PEDRO FRANCISCO GIAVINA-BIANCHI JUNIOR
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina - Líder
24 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 24
- Inter- and intra-patient heterogeneity of PD-L1 expression in metastatic melanomas: A retrospective study(2021) GIAVINA-BIANCHI, Mara; SOTTO, Mirian Nacagamo; GIAVINA-BIANCHI, Pedro; MUNHOZ, Rodrigo; NETO, Cyro Festa; KALIL, Jorge
conferenceObject Anaphylaxis during skin prick test with aeroallergen extract: Case report(2021) OLIVEIRA, I. A.; PRADO, A. I. F.; ALBERTO, N. E. S.; MENECHINO, N. T. C.; KALIL, J.; GIAVINA-BIANCHI, P.; AGONDI, R. C.bookPart Alergia ao látex(2021) GARRO, Laila Sabino; JúNIOR, Pedro Francisco Giavina-BianchibookPart Mastocitose(2021) PEREIRA, Grazielly de Fátima; GONçALVES, Danilo Gois; JúNIOR, Pedro Francisco Giavina-Bianchi- Editorial: The Role of Mast Cells in Immediate Hypersensitivity Reactions(2021) AUN, Marcelo Vivolo; BLANCA-LOPEZ, Natalia; CASTELLS, Mariana C.; GIAVINA-BIANCHI, Pedro
bookPart Terapia monoclonal nas doenças alérgicas(2021) AGONDI, Rosana Câmara; GIAVINA-BIANCHI, Pedro; KALIL FILHO, Jorge Elias- The Challenges in the Follow-Up and Treatment of Brazilian Children with Hereditary Angioedema(2021) ARAUJO-SIMOES, Joanna; BOANOVA, Aline Gisele Pena; CONSTANTINO-SILVA, Rosemeire Navickas; FRAGNAN, Nyla Thyara Melo Lobao; PINTO, Jorge Andrade; MINAFRA, Fernanda G.; GONCALVES, Rozana Fatima; VALLE, Solange Rodrigues do; ALONSO, Maria Luiza Oliva; DORTAS, Sergio Duarte; GOUDOURIS, Ekaterine Simoes; REGO-SILVA, Almerinda Maria; MARQUES, Mayara Madruga; SERPA, Faradiba S.; CHONG-NETO, Herberto Jose; NELSON, Rosario Filho; MANSOUR, Eli; MOREIRA, Iramirton Figueredo; MORENO, Adriana S.; ARRUDA, Luisa Karla; ROXO JUNIOR, Persio; FERRIANI, Mariana Paes Leme; SILVA, Jane; FERREIRA, Janaira Fernandes Severo; GIAVINA-BIANCHI, Pedro; TAKEJIMA, Priscila M.; ENSINA, Luis Felipe; CAMPOS, Regis de Albuquerque; TOLEDO, Eliana; PESQUERO, Joao Bosco; PALMA, Sandra Mitie Ueda; VERONEZ, Camila Lopes; GRUMACH, Anete SevciovicIntroduction: Hereditary angioedema (HAE) with C1 inhibitor (C1-INH) deficiency is a rare autosomal dominant disease. Although the first symptoms can appear in childhood, the diagnosis's delay has a strong impact on the patient's quality of life. We analyzed clinical and laboratory characteristics and the drug therapy of pediatric patients with HAE in Brazil. Methods: Medical records from 18 reference centers of HAE patients under 18 years of age were evaluated after confirmed diagnosis was performed by quantitative and/or functional C1-INH. Results: A total of 95 participants (51 M:44 F; mean age: 7 years old) out of 17 centers were included; 15 asymptomatic cases were identified through family history and genetic screening. Angioedema attacks affected the extremities (73.5%), gastrointestinal tract (57%), face (50%), lips (42.5%), eyelids (23.7%), genitals (23.7%), upper airways (10%), and tongue (6.3%). Family history was present in 84% of patients, and the mean delay in the diagnosis was 3.9 years. Long-term prophylaxis (51/80) was performed with tranexamic acid (39/80) and androgens (13/80); and short-term prophylaxis (9/80) was performed with tranexamic acid (6/80) and danazol (3/80). On-demand therapy (35/80) was prescribed: icatibant in 7/35, fresh frozen plasma in 16/35, C1-INH plasma-derived in 11/35, and tranexamic acid in 12/35 patients. Conclusions: This is the first study on HAE pediatric patients in Latin America. Clinical manifestations were similar to adults. Drugs such as androgens and tranexamic acid were indicated off-label, probably due to restricted access to specific drugs. Educational programs should address pediatricians to reduce late diagnosis and tailored child therapy.
bookPart Introdução à Alergia e à imunopatologia(2021) JúNIOR, Pedro Francisco Giavina-Bianchi; KALIL FILHO, Jorge Elias- 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.
- May polyethylene glycol be the cause of anaphylaxis to mRNA COVID-19 vaccines?(2021) GIAVINA-BIANCHI, Pedro; KALIL, JorgeVaccination against coronavirus is essential to minimize the impact of the COVID-19 pandemic. Rare cases of anaphylaxis associated with the mRNA COVID-19 vaccines are being described, and the mechanisms involved in these reactions are poorly understood. A potential culprit agent of these vaccine-induced anaphylaxis events is polyethylene glycol, which has been reported as a cause of anaphylaxis. However, a cause-effect association has not been demonstrated, and the cases of anaphylaxis to mRNA COVID-19 vaccines should be further investigated. In this scenario, the recommendations are inaccurate and can lead to misinterpretation. At the moment, a more accurate recommendation would be the contraindication of mRNA COVID-19 vaccines in patients with immediate hypersensitivity reaction to polyethylene glycol or polysorbate. Patients with history of anaphylaxis to other or unknown causes should be referred to an allergist-immunologist for further orientation.
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