[1] Univ Fed Estado Rio De Janeiro, Sch Med & Surg, Dept Gen Med, Rio De Janeiro, Brazil
[2] Univ Estado Rio De Janeiro, Fac Med, Dept Pediat, Rio De Janeiro, Brazil
[3] Univ Fed Fluminense, Fac Med, Internal Med Dept, Clin Immunol Serv, Niteroi, Brazil
[4] Univ Porto, Fac Med, Dept Pathol, Basic & Clin Immunol Unit, Porto, Portugal
[5] Brigham & Womens Hosp, Dept Med, Div Rheumatol Allergy & Immunol, Boston, MA USA