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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP-
dc.contributor.authorSILVA, Marco F.-
dc.contributor.authorFERRIANI, Mariana P.-
dc.contributor.authorTERRERI, Maria T.-
dc.contributor.authorPEREIRA, Rosa M.-
dc.contributor.authorMAGALHAES, Claudia S.-
dc.contributor.authorBONFA, Eloisa-
dc.contributor.authorCAMPOS, Lucia M.-
dc.contributor.authorOKUDA, Eunice M.-
dc.contributor.authorAPPENZELLER, Simone-
dc.contributor.authorFERRIANI, Virginia P.-
dc.contributor.authorBARBOSA, Cassia M.-
dc.contributor.authorRAMOS, Valeria C.-
dc.contributor.authorLOTUFO, Simone-
dc.contributor.authorSILVA, Clovis A.-
dc.identifier.citationJOURNAL OF RHEUMATOLOGY, v.42, n.12, p.2296-2303, 2015-
dc.description.abstractObjective. To study the prevalence, risk factors, and mortality of invasive fungal infections (IFI) in patients with childhood-onset systemic lupus erythematosus (cSLE). Methods. A retrospective multicenter cohort study was performed in 852 patients with cSLE from 10 pediatric rheumatology services. An investigator meeting was held and all participants received database training. IFI were diagnosed according to the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group Consensus Group criteria (proven, probable, and possible). Also evaluated were demographic, clinical, and laboratory data, and disease activity [SLE Disease Activity Index 2000 (SLEDAI-2K)], cumulative damage (Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index), treatment, and outcomes. Results. IFI were observed in 33/852 patients (3.9%) with cSLE. Proven IFI was diagnosed in 22 patients with cSLE, probable IFI in 5, and possible IFI in 6. Types of IFI were candidiasis (20), aspergillosis (9), cryptococcosis (2), and 1 each disseminated histoplasmosis and paracoccidioidomycosis. The median of disease duration was lower (1.0 vs 4.7 yrs, p < 0.0001) with a higher current SLEDAI-2K [19.5 (0-44) vs 2 (0-45), p < 0.0001] and current prednisone (PRED) dose [50 (10-60) vs 10 (2-90) mg/day, p < 0.0001] in patients with IFI compared with those without IFI. The frequency of death was higher in the former group (51% vs 6%, p < 0.0001). Logistic regression analysis revealed that SLEDAI-2K (OR 1.108, 95% CI 1.057-1.163, p < 0.0001), current PRED dose (OR 1.046, 95% CI 1.021-1.071, p < 0.0001), and disease duration (OR 0.984, 95% CI 0.969-0.998, p = 0.030) were independent risk factors for IFI (R-2 Nagelkerke 0.425). Conclusion. To our knowledge, this is the first study to characterize IFI in patients with cSLE. We identified that disease activity and current glucocorticoid use were the main risk factors for these life-threatening infections, mainly in the first years of disease course, with a high rate of fatal outcome.-
dc.description.sponsorshipConselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) [301805/2013-0, 305068/2014-8, 302724/2011-7]-
dc.description.sponsorshipFederico Foundation-
dc.description.sponsorshipNucleo de Apoio a Pesquisa ""Saude da Crianca e do Adolescente"" da USP (NAP-CriAd)-
dc.publisherJ RHEUMATOL PUBL CO-
dc.relation.ispartofJournal of Rheumatology-
dc.subject.othereuropean organization-
dc.subject.othermajor infections-
dc.titleA Multicenter Study of Invasive Fungal Infections in Patients with Childhood-onset Systemic Lupus Erythematosus-
dc.rights.holderCopyright J RHEUMATOL PUBL CO-
dc.type.categoryoriginal article-
dc.type.versionpublishedVersion-, Maria T.:Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil-, Claudia S.:Sao Paulo State Univ, Fac Med Botucatu, Sao Paulo, Brazil-, Eunice M.:Irmandade Santa Casa de Misericordia Sao Paulo, Sao Paulo, Brazil-, Simone:Univ Estadual Campinas, Sao Paulo, Brazil-, Virginia P.:Univ Sao Paulo, Ribeirao Preto Med Sch, Sao Paulo, Brazil-, Cassia M.:Hosp Infantil Darcy Vargas, Sao Paulo, Brazil-, Valeria C.:Pontifical Catholic Univ Sorocaba, Sao Paulo, Brazil-, Simone:Hosp Municipal Infantil Menino Jesus, Sao Paulo, Brazil-
hcfmusp.relation.referenceLiang MH, 1999, ARTHRITIS RHEUM-US, V42, P599-
hcfmusp.relation.referenceBarber CE, 2012, J RHEUMATOL, V39, P1772, DOI 10.3899/jrheum.120707-
hcfmusp.relation.referenceBrunner HI, 2008, ARTHRITIS RHEUM, V58, P556, DOI 10.1002/art.23204-
hcfmusp.relation.referenceSilva CA, 2012, ARTHRIT CARE RES, V64, P1787, DOI 10.1002/acr.21757-
hcfmusp.relation.referenceChen HS, 2007, RHEUMATOLOGY, V46, P539, DOI 10.1093/rheumatology/kel343-
hcfmusp.relation.referenceJesus AA, 2011, CLIN DEV IMMUNOL, DOI 10.1155/2011/428703-
hcfmusp.relation.referenceHochberg MC, 1997, ARTHRITIS RHEUM, V40, P1725, DOI 10.1002/art.1780400928-
hcfmusp.relation.referenceGladman D, 1996, ARTHRITIS RHEUM, V39, P363, DOI 10.1002/art.1780390303-
hcfmusp.relation.referenceOzsevik SN, 2015, J PEDIAT HEMATOL ONC, V37, pE69, DOI 10.1097/MPH.0000000000000225-
hcfmusp.relation.referenceAkcan-Arikan A, 2007, KIDNEY INT, V71, P1028, DOI 10.1038/
hcfmusp.relation.referenceFan YC, 2012, GENE, V506, P184, DOI 10.1016/j.gene.2012.06.059-
hcfmusp.relation.referenceColombo AL, 2007, INFECT CONT HOSP EP, V28, P570, DOI 10.1086/513615-
hcfmusp.relation.referenceFranca CMP, 2012, ACTA REUMATOL PORT, V37, P276-
hcfmusp.relation.referenceCanova EG, 2002, CLIN EXP RHEUMATOL, V20, P736-
hcfmusp.relation.referenceGONZALEZCRESPO MR, 1995, SEMIN ARTHRITIS RHEU, V24, P304, DOI 10.1016/S0049-0172(95)80002-6-
hcfmusp.relation.referenceBRANDT JT, 1995, THROMB HAEMOSTASIS, V74, P1185-
hcfmusp.relation.referenceAvcin T, 2009, LUPUS, V18, P894, DOI 10.1177/0961203309106917-
hcfmusp.relation.referenceKim HJ, 2009, LUPUS, V18, P661, DOI 10.1177/0961203309103081-
hcfmusp.relation.referenceAl-Mayouf SM, 2001, CLIN EXP RHEUMATOL, V19, P748-
hcfmusp.relation.referenceHoenigl M, 2012, J ANTIMICROB CHEMOTH, V67, P2029, DOI 10.1093/jac/dks155-
hcfmusp.relation.referenceFaco MMM, 2007, BRAZ J MED BIOL RES, V40, P993, DOI 10.1590/S0100-879X2006005000110-
hcfmusp.relation.referenceLee PPW, 2007, RHEUMATOLOGY, V46, P1290, DOI 10.1093/rheumatology/kem102-
hcfmusp.relation.referenceVinicki JP, 2013, LUPUS, V22, P892, DOI 10.1177/0961203313496342-
hcfmusp.relation.referenceDe Pauw B, 2008, CLIN INFECT DIS, V46, P1813, DOI 10.1086/588660-
hcfmusp.relation.referenceGladman DD, 2002, J RHEUMATOL, V29, P288-
hcfmusp.relation.referenceCavalcante EG, 2014, REV BRAS REUMATOL, V54, P155, DOI [10.1016/j.rbre.2014.03.012, 10.1016/j.rbr.2014.03.012]-
hcfmusp.relation.referenceMarques VLS, 2013, LUPUS, V22, P1409, DOI 10.1177/0961203313502859-
hcfmusp.relation.referenceJesus AA, 2011, LUPUS, V20, P1275, DOI 10.1177/0961203311411598-
hcfmusp.relation.referenceChan James C M, 2002, Pediatr Rev, V23, P47, DOI 10.1542/pir.23-2-47-
hcfmusp.relation.referenceCosta-Reis P, 2013, CLIN IMMUNOL, V149, P442, DOI 10.1016/j.clim.2013.08.009-
hcfmusp.relation.referenceDanza A, 2013, LUPUS, V22, P1286, DOI 10.1177/0961203313493032-
hcfmusp.relation.referenceGroll AH, 2014, LANCET ONCOL, V15, pE327, DOI 10.1016/S1470-2045(14)70017-8-
hcfmusp.relation.referenceLube GE, 2014, ACTA REUMATOL PORT, V39, P182-
hcfmusp.relation.referenceMartinez-Martinez MU, 2012, J RHEUMATOL, V39, P1814, DOI 10.3899/jrheum.111498-
hcfmusp.relation.referenceNational High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents, 2004, PEDIATRICS, V114, P555, DOI 10.1542/PEDS.114.2-
hcfmusp.relation.referenceNational KF, 2002, AM J KIDNEY DIS S, V39, pS1, DOI 10.1053/AJKD.2002.30582.PUBMED:11904577-
hcfmusp.relation.referenceSilva MF, 2012, LUPUS, V21, P1011, DOI 10.1177/0961203312442752-
hcfmusp.relation.referenceWang LDR, 2014, SEMIN ARTHRITIS RHEU, V44, P325, DOI 10.1016/j.semarthrit.2014.06.001-
hcfmusp.relation.referenceWeng CT, 2010, LUPUS, V19, P1204, DOI 10.1177/0961203310368969-
hcfmusp.relation.referenceYeh TC, 2014, CANCER-AM CANCER SOC, V120, P1255, DOI 10.1002/cncr.28524-
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - FM/MPE
Departamento de Pediatria - FM/MPE

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/ICr
Instituto da Criança - HC/ICr

Artigos e Materiais de Revistas Científicas - LIM/17
LIM/17 - Laboratório de Investigação em Reumatologia

Artigos e Materiais de Revistas Científicas - LIM/36
LIM/36 - Laboratório de Pediatria Clínica

Artigos e Materiais de Revistas Científicas - ODS/03
ODS/03 - Saúde e bem-estar

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