LEANDRO LARA DO PRADO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Behcet's Disease Activity: An Important Factor For Immunogenicity Of Unadjuvanted Influenza A/H1N1 Vaccine(2013) PRADO, Leandro L.; SAAD, Carla G. S.; MORAES, Julio C. B.; RIBEIRO, Ana Cristina Medeiros; AIKAWA, Nadia E.; SILVA, Clovis A.; SCHAINBERG, Claudia G.; SAMPAIO-BARROS, Percival D.; PRECIOSO, Alexander R.; ISHIDA, Maria A.; BONFA, Eloisa; GONCALVES, CeliobookPart Síndrome de Behçet(2018) PRADO, Leandro Lara do; GONçALVES, Célio Roberto- Ankylosing spondylitis and psoriatic arthritis: revisiting screening of latent tuberculosis infection and its follow-up during anti-tumor necrosis factor therapy in an endemic area(2020) SHIMABUCO, Andrea Yukie; MEDEIROS-RIBEIRO, Ana Cristina de; MIOSSI, Renata; BONFIGLIOLI, Karina Rossi; MORAES, Julio Cesar Bertacini de; GONCALVES, Celio Roberto; SAMPAIO-BARROS, Percival Degrava; GOLDENSTEIN-SCHAINBERG, Claudia; SOUZA, Fernando Henrique Carlos de; PRADO, Leandro Lara do; UGOLINI-LOPES, Michele Remiao; YUKI, Emily Figueiredo Vieira Neves; BONFA, Eloisa; SAAD, Carla Goncalves SchahinOBJECTIVES: To retrospectively evaluate the performance and distinctive pattern of latent tuberculosis (TB) infection (LTBI) screening and treatment in patients with ankylosing spondylitis (AS) and psoriatic arthritis (PsA) under anti-tumor necrosis factor (TNF) therapy and determine the relevance of re-exposure and other risk factors for TB development. METHODS: A total of 135 and 83 patients with AS and PsA, respectively, were evaluated for LTBI treatment before receiving anti-TNF drugs via the tuberculin skin test (TST), chest radiography, and TB exposure history assessment. All subjects were evaluated for TB infection at 3-month intervals. RESULTS: The patients with AS were more often treated for LTBI than were those with PsA (42% versus 30%, p=0.043). The former also presented a higher frequency of TST positivity (93% versus 64%, p=0.002), although they had a lower frequency of exposure history (18% versus 52%, p=0.027) and previous TB (0.7% versus 6%, p=0.03). During follow-up [median, 5.8 years; interquartile range (1QR), 2.2-9.0 years], 11/218 (5%) patients developed active TB (AS, n=7; PsA, n=4). TB re-exposure was the main cause in seven patients (64%) after 12 months of therapy (median, 21.9 months; IQR, 14.2-42.8 months) and five LTBI-negative patients. TB was identified within the first year in four patients (36.3%) (median, 5.3 months; IQR, 1.2-8.8 months), two of whom were LTBI-positive. There was no difference in the TB-free survival according to the anti-TNF drug type/class; neither synthetic drug nor prednisone use was related to TB occurrence (p > 0.05). CONCLUSION: Known re-exposure is the most critical factor for incident TB cases in spondyloarthritis. There are also some distinct features in AS and PsA LTBI screening, considering the higher frequency of LTBI and TST positivities in patients with AS. Annual risk reassessment taking into consideration these peculiar features and including the TST should be recommended for patients in endemic countries.
bookPart Síndrome de Behçet(2016) PRADO, Leandro Lara do; GONçALVES, Célio RobertobookPart Síndrome de Behçet(2021) PRADO, Leandro Lara do; GONçALVES, Célio RobertoconferenceObject ASSESSMENT OF PARAFOVEAL RETINAL VASCULATURE IN BEHCET'S SYNDROME USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY(2021) FERREIRA, Bruno Fortaleza de Aquino; HIGASHI, Alex Haruo; PRADO, Leandro Lara do; GONCALVES, Celio Roberto; HIRATA, Carlos Eduardo; YAMAMOTO, Joyce Hisae- EARLIER ONSET AND BRAINSTEM INVOLVEMENT AS KEY FEATURES IN A BRAZILIAN NEURO-BEHCET'S DISEASE COHORT(2017) PRADO, L. L.; TINONE, G.; CALLEGARO, D.; SAAD, C. G. S.; LEVY-NETO, M.; GONCALVES, C.
conferenceObject 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
- Frosted branch angiitis and cerebral venous sinus thrombosis as an initial onset of neuro-Behçet’s disease: a case report and review of the literature(2017) FERREIRA, B. F. D. A.; RODRIGUEZ, E. E. C.; PRADO, L. L. D.; GONCALVES, C. R.; HIRATA, C. E.; YAMAMOTO, J. H.Background: Frosted branch angiitis is a rare, severe condition. It can be either a primary or a secondary condition and is characterized by rapid deterioration of vision and fulminant retinal vasculitis that manifests as diffuse sheathing of retinal vessels, macular edema, papillitis, vitritis and anterior uveitis. We aimed to describe a case of frosted branch angiitis and cerebral venous sinus thrombosis as an initial neuro-Behçet’s disease onset. Diagnosis of Behçet’s disease was based on the current 2014 International Criteria for Behçet’s Disease and the International consensus recommendation criteria for neuro-Behçet’s disease. In addition, a literature review using search parameters of “frosted branch angiitis”, “Behçet” and “neuro-Behçet” in the PubMed database is presented. Case presentation: A 28-year-old Brazilian pardo woman presented to our hospital with abrupt bilateral vision loss associated with recurrent aphthous oral ulcers 6 months before visual symptom onset. A fundus examination showed bilateral widespread retinal vasculitis with venous and arterial white sheathing, optic disc swelling, macular edema, and retinal hemorrhages, leading to the diagnosis of frosted branch angiitis. An extensive systemic workup for retinal vasculitis was uneventful, except for brain magnetic resonance imaging demonstrating cerebral venous sinus thrombosis and lymphocytic aseptic meningitis. A diagnosis of neuro-Behçet’s disease was made, and treatment was started with methylprednisolone therapy 1 g/day for 5 consecutive days, followed by oral mycophenolate mofetil and infliximab 5 mg/kg infusion. The patient’s response was rapid, with improvement of visual acuity to hand movement and counting fingers by day 7 and final visual acuity of counting fingers and 20/130. Conclusions: Frosted branch angiitis may be associated with infectious, noninfectious, or idiopathic causes. An extensive workup should be done to exclude systemic vasculitis such as Behçet’s disease. Treatment with systemic steroids must be promptly initiated in association with specific treatment aimed at inflammation control and blindness risk reduction. © 2017 The Author(s).