Flavio Signorelli

Hospital Universitário Clementino Fraga Filho | HUCFF / UFRJ · Department of Internal Medicine

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 hundr...

Background: Characteristics of primary APS (PAPS) in the youth population have never been studied. In contrast with children, pregnancy is genuinely relevant in the youth age, and understanding clinical characteristics of PAPS patients within this specific age stratum may also provide insights regarding the well-known risk of poor obstetric outcome...

Background/Purpose: Primary Antiphospholipid Syndrome (PAPS) patients, when submitted to Systemic Lupus Erythematosus (SLE) classification criteria, can be misclassified. The new 2019 ACR/EULAR classification criteria have never been applied for PAPS patients. The main objective of this study is to evaluate the risk of misclassifying thrombotic PAP...

Objective There is a broad spectrum of eye involvement in antiphospholipid syndrome (APS). The majority of descriptions are presented as case reports that include mostly APS patients secondary to systemic lupus erythematosus (SLE), with no compelling evidence in primary APS (PAPS). This study aimed to describe ocular manifestations in our well-defi...

Aim: To investigate clinical and serologic features of antiphospholipid (aPL) patients with thrombocytopenia. Methods: A cross-sectional study was performed in 140 outpatients with persistent aPL at least 12 week apart, fulfilling or not Primary Antiphospholipid Syndrome (PAPS) classification criteria (Sydney). Clinical characteristics (demographic...

Aim: To investigate clinical and serologic features of primary antiphospholipid syndrome (PAPS) in thrombotic patients with three or more embryonic losses and to explore the utility of aGAPSS in this scenario. Methods: A cross-sectional study was performed with 88 outpatients classified as thrombotic PAPS according to updated Sapporo criteria (Sydn...

Background: Arterial events are a major concern when treating patients with isolated or primary (pAPS), and traditional cardiovascular risk factors may have an important role in increasing their occurrence. The aim of this study was to detect which of these factors were associated with increased risk of arterial events in our cohort of pAPS patient...

Background: Antiphospholipid syndrome (APS) is associated with different clinical and laboratorial manifestations that may impact treatment, but were not included in the current classification criteria (Sydney). The aim of this study is to evaluate the frequency of noncriteria manifestations in our population and their correlation with demographic...

Current therapeutic recommendations for thrombosis prevention in patients with antiphospholipid syndrome (APS) are limited to anticoagulation with vitamin K antagonists (VKA) or heparins and to anti-platelet aggregating agents. Maintaining optimized anticoagulation to prevent recurrent thrombosis or bleeding remains a therapeutic challenge. Althoug...

Purpose of review: Tuberculosis (TB) is a millenarian chronic infection and, yet, remains a major global health problem. The interaction between systemic lupus erythematosus (SLE) and TB is complex, as one seems to be a risk factor for the development of the other. SLE patients are more likely to develop TB, that is more frequently extrapulmonary,...

Catastrophic antiphospholipid syndrome (CAPS) is a rare and life-threatening disease. It is characterized by multiple arterial and/or venous thrombotic events, including the microcirculation, occurring in a short period, and can affect any system. Catastrophic antiphospholipid syndrome can occur in individuals with known APS under treatment, or it...

Background/Purpose: The adjusted Global AntiPhospholipid Syndrome Score (aGAPSS) was described as a tool to estimate the risk of thromboses in patients with APS. The aim of this study is to evaluate if higher values of aGAPSS correlate with the presence of arterial or venous thromboses in thrombotic primary APS patients. Methods: A cross-sectional...

Background The management of patients with recurrent thromboses/pregnancy morbidity and transient detection of antiphospholipids antibodies (aPL) can be a medical challenge. Although these patients are commonly seen in practice, there are no specific guidelines for the treatment in this situations. Objectives To investigate the clinical difference...

Background Triple positivity (TP) to antiphospholipid antibodies (aPL) has been associated with increased risk of thrombotic and gestational events in different populations of antiphospholipid syndrome (APS) patients. Nonetheless, the majority of the studies evolved APS secondary to systemic lupus erythematosus (SLE). Objectives To investigate whe...

Background Antiphospholipid syndrome (APS) is the thrombophilia associated with the highest risk of recurrence of both arterial and venous thromboses. (1,2) In addition to the standard of care (lifelong oral anticoagulation), identification of other risk factors is important to provide better care and to reduce the incidence of rethrombosis. Objec...

Opportunistic infections can cause manifestations that resemble neuropsychiatric systemic lupus erythematosus and they can also trigger lupus flares. Therefore, central nervous system infections as differential diagnosis in neuropsychiatric systemic lupus erythematosus may be difficult, leading to delayed diagnosis and specific treatment. Central n...

Antiphospholipid Syndrome (APS) is an autoimmune disease characterized by recurrent thromboses and fetal losses with the presence of antiphospholipid antibodies. The main treatment to prevent recurrent thrombotic events is oral anticoagulation with vitamin K antagonist (VKA), which requires frequent monitoring and dosage adjustments. Outpatient ant...

The current treatment for antiphospholipid syndrome (APS) with thrombotic manifestation is long-term anticoagulation. Vitamin K antagonists (VKA) are usually the agents of choice. However, VKA limitations, such as unpredictable anticoagulation effects due to interaction with diet and other drugs, require regular monitoring. This may impact on patie...

Adherence to treatment is fundamental for its success. It comprises compliance combined with persistency and should be constantly reassessed. This is true in all medical situations. In antiphospholipid syndrome (or Hughes' syndrome), in addition to taking the medication at the planned time so that its effect on blood can be assessed and the dose ad...

The 'Task Force on Catastrophic Antiphospholipid Syndrome (CAPS)' was developed on the occasion of the 14th International Congress on Antiphospholipid Antibodies. The objectives of this Task Force were to assess the current knowledge on pathogenesis, clinical and laboratory features, diagnosis and classification, precipitating factors and treatment...

The aim of this study was to investigate whether initial and accrued organ damage measured by Systemic Lupus International Collaborating Clinics (SLICC) Damage Index (SDI) predicts mortality in cohort of Brazilian patients with systemic lupus erythematosus (SLE). One hundred and five outpatients with SLE were enrolled from July 2000 to March 2001;...

To determine the prevalence of dyslipoproteinemias and their related factors in a Brazilian systemic lupus erythematosus (SLE) population, fasting lipids were measured in 185 female SLE outpatients. Age, BMI, smoking, post-menopausal status, presence of diabetes and hypertension, SLE duration, number of ARA criteria, drug treatment and disease acti...