VIOLETA REGNIER GALVAO
Projetos de Pesquisa
Unidades Organizacionais
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina
11 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 11
conferenceObject Characterization of Asthmatic Patients with Vocal Cord Dysfunction(2013) AGONDI, Rosana C.; GALVAO, Violeta; AUN, Marcelo; BISACCIONI, Carla; KALIL, Jorge; GIAVINA-BIANCHI, PedroRATIONALE: The vocal cord dysfunction (VCD) is a syndrome characterized by paradoxical movement of the vocal folds that causes respiratory distress. Our goal is to analyze asthmatic patients with VCD. METHODS: This was an observational and cross-sectional study involving patients over 18 years of age who had been diagnosed with asthma according to the Global Initiative for Asthma guidelines. Eighty-five patients were analyzed. They were submitted to spirometry, and tested for total and specific IgE to aeroallergens (skin prick test and/or in vitro ). RESULTS: The mean age was 52.1 years, and 93% were female. Sixty- seven patients had moderate or severe persistent asthma. Spirometry was normal or showed mild obstructive respiratory disease in 81% of them. Spirometric alterations suggestive of VCD were observed in 24% of the patients. The mean serum total IgE was 303 IU/mL and the detection of specific IgE was present in 76% of them. Gastroesophageal reflux disease was observed in 65% of the patients. When classified according to gender, we found that men were younger, had higher total IgE and higher prevalence of specific IgE. CONCLUSIONS: There was a higher prevalence of the association asthma and VCD in women, suggesting that this association could be masked in men. However, we observed that the clinical characteristics were different between men and women. We found a high prevalence of atopy that could be another confounding factor. There was a weak association between asthma and spirometric severity classifications, suggesting a potential role for VCD in making difficult to the asthma control in some patients.conferenceObject Basophil Activation Test As a Biomarker in Allergic Patients to Platins Undergoing Rapid Desensitization(2015) GIAVINA-BIANCHI, Pedro; GALVAO, Violeta; CAIADO, Joana; PICARD, Matthieu; CASTELLS, Mariana C.- Carboplatin-allergicpatients undergoing desensitization: prevalence and impact of the BRCA 1/2 mutation(2017) GALVAO, Violeta Regnier; PHILLIPS, Elizabeth; GIAVINA-BIANCHI, Pedro; CASTELLS, Mariana C.
- Hypersensitivity to Biological Agents-Updated Diagnosis, Management, and Treatment(2015) GALVAO, Violeta Regnier; CASTELLS, Mariana C.Biological agents are used in the treatment of neoplastic, autoimmune, and inflammatory diseases and their clinical applications are becoming broader. Following their increased utilization, hypersensitivity reactions linked to these drugs have become more frequent, sometimes preventing the use of first-line therapies. The clinical presentation of hypersensitivity reactions to biological agents ranges from mild cutaneous manifestations to life-threatening reactions. In this scenario, rapid desensitization is a groundbreaking procedure that enables selected patients to receive the full treatment dose in a safe way, in spite of their immediate hypersensitivity reaction to the drug, and protects them against anaphylaxis. The aim of this review is to update and discuss some of the main biological agents used in clinical practice (rituximab, trastuzumab, cetuximab, ofatumumab, tocilizumab, brentuximab, omalizumab, and tumor necrosis factor alpha inhibitor agents) and their associated hypersensitivity reactions, including clinical presentations, diagnosis, and treatment in the acute setting. In addition, novel management options with rapid desensitization are presented. (C) 2015 American Academy of Allergy, Asthma & Immunology
- Monoclonal Antibodies Hypersensitivity Prevalence and Management(2017) SANTOS, Rafael Bonamichi; GALVAO, Violeta RegnierThe use of monoclonal antibodies (mAbs) has become broader because of their recognized effectiveness in the treatment of autoimmune, neoplastic, and inflammatory diseases. Consequently, hypersensitivity reactions (HSR) secondary to mAbs are being reported more often, and each mAb-related HSR presents specific features. This article discusses the main biological agents and associated HSR, the clinical presentation of such reactions, and the role of tryptase and skin testing in the diagnosis. Rapid drug desensitization procedures to mAbs enable selected allergic patients to receive full therapeutic doses in a safe manner and are also discussed.
- Basophil Activation Test is a Relevant Biomarker of the Outcome of Rapid Desensitization in Platinum Compounds-Allergy(2017) GIAVINA-BIANCHI, Pedro; GALVAO, Violeta Regnier; PICARD, Matthieu; CAIADO, Joana; CASTELLS, Mariana C.BACKGROUND: Rapid drug desensitization (RDD) has become a cornerstone in the management of immediate drug hypersensitivity reactions (DHRs) to chemotherapeutic agents. Because of the inherent risk of anaphylaxis during RDD, biomarkers to predict patients at risk of developing such severe reactions are needed. The basophil activation test (BAT) has been used in DHRs as a diagnostic tool. OBJECTIVE: We evaluated basophil CD63 and CD203c expression (BAT) as a biomarker to assess the safety and effectiveness of RDD in platinum compounds-allergic patients. METHODS: Patients allergic to platinum compounds (n = 15) undergoing RDD were assessed through clinical history, skin testing, serum tryptase levels, and BAT. BAT was performed immediately before RDD, assessing CD203c and CD63 expression on basophils. BAT was also performed in 6 patients tolerant to platinum compounds and in 6 healthy volunteers. RESULTS: BAT was positive to CD203c or CD63 in 11 out of 15 patients allergic to platinum compounds (73%), with increased expression of CD203c and CD63 in 11 (73%) and 6 (40%) patients, respectively. Increased CD63 expression tended to be associated with more severe initial reactions. All controls had negative test results. Reactions during RDD were associated with BAT positivity and increased tryptase levels. Only 1 of 4 patients with negative BAT had a mild reaction during RDD. BAT remained positive in multiple sequential RDD. CONCLUSIONS: BAT identified patients allergic to platinum compounds with an increased risk of reactions during desensitization and higher CD63 expression was observed in severe reactions. Multiple RDDs to platinum compounds did not induce persistent hyporesponsiveness on basophils. BAT is a potential biomarker for RDD. (C) 2016 American Academy of Allergy, Asthma & Immunology
- Current Knowledge and Management of Hypersensitivity Reactions to Monoclonal Antibodies(2017) PICARD, Matthieu; GALVAO, Violeta RegnierHypersensitivity reactions (HSRs) to monoclonal antibodies (mAbs) are increasingly frequent as this class of therapeutic agents is rapidly expanding. Immediate and nonimmediate HSRs have been reported with mAbs. Immediate HSRs can be explained by 3 main mechanisms: cytokine release syndrome, IgE-mediated, and IgG-mediated reactions. Importantly, IgE-mediated reactions can occur on first exposure due to preformed specific IgEs, as shown for cetuximab. Almost all patients with an immediate HSR can be safely re-exposed either through desensitization or challenge depending on the severity and mechanism of the initial reaction. An algorithm detailing the general approach to these HSRs and the preferred method of re-exposure is presented in this review. Also, the mAbs that are most frequently implicated in HSRs are discussed individually. (C) 2016 American Academy of Allergy, Asthma & Immunology
bookPart Alergia ao Látex(2015) GARRO, Laila Sabino; GALVãO, Violeta Régnier; GIAVINA-BIANCHI, Pedro- Perioperative Anaphylaxis(2014) GALVAO, Violeta Regnier; GIAVINA-BIANCHI, Pedro; CASTELLS, MarianaPerioperative anaphylaxis is a life-threatening condition with an estimated prevalence of 1: 3,500 to 1: 20,000 procedures and a mortality rate of up to 9 %. Clinical presentation involves signs such as skin rash, urticaria, angioedema, bronchospasm, tachycardia, bradycardia, and hypotension. Prompt recognition and treatment is of utmost importance to the patient's prognosis, since clinical deterioration can develop rapidly. Epinephrine is the main treatment drug, and its use should not be postponed, since delayed administration is associated with increased mortality. Elevated levels of serum tryptase help to confirm the diagnosis. The main agents involved in IgE-mediated perioperative anaphylaxis are neuromuscular blocking agents, latex, antibiotics, hypnotics, opioids, and colloids. Specific investigation should be conducted 4 to 6 weeks after the reaction and relies on skin tests, serum-specific IgE, and challenge procedures. This review aims to discuss the main aspects of perioperative anaphylaxis: risk factors, diagnosis, treatment, culprit agents, specific investigation, and preventive measures.
- BAT in the Diagnosis of Drug Allergy: a Novel Tool in Clinical Daily Practice?(2019) CAMPOS, Lucila; GALVAO, Violeta Regnier; KALIL, Jorge; CASTELLS, Mariana; GIAVINA-BIANCHI, PedroPurpose of ReviewThe aim of this study is to critically review the relevant literature published on basophil activation test, presenting the current knowledge and future perspectives.Recent FindingsBasophil activation test (BAT) results varied accordingly to the class of the drug studied, and have promising results in immediate hypersensitivity reactions to pyrazolone (selective reactors), neuromuscular blockers, beta-lactams, and platinum compounds, all examples of classical IgE-mediated hypersensitivity drug reactions.SummaryCurrently, BAT is applied in research settings, but based in the results of our review, the test can be considered as a diagnostic tool for daily practice for selected patients and selected drugs, when the test is available, particularly for patients who experienced severe reactions and when diagnosis cannot be stablished by serum-specific IgE and skin testing, in order to avoid unnecessary drug provocations tests.