CARMEN LUCIA ORTIZ AGOSTINHO
Índice h a partir de 2011
4
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina
2 resultados
Resultados de Busca
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- Pancreatic endosonographic findings and clinical correlation in Crohn's disease(2019) MALLUTA, Everson Fernando; MALUF-FILHO, Fauze; LEITE, Andre Zonetti de Arruda; ORTIZ-AGOSTINHO, Carmen Lucia; NISHITOKUKADO, Lecia; ANDRADE, Adriana Ribas; LORDELLO, Maria Laura Lacava; SANTOS, Fabiana Maria dos; SIPAHI, Aytan MirandaOBJECTIVES: We aimed to evaluate the incidence of pancreatic alterations in Crohn's disease using endoscopic ultrasound (EUS) and to correlate the number of alterations with current clinical data. METHODS: Patients diagnosed with Crohn's disease (n= 51) were examined using EUS, and 11 variables were analyzed. A control group consisted of patients with no history of pancreatic disease or Crohn's disease. Patients presenting with three or more alterations underwent magnetic resonance imaging (MRI). Pancreatic function was determined using a fecal elastase assay. RESULTS: Two of the 51 patients (3.9%) presented with four EUS alterations, 3 (5.9%) presented with three, 11 (21.5%) presented with two, and 13 (25.5%) presented with one; in the control group, only 16% presented with one EUS alteration (p< 0.001). Parenchymal abnormalities accounted for 39 of the EUS findings, and ductal abnormalities accounted for 11. Pancreatic lesions were not detected by MRI. Low fecal elastase levels were observed in 4 patients, none of whom presented with significant pancreatic alterations after undergoing EUS. Ileal involvement was predictive of the number of EUS alterations. CONCLUSION: A higher incidence of pancreatic abnormalities was found in patients with Crohn's disease than in individuals in the control group. The majority of these abnormalities are related to parenchymal alterations. In this group of patients, future studies should be conducted to determine whether such morphological abnormalities could evolve to induce exocrine or endocrine pancreatic insufficiency and, if so, identify the risk factors and determine which patients should undergo EUS.
- 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.