Angela Duarte

Publications (2)1.88 Total impact

• Article: Investigation of latent tuberculosis infection in patients with psoriasis who are candidate for receiving immunobiological drugs.

  Emerson Vasconcelos de Andrade Lima, Mariana de Andrade Lima, Angela Duarte, Cláudia Marques, Gil Benard, Virgínia Lorena, Yara Gomes
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  ABSTRACT: The use of tumor necrosis factor inhibitors for the treatment of patients with psoriasis has been related to a higher incidence of tuberculosis, specially the disseminated and extrapulmonary forms. Despite their efficacy, these drugs increase the risk of reactivating latent tuberculosis infection, thus requiring diagnosis of the condition before their administration. Investigation of latent tuberculosis infection with tuberculin skin test is ineffective due to its low specificity and the dubious results that it generates in patients with psoriasis. Assays based on the detection of synthesis of gamma interferon in vitro by peripheral monoclonal cells, stimulated by specific antigens (ESAT-6 and CFP-10), seem to offer better accuracy when compared to the Mantoux test in identifying latent tuberculosis infection. This diagnosis tool has demonstrated higher specificity, since it has no correlation with indirect forms of exposure to M. tuberculosis such as BCG vaccination or with infections by other mycobacteria.
  Anais brasileiros de dermatologia 08/2011; 86(4):716-24.
• Article: Evaluation of an interferon gamma assay in the diagnosis of latent tuberculosis infection in patients with rheumatoid arthritis.

  Cláudia Diniz Lopes Marques, Ângela Luzia Branco Pinto Duarte, Virginia Maria Barros de Lorena, Joelma Rodrigues Souza, Wayner Vieira Souza, Yara de Miranda Gomes, Eduardo Maia Freese de Carvalho
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  ABSTRACT: The tuberculin skin test is not an ideal screening test for the patients with rheumatoid arthritis to identify cases of latent tuberculosis infection (LTBI) prior to the start of treatment with anti-TNFs, as it responds inadequately to late hypersensitivity, which is fundamental for producing a response to the inoculated antigen. Assays based on detection of the production of IFNγ in vitro by mononuclear peripheral cells stimulated by specific antigens are more specific than PPD in detecting LTBI. The aim of this study was to evaluate the performance of T-SPOT.TB in diagnosis of LTBI in patients with rheumatoid arthritis, comparing with the PPD. The specificity of the T-SPOT.TB varied from 87 to 90% and the negative-predictive value (NPV) from 94.4 to 100%. It can be concluded that the T-SPOT.TB showed high specificity and NPV, proving the capability of identifying false-negative cases of PPD, raising the level of safety for the use of anti-TNFs.
  Rheumatology International 05/2009; 30(1):57-62. · 1.88 Impact Factor