Chapters authored
ZIKV Diagnostics: Current Scenario and Future Directions
Since the discovery of the Zika virus in Uganda in 1947, diagnostic challenges remain, especially when we take into account the epidemiological context of the surveyed population. Genetic similarities with other flavivirus are responsible for cross-reactivity during serological evaluation that would often be the only resources to confirm the infection in asymptomatic cases or samples collected after the short window of viral RNA detection. The importance of Zika virus infection diagnosis is undoubtedly useful for pregnant women. This statement became evident after 2015 Brazil’s Zika outbreak when a significant increase in cases of newborn with microcephaly was observed. Reverse transcriptase real-time PCR is the most reliable tool for Zika virus infection diagnosis. It detects viral RNA in both biological fluids and tissues and contributes to clinical case classification for initial description of developmental changes observed in neonates exposed congenitally to Zika virus. In conclusion, advances in serological diagnostic are urgent. The safest pathway for these studies requires laborious, subjective, and low throughput PRNT evaluations. Consequently, critical public health questions remain unanswered: how serum prevalent is the general population and pregnant women; can we define risk for congenital Zika syndrome (CZS) and Guillain-Barré syndrome; and how to assess vaccine efficacy and long-term protection.
Part of the book: Biochemical Testing
Juvenile Idiopathic Arthritis-Associated Uveitis: Evidence-Based Screening, Monitoring, and Treatment
Juvenile idiopathic arthritis (JIA) is the most frequent chronic autoimmune rheumatic disease in children and adolescents. JIA-associated uveitis is its commonest extra-articular manifestation comprising usually a silent iridocyclitis. Due to this asymptomatic clinical presentation, it is estimated that one-third of JIA-associated uveitis may present with ocular complications by the time of diagnosis. Time-appropriate screening and monitoring are crucial for the prevention of sight-threatening ocular manifestations. Updated treatment is also essential for adequate management and, therefore, to guarantee the best long-term functional vision in these patients. The scope of this chapter involves: (a) JIA and JIA-uveitis introduction/background; (b) etiology, pathogenesis, and risk factors; (c) diagnosis, clinical presentation, and ocular complications; (d) monitoring and screening (including national/international screening guidelines); (e) management (treatment options and treatment monitoring); (f) disease burden; and (g) conclusion and take-home messages.
Part of the book: Uveitis