum VEGF-D levels.
- Characterization and outcomes of pulmonary alveolar proteinosis in Brazil: a case series(2018) ATHAYDE, Rodolfo Augusto Bacelar de; ARIMURA, Fabio Eiji; KAIRALLA, Ronaldo Adib; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno GuedesObjective: Pulmonary alveolar proteinosis (PAP) is a rare disease, characterized by the alveolar accumulation of surfactant, which is composed of proteins and lipids. PAP is caused by a deficit of macrophage activity, for which the main treatment is whole-lung lavage (WLL). We report the experience at a referral center for PAP in Brazil. Methods: This was a retrospective study involving patients with PAP followed between 2002 and 2016. We analyzed information regarding clinical history, diagnostic methods, treatments, and outcomes, as well as data on lung function, survival, and complications. Results: We evaluated 12 patients (8 of whom were women). The mean age was 41 +/- 15 years. Most of the patients were diagnosed by means of BAL and transbronchial biopsy. The mean number of WLLs performed per patient was 2.8 +/- 2.5. One third of the patients never underwent WLL. Four patients (33.3%) had associated infections (cryptococcosis, in 2; nocardiosis, in 1; and tuberculosis, in 1), and 2 (16.6%) died: 1 due to lepidic adenocarcinoma and 1 due to complications during anesthesia prior to WLL. When we compared baseline data with those obtained at the end of the follow-up period, there were no significant differences in the functional data, although there was a trend toward an increase in SpO(2). The median follow-up period was 45 months (range, 1-184 months). The 5-year survival rate was 82%. Conclusions: To our knowledge, this is the largest case series of patients with PAP ever conducted in Brazil. The survival rate was similar to that found at other centers. For symptomatic, hypoxemic patients, the treatment of choice is still WLL. Precautions should be taken in order to avoid complications, especially opportunistic infections.
- Clinical, tomographic and functional comparison of sporadic and tuberous sclerosis complex-associated forms of lymphangioleiomyomatosis: a retrospective cohort study(2024) OLIVEIRA, Martina Rodrigues; WANDERLEY, Mark; FREITAS, Carolina Salim Goncalves; KAIRALLA, Ronaldo Adib; CHATE, Rodrigo Caruso; AMARAL, Alexandre Franco; ARIMURA, Fabio Eiji; SAMORANO, Luciana Paula; WATANABE, Elieser Hitoshi; CARVALHO, Carlos Roberto Ribeiro; BALDI, Bruno GuedesBackground Lymphangioleiomyomatosis (LAM) is a rare disease that can occur sporadically (S-LAM) or associated with the tuberous sclerosis complex (TSC-LAM). The natural history of LAM is not completely understood, including whether there is a difference between the clinical courses of the two forms. This study aimed to compare the clinical, functional and tomographic features between S-LAM and TSC-LAM, and evaluate the annual rates of change in lung function. Methods This retrospective cohort study included patients with LAM followed up between 1994 and 2019. Clinical, functional and imaging variables were evaluated, and the lung cysts were automatically quantified. Quality of life and predictors of lung function impairment were accessed, and the annual rate of lung function decline was compared between S-LAM and TSC-LAM. Results Of the 107 patients included, 77 had S-LAM and 30 had TSC-LAM. Although patients with TSCLAM had a higher prevalence of renal angiomyolipomas and neurological and dermatological manifestations, pulmonary function tests were similar. Patients with S-LAM had a greater rate of forced expiratory volume in 1 s decline and a higher extent of cysts. Pneumothorax, desaturation in the 6-minute walking test and a higher extent of lung cysts were predictors of functional impairment. A greater impact on vitality and emotional health was observed in the TSC-LAM. Conclusion Greater functional decline and a higher cystic extension were found in patients with S-LAM. Our study provides a broad clinical, functional and tomographic characterisation of patients with LAM, adding valuable information to the existing evidence to better understand the two forms of the disease.