Supplementary Material for: Efficacy of Recombinant Allergens for Diagnosis of Cockroach Allergy in Patients with Asthma and/or Rhinitis

<b><i>Background:</i></b> Immunoglobulin E (IgE) reactivity to individual allergens among cockroach-allergic patients has revealed wide variability. The aim of this study was to assess the effectiveness of recombinant cockroach allergens for skin testing, and to determine sensitization profiles among cockroach-allergic patients living in Brazil. <b><i>Methods:</i></b> Fifty-seven cockroach-allergic patients with asthma and/or rhinitis were recruited. Skin testing with recombinant (r) allergens from <i>Periplaneta americana</i> (rPer a 1 and rPer a 7) and <i>Blattella germanica </i>(rBla g 2, rBla g 4 and rBla g 5) were performed at 10 μg/ml and 5 μg/ml (rPer a 1). IgE antibodies to rPer a 7 and rPer a 1 were quantitated by ELISA. <b><i>Results:</i></b> Of 57 patients tested, 3 (5.3%), 24 (42.1%), 4 (7%), 3 (5.3%) and 4 (7%) showed positive reactions to rPer a 1, rPer a 7, rBla g 2, rBla g 4 and rBla g 5, respectively. Twenty-eight patients (49.1%) had positive tests to at least one allergen. In keeping with skin test results, 31/57 patients (54.4%) and 5/55 patients (9%) had detectable IgE to rPer a 7 and rPer a 1, respectively. Levels of IgE to rPer a 7 were higher in patients with positive tests to rPer a 7 than those with negative tests (geometric mean 13.2 and 1.8 IU/ml, p < 0.05). There was good concordance of results of skin tests and measurements of serum IgE to rPer a 7. <b><i>Conclusion:</i></b> IgE reactivity to rPer a 7 (<i>P. americana</i> tropomyosin) was dominant among patients in Brazil. However, 50% of the patients did not present reactivity to any of the recombinant allergens tested

Uveitis In Childhood-onset Systemic Lupus Erythematosus Patients: A Multicenter Survey

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The aim of this study is to assess uveitis prevalence in a large cohort of childhood-onset systemic lupus erythematosus (cSLE) patients. A retrospective multicenter cohort study including 852 cSLE patients was performed in ten pediatric rheumatology centers (Brazilian cSLE group). An investigator meeting was held and all participants received database training. Uveitis was diagnosed through clinical assessment by the uveitis expert ophthalmologist of each center. Patients with and without uveitis were assessed for lupus clinical/laboratory features and treatments. Uveitis was observed in 7/852 cSLE patients (0.8%). Two of them had ocular complications: cataract and irreversible blindness in one patient and retinal ischemia with subsequent neovascularization and unilateral blindness in another. Uveitis was identified within the first 6 months of cSLE diagnosis in 6/7 patients (86%). Comparison of a subgroup of cSLE patients with (n = 7) and without uveitis (n = 73) and similar length of disease duration showed that patients with uveitis had increased SLEDAI-2K score (19 vs. 6; p < 0.01). In addition, fever (71 vs. 12%; p < 0.01), lymphadenopathy (29 vs. 1.4%; p = 0.02), arthritis (43 vs. 7%; p = 0.02), and use of intravenous methylprednisolone (71 vs. 22%; p = 0.01) were higher in cSLE patients with uveitis, as compared to those without this manifestation, respectively. Presence of fever was significantly associated with uveitis, independently of SLEDAI scores or use of intravenous methylprednisolone pulses, as shown by adjusted regression analysis (adjusted prevalence ratio 35.7, 95% CI 2.4–519.6; p < 0.01). Uveitis was a rare and initial manifestation of active cSLE patients. Early recognition is essential due to the possibility of irreversible blindness. © 2017, International League of Associations for Rheumatology (ILAR).363547553309520/2012-6, CNPq, Conselho Nacional de Desenvolvimento Científico e TecnológicoConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Vaccination Practice In Children With Rheumatic Disease

Evaluate clinical practice through assessment of vaccination card and recommendation of specific vaccines in pediatric patients with rheumatic diseases in use of different drugs and reveal the possible association between vaccination frequency and time of the clinical practice of pediatric rheumatologists in the state of São Paulo. Material and Methods: A questionnaire was sent to pediatric rheumatologists of the Departamento de Reumatologia da Sociedade de Pediatria de São Paulo. This instrument included questions about practice time on Pediatric Rheumatology, vaccination of patients with juvenile systemic lupus erythematosus (JSLE), juvenile idiopathic arthritis (JIA), juvenile dermatomyositis (JDM), and immunization according to the treatments used. Results: Vaccination card was seen by 100% of the professionals at the first visit and by 36% annually. Vaccines of live agents were not recommended for patients with JSLE, JIA, and JDM in 44%, 64%, and 48%, respectively. The professionals were divided into two groups: Group A (≤ 15 years of practice, n = 12) and B (≥ 16 years, n = 13). No statistical difference was observed in the use of live agent vaccine and vaccines with inactivated agents or protein components in the two treatment groups (P > 0.05). Moreover, the groups had similar opinion regarding severity of immunosuppression in patients with JSLE, JIA, and JDM (with or without activity) and treatment used (P > 0.05). Conclusions: The frequency of immunization by pediatric rheumatologists in São Paulo is low, especially after the first visit, and not influenced by time of professional practice.504356361Len, C.A., Terreri, M.T., Hilário, M.O., Lúpus eritematoso sistêmico juvenil e infecção (2002) Rev Bras Reumatol, 42 (4), pp. 218-222Facó, M.M., Leone, C., Campos, L.M., Febrônio, M.V., Marques, H.H., Silva, C.A., Risk factors associated with the death of patients hospitalized for juvenile systemic lupus erythematosus (2007) Braz J Med Biol Res, 40 (7), pp. 993-1002Facó, M.M., Nukumizu, L.A., Pantoja, A.J., Barros, P.C., Troster, E.J., Silva, C.A., Avaliação dos óbitos e necropsias em pacientes internados em um Serviço de Reumatologia Pediátrica por um período de dez anos (2005) Rev Bras Reumatol, 45 (2), pp. 55-63O'neill, S.G., Isenberg, D.A., Immunizing patients with systemic lupus erythematosus: A review of effectiveness and safety (2006) Lupus, 15 (11), pp. 778-783Gluck, T., Muller-Ladner, U., Vaccination in patients with chronic rheumatic or autoimmune diseases (2008) Clin Infect Dis, 46 (9), pp. 1459-1465Conti, F., Rezai, S., Valesini, G., Vaccination and autoimmune rheumatic diseases (2008) Autoimmunity Reviews, 8 (2), pp. 124-128Maillefert, J.F., Sibilia, J., Toussirot, E., Vignon, E., Eschard, J.P., Lorcerie, B., Rheumatic disorders developed after hepatitis B vaccination (1999) Rheumatology, 38 (10), pp. 978-983. , OxfordSilva, C.A., Terreri, M.T., Barbosa, C.M., Hilário, M.O., Pillegi, G.S., Ferriani, V.P., Consenso de imunização para crianças e adolescentes com doenças reumáticas (2009) Rev Bras Reumatol, 49 (5), pp. 562-589Davies, K., Woo, P., Immunization in rheumatic diseases of childhood: An audit of the clinical practice of British Paediatric Rheumatology Group members and a review of the evidence (2002) Rheumatology (Oxford), 41, pp. 937-941Hochberg, M.C., Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus (1997) Arthritis Rheum, 40 (9), p. 1725Petty, R.E., Southwood, T., Manners, P., Baum, J., Glass, D.N., Goldenberg, J., International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: Second revision, Edmonton, 2001 (2004) J Rheumatol, 31 (2), pp. 390-392Bohan, A., Peter, J.B., Polymyositis and dermatomyositis (1975) N Engl J Med, 292 (7), p. 344Delbecq, A.L., van de Ven, A.H., Gustafson, D.H., (1975) Group Technique For Program Planning - a Guide to Nominal Group and Delphi Processes, , Glenview, Illinois. 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Ministério da Saúde, Manual dos Centros de Referência para Imunobiológicos Especiais (Cries), Acesso em 20 de março de 2009Neves, P.S., Facó, M.M., Sallum, A.M.E., Campos, L.M.A., Rossi Jr., A., Silva, C.A., Herpes zoster em pacientes com lúpus eritematoso sistêmico juvenil (2007) Rev Bras Reumatol, 47 (2), pp. 135-139Bricks, L.F., Silva, C.A., Uso e abuso de anti-inflamatórios não hormonais: Parte I (2005) Pediatria, 27 (2), pp. 114-125. , São PauloBricks, L.F., Silva, C.A., Toxicidade dos anti-inflamatórios não hormonais (AINH) (2005) Pediatria, 27 (3), pp. 181-193. , São PauloSilva, C.A., Silva, C.H., Robazzi, T.C., Lotito, A.P., Mendroni Jr., A., Jacob, C.M., Macrophage activation syndrome associated with systemic juvenile idiopathic arthritis (2004) J Pediatr, 80 (6), pp. 517-522. , Rio JPileggi, G.C., Souza, C.B.S., Ferriani, V.P.L., Safety and immunogenicity of varicella vaccine in patients with juvenile rheumatic diseases using methotrexate and glucocorticoids (2010) Arthritis Care Res, , Hoboken, in pressMota, L.M., Oliveira, A.C., Lima, R.A., Santos-Neto, L.L., Tauil, P.L., Vaccination against yellow fever among patients on imunossupressors with diagnoses of rheumatic diseases (2009) Rev Soc Bras Med Trop, 42 (1), pp. 23-2