ANTONIO ABILIO MOTTA
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
22 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 22
- Drug-induced anaphylaxis in children: Nonsteroidal anti-inflammatory drugs and drug provocation test REPLY(2014) AUN, Marcelo Vivolo; BLANCA, Miguel; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; KALIL, Jorge; MOTTA, Antonio Abilio; CASTELLS, Mariana; GIAVINA-BIANCHI, Pedro
- Multiple comorbidities in patients with long-lasting chronic spontaneous urticaria(2023) AGONDI, Rosana Camara; ARGOLO, Paula Natassya; MOUSINHO-FERNANDES, Mariana; GEHLEN, Bruna; KALIL, Jorge; MOTTA, Antonio Abilio
- Specific questionnaire detects a high incidence of intra-operative hypersensitivity reactions(2018) GARRO, Laila S.; V, Marcelo Aun; SOARES, Iracy Silvia C.; RIBEIRO, Marisa R.; MOTTA, Antonio A.; KALIL, Jorge; CASTELLS, Mariana C.; CARMONA, Maria Jose C.; GIAVINA-BIANCHI, PedroOBJECTIVE: To assess the incidence of intra-operative immediate hypersensitivity reactions and anaphylaxis. METHODS: A cross-sectional observational study was conducted at the Department of Anesthesiology, University of Sao Paulo School of Medicine, Hospital das Clinicas, Sao Paulo, Brazil, from January to December 2010. We developed a specific questionnaire to be completed by anesthesiologists. This tool included questions about hypersensitivity reactions during anesthesia and provided treatments. We included patients with clinical signs compatible with immediate hypersensitivity reactions. Hhypersensitivity reactions were categorized according to severity (grades I-V). American Society of Anesthesiologists physical status classification (ASA 1-6) was analyzed and associated with the severity of hypersensitivity reactions. RESULTS: In 2010, 21,464 surgeries were performed under general anesthesia. Anesthesiologists answered questionnaires on 5,414 procedures (25.2%). Sixty cases of intra-operative hypersensitivity reactions were reported. The majority patients (45, 75%) had hypersensitivity reactions grade I reactions (incidence of 27.9:10,000). Fifteen patients (25%) had grade II, III or IV reactions (intra-operative anaphylaxis) (incidence of 7:10,000). No patients had grade V reactions. Thirty patients (50%) were classified as ASA 1. The frequency of cardiovascular shock was higher in patients classified as ASA 3 than in patients classified as ASA 1 or ASA 2. Epinephrine was administered in 20% of patients with grade III hypersensitivity reactions and in 50% of patients with grade II hypersensitivity reactions. CONCLUSIONS: The majority of patients had hypersensitivity reactions grade I reactions; however, the incidence of intra-operative anaphylaxis was higher than that previously reported in the literature. Patients with ASA 3 had more severe anaphylaxis; however, the use of epinephrine was not prescribed in all of these cases. Allergists and anesthesiologists should implement preventive measures to reduce the occurrence of anaphylaxis.
- Genotype-phenotype correlations in Brazilian patients with hereditary angioedema due to C1 inhibitor deficiency(2019) MAIA, Luana S. M.; MORENO, Adriana S.; FERRIANI, Mariana P. L.; NUNES, Fernanda Leonel; FERRARO, Maria Fernanda; DIAS, Marina M.; ROXO-JUNIOR, Persio; DIAS, Fabricio Cesar; VALLE, Solange O. R.; LEVY, Soloni; ALONSO, Maria Luiza Oliva; FRANCA, Alfeu T.; SERPA, Faradiba Sarquis; MOTTA, Antonio Abilio; MAIA, Felipe G. M.; ARAGON, Davi Casale; SARTI, Willy; SILVA, Wilson Araujo; CICHON, Sven; BORK, Konrad; ARRUDA, L. Karla
- Algorithm to guide re-exposure to penicillin in allergic pregnant women with syphilis: Efficacy and safety(2021) GARCIA, Juliana Foes Bianchini; AUN, Marcelo Vivolo; MOTTA, Antonio Abilio; CASTELLS, Mariana; KALIL, Jorge; GIAVINA-BIANCHI, PedroResults: Ninety-one patients were enrolled. Allergy to penicillin was confirmed in 7.69% of pregnant women with syphilis and clinical history of allergy to penicillin; in all cases the diagnosis was made through intradermal testing, which predicted 100% of the breakthrough reactions observed during rapid drug desensitization (p < 0.001). Risk stratification based on the initial clinical reaction and skin testing to guide penicillin re-introduction through drug challenge or desensitization was safe (97.8%) and effective (97.8%). Conclusion: We developed and showed the efficacy and safety of an algorithm to guide reexposure to penicillin in pregnant women with syphilis and labeled as allergic to this drug. Intradermal test is an excellent biomarker in the diagnosis of immediate hypersensitivity reaction to penicillin and to predict breakthrough reaction during rapid drug desensitization. Further studies Background: Gestational syphilis is underdiagnosed and undertreated, leading to stillbirth, prematurity, low birthweight, neonatal death, and congenital syphilis. Most patients who label as allergic to penicillin are misdiagnosed. Objective: To assess the efficacy and safety of an algorithm to guide re-exposure to penicillin in pregnant women with syphilis and reporting allergy to the antibiotic. Methods: We performed a prospective study assessing pregnant women with syphilis and labeled as allergic to penicillin. Based on clinical history, patients were divided in two groups: high risk and low-risk to penicillin allergy. Low-risk patients with negative skin testing and negative serum specific IgE to penicillin underwent drug provocation test. The remaining patients underwent desensitization. Results: Ninety-one patients were enrolled. Allergy to penicillin was confirmed in 7.69% of pregnant women with syphilis and clinical history of allergy to penicillin; in all cases the diagnosis was made through intradermal testing, which predicted 100% of the breakthrough reactions observed during rapid drug desensitization (p < 0.001). Risk stratification based on the initial clinical reaction and skin testing to guide penicillin re-introduction through drug challenge or desensitization was safe (97.8%) and effective (97.8%). Conclusion: We developed and showed the efficacy and safety of an algorithm to guide re exposure to penicillin in pregnant women with syphilis and labeled as allergic to this drug. Intradermal test is an excellent biomarker in the diagnosis of immediate hypersensitivity reaction to penicillin and to predict breakthrough reaction during rapid drug desensitization. Further studies may confirm the greater safety of the intravenous protocol compared to the oral protocol.
- Brazilian Guidelines for Hereditary Angioedema Management-2017 Update Part 1: Definition, Classification and Diagnosis(2018) GIAVINA-BIANCHI, Pedro; ARRUDA, Luisa Karla; AUN, Marcelo V.; CAMPOS, Regis A.; CHONG-NETO, Herberto J.; CONSTANTINO-SILVA, Rosemeire N.; FERNANDES, Fatima R.; FERRARO, Maria F.; FERRIANI, Mariana P. L.; FRANCA, Alfeu T.; FUSARO, Gustavo; GARCIA, Juliana F. B.; KOMNINAKIS, Shirley; MAIA, Luana S. M.; MANSOUR, Eli; MORENO, Adriana S.; MOTTA, Antonio A.; PESQUERO, Joao B.; PORTILHO, Nathalia; ROSARIO, Nelson A.; SERPA, Faradiba S.; SOLE, Dirceu; TAKEJIMA, Priscila; TOLEDO, Eliana; VALLE, Solange O. R.; VERONEZ, Camila L.; GRUMACH, Anete S.Hereditary angioedema is an autosomal dominant disease characterized by recurrent angioedema attacks with the involvement of multiple organs. The disease is unknown to many health professionals and is therefore underdiagnosed. Patients who are not adequately diagnosed and treated have an estimated mortality rate ranging from 25% to 40% due to asphyxiation by laryngeal angioedema. Intestinal angioedema is another important and incapacitating presentation that may be the main or only manifestation during an attack. In this article, a group of experts from the ""Associacao Brasileira de Alergia e Imunologia (ASBAI)'' and the ""Grupo de Estudos Brasileiro em Angioedema Hereditario (GEBRAEH)'' has updated the Brazilian guidelines for the diagnosis and treatment of hereditary angioedema.
- Use of pdC1-INH concentrate for long-term prophylaxis during pregnancy in hereditary angioedema with normal C1-INH(2018) GARCIA, Juliana F. B.; TAKEJIMA, Priscila; VERONEZ, Camila Lopes; AUN, Marcelo V.; MOTTA, Antonio A.; KALIL, Jorge; PESQUERO, Joao Bosco; GIAVINA-BIANCHI, Pedro
- Gene mapping strategy for Alu elements rearrangements: Detection of new large deletions in the SERPING1 gene causing hereditary angioedema in Brazilian families(2019) NICOLICHT, Priscila; FARIA, Douglas O. S.; MARTINS-SILVA, Leonardo; MAIA, Luana S. M.; MORENO, Adriana S.; ARRUDA, L. Karla; MOTTA, Antonio A.; GRUMACH, Anete S.; PESQUERO, Joao B.Background: Hereditary angioedema (HAE) is a rare genetic disorder mainly caused by mutations in the SERPING1 gene, determining a deficit of C1 inhibitor (C1-INH). In approximately 10% of the cases, HAE with C1-INH deficiency (C1-INH-HAE) is caused by large gene rearrangements, which are not detected by Sanger sequencing. Here we present the exon quantification technique (EQT), a molecular diagnostic test for the detection of large genetic rearrangements in SERPING1, mapping the exact size and location of the deletion caused by the recombination of AM elements. EQT analysis was performed on total DNA extracted from blood of patients belonging to two Brazilian families with a medical history of HAE, low plasma levels of C4 and C1-INH and no pathogenic alteration in SERPING1 analyzed by Sanger sequencing. Results: Two large deletions were found, one of 1356 pb and one of 1804 pb, which resulted from recombination of two Alu elements present in introns 3 and 4 of the gene. Conclusion: These results showed that the EQT could be used as a simple, rapid, and efficient diagnosis test for analysis of large deletions and insertions involving SERPINGI, otherwise not detected by Sanger sequencing, serving as a support technique for molecular diagnosis of HAE.
- Outcomes and safety of drug provocation tests(2011) AUN, Marcelo Vivolo; BISACCIONI, Carla; GARRO, Laila Sabino; RODRIGUES, Adriana Teixeira; TANNO, Luciana Kase; ENSINA, Luis Felipe Chiaverirti; KALIL, Jorge; MOTTA, Antonio Abilio; GIAVINA-BIANCHI, PedroDrug provocation tests (DPTs) are considered the gold standard for identifying adverse drug reactions (ADRs). The aim of this study was to analyze DPT results and discuss severe systemic reactions associated with them. This was a retrospective analysis of 500 patients with ADRs who sought treatment and were submitted to DPTs when indicated between 2006 and 2010. We performed DPTs according to the European Network for Drug Allergy recommendations. Single-blind, placebo-controlled DPTs were performed with antibiotics, local anesthetics, and nonsteroidal anti-inflammatory drugs, as well as with other drugs. Patient characteristics, DPT results, and reactions were analyzed. The sample comprised 198 patients (80.8% of whom were female patients) submitted to 243 DPTs. Ages ranged from 9 to 84 years (mean, 39.9 years). The 243 DPTs were performed with local anesthetics (n = 93), antibiotics (n = 19), acetaminophen (n = 44), benzydamine (n = 33), COX-2 inhibitors (n = 26), dipyrone (n = 7), aspirin (n = 4), or other drugs (n = 17). The results of 4 tests (1.6%) were inconclusive, whereas those of 10 (4.1%) revealed positive reactions to antibiotics (2/19), COX-2 inhibitors (2/26), acetaminophen (3/44), and local anesthetics (3/93). Two severe reactions were observed: cephalexin-induced anaphylactic shock and bupivacaine-induced anaphylaxis without shock. Four patients (2.0%) reacted to the placebo before administration of the drug. Drug provocation tests are safe for use in clinical practice but they should be placebo-controlled and should be performed under the supervision of an allergist. To confirm a presumptive diagnosis and to manage allergies appropriately, it is crucial to perform DPTs. (Allergy Asthma Proc 32:301-306, 2011; doi: 10.2500/aap.2011.32.3450)
article 3 Citação(ões) na Scopus Anafilaxia perioperatória: A experiência brasileira(2016) AUN, Marcelo Vivolo; GARRO, Laila Sabino; RIBEIRO, Marisa Rosimeire; MOTTA, Antônio Abílio; KALIL, Jorge; GIAVINA-BIANCHI, PedroPerioperative anaphylaxis is a rare hypersensitivity reaction, but it has a rapid onset and is potentially fatal. The true incidence is not well known and varies in accordance with the country from 1:1 250 to 1:13 000 surgeries. It may occur through an allergic (IgE-mediated or not) or non-allergic mechanism, but it is believed that the IgE-mediated reactions are the most common and severe. Any product or drug used in the procedure has the potential to be the cause of a reaction, but neuromuscular blocking agents are the most frequently reported, followed by latex and antibiotics. In this mini-review we discuss some key points of the management of these patients and w present Brazilian data, which suggest that an active search for cases by working together with anesthesiologists could lead to an increase in diagnosis and, therefore, better prevention of future reactions
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