GLAUCIA VANESSA NOVAK
Projetos de Pesquisa
Unidades Organizacionais
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina
5 resultados
Resultados de Busca
Agora exibindo 1 - 5 de 5
- Esophageal abnormalities in juvenile localized scleroderma: is it associated with other extracutaneous manifestations?(2017) VALOES, Clarissa C. M.; NOVAK, Glaucia V.; BRUNELLI, Juliana B.; KOZU, Katia T.; TOMA, Ricardo K.; SILVA, Clovis A.Objective: To assess esophageal involvement (EI) in juvenile localized scleroderma (JLS) population and the possible association between this gastrointestinal manifestation and demographic data, clinical features, laboratory exams, treatments and outcomes. Methods: For a period of 30 years, 5881 patients with rheumatic diseases were followed in our Pediatric Rheumatology Division. EI was defined by the presence of symptoms (solid/liquid dysphagia, heartburn, esophageal regurgitation, nausea/vomiting and epigastralgia) and confirmed by at least one EI exam abnormality: barium contrast radiography, upper gastrointestinal endoscopy and 24-hour esophageal pH-monitoring. Results: JLS was observed in 56/5881 patients (0.9%), mainly linear morphea subtype. EI was observed in 23/56(41%) of JLS patients. Eight(35%) of 23 EI patients with JLS were symptomatic and presented heartburn(5/8), solid and liquid dysphagia(3/8), nausea and epigastralgia(1/8). The frequency of any cumulative extracutaneous manifestations (calcinosis, arthritis/arthralgia, central nervous system, interstitial pneumonitis, mesangial nephritis and/or arrhythmia) was significantly higher in JLS patients with EI compared to those without this complication (56% vs. 24%, p = 0.024). No differences were evidenced in demographic data, JLS subtypes and in each extracutaneous manifestation in both groups (p > 0.05). The frequency of methotrexate use was significantly higher in JLS patients with EI compared to those without (52% vs. 12%, p = 0.002). Autoantibody profile (antinuclear antibodies, antiSCL-70, rheumatoid factor, anticentromere, anti-cardiolipin, anti-Ro/SSA and anti-La/SSB) was similar in both groups (p > 0.05). Conclusions: Our study demonstrated that EI was frequently observed in JLS patients, mainly in asymptomatic patients with linear subtype. EI occurred in JLS patients with other extra cutaneous manifestations and required methotrexate therapy. (C) 2016 Published by Elsevier Editora Ltda.
conferenceObject Validation of Flare Criteria for Children and Adolescents with Systemic Lupus Erythematosus(2017) BRUNNER, Hermine I.; HOLLAND, Michael J.; BERESFORD, Michael W.; RUPERTO, Nicolino; ARDOIN, Stacy P.; APPENZELLER, Simone; SILVA, Clovis A.; NOVAK, Glaucia V.; LOURENCO, Daniela M.; FLORES, Francisco; GOILAV, Beatrice; WENDERFER, Scott E.; LEVY, Deborah M.; RAVELLI, Angelo; KHUBCHANDANI, Raju; AVCIN, Tadej; KLEIN-GITELMAN, Marisa S.; FELDMAN, Brian M.; YING, Jun- DIFFUSE ALVEOLAR HEMORRHAGE: A MULTICENTER STUDY IN 847 CHILDHOOD-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS(2017) SILVA, C. A.; BLAY, G.; RODRIGUES, J. C.; LEAL, G. N.; FERREIRA, J. C.; NOVAK, G.; PEREIRA, R. M. R.; TERRERI, M. T.; MAGALHAES, C. S.; MOLINARI, B. C.; SAKAMOTO, A. P.; AIKAWA, N. E.; CAMPOS, L. M. A.; FERNANDES, T. A. P.; CLEMENTE, G.; PERACCHI, O. A. B.; BUGNI, V.; MARINI, R.; SACCHETTI, S. B.; CARVALHO, L. M.; FRAGA, M. M.; CASTRO, T. C. M.; RAMOS, V. C.; BONFA, E.
- Chronic polyarthritis as the first manifestation of childhood systemic polyarteritis nodosa(2017) NOVAK, Glaucia Vanessa; HAYASHI, Koken; SAMPA, Kohei; OKUMURA, Yosuke; FERREIRA, Gabriela Ribeiro Viola; SILVA, Clovis ArturABSTRACT Arthritis has been reported as an acute pattern, generally evanescent with oligoarthritis, mostly affecting knees and ankles in childhood systemic polyarteritis nodosa. However, chronic polyarthritis with morning stiffness mimicking juvenile idiopathic arthritis has not been reported. We describe the case of a 4-year old girl who had additive and chronic polyarthritis with edema, tenderness, pain on motion and morning stiffness for 2 months. After 45 days, she also presented painful subcutaneous nodules and erythematous-violaceous lesions in the extensor region of upper and lower limbs. She was admitted to university hospital due to high fever, malaise, myalgia, anorexia, loss of weight (1kg), painful skin lesions and severe functional disability. She was bedridden by chronic polyarthritis with limitation on motion. Systolic and diastolic blood pressures were greater than 95th percentile for height. Urine protein/creatinine ratio was 0.39g/day, and immunological tests were negative. Anti-streptolysin O was 1,687UI/mL. Skin biopsy revealed necrotizing vasculitis in medium- and small-sized vessels compatible with polyarteritis nodosa. Therefore, we had the diagnosis of systemic polyarteritis nodosa. Prednisone 2mg/kg/day was administered with complete resolution of skin lesions and arthritis, and improvement of proteinuria (0.26g/day) after 15 days. The diagnosis of childhood systemic polyarteritis nodosa should be considered for patients with chronic polyarthritis associated to cutaneous vasculitis triggered by streptococcal infection.
- Anti-RO/SSA and anti-La/SSB antibodies: Association with mild lupus manifestations in 645 childhood-onset systemic lupus erythematosus(2017) NOVAK, Glaucia V.; MARQUES, Mariana; BALBI, Verena; GORMEZANO, Natali W. S.; KOZU, Katia; SAKAMOTO, Ana P.; PEREIRA, Rosa M. R.; TERRERI, Maria T.; MAGALHAES, Claudia S.; GUARIENTO, Andressa; SALLUM, Adriana M. E.; MARINI, Roberto; FERRIANI, Virginia Paes Leme; BARBOSA, Cassia Maria; CASTRO, Tania Caroline Monteiro de; RAMOS, Valeria C.; BONFA, Eloisa; SILVA, Clovis A.Background: To our knowledge there are no studies assessing anti-Ro/SSA and anti-La/SSB autoantibodies in a large population of childhood-systemic lupus erythematosus (cSLE) patients. Methods: This was a retrospective multicenter cohort study performed in 10 Pediatric Rheumatology services, Sao Paulo state, Brazil. Anti-Ro/SSA and anti-La/SSB antibodies were measured by enzyme linked immunosorbent assay (ELISA) in 645 cSLE patients. Results: Anti-Ro/SSA and anti-La/SSB antibodies were evidenced in 209/645 (32%) and 102/645 (16%) of cSLE patients, respectively. Analysis of cSLE patients with and without anti-Ro/SSA antibodies revealed higher frequencies of malar rash (79% vs. 71%, p = 0.032), photosensitivity (73% vs. 65%, p = 0.035), cutaneous vasculitis (43% vs. 35%, p = 0.046) and musculoskeletal involvement (82% vs. 75%, p = 0.046) in spite of long and comparable disease duration in both groups (4.25 vs. 4.58 years, p = 0.973). Secondary Sjogren syndrome was observed in only five patients with this antibody (2.5% vs. 0%, p = 0.0035), two of them with concomitant anti-La/SSB. The presence of associated autoantibodies: anti-Sm (50% vs. 30%, p < 0.0001), anti-RNP (39% vs. 21%, p < 0.0001) and anti-ribossomal P protein (46% vs. 21%, p = 0.002) was also significantly higher in patients with anti-Ro/SAA antibodies. Further evaluation of cSLE patients with the presence of anti-La/SSB antibodies compared to those without these autoantibodies showed that the frequency of alopecia (70% vs. 51%, p = 0.0005), anti-Sm (59% vs. 31%, p < 0.0001) and anti-RNP (42% vs. 23%, p < 0.0001) were significantly higher in the former group. Conclusions: Our large multicenter cohort study provided novel evidence in cSLE that anti-Ro/SSA and/or anti-La/SSB antibodies were associated with mild manifestations, particularly cutaneous and musculoskeletal. Secondary Sjogren syndrome was rarely observed in these patients, in spite of comparable frequencies of anti-Ro/SSA and/or anti-La/SSB reported for adult SLE.