FERNANDO KOK
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Neurologia, Faculdade de Medicina - Docente
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/15 - Laboratório de Investigação em Neurologia, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/15 - Laboratório de Investigação em Neurologia, Hospital das Clínicas, Faculdade de Medicina
17 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 17
- Ceroid lipofuscinosis type 5: novel pathogenic variants and unexpected phenotypic findings(2023) PAIVA, Anderson Rodrigues Brandao de; PESSOA, Andre Luiz Santos; NOBREGA, Paulo Ribeiro; MORENO, Cristiane Araujo Martins; LYNCH, David S.; TANIGUTI, Lucas Mitsuo; KITAJIMA, Joao Paulo; FREUA, Fernando; DELLA-RIPA, Bruno; CUNHA, Paulina; BARCELOS, Isabella Peixoto de; MACEDO-SOUZA, Lucia Ines; TAKEUCHI, Carlos Augusto; GARCIA, Antonio Milton Silva; NARDES, Flavia; FONTAO, Ramiro; ANTONIUK, Sergio Antonio; TRONCOSO, Monica; SPECOLA, Norma; DURAND, Consuelo; MADEIRO, Bianca de Aguiar Coelho Silva; DORIQUI, Maria Juliana Rodovalho; VERGARA, Diane; HOULDEN, Henry; KOK, Fernando
- SCA23 and prodynorphin: is it time for gene retraction?(2016) PEDROSO, Jose Luiz; VALE, Thiago Cardoso; FREUA, Fernando; BARSOTTINI, Orlando G. P.; KOK, Fernando
- Clinical and genetic characterization of leukoencephalopathies in adults(2017) LYNCH, David S.; PAIVA, Anderson Rodrigues Brandao de; ZHANG, Wei Jia; BUGIARDINI, Enrico; FREUA, Fernando; LUCATO, Leandro Tavares; MACEDO-SOUZA, Lucia Ines; LAKSHMANAN, Rahul; KINSELLA, Justin A.; MERWICK, Aine; ROSSOR, Alexander M.; BAJAJ, Nin; HERRON, Brian; MCMONAGLE, Paul; MORRISON, Patrick J.; HUGHES, Deborah; PITTMAN, Alan; LAURA, Matilde; REILLY, Mary M.; WARREN, Jason D.; MUMMERY, Catherine J.; SCHOTT, Jonathan M.; ADAMS, Matthew; FOX, Nick C.; MURPHY, Elaine; DAVAGNANAM, Indran; KOK, Fernando; CHATAWAY, Jeremy; HOULDEN, HenryLeukodystrophies and genetic leukoencephalopathies are a rare group of disorders leading to progressive degeneration of cerebral white matter. They are associated with a spectrum of clinical phenotypes dominated by dementia, psychiatric changes, movement disorders and upper motor neuron signs. Mutations in at least 60 genes can lead to leukoencephalopathy with often overlapping clinical and radiological presentations. For these reasons, patients with genetic leukoencephalopathies often endure a long diagnostic odyssey before receiving a definitive diagnosis or may receive no diagnosis at all. In this study, we used focused and whole exome sequencing to evaluate a cohort of undiagnosed adult patients referred to a specialist leukoencephalopathy service. In total, 100 patients were evaluated using focused exome sequencing of 6100 genes. We detected pathogenic or likely pathogenic variants in 26 cases. The most frequently mutated genes were NOTCH3, EIF2B5, AARS2 and CSF1R. We then carried out whole exome sequencing on the remaining negative cases including four family trios, but could not identify any further potentially disease-causing mutations, confirming the equivalence of focused and whole exome sequencing in the diagnosis of genetic leukoencephalopathies. Here we provide an overview of the clinical and genetic features of these disorders in adults.
- Subacute Partially Reversible Leukoencephalopathy Expands the Aicardi-Goutieres Syndrome Phenotype(2023) BARCELOS, Isabella Peixoto de; BUENO, Clarissa; GODOY, Luis Filipe S.; PESSOA, Andre; COSTA, Larissa A.; MONTI, Fernanda C.; SOUZA-CABRAL, Katiane; LISTIK, Clarice; CASTRO, Diego; DELLA-RIPA, Bruno; FREUA, Fernando; PIRES, Lais C.; KRUGER, Lia T.; GHERPELLI, Jose Luiz D.; PIAZZON, Flavia B.; MONTEIRO, Fabiola P.; LUCATO, Leandro T.; KOK, FernandoObjective: To report a series of atypical presentations of Aicardi-Goutieres syndrome. Methods: Clinical, neuroimaging, and genetic data. Results: We report a series of six unrelated patients (five males) with a subacute loss of developmental milestones, pyramidal signs, and regression of communication abilities, with onset at ages ranging from 7 to 20 months, reaching a nadir after 4 to 24 weeks. A remarkable improvement of lost abilities occurred in the follow-up, and they remained with residual spasticity and dysarthria but preserved cognitive function. Immunization or febrile illness occurred before disease onset in all patients. CSF was normal in two patients, and in four, borderline or mild lymphocytosis was present. A brain CT scan disclosed a subtle basal ganglia calcification in one of six patients. Brain MRI showed asymmetric signal abnormalities of white matter with centrum semi-ovale involvement in five patients and a diffuse white matter abnormality with contrast enhancement in one. Four patients were diagnosed and treated for acute demyelinating encephalomyelitis (ADEM). Brain imaging was markedly improved with one year or more of follow-up (average of 7 years), but patients remained with residual spasticity and dysarthria without cognitive impairment. Demyelination relapse occurred in a single patient four years after the first event. Whole-exome sequencing (WES) was performed in all patients: four of them disclosed biallelic pathogenic variants in RNASEH2B (three homozygous p.Ala177Thr and one compound heterozygous p.Ala177Thr/p.Gln58*) and in two of them the same homozygous deleterious variants in RNASEH2A (p.Ala249Val). Conclusions: This report expands the phenotype of AGS to include subacute developmental regression with partial clinical and neuroimaging improvement. Those clinical features might be misdiagnosed as ADEM.
- Stroke in vascular Ehlers-Danlos syndrome(2023) MARTINS, Rebecca Ranzani; PAIVA, Mauricio Leonardo da Silva; TEIXEIRA, Weverton Carlos da Silva; KAWAHIRA, Rachel Sayuri Honjo; FREUA, Fernando; CASTRO, Matheus Augusto Araujo; KIM, Chong Ae; KOK, Fernando
- A novel GFAP mutation in a type II (late-onset) Alexander disease patient(2016) PAIVA, Anderson Rodrigues Brandao de; FREUA, Fernando; LUCATO, Leandro Tavares; PARMERA, Jacy; DORIA, Denise; NOBREGA, Paulo Ribeiro; OLAVIO, Thiago Rosa; MACEDO-SOUZA, Lucia Ines; KOK, Fernando
- Typical clinical and neuroimaging features in Sjogren-Larsson syndrome(2018) PAIVA, Anderson Rodrigues Brandao de; MELO, Uira Souto; FREUA, Fernando; DORIA, Denise; CABRAL, Katiane Sayao Souza; MACEDO-SOUZA, Lucia Ines; LUCATO, Leandro Tavares; KOK, Fernando
- Chronic stage of Marchiafava-Bignami disease(2015) LUCATO, Leandro Tavares; FREUA, Fernando; KOK, Fernando
bookPart Paraparesias espásticas hereditárias(2021) FREUA, Fernando; KOK, Fernando- Incidental magnetic resonance imaging findings leading to an unusual diagnosis: Adult onset Krabbe disease(2022) PAIVA, Anderson Rodrigues Brandao; FONSECA NETO, Ronald Edington; AFONSO, Clara Lima; FREUA, Fernando; NOBREGA, Paulo Ribeiro; KOK, FernandoBackground and purpose Krabbe disease (KD), or globoid cell leukodystrophy (Online Mendelian Inheritance in Man #245200), is an autosomal recessive lysosomal storage disease caused by mutations in GALC leading to galactocerebrosidase deficiency. Age at onset can vary from early infancy (3-6 months of age) to adulthood, which has rarely been reported. Little is known about the natural history and early manifestations of adult onset KD (AOKD). Methods Here, we report a patient with an incidental diagnosis of AOKD and discuss management options in this scenario. Results A 32-year-old woman came to medical attention because of headache and had brain magnetic resonance imaging findings compatible with AOKD, two pathogenic variants in GALC, and reduced activity of galactocerebrosidase. The jury is still out about the best management of such cases, and clinicians should be aware of this diagnosis, as AOKD is a potentially treatable condition. Conclusions AOKD is a rare and potentially treatable condition. More studies on natural history of AOKD are urgently needed to guide the best management of this disease.