Browsing by Author "Goecke, Annelise"

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    Enfermedad relacionada a IgG4. Serie clínica de pacientes chilenos
    (2022) Cuéllar, María C.; Gutiérrez, Miguel; Herrera, Alejandra; Elgueta, Fabián; Wurmann, Pamela; Badilla, Natalia; Mansilla, Bellanides; Basualdo, Javier; Vega, Jorge; Erlij, Daniel; Labarca, Cristian; Vergara, Cristian; Mezzano, Verónica; Méndez, Ignacio; Stange, Lilith; Michalland, Susana; Silva, Francisco; Jara, Aquiles; Goecke, Annelise; Burgos, Paula; Iruretagoyena, Mirentxu; Fernández, Cristina; Landeros, Carolina; Neira Quiroga, Oscar
    Background: IgG4-related disease (IgG4 RD) is an immune-mediated fibro-inflammatory disorder, with tissue infiltration of IgG4+ plasma cells. It causes pseudotumors, tumors, and a wide spectrum of clinical manifestations. Aim: To report the clinical, laboratory, histopathological and treatment characteristics of a group of Chilean patients with IgG4 RD. Material and Methods: Review of medical records of 52 patients aged 18 to 76 years with IgG4 RD seen at six medical centers. Results: Elevated IgG4 serum levels (> 135 mg/dl) were found in 18 of 44 (41%) patients. There was histological confirmation of the disease in 46 patients. The most common sites of involvement were lungs, eyes and kidneys. Eighteen (35%) patients had only one organ involved, 34 (65%) patients had two organs and 13 (25%) patients had three or more organs. The involvement of two organs was significantly more common in men (p < 0.05). In patients with only one organ involvement, the most frequent location was orbital and meningeal. All patients with kidney or lung disease had multiorgan involvement. All patients received corticosteroid therapy, 67% synthetic immunosuppressants, and 16% rituximab. Conclusions: ER-IgG4 can affect any tissue. Multiorgan involvement was more common in this series, with preference for lungs, eyes and kidneys. An excellent response to steroids is characteristic of the disease, but with a high relapse rate that requires additional immunosuppression.
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    Glucocorticoid Receptor-α and MKP-1 as Candidate Biomarkers for Treatment Response and Disease Activity in Vogt-Koyanagi-Harada Disease
    (Elsevier Inc, 2019) Urzúa, Cristhian; Chen, Ping; Chaigne-Delalande, Benjamin; Liu, Baoying; Anguita, Rodrigo; Guerrero, Julia; Sabat, Pablo; Velásquez, Víctor; Sen, Nida; Lee, Richard; Goecke, Annelise
    Purpose To investigate the potential of utilizing the expression of genes for glucocorticoid receptor (GR) and mitogen-activated protein kinase phosphatase-1 (MKP-1) as biomarkers of corticosteroid (CS) refractoriness and disease activity in patients with Vogt-Koyanagi-Harada (VKH) disease. Design Prospective cohort study. Methods Twenty VKH patients receiving their first cycle of CS treatment in the absence of additional systemic immunosuppressive therapy and a control group of fifteen healthy volunteers were recruited from the University of Chile (Santiago, Chile) and US National Institutes of Health (Bethesda, United States). Intraocular inflammation was clinically quantified at enrolment and all follow-up visits. CS refractoriness was defined as an ocular reactivation of VKH upon CS withdrawal at a daily oral prednisone dose of 10 mg or more. Quantitative Reverse transcription polymerase chain reaction (qRT-PCR) was performed to measure the mRNA levels of the alpha (α) and beta (β) isoforms of GR and MKP-1 in peripheral blood mononuclear cells (PBMC) after in vitro stimulation with either anti-CD3/anti-CD28 antibodies, lipopolysaccharide (LPS), or phytohemagglutinin (PHA), in the presence or absence of dexamethasone (Dex). Results After 6 hours of stimulation in the presence of Dex, PBMC from CS-refractory VKH patients had an impaired elevation in GRα expression (P = .03). Furthermore, inactive patients showed a significant Dex-induced upregulation of MKP-1 (P = .005). Conclusions In this pilot study, the expression of GR isoforms and MKP-1 corresponded with patients' clinical response to systemic CS treatment and disease activity, respectively. Hence, these candidate biomarkers have potential clinical utility in the early identification of CS refractoriness and subclinical inflammation in patients with VKH disease.
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    Recomendaciones sobre el manejo del compromiso renal del lupus eritematoso sistémico. Documento de Consenso de las Sociedades Chilenas de Nefrología y Reumatología
    (Sociedad Medica de Santiago, 2015) Aguirre, Verónica; Alvo, Miriam; Ardiles, Leopoldo; Carpio, Daniel; Foster, Carolina; Goecke, Annelise; Jalil, Roberto; Massardo, Loreto; Palma, Sergio; Roessler, Emilio; Wurgaft, Andrés
    Renal involvement affects over one half of patients with Systemic Lupus Erythematosus increasing their mortality and morbidity, including chronic renal disease and the need of renal replacement therapies. Aiming to achieve a consensus in the most relevant topics on diagnosis, therapy and follow-up of patients with lupus renal disease, the Chilean Societies of Nephrology and Rheumatology constituted a workgroup that, based on a critical review of the available literature and their experience, raised and answered by consensus a set of relevant questions. This document includes aspects related to the clinical diagnosis, the importance of a suitable histological classification, therapeutic alternatives to induce and maintain disease remission, strategies for follow-up, additional therapies and gynecological-obstetric issues.

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