Banca de QUALIFICAÇÃO: MARIO EMILIO TEIXEIRA DOURADO JUNIOR

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
DISCENTE: MARIO EMILIO TEIXEIRA DOURADO JUNIOR
DATA: 04/04/2013
HORA: 08:30
LOCAL: SALA DE AULA 1 - PPGCSA
TÍTULO:

Risk factors and clinical outcomes of Guillain Barre Syndrome


PALAVRAS-CHAVES:

Guillain-Barré Syndrome, Neuroepidemiology, Neuroimmunology, FcyR, Polymorphism


PÁGINAS: 50
GRANDE ÁREA: Ciências da Saúde
ÁREA: Medicina
RESUMO:

Guillain–Barré syndrome (GBS) is an autoimmune disorder of the peripheral nervous system, often triggered by an aberrant immune response to an infectious pathogen. GBS affects all age-groups, with an annual worldwide incidence of 0.4–4 cases per 100,000 people. In addition to the classic GBS or the acute inflammatory demyelinating polyneuropathy (AIDP), the other variants of GBS include acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN), and Miller-Fisher syndrome (MFS). Differences in geographical distribution of variants have been reported. AIDP is the predominant variant in Europe and the United States, whereas AMAN is the predominant one in China, Japan, Mexico, Argentina and Curacao Island. In Brazil, there are few studies describing the
characteristics of GBS, but none on the frequency of GBS variants and their clinical manifestations. Although several infection agents have been implicated in the development of GBS, not all infected individuals develop this disorder, and infection with a single agent might also lead to different subtypes of GBS. These observations emphasize the role of host factors, including genetic factors, in the development of GBS and its differential manifestations in different areas of the world. Biallelic
functional polymorphisms reported in three subclasses of FcyRs–FcyRIIA, FcyRIIIA, and FcyRIIIB significantly influence the receptor affinity for IgG subclasses and consequently the efficacy of IgG-mediated effector functions. Although IgG autoantibodies and mononuclear cells play important role in the pathogenesis of GBS, studies on different FcyRs in GBS patients are lacking. It remains unclear
whether individuals carrying different FcyR alleles have differential risk for GBS and ⁄ or disease severity. Herein, we characterize GBS and describe the clinical findings in a cohort of patients with GBS from the state of Rio Grande do Norte, Brazil. In addition, we also assessed whether Fc receptor (FcyRs) polymorphism is involved in GBS. Materials and methods – Clinical and laboratory data of 149 cases of GBS diagnosed from 1994 to 2007 were analyzed. Genomic DNA was extracted from whole blood. A total of 142 patients were genotyped for FcyRIIA and FcyRIIIB using allelic specific PCR. Eighty-nine healthy blood donors were recruited as controls. Results – Acute inflammatory demyelinating polyneuropathy (AIDP) was the most frequent variant (81.8%) of GBS, followed by acute motor axonal neuropathy (AMAN) (14.7%) and acute motor and sensory axonal neuropathy (AMSAN) (3.3%). The incidence of GBS was 0.3 ⁄ 100,000 for the state of Rio Grande do Norte and
cases occurred at a younger age. GBS was preceded by infections, with the axonal variant associated with episodes of diarrheas (P = 0.025). Proximal weakness was more frequent in AIDP, and distal weakness predominant in the axonal variant. Compared to 42.4% of cases with AIDP (P < 0.0001), 84.6% of cases with the axonal variant had nadir in <10 days. Individuals with the axonal variant took longer to recover deambulation (P < 0.0001). The mortality of GBS was 5.3%. Con clusion – A predominance of the AIDP variant was seen, and the incidence of the disease decreased with age. As expected, the distribution of weakness correlated with the clinical variants, and individuals with the axonal variant had a poorer prognosis. Finally, early diagnosis and variant identification which results in proper intervention results in decrease in long term morbidity.


MEMBROS DA BANCA:
Externo ao Programa - 1369275 - CLECIO DE OLIVEIRA GODEIRO JUNIOR
Externo ao Programa - 1674643 - MARCOS ROMUALDO COSTA
Presidente - 350647 - SELMA MARIA BEZERRA JERONIMO
Notícia cadastrada em: 25/03/2013 11:08
SIGAA | Superintendência de Tecnologia da Informação - (84) 3342 2210 | Copyright © 2006-2024 - UFRN - sigaa03-producao.info.ufrn.br.sigaa03-producao