A Multicenter Study Of Invasive Fungal Infections In Patients With Childhood-onset Systemic Lupus Erythematosus

dc.creatorSilva
dc.creatorMarco F.; Ferriani
dc.creatorMariana P.; Terreri
dc.creatorMaria T.; Pereira
dc.creatorRosa M.; Magalhaes
dc.creatorClaudia S.; Bonfa
dc.creatorEloisa; Campos
dc.creatorLucia M.; Okuda
dc.creatorEunice M.; Appenzeller
dc.creatorSimone; Ferriani
dc.creatorVirginia P.; Barbosa
dc.creatorCassia M.; Ramos
dc.creatorValeria C.; Lotufo
dc.creatorSimone; Silva
dc.creatorClovis A.
dc.date2015-DEC
dc.date2016-06-07T13:35:42Z
dc.date2016-06-07T13:35:42Z
dc.date.accessioned2018-03-29T01:51:13Z
dc.date.available2018-03-29T01:51:13Z
dc.identifier
dc.identifierA Multicenter Study Of Invasive Fungal Infections In Patients With Childhood-onset Systemic Lupus Erythematosus. J Rheumatol Publ Co, v. 42, p. 2296-2303 DEC-2015.
dc.identifier0315-162X
dc.identifierWOS:000365909900012
dc.identifier10.3899/jrheum.150142
dc.identifierhttp://www.jrheum.org/content/42/12/2296
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/244179
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1307877
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionObjective. 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.description42
dc.description12
dc.description
dc.description2296
dc.description2303
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionFederico Foundation
dc.descriptionNucleo de Apoio a Pesquisa "Saude da Crianca e do Adolescente" da USP (NAP-CriAd)
dc.descriptionConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.descriptionCNPq [301805/2013-0, 305068/2014-8, 302724/2011-7]
dc.description
dc.description
dc.description
dc.languageen
dc.publisherJ RHEUMATOL PUBL CO
dc.publisher
dc.publisherTORONTO
dc.relationJOURNAL OF RHEUMATOLOGY
dc.rightsembargo
dc.sourceWOS
dc.subjectEuropean Organization
dc.subjectMajor Infections
dc.subjectRisk-factors
dc.subjectDisease
dc.subjectAspergillosis
dc.subjectChildren
dc.subjectCriteria
dc.subjectExperience
dc.subjectDiagnosis
dc.subjectInstitute
dc.titleA Multicenter Study Of Invasive Fungal Infections In Patients With Childhood-onset Systemic Lupus Erythematosus
dc.typeArtículos de revistas


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