ANA KAROLINA BARRETO BERSELLI MARINHO
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
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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 ToledoIntroduction: 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.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 MariaconferenceObject CASE REPORT: LEPROSY ASSOCIATED TO COMMON VARIABLE IMMUNODEFICIENCY(2013) BARROS, Myrthes Toledo; TRINDADE, M. B.; SINI, B. C.; OLIVEIRA, Ana Karolina Barreto; SANCHEZ, J. A.; KALIL, Jorge; KOKRON, C. M.Introduction: Common variable immunodeficiency (CVID) is characterized by recurrent infections and, less often, opportunistic infections. Objective: To report a patient with CVID and leprosy. Case: White male, 25 years, with CVID diagnostic established 2 ½ years before, under IGIV monthly replacement. Two years after the diagnosis of CVID, he reported recent appearance of hypopigmented anesthetic spots in the upper limbs and trunk. Skin biopsy: lymphocytic inflammatory infiltrate with sketches of perivascular and perianexial granulomas attacking nerve fibers in the middle and deep dermis. The bacterial index, the tuberculin skin test and research for HIV were negative. The diagnosis of borderline tuberculoid leprosy was established. The number of TCD4+ cells was lower before (572 cells/mm 3) than after (665 cells/mm 3) skin lesions detection. We found no previous reports in the literature of leprosy associated to CVID. Conclusion: We speculate if in this CVID patient the skin lesions corresponded to inflammatory immune reconstitution syndrome (IRIS) associated to leprosy andif IGIVreplacement could modified the outcome of a previous infection by M. leprae.conferenceObject Evaluation of Clinical and Laboratory Response to Influenza and H1N1 Vaccines in a Group of Brazilian CVID Patients(2012) PEDRESCHI, Maira; OLIVEIRA, Ana Karolina Barreto; BARROS, Myrthes Toledo; COHON, Andrea; CELESTINO, A. T.; VILAS-BOAS, L. S.; FELIX, A. C.; PANNUTI, C. S.; KALIL, Jorge; KOKRON, Cristina M.CVID pts lack vaccine-specific ab production. We studied the clinical / laboratorial responses to influenza and H1N1 immunization in 22 CVID pts. Clinical evaluation was done through a score (infections, hospitalizations, antibiotic use). The score was applied during the previous and following year post immunization (PI). Blood was drawn before and 1/3/6/12 m PI. A significant reduction was observed in upper respiratory infections and sinusitis in the year PI (p<0.001), and 6 pts seroconverted. Statistical analysis showed no difference among ab levels before and PI. Among the 9 pts who presented H1N1 ab production, 4 reduced the clinical score. Of note, 50% of the 22 pts presented reduction of clinical scores. Then, although ab production to H1N1 wasn’t statistically significant, we observed a reduction in the number of infections in the year PI. This observation may be due to eventual presence of influenza’sabs but reinforces potential benefits of vaccination in CVID pts.conferenceObject Causes of Death in Common Variable Immunodeficiency (CVID) Patients Followed at the Primary Immunodeficiency Outpatient Clinic Between 1995 and 2015(2015) GARCIA, Giane; TORRES, Pablo; MARINHO, Anna Karolina; COHON, Andrea; GRECCO, Octavio; KALIL, Jorge; BARROS, Myrthes Toledo; KOKRON, Cristina MariaconferenceObject Thromboembolic Phenomena Related to the Intravenous Infusion of Immunoglobulin in Patients with Primary Immunodeficiencies(2015) GARCIA, Juliana Bianchini; SPENGLER, Ana Laura; KOKRON, Cristina Maria; OLIVEIRA, Ana Karolina Barreto de; GRECCO, Octavio; KALIL, Jorge; BARROS, Myrthes ToledoconferenceObject Retrospective Analysis of 31 Adult Patients with Selective IGM Deficiency(2015) CORDOVA, Pablo Torres; LIMA, Fabiana Mascarenhas Souza; BOUFLEUR, Karla; GRECCO, Octavio; COHON, Andrea; MARINHO, Anna Karolina; KALIL, Jorge; BARROS, Myrthes Toledo; KOKRON, Cristina Maria- Primary Immunodeficiency Diseases in Different Age Groups: A Report on 1,008 Cases from a Single Brazilian Reference Center(2013) CARNEIRO-SAMPAIO, Magda; MORAES-VASCONCELOS, Dewton; KOKRON, Cristina M.; JACOB, Cristina M. A.; TOLEDO-BARROS, Myrthes; DORNA, Mayra B.; WATANABE, Leticia A.; MARINHO, Ana Karolina B. B.; CASTRO, Ana Paula Moschione; PASTORINO, Antonio C.; SILVA, Clovis Artur A.; FERREIRA, Mauricio D.; RIZZO, Luiz V.; KALIL, Jorge E.; DUARTE, Alberto J. S.Primary immunodeficiencies (PIDs) represent a large group of diseases that affect all age groups. Although PIDs have been recognized as rare diseases, there is epidemiological evidence suggesting that their real prevalence has been underestimated. We performed an evaluation of a series of 1,008 infants, children, adolescents and adults with well-defined PIDs from a single Brazilian center, regarding age at diagnosis, gender and PID category according to the International Union of Immunological Societies classification. Antibody deficiencies were the most common category in the whole series (61 %) for all age groups, with the exception of <2-year-old patients (only 15 %). In the >30-year-old group, antibody deficiencies comprised 84 % of the diagnoses, mostly consisting of common variable immunodeficiency, IgA deficiency and IgM deficiency. Combined immunodeficiencies represented the most frequent category in <2-years-old patients. Most congenital defects of phagocytes were identified in patients <5 -years of age, as were the diseases of immune dysregulation, with the exception of APECED. DiGeorge syndrome and ataxia-telangiectasia were the most frequent entities in the category of well-defined syndromes, which were mostly identified in patients <10-years of age. Males represented three-quarters and two-thirds of <2 -years-old and 2-5-years -old patients, respectively, whereas females predominated among the >30-year-old patients. Our data indicated that some PIDs were only detected at early ages, likely because affected patients do not survive long. In addition, our data pointed out that different strategies should be used to search for PIDs in infants and young children as compared to older patients.
conferenceObject Evolution of Patients with Hypogammaglobulinemia Secondary to the Use of Rituximab Accompanied in a Tertiary Outpatient Clinic(2017) CAU, Larissa Prando; ASSIS, Joao Paulo de; BRUGNOLLI, Rebeca Mussi; CASTRO, Raisa Borges de; MOUCO, Claudia Castilho; GRECCO, Octavio; KALIL, Jorge; BARROS, Myrthes Toledo; KOKRON, Cristina Maria; MARINHO, Ana Karolina Barreto BerselliconferenceObject Thrombosis Association with Administration of Intravenous Human Immunoglobulin in Patients with Primary or Secondary Immunodeficiencies(2017) GONCALVES, Danilo Gois; ASSIS, Joao Paulo de; SINI, Bruno; MARINHO, Ana Karolina; KOKRON, Cristina Maria; GRECCO, Octavio; KALIL, Jorge; BARROS, Myrthes Toledo