CRISTINA MARIA KOKRON
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
24 resultados
Resultados de Busca
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bookPart Imunodeficiências Primárias(2015) KOKRON, Cristina Maria; BARROS, Myrthes ToledoconferenceObject FREQUENCY OF LYMPHOMAS IN A COHORT OF PATIENTS WITH COMMON VARIABLE IMMUNODEFICIENCY(2013) SINI, B. C.; KOKRON, C. M.; LEVY, D.; PEREIRA, Juliana; OLIVEIRA, Ana Karolina Barreto; COHON, Andrea; KALIL, Jorge; BYDLOWSKI, S. P.; BARROS, Myrthes ToledoIntroduction: Common variable immunodeficiency (CVID) is characterized by recurrent infections and in-creased susceptibility to autoimmunity and malignancies. Objective: To evaluate the frequency of lymphoma in a cohort of patients with CVID. Methods: Analysis of data obtained from medical records. Results: We analyzed 144 patients, 80 men and 64 women, aged 15-72 years. Seven (0.5 %) lymphoma cases were diagnosed (1 Hodgkin lymphoma and 6 non-Hodgkin lymphomas), affecting 5 men and 2 women aged 1953 years at lymphoma diagnosis. The time period between the onset of symptoms of CVID and lymphoma diagnosis ranged from 7 to 24 years in 4 patients and in 3 of them the diagnosis of both diseases were nearly overlapped preceding the CVID diagnosis in only 1, 3 and 6 months. Fever, splenomegaly and lymphadenopathy occurred in all patients. Lymphocytosis with inversion of the CD4/CD8 ratio at the expense of increased CD8+ T cells was detected in 2 patients and lymphopenia in one. B lymphocytes were undetectable in 3 patients in whom the diagnosis of lymphoma and CVID were established simultaneously and in one B cells were present at the beginning of CVID but undetectable at diagnosis of lymphoma. Conclusions: Patients with absence of B cells in recently diagnosed CVID or absence of B cells in long term followed CVID with previously detectable B cells demands a screening for the presence of lymphomas.conferenceObject Altered Expression of BAFF-R and TACI in Common Variable Immunodeficiency (CVID) Patients(2015) SILVA, Diana Cordeiro de Oliveira; BARSOTTI, Nathalia Silveira; OLIVEIRA, Ana Karolina Barreto de; ZILINSKI, Fernando Ramon; BARROS, Myrthes Toledo; KALIL, Jorge; KOKRON, Cristina Maria- Oral manifestations in patients with hypogammaglobulinemia(2012) FERNANDES, Karin Sa; KOKRON, Cristina Maria; BARROS, Myrthes Toledo; KALIL, Jorge; GALLOTTINI, MarinaObjective. The overall objective of this study was to assess the oral manifestations and their association with immunologic status and health history, of individuals with hypogammaglobulinemia. Study Design. A case-controlled study of 100 subjects with hypogammaglobulinemia and 93 control individuals was performed. All participants were examined for dental caries, periodontal disease, mucosal lesions/infections, and general oral health problems. Decayed, missing, filled teeth and community periodontal index were recorded. Complete blood count, serum immunoglobulins, and lymphocyte immunophenotyping were measured on the same day of the oral health assessment. Results. Individuals with hypogammaglobulinemia showed higher prevalence of enamel hypoplasia and complaints of dry mouth, and lower prevalence of dental caries and periodontal disease. Conclusions. The systemic conditions associated with hypogammaglobulinemia were not associated with enhanced susceptibility to caries, gingivitis, or periodontitis; however, individuals with hypogammaglobulinemia were more likely to report more episodes of recurrent aphthous ulcers compared with control individuals. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:e19-e24)
conferenceObject CASE REPORT: LEPROSY ASSOCIATED TO COMMON VARIABLE IMMUNODEFICIENCY(2013) BARROS, Myrthes Toledo; TRINDADE, M. B.; SINI, B. C.; OLIVEIRA, Ana Karolina Barreto; SANCHEZ, J. A.; KALIL, Jorge; KOKRON, C. M.Introduction: Common variable immunodeficiency (CVID) is characterized by recurrent infections and, less often, opportunistic infections. Objective: To report a patient with CVID and leprosy. Case: White male, 25 years, with CVID diagnostic established 2 ½ years before, under IGIV monthly replacement. Two years after the diagnosis of CVID, he reported recent appearance of hypopigmented anesthetic spots in the upper limbs and trunk. Skin biopsy: lymphocytic inflammatory infiltrate with sketches of perivascular and perianexial granulomas attacking nerve fibers in the middle and deep dermis. The bacterial index, the tuberculin skin test and research for HIV were negative. The diagnosis of borderline tuberculoid leprosy was established. The number of TCD4+ cells was lower before (572 cells/mm 3) than after (665 cells/mm 3) skin lesions detection. We found no previous reports in the literature of leprosy associated to CVID. Conclusion: We speculate if in this CVID patient the skin lesions corresponded to inflammatory immune reconstitution syndrome (IRIS) associated to leprosy andif IGIVreplacement could modified the outcome of a previous infection by M. leprae.- Outcome of SARS-CoV-2 Infection in 121 Patients with Inborn Errors of Immunity: A Cross-Sectional Study(2021) GOUDOURIS, Ekaterini Simoes; PINTO-MARIZ, Fernanda; MENDONCA, Leonardo Oliveira; ARANDA, Carolina Sanchez; GUIMARAES, Rafaela Rolla; KOKRON, Cristina; BARROS, Myrthes Toledo; ANISIO, Flavia; ALONSO, Maria Luiza Oliva; MARCELINO, Fernanda; VALLE, Solange Oliveira Rodrigues; DORTAS JUNIOR, Sergio; BARRETO, Irma Douglas Paes; FERREIRA, Janaira Fernandes Severo; ROXO-JUNIOR, Persio; SILVA, Almerinda Maria do Rego; CAMPINHOS, Fernanda Lugao; BONFIM, Carmem; LOTH, Gisele; FERNANDES, Juliana Folloni; GARCIA, Julia Lopes; CAPELO, Albertina; TAKANO, Olga Akiko; NADAF, Maria Isabel Valdomir; TOLEDO, Eliana C.; CUNHA, Luciana Araujo Oliveira; GESU, Regina Sumiko Watanabe Di; SCHIDLOWSKI, Laire; FILLIPO, Priscila; BICHUETTI-SILVA, Danielli C.; SOLDATELI, Gustavo; FERRARONI, Natasha Reboucas; DANTAS, Ellen de Oliveira; PESTANA, Simone; MANSOUR, Eli; ULAF, Raisa Gusso; PRANDO, Carolina; CONDINO-NETO, Antonio; GRUMACH, Anete SevciovicPurpose There is still scarce data on SARS-CoV-2 infection in patients with Inborn Errors of Immunity (IEI) and many unresolved questions. We aimed to describe the clinical outcome of SARS-CoV-2 infection in Brazilian IEI patients and identify factors influencing the infection. Methods We did a cross-sectional, multicenter study that included patients of any age affected by IEI and SARS-CoV-2 infection. The variables studied were sex, age, type of IEI, comorbidities (number and type), treatment in use for IEI, clinical manifestations and severity of SARS-CoV-2 infection. Results 121 patients were included: 55.4% female, ages from six months to 74 yo (median age = 25.1 yo). Most patients had predominantly antibody deficiency (n = 53). The infection was mostly asymptomatic (n = 21) and mild (n = 66), and one child had multisystem inflammatory syndrome (MIS-C). We could not observe sex-related susceptibility, and there was a weak correlation between age and severity of infection. The number of comorbidities was higher in severe cases, particularly bronchiectasis and cardiopathy. There were no severe cases in hereditary angioedema patients. Six patients aged 2 to 74 years died, three of them with antibody deficiency. Conclusion The outcome was mild in most patients, but the Case Fatality Ratio was higher than in the general population. However, the type of IEI was not a determining factor for severity, except for complement deficiencies linked to milder COVID-19. The severity of SARS-CoV-2 infection seems to be more related to older age, a higher number of comorbidities and type of comorbidities (bronchiectasis and cardiopathy).
conferenceObject Evaluation of Clinical and Laboratory Response to Influenza and H1N1 Vaccines in a Group of Brazilian CVID Patients(2012) PEDRESCHI, Maira; OLIVEIRA, Ana Karolina Barreto; BARROS, Myrthes Toledo; COHON, Andrea; CELESTINO, A. T.; VILAS-BOAS, L. S.; FELIX, A. C.; PANNUTI, C. S.; KALIL, Jorge; KOKRON, Cristina M.CVID pts lack vaccine-specific ab production. We studied the clinical / laboratorial responses to influenza and H1N1 immunization in 22 CVID pts. Clinical evaluation was done through a score (infections, hospitalizations, antibiotic use). The score was applied during the previous and following year post immunization (PI). Blood was drawn before and 1/3/6/12 m PI. A significant reduction was observed in upper respiratory infections and sinusitis in the year PI (p<0.001), and 6 pts seroconverted. Statistical analysis showed no difference among ab levels before and PI. Among the 9 pts who presented H1N1 ab production, 4 reduced the clinical score. Of note, 50% of the 22 pts presented reduction of clinical scores. Then, although ab production to H1N1 wasn’t statistically significant, we observed a reduction in the number of infections in the year PI. This observation may be due to eventual presence of influenza’sabs but reinforces potential benefits of vaccination in CVID pts.conferenceObject Causes of Death in Common Variable Immunodeficiency (CVID) Patients Followed at the Primary Immunodeficiency Outpatient Clinic Between 1995 and 2015(2015) GARCIA, Giane; TORRES, Pablo; MARINHO, Anna Karolina; COHON, Andrea; GRECCO, Octavio; KALIL, Jorge; BARROS, Myrthes Toledo; KOKRON, Cristina MariabookPart Imunodeficiências Primárias(2016) KOKRON, Cristina Maria; BARROS, Myrthes ToledoconferenceObject Was the PON1-55MM Polymorphism Associated to Higher Disease Severity in Common Variable Deficiency Patients?(2014) SINI, B. C.; BYDLOWSKI, S. P.; LEVY, Debora; MASELLI, Luciana M. F.; COHON, Andrea; KOKRON, Cristina M.; OLIVEIRA, Ana Karolina Barreto; KALIL, Jorge; BARROS, Myrthes Toledo
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