DAGOBERTO CALLEGARO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/45 - Laboratório de Fisiopatologia Neurocirúrgica, Hospital das Clínicas, Faculdade de Medicina
LIM/62 - Laboratório de Fisiopatologia Cirúrgica, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- A comparative study of visual outcome in patients with optic neuritis treated with five or seven days of intravenous corticosteroid treatment(2023) SILVA, Guilherme Diogo; TERRIM, Sara; FALCAO, Fernando Cavalcantide Sa e Benevides; FALCA, Maria Alice Pimentel; CHAVES, Cleuber Esteves; APOSTOLOS-PEREIRA, Samira; FORTINI, Ida; GONCALVES, Marcia Rubia Rodrigues; COMERLATTI, Luiz Roberto; CASTRO, Luiz Henrique Martins; CALLEGARO, Dagoberto; MONTEIRO, Mario Luiz RibeiroBackground: Optic neuritis (ON), a major cause of visual impairment in young adults, is generally associated with rapid visual recovery when treated with intravenous methylprednisolone treatment (IVMPT). However, the optimal duration of such treatment is unknown, ranging from three to seven days in clinical practice. We aimed to compare the visual recovery in patients treated with 5-day or 7-day duration IVMPT.Methods: We performed a retrospective cohort study of consecutive patients with ON in Sa similar to o Paulo, Brazil, from 2016 to 2021. We compared the proportion of participants with visual impairment in 5-day and 7-day treatment schedules at discharge, at 1 month and between 6 and 12 months after the diagnosis of ON. The findings were adjusted to age, severity of the visual impairment, co-intervention with plasma exchange, time from symptom onset to IVMPT and the etiology of the ON to mitigate indication bias.Results: We included 73 patients with ON treated with 5 or 7-day duration of 1 g/d intravenous methylprednisolone therapy. Visual impairment at 6-12 months in the 5-day or the 7-day treatment groups was similar (57% x 59%, p > 0.9, Odds Ratio 1.03 [95% CI 0.59-1.84]). The results were similar after adjusting for prognostic variables and when observed at different time points.Conclusion: Visual recovery is similar in patients treated with 5-day and 7-day duration treatments of 1 g/day intravenous methylprednisolone, suggesting a ceiling effect. Limiting the duration of the treatment can reduce hospital stay and costs, without interfering with clinical benefit.
conferenceObject MOG-IgA characterizes a subgroup of patients with central nervous system demyelination(2023) GOMES, Ana Beatriz Ayroza Galvao Ribeiro; KULSVEHAGEN, Laila; LIPPS, Patrick; CAGOL, Alessandro; FUERTES, Nuria Cerda; NEZIRAJ, Tradite; FLAMMER, Julia; LERNER, Jasmine; LECOURT, Anne-Catherine; SIEBENBORN, Nina de Oliveira S.; CORTESE, Rosa; SCHADELIN, Sabine; SCHOEPS, Vinicius; MATOS, Aline; MENDES, Natalia; PEREIRA, Clarissa dos Reis; MONTEIRO, Mario Luiz; PEREIRA, Samira Luisa Dos Apostolos; SCHINDLER, Patrick; CHIEN, Claudia; SCHWAKE, Carolin; SCHNEIDER, Ruth; PAKEERATHAN, Thivya; KIM, Ki Hoon; AKTAS, Orhan; FISCHER, Urs; MEHLING, Matthias; DERFUSS, Tobias; KAPPOS, Ludwig; AYZENBERG, Ilya; RINGELSTEIN, Marius; PAUL, Friedemann; CALLEGARO, Dagoberto; KIM, Ho Jin; KUHLE, Jens; PAPADOPOULOU, Athina; GRANZIERA, Cristina; PROBSTEL, Anne-Katrin- Paracentral Acute Middle Maculopathy Associated with Severe Anti-Mog (Myelin Oligodendrocyte Glycoprotein)-Positive Optic Neuritis(2023) FERNANDES, Rodrigo Dahia; ANDRADE, Thais de Souza; PRETI, Rony C. C.; ZACHARIAS, Leandro C. C.; SILVA, Guilherme Diogo; LUCATO, Leandro Tavares; APOSTOLOS-PEREIRA, Samira L. L.; CALLEGARO, Dagoberto; MONTEIRO, Mario Luiz R.Retinal complications in patients with inflammatory optic neuritis (ON) are generally related to post-infectious neuroretinitis and are considered uncommon in autoimmune/demyelinating ON, whether isolated or caused by multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD). More recently, however, cases with retinal complications have been reported in subjects positive for myelin oligodendrocyte glycoprotein (MOG) antibodies. We report a 53-year-old woman presenting with severe bilateral ON associated with a focal area of paracentral acute middle maculopathy (PAMM) in one eye. Visual loss recovered remarkably after high-dose intravenous corticosteroid treatment and plasmapheresis, but the PAMM lesion remained visible on both optical coherence tomography and angiography as an ischaemic lesion affecting the middle layers of the retina. The report emphasises the possible occurrence of retinal vascular complications in MOG-related optic neuritis, an important addition to the diagnosis of, and possible differentiation from, MS-related or NMOSD-related ON.
- Immunoglobulin A Antibodies Against Myelin Oligodendrocyte Glycoprotein in a Subgroup of Patients With Central Nervous System Demyelination(2023) GOMES, Ana Beatriz Ayroza Galvao Ribeiro; KULSVEHAGEN, Laila; LIPPS, Patrick; CAGOL, Alessandro; CERDA-FUERTES, Nuria; NEZIRAJ, Tradite; FLAMMER, Julia; LERNER, Jasmine; LECOURT, Anne-Catherine; SIEBENBORN, Nina De Oliveira S.; CORTESE, Rosa; SCHAEDELIN, Sabine; SCHOEPS, Vinicius Andreoli; MATOS, Aline de Moura Brasil; MENDES, Natalia Trombini; PEREIRA, Clarissa dos Reis; MONTEIRO, Mario Luiz Ribeiro; APOSTOLOS-PEREIRA, Samira Luisa dos; SCHINDLER, Patrick; CHIEN, Claudia; SCHWAKE, Carolin; SCHNEIDER, Ruth; PAKEERATHAN, Thivya; AKTAS, Orhan; FISCHER, Urs; MEHLING, Matthias; DERFUSS, Tobias; KAPPOS, Ludwig; AYZENBERG, Ilya; RINGELSTEIN, Marius; PAUL, Friedemann; CALLEGARO, Dagoberto; KUHLE, Jens; PAPADOPOULOU, Athina; GRANZIERA, Cristina; PROBSTEL, Anne-KatrinIMPORTANCE Differential diagnosis of patients with seronegative demyelinating central nervous system (CNS) disease is challenging. In this regard, evidence suggests that immunoglobulin (Ig) A plays a role in the pathogenesis of different autoimmune diseases. Yet little is known about the presence and clinical relevance of IgA antibodies against myelin oligodendrocyte glycoprotein (MOG) in CNS demyelination. OBJECTIVE To investigate the frequency of MOG-IgA and associated clinical features in patients with demyelinating CNS disease and healthy controls. DESIGN, SETTING, AND PARTICIPANTS This longitudinal study comprised 1 discovery and 1 confirmation cohort derived from 5 centers. Participants included patients with suspected or confirmed demyelinating diseases and healthy controls. MOG-IgA, MOG-IgG, and MOG-IgM were measured in serum samples and cerebrospinal fluid (CSF) of patients, who were assessed from September 2012 to April 2022. MAIN OUTCOMES AND MEASURES Frequency and clinical features of patients who were seropositive for MOG-IgA and double-seronegative for aquaporin 4 (AQP4) IgG and MOG-IgG. RESULTS After the exclusion of 5 participants with coexisting AQP4-IgG and MOG-IgA, MOG-IgG, and/or MOG-IgM, 1339 patients and 110 healthy controls were included; the median follow-up time was 39 months (range, 0-227 months). Of included patients with isolated MOG-IgA, 11 of 18 were female (61%), and the median age was 31.5 years (range, 3-76 years). Among patients double-seronegative for AQP4-IgG and MOG-IgG (1126/1339; 84%), isolated MOG-IgA was identified in 3 of 50 patients (6%) with neuromyelitis optica spectrum disorder, 5 of 228 patients (2%) with other CNS demyelinating diseases, and 10 of 848 patients (1%) with multiple sclerosis but in none of the healthy controls (0/110). The most common disease manifestation in patients seropositive for isolated MOG-IgA was myelitis (11/17 [65%]), followed by more frequent brainstem syndrome (7/16 [44%] vs 14/75 [19%], respectively; P =.048), and infrequent manifestation of optic neuritis (4/15 [27%] vs 46/73 [63%], respectively; P =.02) vs patients with MOG-IgG. Among patients fulfilling 2017 McDonald criteria for multiple sclerosis, MOG-IgA was associated with less frequent CSF-specific oligoclonal bands (4/9 [44%] vs 325/351 [93%], respectively; P <.001) vs patients with multiple sclerosis who were MOG-IgG/IgA seronegative. Further, most patients with isolated MOG-IgA presented clinical attacks after recent infection or vaccination (7/11 [64%]). CONCLUSION AND RELEVANCE In this study, MOG-specific IgA was identified in a subgroup of patients who were double-seronegative for AQP4-/MOG-IgG, suggesting that MOG-IgA may be a novel diagnostic biomarker for patients with CNS demyelination.
- Real-world application of the 2022 diagnostic criteria for first-ever episode of optic neuritis(2023) TERRIM, Sara; SILVA, Guilherme Diogo; FALCAO, Fernando Cavalcanti de Sa e Benevides; PEREIRA, Clarissa dos Reis; BENASSI, Thais de Souza Andrade; FORTINI, Ida; GONCALVES, Marcia Rubia Rodrigues; CASTRO, Luiz Henrique Martins; COMERLATTI, Luiz Roberto; RIMKUS, Carolina de Medeiros; ADONI, Tarso; PEREIRA, Samira Luisa Apostolos; MONTEIRO, Mario Luiz; CALLEGARO, DagobertoOptic neuritis (ON) admits diverse differential diagnoses. Petzold proposed diagnostic criteria for ON in 2022, although real-world application of these criteria is missing. We conducted a retrospective review of patients with ON. We classified patients into definite or possible ON, and into groups A (typical neuritis), B (painless), or C (binocular) and estimated the frequency of etiologies for each group. We included 77 patients, with 62% definite and 38% possible ON. CRION and NMOSD-AQP4 negative-ON were less commonly seen in definite ON. Application of the 2022 criteria revealed a lower-than-expected frequency of definite ON, particularly for seronegative non-MS causes.
conferenceObject Evaluation of retinal layers in eyes with previous optic neuritis and anti-MOG or anti-AQP4 antibody(2023) PEREIRA, Clarissa; ANDRADE, Thais; MELLO, Luiz Marchesi; FILGUEIRAS, Thiago; CUNHA, Leonardo; ZACHARIAS, Leandro; GOMES, Ana Galvao Ribeiro; PEREIRA, Samira dos Apostolos; CALLEGARO, Dagoberto; PROEBSTEL, Anne-Katrin; SATO, Douglas; MONTEIRO, Mario Ribeiro