MARIA HELENA SAMPAIO FAVARATO

(Fonte: Lattes)
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/20 - Laboratório de Terapêutica Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • article 20 Citação(ões) na Scopus
    Current and relevant concepts in psoriatic arthritis
    (2012) GOLDENSTEIN-SCHAINBERG, Claudia; FAVARATO, Maria Helena Sampaio; RANZA, Roberto
    Psoriatic arthritis (PsA) is a systemic, polymorphic joint disease with variable presentation and clinical course. The outcome depends on the association with severe comorbidities such as diabetes, hypertension and dyslipidemia. Early diagnosis requires a high degree of clinical suspicion, especially when skin manifestations are subtle and poorly defined. Progressive erosive disease can occur in up to half of patients, associated with anatomical and functional changes in about 20%. Thus, the prognosis of PsA remains unclear, especially if diagnosis and treatment are delayed. Based on extensive literature review (PubMed and Lilacs) and experience of our services, new concepts of immunogenetics, pathophysiology, and clinical and therapeutic aspects are discussed. Factors that reduce the quality of life and life expectancy of patients, as well as new guidelines for treatment, will be emphasized. Control of inflammation, especially in enthesitis and axial forms of PsA, was made possible due to the introduction of anti-TNF biologics. Finally, the role of GRAPPA (Group for Research and Assessment of Psoriasis and Psoriatic Arthritis) should be emphasized, since it promotes meetings and joint studies between rheumatologists and dermatologists to provide scientific evidence for the sweeping changes in clinical management and treatment of patients with PsA.
  • conferenceObject
    THYROID DYSFUNCTION IS MARKED IN PATIENTS WITH PSORIATIC ARTHRITIS (PsA)
    (2012) FAVARATO, M. H.; SCHMITZ, M. K.; TOMITA, R. B.; SAAD, C. G.; GONCALVES, C.; SAMPAIO-BARROS, R.; GOLDENSTEIN-SCHAINBERG, C.
    Introduction: Whereas autoimmune thyroiditis is associated to rheumatic diseases (ex:SLE, Sjögren’s, RA), few controversial studies have assessed thyroid involvement in PsA. Aim: To evaluate thyroid function and serum thyroid antibodies antithyroglobulin (TGAb) and antithyroperoxidase (AbTPO) in patients with PsA searching for clinical associations in relation to PsA subtypes. Patients and Methods: Subjects fulfilling CASPAR criteria for PsA were consecutively enrolled and interviewed after approval of local ethics committee. Additional clinical data were obtained by specific questionnaire and extensive chart review. Patients were classified in five subgroups according to Moll/Wright PsA subtypes. Serum TSH, fT4, TPOAb and TgAb levels were determined by routine laboratory analysis and tested by AutoDELFIA immunoassay (PW-USA). Statistical significance was considered if P≤0.05. Results: Eighty PsA patients, 39M (48.8%), 41F (51.3%), mean age=52years (20- 83±14yrs) were included. Mean disease duration was 17±11years for cutaneous psoriasis (1-50) and 12±8years for arthritis (1-49). Twenty-seven (34%) patients had symmetric polyarthritis, followed by 21 (26.3%) oligoarticular, 21 (26.3%) axial, 6 (7.5%) mutilans and 5 (6.5%) classical PsA. Remarkably, 18 (22.5%) patients had thyroid dysfunction: 9 (11.25%) hypothyroidism, 6 (7.5%) subclinical hypothyroidism and 3 (3.75%) subclinical hyperthyroidism. Thyroid autoantibodies were positive in 22/80 (27.5%) patients’ sera: 3 (3.75%) TPOAb+, 12 (15%) TgAb+, 7 (8.75%) AbTPO+ and TGAb+. Four of 18 patients with thyroid dysfunction (22.2%) had sera anti-thyroid antibodies: 1 TPOAb and 3 TgAb. Mean age, sex distribution, ethnic, tabagism, PsA subtype, thyroid antibodies and ANA positivity were alike among patients with thyroid dysfunction and those with normal thyroid function. Remarkably, family history for cutaneous psoriasis was higher in patients with hypothyroidism compared to those with normal thyroid function (40 vs 11%, p=0.0158). Conclusions: Thyroid dysfunction and self-organ-specific antibodies in almost one fourth of PsA patients, mostly related to familiar cutaneous disease indicate the need of routine clinical thyroid evaluation as part of PsA patients’ approach, in order to enable adequate care and specific prompt treatment.