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.
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.- Quality of life, fatigue, sleep quality, and mental health in systemic lupus erythematosus patients with a high cardiovascular risk profile(2023) MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; SIECZKOWSKA, Sofia; ROMERO, Marina; RIBEIRO, Thaina Toledo; AMARANTE, Milla Cordeiro; PASOTO, Sandra; PINTO, Ana Lucia de Sa; LIMA, Fernanda Rodrigues; BENATTI, Fabiana Braga; BONFA, Eloisa; ROSCHEL, Hamilton; GUALANO, BrunoSystemic lupus erythematosus (SLE) patients report worse health-related quality of life (HRQL), fatigue, anxiety, depression, and sleep quality, when compared to the general population and other chronic diseases. Furthermore, cardiometabolic diseases are highly prevalent in SLE and are also associated with these parameters. Thus, it is plausible to suggest that SLE patients with a high cardiovascular risk may report worse results for these parameters. The aim of the study is to describe HRQL, fatigue, anxiety and depression symptoms, and sleep quality in a sample of SLE patients with a high cardiovascular risk profile (i.e., BMI between 25 and 40 kg/m2 and/or dyslipidemia, hypertension, or diabetes). This was a cross-sectional study where patients were assessed for (i) demographic, anthropometric, and disease-related parameters, (ii) HRQL, (iii) fatigue, (iv) anxiety and depression symptoms, and (v) sleep quality. One-hundred patients completed the study; however, only 87 patients were assessed for sleep quality data. Patients averaged 41.7 & PLUSMN; 9 years, and most patients were classified as overweight/obese (87%). SF-36 scores for physical and mental components summary were 51.3 & PLUSMN; 9.6 and 54.2 & PLUSMN; 15.6, respectively, with ""bodily pain"" and ""role emotional"" presenting the lower scores. The total SLEQOL score was 105.1 & PLUSMN; 42.0, with lower scores reported for ""self-image"" and ""mood."" Fatigue score was 30.8 & PLUSMN; 8.9, and 78% and 93% reported severe symptoms of anxiety and depression, respectively. The average sleep effectiveness was 82.9 & PLUSMN; 6.6%. Sleep latency, total time in bed (TTiB), and total sleep time (TST) were 8.4 & PLUSMN; 8.9, 495.8 & PLUSMN; 79.7, and 409.7 & PLUSMN; 69.9 min, respectively. Patients reported an average of 17.8 & PLUSMN; 6.2 WE, with 4.5 & PLUSMN; 1.5 min duration and a WASO of 77.7 & PLUSMN; 36.6 min. Despite similar HRQL, fatigue, and sleep quality parameters to those reported by other SLE populations, SLE patients with a high cardiovascular risk had a higher prevalence of depression and anxiety. Understanding SLE patients' quality of life and psychological symptoms is of utmost importance to improve disease management. The findings of this study highlight the need for more intensive and global care regarding mental health when considering a high cardiovascular risk in SLE.
- Performance of alpha-defensin lateral flow test after synovial fluid centrifugation for diagnosis of periprosthetic knee infection(2021) ABDO, Rodrigo Calil Teles; GOBBI, Riccardo Gomes; LEITE, Chilan Bou Ghosson; PASOTO, Sandra Gofinet; LEON, Elaine Pires; LIMA, Ana Lucia Lei Munhoz; BONFA, Eloisa; PECORA, Jose Ricardo; DEMANGE, Marco KawamuraBACKGROUND The quantitative alpha-defensin enzyme-linked immunosorbent assay (ELISA) demands a prior synovial fluid centrifugation, whereas this processing is not routinely required prior to the alpha-defensin lateral flow test. AIM To evaluate whether a prior synovial fluid centrifugation could lead the lateral flow performance to achieve comparable results to ELISA during periprosthetic joint infection (PJI) diagnosis. METHODS Fifty-three cases were included in this study: 22 classified as PJI and 31 classified as aseptic cases, according to Musculoskeletal Infection Society 2013 criteria. Synovial fluid samples were submitted to centrifugation, and the supernatant was evaluated by ELISA and lateral flow tests. The sensitivity (SE), specificity (SP) and accuracy of each method were calculated as well as the agreement between those two methods. RESULTS In all of the 31 samples from aseptic patients, alpha-defensin ELISA and lateral flow tests showed negative results for infection. Regarding the 22 infected patients, the lateral flow test was positive in 19 cases (86.4%) and the ELISA was positive in 21 (95.5%). Sensibility, SP and accuracy were, respectively, 86.4% (95%CI: 65.1%-97.1%), 100% (95%CI: 88.8%-100%) and 93.2% (95%CI: 82.8%-98.3%) for the lateral flow test and 95.5% (95%CI: 77.2%-99.9%), 100% (95%CI: 88.8%-100%) and 98.1% (95%CI: 89.9%-100%) for ELISA. An agreement of 96.2% between those methods were observed. No statistical difference was found between them (P = 0.48). CONCLUSION Alpha-defensin lateral flow test showed high SE, SP and accuracy after a prior synovial fluid centrifugation, achieving comparable results to ELISA. Considering the lower complexity of the lateral flow and its equivalent performance obtained in this condition, a prior centrifugation might be added as a valuable step to enhance the PJI diagnosis.
- LONGITUDINAL ASSESSMENT OF HAND AND WRIST BONE DESTRUCTION BY ULTRASOUND, AND ITS ASSOCIATION WITH DISEASE ACTIVITY IN PRIMARY SJOGREN'S SYNDROME(2023) FRANCO, A. Silva; MURAI, I.; YANG, T.; SALES, L. Peixoto; GUEDES, L.; PASOTO, S.; FIGUEIREDO, C.; PEREIRA, R. M.
conferenceObject Salivary gland damage in Sjogren's syndrome: are endothelial and vascular alterations associated with the secretion of IL-17?(2018) LOURENCO, Silvia V.; BOLOGNA, Sheyla B.; CAVALCANTE, Wanessa S.; PASOTO, Sandra G.; FLOREZI, Giovanna P.conferenceObject Ultrasonography of major salivary glands in juvenile Sjogren's syndrome: an international multicentre study(2018) HAMMENFORS, Daniel S.; VALIM, Valeria; BICA, Blanca E. R. G.; PASOTO, Sandra G.; LILLEBY, Vibke; NIETO-GONZALEZ, Juan Carlos; SILVA, Clovis A.; MOSSEL, Esther; PEREIRA, Rosa M. R.; COELHO, Aline; BOOTSMA, Hendrika; THATAYATIKOM, Akaluck; BRUN, Johan G.; JONSSON, Roland; JONSSON, Malin V.- Short-term Accrual 2019 European League Against Rheumatism/American College of Rheumatology Domains and Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage in Lupus Patients With and Without Nephritis at Disease Onset(2023) MUNHOZ, Gabriela A.; AIKAWA, Nadia E.; SILVA, Clovis A.; PASOTO, Sandra G.; PEDROSA, Tatiana N.; SEGURO, Luciana P. C.; BONFA, Eloisa; BORBA, Eduardo F.ObjectiveTo determine in a historical inception cohort the impact of lupus nephritis at disease onset in short-term accrual 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) domains. The possible association with treatment and damage was also investigated.MethodsOne hundred thirty-three consecutive adult systemic lupus erythematosus patients according to the 2019 EULAR/ACR criteria were divided according to the presence (RENAL-lupus) or absence of renal involvement (NONRENAL-lupus) at disease onset. The 2019 EULAR/ACR score and Systemic Lupus International Collaborating Clinics/ACR (SDI) were longitudinally evaluated over 3 years.ResultsRENAL-lupus (n = 49 [36.8%]) and NONRENAL-lupus (n = 84 [63.2%]) were similar regarding age (p = 0.704), female sex (p = 0.313), and black race (p = 0.506). At study entry, RENAL-lupus had higher 2019 EULAR/ACR total domains (30 [12-42] vs. 22 [10-36], p < 0.001) and used more often glucocorticoid (p < 0.001), mycophenolate mofetil (p = 0.007), and cyclophosphamide (p = 0.001). After 3 years, a stable number of domain scores was observed for the RENAL-lupus (30 [12-42] vs. 30 [12-42], p = 0.125), whereas an increase was observed for the NONRENAL-lupus (22 [10-36] vs. 23 [10-40], p < 0.001) compared with baseline. Accordingly, RENAL-lupus patients had a lower frequency of additional domains (3/49 [6.1%] vs. 37/84 [44.0%], p < 0.0001). New kidney involvement occurred in 15 (44.1%) of 34 patients of the NONRENAL-lupus. Both groups evolved with a comparable increase in frequency of patients with damage (SDI >= 1) at the end of the study (23/49 [46.9%] vs. 34/89 [40.54%], p = 0.585) with a similar median of SDI (1 [0-4] vs. 0 [0-2], p = 0.132).ConclusionsThe distinct pattern of accrual 2019 EULAR/ACR domains in patients with and without nephritis at disease onset suggests that close surveillance for additional organ involvement, including kidney, is mandatory in NONRENAL lupus in the first 3 years of disease. The unexpected comparable early damage in both groups despite milder disease and less intense immunosuppression in NONRENAL lupus reinforces the need for new and tailored therapies for these patients.
conferenceObject Is Sjogren's syndrome sialadenitis similar to salivary gland impairment in Lupus erythematosus?(2018) BOLOGNA, Sheyla B.; FLOREZI, Giovanna; CAVALCANTE, Wanessa S.; PASOTO, Sandra G.; LOURENCO, Silvia V.