DANIELI CASTRO OLIVEIRA DE ANDRADE
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina
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conferenceObject Antiphospholipid Antibody Profile Stability over Time: Prospective Results from AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (""Registry"")(2019) GKROUZMAN, Elena; SEVIM, Ecem; FINIK, Jackie; ANDRADE, Danieli; PENGO, Vittorio; SCIASCIA, Savino; TEKTONIDOU, Maria; UGARTE, Amaia; CHIGHIZOLA, Cecilia; BELMONT, H. Michael; SANCHEZ, Laura Perez; JI, Lanlan; FORTIN, Paul; EFTHYMIOU, Maria; JESUS, Guilherme De; BRANCH, David; NALLI, Cecilia; PETRI, Michelle; CERVERA, Ricard; ROD, Esther; KNIGHT, Jason; ATSUMI, Tatsuya; WILLIS, Rohan; BERTOLACCINI, Maria Laura; COHEN, Hannah; RAND, Jacob; ERKAN, Doruk- Characteristics of Patients With Antiphospholipid Antibody Positivity in the APS ACTION International Clinical Database and Repository(2022) SEVIM, Ecem; ZISA, Diane; ANDRADE, Danieli; SCIASCIA, Savino; PENGO, Vittorio; TEKTONIDOU, Maria G.; UGARTE, Amaia; GEROSA, Maria; BELMONT, H. Michael; ZAMORANO, Maria Angeles Aguirre; FORTIN, Paul R.; JI, Lanlan; EFTHYMIOU, Maria; COHEN, Hannah; BRANCH, D. Ware; JESUS, Guilherme Ramires; ANDREOLI, Laura; PETRI, Michelle; RODRIGUEZ, Esther; CERVERA, Ricard; KNIGHT, Jason S.; ATSUMI, Tatsuya; WILLIS, Rohan; ROUBEY, Robert; BERTOLACCINI, Maria Laura; ERKAN, Doruk; BARBHAIYA, MedhaObjective To describe the baseline characteristics of patients with positivity for antiphospholipid antibodies (aPLs) who were enrolled in an international registry, the Antiphospholipid Syndrome (APS) Alliance for Clinical Trials and International Networking (APS ACTION) clinical database and repository, overall and by clinical and laboratory subtypes. Methods The APS ACTION registry includes adults who persistently had positivity for aPLs. We evaluated baseline sociodemographic and aPL-related (APS classification criteria and ""non-criteria"") characteristics of patients overall and in subgroups (aPL-positive without APS, APS overall, thrombotic APS only, obstetric APS only, and both thrombotic APS/obstetric APS). We assessed baseline characteristics of patients tested for the presence of three aPLs (lupus anticoagulant [LAC] test, anticardiolipin antibody [aCL], and anti-beta(2)-glycoprotein I [anti-beta(2)GPI]) antibodies by aPL profiles (LAC only, single, double, and triple aPL positivity). Results The 804 aPL-positive patients assessed in the present study had a mean age of 45 +/- 13 years, were 74% female, and 68% White; additionally, 36% had other systemic autoimmune diseases. Of these 804 aPL-positive patients, 80% were classified as having APS (with 55% having thrombotic APS, 9% obstetric APS, and 15% thrombotic APS/obstetric APS). In the overall cohort, 71% had vascular thrombosis, 50% with a history of pregnancy had obstetric morbidity, and 56% had experienced at least one non-criteria manifestation. Among those with three aPLs tested (n = 660), 42% were triple aPL-positive. While single-, double-, and triple aPL-positive subgroups had similar frequencies of vascular, obstetric, and non-criteria events, these events were lowest in the single aPL subgroup, which consisted of aCLs or anti-beta(2)GPI only. Conclusion Our study demonstrates the heterogeneity of aPL-related clinical manifestations and laboratory profiles in a multicenter international cohort. Within single aPL positivity, LAC may be a major contributor to clinical events. Future prospective analyses, using standardized core laboratory aPL tests, will help clarify aPL risk profiles and improve risk stratification.
conferenceObject Clinical and Laboratory Characteristics of Antiphospholipid Antibody Positive Patients Included in the APS ACTION Registry(2019) SEVIM, Ecem; ZISA, Diane; ANDRADE, Danieli; SCIASCIA, Savino; GEROSA, Maria; BELMONT, H. Michael; EFTHYMIOU, Maria; FORTIN, Paul R.; LOPEZ-PEDRERA, Rosario; RODRIGUEZ, Esther; WILLIS, Rohan; ERKAN, Doruk; BARBHAIYA, MedhaconferenceObject Immunogenicity and Safety of an Inactivated Virus Vaccine Against SARS-CoV-2 in Patients with Autoimmune Rheumatic Diseases(2021) MEDEIROS-RIBEIRO, Ana; AIKAWA, Nadia; SAAD, Carla Goncalves Schahin; YUKI, Emily Figueiredo Vieira Neves; PEDROSA, Tatiana do Nascimento; FUSCO, Solange; ROJO, Priscila; PEREIRA, Rosa; SHINJO, Samuel; ANDRADE, Danieli; SAMPAIO-BARROS, Percival; RIBEIRO, Carolina; DEVEZA, Giordano; MARTINS, Victor Adriano de Oliveira; SILVA, Clovis Artur; LOPES, Marta; DUARTE, Alberto; ANTONANGELO, Leila; SABINO, Ester; KALLAS, Esper; PASOTO, Sandra Gofinet; BONFA, Eloisa- The Impact of Systemic Lupus Erythematosus on the Clinical Phenotype of Antiphospholipid Antibody-Positive Patients: Results From the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Clinical Database and Repository(2019) UNLU, Ozan; ERKAN, Doruk; BARBHAIYA, Medha; ANDRADE, Danieli; NASCIMENTO, Iana; ROSA, Renata; BANZATO, Alessandra; PENGO, Vittorio; UGARTE, Amaia; GEROSA, Maria; JI, Lanlan; EFTHYMIOU, Maria; BRANCH, D. Ware; JESUS, Guilherme Ramires de; TINCANI, Angela; BELMONT, H. Michael; FORTIN, Paul R.; PETRI, Michelle; RODRIGUEZ, Esther; PONS-ESTEL, Guillermo J.; KNIGHT, Jason S.; ATSUMI, Tatsuya; WILLIS, Rohan; ZUILY, Stephane; TEKTONIDOU, Maria G.Objective Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist regarding the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective of this study was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with SLE with those of aPL-positive patients without SLE. Methods A secure web-based data capture system was used to store patient demographic characteristics and aPL-related clinical and laboratory characteristics. Inclusion criteria included positive aPL according to the updated Sapporo classification criteria. Antiphospholipid antibody-positive patients fulfilling the American College of Rheumatology criteria for the classification of SLE (""aPL with SLE"") and those with no other autoimmune diseases (""aPL only"") were included in the analysis. Results Six hundred seventy-two aPL-positive patients were recruited from 24 international centers; 426 of these patients did not have other autoimmune disease, and 197 had SLE. The frequency of thrombocytopenia, hemolytic anemia, low complement levels, and IgA anti-beta(2)-glycoprotein I (anti-beta(2)GPI) antibodies was higher in the aPL-positive patients with SLE, whereas the frequency of cognitive dysfunction and IgG anti-beta(2)GPI antibodies was higher in the aPL-only group. The frequency of arterial and venous thromboses (including recurrent) as well as pregnancy morbidity was similar in the 2 groups. The prevalence of cardiovascular disease risk factors at the time of entry into the registry entry did not differ between the 2 groups, with the exception of current smoking, which was more frequent in aPL-positive patients with SLE. Conclusion Although the frequencies of thrombosis and pregnancy morbidity are similar in aPL-positive patients with and those without SLE, the diagnosis of SLE in patients with persistently positive aPL is associated with an increased frequency of thrombocytopenia, hemolytic anemia, low complement levels, and positive IgA anti-beta(2)GPI antibodies.
conferenceObject Thrombocytopenia and Autoimmune Hemolytic Anemia in Antiphospholipid Antibody-positive Patients: Descriptive Analysis of the AntiPhospholipid Syndrome Alliance for Clinical Trials and InternatiOnal Networking (APS ACTION) Clinical Database and Repository (""Registry"")(2022) ERTON, Zeynep Belce; LEAF, Rebecca K.; ANDRADE, Danieli Castro Oliveira de; BARBER, Megan; TEKTONIDOU, Maria G.; PENGO, Vittorio; SCIASCIA, Savino; UGARTE, Amaia; BELMONT, H. Michael; LOPEZ-PEDRERA, Chary; FORTIN, Paul R.; GEROSA, Maria; JESUS, Guilherme de; ATSUMI, Tatsuya; ZHANG, Zhuoli; COHEN, Hannah; BRANCH, D. Ware; WAHL, Denis; ANDREOLI, Laura; ALMARAZ, Esther Rodriguez; PETRI, Michelle; CERVERA, Ricard; ZUO, Yu Ray; ARTIM-ESEN, Bahar; WILLIS, Rohan; BERTOLACCINI, Maria Laura; ROUBEY, Robert; ERKAN, Doruk- Pregnancy outcomes in mixed connective tissue disease: a multicentre study(2019) RADIN, Massimo; SCHREIBER, Karen; CUADRADO, Maria Jose; CECCHI, Irene; ANDREOLI, Laura; FRANCESCHINI, Franco; CALEIRO, Teresa; ANDRADE, Danieli; GIBBONE, Elena; KHAMASHTA, Munther; BUYON, Jill; IZMIRLY, Peter; AGUIRRE, Maria Angeles; BENEDETTO, Chiara; ROCCATELLO, Dario; MAROZIO, Luca; SCIASCIA, SavinoObjectives. In this study we aimed to investigate foetal and maternal pregnancy outcomes from a large multicentre cohort of women diagnosed with MCTD and anti-U1RNP antibodies. Methods. This multicentre retrospective cohort study describes the outcomes of 203 pregnancies in 94 consecutive women ever pregnant who fulfilled the established criteria for MCTD with confirmed U1RNP positivity. Results. The foetal outcomes in 203 pregnancies were as follows: 146 (71.9%) live births, 38 (18.7%) miscarriages (first trimester pregnancy loss of <12 weeks gestation), 18 (8.9%) stillbirths (pregnancy loss after 20 weeks gestation) and 11 (5.4%) cases with intrauterine growth restriction. Maternal pregnancy outcomes were as follows: 8 (3.9%) developed pre-eclampsia, 2 (0.9%) developed eclampsia, 31 (15.3%) developed gestational hypertension and 3 (1.5%) developed gestational diabetes. Women with MCTD and aPL and pulmonary or muscular involvement had worse foetal outcomes compared with those without. Moreover, we report a case of complete congenital heart block (0.45%) and a case of cutaneous neonatal lupus, both born to a mother with positive isolated anti-U1RNP and negative anti-Ro/SSA antibodies. Conclusion. In our multicentre cohort, women with MCTD had a live birth rate of 72%. While the true frequency of heart block associated with anti-U1RNP remains to be determined, this study might raise the consideration of echocardiographic surveillance in this setting. Pregnancy counselling should be considered in women with MCTD.
- Ocular retinal findings in asymptomatic patients with antiphospholipid syndrome secondary to systemic lupus erythematosus(2023) NETO, Epitacio D. S.; NETO, Taurino S. R.; SIGNORELLI, Flavio; BALBI, Gustavo G. M.; HIGASHI, Alex H.; MONTEIRO, Mario Luiz R.; BONFA, Eloisa; ANDRADE, Danieli C. O.; ZACHARIAS, Leandro C.The objective is to perform a multimodal ophthalmological evaluation, including optical coherence angiography ( OCTA), asymptomatic APS secondary to SLE (APS/SLE), and compare to SLE patients and control group (CG). We performed a complete structural/functional ophthalmological evaluation using OCTA/microperimetry exam in all participants. One hundred fifty eyes/75 asymptomatic subjects [APS/SLE (n = 25), SLE (n = 25), and CG (n = 25)] were included. Ophthalmologic abnormalities occurred in 9 (36%) APS/SLE, 11 (44%) SLE, and none of CG (p < 0.001). The most common retinal finding was Drusen-like deposits (DLDs) exclusively in APS/SLE and SLE (16% vs. 24%, p = 0.75) whereas severe changes occurred solely in APS/SLE [2 paracentral acute middle maculopathy (PAMM) and 1 homonymous quadrantanopsia]. A trend of higher frequency of antiphospholipid antibody (aPL) triple positivity (100% vs. 16%, p = 0.05) and higher mean values of adjusted Global Antiphospholipid Syndrome Score ( aGAPSS) (14 +/- 0 vs. 9.69 +/- 3.44, p = 0.09) was observed in APS/SLE with PAMM vs. those without this complication. We identified that ophthalmologic retinal abnormalities occurred in more than 1/4 of asymptomatic APS/SLE and SLE. DLDs are the most frequent with similar frequencies in both conditions whereas PAMM occurred exclusively in APS/SLE patients. The possible association of the latter condition with aPL triple positivity and high aGAPSS suggests these two conditions may underlie the retinal maculopathy. Our findings in asymptomatic patients reinforce the need for early surveillance in these patients.
- A multicentre study of 244 pregnancies in undifferentiated connective tissue disease: maternal/fetal outcomes and disease evolution(2020) RADIN, Massimo; SCHREIBER, Karen; CECCHI, Irene; BORTOLUZZI, Alessandra; CRISAFULLI, Francesca; FREITAS, Cristiano M. de; BACCO, Beatrice; RUBINI, Elena; FODDAI, Silvia G.; PADOVAN, Melissa; CASSARINO, Silvia Gallo; FRANCESCHINI, Franco; ANDRADE, Danieli; BENEDETTO, Chiara; GOVONI, Marcello; BERTERO, Tiziana; MAROZIO, Luca; ROCCATELLO, Dario; ANDREOLI, Laura; SCIASCIA, SavinoObjectives. To investigate fetal/perinatal and maternal outcomes from a large multicentre cohort of women diagnosed with UCTD. Methods. This multicentre retrospective cohort study describes the outcomes of 224 pregnancies in 133 consecutive women with a diagnosis of UCTD, positive for ANA and aged <45 years old at study inclusion. Results. Of the 224 pregnancies analysed, 177 (79%) resulted in live births, 45 (20.1%) in miscarriages (defined as pregnancy loss before 12 weeks' gestation), 2 (0.9%) in stillbirths (pregnancy loss after 20 weeks' gestation) and 6 (2.7%) cases showed intrauterine growth restriction. Miscarriages and stillbirths were strongly associated with the presence of aPL and ENA antibodies (P < 0.05). Maternal pregnancy complications were as follows: 5 (2.2%) cases developed pre-eclampsia, 11 (4.9%) cases gestational hypertension and 12 (5.4%) cases gestational diabetes. Joint involvement represented the most frequent clinical manifestation of the cohort (57.9%), followed by RP (40.6%), photosensitivity (32.3%) and haematological manifestations (27.1%). The rate of disease evolution of our cohort from a diagnosis of UCTD to a diagnosis of definite CTD was 12% within a mean time of 5.3 +/- 2.8 years. With a total follow-up after first pregnancy of 1417 patient-years, we observed the evolution to a defined CTD in one out of every 88 patient-years. Conclusion. In our multicentre cohort, women with UCTD had a live birth rate of 79%. Women with UCTD should be referred to specialist follow-up when planning a pregnancy. ENA profiling and aPL testing should be mandatory in this setting, and further therapeutic approaches and management should be planned accordingly.
conferenceObject CORRELATION BETWEEN SHORTER DISEASE DURATION IN SYSTEMIC SCLEROSIS (SSC) AND ANTI-COLLAGEN TYPE V(2014) UGOLINI, M.; MANTOVANI, E.; DINIS, V.; BONOLDI, V.; RIBEIRO, A.; YOSHINARI, N.; ANDRADE, D.