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
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conferenceObject 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 Low bone mineral density and muscle mass in common variable immunodeficiency patients: Association with CD4+T cells and B cells(2019) BARROS, M. Toledo; MELO, D. Barreto De; PEREIRA, R. M. Rodrigues; SINI, B.; COUTINHO, E. M.; TAKAYAMA, L.; KOKRON, C. M.; MARINHO, A. K.; GRECCO, O.; KALIL, J.; ANTILA, H. G.conferenceObject Mortality in a cohort of common variable immunodeficiency (CVID) patients from 1980 to 2019(2020) BARROS, M. T.; MARINHO, A. K. B. B.; SINI, B.; GRECCO, O.; KALIL, J.; KOKRON, C. M.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.conferenceObject 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- Bone Mineral Density is Related to CD4+ T Cell Counts and Muscle Mass is Associated with B Cells in Common Variable Immunodeficiency Patients(2024) MELO, Daniel Barreto de; PEREIRA, Rosa Maria Rodrigues; SINI, Bruno; LEVY, Debora; TAKAYAMA, Lilian; KOKRON, Cristina Maria; MARINHO, Ana Karolina Berselli; GRECCO, Octavio; KALIL FILHO, Jorge Elias; BARROS, Myrthes ToledoBackground: Common variable immunodeficiency (CVID) is a primary immunodeficiency characterized by chronic/recurrent respiratory infections, bronchiectasis, autoimmunity, inflammatory, gastrointestinal diseases and malignancies associated with a chronic inflammatory state and increased risk of osteoporosis and muscle loss. Aim: The aim of this study was to evaluate bone mineral density (BMD), body composition and their relationship with lymphocyte subpopulations in CVID patients. Methods: Dual-energy X-ray absorptiometry was performed to assess BMD, lean mass, and fat mass in CVID patients. Peripheral blood CD4(+), CD8(+), and CD19(+) cells were measured using flow cytometry. Results: Thirty-three patients (37.3 +/- 10.8 years old) were examined. Although only 11.8% of the individuals were malnourished (BMI <18.5 kg/m(2)), 27.7% of them had low skeletal muscle mass index (SMI), and 57.6% of them had low BMD. Patients with osteopenia/osteoporosis presented lower weight (p = 0.007), lean mass (p = 0.011), appendicular lean mass (p = 0.011), SMI (p = 0.017), and CD4+ count (p = 0.030). Regression models showed a positive association between CD4+ count and bone/muscle parameters, whereas CD19+ B cell count was only associated with muscle variables. Analysis of ROC curves indicated a cutoff value of CD4+ count (657 cells/mm3; AUC: 0.71, 95% CI 0.52-0.90) which was related to low BMD. Weight (p = 0.004), lean mass (p = 0.027), appendicular lean mass (p = 0.022), SMI (p = 0.029), total bone mineral content (p = 0.005), lumbar (p = 0.005), femoral neck (p = 0.035), and total hip BMD (p<0.001) were found to be lower in patients with CD4+ count below the cutoff. Conclusion: CVID patients presented with low BMD, which was associated with CD4+ count. Moreover, low muscle parameters were correlated with B cell count.
conferenceObject Thrombosis Association with Administration of Intravenous Human Immunoglobulin in Patients with Primary or Secondary Immunodeficiencies(2017) GONCALVES, Danilo Gois; ASSIS, Joao Paulo de; SINI, Bruno; MARINHO, Ana Karolina; KOKRON, Cristina Maria; GRECCO, Octavio; KALIL, Jorge; BARROS, Myrthes ToledoconferenceObject Is the incidence of gastric tumor increasing in variable common immunodeficiency patients?(2019) GRECCO, O.; BARBUTI, R. C.; KOKRON, C. M.; MARINHO, A. K. B.; SINI, B. C.; FIGUEIRA, R. C. L.; KALIL, J.; BARROS, M. T.