<\/h4>\n<\/h4>\n\u015eef lucr. Dr. Florea Laura<\/span><\/strong>
\n Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fi<\/span><\/strong><\/h4>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.4.8″ hover_enabled=”0″]<\/p>\n
Actualit\u0103\u021bi \u00een terapia vasculitelor sistemice asociate cu ANCA<\/span>
\nAutori: Laura Florea, Cristiana-Elena Vlad<\/span><\/p>\nVasculitele sistemice sunt boli autoimune caracterizate prin inflama\u021bia pere\u021bilor vaselor mari, mijlocii \u0219i mici. Etiologia este plurifactorial\u0103 fiind implica\u021bi factori genetici, infec\u021bio\u0219i, de mediu, imuni.
\nPoliangeita microscopic\u0103, granulomatoza cu poliangeit\u0103 \u0219i granulomatoza eozinofilic\u0103 cu poliangeit\u0103 sunt \u00eencadrate \u00een vasculite de vase mici asociate cu ANCA (auto anticorpi dirija\u021bi contra citoplasmei neutrofilului). Anticorpii ANCA pot fi de dou\u0103 tipuri : p ANCA (Ac antimieloperoxidaz\u0103 MPO prin metoda ELISA, cu fluorescen\u021b\u0103 perinuclear\u0103 prin imunofluorescen\u021b\u0103 indirect\u0103) \u0219i c ANCA (Ac antiproteinaz\u0103 3 PR 3 prin metoda ELISA, cu fluorescen\u021b\u0103 citoplasmatic\u0103 prin imunofluorescen\u021b\u0103 indirect\u0103). MPO \u0219i PR3 se g\u0103sesc pe suprafa\u021ba neutrofilelor, iar interac\u021biunea dintre antigene \u0219i anticorpi se soldeaz\u0103 cu activarea neutrofilelor, eliberarea de enzime lizozomale \u0219i specii reactive de oxigen ce conduc \u00een final la lezarea pere\u021bilor vasculari.
\nManifest\u0103rile clinice sunt variate, caracteristice fiind cele renale, pulmonare \u0219i \u00een sfera ORL. Diagnosticul de certitudine se pune prin examen histologic.
\nTratamentul de induc\u021bie se face cu corticoterapie, methotrexat, ciclofosfamida, micofenolat de mofetil sau rituximab, imunosupresorul aleg\u00e2ndu \u2013se \u00een func\u021bie de forma clinic\u0103. Se poate asocia plasmafereza \u0219i \u00een unele cazuri hemodializa. Alte op\u021biuni pentru terapia de induc\u021bie sunt Avacopan \u2013 inhibitor oral al receptorului frac\u021biunii C5a a complementului, imunoglobuline, alemtuzumab, deoxysperguatine, etanercept.
\nTratamentul de \u00eentre\u021binere se face cu ciclofosfamid\u0103, azathioprina, methotrexat, rituximab, leflunomida, micofenolat de mofetil, belimumab asociat corticoterapiei.
\nLucrarea \u00ee\u0219i propune prezentarea schemelor de tratament \u00een induc\u021bie \u0219i \u00eentre\u021binere, evaluarea beneficiilor \u0219i efectelor adverse ale tratamentului vasculitelor la adult, date comparative privind mortalitatea, func\u021bia renal\u0103, necesitatea terapiei de supleere a func\u021biei renale, remisiunea \u0219i rec\u0103derea \u00een func\u021bie de tratamentul ales.<\/p>\n
New approaches to treatment in ANCA associated-vasculitis<\/span>
\nAuthors: Laura Florea, Cristiana-Elena Vlad<\/span><\/p>\nSystemic vasculitis is a group of autoimmune diseases definited by wall inflammation of large, medium and small vessels. The etiology is multifactorial, involving genetic, infectious, environmental and immune factors.
\nMicroscopic polyangiitis, granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis are framed in ANCA-associated small-vessel vasculitis (antineutrophil cytoplasmic antibodies). There are two main kinds of ANCA: pANCA (MPO: antiodies antimieloperoxidase by ELISA method, with perinuclear fluorescence by indirect immunofluorescence) and cANCA (PR3: antiodies antiproteinase 3 by ELISA method, with cytoplasmic fluorescence by indirect immunofluorescence). MPO and PR3 are found on the surface of neutrophils, and the interaction between antigens and antibodies results in the activation of neutrophils, the release of lysosomal enzymes and of reactive oxygen species, that finally lead to damage of the vascular walls.
\nThe clinical manifestations are different, characterized by the renal, pulmonary and ORL disorders. The final diagnosis is performed by histological examination.
\nInduction therapy should be achieved with corticosteroid therapy, methotrexate, cyclophosphamide, mycophenolate mofetil or rituximab, the immunosuppressant being chosen according to the clinical form. Also, plasmapheresis and in some cases hemodialysis may be associated. Other options for induction therapy are Avacopan – an oral small-molecule C5a receptor antagonist that blocks the effects of C5a, immunoglobulins, alemtuzumab, deoxyspergualin, etanercept.
\nMaintenance therapy include an association between corticosteroids and cyclophosphamide, azathioprine, methotrexate, rituximab, leflunomide, mofetil mycophenolate, belimumab.
\nThe paper aims to expose the novel treatments for induction and maintenance, the evaluation of the benefits and the adverse effect of treatment of vasculitis in adults, comparative analysis of mortality, renal function, need for renal replacement therapy, the remission and the relapse depending on the treatment options.\n<\/p>\n
Scurt CV<\/span><\/p>\nEste medic primar medicin\u0103 intern\u0103 \u015fi nefrologie, \u015fef de lucr\u0103ri la Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fi, doctor \u00een \u015ftiin\u0163e medicale \u015fi are competen\u0163\u0103 \u00een ecografie general\u0103. Este coordonator al Compartimentului de Medicin\u0103 Intern\u0103, Spital \u201cDr C I Parhon\u201d \u0219i al Centrului de Dializ\u0103 DMD.
\nA lucrat ca Chef de Clinique la Universitatea Paris VII Denis Diderot.
\nA ob\u0163inut Attestation de Formation Specialisee de Nephrologie \u00een Fran\u0163a (Faculte de Medicine Amiens) \u015fi Formation Investigateurs aux Essais Cliniques (Universite Paris VII Denis Diderot).
\nEste autor \u015fi coautor a numeroase c\u0103r\u0163i, capitole de carte \u015fi articole ap\u0103rute \u00een reviste na\u0163ionale \u015fi interna\u0163ionale.
\nEste membru al Societ\u0103\u0163ii Rom\u00e2ne de Nefrologie, Societ\u0103\u0163ii Rom\u00e2ne de Medicin\u0103 Intern\u0103 \u015fi al Societ\u0103\u0163ii Europene de Dializ\u0103 \u015fi Transplant Renal (ERA-EDTA).
\nDomenii de interes: bolile autoimune, patologia cardio-vascular\u0103 \u00een popula\u021bia general\u0103 \u0219i \u00een boala cronic\u0103 de rinichi, nutri\u021bia pacientului cu boal\u0103 cronic\u0103 renal\u0103, hemodializa, dializa peritoneal\u0103.
\n\u00ce\u015fi desf\u0103\u015foar\u0103 activitatea \u00een Clinica de Medicin\u0103 Intern\u0103 – Nefrologie a Spitalului “Dr. C.I. Parhon\u201d \/ U.M.F. \u201cGrigore T. Popa” Ia\u0219i.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”3.22″ background_color=”rgba(117,194,33,0.23)” background_image=”https:\/\/pdi.ro\/2020\/wp-content\/uploads\/2020\/02\/back_justflowers_overlay1.png” background_blend=”luminosity” custom_padding=”54px|0px|0|0px|false|false” top_divider_style=”waves2″ top_divider_color=”#ffffff” top_divider_height=”155px” top_divider_height_tablet=”” top_divider_height_phone=”97px” top_divider_height_last_edited=”on|desktop” bottom_divider_style=”waves2″ bottom_divider_color=”#75c221″ bottom_divider_flip=”vertical” bottom_divider_height_tablet=”” bottom_divider_height_phone=”59px” bottom_divider_height_last_edited=”on|desktop”][et_pb_row column_structure=”3_5,2_5″ _builder_version=”3.25″ custom_padding=”61px|0px|69px|0px|false|false”][et_pb_column type=”3_5″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.0.11″ 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\u015eef lucr. Dr. Florea Laura<\/span><\/strong>
\n Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fi<\/span><\/strong><\/h4>\n[\/et_pb_text][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”3.25″][et_pb_column type=”4_4″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.4.8″ hover_enabled=”0″]<\/p>\n
Actualit\u0103\u021bi \u00een terapia vasculitelor sistemice asociate cu ANCA<\/span>
\nAutori: Laura Florea, Cristiana-Elena Vlad<\/span><\/p>\nVasculitele sistemice sunt boli autoimune caracterizate prin inflama\u021bia pere\u021bilor vaselor mari, mijlocii \u0219i mici. Etiologia este plurifactorial\u0103 fiind implica\u021bi factori genetici, infec\u021bio\u0219i, de mediu, imuni.
\nPoliangeita microscopic\u0103, granulomatoza cu poliangeit\u0103 \u0219i granulomatoza eozinofilic\u0103 cu poliangeit\u0103 sunt \u00eencadrate \u00een vasculite de vase mici asociate cu ANCA (auto anticorpi dirija\u021bi contra citoplasmei neutrofilului). Anticorpii ANCA pot fi de dou\u0103 tipuri : p ANCA (Ac antimieloperoxidaz\u0103 MPO prin metoda ELISA, cu fluorescen\u021b\u0103 perinuclear\u0103 prin imunofluorescen\u021b\u0103 indirect\u0103) \u0219i c ANCA (Ac antiproteinaz\u0103 3 PR 3 prin metoda ELISA, cu fluorescen\u021b\u0103 citoplasmatic\u0103 prin imunofluorescen\u021b\u0103 indirect\u0103). MPO \u0219i PR3 se g\u0103sesc pe suprafa\u021ba neutrofilelor, iar interac\u021biunea dintre antigene \u0219i anticorpi se soldeaz\u0103 cu activarea neutrofilelor, eliberarea de enzime lizozomale \u0219i specii reactive de oxigen ce conduc \u00een final la lezarea pere\u021bilor vasculari.
\nManifest\u0103rile clinice sunt variate, caracteristice fiind cele renale, pulmonare \u0219i \u00een sfera ORL. Diagnosticul de certitudine se pune prin examen histologic.
\nTratamentul de induc\u021bie se face cu corticoterapie, methotrexat, ciclofosfamida, micofenolat de mofetil sau rituximab, imunosupresorul aleg\u00e2ndu \u2013se \u00een func\u021bie de forma clinic\u0103. Se poate asocia plasmafereza \u0219i \u00een unele cazuri hemodializa. Alte op\u021biuni pentru terapia de induc\u021bie sunt Avacopan \u2013 inhibitor oral al receptorului frac\u021biunii C5a a complementului, imunoglobuline, alemtuzumab, deoxysperguatine, etanercept.
\nTratamentul de \u00eentre\u021binere se face cu ciclofosfamid\u0103, azathioprina, methotrexat, rituximab, leflunomida, micofenolat de mofetil, belimumab asociat corticoterapiei.
\nLucrarea \u00ee\u0219i propune prezentarea schemelor de tratament \u00een induc\u021bie \u0219i \u00eentre\u021binere, evaluarea beneficiilor \u0219i efectelor adverse ale tratamentului vasculitelor la adult, date comparative privind mortalitatea, func\u021bia renal\u0103, necesitatea terapiei de supleere a func\u021biei renale, remisiunea \u0219i rec\u0103derea \u00een func\u021bie de tratamentul ales.<\/p>\n
New approaches to treatment in ANCA associated-vasculitis<\/span>
\nAuthors: Laura Florea, Cristiana-Elena Vlad<\/span><\/p>\nSystemic vasculitis is a group of autoimmune diseases definited by wall inflammation of large, medium and small vessels. The etiology is multifactorial, involving genetic, infectious, environmental and immune factors.
\nMicroscopic polyangiitis, granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis are framed in ANCA-associated small-vessel vasculitis (antineutrophil cytoplasmic antibodies). There are two main kinds of ANCA: pANCA (MPO: antiodies antimieloperoxidase by ELISA method, with perinuclear fluorescence by indirect immunofluorescence) and cANCA (PR3: antiodies antiproteinase 3 by ELISA method, with cytoplasmic fluorescence by indirect immunofluorescence). MPO and PR3 are found on the surface of neutrophils, and the interaction between antigens and antibodies results in the activation of neutrophils, the release of lysosomal enzymes and of reactive oxygen species, that finally lead to damage of the vascular walls.
\nThe clinical manifestations are different, characterized by the renal, pulmonary and ORL disorders. The final diagnosis is performed by histological examination.
\nInduction therapy should be achieved with corticosteroid therapy, methotrexate, cyclophosphamide, mycophenolate mofetil or rituximab, the immunosuppressant being chosen according to the clinical form. Also, plasmapheresis and in some cases hemodialysis may be associated. Other options for induction therapy are Avacopan – an oral small-molecule C5a receptor antagonist that blocks the effects of C5a, immunoglobulins, alemtuzumab, deoxyspergualin, etanercept.
\nMaintenance therapy include an association between corticosteroids and cyclophosphamide, azathioprine, methotrexate, rituximab, leflunomide, mofetil mycophenolate, belimumab.
\nThe paper aims to expose the novel treatments for induction and maintenance, the evaluation of the benefits and the adverse effect of treatment of vasculitis in adults, comparative analysis of mortality, renal function, need for renal replacement therapy, the remission and the relapse depending on the treatment options.\n<\/p>\n
Scurt CV<\/span><\/p>\nEste medic primar medicin\u0103 intern\u0103 \u015fi nefrologie, \u015fef de lucr\u0103ri la Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fi, doctor \u00een \u015ftiin\u0163e medicale \u015fi are competen\u0163\u0103 \u00een ecografie general\u0103. Este coordonator al Compartimentului de Medicin\u0103 Intern\u0103, Spital \u201cDr C I Parhon\u201d \u0219i al Centrului de Dializ\u0103 DMD.
\nA lucrat ca Chef de Clinique la Universitatea Paris VII Denis Diderot.
\nA ob\u0163inut Attestation de Formation Specialisee de Nephrologie \u00een Fran\u0163a (Faculte de Medicine Amiens) \u015fi Formation Investigateurs aux Essais Cliniques (Universite Paris VII Denis Diderot).
\nEste autor \u015fi coautor a numeroase c\u0103r\u0163i, capitole de carte \u015fi articole ap\u0103rute \u00een reviste na\u0163ionale \u015fi interna\u0163ionale.
\nEste membru al Societ\u0103\u0163ii Rom\u00e2ne de Nefrologie, Societ\u0103\u0163ii Rom\u00e2ne de Medicin\u0103 Intern\u0103 \u015fi al Societ\u0103\u0163ii Europene de Dializ\u0103 \u015fi Transplant Renal (ERA-EDTA).
\nDomenii de interes: bolile autoimune, patologia cardio-vascular\u0103 \u00een popula\u021bia general\u0103 \u0219i \u00een boala cronic\u0103 de rinichi, nutri\u021bia pacientului cu boal\u0103 cronic\u0103 renal\u0103, hemodializa, dializa peritoneal\u0103.
\n\u00ce\u015fi desf\u0103\u015foar\u0103 activitatea \u00een Clinica de Medicin\u0103 Intern\u0103 – Nefrologie a Spitalului “Dr. C.I. Parhon\u201d \/ U.M.F. \u201cGrigore T. Popa” Ia\u0219i.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”3.22″ background_color=”rgba(117,194,33,0.23)” background_image=”https:\/\/pdi.ro\/2020\/wp-content\/uploads\/2020\/02\/back_justflowers_overlay1.png” background_blend=”luminosity” custom_padding=”54px|0px|0|0px|false|false” top_divider_style=”waves2″ top_divider_color=”#ffffff” top_divider_height=”155px” top_divider_height_tablet=”” top_divider_height_phone=”97px” top_divider_height_last_edited=”on|desktop” bottom_divider_style=”waves2″ bottom_divider_color=”#75c221″ bottom_divider_flip=”vertical” bottom_divider_height_tablet=”” bottom_divider_height_phone=”59px” bottom_divider_height_last_edited=”on|desktop”][et_pb_row column_structure=”3_5,2_5″ _builder_version=”3.25″ custom_padding=”61px|0px|69px|0px|false|false”][et_pb_column type=”3_5″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.0.11″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” text_line_height=”1.2em” header_font=”||||||||” background_layout=”dark” text_font_size_tablet=”” text_font_size_phone=”” text_font_size_last_edited=”on|desktop”]Contacteaz\u0103 operatorul PDI 2020[\/et_pb_text][et_pb_contact_form email=”contact@primaderma.ro\/2019″ submit_button_text=”Trimite mesajul” _builder_version=”3.19.4″ title_font=”||||||||”][et_pb_contact_field field_id=”Name” field_title=”Nume” _builder_version=”3.18.9″ button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Email” field_title=”Adresa de e-mail” field_type=”email” _builder_version=”3.19.4″ button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Message” field_title=”Mesajul dvs.” field_type=”text” fullwidth_field=”on” _builder_version=”3.18.9″ button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][\/et_pb_contact_form][\/et_pb_column][et_pb_column type=”2_5″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.0.11″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark”]Operatorul PDI 2020[\/et_pb_text][et_pb_text _builder_version=”4.0.11″ text_font=”||||||||”]<\/p>\n
<\/p>\n
<\/p>\n
Adresa: Str. A. Panu nr. 13, Iasi
\nTel.: 0332.40.88.00-05
\nE-mail: inscrieri@primaderma.ro<\/a>
\nWebsite:\u00a0www.eventernet.ro<\/a>[\/et_pb_text][et_pb_text disabled_on=”off|off|off” _builder_version=”4.0.11″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark” locked=”off”]Parteneri Media[\/et_pb_text][et_pb_gallery gallery_ids=”7203,7204,7232,7231″ fullwidth=”on” _builder_version=”4.0.11″ transform_scale=”86%|86%” max_width=”63%” auto=”on” auto_speed=”3500″ hover_transition_duration=”100ms” hover_transition_delay=”50ms” hover_transition_speed_curve=”ease-in-out” locked=”off”][\/et_pb_gallery][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"\u015eef lucr. Dr. Florea Laura Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fiActualit\u0103\u021bi \u00een terapia vasculitelor sistemice asociate cu ANCA Autori: Laura Florea, Cristiana-Elena Vlad Vasculitele sistemice sunt boli autoimune caracterizate prin inflama\u021bia pere\u021bilor vaselor mari, mijlocii \u0219i mici. Etiologia este plurifactorial\u0103 fiind implica\u021bi factori genetici, infec\u021bio\u0219i, de mediu, imuni. Poliangeita microscopic\u0103, granulomatoza cu […]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-7853","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages\/7853","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/comments?post=7853"}],"version-history":[{"count":7,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages\/7853\/revisions"}],"predecessor-version":[{"id":8458,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages\/7853\/revisions\/8458"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/media?parent=7853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nAutori: Laura Florea, Cristiana-Elena Vlad<\/span><\/p>\n
Vasculitele sistemice sunt boli autoimune caracterizate prin inflama\u021bia pere\u021bilor vaselor mari, mijlocii \u0219i mici. Etiologia este plurifactorial\u0103 fiind implica\u021bi factori genetici, infec\u021bio\u0219i, de mediu, imuni.
\nPoliangeita microscopic\u0103, granulomatoza cu poliangeit\u0103 \u0219i granulomatoza eozinofilic\u0103 cu poliangeit\u0103 sunt \u00eencadrate \u00een vasculite de vase mici asociate cu ANCA (auto anticorpi dirija\u021bi contra citoplasmei neutrofilului). Anticorpii ANCA pot fi de dou\u0103 tipuri : p ANCA (Ac antimieloperoxidaz\u0103 MPO prin metoda ELISA, cu fluorescen\u021b\u0103 perinuclear\u0103 prin imunofluorescen\u021b\u0103 indirect\u0103) \u0219i c ANCA (Ac antiproteinaz\u0103 3 PR 3 prin metoda ELISA, cu fluorescen\u021b\u0103 citoplasmatic\u0103 prin imunofluorescen\u021b\u0103 indirect\u0103). MPO \u0219i PR3 se g\u0103sesc pe suprafa\u021ba neutrofilelor, iar interac\u021biunea dintre antigene \u0219i anticorpi se soldeaz\u0103 cu activarea neutrofilelor, eliberarea de enzime lizozomale \u0219i specii reactive de oxigen ce conduc \u00een final la lezarea pere\u021bilor vasculari.
\nManifest\u0103rile clinice sunt variate, caracteristice fiind cele renale, pulmonare \u0219i \u00een sfera ORL. Diagnosticul de certitudine se pune prin examen histologic.
\nTratamentul de induc\u021bie se face cu corticoterapie, methotrexat, ciclofosfamida, micofenolat de mofetil sau rituximab, imunosupresorul aleg\u00e2ndu \u2013se \u00een func\u021bie de forma clinic\u0103. Se poate asocia plasmafereza \u0219i \u00een unele cazuri hemodializa. Alte op\u021biuni pentru terapia de induc\u021bie sunt Avacopan \u2013 inhibitor oral al receptorului frac\u021biunii C5a a complementului, imunoglobuline, alemtuzumab, deoxysperguatine, etanercept.
\nTratamentul de \u00eentre\u021binere se face cu ciclofosfamid\u0103, azathioprina, methotrexat, rituximab, leflunomida, micofenolat de mofetil, belimumab asociat corticoterapiei.
\nLucrarea \u00ee\u0219i propune prezentarea schemelor de tratament \u00een induc\u021bie \u0219i \u00eentre\u021binere, evaluarea beneficiilor \u0219i efectelor adverse ale tratamentului vasculitelor la adult, date comparative privind mortalitatea, func\u021bia renal\u0103, necesitatea terapiei de supleere a func\u021biei renale, remisiunea \u0219i rec\u0103derea \u00een func\u021bie de tratamentul ales.<\/p>\n
New approaches to treatment in ANCA associated-vasculitis<\/span> Systemic vasculitis is a group of autoimmune diseases definited by wall inflammation of large, medium and small vessels. The etiology is multifactorial, involving genetic, infectious, environmental and immune factors. Scurt CV<\/span><\/p>\n Este medic primar medicin\u0103 intern\u0103 \u015fi nefrologie, \u015fef de lucr\u0103ri la Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fi, doctor \u00een \u015ftiin\u0163e medicale \u015fi are competen\u0163\u0103 \u00een ecografie general\u0103. Este coordonator al Compartimentului de Medicin\u0103 Intern\u0103, Spital \u201cDr C I Parhon\u201d \u0219i al Centrului de Dializ\u0103 DMD. <\/p>\n <\/p>\n Adresa: Str. A. Panu nr. 13, Iasi \u015eef lucr. Dr. Florea Laura Universitatea de Medicin\u0103 \u015fi Farmacie “Grigore T. Popa\u201d Ia\u015fiActualit\u0103\u021bi \u00een terapia vasculitelor sistemice asociate cu ANCA Autori: Laura Florea, Cristiana-Elena Vlad Vasculitele sistemice sunt boli autoimune caracterizate prin inflama\u021bia pere\u021bilor vaselor mari, mijlocii \u0219i mici. Etiologia este plurifactorial\u0103 fiind implica\u021bi factori genetici, infec\u021bio\u0219i, de mediu, imuni. Poliangeita microscopic\u0103, granulomatoza cu […]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-7853","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages\/7853","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/comments?post=7853"}],"version-history":[{"count":7,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages\/7853\/revisions"}],"predecessor-version":[{"id":8458,"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/pages\/7853\/revisions\/8458"}],"wp:attachment":[{"href":"https:\/\/pdi.ro\/2020\/wp-json\/wp\/v2\/media?parent=7853"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
\nAuthors: Laura Florea, Cristiana-Elena Vlad<\/span><\/p>\n
\nMicroscopic polyangiitis, granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis are framed in ANCA-associated small-vessel vasculitis (antineutrophil cytoplasmic antibodies). There are two main kinds of ANCA: pANCA (MPO: antiodies antimieloperoxidase by ELISA method, with perinuclear fluorescence by indirect immunofluorescence) and cANCA (PR3: antiodies antiproteinase 3 by ELISA method, with cytoplasmic fluorescence by indirect immunofluorescence). MPO and PR3 are found on the surface of neutrophils, and the interaction between antigens and antibodies results in the activation of neutrophils, the release of lysosomal enzymes and of reactive oxygen species, that finally lead to damage of the vascular walls.
\nThe clinical manifestations are different, characterized by the renal, pulmonary and ORL disorders. The final diagnosis is performed by histological examination.
\nInduction therapy should be achieved with corticosteroid therapy, methotrexate, cyclophosphamide, mycophenolate mofetil or rituximab, the immunosuppressant being chosen according to the clinical form. Also, plasmapheresis and in some cases hemodialysis may be associated. Other options for induction therapy are Avacopan – an oral small-molecule C5a receptor antagonist that blocks the effects of C5a, immunoglobulins, alemtuzumab, deoxyspergualin, etanercept.
\nMaintenance therapy include an association between corticosteroids and cyclophosphamide, azathioprine, methotrexate, rituximab, leflunomide, mofetil mycophenolate, belimumab.
\nThe paper aims to expose the novel treatments for induction and maintenance, the evaluation of the benefits and the adverse effect of treatment of vasculitis in adults, comparative analysis of mortality, renal function, need for renal replacement therapy, the remission and the relapse depending on the treatment options.\n<\/p>\n
\nA lucrat ca Chef de Clinique la Universitatea Paris VII Denis Diderot.
\nA ob\u0163inut Attestation de Formation Specialisee de Nephrologie \u00een Fran\u0163a (Faculte de Medicine Amiens) \u015fi Formation Investigateurs aux Essais Cliniques (Universite Paris VII Denis Diderot).
\nEste autor \u015fi coautor a numeroase c\u0103r\u0163i, capitole de carte \u015fi articole ap\u0103rute \u00een reviste na\u0163ionale \u015fi interna\u0163ionale.
\nEste membru al Societ\u0103\u0163ii Rom\u00e2ne de Nefrologie, Societ\u0103\u0163ii Rom\u00e2ne de Medicin\u0103 Intern\u0103 \u015fi al Societ\u0103\u0163ii Europene de Dializ\u0103 \u015fi Transplant Renal (ERA-EDTA).
\nDomenii de interes: bolile autoimune, patologia cardio-vascular\u0103 \u00een popula\u021bia general\u0103 \u0219i \u00een boala cronic\u0103 de rinichi, nutri\u021bia pacientului cu boal\u0103 cronic\u0103 renal\u0103, hemodializa, dializa peritoneal\u0103.
\n\u00ce\u015fi desf\u0103\u015foar\u0103 activitatea \u00een Clinica de Medicin\u0103 Intern\u0103 – Nefrologie a Spitalului “Dr. C.I. Parhon\u201d \/ U.M.F. \u201cGrigore T. Popa” Ia\u0219i.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”3.22″ background_color=”rgba(117,194,33,0.23)” background_image=”https:\/\/pdi.ro\/2020\/wp-content\/uploads\/2020\/02\/back_justflowers_overlay1.png” background_blend=”luminosity” custom_padding=”54px|0px|0|0px|false|false” top_divider_style=”waves2″ top_divider_color=”#ffffff” top_divider_height=”155px” top_divider_height_tablet=”” top_divider_height_phone=”97px” top_divider_height_last_edited=”on|desktop” bottom_divider_style=”waves2″ bottom_divider_color=”#75c221″ bottom_divider_flip=”vertical” bottom_divider_height_tablet=”” bottom_divider_height_phone=”59px” bottom_divider_height_last_edited=”on|desktop”][et_pb_row column_structure=”3_5,2_5″ _builder_version=”3.25″ custom_padding=”61px|0px|69px|0px|false|false”][et_pb_column type=”3_5″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.0.11″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” text_line_height=”1.2em” header_font=”||||||||” background_layout=”dark” text_font_size_tablet=”” text_font_size_phone=”” text_font_size_last_edited=”on|desktop”]Contacteaz\u0103 operatorul PDI 2020[\/et_pb_text][et_pb_contact_form email=”contact@primaderma.ro\/2019″ submit_button_text=”Trimite mesajul” _builder_version=”3.19.4″ title_font=”||||||||”][et_pb_contact_field field_id=”Name” field_title=”Nume” _builder_version=”3.18.9″ button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Email” field_title=”Adresa de e-mail” field_type=”email” _builder_version=”3.19.4″ button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][et_pb_contact_field field_id=”Message” field_title=”Mesajul dvs.” field_type=”text” fullwidth_field=”on” _builder_version=”3.18.9″ button_text_size__hover_enabled=”off” button_one_text_size__hover_enabled=”off” button_two_text_size__hover_enabled=”off” button_text_color__hover_enabled=”off” button_one_text_color__hover_enabled=”off” button_two_text_color__hover_enabled=”off” button_border_width__hover_enabled=”off” button_one_border_width__hover_enabled=”off” button_two_border_width__hover_enabled=”off” button_border_color__hover_enabled=”off” button_one_border_color__hover_enabled=”off” button_two_border_color__hover_enabled=”off” button_border_radius__hover_enabled=”off” button_one_border_radius__hover_enabled=”off” button_two_border_radius__hover_enabled=”off” button_letter_spacing__hover_enabled=”off” button_one_letter_spacing__hover_enabled=”off” button_two_letter_spacing__hover_enabled=”off” button_bg_color__hover_enabled=”off” button_one_bg_color__hover_enabled=”off” button_two_bg_color__hover_enabled=”off”][\/et_pb_contact_field][\/et_pb_contact_form][\/et_pb_column][et_pb_column type=”2_5″ _builder_version=”3.25″ custom_padding=”|||” custom_padding__hover=”|||”][et_pb_text _builder_version=”4.0.11″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark”]Operatorul PDI 2020[\/et_pb_text][et_pb_text _builder_version=”4.0.11″ text_font=”||||||||”]<\/p>\n
\nTel.: 0332.40.88.00-05
\nE-mail: inscrieri@primaderma.ro<\/a>
\nWebsite:\u00a0www.eventernet.ro<\/a>[\/et_pb_text][et_pb_text disabled_on=”off|off|off” _builder_version=”4.0.11″ text_font=”Kaushan Script||||||||” text_text_color=”#f0622a” text_font_size=”30px” header_font=”||||||||” background_layout=”dark” locked=”off”]Parteneri Media[\/et_pb_text][et_pb_gallery gallery_ids=”7203,7204,7232,7231″ fullwidth=”on” _builder_version=”4.0.11″ transform_scale=”86%|86%” max_width=”63%” auto=”on” auto_speed=”3500″ hover_transition_duration=”100ms” hover_transition_delay=”50ms” hover_transition_speed_curve=”ease-in-out” locked=”off”][\/et_pb_gallery][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"