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Síndrome autoinflamatório associado aos proteassomas
ORPHA:324977CID-10 · D89.8CID-11 · 4A60.YDOENÇA RARA
Mantido por Agente Raras·Colaborar como especialista →

Introdução

O que você precisa saber de cara

📋

Doenças autoinflamatórias (DAIs) são um grupo de distúrbios raros causados por disfunção do sistema imunológico inato. Essas respostas são caracterizadas por inflamação sistêmica periódica ou crônica, geralmente sem o envolvimento da imunidade adaptativa.

Publicações científicas
24 artigos
Último publicado: 2026 Feb

Escala de raridade

CLASSIFICAÇÃO ORPHANET · BRASIL 2024
<1 / 1 000 000
Ultra-rara
<1/50k
Muito rara
1/20k
Rara
1/10k
Pouco freq.
1/5k
Incomum
1/2k
Prevalência
0.0
Worldwide
Casos conhecidos
40
pacientes catalogados
Início
Childhood
+ infancy, neonatal
🏥
SUS: Sem cobertura SUSScore: 0%
CID-10: D89.8
Você se identifica com essa condição?
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Sinais e sintomas

O que aparece no corpo e com que frequência cada sintoma acontece

Partes do corpo afetadas

🩸
Sangue
10 sintomas
🦴
Ossos e articulações
9 sintomas
💪
Músculos
9 sintomas
🧬
Pele e cabelo
9 sintomas
📏
Crescimento
7 sintomas
🫃
Digestivo
6 sintomas

+ 66 sintomas em outras categorias

Características mais comuns

Anemia
Atraso de crescimento
Constipação crônica
Anormalidade de crescimento
Abdome protuberante
Sinusite recorrente
137sintomas
Sem dados (137)

Os sintomas variam de pessoa para pessoa. Abaixo estão as 137 características clínicas mais associadas, ordenadas por frequência.

Anemia
Atraso de crescimentoGrowth delay
Constipação crônicaChronic constipation
Anormalidade de crescimentoGrowth abnormality
Abdome protuberanteProtuberant abdomen

Linha do tempo da pesquisa

Publicações por ano — veja quando o interesse científico cresceu
Anos de pesquisa1desde 2026
Total histórico24PubMed
Últimos 10 anos23publicações
Pico20226 papers
Linha do tempo
2026Hoje · 2026📈 2022Ano de pico
Publicações por ano (últimos 10 anos)

Encontrou um erro ou informação desatualizada? Sugira uma correção →

Genética e causas

O que está alterado no DNA e como passa nas famílias

Genes associados

6 genes identificados com associação a esta condição. Padrão de herança: Autosomal recessive.

PSMB8Proteasome subunit beta type-8Disease-causing germline mutation(s) inTolerante
FUNÇÃO

The proteasome is a multicatalytic proteinase complex which is characterized by its ability to cleave peptides with Arg, Phe, Tyr, Leu, and Glu adjacent to the leaving group at neutral or slightly basic pH. The proteasome has an ATP-dependent proteolytic activity. This subunit is involved in antigen processing to generate class I binding peptides. Replacement of PSMB5 by PSMB8 increases the capacity of the immunoproteasome to cleave model peptides after hydrophobic and basic residues. Involved i

LOCALIZAÇÃO

CytoplasmNucleus

VIAS BIOLÓGICAS (4)
Antigen processing: Ub, ATP-independent proteasomal degradationCross-presentation of soluble exogenous antigens (endosomes)ER-Phagosome pathwayProteasome assembly
MECANISMO DE DOENÇA

Proteasome-associated autoinflammatory syndrome 1

An autosomal recessive autoinflammatory disorder characterized by early childhood onset of recurrent fever, joint stiffness and severe contractures of the hands and feet, and erythematous skin lesions with subsequent development of lipodystrophy and laboratory evidence of immune dysregulation. Accompanying features may include muscle weakness and atrophy, hepatosplenomegaly, and microcytic anemia.

EXPRESSÃO TECIDUAL(Ubíquo)
Linfócitos
416.8 TPM
Baço
277.5 TPM
Pulmão
166.8 TPM
Intestino delgado
160.6 TPM
Sangue
155.0 TPM
OUTRAS DOENÇAS (2)
proteasome-associated autoinflammatory syndrome 1proteosome-associated autoinflammatory syndrome
HGNC:9545UniProt:P28062
PSMG2Proteasome assembly chaperone 2Disease-causing germline mutation(s) inTolerante
FUNÇÃO

Chaperone protein which promotes assembly of the 20S proteasome as part of a heterodimer with PSMG1. The PSMG1-PSMG2 heterodimer binds to the PSMA5 and PSMA7 proteasome subunits, promotes assembly of the proteasome alpha subunits into the heteroheptameric alpha ring and prevents alpha ring dimerization

LOCALIZAÇÃO

Nucleus

VIAS BIOLÓGICAS (1)
Proteasome assembly
MECANISMO DE DOENÇA

Proteasome-associated autoinflammatory syndrome 4

An autosomal recessive, autoinflammatory disorder characterized by panniculitis and erythematous skin lesions apparent in early infancy. Additional features include hepatosplenomegaly, lymphadenopathy, autoimmune hemolytic anemia, fever, generalized lipodystrophy, myositis, joint contractures, and mild motor and speech delay.

VIAS REACTOME (1)
EXPRESSÃO TECIDUAL(Ubíquo)
Testículo
68.7 TPM
Linfócitos
63.5 TPM
Artéria tibial
57.5 TPM
Cervix Ectocervix
54.2 TPM
Aorta
54.0 TPM
OUTRAS DOENÇAS (1)
proteasome-associated autoinflammatory syndrome 4
HGNC:HGNC:24929UniProt:Q969U7
PSMB4Proteasome subunit beta type-4Disease-causing germline mutation(s) inTolerante
FUNÇÃO

Non-catalytic component of the 20S core proteasome complex involved in the proteolytic degradation of most intracellular proteins. This complex plays numerous essential roles within the cell by associating with different regulatory particles. Associated with two 19S regulatory particles, forms the 26S proteasome and thus participates in the ATP-dependent degradation of ubiquitinated proteins. The 26S proteasome plays a key role in the maintenance of protein homeostasis by removing misfolded or d

LOCALIZAÇÃO

CytoplasmNucleus

VIAS BIOLÓGICAS (10)
Vif-mediated degradation of APOBEC3GVpu mediated degradation of CD4Degradation of GLI2 by the proteasomeDegradation of GLI1 by the proteasomeHedgehog 'on' state
MECANISMO DE DOENÇA

Proteasome-associated autoinflammatory syndrome 3

An autoinflammatory disorder characterized by onset in early infancy and recurrent fever, nodular dermatitis, myositis, panniculitis-induced lipodystrophy, lymphadenopathy, and immune dysregulation. Variable accompanying features may include joint contractures, hepatosplenomegaly, anemia, thrombocytopenia, recurrent infections, autoantibodies, and hypergammaglobulinemia. Some patients may have intracranial calcifications. PRAAS3 inheritance is autosomal recessive or digenic.

EXPRESSÃO TECIDUAL(Ubíquo)
Linfócitos
509.3 TPM
Fibroblastos
468.9 TPM
Útero
432.8 TPM
Aorta
427.2 TPM
Cervix Ectocervix
417.9 TPM
OUTRAS DOENÇAS (1)
proteasome-associated autoinflammatory syndrome 3
HGNC:HGNC:9541UniProt:P28070
PSMB10Proteasome subunit beta type-10Disease-causing germline mutation(s) inTolerante
FUNÇÃO

The proteasome is a multicatalytic proteinase complex which is characterized by its ability to cleave peptides with Arg, Phe, Tyr, Leu, and Glu adjacent to the leaving group at neutral or slightly basic pH. The proteasome has an ATP-dependent proteolytic activity. This subunit is involved in antigen processing to generate class I binding peptides

LOCALIZAÇÃO

CytoplasmNucleus

VIAS BIOLÓGICAS (4)
Antigen processing: Ub, ATP-independent proteasomal degradationCross-presentation of soluble exogenous antigens (endosomes)ER-Phagosome pathwayProteasome assembly
MECANISMO DE DOENÇA

Proteasome-associated autoinflammatory syndrome 5

An autosomal recessive, autoinflammatory disorder characterized by recurrent, polymorphic disseminated cutaneous rash with annular lesions, non-specific lymphocytic infiltration in the skin, fever, failure to thrive, and persistent hepatosplenomegaly. Disease onset is in early infancy.

EXPRESSÃO TECIDUAL(Ubíquo)
Linfócitos
302.5 TPM
Baço
186.4 TPM
Sangue
148.5 TPM
Intestino delgado
126.3 TPM
Pulmão
94.2 TPM
OUTRAS DOENÇAS (3)
immunodeficiency 121 with autoinflammationproteasome-associated autoinflammatory syndrome 5Omenn syndrome
HGNC:9538UniProt:P40306
PSMB9Proteasome subunit beta type-9Disease-causing germline mutation(s) inTolerante
FUNÇÃO

The proteasome is a multicatalytic proteinase complex which is characterized by its ability to cleave peptides with Arg, Phe, Tyr, Leu, and Glu adjacent to the leaving group at neutral or slightly basic pH (PubMed:33727065, PubMed:34819510). The proteasome has an ATP-dependent proteolytic activity. This subunit is involved in antigen processing to generate class I binding peptides. Replacement of PSMB6 by PSMB9 increases the capacity of the immunoproteasome to cleave model peptides after hydroph

LOCALIZAÇÃO

CytoplasmNucleus

VIAS BIOLÓGICAS (4)
Antigen processing: Ub, ATP-independent proteasomal degradationCross-presentation of soluble exogenous antigens (endosomes)ER-Phagosome pathwayProteasome assembly
MECANISMO DE DOENÇA

Proteasome-associated autoinflammatory syndrome 3

An autoinflammatory disorder characterized by onset in early infancy and recurrent fever, nodular dermatitis, myositis, panniculitis-induced lipodystrophy, lymphadenopathy, and immune dysregulation. Variable accompanying features may include joint contractures, hepatosplenomegaly, anemia, thrombocytopenia, recurrent infections, autoantibodies, and hypergammaglobulinemia. Some patients may have intracranial calcifications. PRAAS3 inheritance is autosomal recessive or digenic.

EXPRESSÃO TECIDUAL(Ubíquo)
Linfócitos
537.0 TPM
Baço
236.5 TPM
Sangue
182.6 TPM
Intestino delgado
116.3 TPM
Pulmão
105.2 TPM
OUTRAS DOENÇAS (1)
proteasome-associated autoinflammatory syndrome 6
HGNC:HGNC:9546UniProt:P28065
POMPProteasome maturation proteinDisease-causing germline mutation(s) inTolerante
FUNÇÃO

Molecular chaperone essential for the assembly of standard proteasomes and immunoproteasomes. Degraded after completion of proteasome maturation. Mediates the association of 20S preproteasome with the endoplasmic reticulum

LOCALIZAÇÃO

Cytoplasm, cytosolNucleusMicrosome membrane

VIAS BIOLÓGICAS (1)
Proteasome assembly
MECANISMO DE DOENÇA

Keratosis linearis with ichthyosis congenita and sclerosing keratoderma

A keratinizing disorder characterized by ichthyosis, palmoplantar keratoderma with constricting bands around fingers, flexural deformities of fingers and keratotic papules in a linear distribution on the flexural side of large joints. Histological examination of the skin of affected individuals shows hypertrophy and hyperplasia of the spinous, granular and horny epidermal layer.

VIAS REACTOME (1)
EXPRESSÃO TECIDUAL(Ubíquo)
Linfócitos
254.5 TPM
Fibroblastos
199.6 TPM
Testículo
152.9 TPM
Artéria tibial
132.7 TPM
Artéria coronária
128.2 TPM
OUTRAS DOENÇAS (2)
proteasome-associated autoinflammatory syndrome 2keratosis linearis-ichthyosis congenita-sclerosing keratoderma syndrome
HGNC:20330UniProt:Q9Y244

Variantes genéticas (ClinVar)

170 variantes patogênicas registradas no ClinVar.

🧬 PSMB8: NM_148919.4(PSMB8):c.147+1G>T ()
🧬 PSMB8: NM_148919.4(PSMB8):c.742+45G>A ()
🧬 PSMB8: NM_148919.4(PSMB8):c.434del (p.Arg145fs) ()
🧬 PSMB8: NM_148919.4(PSMB8):c.31C>T (p.Arg11Ter) ()
🧬 PSMB8: NM_148919.4(PSMB8):c.636_643del (p.Asp212fs) ()
Ver todas no ClinVar

Classificação de variantes (ClinVar)

Distribuição de 97 variantes classificadas pelo ClinVar.

44
53
Patogênica (45.4%)
VUS (54.6%)
VARIANTES MAIS SIGNIFICATIVAS
PSMB10: NM_002801.4(PSMB10):c.56+1G>A [Conflicting classifications of pathogenicity]
PSMB10: NM_002801.4(PSMB10):c.710+1G>C [Pathogenic]
PSMB10: NM_002801.4(PSMB10):c.247dup (p.Cys83fs) [Pathogenic]
LOC130059250: NM_002801.4(PSMB10):c.500G>A (p.Gly167Asp) [Pathogenic]
PSMB10: NM_002801.4(PSMB10):c.40_42del (p.Phe14del) [Pathogenic]

Diagnóstico

Os sinais que médicos procuram e os exames que confirmam

Carregando...

Tratamento e manejo

Remédios, cuidados de apoio e o que precisa acompanhar

Carregando informações de tratamento...

Onde tratar no SUS

Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)

🇧🇷 Atendimento SUS — Síndrome autoinflamatório associado aos proteassomas

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Selecione um estado ou use sua localização para ver resultados.

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Pesquisa ativa

Ensaios clínicos abertos e novidades científicas recentes

Pesquisa e ensaios clínicos

Nenhum ensaio clínico registrado para esta condição.

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Publicações mais relevantes

Timeline de publicações
23 papers (10 anos)
#1

A new digenic inheritance of proteasome-associated autoinflammatory syndrome involving the PSMA6 gene.

The journal of allergy and clinical immunology. In practice2026 Feb
#2

Genetic Basis of Autoinflammatory Skin Diseases. Part I. Genetic Pathways of Complex Autoinflammatory Skin Diseases.

Journal of the American Academy of Dermatology2025 Jun 19

This continuing medical education article provides a comprehensive review of the genetic underpinnings of complex autoinflammatory skin diseases, with a focus on neutrophilic dermatoses, autoinflammatory syndromes, and certain vasculitides. Genetic mutations play a critical role in both the diagnosis and management of these conditions, making a detailed understanding of genetic markers essential for clinicians. Each disease is examined in terms of clinical manifestations, genetic mutations, and available treatment options. This work aims to provide clinicians with practical guidance on genetic testing strategies, diagnosis, and personalized management of inflammatory skin diseases, reflecting advances in precision medicine and the growing importance of targeted therapies for patients with rare genetic conditions.

#3

A case of mother and child with CANDLE syndrome: Diagnosis and subsequent treatment with baricitinib.

Pediatric dermatology2024

Chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature (CANDLE) or proteasome-associated autoinflammatory syndrome is a rare autoinflammatory disorder that typically presents in infancy with characteristic symptoms, including recurrent fever, panniculitis, and progressive lipodystrophy, among other findings. We present a case of mother and child with CANDLE syndrome. The child was eventually started on baricitinib with normalization of rash and systemic findings.

#4

Disease flares with baricitinib dose reductions and development of flare criteria in patients with CANDLE/PRAAS.

Annals of the rheumatic diseases2024 Aug 27

Patients with chronic atypical neutrophilic dermatosis with lipodystrophy and elevated temperature/proteasome-associated autoinflammatory syndrome (CANDLE/PRAAS) respond to the janus kinase inhibitor 1/2 inhibition with baricitinib at exposures higher than in rheumatoid arthritis. Baricitinib dose reductions to minimise exposure triggered disease flares which we used to develop 'flare criteria'. Of 10 patients with CANDLE/PRAAS treated with baricitinib in an open-label expanded-access programme, baricitinib doses were reduced 14 times in 9 patients between April 2014 and December 2019. Retrospective data analysis of daily diary scores and laboratory markers collected before and after the dose reductions were used to develop 'clinical' and 'subclinical' flare criteria. Disease flare rates were compared among patients with <25% and >25% dose reductions and during study visits when patients received recommended 'optimized' baricitinib doses (high-dose visits) versus lower than recommended baricitinib doses (low-dose visits) using two-sided χ2 tests. In the 9/10 patients with CANDLE with dose reduction, 7/14 (50%) times the dose was reduced resulted in a disease flare. All four dose reductions of >25% triggered a disease flare (p <0.05). Assessment of clinical and laboratory changes during disease flares allowed the development of disease flare criteria that were assessed during visits when patients received high or low doses of baricitinib. Disease flare criteria were reached during 43.14% of low-dose visits compared with 12.75% of high-dose visits (p <0.0001). Addition of an interferon score as an additional flare criterion increased the sensitivity to detect disease flares. We observed disease flares and rebound inflammation with baricitinib dose reductions and proposed flare criteria that can assist in monitoring disease activity and in designing clinical studies in CANDLE/PRAAS.

#5

Proteasome inhibitor-associated histiocytoid Sweet's syndrome: Clinical and histological similarities to Nakajo-Nishimura syndrome suggest a potential mechanism.

The Journal of dermatology2024 Oct

Histiocytoid Sweet's syndrome (HSS) is a variant of Sweet's syndrome (SS) that clinically resembles SS but differs histologically by infiltrates, predominantly composed of immature cells of the myeloid lineage. Medications such as proteasome inhibitors have been reported to cause HSS but there has been little discussion on the underlying mechanism. Here we report two cases of HSS associated with a proteasome inhibitor. Both patients were on ixazomib for the treatment of multiple myeloma and presented with acute erythematous plaques on the upper half of the body. Pathological findings were consistent with HSS. Similarities between proteasome inhibitor-induced HSS and Nakajo-Nishimura syndrome, an inherited inflammatory disease, can be identified both clinically and histologically, suggesting a potential explanation of the mechanism behind proteasome inhibitor-associated HSS.

Publicações recentes

Ver todas no PubMed

📚 EuropePMC4 artigos no totalmostrando 23

2026

A new digenic inheritance of proteasome-associated autoinflammatory syndrome involving the PSMA6 gene.

The journal of allergy and clinical immunology. In practice
2025

Genetic Basis of Autoinflammatory Skin Diseases. Part I. Genetic Pathways of Complex Autoinflammatory Skin Diseases.

Journal of the American Academy of Dermatology
2024

A case of mother and child with CANDLE syndrome: Diagnosis and subsequent treatment with baricitinib.

Pediatric dermatology
2024

Disease flares with baricitinib dose reductions and development of flare criteria in patients with CANDLE/PRAAS.

Annals of the rheumatic diseases
2024

Proteasome inhibitor-associated histiocytoid Sweet's syndrome: Clinical and histological similarities to Nakajo-Nishimura syndrome suggest a potential mechanism.

The Journal of dermatology
2024

Proteasome-associated autoinflammatory syndrome 2 in a neonate.

Pediatric dermatology
2023

Identification of eight novel proteasome variants in five unrelated cases of proteasome-associated autoinflammatory syndromes (PRAAS).

Frontiers in immunology
2022

Assessment of type I interferon signatures in undifferentiated inflammatory diseases: A Japanese multicenter experience.

Frontiers in immunology
2022

The 2021 European Alliance of Associations for Rheumatology/American College of Rheumatology Points to Consider for Diagnosis and Management of Autoinflammatory Type I Interferonopathies: CANDLE/PRAAS, SAVI, and AGS.

Arthritis &amp; rheumatology (Hoboken, N.J.)
2022

The 2021 European Alliance of Associations for Rheumatology/American College of Rheumatology points to consider for diagnosis and management of autoinflammatory type I interferonopathies: CANDLE/PRAAS, SAVI and AGS.

Annals of the rheumatic diseases
2022

Haploinsufficiency of PSMD12 Causes Proteasome Dysfunction and Subclinical Autoinflammation.

Arthritis &amp; rheumatology (Hoboken, N.J.)
2022

Pathogenic insights from genetic causes of autoinflammatory inflammasomopathies and interferonopathies.

The Journal of allergy and clinical immunology
2021

Heterozygous missense variant of the proteasome subunit β-type 9 causes neonatal-onset autoinflammation and immunodeficiency.

Nature communications
2022

Hematopoietic stem cell transplantation in a patient with proteasome-associated autoinflammatory syndrome (PRAAS).

The Journal of allergy and clinical immunology
2021

Role of Proteasomes in Inflammation.

Journal of clinical medicine
2020

A Chinese case of Nakajo-Nishimura syndrome with novel compound heterozygous mutations of the PSMB8 gene.

BMC medical genetics
2020

KLICK Syndrome Linked to a POMP Mutation Has Features Suggestive of an Autoinflammatory Keratinization Disease.

Frontiers in immunology
2020

Myositis with sarcoplasmic inclusions in Nakajo-Nishimura syndrome: a genetic inflammatory myopathy.

Neuropathology and applied neurobiology
2019

Induced pluripotent stem cells representing Nakajo-Nishimura syndrome.

Inflammation and regeneration
2019

State of care for patients with systemic autoinflammatory diseases - Results of a tertiary care survey.

The World Allergy Organization journal
2019

New data in causes of autoinflammatory diseases.

Joint bone spine
2018

A homozygous mutation in the PSMB8 gene in a case with proteasome-associated autoinflammatory syndrome.

Scandinavian journal of rheumatology
2015

Additive loss-of-function proteasome subunit mutations in CANDLE/PRAAS patients promote type I IFN production.

The Journal of clinical investigation

Associações

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Doenças relacionadas

Doenças com sintomas parecidos — ajudam quem ainda está buscando diagnóstico

Referências e fontes

Bases de dados externas citadas neste artigo

Publicações científicas

Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.

  1. A new digenic inheritance of proteasome-associated autoinflammatory syndrome involving the PSMA6 gene.
    The journal of allergy and clinical immunology. In practice· 2026· PMID 41205671mais citado
  2. Genetic Basis of Autoinflammatory Skin Diseases. Part I. Genetic Pathways of Complex Autoinflammatory Skin Diseases.
    Journal of the American Academy of Dermatology· 2025· PMID 40543672mais citado
  3. A case of mother and child with CANDLE syndrome: Diagnosis and subsequent treatment with baricitinib.
    Pediatric dermatology· 2024· PMID 38881047mais citado
  4. Disease flares with baricitinib dose reductions and development of flare criteria in patients with CANDLE/PRAAS.
    Annals of the rheumatic diseases· 2024· PMID 38653530mais citado
  5. Proteasome inhibitor-associated histiocytoid Sweet's syndrome: Clinical and histological similarities to Nakajo-Nishimura syndrome suggest a potential mechanism.
    The Journal of dermatology· 2024· PMID 38558105mais citado

Bases de dados e fontes oficiais

Identificadores e referências canônicas usadas para montar este verbete.

  1. ORPHA:324977(Orphanet)
  2. MONDO:0009726(MONDO)
  3. GARD:13824(GARD (NIH))
  4. Variantes catalogadas(ClinVar)
  5. Busca completa no PubMed(PubMed)
  6. Q106481463(Wikidata)

Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.

Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar

Compêndio · Raras BR

Síndrome autoinflamatório associado aos proteassomas

ORPHA:324977 · MONDO:0009726
Prevalência
<1 / 1 000 000
Casos
40 casos conhecidos
Herança
Autosomal recessive
CID-10
D89.8 · Outros transtornos especificados que comprometem o mecanismo imunitário não classificados em outra parte
CID-11
Início
Childhood, Infancy, Neonatal
Prevalência
0.0 (Worldwide)
MedGen
EuropePMC
Wikidata
Papers 10a
DiscussaoAtiva

Nenhuma novidade ainda. O agente esta monitorando.

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