DEBORA RAQUEL BENEDITA TERRABUIO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/07 - Laboratório de Gastroenterologia Clínica e Experimental, Hospital das Clínicas, Faculdade de Medicina

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Autor e Coautores FMUSP-HC Normalizados: FLAIR JOSE CARRILHO ×

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Agora exibindo 1 - 10 de 16
  • article 1 Citação(ões) na Scopus
    Liver elastography can predict degree of advanced fibrosis for autoimmune hepatitis in biochemical remission
    (2023) PARANAGUA-VEZOZZO, Denise Cerqueira; TERRABUIO, Debora Raquel Benedita; REINOSO-PEREIRA, Gleicy Luz; MOUTINHO, Renata; ONO, Suzane Kioko; SALAS, Veronica Walwyn; FRANCA, Joao Italo Dias; ALVES, Venancio Avancini Ferreira; CANCADO, Eduardo Luiz Rachid; CARRILHO, Flair Jose
    Background and AimThe aim was to analyze the concordance of liver stiffness measurement (LSM) either by transient elastography (TE) or ARFI with liver biopsy in autoimmune hepatitis (AIH) patients with biochemical remission and to identify those with histological remission. Liver biopsy is still the golden standard for AIH diagnosis. However, it is an invasive procedure and these patients, most of the time, require many biopsies, so it would be valuable to search for noninvasive method that could select all these patients and keep under observation. MethodsThirty-three patients with AIH were submitted for liver biopsy to evaluate histological remission after at least 18 months of normal aminotransferases. The efficiency of LSM and fibrosis stages was tested by a receiver operating characteristic curve analysis (AUROC). ResultsOne patient (3%) was F0, 6 (18.2%) were F1, 8 (24.2%) were F2, 10 (30.3%) were F3, and 8 (24.2%) were F4, according to METAVIR. Thirteen of thirty-three (39.4%) patients did not achieve histological remission. AUROC for F4 stage was 0.83 (IC: 0.76-0.99) for TE and 0.78 (IC: 0.65-0.95) for ARFI. Optimal LSM cutoff values were 12.3 kPa (Se = 87.5%, Sp = 88%) for TE and 1.65 m/s (Se = 87.5%, Sp = 76%) for ARFI. The tests were unable to differentiate patients with histological activity from those in histological remission (P < 0.05). ConclusionTE and ARFI accurately identify liver fibrosis by METAVIR score in AIH patients with biochemical remission. No cutoff value was detected to indicate whether the patient achieved histological remission.
  • article 6 Citação(ões) na Scopus
    Evolution of Biomarkers of Atherogenic Risk in Liver Transplantation Recipients
    (2018) LINHARES, L. M. C.; OLIVEIRA, C. P.; ALVARES-DA-SILVA, M. R.; STEFANO, J. T.; BARBEIRO, H. V.; BARBEIRO, D. F.; TERRABUIO, D. R. B.; ABDALA, E.; SORIANO, F. G.; CARRILHO, F. J.; FARIAS, A. Q.; SIDDIQUI, M. S.; D'ALBUQUERQUE, L. A. C.
    Background. Cardiovascular disease is a major contributing factor to long-term mortality after liver transplantation (LT). Methods. This study evaluated the evolution of atherogenic risk in liver transplant recipients (LTRs). Thirty-six subjects were prospectively enrolled at 12 months and followed for 48 months after liver transplantation. Serum biomarkers of endothelial dysfunction (sICAM-1 and sVCAM-1), chronic inflammation (serum amyloid A), and oxidative stress (myeloperoxidase) were measured at 12 and 48 months after LT. Additionally, at 12 months all patients underwent a cardiac computed tomography (CT) scan and a coronary artery calcium score (CACS). Results. The prevalence of risk factors of metabolic syndrome (MS) increased over the course of the study. The patients' sVCAM-1 and sICAM-1 increased from 1.82 +/- 0.44 ng/mL to 9.10 +/- 5.82 ng/mL (P < .001) and 0.23 +/- 0.09 ng/mL to 2.7 +/- 3.3 ng/mL, respectively from month 12 to 48. Serum myeloperoxidase increased from 0.09 +/- 0.07 ng/mL to 3.46 +/- 3.92 ng/mL (P < .001) over the course of the study. Serum amyloid A also increased from 21.4 +/- 40.7 ng/mL at entry to 91.5 +/- 143.6 ng/mL at end of study (P < .001). Conclusion. No association between these biomarkers and MS was noted. The cardiac CT revealed mild and moderate disease in 19% and 25% of the cohort, respectively. No association between serum biomarkers and CACS was noted. Serum biomarkers of atherogenic risk increase rapidly in LTRs and precede coronary plaques.
  • conferenceObject
    Chloroquine in monotherapy is safe and effective for induction of remission in anti-SLA/LP positive patients with autoimmune hepatitis
    (2018) TERRABUIO, D.; EVANGELISTA, A. S.; GUEDES, A. L. V.; GALVAO, A. R. de Moreto Longo; CARRILHO, F. J.; CANCADO, E.
  • conferenceObject
    Transient Elastography (TE) And Acoustic Radiation Force Impulse Imaging (ARFI) Can Predict Degree Of Advanced Fibrosis For Autoimmune Hepatitis In Biochemical Remission
    (2017) PARANAGUA-VEZOZZO, Denise; TERRABUIO, Debora R.; MOUTINHO, Renata D.; CANCADO, Eduardo L.; ONO, Suzane; SALAS, Veronica; CARRILHO, Flair; ALVES, Venancio Ferreira
  • conferenceObject
    Cardiovascular risk and coronary artery calcium score after liver transplantation: study at fouth year
    (2017) LINHARES, L. M.; OLIVEIRA, C. P.; ALVARES-DA-SILVA, M. R.; STEFANO, J. T.; GEBRIM, E. M.; BARBEIRO, H. V.; BARBEIRO, D. F.; TERRABUIO, D. R.; ABDALA, E.; SORIANO, F. G.; CARRILHO, F. J.; FARIAS, A. Q.; AUGUSTO, L.; ALBUQUERQUE, C. D'
  • article 1 Citação(ões) na Scopus
    Insights in the approach of long-term liver transplant recipients with COVID-19
    (2021) TERRABUIO, Debora Raquel Benedita; HADDAD, Luciana; DUCATTI, Liliana; GOUVEIA, Larissa Nunes; ROCHA-SANTOS, Vinicius; FERREIRA, Renee Mignolo Tanaka; DARCE, George Felipe; CARDOSO, Ana Julia Andrade; CARRILHO, Flair Jose; ANDRAUS, Wellington; ABDALA, Edson; D'ALBUQUERQUE, Luiz Augusto Carneiro
  • article 4 Citação(ões) na Scopus
    Technological Innovation in Outpatient Assistance for Chronic Liver Disease and Liver Transplant Patients During the Coronavirus Disease Outbreak: A Method to Minimize Transmission
    (2020) ONO, Suzane Kioko; ANDRAUS, Wellington; TERRABUIO, Debora Raquel Benedita; COBELLO-JUNIOR, Vilson; ARAI, Lilian; DUCATTI, Liliana; HADDAD, Luciana Bertocco de Paiva; D'ALBUQUERQUE, Luiz Augusto Carneiro; CARRILHO, Flair Jose
  • conferenceObject
    Ursodeoxycholic acid and/or ciprofibrate for treating patients with presumptive diagnosis of low phospholipid cholelithiasis, a clinical spectrum of progressive familial intrahepatic cholestasis type 3
    (2020) LINHARES, Fernanda S.; CARDOSO, Ana; TERRABUIO, Debora; HARRIZ, Michelle; GUEDES, Laura; CARRILHO, Flair Jose; CANCADO, Eduardo Luiz Rachid
  • conferenceObject
    ALLOPURINOL IS SAFE AND EFFECTIVE TO ACHIEVE BIOCHEMICAL AND HISTOLOGICAL REMISSION IN PATIENTS WITH AUTOIMMUNE HEPATITIS WITH INCOMPLETE THERAPEUTIC RESPONSE
    (2016) TERRABUIO, D. R.; FALCAO, L. T. De Moraes; ONO, S. K.; DINIZ, M. A.; CARRILHO, F. J.; CANCADO, E.
  • article 13 Citação(ões) na Scopus
    Chloroquine Is Effective for Maintenance of Remission in Autoimmune Hepatitis: Controlled, Double-Blind, Randomized Trial
    (2019) TERRABUIO, Debora Raquel Benedita; DINIZ, Marcio Augusto; FALCAO, Lydia Teofilo de Moraes; GUEDES, Ana Luiza Vilar; NAKANO, Larissa Akeme; EVANGELISTA, Andreia Silva; LIMA, Fabiana Roberto; ABRANTES-LEMOS, Clarice Pires; CARRILHO, Flair Jose; CANCADO, Eduardo Luiz Rachid
    Between 50% and 86% of patients with autoimmune hepatitis (AIH) relapse after immunosuppression withdrawal; long-term immunosuppression is associated with increased risk of neoplasias and infections. Chloroquine diphosphate (CQ) is an immunomodulatory drug that reduces the risk of flares in rheumatologic diseases. Our aims were to investigate the efficacy and safety of CQ for maintenance of biochemical remission of AIH in a double-blind randomized trial and to define a subgroup that obtained a greater benefit from its use. A total of 61 patients with AIH in histologic remission (90.1% AIH type 1 [AIH-1]) were randomized to receive CQ 250 mg/day or placebo for 36 months. Of the 61 patients, 31 received CQ and 30 placebo. At baseline, clinical, laboratory, histologic findings, and human leukocyte antigen (HLA) profile were similar between the two groups. Relapse-free survival was significantly higher in the CQ group compared to the placebo group (59.3% and 19.9%, respectively P = 0.039). For those patients completing 3-year treatment, relapse rates were 41.6% and 0% after CQ and placebo withdrawal, respectively. Factors associated with a higher risk of relapse in multiple Cox regression were placebo use (hazard ratio, 2.4; 95% confidence interval [CI], 1.055.5; P = 0.039) and anti-soluble liver antigen/liver-pancreas (anti-SLA/LP) seropositivity (hazard ratio, 5.4; 95% CI, 1.91-15.3; P = 0.002). Although it was not possible to define a subgroup that obtained a greater benefit from CQ according to anti-SLA/LP reactivity or HLA profile, 100% of patients who were anti-SLA/LP-positive (+) relapsed with placebo compared to 50% with CQ (P = 0.055). In the CQgroup, 54.8% had side effects and 19.3% interrupted the drug regimen. Conclusion: CQ safely reduced the risk of relapse of AIH, but it was not possible to define a subgroup that obtained a greater benefit with CQ use, probably because of sample size.