Exposure to intrinsic Hg in fish was studied in Amazon populations with high prevalence of malaria disease. High fish-eater riverines were compared to urban (Manaus residents) low fish-eater riverines in regards to Hg exposure (hair-Hg) and serum antinuclear antibodies (ANA). Most riverines (99.0%) ate fish daily compared to only 3% of controls. Fish species high in MeHg was consumed more frequently (45.5%) by riverines than controls (18.8%). Mean hair-Hg (34.5 ppm) of riverines was significantly higher than controls (1.0 ppm). Although positive serum ANA was more frequently observed in riverine fish-eaters (12.4%) than controls (2.9%), there was no significant association between hair-Hg and ANA. High prevalence of malaria reporting among riverines was neither associated with Hg exposure nor with serum ANA. An autoimmune dysfunction is unlikely to occur as a result of MMHg exposure due to fish consumption.

Lupus Nephritis (LN) develops in more than half of the Systemic Lupus Erythematous (SLE) patients. However, lack of reliable, specific biomarkers for LN hampers clinical management of patients and impedes development of new therapeutics. The goal of this study was to investigate whether oxidative stress biomarkers in patients with SLE is predictive of renal pathology. Serum biochemical and oxidative stress markers were measured in patients with inactive lupus, active lupus with and without nephritis and compared to healthy control group. To assess the predictive performance of biomarkers, Receiver Operating Characteristic (ROC) curves were constructed and cut-offs were used to identify SLE patients with nephritis. We observed an increased oxidative stress response in all SLE patients compared to healthy controls. Among the several biomarkers tested, serum thiols had a significant inverse association with SLE Disease Activity Index (SLEDAI). Interestingly, thiols were able too aptly differentiate between SLE patients with and without renal pathology, and serum thiol levels were not affected by immunosuppressive drug therapy. The decreased thiols in SLE correlated significantly with serum creatinine and serum C3 levels. Further retrospective evaluation using serum creatinine or C3 levels in combination with thiol’s cutoff values from ROC analysis, we could positively predict chronicity of renal pathology in SLE patients. In summary, serum thiols emerge as an inexpensive and reliable indicator of LN, which may not only help in early identification of renal pathology but also aid in the therapeutic management of the disease, in developing countries with resource poor settings.

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relato De caso case rePort INTRODUÇÃO O lúpus eritematoso sistêmico (LES) é uma doença inflamatória multissistêmica, caracterizada por episódios intercalados de intensa atividade inflamatória e remissão. Assim como os processos inflamatórios específicos de cada órgão, as infecções são responsáveis por altos índices de morbimortalidade, manifestando-se com freqüência e gravidade variadas (1,2). Nestes pacientes observa-se aumento do risco de infecção em virtude de defeitos imunológicos intrínsecos associados à doença, presença de leucopenia com linfopenia, necessidade de tratamento imunossupressor e internações freqüentes (1-3) .