MATHEUS FREITAS CARDOSO DE AZEVEDO
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5
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
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conferenceObject Clinical features of thrombosis in patients with Crohn's disease followed at the Clinical Hospital of the University of Sao Paulo, Brazil(2016) ANDRADE, A. Ribas; BARROS, L. Leite; AZEVEDO, M.; SIPAHI, A.; LEITE, A. Zonetti de ArrudaconferenceObject Inflammatory Bowel Diseases and Autoimmune Hepatitis: Is Anti-TNF Therapy an Option?(2019) ROCHA, Beatriz; QUEIROZ, Natalia; AZEVEDO, Matheus; ALEXANDRE, Carlos; MILANI, Luciane; CANCADO, Eduardo; TERRABUIO, Debora; BARROS, Luisa; OBA, Jane; LEITE, Andre; SIPAHI, Aytan; DAMIAO, Aderson- Risk of thrombosis and mortality in inflammatory bowel disease(2018) ANDRADE, Adriana R.; BARROS, Luisa L.; AZEVEDO, Matheus F. C.; CARLOS, Alexandre S.; DAMIAO, Aderson O. M. C.; SIPAHI, Aytan M.; LEITE, Andre Z. A.Objectives: Patients with inflammatory bowel disease have a higher risk of thrombosis, which is associated with a higher morbidity and mortality. Most data about VTE are related to hospitalized patients with active disease, but several cases happen in the outpatient setting, and are not covered by current prophylaxis recommendation. As the knowledge of VTE in outpatients is still poor, the aim of this study is to evaluate the risk, clinical data and mortality of thrombosis in patients followed in our center, comparing our findings with the current prophylaxis recommendation. Methods: The medical electronic chart of 1093 inflammatory bowel disease patients and their image exams were actively searched for words related to thrombosis, followed by charts reviewed to collect information about the event and data regarding clinical settings and thrombosis profile. Results: Overall, 654 Crohn's and 439 Colitis patients were included. Thrombosis prevalence was 5.1%, and mortality rate was higher in patients who had suffered thrombosis (10.71% vs. 1.45%, OR 8.0). Half of them developed thrombosis in the outpatient setting, 52% of these had disease activity, 17% had recent hospitalization, and 10% had previous thrombosis. In 27% of cases, diagnosis was done by routine image exams, with no clinical symptoms or previous history of thrombosis. None of them had used thromboprophylaxis. However, a great majority of patients who had thrombosis during hospitalization used heparin prophylaxis. Conclusion: Inflammatory bowel disease patients who develop thrombosis have an increased mortality risk. A significant proportion of the events happened in patients without a clear thromboprophylaxis recommendation or in those receiving heparin prophylaxis.
- Endoscopic activity, tissue factor and Crohn's disease: findings in clinical remission patients(2020) ANDRADE, Adriana Ribas; ROCHA, Tania Rubia Flores da; ORTIZ-AGOSTINHO, Carmen Lucia; NISHITOKUKADO, Ieda; CARLOS, Alexandre Sousa; AZEVEDO, Matheus Freitas Cardoso de; HASHIMOTO, Claudio Lioshi; DAMIAO, Aderson Omar Moura Cintra; CARRILHO, Flair Jose; D'AMICO, Elbio; SIPAHI, Aytan Miranda; LEITE, Andre Zonetti de ArrudaBackground: As Crohn's disease (CD) is associated with a high risk of thromboembolic events (TE), including patients with subclinical inflammation, we aim to evaluate the correlation between the impact of endoscopic activity (EA) in the coagulation profiling of CD patients while in clinical remission. Methods: From 164 consecutive CD patients included in clinical remission [Crohn's disease activity index (CDAI) < 150], 75 were in the EA group [Simplified Endoscopic Score for CD (SES-CD) > 7], 89 were in the endoscopic remission (ER) group (SES-CD <= 2), and 50 were included as healthy controls in the study. Blood samples were analyzed for tissue factor (TF), factor VIII (FVIII), thrombomodulin (TM), ADAMTS-13, von Willebrand factor (VWF), and endogenous thrombin potential (ETP), as well as collecting data regarding risk factors for TE and CD profile. Results: Mean plasma TF activity showed significantly higher levels in the EA group when compared with the ER and control groups (127 pMversus103 pMversus84 pM;p = 0.001), although the VWF:Ag (160%versus168%versus110%;p = 0.001), VWF/ADAMTS-13 (191versus219versus138;p = 0.003), FVIII (150%versus144%versus90%;p = 0.001) and TM (5.13 ng/mlversus4.91 ng/mLversus3.81 ng/ml;p < 0.001) were only increased in CD regardless of EA status when compared with controls. Lastly, ETP with and without TM remained the same in all three groups. Conclusions: CD patients in clinical remission with EA present endothelial lesion inducing TF exposure and subsequent coagulation cascade activation. Recommended thromboprophylaxis for EA outpatient subgroups will require additional investigation in order to be validated.
conferenceObject Clinical Outcomes of Primary Sclerosing Cholangitis in IBD Patients: A Single Center Experience(2019) MARTINS, Camilla; ELISA, Caon Ana; CRUZ, Marilia; BARROS, Luisa; AZEVEDO, Matheus; CARLOS, Alexandre; QUEIROZ, Natalia; MILANI, Luciane; OBA, Jane; ROCHA, Beatriz; LEITE, Andre; SIPAHI, Aytan; CANCADO, Eduardo; DAMIAO, AdersonconferenceObject Active Tuberculosis Infection in Patients With Inflammatory Bowel Disease Followed in a Referral Center(2019) LIMA, Camila; GARCIA, Karoline; FACAS, Bianca; AZEVEDO, Matheus; QUEIROZ, Natalia; BARROS, Luisa; LEITE, Andre; ALEXANDRE, Carlos; GASPARINI, Rodrigo; MILANI, Luciane; SIPAHI, Aytan; DAMIAO, Aderson; OBA, Jane; ROCHA, BeatrizconferenceObject Ophthalmic Complications in Patients With Inflammatory Bowel Disease During Anti-TNF Treatment(2019) MILANI, Luciane; QUEIROZ, Natalia; AZEVEDO, Matheus; CARLOS, Alexandre; OBA, Jane; ROCHA, Beatriz; BARROS, Luisa; SOBRADO, Carlos; GONCALVES, Aline; LEITE, Andre; SIPAHI, Aytan; DAMIAO, Aderson