Naslov (srp)

Povezanost antifosfolipidnog sindroma sa kliničkim ispoljavanjem i pojavom komplikacija kod dece sa sistemskim eritemskim lupusom : doktorska disertacija

Autor

Petrović, Gordana S., 1972-

Doprinosi

Šefik-Bukilica, Mirjana, 1964-
Milanović, Borko, 1977-
Rašković, Sanvila, 1959-
Pašić, Srđan, 1962-

Opis (eng)

Onset systemic lupus erythematosus(SEL) is a prototype of a chronical,multisystemic autoimmune condition which in 10-15% of patients diagnosed starts in childhood(also known as juvenile or pediatric SEL). It is related to significant morbidity caused by thenature of the disease itself, as well as by the prescribed therapy. Antiphospholipid syndrome(APS) is a system autoimmune condition characterized by vascular thrombosis in the presence ofantiphospholipid antibodies (aPLA). Antiphospholipid antibodies which are applied in clinicalpractice are lupus anticoagulants (LA), anticardiolipin antibodies (aCLA) and anti 2glycoprotein I (2GPI antibodies ). Unlike Antiphospholipid syndrome, which has low incidencein early childhood, aPLA can often be diagnosed primary in completely healthy children, butalso as secondary to numerous diseases, and most frequently in cSEL. The majority of clinicianswhen diagnosing cSEL apply the criteria recommended by the American College ofRheumatology (ACR), 1997, and when diagnosing APS in children Sapporo criteria are applied.Laboratory analysis are used in order to monitor these patients. To estimate the disease activityand register deterioration SLEDAI-2K Index (Systemic Lupus Erythematosus Disease ActivityIndex) is commonly used, and for estimate of tissue damage the index used is SDI (SystemicLupus International Collaborating Clinics/American College of Rheumatology-Damage Index).Although more frequent incidence of certain clinical manifestations is registered in childrendiagnosed with cSEL and aPLA, the influence of these antibodies has not been clarifiedcompletely, so far.Research objectives: To estimate the frequency of occurrence of aPLA in children diagnosedwith cSEL; to analyse characteristics ( frequency, concentration value) of each aPLA; to analysethe correlation between aPLA diagnosis and clinical manifestations and complications in patientssuffering from cSEL; to determine the influence of aPLA on disease activity in patientsdiagnosed with cSEL.Patients and methods: The research was conducted among 40 cSEL patients; the diseasediagnosis was established upon classification criteria of the American College of Rheumatology(ACR), 1997. Monitoring of characteristics of blood tests was conducted in a hematology lab,while coagulation tests were run in the blood transfusion lab at the Institute for Mother andChild Health Care of Serbia. Determination and monitoring of the presence and value ofautoantibodies specific to SEL (ANA, anti ds DNA) and the values of components ofcomplement were conducted in the immune lab at Institute for Mother and Child Health Care ofSerbia as well as at the Department for highly specialized diagnostics of allergological andimmune diseases of the University Clinical Center of Serbia. The results of anticardiolipin(aCLA) diagnostics, antibodies against 2 glycoproteins 1 ( 2GPI ), lupus anticoagulants (LA)at the time when the disease was diagnosed and during the monitoring (a year later and three years later) were analysed...

Opis (srp)

Sistemski eritemski lupus (SEL) je hronična, multisistemska autoimunska bolest koja kod10-15% bolesnika počinje u detinjstvu (cSEL-prevod engleskog naziva childhood-onset systemiclupus erythematosus, nekada nazivan juvenilni ili pedijatrijski SEL). Povezana je sa značajnimmorbiditetom uzrokovanim prirodom same bolesti, ali i primenjenom terapijom. Antifosfolipidnisindrom (APS) je sistemska autoimunska bolest koju karakteriše pojava vaskularnih tromboza uprisustvu antifosfolipidnih antitela (aPLA). Antifosfolipidna antitela koja se primenjuju ukliničkoj praksi su lupus antikoagulans (LA), antikardiolipinska antitela (aCLA) i anti beta2glikoprotein I (β2GPIantitela). Za razliku od antifosfolipidnog sindroma, koji je u detinjstvuredak, aPLA se često mogu javiti i kod potpuno zdrave dece, ali i sklopu brojnih bolesti, anajčešće kod cSEL. Većina kliničara pri dijagnostikovanju cSEL primenjuje kriterijumepredložene od Američkog koledža za reumatologiju (American College of Rheumatology, ACR),1997. godine, a za dijagnozu APS i kod dece aktuelni su Sapporo kriterijumi. U praćenju ovihbolesnika primenjuju se laboratorijske analize. Za procenu aktivnosti bolesti i registrovanjepogoršanja najčešće se koristi SLEDAI-2K skor (Systemic Lupus Erythematosus DiseaseActivity Index), a za procenu oštećenja tkiva skor razvijen od strane internacionalne grupe, SDI(Systemic Lupus International Collaborating Clinics/American College of Rheumatology-Damage Index). Iako je primećena češća pojava pojedinih kliničkih manifestacija kod dece sacSEL i aPLA, uticaj prisustva ovih antitela nije u potpunosti razjašnjen.Ciljevi istraživanja: procena učestalosti pojave aPLA kod dece sa cSEL; analiza karakteristika(učestalost, vrednosti koncentracija) svakog od aPLA; analiza povezanosti prisustva aPLA saispoljavanjem kliničkih manifestacija i pojavom komplikacija kod bolesnika sa cSEL;utvrđivanje uticaja aPLA na aktivnost bolesti pacijenata obolelih od cSEL.Pacijenti i metode: ovom studijom obuhvaćeno je 40 bolesnika sa cSEL; dijagnoza bolestipostavljena je na osnovu klasifikacionih kriterijuma Američkog koledža za reumatologiju(American College of Rheumathology, ACR) iz 1997. godine. Praćenje karakteristika krvnihslika sprovođeno je u hematološkoj, a koagulacionog statusa u laboratoriji za transfuziologijuInstituta za majku i dete. Određivanje i praćenje prisustva i vrednosti autoantitela specifičnih zaSEL (ANA, anti ds DNA) i vrednosti komponenata komplementa vršeno je u imunološkojlaboratoriji Instituta za majku i dete i u Odeljenju za visokospecijalizovanu in vitro dijagnostikualergoloških i imunoloških oboljenja Kliničkog centra Srbije.Analizirani su rezultati dijagnostike antikardiolipinskih (aCLA), antitela protiv β2 glikoproteina1 (β2GPI), lupus antikoagulansa (LA) u trenutku dijagnostikovanja bolesti i tokom praćenja(nakon godinu dana i nakon tri godine)...

Opis (srp)

Medicina - Zapaljenje i autoimunost / Medicine- Inflammation and autoimmunity Datum odbrane: 22.09.2023.

Jezik

srpski

Datum

2023

Licenca

Ovo delo je licencirano pod uslovima licence
Creative Commons CC BY-NC-ND 3.0 AT - Creative Commons Autorstvo - Nekomercijalno - Bez prerada 3.0 Austria License.

http://creativecommons.org/licenses/by-nc-nd/3.0/at/legalcode

Predmet

OSNO - Opšta sistematizacija naučnih oblasti, Imunologija i alergologija

Systemic Lupus Erythematosus, Antiphospholipid syndrome, Children, Anticardiolipin antibodies, Anti beta2 glycoprotein I antibodies, Lupus anticoagulants, Thrombosis, SLEDAI, SDI

OSNO - Opšta sistematizacija naučnih oblasti, Imunologija i alergologija

Sistemski eritemski lupus, Antifosfolipidni sindrom, Deca, Anti kardiolipinska antitela, Anti beta2GPI antitela, Lupus antikoagulans, tromboza, SLEDAI, SDI

616-097-053.2(043.3)