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Coelho, Mariana Guimarães. "Histopatologia da paracoccidioidomicose : granuloma sarcoide e formas pequenas do paracoccidioides." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2015. http://hdl.handle.net/10183/143063.
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A paracoccidioidomicose (PCM) é uma infecção sistêmica causada pelo fungo Paracoccidioides sp. A doença é endêmica na maior parte dos países da América Latina, sendo os pulmões os órgãos mais afetados. O diagnóstico de PCM é feito com base na história clínica e epidemiológica, e confirmado pela visualização microscópica das estruturas fúngicas do Paracoccidioides a partir de secreções ou tecidos. Por vezes, a apresentação clínica e os achados histopatológicos da PCM simulam os de outras doenças, como a sarcoidose, e ocasionalmente são encontradas nas lesões formas excepcionalmente pequenas do Paracoccidioides, que podem ser confundidas com outros fungos, como o Histoplasma capsulatum. O presente trabalho objetivou identificar e caracterizar os casos que simularam sarcoidose e os que apresentaram formas pequenas de Paracoccidioides dentre os 856 casos de paracoccidioidomicose diagnosticados no Laboratório de Micologia do Complexo Hospitalar Santa Casa de Porto Alegre, no período de 1981 a dezembro de 2013. Foram identificados 8 casos mimetizando a sarcoidose e 12 apresentando formas pequenas de Paracoccidoides. Dos casos que simularam a sarcoidose, todos eram fumantes do sexo masculino, com idades variando entre 27 e 59 anos (média = 42,5 anos) e apresentaram tosse produtiva, infiltrado fibronodular bilateral aos exames de imagem e granulomas sarcoides na biópsia pulmonar, recebendo prednisona como tratamento inicial. O diagnóstico de PCM, nestes casos, foi realizado por meio de cortes histológicos corados ao GMS (n=8), exame direto do escarro (n=2) e imunodifusão (n=4). Dentre os casos que apresentaram formas pequenas do Paracoccidioides, todos eram fumantes, tinham idades variando entre 33 e 68 anos (média = 55,58 anos), 10 eram do sexo masculino, e 10 apresentavam sintomas consistentes com os da PCM (dois pacientes eram assintomáticos). O diagnóstico etiológico, em todos os casos, foi realizado por meio de cortes histológicos seriados corados ao GMS (que revelaram as formas multibrotantes patognomônicas do Paracoccidioides) e corroborado por exame direto do escarro (n=3), imunodifusão (n=6) e cultura (n=1). Com isto, ressalta-se a importância da consideração dos diagnósticos diferenciais da paracoccidioidomicose. Visto que a sarcoidose é um diagnóstico de exclusão, o achado de granulomas epitelioides sem necrose deve incitar a busca ativa por agentes etiológicos com a utilização das colorações de ZN e GMS. E nos casos em que se encontram formas pequenas ou pouco usuais do Paracoccidioides, devem-se realizar cortes histológicos seriados e escalonados corados ao GMS e utilizar técnicas laboratoriais complementares, como imunodifusão e cultura, para assegurar o seu diagnóstico.Paracoccidioidomycosis (PCM) is a systemic infection caused by the fungus Paracoccidioides sp. The disease is endemic in most Latin American countries, and the lungs are the most affected organs. The diagnosis of PCM is based on clinical and epidemiological features, and confirmed by the microscopic visualization of yeasts of Paracoccidioides from clinical specimens. Sometimes the clinical presentation and histopathological findings of PCM mimic those of other diseases, such as sarcoidosis, and occasionally exceedingly small forms of Paracoccidioides are found in lesions, which can be confused with other fungi, such as Histoplasma capsulatum. This study aimed to identify and characterize the cases that simulated sarcoidosis and those with small forms of Paracoccidioides among the 856 cases of paracoccidioidomycosis diagnosed in the Mycology Laboratory of the Hospital Complex Santa Casa de Porto Alegre, from 1981 to December 2013. 8 cases were identified mimicking sarcoidosis and 12 with small forms of Paracoccidoides. All the cases that mimicked sarcoidosis were male smokers, aged between 27 and 59 years (mean = 42.5 years) and had productive cough, bilateral fibronodular infiltrates on X-ray and sarcoid granulomas in the lung biopsy, receiving prednisone as initial treatment. The diagnosis of PCM in these cases was carried out by histological sections stained with GMS (n = 8), direct examination of sputum (n = 2) and immunodiffusion (n = 4). Among the cases with small forms of Paracoccidioides, all were smokers, aged between 33 and 68 years (mean = 55.58 years), 10 were male, and 10 had symptoms consistent with PCM (two patients were asymptomatic). The etiologic diagnosis in all the 12 cases was made by serial tissue sections stained with GMS (which revealed the multibudding pathognomonic forms of Paracoccidioides) and confirmed by direct examination of sputum (n = 3), immunodiffusion (n = 6) and culture (n = 1). In conclusion, it is emphasized the importance of considering the differential diagnosis of paracoccidioidomycosis. Since sarcoidosis is a diagnosis of exclusion, the finding of epithelioid granulomas without necrosis should encourage the active search for etiologic agents with the use of ZN and GMS stains. And in cases in which small or unusual forms of Paracoccidioides are found, serial histological sections stained with GMS and complementary laboratory techniques such as immunodiffusion and culture should be performed to ensure their diagnosis.
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Foley, Patrick James. "Immunogenetic predisposition in sarcoidosis." Thesis, Imperial College London, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399271.
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Araújo, Ana Rafaela da Silva. "Caracterização dos doentes com diagnóstico de sarcoidose do serviço de pneumologia do CHCB entre os anos de 2001 e 2010." Master's thesis, Universidade da Beira Interior, 2011. http://hdl.handle.net/10400.6/892.
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Introdução: A Sarcoidose é a doença pulmonar intersticial mais frequente. Afecta predominantemente adultos jovens e caracteriza-se pela presença de adenopatias hilares bilaterais, infiltrados pulmonares, lesões oculares e cutâneas, mas virtualmente qualquer órgão pode estar envolvido. O diagnóstico é estabelecido quando os achados clínico-radiológicos são suportados pela evidência histológica de granulomas não caseosos. Níveis aumentados de enzima conversora de angiotensina e metabolismo anormal do cálcio são dois marcadores de actividade da patologia. A corticoterapia permanece o marco do tratamento e a remissão espontânea é comum, contudo alguns doentes evoluem para a cronicidade. Permanece um diagnóstico desafiante, pela imprevisibilidade que a caracteriza, afectando todos os doentes de forma diferente.
Objectivos: Caracterizar epidemiologicamente e clinicamente os doentes com diagnóstico de Sarcoidose do Serviço de Pneumologia do CHCB e realizar correlação dos resultados com o estado da arte.
Material e métodos: foi realizada a análise dos processos clínicos individuais dos doentes adultos com diagnóstico de Sarcoidose do Serviço de Pneumologia do CHCB, entre os anos de 2001 e 2010, incluindo os doentes internados e não internados, recorrendo a informações cedidas pelo Serviço de Pneumologia para a constituição da amostra. Para o tratamento estatístico recorreu-se a testes de estatística descritiva e ao t-student na comparação de grupos.
Resultados: A média de idades dos 34 doentes da amostra foi de 47,26 anos, sendo a maioria dos doentes do sexo feminino (22). Quanto aos hábitos tabágicos, a maioria era não fumadora (85%). As principais ocupações desempenhadas pelos pacientes na altura do diagnóstico foram a indústria têxtil (oito) e serviços administrativos (sete). O eritema nodoso foi o sintoma inicial mais frequente. 56% da amostra analisada apresentava um estudo funcional respiratório normal e em 11 doentes foi encontrada uma alteração obstructiva. A capacidade de difusão do monóxido de carbono (DLCO) estava normal em 82% do grupo analisado. Na radiografia do tórax, o reforço hilar bilateral estava presente em 53% dos doentes. Na TC torácica, o padrão micronodular (nove) e as adenopatias mediastínicas e hilares bilaterais (15) foram os achados mais frequentes. Dos doentes que realizaram lavado broncoalveolar, dez apresentavam uma relação CD4/CD8 superior a 3,5. O procedimento mais realizado para obtenção do diagnóstico histológico foi a mediastinoscopia (56%). A enzima conversora de angiotensina estava aumentada em 50% da amostra, a velocidade de sedimentação em 24%, a calcémia em 12%, a calciúria e a creatinina em 9% e a fosfatase alcalina em 12%. A maioria dos doentes iniciou tratamento médico no momento do diagnóstico (79%), sendo que nove destes doentes cessaram o mesmo por remissão da doença. Contudo três reiniciaram corticoterapia por doença recidivante. A fibrose pulmonar foi a complicação mais frequente (12%), mas a maioria da amostra (79%) não desenvolveu complicações.
Conclusões: Verificou-se que a maioria dos resultados obtidos para a amostra analisada estão de acordo com a literatura vigente, nomeadamente em relação ao género acometido, aos hábitos tabágicos, à sintomatologia inicial, dominada pelo envolvimento cutâneo, ocular e pulmonar, estudo funcional respiratório, alterações na radiografia do tórax e TC torácica, relação CD4/CD8, tratamento realizado e complicações desenvolvidas durante a evolução. O mesmo não se verificou na totalidade para a idade do diagnóstico, modalidade de biópsia utilizada e alguns parâmetros analíticos estudados. A Sarcoidose é uma doença com grande variabilidade à apresentação, com inúmeras dificuldades diagnósticas e com um curso imprevisível, sendo um terreno fértil para a investigação.Introduction: Sarcoidosis is the most common interstitial lung disease. It affects primarily young adults and it is characterized by the presence of bilateral hilar adenopathy, pulmonary infiltrates, skin and eye damage, however virtually any organ can be involved. The diagnosis is established when the clinical and radiographical findings are supported by histological evidence of noncaseating granulomas. Increased levels of angiotensin converting enzyme and abnormal calcium metabolism are two markers of disease activity. Corticosteroid therapy remains the hallmark of treatment and spontaneous remission is common, but some patients progress to chronicity. Remains a challenging diagnosis due to its characteristic unpredictability, affecting every patient differently. Objectives: To clinically and epidemiologically characterize the patients diagnosed with Sarcoidosis of the Pneumology Department of CHCB and perform correlation of the results with current literature. Materials and Methods: We performed an analysis of the individual clinical files of adult patients diagnosed with Sarcoidosis of the Pneumology Department of CHCB, between 2001 and 2010, including inpatients and outpatients, using information provided by the Department of Pneumology for the formation of sample. For statistical tests we used descriptive statistics and t-student in the comparison group. Results: The average age of the 34 patients in the sample was 47.26 years, and most patients were female (22). Regarding smoking habits, the majority were non smokers (85%). The main occupations performed by patients at diagnosis were the textile industry (eight) and administrative services (seven). Erythema nodosum is the most common initial symptom. 56% of the sample had a normal lung function and in 11 patients was found an obstructive change. The diffusing capacity for carbon monoxide (DLCO) was normal in 82% of the analyzed group. On chest radiograph, bilateral hilar strengthening was present in 53% of patients. On CT scan, the micronodular pattern (nine) and bilateral hilar and mediastinal adenopathy (15) were the most frequent findings. Among the patients who underwent bronchoalveolar lavage, ten had a CD4/CD8 ratio greater than 3,5. The procedure most often performed to obtain the histological diagnosis was mediastinoscopy (56%). The angiotensin converting enzyme was increased in 50% of the sample, erythrocyte sedimentation rate in 24%, increased calcium blood levels in 12%, calciuria and creatinine in 9% and alkaline phosphatase in 12%. Most patients started treatment at the time of diagnosis (79%), and nine of these patients stopped the treatment because of disease remission. However three of these patients restarted corticosteroid therapy because of disease recurrence. Pulmonary fibrosis was the most frequent complication (12%), but most of the sample (79%) developed no complications. Conclusions: We found that most of the results obtained for the analyzed sample are consistent with the current literature, particularly with regard to the affected gender, smoking habits, the initial symptoms, dominated by cutaneous, ocular and pulmonary involvement, lung function studies , changes on chest radiograph and CT scan, CD4/CD8 ratio, performed treatment and complications developed during evolution. The same was not true for the age at diagnosis, type of biopsy utilized and some analytical parameters studied. Sarcoidosis is a disease with great variability at presentation, with numerous diagnostic difficulties and with an unpredictable course, being a fertile ground for research.
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BAUDOIN, MARIE-FRANCE. "La sarcoidose de l'enfant." Nancy 1, 1992. http://www.theses.fr/1992NAN11028.
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Boruchowicz, Arnaud. "Sarcoidose et tube digestif." Lille 2, 1993. http://www.theses.fr/1993LIL2M136.
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Amiel, Olivier. "Erythroblastopenie chronique et sarcoidose." Aix-Marseille 2, 1994. http://www.theses.fr/1994AIX20161.
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Rosa, Bárbara Santa. "Sarcoidose, dúvidas ou certezas? : proposta de protocolos de abordagem ao doente." Master's thesis, Universidade da Beira Interior, 2009. http://hdl.handle.net/10400.6/1019.
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Introdução: A Sarcoidose permanece uma das doenças mais desafiadoras em medicina. Pode afectar qualquer sistema de órgãos e apresentar uma grande variedade de sinais e sintomas. Apesar da resolução espontânea da doença ser a regra a evolução para a cronicidade ocorre em 10 a 30% dos doentes e 5 a 8% vão eventualmente morrer, sendo a principal causa de morte a insuficiência respiratória.
Objectivo: Fazer uma revisão teórica e propor protocolos de diagnóstico, tratamento e seguimento com base nos últimos avanços científicos sobre a Sarcoidose, podendo por ventura melhorar a abordagem a estes doentes e impulsionar mais estudos sobre a etiologia e a patogénese da doença.
Métodos: Recolha de bibliografia através das bases de dados digitais tais como PubMed, Portal B-on e Cochrane com os termos “Sarcoidosis” e “historic review”, “epidemiology”, “diagnosis”, “course and prognosis”, “treatment”, “follow-up”, “guidelines”. Nos idiomas Português, Inglês, Francês e Espanhol.
Discussão: A Sarcoidose é uma doença multissistémica. A sua incidência é de sensivelmente 16.5/100 000 nos homens e de 19/100 000 nas mulheres. Pode atingir qualquer órgão. Sintomas mais comuns são dispneia, tosse e dor torácica. É comum o aparecimento de adenopatias hilares bilaterais e infiltrados pulmonares difusos na radiografia e lesões na pele ou oculares. O granuloma não caseoso é histologicamente característico da Sarcoidose. O diagnóstico faz-se através da apresentação clínica e curso da doença, por exclusão de outras doenças granulomatosas e, na maioria dos casos, por confirmação histológica através de biopsia dos granulomas. O diagnóstico diferencial é extenso e deve incluir infecção e neoplasia. As indicações para tratamento são doença pulmonar sintomática, deterioração da doença pulmonar, hipercalcemia e envolvimento extra-pulmonar. Muitos doentes com alterações na radiografia do tórax e nos testes de função pulmonar têm doença crónica estável e não requerem terapêutica. Os corticoesteróides são a terapêutica de primeira linha. Cerca de 60% dos doentes sofrem recaída.
Conclusão: Apesar dos avanços na compreensão da patogénese e tratamento da doença, muitos enigmas permanecem. A procura de um agente estiológico continua. Existem dúvidas sobre o mecanismo envolvido na destruição inflamatória que ocorre nos granulomas não caseosos da Sarcoidose. A avaliação laboratorial da actividade da doença baseia-se em testes inespecíficos, sendo importante descobrir biomarcadores mais específicos. Na área do tratamento há ainda controvérsia sobre quais os doentes a tratar e qual a terapêutica mais adequada. São necessários mais estudos em nestas áreas.
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Pereira, Marisa. "Sarcoidose : estudo de 138 casos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 1994. http://hdl.handle.net/10183/118302.
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A autora estudou 138 pacientes com o diagnóstico de sarcoidose, sendo esta uma das maiores séries do Brasil. Estes pacientes foram atendidos no Pavilhão Pereira Filho, Serviço de Doenças Pulmonares, da Santa Casa de Misericórdia de Porto Alegre, no período de 1967 a 1989. Os objetivos do trabalho foram avaliar os critérios disponíveis em nosso meio para investigação diagnóstica, estadiamento, tratamento e estabelecimento do prognóstico da doença. O protocolo aplicado nesta série p~ocurou delinear o quadro cl ínico, radiológico e laboratorial. Foram incluídos no trabalho 79 mulheres (57%) e 59 homens (43%), dos quais 106 brancos (77%) e 32 pretos (23%), com idades entre 4 e 77 anos, e média de 31 anos. Os resultados obtidos foram comparados aos da 7ª Conferência Internacional sobre Sarcoidose (1975). Assim, encontrou-se 82% dos casos com menos de 40 anos de idade, o que demonstrou uma diferença estatisticamente significativa em relação ao estudo multicêntrico de 3.676 casos, que apresentou 68%. Não houve diferença quanto ao sexo. Tanto a presente série quanto o estudo multicêntrico mostraram uma grande proporção de negros. Em 98,5% da série houve envolvimento intratorácico; no estudo multicêntrico, 92%. O perfil clínico demonstrou um índice significativo de linfonodos periféricos (30,5%) e de lesões oculares (18,8%). Em 79% dos casos sintomáticos o tempo do início dos sintomas foi inferior a dois anos. Não houve diferença significativa nos percentuais de casos dos tipos radiológicos I e 11 (38,4% e 36,2%, respectivamente). Houve menor incidência dos tipos radiológicos O e I em comparação com O· estudo multicêntrico. Houve comprometimento ocular detectado somente através de angiografia ocular com fluoresceína em 10/46 casos (21 ,7%). O teste tuberculínico foi negativo em 91,0% dos casos, enquanto na série multicêntrica o foi em 64%. Houve 11 crianças com sarcoidose fazendo parte desta série. O tratamento com corticóide mostrou-se efetivo em 67% dos casos tratados.The author studied 138 sarcoidosis patients, which represents one of the largest Brazilian series. The patients were attended at the Pavilhão Pereira Filho, Pulmonary Disease Service, of the Santa Casa de Misericórdia de Porto Alegre, from 1967 to 1989. The purposes of the study were to define practical criteria to diagnose, stage, treat and also to establish the prognosis of the disease. The protocol had as main purpose the delineation of the clinicai, radiological and laboratorial picture. The study included 79 women (57%) and 59 men (43%), 106 Caucasians (77%) and 32 Negroes (23%), aging between 4 and 77 years, averaging 31. The results were compared to those of the 7th lnternational Conference on Sarcoidosis (1975). lt was observed 82% of patients aging less than 40 years old, which showed a statistically significant difference in relation to the multicentric study of 3,676 cases, which presented 68%. No difference was found in respect to sex. 8oth studies demonstrated a high proportion of Negroes. There was intrathoracic involvement in 98.5% of our series, and in 92% of the multicentric study. lt was observed a significant involvement of peripheral nades (30.5%) and ophtalmic abnormalities (18.8%). In 79% of symptomatic patients the beginning time of symptoms were less than two years. Radiological types I and 11 were proportionally equivalent (38.4% and 36 .2%, respectively). lncidence of radiological types O and I were lower when compared to the multicentric study. There was ocular abnormality detected only by fluorescein ocular angiography in 1 O of 46 patients (21.7%) . Tuberculin test was negative in 91.0%, against 64% of the multicentric series. There were 11 children with sarcoidosis in this series. Treatment with steroids showed effectiveness in 67% of the treated patients.
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Wasfi, Yasmine S. "Apoptosis-related genetic polymorphisms in sarcoidosis /." Connect to full text via ProQuest. IP filtered, 2005.
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Crawshaw, Anjali Priya. "Monocyte profile and function in sarcoidosis." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:3378bf46-a494-45a0-b68e-81b37c1dae49.
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Sarcoidosis is a multisystem inflammatory disorder of unknown aetiology. The immune pathology is characterised by dysregulated T cell (TH1) activity, macrophage activation and granuloma formation, resulting in systemic inflammation, and organ dysfunction. I hypothesised that, as the systemic precursor to the macrophage, altered monocyte activity in sarcoidosis may contribute to the early immune pathology of the disease. In this thesis, I examined their phenotype, four key monocytic functions: cytokine production, suppression of T cell proliferation, phagocytosis and fusion (as a precursor to granulomagenesis); and their gene expression profile compared to monocytes from healthy controls. My data show that the expanded monocyte compartment comprise a greater proportion of the inflammatory (CD14++CD16+) and patrolling (CD14+CD16++) subsets, increased TNFα and IL-12 and decreased IL-10 and IL-4 production in sarcoidosis compared with healthy controls. The IL-10 deficit renders the monocytes less able to regulate T cell proliferation or their own fusion to multinucleate giant cells, potentially contributing to T cell expansion and granuloma formation respectively. Additionally, sarcoidosis monocytes are less able to phagocytose inert material. I also showed that previously reported deficiency in invariant NKT cells and low serum vitamin D levels in sarcoidosis may be linked to reduced IL-10 production by monocytes. Vitamin D treatment in vitro restored most of these deficiencies and provides a potential therapeutic method for manipulating monocyte function and disease genesis in sarcoidosis.
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Mouchtaridi, Elli. "The role of exosomes in sarcoidosis." Thesis, Uppsala universitet, Institutionen för biologisk grundutbildning, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-446010.
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Sarcoidosis is a systemic inflammatory disease mostly affecting the lungs, marked by the presence of granulomas and the accumulation of interferon gamma (IFNγ)-producing T cells in the affected organs. Extracellular vesicles (EVs) are membranous vesicles with a size range of 50 nm to 5000 nm, with exosomes ranging from 50 to 150 nm. They are major players in intercellular communication and have been found in all body fluids including plasma. In this study, we wanted to characterize the exosomes from sarcoidosis patients’ plasma and try to detect differences in their surface marker expression. Additionally, we aimed to investigate the cellular origin of these exosomes in the blood circulation of mice. We used a combination of Nanoparticle Tracking Analysis (NTA), Transmission Electron Microscopy (TEM), Western Blot and Flow cytometry as characterization methods. Moreover, we took advantage of immune cell-specific knock-out mice (Rag KO, Ly6G-Mcl-1 KO) and examined the effect on the number of vesicles and on the marker expression levels on the vesicle surface. We showed that in Rag KO mice, that lack mature B cells and T cells, the levels of T cell markers CD4 and CD8 were decreased. No difference was detected between wild type and neutrophil KO mice on neither of the neutrophil-specific markers Ly6G and CD11b. Sarcoidosis patient plasma EVs showed lower levels of CD9 expression compared to healthy subjects. Differences were observed in a subgroup of patients, namely Löfgren syndrome patients that exhibited higher CD31 expression than the non-Löfgren patients. Overall, our data indicate a possible contribution of the immune cell-derived exosomes in the blood. Furthermore, differences detected in the sarcoidosis plasma EVs could give a better insight on the role of those exosomes during lung inflammation and provide grounds for their use as liquid tissue biomarkers.
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Koivunen, Elli. "Hematologiset löydökset sarkoidoosissa Haematological findings in sarcoidosis /." Tampere : Tampereen yliopisto, 1985. http://catalog.hathitrust.org/api/volumes/oclc/57781487.html.
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Planck, Anders. "Sarcoidosis : inflammatory mechanisms and markers of activity /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-355-4/.
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Spagnolo, Paolo. "Genetic determinants of clinical phenotypes of sarcoidosis." Thesis, Imperial College London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.498439.
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Fraser, Simon D. "Peripheral blood leukocyte immune responses in sarcoidosis." Thesis, University of Hull, 2016. http://hydra.hull.ac.uk/resources/hull:15182.
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Sarcoidosis is a multisystem granulomatous inflammatory disease of unknown aetiology with heterogeneous clinical manifestations. The disease is characterised by elevated Th1-like pro-inflammatory immune responses in tissue, whereas peripheral blood has been described as either having enhanced, diminished or similar responses in patients compared with healthy controls. The aim of this study was to characterise the immune responses from peripheral leukocytes in patients with sarcoidosis, focussing on inflammatory and regulatory features present in the disease. Immunophenotyping of peripheral blood mononuclear cells (PBMCs) by flow cytometry showed that 86% of patients with sarcoidosis displayed a T-cell lymphocytopenia, with over a 2 fold reduction in cell number compared to healthy controls, confirming the findings of other groups. The proportion of the more pro-inflammatory ‘Intermediate’ monocyte subset (CD14++ CD16+) was increased in patients with sarcoidosis, matched by a reduction in the ‘Classical’ monocyte subset (CD14++ CD16-). High concentrations of phytohaemagglutinin (PHA) induced significantly increased IL-6 and TNF-α release from the blood of patients with sarcoidosis compared with controls in ex vivo whole blood assays. By contrast, IL-6 release in response to a high concentration of Staphylococcal enterotoxin A was significantly reduced in patients. There was no statistically significant difference in cytokine release from patients compared with controls when whole blood was treated with a range of other ligands and cytokines. The regulatory CD200 receptor (CD200R) expression was reduced on monocytes from patients with sarcoidosis, whereas there was no significant difference in IL-10 receptor or SIRP-α expression between patients and controls. The CD200Rlow phenotype on monocytes was associated with elevated PHA induced IL-6 and TNF-α release from whole blood. Patients with sarcoidosis are capable of robust peripheral blood leukocyte immune responses and display alterations in the regulatory CD200R/CD200L axis that may play a role in the immuopathogenesis of the disease.
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Becker, Pascal. "Les localisations neurologiques centrales de la sarcoidose." Nancy 1, 1989. http://www.theses.fr/1989NAN11221.
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Kendrick, Yvonne Rene. "Transcriptomic approach to understanding and characterising disease pathogenesis in sarcoidosis." Thesis, University of Oxford, 2017. http://ora.ox.ac.uk/objects/uuid:a80438bc-ec6f-4f2f-bf59-12ed7e047805.
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Sarcoidosis is a multisystem immunological disorder, centred on the dysregulation of T cell activity, macrophage activation and granuloma formation. Most pulmonary sarcoidosis patients have a good prognosis, but up to 20% can go on to develop lung fibrosis. Previous research in sarcoidosis has generally focused on sarcoidosis as a single disease entity, whereas this thesis has focused on the importance of phenotypical characterisation, in particular active fibrotic pulmonary disease, and the standardisation of measuring disease activity. I first developed a scoring system to measure disease activity based on typical findings on high resolution CT scanning (CTAS). I then identified a set of readily available blood markers and a chest radiographic score as a surrogate for the CT activity score, which enables the physician to easily assess the level of disease activity in the clinic setting (SCAS). Using a transcriptomic approach, I used the activity score to identify the immunological pathways and individual genes correlating directly with increasing activity, both at the site of disease and in the periphery. Enrichment of immune response and defense response gene sets, particularly in BAL cell samples, were observed as disease activity increased, with CCR2, TREM2, and CCL18 featuring as prominent genes involved in the propagation of activity. CXCL9 and CXCL10 were identified as peripheral markers of active disease reflecting the activity in various compartments. In addition, after phenotyping patients with active disease into those with and without fibrosis, differential gene expression showed enrichment of immune related gene sets in the fibrotic cohort, and highlighted the roles of several significantly upregulated genes including CCL19, CCR7, CXCR3, CCR2, ADAMDEC1 and MMP12 in the pathogenesis of fibrotic sarcoidosis. Finally, enrichment of an IPF signature derived from differential expression to sarcoidosis, was observed in the fibrotic sarcoidosis cohort. This information may lend itself to further therapeutic treatments options already used in other fibrotic lung conditions in this interesting and understudied phenotype.
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Wirnsberger, Ruth Margarethe. "Quality of life and health status in sarcoidosis." [Maastricht : Maastricht : Universiteit Maastricht] ; University Library, Maastricht University [Host], 1999. http://arno.unimaas.nl/show.cgi?fid=8565.
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Saboor, Syed Abdul. "Detection of mycobacterial DNA in tuberculosis and sarcoidosis." Thesis, University College London (University of London), 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.283519.
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BROS, SCHUMACHER MARIE. "L'association maladie de hodgkin - sarcoidose existe-t-elle ?" Toulouse 3, 1991. http://www.theses.fr/1991TOU31026.
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GAYOT, BRIGITTE. "Sarcoidose et purpura thrombophenique : a propos d'un cas." Lyon 1, 1990. http://www.theses.fr/1990LYO1M378.
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GILBERT, EMMANUEL. "Association sarcoidose - sida : a propos d'un cas clinique." Lyon 1, 1988. http://www.theses.fr/1988LYO1M234.
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FABRI, MARIE-CHRISTINE. "Atteinte intestinale infraclinique au cours de la sarcoidose." Lille 2, 1989. http://www.theses.fr/1989LIL2M280.
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Lebourgeois, Bruno. "Sarcoidose aigue fibrosante : a propos de 3 observations." Lille 2, 1988. http://www.theses.fr/1988LIL2M119.
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Brådvik, Ingela. "Lung functions studies in diagnostics and follow-up of pulmonary sarcoidosis." Lund : Dept. of Lung Medicine and the Dept. of Clinical Physiology, University of Lund, 1994. http://catalog.hathitrust.org/api/volumes/oclc/39781480.html.
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Sheffield, Edward Alexander. "The ultrastructural features of developing epithelioid cell granulomas in man." Thesis, University of Southampton, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259692.
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SAVARY, MARIE-LAURE. "Thrombopenie peripherique et sarcoidose : a propos de deux cas." Angers, 1988. http://www.theses.fr/1988ANGE1062.
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HERMANT, BRUNO. "La sarcoidose pulmonaire grave de l'adulte : a propos de 7 observations." Reims, 1991. http://www.theses.fr/1991REIMM002.
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DELLINGER, RIGAUD ELISABETH. "Les arthrites chroniques de la sarcoidose : a propos d'un cas ; revue de la litterature." Lyon 1, 1989. http://www.theses.fr/1989LYO1M325.
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SIGNORET, BRUNO. "Sarcoidose de l'enfant : rappels physiopathologiques ; particularites cliniques et manifestations exceptionnelles (otorhinolaryngologique, pleurale et digestive) ; a partir de deux observations." Reims, 1992. http://www.theses.fr/1992REIMM094.
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LOUIS, LANCRENON CORINNE. "Hypercalcemie majeure revelatrice d'une sarcoidose stade o : a propos d'une observation avec revue de la litterature." Besançon, 1993. http://www.theses.fr/1993BESA3104.
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DOHEN, JEAN-MICHEL. "Granulomatoses pluriviscerales : difficultes du diagnostic etiologique ; a propos d'un cas de sarcoidose." Lille 2, 1994. http://www.theses.fr/1994LIL2M058.
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TRABATTONI, MICHELE. "Les lesions hypodermiques de la sarcoidose : a propos d'un cas avec revue de la litterature." Amiens, 1989. http://www.theses.fr/1989AMIEM080.
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LEGENDRE, CARRARA SOPHIE. "Une observation de sarcoidose medullaire : revue de la litterature." Clermont-Ferrand 1, 1994. http://www.theses.fr/1994CLF1M028.
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PANAYE, JEAN-PAUL. "Sarcoidose et inhibiteurs de l'enzyme de conversion de l'angiotensine." Toulouse 3, 1988. http://www.theses.fr/1988TOU31034.
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CHOPIN, MARTINE. "Sarcoidose osseuse et hypercalcemie : a propos de quatre observations personnelles." Lyon 1, 1992. http://www.theses.fr/1992LYO1M110.
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PEINNEQUIN, ERIC. "Sarcoidose familiale : a propos de cinq cas dans deux familles." Lyon 1, 1992. http://www.theses.fr/1992LYO1M097.
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DARD, LUCIEN. "Sarcoidose et maladie de horton : a propos d'un cas d'association." Besançon, 1991. http://www.theses.fr/1991BESA3013.
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Fernandes, Juliana Cardozo. "Estudo das associações clínicas, radiológicas e funcionais em pacientes com sarcoidose : série de casos." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2009. http://hdl.handle.net/10183/27757.
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Objetivo: Este estudo de uma série de casos de sarcoidose propõe-se a descrever a correlação clinica, radiológica e funcional pulmonar, no momento do diagnóstico. Perfil demográfico, sintomas sistêmicos, manifestações extrapulmonares da doença, associação com outras doenças granulomatosas, histopatologia e achados laboratoriais. Métodos: Estudo retrospectivo de 103 casos com sarcoidose, atendidos em centro de referência no sul do Brasil, entre 1990 e 2003. Resultados: Não houve diferença de frequência entre homens e mulheres (42% e 58% respectivamente). A média de idade foi de 41,8 ± 14,1 anos. Houve predomínio em caucasianos (84%). Dados sobre tabagismo mostraram que 62% dos pacientes nunca fumaram, 29% eram tabagistas em abstinência e 9% tabagistas ativos. Dentre os dados clínicos destacaram-se: 86% eram sintomáticos, dentre eles, 77% tinham sintomas torácicos, sendo os mais prevalentes tosse (48%), dispnéia (41%) e dor torácica (18%). As manifestações extrapulmonares foram encontradas em 80% dos casos, sendo 21% com adenopatia periférica, 20% com artralgia, 17% com alterações cutâneas, 20% com alterações oftalmológicas, 10% com alterações cardiológicas, e 6% com litíase urinária. Sintomas sistêmicos como emagrecimento, febre e astenia foram encontrados em 35%, 23% e 23%, respectivamente. A espirometria foi realizada em 83 (82%) pacientes, com resultados anormais em 45% deles, com os seguintes padrões: restritivo em 23%, obstrutivo em 18% e misto em 4%. A distribuição dos tipos radiológicos mostrou 1% tipo 0, 32% tipo I, 49% tipo II e 18% tipo III. Realizaram radiograma de tórax e função pulmonar simultaneamente 73 pacientes, evidenciando-se correlação significativa entre a presença de distúrbio ventilatório e os tipos radiológicos I, II, III (p = 0,036). Conclusão: Os achados demográficos desta série mostram-se semelhantes aos descritos na literatura, particularmente na população européia. Houve correlação significativa dos diferentes tipos radiológicos (I, II, III) com a presença de alteração funcional pulmonar; entretanto, esses achados radiográficos e funcionais não se mostraram importantemente relacionados com os sintomas clínicos.Objective: This case study, aims to describe the correlation between clinical presentation, radiological findings and pulmonary function tests at the time of the diagnosis. Demographics, symptoms, extra pulmonary manifestation of the disease, association with other granulomatous diseases, hystopathological and laboratorial findings are also described. Methods: A retrospective study of 103 patients with sarcoidosis treated at a referral centre in the south of Brazil , between 1990 and 2003. Results: The gender distribution was not significantly different (men, 42%; women, 58%). Mean age was 41,8 ± 14,1 years. Eighty four percent (84%) of the patients were Caucasians. Sixty two percent (62%) of the patients had never smoked, 29% were former smokers, and 9% were current smokers. Eighty six percent (86%) of the patients were symptomatic, where 77% presented with respiratory symptoms: cough (48%); dyspnea (41%); and chest pain (18%). The extra pulmonary symptoms were present in 80% of patients, lymphadenopathy (21%), articular manifestation (20%), skin lesions (17%), ocular lesions (20%), cardiac manifestations (10%) and renal stones (6%). Constitutional symptoms included like weight loss (35%), fever (23%) and fatigue (23%). Spirometry was performed in 83 (82%) of patients. Abnormal results were observed in 45%: restrictive pattern (23%), obstructive pattern (18%) and mixed pattern (4%). Radiological types were distributed as follows: 1% type 0; 32% type I, 49% type II and 18% type III. Seventy three patients had both chest radiograph and spirometry. Correlation was found between radiological type and function tests (p=0,036). Conclusion: The findings observed on our local cohort were similar to previously published studies from European cohorts. Significant correlation between radiological type and pulmonary function tests was found, although neither radiological type nor severity of pulmonary functional tests correlated with the clinical symptoms.
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GRAGNOLINI, PASCAL. "La neurosarcoidose : a propos de huit observations." Clermont-Ferrand 1, 1990. http://www.theses.fr/1990CLF13031.
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CATTIN, OLIVIER. "Ichtyose sarcoidosique : a propos d'une observation." Lyon 1, 1993. http://www.theses.fr/1993LYO1M031.
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Ruchon, François. "Les manifestations endocriniennes au cours de la sarcoidose : a propos d'une observation." Lille 2, 1988. http://www.theses.fr/1988LIL2M190.
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Dulac-Laveau, Françoise. "Sarcoi͏̈dose familiale : à propos d'un cas clinique." Montpellier 1, 2000. http://www.theses.fr/2000MON11159.
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RONDEPIERRE, DIDIER. "Splenomegalie avec thrombopenie au cours de la sarcoidose : etude d'un cas." Lyon 1, 1990. http://www.theses.fr/1990LYO1M045.
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CHOPRA, SOEB. "Formes pseudo-myopathiques ou myopathiques chroniques et aigues revelatrices de la sarcoidose : trois observations ; revue de la litterature." Nantes, 1991. http://www.theses.fr/1991NANT038M.
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Katchar, Kianoosh. "T lymphocyte and NK cell function in pulmonary inflammation in sarcoidosis /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-625-1/.
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Tomlinson, G. S. "Inflammatory responses by monocytes and macrophages in pulmonary sarcoidosis and infection." Thesis, University College London (University of London), 2012. http://discovery.ucl.ac.uk/1344095/.
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Inflammatory responses by macrophages are essential for host defense, but also underpin the pathogenesis of numerous diseases. I adopted a systems biology approach using transcriptional profiling to investigate monocyte and macrophage inflammatory responses in relation to pulmonary sarcoidosis and infection, to compare alveolar macrophages (AM) and monocyte derived macrophages (MDM), and to probe integrated innate and adaptive immunological responses within the tuberculin skin test (TST). In sarcoidosis I established the importance of prostaglandin endoperoxide synthase (PTGS)2 promoter haplotypes in determining susceptibility to disease across two genetically dissimilar ethnic groups, UK Whites and Afro-Caribbeans, but found no functional effect of promoter haplotype on PTGS2 gene expression, in mononuclear phagocytic cells. In contrast to the widely held view that AM have an anti-inflammatory bias, I show that freshly isolated AM have a striking pro-inflammatory profile that may confound the study of their responses to innate immune stimulation. In human immunodeficiency virus (HIV)/Mycobacterium tuberculosis (Mtb) co-infection I show that HIV-1 infection of macrophages leads to augmented inflammatory responses to Mtb, accompanied by enhanced viral replication, due to deficient induction of anti-inflammatory IL10, via attenuation in mitogen activated protein kinase (MAPK) signalling pathways downstream of TLR2 and dectin-1. These changes were not evident in HIV-1/Streptococcus pneumoniae co-infected macrophages, and the specificity of the effect in Mtb co-infection was mirrored by lower IL10 and higher pro-inflammatory IL1β in HIV-infected patients with pulmonary tuberculosis compared with non-tuberculous infection. Finally, I show that the TST is characterised by Th1 polarised and cytotoxic T cell responses. Distinct innate immune and IFNγ-stimulated gene expression signatures under NFκB and STAT1 transcriptional control and highly enriched for chemokines and MHC class II molecules, provide a mechanism for paracrine amplification of inflammatory responses in the TST. Strikingly, identical responses of lower magnitude were also detectable in clinically negative TST subjects.
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BAURIEDL, LUISE. "Paralysie recurrentielle gauche revelatrice d'une sarcoidose mediastinale : a propos d'une observation." Reims, 1990. http://www.theses.fr/1990REIMM051.
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Neto, Agostinho Hermes de Medeiros. "Estudo da prevalência de hipertensão pulmonar em pacientes com sarcoidose, e sua correlação com aspectos clínicos, sorológicos, radiológicos e funcionais." Universidade de São Paulo, 2011. http://www.teses.usp.br/teses/disponiveis/5/5150/tde-23112011-172934/.
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INTRODUÇÃO: A hipertensão pulmonar (HP) tem impacto prognóstico negativo na sarcoidose. Não foram publicados estudos de rastreamento de HP seguido de confirmação por estudo hemodinâmico da circulação pulmonar entre pacientes ambulatoriais com sarcoidose. OBJETIVOS: 1) verificar a prevalência de HP em pacientes ambulatoriais com sarcoidose; 2) testar a associação do peptídeo natriurético tipo B (BNP) e de dados tomográficos e funcionais pulmonares com HP na sarcoidose e 3) comparar, em pacientes com refluxo tricúspide (VRT) 2,5 m/s, o achado de pressão sistólica da artéria pulmonar (PSAP 40 mmHg) estimada no ecocardiograma com o diagnóstico de hipertensão pulmonar pelo padrão ouro (pressão média da artéria pulmonar PAPm 25 mmHg na avaliação hemodinâmica invasiva). CASUÍSTICA E MÉTODO: 72 dos 163 pacientes do Serviço de Pneumologia do InCor, com diagnóstico de sarcoidose (critérios da American Thoracic Society) realizaram ecocardiograma para mensuração da velocidade do refluxo tricúspide (VRT) e cálculo da PSAP. Pacientes com VRT 2,5 m/s (possível HP) foram submetidos à avaliação hemodinâmica invasiva. Foram realizados também dosagem do BNP sérico, tomografia de tórax de alta resolução e prova de função pulmonar completa. RESULTADOS: 19 pacientes apresentaram VRT 2,5 m/s: 18 realizaram cateterismo e um faleceu antes do procedimento. HP foi diagnosticada em 4 pacientes, com prevalência de 5,6% (IC95% 0,2-10,8%). O valor do BNP sérico foi semelhante nos pacientes com e sem HP (mediana 15,5 vs 11,0 pg/ml, p>0.05). Pacientes com HP tiveram mais alterações tomográficas sugestivas de fibrose (50% vs 4,7%; p=0,04), menor VEF1 (63,7±4,9 vs 85,6±14,8; p=0,02) e tendência a menor CVF (69,1±16,2 vs. 86,7±16,2; p=0,07). A capacidade pulmonar total e a difusão de monóxido de carbono não distinguiram pacientes com e sem HP. Pela estimativa do ecocardiograma, 5 pacientes tiveram PSAP 40 mmHg (6,9%), mas só dois destes pacientes tinham HP (PAPm25 mmHg) no estudo invasivo. O critério PSAP 40 mmHg pela estimativa do ecocardiograma levou a erro diagnóstico em 5 pacientes: 3 falso-positivos e 2 falso-negativos. CONCLUSÃO: A prevalência de HP entre os pacientes ambulatoriais com sarcoidose foi de 5,6%. O BNP não distinguiu pacientes com HP. Pacientes com HP tiveram função pulmonar mais comprometida e mais achados sugestivos de fibrose. A PSAP foi pouco acurado no diagnóstico de HPBACKGROUND: Pulmonary hypertension (PH) has negative impact in sarcoid patients prognosis. Prevalence of pulmonary hypertension (PH) among sarcoid outpatients has not been investigated by screening studies confirmed by hemodynamic evaluation. OBJECTIVES: (1) to determine the prevalence of PH among sarcoid outpatients in a tertiary center; (2) test whether brain natriuretic peptide (BNP) levels, tomographic findings or pulmonary function tests distinguish patients with and without PH and (3) compare the presence of systolic pulmonary artery pressure estimated by echocardiogram (SPAP 40 mmHg) to the diagnostic gold standard for PH (mean pulmonary artery pressure mPAP 25 mmHg) measured by pulmonary artery catheterization, in patients with tricuspid reflux velocity (TRV) 2.5 m/s. METHODS: Seventy-two of 163 outpatients from InCor-Hospital das Clinicas Pulmonary Division with sarcoidosis (ATS criteria) underwent echocardiographic evaluation to asses TRV and to estimate SPAP. Patients with TRV 2.5 m/s (possible PH) underwent pulmonary artery catheterization. BNP dosage, lung function testing (spirometry, lung volumes by plethismography and single-breath carbon monoxide diffusing capacity DLCOsb) and high-resolution CT (HRCT) also were performed. RESULTS: Nineteen patients had TRV2.5 m/s; 18 underwent hemodynamic evaluation (one patient died before the procedure). PH (mPAP 25 mmHg) was diagnosed in 4 patients and its prevalence was 5.6% (IC95% 0.2-10.8%). Patients with and without PH had similar BNP values (median 15.5 vs 11 pg/ml, p>0.05). Patients with PH had more tomographic findings suggesting pulmonary fibrosis (50% x 4.7%; p=0.04), lower forced expiratory volume in 1st second (63.7±4.9 vs. 85.6±14.8; p=0.02) and a trend to lower forced vital capacity (69.1±16.2 vs. 86.7±16.2;p=0.07). Total lung capacity and DLCOsb values were similar between both groups. Echocardiogram estimated SPAP 40 mmHg was present in 5 patients (6.9%), but only 2 of those had PH (mPAP 25 mmHg). Echocardiogram PASP 40 mmHg misdiagnosed 5 patients: 3 false positive and 2 false negative. CONCLUSION: PH prevalence in sarcoid outpatients was 5.6%. BNP levels did not mash PH patients. PH patients had worse lung function. SPAP estimated by echocardiogram was not accurate to diagnose PH
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Ho, Ling-Pei. "The role of CD1d restricted NKT cells in the immunopathology of sarcoidosis." Thesis, University of Oxford, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.410680.
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