ELAINE MARIA FRADE COSTA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/42 - Laboratório de Hormônios e Genética Molecular, Hospital das Clínicas, Faculdade de Medicina
LIM/42 - Laboratório de Hormônios e Genética Molecular, Hospital das Clínicas, Faculdade de Medicina
13 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 13
- Diagnosis of prolactinoma in two male-to-female transsexual subjects following high-dose cross-sex hormone therapy(2015) CUNHA, F. S.; DOMENICE, S.; CAMARA, V. L.; SIRCILI, M. H. P.; GOOREN, L. J. G.; MENDONCA, B. B.; COSTA, E. M. F.Male-to-female transsexual persons use oestrogens+antiandrogens to adapt their physical bodies to the female sex. Doses are usually somewhat higher than those used by hypogonadal women receiving oestrogen replacement. Particularly in cases of self-adminstration of cross-sex hormones, doses may be very high. Oestrogens are powerful stimulators of synthesis and release of prolactin and serum prolactin levels are usually somewhat increased following oestrogen treatment. Prolactinomas have been reported in male-to-female transsexual persons, both after use of high and conventional doses of oestrogens but remain rare events. We report two new cases of prolactinomas in male-to-female transsexual persons, one in a 41-year-old subject who had used nonsupervised high-dose oestrogen treatment since the age of 23years and another one in a 42year old who had initiated oestrogen treatment at the age of 17years. Their serum prolactin levels were strongly increased, and the diagnosis of a pituitary tumour was confirmed by imaging techniques. Both cases responded well to treatment with cabergoline treatment whereupon serum prolactin normalised. Our two cases are added to the three cases of prolactinomas in the literature in persons who had used supraphysiological doses of oestrogens.
- Partial androgen insensitivity syndrome due to somatic mosaicism of the androgen receptor(2018) BATISTA, Rafael Loch; RODRIGUES, Andresa De Santi; MACHADO, Aline Zamboni; NISHI, Mirian Yumie; CUNHA, Flavia Siqueira; SILVA, Rosana Barbosa; COSTA, Elaine M. F.; MENDONCA, Berenice B.; DOMENICE, SorahiaBackground: Androgen insensitivity syndrome (AIS) is the most frequent etiology of 46, XY disorders of sex development (DSDs), and it is an X-linked disorder caused by mutations in the androgen receptor (AR) gene. AIS patients present a broad phenotypic spectrum and individuals with a partial phenotype present with different degrees of undervirilized external genitalia. There are more than 500 different AR gene allelic variants reported to be linked to AIS, but the presence of somatic mosaicisms has been rarely identified. In the presence of a wild-type AR gene, a significant degree of spontaneous virilization at puberty can be observed, and it could influence the gender assignment, genetic counseling and the clinical and psychological management of these patients and the psychosexual outcomes of these patients are not known. Case presentation: In this study, we report two patients with AR allelic variants in heterozygous (c.382G>T and c.1769-1G>C) causing a partial AIS (PAIS) phenotype. The first patient was raised as female and she had undergone a gonadectomy at puberty. In both patients there was congruency between gender of rearing and gender identity and gender role. Conclusions: Somatic mosaicism is rare in AIS and nonsense AR variant allelic can cause partial AIS phenotype in this situation. Despite the risk of virilization and prenatal androgen exposure, the gender identity and gender role was concordant with sex of rearing in both cases. A better testosterone response can be expected in male individuals and this should be considered in the clinical management.
conferenceObject GnRH Analogue's Use in the Diagnostic Approach of Patients with Suspected 46,XX Ovotesticular Disorders of Sex Development(2014) PELAES, Tatiana S.; SANTANA, Nathalie Oliveira; SILVA, Rosana Barbosa; COSTA, Elaine Maria Frade; SIRCILI, Maria Helena Palma; CUNHA, Flavia Siqueira; MENDONCA, Berenice B.; DOMENICE, Sorahia- TRANSSEXUAL GENITAL SURGERY: COMPLICATIONS AND FUNCTIONAL RESULTS AFTER 13 YEARS OF EXPERIENCE(2013) SIRCILI, Maria Helena; DENES, Francisco Tibor; TAVARES, Alessandro; COSTA, Elaine Maria Frade; DOMENICE, Sorahia; CUNHA, Flavia Siqueira; SROUGI, Miguel; MENDONCA, Berenice
conferenceObject Sexual Outcomes in Brazilian Patients with 46,XY DSD(2016) BATISTA, Rafael Loch; INACIO, Marlene; CUNHA, Flavia Siqueira; GOMES, Nathalia Lisboa; BRITO, Vinicius Nahime; COSTA, Elaine Frade; DOMENICO, Sorahia; MENDONCA, Berenice Bilharinho deconferenceObject Long-Term Follow-Up of Patients with 46,XY Partial Gonadal Dysgenesis Accordingly Gender Assignment(2016) GOMES, Nathalia; COSTA, Elaine; ZAMBONI, Aline; NISHI, Mirian; BATISTA, Rafael; CUNHA, Flavia; INACIO, Marlene; DOMENICE, Sorahia; MENDONCA, Berenice- A SEVERE PHENOTYPE OF KENNEDY DISEASE ASSOCIATED WITH A VERY LARGE CAG REPEAT EXPANSION(2018) MADEIRA, Joao L. O.; SOUZA, Alexandre B. C.; CUNHA, Flavia S.; BATISTA, Rafael L.; GOMES, Nathalia L.; RODRIGUES, Andresa S.; JORGE, Frederico Mennucci de Haidar; CHADI, Gerson; CALLEGARO, Dagoberto; MENDONCA, Berenice B.; COSTA, Elaine M. F.; DOMENICE, Sorahia
conferenceObject Exonic Splicing Mutations by Silent Nucleotide Variation in the Androgen Receptor Gene Causes Androgen Insensitivity Syndrome(2016) BATISTA, Rafael Loch; RODRIGUES, Andreza de Santi; SILVA, Tathiana Evilen da; CUNHA, Flavia Siqueira; GOMES, Nathalia Lisboa; RODRIGUES, Daniela; DOMENICE, Sorahia; COSTA, Elaine Frade; MENDONCA, Berenice Bilharinho de- Arterial Stiffness in Transgender Men Receiving Long-term Testosterone Therapy(2023) CUNHA, Flavia Siqueira; BACHEGA, Tania Aparecida Sanchez; COSTA, Elaine Maria Frade; BRITO, Vinicius Nahime; ALVARES, Leonardo Azevedo; COSTA-HONG, Valeria Aparecida; VERARDINO, Renata Gomes Sanches; SIRCILI, Maria Helena Palma; MENDONCA, Berenice Bilharinho de; BORTOLOTTO, Luiz Aparecido; DOMENICE, SorahiaContext: The effects of androgen therapy on arterial function in transgender men (TM) are not fully understood, particularly concerning long-term androgen treatment. Objective: To evaluate arterial stiffness in TM receiving long-term gender-affirming hormone therapy by carotid-femoral pulse wave velocity (cf-PWV). Methods: A cross-sectional case-control study at the Gender Dysphoria Unit of the Division of Endocrinology, HC-FMUSP, Sao Paulo, Brazil. Thirty-three TM receiving intramuscular testosterone esters as regular treatment for an average time of 14 +/- 8 years were compared with 111 healthy cisgender men and women controls matched for age and body mass index. Aortic stiffness was evaluated by cf-PWV measurements using Complior device post-testosterone therapy. The main outcome measure was aortic stiffness by cf-PWV as a cardiovascular risk marker in TM and control group. Results: The cf-PWV after long-term testosterone therapy was significantly higher in TM (7.4 +/- 0.9 m/s; range 5.8-8.9 m/s) than in cisgender men (6.6 +/- 1.0 m/s; range 3.8-9.0 m/s, P <.01) and cisgender women controls (6.9 +/-.9 m/s; range 4.8-9.1 m/s, P =.02). The cf-PWV was significantly and positively correlated with age. Analysis using blood pressure as a covariate showed a significant relationship between TM systolic blood pressure (SBP) and cf-PWV in relation to cisgender women but not to cisgender men. Age, SBP, and diagnosis of hypertension were independently associated with cf-PWV in the TM group. Conclusion: The TM group on long-term treatment with testosterone had higher aging-related aortic stiffening than the control groups. These findings indicate that aortic stiffness might be accelerated in the TM group receiving gender-affirming hormone treatment, and suggest a potential deleterious effect of testosterone on arterial function. Preventive measures in TM individuals receiving testosterone treatment, who are at higher risk for cardiovascular events, are highly recommended.
bookPart Disforia de gênero(2022) CUNHA, Flávia Siqueira; DOMENICE, Sorahia; COSTA, Elaine Maria Frade