ANA KAROLINA BARRETO BERSELLI MARINHO

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Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/60 - Laboratório de Imunologia Clínica e Alergia, Hospital das Clínicas, Faculdade de Medicina

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Autor: KALIL, Jorge ×

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  • conferenceObject
    Immune Responses Of CVID Patients To COVID-19 Vaccines
    (2023) MEDEIROS, Giuliana Xavier de; FERREIRA, Loisi de Carvalho Pereira; MAGAWA, Jhosiene Yukari; KURAMOTO, Andreia; SASAHARA, Greyce Luri; FERREIRA, Marcelo; BARROS, Myrthes Maragna Toledo; KALIL, Jorge; MARINHO, Ana Karolina Barreto Berselli; CUNHA-NETO, Edecio; SANTOS, Keity Souza; KOKRON, Cristina
  • conferenceObject
    FREQUENCY OF LYMPHOMAS IN A COHORT OF PATIENTS WITH COMMON VARIABLE IMMUNODEFICIENCY
    (2013) SINI, B. C.; KOKRON, C. M.; LEVY, D.; PEREIRA, Juliana; OLIVEIRA, Ana Karolina Barreto; COHON, Andrea; KALIL, Jorge; BYDLOWSKI, S. P.; BARROS, Myrthes Toledo
    Introduction: Common variable immunodeficiency (CVID) is characterized by recurrent infections and in-creased susceptibility to autoimmunity and malignancies. Objective: To evaluate the frequency of lymphoma in a cohort of patients with CVID. Methods: Analysis of data obtained from medical records. Results: We analyzed 144 patients, 80 men and 64 women, aged 15-72 years. Seven (0.5 %) lymphoma cases were diagnosed (1 Hodgkin lymphoma and 6 non-Hodgkin lymphomas), affecting 5 men and 2 women aged 1953 years at lymphoma diagnosis. The time period between the onset of symptoms of CVID and lymphoma diagnosis ranged from 7 to 24 years in 4 patients and in 3 of them the diagnosis of both diseases were nearly overlapped preceding the CVID diagnosis in only 1, 3 and 6 months. Fever, splenomegaly and lymphadenopathy occurred in all patients. Lymphocytosis with inversion of the CD4/CD8 ratio at the expense of increased CD8+ T cells was detected in 2 patients and lymphopenia in one. B lymphocytes were undetectable in 3 patients in whom the diagnosis of lymphoma and CVID were established simultaneously and in one B cells were present at the beginning of CVID but undetectable at diagnosis of lymphoma. Conclusions: Patients with absence of B cells in recently diagnosed CVID or absence of B cells in long term followed CVID with previously detectable B cells demands a screening for the presence of lymphomas.
  • article 14 Citação(ões) na Scopus
    Dysregulated CD1 profile in myeloid dendritic cells in CVID is normalized by IVIg treatment
    (2013) PAQUIN-PROULX, Dominic; SANTOS, Bianca A. N.; CARVALHO, Karina I.; TOLEDO-BARROS, Myrthes; OLIVEIRA, Ana Karolina Barreto de; KOKRON, Cristina M.; KALIL, Jorge; MOLL, Markus; KALLAS, Esper G.; SANDBERG, Johan K.
  • conferenceObject
    Gastrointestinal Multiplex Polymerase Chain Reaction, Patterns of Bowel Histology and The Etiologic Diagnosis of Diarrhea in Common Variable Immunodeficiency
    (2023) TODT, Beatriz; KOKRON, Cristina; TOLEDO-BARROS, Myrthes; PINHO, Joao Renato; CHARBEL, Cecilia; SAIHG, Priscila; GRECCO, Octavio; MARINHO, Ana Karolina BB.; SILVA, Carlos Felipe; KALIL, Jorge; LIMA, Fabiana
  • article 17 Citação(ões) na Scopus
    Can patients with common variable immunodeficiency have allergic rhinitis?
    (2013) AGONDI, Rosana C.; BARROS, Myrthes T.; KOKRON, Cristina M.; COHON, Andrea; OLIVEIRA, Ana K. B.; KALIL, Jorge; GIAVINA-BIANCHI, Pedro
    Background: Rhinosinusitis is highly prevalent in patients with common variable immunodeficiency (CVID), and probably allergic rhinitis (AR) may be masked by a history of repeated respiratory infections. The diagnosis of AR is based on the patient's symptoms and detection of specific immunoglobulin E (IgE) to aeroallergens. This study was designed to identify rhinitis of probable allergic cause in patients with CVID. Methods: This study included 72 adult CVID patients. The patients were divided into three groups according to their history: suggestive of AR, nonallergic rhinitis, and without rhinitis. They were tested for total and specific IgE (in vivo and in vitro). Results: The patients' mean age was 38.2 years. A history of chronic rhinitis was observed in 59 (81.9%) of the cases, 31 of which (43%) had a history suggestive of AR. Patients with a history of rhinitis (whether allergic or nonallergic) presented an earlier onset of symptoms and diagnosis of CVID. Total IgE was undetectable in 86.1% of patients. AR was confirmed by detection of specific IgE to aeroallergens in only 5.6% of the patients. Conclusion: In CVID patients, chronic rhinitis may be allergic, because many have personal and family histories suggestive of atopy. However, in this study, allergy was confirmed by specific IgE detection in only 5.6% of cases. CVID patients with a history suggestive of AR commonly present negative results on traditional testing, so additional experiments may be necessary. One suggestion for the investigation of AR in CVID patients would be nasal provocation with the most prevalent allergens.
  • conferenceObject
    Altered Expression of BAFF-R and TACI in Common Variable Immunodeficiency (CVID) Patients
    (2015) SILVA, Diana Cordeiro de Oliveira; BARSOTTI, Nathalia Silveira; OLIVEIRA, Ana Karolina Barreto de; ZILINSKI, Fernando Ramon; BARROS, Myrthes Toledo; KALIL, Jorge; KOKRON, Cristina Maria
  • conferenceObject
    Frequency of Follicular T cells in a cohort of Brazilian Common Variable Immunodeficiency (CVID) patients
    (2021) KOKRON, Cristina; ZILINSKI, Fernando; SANTOS, Bianca; COUTINHO, Erica; APOSTOLICO, Juliana; ANDRADE, Milena; MARINHO, Ana Karolina; BARROS, Myrthes; GRECCO, Octavio; KALIL, Jorge
  • conferenceObject
    Cancer mortality in a cohort of 202 common variable immunodeficiency patients from Sao Paulo, Brazil, followed for up to forty years
    (2021) FONSECA, Luiz; BARROS, Myrthes; KOKRON, Cristina; GRECCO, Octavio; BARRETO, Ana; KALIL, Jorge
  • conferenceObject
    Description of COVID-19 infection in 92 patients with primary or secondary immunodeficiency followed at the Immunodeficiency Outpatient Clinic of a tertiary hospital
    (2023) FRANCO, Guacira; MENECHINO, Natalia; LOPES, Larissa Nathalia; PITCHON, Adriana; LIMA, Fabiana; MARINHO, Ana Karolina; GRECCO, Octavio; TOLEDO-BARROS, Myrthes; KALIL, Jorge; KOKRON, Cristina
  • article 7 Citação(ões) na Scopus
    Liver disease accompanied by enteropathy in common variable immunodeficiency: Common pathophysiological mechanisms
    (2022) LIMA, Fabiana Mascarenhas Souza; TOLEDO-BARROS, Myrthes; ALVES, Venancio Avancini Ferreira; DUARTE, Maria Irma Seixas; TAKAKURA, Cleusa; BERNARDES-SILVA, Carlos Felipe; MARINHO, Ana Karolina Barreto Berselli; GRECCO, Octavio; KALIL, Jorge; KOKRON, Cristina Maria
    Common variable immunodeficiency (CVID) is one of the inborn errors of immunity that have the greatest clinical impact. Rates of morbidity and mortality are higher in patients with CVID who develop liver disease than in those who do not. The main liver disorder in CVID is nodular regenerative hyperplasia (NRH), the cause of which remains unclear and for which there is as yet no treatment. The etiology of liver disease in CVID is determined by analyzing the liver injury and the associated conditions. The objective of this study was to compare CVID patients with and without liver-spleen axis abnormalities in terms of clinical characteristics, as well as to analyze liver and duodenal biopsies from those with portal hypertension (PH), to elucidate the pathophysiology of liver injury. Patients were divided into three groups: Those with liver disease/PH, those with isolated splenomegaly, and those without liver-spleen axis abnormalities. Clinical and biochemical data were collected. Among 141 CVID patients, 46 (32.6%) had liver disease/PH; 27 (19.1%) had isolated splenomegaly; and 68 (48.2%) had no liver-spleen axis abnormalities. Among the liver disease/PH group, patients, even those with mild or no biochemical changes, had clinical manifestations of PH, mainly splenomegaly, thrombocytopenia, and esophageal varices. Duodenal celiac pattern was found to correlate with PH (p < 0.001). We identified NRH in the livers of all patients with PH (n = 11). Lymphocytic infiltration into the duodenal mucosa also correlated with PH. Electron microscopy of liver biopsy specimens showed varying degrees of lymphocytic infiltration and hepatocyte degeneration, which is a probable mechanism of lymphocyte-mediated cytotoxicity against hepatocytes and enterocytes. In comparison with the CVID patients without PH, those with PH were more likely to have lymphadenopathy (p < 0.001), elevated beta(2)-microglobulin (p < 0.001), low B-lymphocyte counts (p < 0.05), and low natural killer-lymphocyte counts (p < 0.05). In CVID patients, liver disease/PH is common and regular imaging follow-up is necessary. These patients have a distinct immunological phenotype that may predispose to liver and duodenal injury from lymphocyte-mediated cytotoxicity. Further studies could elucidate the cause of this immune-mediated mechanism and its treatment options.