SANDRA FATIMA MENOSI GUALANDRO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/31 - Laboratório de Genética e Hematologia Molecular, Hospital das Clínicas, Faculdade de Medicina
28 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 28
- Fc gamma R2B B2.4 haplotype predicts increased risk of red blood cell alloimmunization in sickle cell disease patients(2020) COSTA NETO, Abel; SANTOS, Flavia; RIBEIRO, Ingrid; OLIVEIRA, Valeria; DEZAN, Marcia; KASHIMA, Simone; COVAS, Dimas; PEREIRA, Alexandre; FONSECA, Guilherme; MOREIRA, Frederico; KRIEGER, Jose; GUALANDRO, Sandra; ROCHA, Vanderson; MENDRONE JR., Alfredo; DINARDO, Carla L.BACKGROUND Red blood cell (RBC) alloimmunization is an important transfusion complication which is prevalent among sickle cell disease (SCD) patients. Autoimmune diseases are a known risk factor for RBC alloimmunization, suggesting that autoimmunity and post-transfusion alloantibody development occur through similar physiopathological pathways. Polymorphisms in the Fc gamma R2B gene have already been associated with several autoimmune disorders and hypothetically could be associated with RBC alloimmunization. Our goal was to evaluate if important polymorphisms of Fc gamma R2B have an impact on the risk of RBC alloimmunization among SCD patients. STUDY DESIGN AND METHODS This was a case-control study in which alloimmunized and non-alloimmunized SCD patients were compared in terms of the genotype frequency of the Fc gamma R2B polymorphisms -386G/C, -120 T/A, and 695C/T, genotyped through direct Sanger sequencing. RESULTS A total of 237 patients met the eligibility criteria, 120 cases (alloimmunized) and 117 controls (non-alloimmunized). RBC alloimmunization was associated with female sex (p < 0.001), lifetime number of RBC units transfused (p = 0.002) and 120 T/A Fc gamma R2B genotype (p = 0.031). The Fc gamma R2B promoter region haplotype 2B.4 (386C120A) was positively associated with RBC alloimunization (p = 0.045). The logistic regression (LR) model identified female sex (OR 10.03, CI 95% 5.16-19.49; p < 0.001) and Fc gamma R2B 2B.4 haplotype (OR 4.55, CI95% 1.1118.65; p = 0.035) as independent predictors of RBC alloimmunization in SCD patients. CONCLUSION SCD patients with the Fc gamma R2B 2B.4 haplotype had over a fourfold higher risk for RBC alloimmunization. This highlights the role played by Fc gamma R2B on RBC alloimmunization and may be helpful in identifying the immune responders.
conferenceObject NIH Bayesian Score As a Stratification Tool in Sickle Cell Disease - Results from a Single Center Cohort in Brazil(2017) FONSECA, Guilherme Henrique Hencklain; GRACA, Lutu Ima Viana da; SOUZA, Rogerio; SUGANUMA, Liliana Mitie; ROCHA, Vanderson; GUALANDRO, Sandra Fatima- A Polymorphism in Toll-like Receptor 2 Gene Is Associated with Occurrence of Bacterial Infections in Sickle Cell Disease Patients(2018) TOZATTO-MAIO, Karina; GIROT, Robert; LY, Indou Deme; ROCHA, Vanderson; PINTO, Ana Cristina Silva; DIAGNE, Ibrahima; BENZERARA, Yahia; DINARDO, Carla Luana; KASHIMA, Simone; ARAUJO, Itaua Leston; KENZEY, Chantal; FONSECA, Guilherme Henrique Hencklain; RODRIGUES, Evandra; VOLT, Fernanda; JARDULI, Luciana Ribeiro; RUGGERI, Annalisa; MARIASELVAM, Christina Mary; GUALANDRO, Sandra Fatima Menosi; ELAYOUBI, Hanadi; CUNHA, Renato; CAPPELLI, Barbara; SIMOES, Belinda Pinto; GLUCKMAN, Eliane; TAMOUZA, Ryad
- A Toll-like receptor 2 genetic variant modulates occurrence of bacterial infections in patients with sickle cell disease(2019) TOZATTO-MAIO, Karina; GIROT, Robert; LY, Indou D.; ROCHA, Vanderson; PINTO, Ana C. Silva; DIAGNE, Ibrahima; BENZERARA, Yahia; DINARDO, Carla L.; KASHIMA, Simone; LESTON-ARAUJO, Itaua; KENZEY, Chantal; FONSECA, Guilherme H. H.; RODRIGUES, Evandra S.; VOLT, Fernanda; JARDULI, Luciana R.; RUGGERI, Annalisa; MARIASELVAM, Christina M.; GUALANDRO, Sandra F. M.; ELAYOUBI, Hanadi; CUNHA, Renato; CAPPELLI, Barbara; MALMEGRIM, Kelen C. R.; SIMOES, Belinda P.; GLUCKMAN, Eliane; TAMOUZA, RyadDespite adequate immunization and penicillin prophylaxis, bacterial infections remain a leading cause of morbidity and mortality in patients with sickle cell disease (SCD). Besides hyposplenism, inflammatory and genetic factors might modulate their susceptibility to bacterial infections. We performed a candidate gene association of single nucleotide polymorphisms (SNPs) located in Toll-like receptor (TLR) genes, encoding prominent molecules for innate immune responses, with the occurrence of bacterial infections in patients with SCD. A cohort followed in centres in Brazil, France and Senegal (n=430) was divided in two groups: patients who presented at least one episode of bacterial infection (n=235) and patients who never had bacterial infections (n=195). There were no differences in gender or age distribution among the groups. The frequency of the TLR2 rs4696480 TA genotype was significantly lower in the infected group (50% vs. 67%, odds ratio [OR]=050, 95% confidence interval [CI] 034-075, P<0001), and the TT genotype was significantly higher in the infected group (15% vs. 5%, OR=318, 95% CI 153-661, P<0001). Previous reports demonstrated higher secretion of inflammatory factors in cells from AA individuals, lower occurrence and severity of immune diseases in T carriers. The rs4696480 TA genotype might stand between deleterious effects of over inflammatory response (AA genotype) and inefficient responses (TT genotype) to infectious agents in SCD settings.
- Acute splenic sequestration in a pregnant woman with homozygous sickle-cell anemia(2013) MAIA, Carolina Bastos; NOMURA, Roseli Mieko Yamamoto; IGAI, Ana Maria Kondo; FONSECA, Guilherme Hencklain; GUALANDRO, Sandra Menosi; ZUGAIB, MarceloCONTEXT: Homozygous (SS) sickle-cell anemia complicated by acute splenic sequestration in adults is a rare event, and it has never been reported during pregnancy. CASE REPORT: A 25-year-old woman with homozygous (SS) sickle-cell disease was hospitalized at 32 weeks' of gestation presenting weakness, abdominal pain, fever and hemoglobin of 2.4 g/dl. Abnormal fetal heart rate was detected by means of cardiotocography, and 5 units of packed red cells were transfused. Cesarean was performed at 37 weeks. Both mother and baby were discharged in a good general condition. CONCLUSION: This case report demonstrates the importance of immediate blood transfusion for treatment of fetal distress in cases of splenic sequestration during pregnancy. This treatment is essential for avoiding maternal and fetal complications.
conferenceObject PAROXYSMAL NOCTURNAL HEMOGLOBINURIA: CLINICAL FEATURES AND OUTCOME IN 124 PATIENTS EVALUATED IN A SINGLE CENTER(2016) ZANICHELLI, M.; MOROMIZATO, D.; FONSECA, G.; SUGANUMA, L.; GUALANDRO, S.bookPart Porfirias(2016) SILVEIRA, Paulo Augusto Achucarro; GUALANDRO, Sandra Fátima Menosi; FONSECA, Guilherme Henrique HenclainbookPart Anemias(2013) GUALANDRO, Sandra Fátima Menosi; FONSECA, Guilherme Henrique Hencklain- Pulmonary hypertension diagnosed by right heart catheterisation in sickle cell disease(2012) FONSECA, G. H. H.; SOUZA, R.; SALEMI, V. M. C.; JARDIM, C. V. P.; GUALANDRO, S. F. M.Recent studies have recognised the importance of pulmonary hypertension (PH) in sickle cell disease (SCD). The aim of this study was to determine the prevalence and prognostic impact of PH and its features in patients with SCD. 80 patients with SCD underwent baseline clinical evaluation, laboratory testing, 6-min walk tests (6MWTs) and echocardiography. Patients with a peak tricuspid regurgitant jet velocity (TRV) of >= 2.5 m.s(-1) were further evaluated through right heart catheterisation (RHC) to assure the diagnosis of PH. Our study evidenced a 40% prevalence of patients with elevated TRV at echocardiography. RHC (performed in 25 out of 32 patients) confirmed PH in 10% (95% CI 3.4-16.5%) of all patients, with a prevalence of post-capillary PH of 6.25% (95% CI 0.95-11.55%) and pre-capillary PH of 3.75% (95% CI -0.4-7.9%). Patients with PH were older, had worse performance in 6MWTs, and more pronounced anaemia, haemolysis and renal dysfunction. Survival was shorter in patients with PH. Our study reinforced the use of echocardiography as a screening tool for PH in SCD and the mandatory role of RHC for proper diagnosis. Our findings confirmed the prognostic significance of PH in SCD as its association to pronounced haemolytic profile.
- Accelerated erythrocyte destruction mimicking post-transfusion hyperhaemolysis in the course of uncomplicated vaso-occlusive crisis associated with sickle cell disease(2020) CONRADO, Marina C. A. V.; FONSECA, Guilherme S. V. C.; DEZAN, Marcia R.; MENDES, Fernanda R.; HAMASAKI, Debora T.; CHINOCA, Karen Z.; FONSECA, Guilherme H.; GUALANDRO, Sandra F. M.; ROCHA, Vanderson; MENDRONE-JUNIOR, Alfredo; DINARDO, Carla L.
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