SANDRA GOFINET PASOTO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/03 - Laboratório de Medicina Laboratorial, Hospital das Clínicas, Faculdade de Medicina
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article 51 Citação(ões) na Scopus Systemic manifestations of primary Sjogren's syndrome out of the ESSDAI classification: prevalence and clinical relevance in a large international, multi-ethnic cohort of patients(2019) RETAMOZO, S.; ACAR-DENIZLI, N.; RASMUSSEN, A.; HORVATH, I. F.; BALDINI, C.; PRIORI, R.; SANDHYA, P.; HERNANDEZ-MOLINA, G.; ARMAGAN, B.; PRAPROTNIK, S.; KVARNSTROM, M.; GERLI, R.; SEBASTIAN, A.; SOLANS, R.; RISCHMUELLER, M.; PASOTO, S. G.; VALIM, V.; NORDMARK, G.; KRUIZE, A. A.; NAKAMURA, H.; HOFAUER, B.; GIACOMELLI, R.; TREVISANI, V. Fernandes Moca; DEVAUCHELLE-PENSEC, V.; ATZENI, F.; GHEITA, T. A.; CONSANI-FERNANDEZ, S.; SZANTO, A.; SIVILS, K.; GATTAMELATA, A.; DANDA, D.; KILIC, L.; BARTOLONI, E.; BOMBARDIERI, S.; SANCHEZ-GUERRERO, J.; WAHREN-HERLENIUS, M.; MARIETTE, X.; RAMOS-CASALS, M.; BRITO-ZERON, P.Objectives: To analyse the frequency and characterise the systemic presentation of primary Sjogren's syndrome (SS) out of the ESSDAI classification in a large international, multi-ethnic cohort of patients. Methods: The Big Data Sjogren Project Consortium is an international, multicentre registry based on world-wide data-sharing and cooperative merging of pre-existing clinical SS databases from leading centres in clinical research in SS from the five continents. A list of 26 organ-by-organ systemic features not currently included in the ESSDAI classification was defined according to previous studies; these features were retrospectively recorded. Results: Information about non-ESSDAI features was available in 6331 patients [5,917 female, mean age at diagnosis 52 years, mainly White (86.3%)]. A total of 1641 (26%) patients had at least one of the ESSDAI systemic features. Cardiovascular manifestations were the most frequent organ-specific group of non-ESSDAI features reported in our patients (17% of the total cohort), with Raynaud's phenomenon being reported in 15%. Patients with systemic disease due to non-ESSDAI features had a lower frequency of dry mouth (90.7% vs. 94.1%, p<0.001) and positive minor salivary gland biopsy (86.7% vs. 89%, p=0.033), a higher frequency of anti-Ro/SSA (74.7% vs. 68.7%, p<0.001), anti-La/SSB antibodies (44.5% vs. 40.4%, p=0.004), ANA (82.7% vs. 79.5%, p=0.006), low C3 levels (17.4% vs. 9.7%, p<0.001), low C4 levels (14.4% vs. 9.6%, p<0.001), and positive serum cryoglobulins (8.6% vs. 5.5%, p=0.001). Systemic activity measured by the ESSDAI, clinESSDAI and DAS was higher in patients with systemic disease out of the ESSDAI in comparison with those without these features (p<0.001 for all comparisons). Conclusions: More than a quarter of patients with primary SS may have systemic manifestations not currently included in the ESSDAI classification, with a wide variety of cardiovascular, digestive, pulmonary, neurological, ocular, ENT (ear, nose, and throat), cutaneous and urological features that increase the scope of the systemic phenotype of the disease. However, the individual frequency of each of these non-ESSDAI features was very low, except for Raynaud's phenomenon.- Neurosarcoidosis during the treatment of primary Sjogren's syndrome: is it a paradoxical effect of rituximab?(2022) CORDEIRO, R. A.; OLIVEIRA, J. L. De; FERRACIOLLI, S. F.; GUEDES, L. K. N.; PASOTO, S. G.
conferenceObject Preliminary Proteomic Analysis of Saliva from Patients with Sjogren's Syndrome(2015) BOLOGNA, S. B.; SOUZA, M. M.; NUNES, T. B.; NICO, M. M. S.; PASOTO, S. G.; LOURENCO, S. V.conferenceObject CLINICAL AND SEROLOGICAL COMPARATIVE ANALYSIS OF SYSTEMIC SCLEROSIS WITH OR WITHOUT OVERLAP SYNDROMES IN A LARGE BRAZILIAN COHORT(2014) SILVA, C. M.; PASOTO, S. G.; VIANA, V. S.; SEGURO, L. P. C.; ANDRADE, D. C. O.; BONFA, E.; SAMPAIO-BARROS, P. D.- Ovarian reserve in adult patients with childhood-onset lupus: a possible deleterious effect of methotrexate?(2014) ARAUJO, D. B. de; YAMAKAMI, L. Y. S.; AIKAWA, N. E.; BONFA, E.; VIANA, V. S. T.; PASOTO, S. G.; PEREIRA, R. M. R.; SERAFIN, P. C.; BORBA, E. F.; SILVA, C. A.Objectives: To assess ovarian reserve markers and anti-corpus luteum antibodies (anti-CoL) in adult patients with childhood-onset systemic lupus erythematosus (c-SLE). Method: Fifty-seven adult c-SLE female patients and 21 healthy controls were evaluated for anti-CoL. Ovarian reserve was assessed by: follicle stimulating hormone (FSH), luteinizing hormone (LH), oestradiol, anti-Mullerian hormone (AMH), and antral follicle count (AFC). Demographic data, menstrual abnormalities, disease activity, damage, and treatment were also analysed. Results: The median current age was similar in adult c-SLE patients and controls (27.7 vs. 27.7 years, p = 0.414). The medians of AMH (1.1 vs. 1.5 ng/mL, p = 0.037) and AFC (6 vs. 16, p < 0.001) were significantly reduced in SLE patients compared to controls without significant menstrual abnormalities. Anti-CoL were solely observed in c-SLE patients (16% vs. 0%, p = 0.103) and were not associated with demographic data, ovarian reserve parameters, disease activity/damage, and treatment. Further evaluation of c-SLE patients treated with cyclophosphamide revealed a higher median of FSH levels compared to c-SLE patients not treated with cyclophosphamide and controls (8.8 vs. 5.7 vs. 5.6 IU/L, p = 0.032) and lower median AMH (0.4 vs. 1.5 vs. 1.5 ng/mL, p = 0.004) and AFC (4.0 vs. 6.5 vs. 16 IU/L, p = 0.001) levels. Nineteen patients treated exclusively with methotrexate demonstrated a negative correlation between the cumulative dose and AMH levels (p = 0.027, r = -0.507). Conclusions: The present study demonstrated for the first time that a high cumulative methotrexate dose is a possible cause of subclinical ovarian dysfunction in adult c-SLE patients. Further studies are required to confirm this deleterious effect in other rheumatic diseases, particularly juvenile idiopathic arthritis and idiopathic inflammatory myopathy.
article 20 Citação(ões) na Scopus Influence of the age at diagnosis in the disease expression of primary Sjogren's syndrome. Analysis of 12,753 patients from the Sjogren Big Data Consortium(2021) RETAMOZO, S.; ACAR-DENIZLI, N.; HORVATH, I. F.; NG, W-F; RASMUSSEN, A.; DONG, X.; LI, X.; BALDINI, C.; OLSSON, P.; PRIORI, R.; SEROR, R.; GOTTENBERG, J-E; KRUIZE, A. A.; HERNANDEZ-MOLINA, G.; VISSINK, A.; SANDHYA, P.; ARMAGAN, B.; QUARTUCCIO, L.; SEBASTIAN, A.; PRAPROTNIK, S.; BARTOLONI, E.; KWOK, S-K; KVARNSTROM, M.; RISCHMUELLER, M.; SOLANS-LAQUE, R.; SENE, D.; PASOTO, S. G.; SUZUKI, Y.; ISENBERG, D. A.; VALIM, V.; NORDMARK, G.; NAKAMURA, H.; TREVISANI, V Fernandes Moca; HOFAUER, B.; SISO-ALMIRALL, A.; GIACOMELLI, R.; DEVAUCHELLE-PENSEC, V; BOMBARDIERI, M.; ATZENI, F.; HAMMENFORS, D.; MAURE, B.; CARSONS, S. E.; GHEITA, T.; SANCHEZ-BERNA, I; LOPEZ-DUPLA, M.; MOREL, J.; INANC, N.; FONSECA-AIZPURU, E.; MORCILLO, C.; VOLLENWEIDER, C.; MELCHOR, S.; VAZQUEZ, M.; DIAZ-CUIZA, E.; CONSANI-FERNANDEZ, S.; DE-MIGUEL-CAMPO, B.; SZANTO, A.; BOMBARDIERI, S.; GATTAMELATA, A.; HINRICHS, A.; SANCHEZ-GUERRERO, J.; DANDA, D.; KILIC, L.; VITA, S. de; WILAND, P.; GERLI, R.; PARK, S-H; WAHREN-HERLENIUS, M.; BOOTSMA, H.; MARIETTE, X.; RAMOS-CASALS, M.; BRITO-ZERON, P.Objective. To analyse how the main components of the disease phenotype (sicca symptoms, diagnostic tests, immunological markers and systemic disease) can be driven by the age at diagnosis of primary Sjogren's syndrome (pSS). Methods. By January 2021, the participant centres had included 12,753 patients from 25 countries that fulfilled the 2002/2016 classification criteria for pSS. The age at diagnosis was defined as the time when the attending physician confirmed fulfilment of the criteria. Patients were clustered according to age at diagnosis. 50 clusters with more than 100 observations (from 27 to 76 years) were used to study the influence of the age at diagnosis in the disease expression. Results. There was a consistent increase in the frequency of oral dryness according to the age at diagnosis, with a frequency of <90% in patients diagnosed at the youngest ages and >95% in those diagnosed at the oldest ages. The smooth curves that best fitted a linear model were the frequency of dry mouth (adjusted R-2 0.87) and the frequency of abnormal oral tests (adjusted R-2 0.72). Therefore, for each 1-year increase in the age at diagnosis, the frequency of dry mouth increased by 0.13%, and the frequency of abnormal oral diagnostic tests by 0.11%. There was a consistent year-by-year decrease in the frequency of all autoantibodies and immunological markers except for cryoglobulins. According to the linear models, for each 1-year increase in the age at diagnosis, the frequency of a positive result decreased by 0.57% (for anti-Ro antibodies), 0.47% (for RF) and 0.42% (for anti-La antibodies). The ESSDAI domains which showed a more consistent decrease were glandular and lymph node involvement (for each 1-year increase in the age at diagnosis, the frequency of activity decreased by 0.18%), and constitutional, cutaneous, and haematological involvements (the frequency decreased by 0.09% for each 1-year increase). In contrast, other domains showed an ascending pattern, especially pulmonary involvement (for each 1-year increase in the age at diagnosis, the frequency of activity increased by 0.22%), and peripheral nerve involvement (the frequency increased by 0.09% for each 1-year increase). Conclusion. The influence of the age at diagnosis on the key phenotypic features of pSS is strong, and should be considered critical not only for designing a personalised diagnostic approach, but also to be carefully considered when analysing the results of diagnostic tests and immunological parameters, and when internal organ involvement is suspected at diagnosis.article 134 Citação(ões) na Scopus How immunological profile drives clinical phenotype of primary Sjogren's syndrome at diagnosis: analysis of 10,500 patients (Sjogren Big Data Project)(2018) BRITO-ZERON, P.; ACAR-DENIZLI, N.; NG, W. F.; ZEHER, M.; RASMUSSEN, A.; MANDL, T.; SEROR, R.; LI, X.; BALDINI, C.; GOTTENBERG, J. -E.; DANDA, D.; QUARTUCCIO, L.; PRIORI, R.; HERNANDEZ-MOLINA, G.; ARMAGAN, B.; KRUIZE, A. A.; KWOK, S. -K.; KVARNSTROM, M.; PRAPROTNIK, S.; SENE, D.; BARTOLONI, E.; SOLANS, R.; RISCHMUELLER, M.; SUZUKI, Y.; ISENBERG, D. A.; VALIM, V.; WILAND, P.; NORDMARK, G.; FRAILE, G.; BOOTSMA, H.; NAKAMURA, T.; GIACOMELLI, R.; DEVAUCHELLE-PENSEC, V.; KNOPF, A.; BOMBARDIERI, M.; TREVISANI, V. -F; HAMMENFORS, D.; PASOTO, S. G.; RETAMOZO, S.; GHEITA, T. A.; ATZENI, F.; MOREL, J.; VOLLENVEIDER, C.; HORVATH, I-F.; SIVILS, K. L.; OLSSON, P.; VITA, S. De; SANCHEZ-GUERRERO, J.; KILIC, L.; WAHREN-HERLENIUS, M.; MARIETTE, X.; RAMOS-CASALS, M.Objective. To evaluate the influence of the main immunological markers on the disease phenotype at diagnosis in a large international cohort of patients with primary Sjogren's syndrome (SjS). Methods. The Big Data Sjogren Project Consortium is an international, multicentre registry created in 2014. As a first step, baseline clinical information from leading centres on clinical research in SjS of the 5 continents was collected. The centres shared a harmonised data architecture and conducted cooperative online efforts in order to refine collected data under the coordination of a big data statistical team. Inclusion criteria were the fulfillment of the 2002 classification criteria. Immunological tests were carried out using standard commercial assays. Results. By January 2018, the participant centres had included 10,500 valid patients from 22 countries. The cohort included 9,806 (93%) women and 694 (7%) men, with a mean age at diagnosis of primary SjS of 53 years, mainly White (78%) and included from European countries (71%). The frequency of positive immunological markers at diagnosis was 79.3% for ANA, 73.2% for anti-Ro, 48.6% for RF, 45.1% for anti-La, 13.4% for low C3 levels, 14.5% for low C4 levels and 7.3% for cryoglobulins. Positive autoantibodies (ANA, Ro, La) correlated with a positive result in salivary gland biopsy, while hypocomplementaemia and especially cryoglobulinaemia correlated with systemic activity (mean ESSDAI score of 17.7 for ctyoglobulins, 11.3 for low C3 and 9.2 for low C4, in comparison with 3.8 for negative markers). The immunological markers with a great number of statistically-significant associations (p<0.001) in the organ-by-organ ESSDAI evaluation were cryoglobulins (9 domains), low C3 (8 domains), anti-La (7 domains) and low C4 (6 domains). Conclusion. We confirm the strong influence of immunological markers on the phenotype of primary SjS at diagnosis in the largest multi-ethnic international cohort ever analysed, with a greater influence for cryoglobulinaemic-related markers in comparison with Ro/La autoantibodies and ANA. Immunological patterns play a central role in the phenotypic expression of the disease already at the time of diagnosis, and may guide physicians to design a specific personalised management during the follow-up of patients with primary SjS.conferenceObject PERIPHERAL NERVOUS SYSTEM DISEASE IN SYSTEMIC LUPUS ERYTHEMATOSUS: THE ROLE OF PREDISPOSING CONDITIONS(2018) FARGETTI, S.; BONFA, E.; SHINJO, S. K.; PASOTO, S. G.; SEGURO, L. P. C.; LOPES, M. R. U.; GONCALVES, C. R.; BORBA, E. F.- SYSTEMIC SCLEROSIS-RELATED AUTO-ANTIBODIES ARE MARKERS OF NEW CLINICAL ASSOCIATIONS IN A COHORT OF 328 BRAZILIAN PATIENTS(2014) SILVA, C. M.; BORTOLUZZO, A. B.; VIANA, V. S.; PASOTO, S. G.; LEON, E. P.; BONFA, E.; SAMPAIO-BARROS, P. D.
conferenceObject SHORT AND LONG-TERM FOLLOW-UP OF PERIPHERAL NEUROPATHY DUE TO SYSTEMIC LUPUS ERYTHEMATOSUS: EVIDENCE OF A FAVORABLE OUTCOME(2018) FARGETTI, S.; BONFA, E.; SHINJO, S. K.; PASOTO, S. G.; SEGURO, L. P. C.; LOPES, M. R. U.; GONCALVES, C. R.; BORBA, E. F.