7 research outputs found
Cytokine profile in childhood-onset systemic lupus erythematosus: a cross-sectional and longitudinal study
No full textChildhood-onset systemic lupus erythematosus (cSLE) exhibits an aggressive clinical phenotype and severe complications. This could be due to a pro-inflammatory cytokine milieu. Therefore, we determined plasma levels of Th1 (IL-2, IFN-γ, TNF), Th2 (IL-4), Th17 (IL-17A, IL-6), and Treg (IL-10) cytokines in a cohort of cSLE patients and healthy controls, and we evaluated the association between these cytokines and disease activity. We conducted a cross-sectional study with 51 cSLE patients from two pediatric rheumatology services. Ten cSLE patients participated in a longitudinal follow-up study. Blood samples were collected from the same patient during active and inactive disease. Disease activity was evaluated according to SLE Disease Activity Index 2000 (SLEDAI-2K). Cytokines levels were measured by cytometric bead array technique. cSLE patients had higher IL-6 (P</div
Cytokine profile in childhood-onset systemic lupus erythematosus: a cross-sectional and longitudinal study
No full textChildhood-onset systemic lupus erythematosus (cSLE) exhibits an aggressive clinical phenotype and severe complications. This could be due to a pro-inflammatory cytokine milieu. Therefore, we determined plasma levels of Th1 (IL-2, IFN-γ, TNF), Th2 (IL-4), Th17 (IL-17A, IL-6), and Treg (IL-10) cytokines in a cohort of cSLE patients and healthy controls, and we evaluated the association between these cytokines and disease activity. We conducted a cross-sectional study with 51 cSLE patients from two pediatric rheumatology services. Ten cSLE patients participated in a longitudinal follow-up study. Blood samples were collected from the same patient during active and inactive disease. Disease activity was evaluated according to SLE Disease Activity Index 2000 (SLEDAI-2K). Cytokines levels were measured by cytometric bead array technique. cSLE patients had higher IL-6 (P<0.001) and IL-10 (P<0.001) levels than healthy controls. Patients with active disease had higher IL-6 and IL-10 levels than patients with inactive disease (P=0.001 and P=0.014, respectively) and the control group (both P<0.001). IL-6 (P=0.022), IL-10 (P=0.013), and IL-17A (P=0.041) levels were significantly higher during active than inactive disease. Linear regression analysis revealed IL-6 (P=0.002, 95%CI=0.006-0.025) and IL-10 (P=0.01 95%CI=0.021-0.150) as independent factors for increased SLEDAI-2K. IL-6, IL-10, and IL-17A are candidate biomarkers for disease activity in cSLE patients. This is the first longitudinal study to support their pivotal role in the pathogenesis of the disease
Cytokine profile in childhood-onset systemic lupus erythematosus: a cross-sectional and longitudinal study
No full textUniversidade Federal de Pernambuco. Hospital das Clínicas. Unidade de Reumatologia. Recife, PE, Brasil / Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento de Imunologia. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento de Imunologia. Recife, PE, Brasil.Instituto de Medicina Integral Professor Fernando Figueira. Unidade de Reumatologia Pediátrica. Recife, PE, Brasil.Universidade Federal de Pernambuco. Hospital das Clínicas. Unidade de Reumatologia. Recife, PE, Brasil.Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Departamento de Imunologia. Recife, PE, Brasil / Instituto de Medicina Integral Professor Fernando Figueira. Unidade de Oncologia Pediátrica. Recife, PE, Brasil.Childhood-onset systemic lupus erythematosus (cSLE) exhibits an aggressive clinical phenotype and severe complications. This could be due to a pro-inflammatory cytokine milieu. Therefore, we determined plasma levels of Th1 (IL-2, IFN-γ, TNF), Th2 (IL-4), Th17 (IL-17A, IL-6), and Treg (IL-10) cytokines in a cohort of cSLE patients and healthy controls, and we evaluated the association between these cytokines and disease activity. We conducted a cross-sectional study with 51 cSLE patients from two pediatric rheumatology services. Ten cSLE patients participated in a longitudinal follow-up study. Blood samples were collected from the same patient during active and inactive disease. Disease activity was evaluated according to SLE Disease Activity Index 2000 (SLEDAI-2K). Cytokines levels were measured by cytometric bead array technique. cSLE patients had higher IL-6 (P<0.001) and IL-10 (P<0.001) levels than healthy controls. Patients with active disease had higher IL-6 and IL-10 levels than patients with inactive disease (P=0.001 and P=0.014, respectively) and the control group (both P<0.001). IL-6 (P=0.022), IL-10 (P=0.013), and IL-17A (P=0.041) levels were significantly higher during active than inactive disease. Linear regression analysis revealed IL-6 (P=0.002, 95%CI=0.006-0.025) and IL-10 (P=0.01 95%CI=0.021-0.150) as independent factors for increased SLEDAI-2K. IL-6, IL-10, and IL-17A are candidate biomarkers for disease activity in cSLE patients. This is the first longitudinal study to support their pivotal role in the pathogenesis of the disease
DOR NEUROPÁTICA E CORRELAÇÕES CLÍNICAS NA FEBRE CHIKUNGUNYA COM MANIFESTAÇÕES MUSCULOESQUELÉTICAS PERSISTENTES
No full textAVALIAÇÕES DE NÍVEIS SÉRICOS DE VITAMINA D E MANIFESTAÇÕES CLÍNICAS DA FEBRE CHIKUNGUNYA
No full textProfile Of The Use Of Disease Modifying Drugs In The Brazilian Registry Of Spondyloarthritides [perfil Do Uso De Drogas Modificadoras De Doença No Registro Brasileiro De Espondiloartrites]
No full textIntroduction: Few studies have evaluated the profile of use of disease modifying drugs (DMD) in Brazilian patients with spondyloarthritis (SpA). Methods: A common research protocol was applied prospectively in 1505 patients classified as SpA by criteria of the European Spondyloarthropathies Study Group (ESSG), followed at 29 referral centers in Rheumatology in Brazil. Demographic and clinical variables were obtained and evaluated, by analyzing their correlation with the use of DMDs methotrexate (MTX) and sulfasalazine (SSZ). Results: At least one DMD was used by 73.6 % of patients: MTX by 29.2 % and SSZ by 21.7%, while 22.7 % used both drugs. The use of MTX was significantly associated with peripheral involvement, and SSZ was associated with axial involvement, and the two drugs were more administered, separately or in combination, in the mixed involvement (p < 0.001). The use of a DMD was significantly associated with Caucasian ethnicity (MTX, p = 0.014), inflammatory back pain (SSZ, p = 0.002), buttock pain (SSZ, p = 0.030), neck pain (MTX, p = 0.042), arthritis of the lower limbs (MTX, p < 0.001), arthritis of the upper limbs (MTX, p < 0.001), enthesitis (p = 0.007), dactylitis (MTX, p < 0.001), inflammatory bowel disease (SSZ, p < 0.001) and nail involvement (MTX, p < 0.001). Conclusion: The use of at least one DMD was reported by more than 70% of patients in a large cohort of Brazilian patients with SpA, with MTX use more associated with peripheral involvement and the use of SSZ more associated with axial involvement. © 2014 Elsevier Editora Ltda.5413337Sieper, J., Rudwaleit, M., Baraliakos, X., Brandt, J., Braun, J., Burgos-Vargas, R., The Assessment of SpondyloArthritis international Society (ASAS) handbook: A guide to assess spondyloarthritis (2009) Ann Rheum Dis, 68 (SUPPL. II), pp. ii1-ii44Rudwaleit, M., van der Heijde, D., Landewé, R., Listing, J., Brandt, J., Braun, J., The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection (2009) Ann Rheum Dis, 68, pp. 770-776Rudwaleit, M., van der Heijde, D., Landewé, R., Akkoc, N., Brandt, J., Chou, C.T., The development of Assessment of SpondyloArthritis international Society classification criteria for peripheral spondyloarthritis (2011) Ann Rheum Dis, 70, pp. 25-31Sampaio-Barros, P.D., Gonçalves, C.R., Braga da Silva, J.A., Ximenes, A.C., Azevedo, V.C., Bianchi, W.A., Registro Iberoamericano de Espondiloartritis (RESPONDIA): Brasil (2008) Reumatol. Clin., 4 (SUPPL. 4), pp. 30-35Benegas, M., Muñoz-Gomariz, E., Font, P., Burgos-Vargas, R., Chaves, J., Palleiro, D., Comparison of the clinical expression of patients with ankylosing spondylitis from Europe and Latin America (2012) J Rheumatol, 39, pp. 2315-2320Braun, J., van den Berg, R., Baraliakos, X., Boehm, H., Burgos-Vargas, R., Collantes-Estevez, E., 2010 Update of the ASAS/EULAR recommendations for the management of ankylosing spondyltis (2011) Ann Rheum Dis, 70, pp. 896-904Sampaio-Barros, P.D., Pinheiro, M.M., Ximenes, A.C., Meirelles, E.S., Keiserman, M., Azevedo, V.F., Recomendações sobre o tratamento da espondilite anquilosante (2013) Rev Bras Reumatol, 53, pp. 242-257Gossec, L., Smolen, J.S., Gaujoux-Viala, C., Ash, Z., Marzo-Ortega, H., van der Heijde, D., European League Against Rheumatism recommendations for the management of psoriatic arthritis with pharmacological therapies (2012) Ann Rheum Dis, 71, pp. 4-12Carneiro, S., Azevedo, V.F., Bonfiglioli, R., Ranza, R., Gonçalves, C.R., Keiserman, C.R., Recomendações sobre o tratamento da artrite psoriásica (2013) Rev Bras Reumatol, 53, pp. 227-241Dougados, M., van der Linden, S., Julin, R., Huitfeld, B., Amor, B., Calin, A., The European Spondyloarthropathy Study Group preliminary criteria for the classification of spondyloarthropathy (1991) Arthritis Rheum, 34, pp. 1218-1227van der Linden, S., Valkenburg, H.A., Cats, A., Evaluation of diagnostic criteria for ankylosing spondylitis (1984) A proposal for modification of the New York criteria. Arthritis Rheum, 27, pp. 361-368Moll, J.M.H., Wright, V., Psoriatic arthritis (1973) Semin Arthritis Rheum, 3, pp. 55-78Kingsley, G., Sieper, J., Third International Workshop on Reactive Arthritis, 23-26 September 1995, Berlin, Germany (1996) Ann Rheum Dis, 55, pp. 564-584Bodur, H., Ataman, S., Akbulut, L., Evcik, D., Kavuncu, V., Kaya, T., Characteristics and medical management of patients with rheumatoid arthritis and ankylosing spondylitis (2008) Clin Rheumatol, 27, pp. 1119-1125Altan, L., Bingöl, U., Karakoç, Y., Aydiner, S., Yurtkuran, M., Yurtkuran, M., Clinical investigation of methotrexate in the treatment of ankylosing spondylitis (2001) Scand J Rheumatol, 30, pp. 255-259Marshall, R.W., Kirwan, J.R., Methotrexate in the treatment of ankylosing spondylitis (2001) Scand J Rheumatol, 30, pp. 313-314Roychowdhury, B., Bintley-Bagot, S., Bulgen, D.Y., Thompson, R.N., Tunn, E.J., Moots, R.J., Is methotrexate effective in ankylosing spondylitis? (2002) Rheumatology (Oxford), 41, pp. 1330-1332Sampaio-Barros, P.D., Costallat, L.T., Bertolo, M.B., Marques-Neto, J.F., Samara, A.M., Methotrexate in the treatment of ankylosing spondylitis (2000) Scand J Rheumatol, 29, pp. 160-162Gonzalez-Lopez, L., Garcia-Gonzalez, A., Vazquez-Del-Mercado, M., Muñoz-Valle, J.F., Gomez-Nava, J.I., Efficacy of methotrexate in ankylosing spondylitis: a randomized, double blind, placebo controlled trial (2004) J Rheumatol, 31, pp. 1568-1574Haibel, H., Brandt, H.C., Song, I.H., Brandt, A., Listing, J., Rudwaleit, M., Sieper, J., No efficacy of subcutaneous methotrexate in active ankylosing spondylitis: a 16-week open-label trial (2007) Ann Rheum Dis., 66, pp. 419-421Abu-Shakra, M., Gladman, D.D., Thorne, J.C., Long, J., Gough, J., Farewell, V.T., Long-term methotrexate therapy in psoriatic arthritis: clinical and radiological outcome (1995) J Rheumatol, 22, pp. 241-245Scarpa, R., Peluso, R., Atteno, M., Manguso, F., Spanò, A., Iervolino, S., The effectiveness of a traditional therapeutical approach in early psoriatic arthritis: Results of a pilot randomised 6-month trial with methotrexate (2008) Clin Rheumatol, 27, pp. 823-826Lie, E., van der Heijde, D., Uhlig, T., Heiberg, M.S., Koldingsnes, W., Rødevand, E., Effectiveness and retention rates of methotrexate in psoriatic arthritis in comparison with methotrexate-treated patients with rheumatoid arthritis (2010) Ann Rheum Dis, 69, pp. 671-676Chandran, V., Raychaudhuri, S.P., Geoepidemiology and environmental factors of psoriasis and psoriatic arthritis (2010) J Autoimm, 34, pp. 314-321Skare, T.L., Bortoluzzo, A.B., Gonçalves, C.R., Braga da Silva, J.A., Ximenes, A.C., Bértolo, M.B., Ethnic influence in clinical and functional measures of Brazilian patients with spondyloarthritis (2012) J. Rheumatol, 39, pp. 141-147Clegg, D.O., Reda, D.J., Weisman, M.H., Blackburn, W.D., Cush, J.J., Cannon, G.W., Comparison of sulfasalazine and placebo in the treatment of ankylosing spondylitis (1996) A Department of Veterans Affairs Cooperative Study. Arthritis Rheum, 39, pp. 2004-2012Chen, J., Liu, C., Is sulfasalazine effective in ankylosing spondylitis? (2006) A systematic review of randomized controlled trials. J Rheumatol, 33, pp. 722-731Gupta, A.K., Grober, J.S., Hamilton, T.A., Ellis, C.N., Siegel, M.T., Voorhees, J.J., Sulfasalazine therapy for psoriatic arthritis: a double blind, placebo controlled trial (1995) J Rheumatol, 22, pp. 894-898Combe, B., Goupille, P., Kuntz, J.L., Tebib, J., Lioté, F., Bregeon, C., Sulphasalazine in psoriatic arthritis: a randomized, multicentre, placebo-controlled study (1996) Br J Rheumatol, 35, pp. 664-668Clegg, D.O., Reda, D.J., Mejias, E., Cannon, G.W., Weisman, M.H., Taylor, T., Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis (1996) A Department of Veterans Affairs Cooperative Study. Arthritis Rheum, 39, pp. 2004-2012Clegg, D.O., Reda, D.J., Weisman, M.H., Cush, J.J., Vasey, F.B., Schumacher Jr., H.R., Comparison of sulfasalazine and placebo in the treatment of reactive arthritis (Reiter's syndrome) (1996) A Department of Veterans Affairs Cooperative Study. Arthritis Rheum, 39, pp. 2021-2027Consensus guidelines for the management of inflammatory bowel disease (2010) Arq Gastroenterol, 47, pp. 313-325. , Brazilian Study Group of Inflammatory Bowel DiseasesD'Haens, G.R., Panaccione, R., Higgins, P.D., Vermeire, S., Gassull, M., Chowers, Y., The London Position Statement of the World Congress of Gastroenterology on Biological Therapy for IBD with the European Crohn's and Colitis Organization: When to start, when to stop, which drug to choose, and how to predict response? (2011) Am J Gastroenterol, 106, pp. 199-212Carneiro, S., Bortoluzzo, A.B., Gonçalves, C.R., Braga da Silva, J.A., Ximenes, A.C., Bértolo, M.B., Impact of enthesitis in 1505 Brazilian patients with spondyloarthritis (2013) J Rheumatol, 40, pp. 1719-172
Low Prevalence Of Reactive Ppd Prior To Infliximab Use: Comparative Study On A Population Sample Of Hospital Geral De Fortaleza
No full textObjective: To identify tuberculosis infection in rheumatic patients on infliximab by use of PPD testing prior to immunobiologic therapy. Methods: This study comprised 157 patients undergoing infliximab treatment and 734 other patients undergoing laboratory screening for tuberculosis infection originating from several services. The Mantoux technique was used for PPD testing, and an induration of at least 5 mm was considered reactive status. Results: In the infliximab group, 13% of the patients reacted to PPD, while, in the other group, 27% of the patients reacted to PPD (χ2 = 13; P = 0.0003). These patients were divided into categories: adults with chronic diseases, PPD reactivity of 22%; and other controls, PPD reactivity of 31%. This shows the heterogeneous response of that population (χ2 = 7; P < 0.009). In the infliximab group, subdivided according to pathologies [rheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PA)], different reactivity rates were observed, the lowest value occurring among RA patients: (RA x AS: OR = 0.13; CI: 0.03-0.47; χ2 = 12; P = 0.0004) and (RA × PA: OR = 0.16; CI: 0.02-1.04; χ2Yates corrected = 3.6; P = 0.05). The PPD reactivity in the RA subgroup (4%) was also lower as compared with that of the chronic patients group (22%) (OR = 0.16; CI: 0.05-0.49; χ2 = 14; P = 0.0002), even when reclassified into four subgroups: rheumatology (OR = 0.19; CI: 0.04-0.72), kidney transplantation (OR = 0.16; CI: 0.05-0.51), infectology (OR = 0.21; CI: 0.05-0.75), and other conditions (OR = 0.13; CI: 0.04-0.44). Conclusion: The low prevalence of PPD reaction in this Brazilian population, mainly in chronic patients, with the worst performance among RA patients, shwoed that the test has limited value for diagnosis of tuberculosis infection in candidates to infliximab therapy. © Elsevier Editora Ltda.5114052Keane, J., TNF-Blocking agents and tuberculosis: New drugs illuminate an old topic (2005) Rheumatology, 44, pp. 714-720Wallis, R.S., Broder, M.S., Wong, J.Y., Hanson, M.E., Beenhouwer, D.O., Granulomatosis infectious diseases associated with tumor necrosis factor antagonists (2004) Clin Infect Dis, 38, pp. 1261-1265Sociedade Brasileira de Reumatologia. Projeto Diretrizes da Associação Médica Brasileira e Conselho Federal de Medicina Artrite Reumatóide: Diagnóstico E Tratamento, , http://www.projetodiretrizes.org.br/projeto_diretrizes/015.pdf, Acessado em 23 de outubro de 2009Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection, , http://www.cdc.gov/mmwr/preview/mmwrhtml/rr4906a1.htm, Acessado em 23 de outubro de 2009Guidelines for using the QuantiFERON TB Gold Test For Detecting Mycobacterium Tuberculosis Infection, United States, , http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5415a4.htm, Acessado em 23 de outubro de 2009http://bvsms.saude.gov.br/bvs/publicacoes/manual_tuberculose_2006.pdf, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Guia para o diagnóstico, tratamento e prevenção da tuberculose, Acessado em 26 de outubro de 2009Rangel-Frausto, M.S., Ponce-De-León-Rosales, S., Martinez-Abaroa, C., Haslov, K., Tuberculosis and tuberculin quality: Best intentions, misleading results (2001) Infect Control Hosp Epidemiol, 22 (8), pp. 481-484Teixeira, L., Maciel, E., Dutra, M.E., Perkins, M.D., Johnson, J.L., do Valle Dettoni, V., Simultaneous comparison of reactivity to purified protein derivative RT-23 and Tubersol in health care workers in Vitória, Brazil (2000) Int J Tuberc Lung Dis, 4 (11), pp. 1074-1077Muñoz-Barret, J.M., Macías-Hernández, A.E., Hernández-Ramos, I., Durán-Martínez, E., Martínez-Magdaleno, R.M., Medina-Valdovinos, H., Comparative tuberculin reactivity to two protein derivatives (1996) Rev Invest Clin, 48 (5), pp. 377-381Keane, J., Gershon, S., Wise, R.P., Mirabile-Levens, E., Kasznica, J., Schwieterman, W.D., Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent (2001) N Engl J Med, 345 (15), pp. 1098-1104Criscione, L.G., Clair, E.W., Tumor necrosis factor-alfa antagonists for the treatment of rheumatic diseases (2002) Curr Opin Rheumatol, 14, pp. 204-211Gomez-Reino, J.J., Carmona, L., Valverde, V.R., Mola, E.M., Montero, M.D., Treatment of rheumatoid arthritis with tumor necrosis factor inibitors may predispose to significant increase in tuberculosis risk: A multi center active-surveillance report (2003) Arthritis Rheum, 48, pp. 2122-2127Ministério Da Saúde - Programa Nacional De Controle Da Tuberculose, , http://portal.saude.gov.br/portal/saude/visualizar_texto.cfm?idtxt=28055, Acessado em 07 de outubro de 2009Filho, A.C., Kritski, A.L., Barreto, A.W., Lemos, A.C.M., Netto, A.R., Guimarães, C.A., II Consenso Brasileiro de Tuberculose. Diretrizes Brasileiras para Tuberculose (2004) J Bras Pneumol, 30 (1), pp. 1-55Façanha, M.C., Guerreiro, M.F.F., Pinheiro, A.C., Costa Lima, J.R., Vale, R.L.V., Teixeira, G.F.D., Resgate de casos subnotifcados de tuberculose em Fortaleza-CE, 2000-2002 (2003) Bol Pneumol Sanit, 11 (2), pp. 13-16Marques, C.D.L., Duarte, A.L.B.P., Lorena, V.M.B., Souza, J.R., Souza, W., Gomes, Y.M., Resposta atenuada ao PPD no diagnóstico de infecção tuberculosa latente em pacientes com artrite reumatóide (2009) Rev Bras Reumatol, 49 (2), pp. 121-125Cattamanchi, A., Dantes, R.B., Metcalfe, J.Z., Jarlsberg, L.G., Grinsdale, J., Kawamura, L.M., Clinical characteristics and treatment outcomes of patients with isoniazid-monoresistant tuberculosis (2009) Clin Infect Dis, 48 (2), pp. 179-185Jain, A., Dixit, P., Multidrug-resistant to extensively drug resistant tuberculosis: What is next? (2008) J Biosci, 33 (4), pp. 605-616Braga, J.U., Equivalência das Reações cutâneas do PPD entre dois produtos comercializados no Brasil (2000) Informe Epidemiológico Do SUS, , http://bvsms.saude.gov.br/bvs/periodicos/informe_epi_sus_v09_n3.pdf, Acessado em 22 de outubro de 2009Teixeira, L., Maciel, E., Dutra, M.E., Perkins, M.D., Johnson, J.L., do Valle Dettoni, V., Simultaneous comparison of reactivity to purified protein derivative RT-23 and Tubersol in health care workers in Vitória, Brazil (2000) Int J Tuberc Lung Dis, 4 (11), pp. 1074-1077Muñoz-Barret, J.M., Macías-Hernández, A.E., Hernández-Ramos, I., Durán-Martínez, E., Martínez-Magdaleno, R.M., Medina-Valdovinos, H., Comparative tuberculin reactivity to two protein derivatives (1996) Rev Invest Clin, 48 (5), pp. 377-381Alonso Moreno, F.J., García Bajo, M.C., Lougedo Calderón, M.J., Comas Samper, J.M., García Palencia, M., de Castro, F.L., Prevalence of tuberculosis infection among immigrants in the Toledo Health District, Spain (2004) Rev Esp Salud Publica, 78 (5), pp. 593-600Ostrosky-Zeichner, L., Rangel-Frausto, M.S., García-Romero, E., Vázquez, A., Ibarra, M.J., de León-Rosales, S.P., Tuberculosis in health personnel: Importance of surveillance and control programs (2000) Salud Publica Mex, 42 (1), pp. 48-52Kunins, H.V., Howard, A.A., Klein, R.S., Arnsten, J.H., Litwin, A.H., Schoenbaum, E.E., Validity of a self-reported history of a positive tuberculin skin test. A prospective study of drug users (2004) J Gen Intern Med, 19 (10), pp. 1039-1044Linquist, J.A., Rosaia, C.M., Riemer, B., Heckman, K., Alvarez, F., Tuberculosis exposure of patients and staff in an outpatient hemodialysis unit (2002) Am J Infect Control, 30 (5), pp. 307-310Poduval, R.D., Hammes, M.D., Tuberculosis screening in dialysis patients is the tuberculin test effective? (2003) Clin Nephrol, 59 (6), pp. 436-440Wauters, A., Peetermans, W.E., Van den Brande, P., de Moor, B., Evenepoel, P., Keuleers, H., The value of tuberculin skin testing in haemodialysis patients (2004) Nephrol Dial Transplant, 19 (2), pp. 433-438Sester, M., Sester, U., Clauer, P., Heine, G., Mack, U., Moll, T., Tuberculin skin testing underestimates a high prevalence of latent tuberculosis infection in hemodialysis patients (2004) Kidney Int, 65 (5), pp. 1826-1834Habesoglu, M.A., Torun, D., Demiroglu, Y.Z., Karatasli, M., Sen, N., Ermis, H., Value of the tuberculin skin test in screening for tuberculosis in dialysis patients (2007) Transplant Proc, 39 (4), pp. 883-886Laurindo, I.M.M., Seiscento, M., Bombardia, S., Souza, T.N.L., Eluf Neto, J., Radu, A.S., Diagnosis of latent tuberculosis in rheumatoid arthritis (RA) patients: Tuberculin test (PPD) assessment. EULAR (2004) Rheumatoid Arthritis Clinical Aspects [THU0235], , http://www.abstracts2view.com/eular/sessionindex.php?session=2004374&day=2004, Acessado em 27 de janeiro de 2010Ehrenstein, M.R., Evans, J.G., Singh, A., Moore, S., Warnes, G., Isenberg, D.A., Mauri, C., Compromised Function of Regulatory T Cells in Rheumatoid Arthritis and Reversal by Anti-TNF-α Therapy (2004) J Exp Med, 200, pp. 277-285Martins, M., Lima, M., Duppre, N., Matos, H., Spencer, J., Brennan, P., The level of PPD-specifc INF- γ-producing CD4+ T cells in the blood predicts the in vivo response to PPD (2006) Tuberculosis, 87 (3), pp. 202-211Andrade, T.C.B., Maia, R.M., Cosgrove, C., Castelo Branco, L.R.R., BCG Moreau Rio de Janeiro - An oral vaccine aginst tuberculosis - Review (2005) Men Inst Oswaldo Cruz, 100 (5), pp. 459-465Maciel, E.L.N., Viana, M.C., Zeitoune, R.C.G., Ferreira, I., Fregona, G., Dietze, R., Prevalence and incidence of Mycobacterium tuberculosis infection in nursing students in Vitória, Espírito Santo (2005) Rev Soc Bras Med Trop, 38 (6), pp. 469-472Pilsczek, F.H., Kaufmann, S.H.E., Prevalence and predictors of positive tuberculin skin test results in a research laboratory (2008) Rev Soc Bras Med Trop, 41 (4), pp. 416-418Ponce de León, D., Acevedo-Vásquez, E., Sánchez-Torres, A., Cucho, M., Alfaro, J., Perich, R., Attenuated response to purifed protein derivate in patients with rheumatoid artritis: Study in a population with high prevalence of tuberculosis (2005) Ann Rheum Dis, 64, pp. 1360-1361Köker, I.H., Pamuk, A.-N., Karlikaya, N., Tunçbilek, N., Cakir, N., A low prevalence of purifed protein derivative test positivity in Turkish patients with rheumatoid arthritis. Association with clinical features and HRCT fndings (2007) Clin Exp Rheumatol, 25 (1), pp. 54-59Maciel, E.L.N., Meireles, W., Silva, A.P., Fiorotti, K., Dietze, R., Transmissão nosocomial por Mycobacterium tuberculosis nos estudantes da área de saúde em uma região de alta incidência de tuberculose, Vitória, Estado do Espírito Santo (2007) Rev Soc Bras Med Trop, 40 (4), pp. 397-39
