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
2 resultados
Resultados de Busca
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- Myasthenia gravis and neuromyelitis optica spectrum disorder A multicenter study of 16 patients(2012) LEITE, M. I.; COUTINHO, E.; LANA-PEIXOTO, M.; APOSTOLOS, S.; WATERS, P.; SATO, D.; MELAMUD, L.; MARTA, M.; GRAHAM, A.; SPILLANE, J.; VILLA, A. M.; CALLEGARO, D.; SANTOS, E.; SILVA, A. Martins da; JARIUS, S.; HOWARD, R.; NAKASHIMA, I.; GIOVANNONI, G.; BUCKLEY, C.; HILTON-JONES, D.; VINCENT, A.; PALACE, J.Objective: To describe 16 patients with a coincidence of 2 rare diseases: aquaporin-4 antibody (AQP4-Ab)-mediated neuromyelitis optica spectrum disorder (AQP4-NMOSD) and acetylcholine receptor antibody (AChR-Ab)-mediated myasthenia gravis (AChR-MG). Methods: The clinical details and antibody results of 16 patients with AChR-MG and AQP4-NMOSD were analyzed retrospectively. Results: All had early-onset AChR-MG, the majority with mild generalized disease, and a high proportion achieved remission. Fifteen were female; 11 were Caucasian. In 14/16, the MG preceded NMOSD (median interval: 16 years) and 11 of these had had a thymectomy although 1 only after NMOSD onset. In 4/5 patients tested, AQP4-Abs were detectable between 4 and 16 years prior to disease onset, including 2 patients with detectable AQP4-Abs prior to thymectomy. AChR-Abs decreased and the AQP4-Ab levels increased over time in concordance with the relevant disease. AChR-Abs were detectable at NMOSD onset in the one sample available from 1 of the 2 patients with NMOSD before MG. Conclusions: Although both conditions are rare, the association of MG and NMOSD occurs much more frequently than by chance and the MG appears to follow a benign course. AChR-Abs or AQP4-Abs may be present years before onset of the relevant disease and the antibody titers against AQP4 and AChR tend to change in opposite directions. Although most cases had MG prior to NMOSD onset, and had undergone thymectomy, NMOSD can occur first and in patients who have not had their thymus removed.
- 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.