CLAUDIA GOLDENSTEIN SCHAINBERG
Projetos de Pesquisa
Unidades Organizacionais
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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- Nephrolithiasis in gout: prevalence and characteristics of Brazilian patients(2019) HOFF, Leonardo Santos; GOLDENSTEIN-SCHAINBERG, Claudia; FULLER, RicardoBackground The aims of this article were to assess the prevalence of nephrolithiasis and the factors associated with nephrolithiasis in Brazilian patients with primary gout. Methods One hundred twenty-three patients with primary gout were recruited from a tertiary referral hospital in Sao Paulo, Brazil. All patients underwent ultrasonography and had their clinical and laboratory characteristics assessed. Results One hundred fifteen (93.5%) patients were male, with a mean age of 62.9 +/- 9.4 years. Twenty-three (18.7%) patients had asymptomatic nephrolithiasis (detected only by ultrasonography), 7 (6.0%) had symptomatic nephrolithiasis (detected by ultrasonography and a positive clinical history), and 13 (10.0%) had a history of kidney stones, but ultrasonography at evaluation did not show nephrolithiasis. Therefore, 35.0% of the patients had nephrolithiasis (detected either by ultrasonography and/or a positive clinical history). Nephrolithiasis was associated with male gender (43 [100%] vs 72 [90%], p = 0.049), the use of potassium citrate (13 [30.2%] vs 0, p < 0.001) and the use of medications for diabetes (10 [23.3%] vs 8 [10%], p = 0.047) and dyslipidemia (15 [34.9%] vs 10 [12.5%], p = 0.003); benzbromarone had an inverse association with nephrolithiasis (21 [48.8%] vs 55 [68.8%], p = 0.030). In patients with and without nephrolithiasis, no differences were found in the laboratory and ultrasonography characteristics, including serum uric acid levels, urinary uric acid excretion and urine pH. Conclusions The prevalence of nephrolithiasis in primary gout was 35.0%, and 18.7% of the patients were asymptomatic. Nephrolithiasis was associated with male gender, diabetes and dyslipidemia. A positive history of nephrolithiasis probably biased the prescription of potassium citrate and benzbromarone.
conferenceObject Interstitial lung disease in systemic sclerosis is associated with autoimmunity to alpha 1(V) chain of type V collagen(2019) VELOSA, A. P. Pereira; BRITO, L.; QUEIROZ, Z. A.; CARRASCO, S.; MIRANDA, J. Tomaz de; GOLDENSTAIN-SCHAINBERG, C.; PARRA, E. Roger; CAPELOZZI, V. L.; TEODORO, W. RosoliaconferenceObject Distinctive Pattern of LTBI Screening Parameters in Ankylosing Spondylitis (AS) and Psoriatic Arthritis (PsA) in Endemic Areas(2019) SHIMABUCO, Andrea; RIBEIRO, Ana Cristina de Medeiros; MIOSSI, Renata; BONFIGLIOLI, Karina; MORAES, Julio Cesar Bertacini; GONCALVES, Celio; SAMPAIO-BARROS, Percival; GOLDENSTEIN-SCHAINBERG, Claudia; SOUZA, Fernando Henrique; PRADO, Leandro; UGOLINI-LOPES, Michelle Remiao; YUKI, Emily; BONFA, Eloisa; SAAD, Carla Goncalves Schahin- LTBI SCREENING IN SPONDYLOARTHRITIS PATIENTSPRIOR TO ANTI-TNF TREATMENT AND FOLLOW-UP IN AN ENDEMIC AREA(2019) SHIMABUCO, Andrea; MEDEIROS, Ana; MIOSSI, Renata; BONFIGLIOLI, Karina; MORAES, Julio; GONCALVES, Celio; SAMPAIO-BARROS, Percival D.; GOLDENSTEIN-SCHAINBERG, Claudia; SOUZA, Fernando; PRADO, Leandro; LOPES, Michelle; BONFA, Eloisa; SAAD, Carla
- Ovarian reserve in young juvenile idiopathic arthritis patients(2019) FERREIRA, Gabriela R. V.; TOMIOKA, Renato B.; AIKAWA, Nadia E.; LEON, Elaine P.; MACIEL, Gustavo A. R.; SERAFINI, Paulo C.; BARACAT, Edmund C.; GOLDENSTEIN-SCHAINBERG, Claudia; PEREIRA, Rosa M. R.; BONFA, Eloisa; SILVA, Clovis A.Objectives: Juvenile idiopathic arthritis (JIA) occurs during reproductive age, however, there are no systematic data regarding ovarian function in this disease. Methods: Twenty-eight post-pubertal JIA patients and age-matched 28 healthy controls were studied. Complete ovarian function was assessed during the early follicular phase of the menstrual cycle including anti-Mullerian hormone (AMH), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and antral follicle count (AFC) by ovarian ultrasound, and anti-corpus lutheum antibodies (anti-CoL). Demographic data, menstrual abnormalities, disease parameters and treatment were also evaluated. Results: The mean current age (22.6 +/- 6.59 vs. 22.5 +/- 6.59 years, p = .952) was similar in JIA patients and healthy controls with a higher median menarche age [13(8-16) vs. 12(8-14) years, p = .029]. A lower median AMH levels [2.65(0.47-9.08) vs. 4.83(0.74-17.24) ng/mL, p = .029] with a higher LH [8.44 +/- 4.14 vs. 6.03 +/- 2.80 IU/L, p = .014] and estradiol levels [52.3(25.8-227.4) vs. 38.9(26.2-133.6) pg/mL, p = .008] were observed in JIA compared to control group. Anti-CoL and AFC were similar in both groups (p > .05). Further analysis of JIA patients revealed that current age, disease duration, number of active/limited joints, ESR, CRP, patient/physician VAS, JADAS 71, DAS 28, CHAQ, HAQ, patient/parents PedsQL, PF-SF 36, cumulative glucocorticoid and cumulative methotrexate doses were not correlated with AMH, FSH, estradiol levels or AFC (p > .05). Conclusion: The present study was the first to suggest diminished ovarian reserve, not associated to hypothalamic pituitary gonadal axis, in JIA patients during reproductive age. The impact of this dysfunction in future fertility of these patients needs to be evaluated in prospective studies.
- CD4(+)CD69(+) T cells and CD4(+)CD25(+)FoxP3(+) Treg cells imbalance in peripheral blood, spleen and peritoneal lavage from pristane-induced systemic lupus erythematosus (SLE) mice(2019) PEIXOTO, Tatiana Vasconcelos; CARRASCO, Solange; BOTTE, Domingos Alexandre Ciccone; CATANOZI, Sergio; PARRA, Edwin Roger; LIMA, Thais Martins; UGRIUMOV, Natasha; SORIANO, Francisco Garcia; MELLO, Suzana Beatriz Verissimo de; RODRIGUES, Caio Manzano; GOLDENSTEIN-SCHAINBERG, ClaudiaBackground: Adaptive immune cells, including CD4(+)CD69(+) and CD4(+)CD25(+)FoxP3(+) regulatory T (Treg) cells, are important for maintaining immunological tolerance. In human systemic lupus erythematosus (SLE), CD4(+)CD25(+)FoxP3(+) Treg cells are reduced, whereas CD69 expression is increased, resulting in a homeostatic immune imbalance that may intensify autoreactive T cell activity. To analyze the mechanisms implicated in autotolerance failure, we evaluated CD4(+)CD69(+) and CD4(+)CD25(+)FoxP3(+) T cells and interleukin profiles in a pristane-induced SLE experimental model. Methods: For lupus induction, 26 female Balb/c mice received a single intraperitoneal 0.5 ml dose of pristane, and 16 mice received the same dose of saline. Blood and spleen samples were collected from euthanized mice 90 and 120 days after pristane or saline inoculation. Mononuclear cells from peripheral blood (PBMC), peritoneal lavage (PL) and splenocytes were obtained by erythrocyte lysis and cryopreserved for further evaluation by flow cytometry using the GuavaEasyCyte TM HT. After thawing, cells were washed and stained with monoclonal antibodies against CD3, CD4, CD8, CD25, CD28, CD69, FoxP3, CD14 and Ly6C (BD Pharmingen TM). Interleukins were quantified using Multiplex (R) MAP. The Mann-Whitney test and the Pearson coefficient were used for statistical analysis, and p < 0.05 considered significant. Results: Compared with the controls, SLE-induced animals presented increased numbers of CD4(+)CD69(+) T cells in the blood on T90 and T120 (p = 0.022 and p = 0.008) and in the spleen on T120 (p = 0.049), but there were decreased numbers in the PL (p = 0.049) on T120. The percentage of Treg was lower in blood (p < 0.005 and p < 0.012) on T90 and T120, in spleen (p = 0.043) on T120 and in PL (p = 0.001) on T90. Increased numbers of CD4+ CD69+ T cells in the PL were positively associated with high IL-2 (p = 0.486) and IFN-gamma (p = 0.017) levels, whereas reduced Treg cells in the blood were negatively correlated with TNF alpha levels (p = 0.043) and positively correlated with TGF beta 1 (p = 0.038). Conclusion: Increased numbers of CD4(+)CD69(+) T cells and reduced numbers of CD4(+)CD25(+)FoxP3(+) Treg cells with an altered interleukin profile suggests loss of autotolerance in pristane-induced lupus mice, which is similar to human lupus. Therefore, this model is useful in evaluating mechanisms of cellular activation, peripheral tolerance and homeostatic immune imbalance involved in human SLE.