LIGIA MARIA ICHIMURA FUKUMORI

Índice h a partir de 2011
3
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina

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  • article 10 Citação(ões) na Scopus
    Analysis of the reactivity of indirect immunofluorescence in patients with pemphigus foliaceus and pemphigus vulgaris using rat bladder epithelium as a substrate
    (2011) ORTOLAN, Damaris G.; SOUZA, Danielle P. G.; AOKI, Valeria; SANTI, Claudia G.; GABBI, Tatiana V. B.; ICHIMURA, Ligia M. F.; MARUTA, Celina W.
    OBJECTIVES: To evaluate the reactivity of indirect immunofluorescence using rat bladder epithelium as a substrate in patients with pemphigus foliaceus and pemphigus vulgaris from the Department of Dermatology, University of Sao Paulo Medical School, Brazil. METHODS: Thirty-two patients (8 male and 24 female) from the Department of Dermatology, University of Sao Paulo Medical School, were selected. Three had mucosal pemphigus vulgaris, 20 had mucocutaneous pemphigus vulgaris, and 9 had pemphigus foliaceus. Patients' sera were tested by indirect immunofluorescence performed on human foreskin and rat bladder epithelium and by ELISA assays utilizing baculovirus-expressed recombinant desmoglein 3 and desmoglein 1. RESULTS: No patients with mucosal pemphigus vulgaris, 5 of 20 patients with mucocutaneous pemphigus vulgaris (25%) and 4 of 9 patients with pemphigus foliaceus (44%) had positive indirect immunofluorescence using rat bladder epithelium as a substrate. CONCLUSION: Indirect immunofluorescence using rat bladder epithelium as a substrate is recommended whenever a diagnosis of paraneoplastic pemphigus is considered. The identification of a subset of pemphigus foliaceus and pemphigus vulgaris patients that recognizes desmoplakins by this laboratory tool is critical to avoid the misdiagnosis of paraneoplastic pemphigus.
  • article
    Correlation between Histopathological Findings and Results of Direct Immunofluorescence in the Diagnosis of Canine Localized Cutaneous Chronic Lupus Erythematosus
    (2017) ODAGUIRI, Juliana; AOKI, Valeria; FUKUMORI, Ligia Maria Ichimura; PERIGO, Alexandre Marques; MICHALANY, Nilceo Scwery; FONTANA, Isabella; LARSSON, Carlos Eduardo
    Background: Localized chronic cutaneous lupus erythematosus (CCLE), also known as discoid lupus erythematosus, is one of the most prevalent canine autoimmune skin diseases. Histopathology is considered the gold standard for the diagnosis of CCLE and the accuracy of which can be increased by use of direct immunofluorescence (DIF). This study aimed to investigate the fluorescence pattern revealed by DIF in cases of canine localized CCLE and to establish and compare its effectiveness with that obtained from histopathology. Materials, Methods & Results: Eleven dogs suspicious to localized CCLE, i.e., those animals that presented mucocutaneous lesions as erythema, leucoderma, erosive-ulcerative lesions, and loss of nasal planum architecture and its transition to the haired skin underwent medical physical and laboratory examinations (blood count, platelet count, determination of alanine transaminase, alkaline phosphatase, total protein, serum albumin, urea, creatinine). Only those animals that proved to be normal across both the physical and laboratorial evaluation were included in Group I. Animals belonging to this group were submitted to general anesthesia to biopsy two samples of lesioned skin from nasal planum to histopathologic examination and DIF test. Five dogs with no skin lesions were included in Group II as negative control to the DIF assay. Two samples of no lesioned skin from nasal planum were biopsied to histopathologic and DIF evaluation. The kappa (k) coefficient was used to determine the degree of agreement and reliability of the results of both tests. A P-value < 5% was considered to be statistically significant. In Group I, all animals were normal across both the physical and laboratorial evaluation. A diagnosis of canine CCLE was established in 81.8% (9/11) of the animals based on histopathology analysis. Two dogs, numbers 10 and 11, respectively, had histopathologic findings suggestive of cutaneous leishmaniasis and compatible with canine demodicosis. The DIF assay confirmed the diagnostic of canine CCLE in 100% (11/11) of the cases, including dogs numbers 10 and 11. Direct immunofluorescence positivity for canine localized CCLE was determined by the presence of homogeneous green fluorescence in the basement membrane zone, with IgM and C3 immunoreagents being found at a significantly higher frequency (P = 0.007) than IgA and IgG (P = 0.017 and P = 0.037, respectively). In Group II, no alterations from histopathologic examination and unspecific fluorescence from DIF reaction were shown in all animals belonging to this group. A substantial and significant degree of agreement or reliability (k = 0.738 and P = 0.002, respectively) was established between the results of both tests. Discussion: In veterinary medicine, there is a lack of studies about DIF around autoimmune dermatoses. This is the first manuscript comparing histopathological and direct immunofluorescence findings in the diagnostic of dogs with localized CCLE. In the present study, the positivity to the DIF assay for canine localized CCLE was established by the presence of green fluorescence of a homogeneous morphologic pattern, especially for IgM and C3, located in the BMZ and cutaneous annexes. Direct immunofluorescence excluded the suspicion of cutaneous leishmaniasis determined by the histopathological findings and confirmed the diagnostic of canine localized CCLE in the dog number 10. Statistically, a substantial degree of agreement and reliability was shown between DIF and histopathology. Therefore, we concluded that the DIF assay is a highly effective and useful complementary examination that improves our ability to diagnose canine CCLE.
  • article 3 Citação(ões) na Scopus
    Profile of Trypanosoma cruzi Reactivity in a Population at High Risk for Endemic Pemphigus Foliaceus (Fogo Selvagem)
    (2012) SOUSA JR., Joaquim X.; DIAZ, Luis A.; EATON, Donald P.; HANS-FILHO, Guenter; FREITAS, Elder Lanzani de; DELGADO, Livia; ICHIMURA, Ligia Maria F.; CRISTALDI, Flavia; ORLANDI, Renata; KESPER JR., Norival; UMEZAWA, Eufrosina S.; RIVITTI, Evandro A.; AOKI, Valeria
    Fogo Selvagem (FS) is an autoimmune bullous disease with pathogenic IgG autoantibodies recognizing desmoglein 1 (Dsg1), a desmosomal glycoprotein. In certain settlements of Brazil, a high prevalence of FS (3%) is reported, suggesting environmental factors as triggers of the autoimmune response. Healthy individuals from endemic areas recognize nonpathogenic epitopes of Dsg1, and exposure to hematophagous insects is a risk factor for FS. Fogo selvagem and Chagas disease share some geographic sites, and anti-Dsg1 has been detected in Chagas patients. Indeterminate Chagas disease was identified in a Brazilian Amerindian population of high risk for FS. In counterpart, none of the FS patients living in the same geographic region showed reactivity against Trypanosoma cruzi. The profile of anti-Dsg1 antibodies showed positive results in 15 of 40 FS sera and in 33 of 150 sera from healthy individuals from endemic FS sites, and no cross-reactivity between Chagas disease and FS was observed.
  • conferenceObject
    Increased vascular endothelial growth factor expression in erythrodermic pemphigus foliaceus patients
    (2016) MIYAMOTO, Denise; OTANI, Camila Sayuri Vicentini; FUKUMORI, Ligia Maria Ichimura; PEREIRA, Naiura Vieira; SOTTO, Mirian Nacagami; MARUTA, Celina Wakisaka; SANTI, Claudia Giuli; REBEIS, Marina Mattos; AOKI, Valeria