DAGOBERTO CALLEGARO

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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

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Autor e Coautores FMUSP-HC Normalizados: SAMIRA LUISA DOS APOSTOLOS PEREIRA × Categoria: original article × Tipo de acesso: openAccess ×

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  • article 2 Citação(ões) na Scopus
    Longitudinal analysis of verbal episodic memory in patients with relapsing-remitting multiple sclerosis
    (2018) BOA, Izadora Nogueira Fonte; RIMKUS, Carolina de Medeiros; COMPANHOLO, Kenia Repiso; PEREIRA, Samira Luisa Apostolos; JUNQUEIRA, Thiago de Faria; MACHADO, Melissa de Almeida Rodrigues; CALLEGARO, Dagoberto; OTACLUY, Maria Concepcion Garcia; LEITE, Claudia da Costa; MIOTTO, Eliane Correa
    Objective: A 4.5-year follow-up study was conducted to characterize baseline verbal episodic memory (VEM) and its behavior and to assess the effects of relapsing-remitting multiple sclerosis (RRMS) on this domain. Methods: Twenty-nine patients with RRMS underwent two neuropsychological assessments performed an average of 4.5 years apart. Twenty-six control participants underwent a single neuropsychological assessment. A significance level of p < 0.005 was adopted to denote a significant difference between the groups on the Mann Whitney and Wilcoxon paired statistical analyses. Results: No statistical difference was found in the results of the VEM tests between the first and second neuropsychological assessments of the patients. However, a statistical difference was evident between the patient and control groups in the results of the VEM tests. Conclusion: The patient group showed changes in the VEM relative to the control group.After approximately 4.5 years of disease, the patient performance on the VEM stabilized or improved.
  • article 19 Citação(ões) na Scopus
    Brazilian Consensus for the Treatment of Multiple Sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis
    (2018) MARQUES, Vanessa Daccach; PASSOS, Giordani Rodrigues dos; MENDES, Maria Fernando; CALLEGARO, Dagoberto; LANA-PEIXOTO, Marco Aurelio; COMINI-FROTA, Elizabeth Regina; VASCONCELOS, Claudia Cristina Ferreira; SATO, Douglas Kazutoshi; FERREIRA, Maria Lucia Brito; PAROLIN, Monica Koncke Fiuza; DAMASCENO, Alfredo; GRZESIUK, Anderson Kuntz; MUNIZ, Andre; MATTA, Andre Palma da Cunha; OLIVEIRA, Bianca Etelvina Santos de; TAUI, Carlos Bernardo; MACIEL, Damacio Ramon Kaimen; DINIZ, Denise Sisteroli; CORREA, Eber Castro; CORONETTI, Fernando; JORGE, Frederico M. H.; SATO, Henry Koiti; GONCALVES, Marcus Vinicius Magno; SOUSA, Nise Alessandra de C.; NOSCIMENTO, Osvaldo J. M.; GAMA, Paulo Diniz da; DOMINGUES, Renan; SIMM, Renato Faria; THOMAZ, Rodrigo Barbosa; MORALES, Rogerio de Rizo; DIAS, Ronaldo Maciel; APOSTOLOS-PEREIRA, Samira dos; MACHADO, Suzana Costa Nunes; JUNQUEIRA, Thiago de Faria; BECKER, Jefferson
    The expanding therapeutic arsenal in multiple sclerosis (MS) has allowed for more effective and personalized treatment, but the choice and management of disease-modifying therapies (DMTs) is becoming increasingly complex. In this context, experts from the Brazilian Committee on Treatment and Research in Multiple Sclerosis and the Neuroimmunology Scientific Department of the Brazilian Academy of Neurology have convened to establish this Brazilian Consensus for the Treatment of MS, based on their understanding that neurologists should be able to prescribe MS DMTs according to what is better for each patient, based on up-to-date evidence and practice. We herein propose practical recommendations for the treatment of MS, with the main focus on the choice and management of DMTs, as well as present a review of the scientific rationale supporting therapeutic strategies in MS.
  • article 6 Citação(ões) na Scopus
    Recommendations by the Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and the Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) on vaccination in general and specifically against SARS-CoV-2 for patients with demyelinating diseases of the central nervous system
    (2021) BECKER, Jefferson; FERREIRA, Lis Campos; DAMASCENO, Alfredo; BICHUETTI, Denis Bernardi; CHRISTO, Paulo Pereira; CALLEGARO, Dagoberto; PEIXOTO, Marco Aurelio Lana; SOUSA, Nise Alessandra de Carvalho; ALMEIDA, Sergio Monteiro de; ADONI, Tarso; SANTIAGO-AMARAL, Juliana; JUNQUEIRA, Thiago; PEREIRA, Samira Luisa Apostolos; GOMES, Ana Beatriz Ayroza Galvao Ribeiro; PITOMBEIRA, Milena; PAOLILO, Renata Barbosa; GRZESIUK, Anderson Kuntz; PICCOLO, Ana Claudia; ALMEIDA, Jose Arthur Costa D.; GOMES NETO, Antonio Pereira; OLIVEIRA, Augusto Cesar Penalva de; OLIVEIRA, Bianca Santos de; TAUIL, Carlos Bernardo; VASCONCELOS, Claudia Ferreira; KAIMEN-MACIEL, Damacio; VARELA, Daniel; DINIZ, Denise Sisterolli; OLIVEIRA, Enedina Maria Lobato De; MALFETANO, Fabiola Rachid; BORGES, Fernando Elias; FIGUEIRA, Fernando Faria Andrade; GONDIM, Francisco de Assis Aquino; PASSOS, Giordani Rodrigues dos; SILVA, Guilherme Diogo; OLIVAL, Guilherme Sciascia Do; SANTOS, Gutemberg Augusto Cruz dos; RUOCCO, Heloisa Helena; SATO, Henry Koiti; SOARES NETO, Herval Ribeiro; CALIA, Leandro Cortoni; GONCALVES, Marcus Vinicius Magno; VECINO, Maria Cecilia Aragon De; PIMENTEL, Maria Lucia Vellutini; RIBEIRO, Marlise de Castro; BOAVENTURA, Mateus; PAROLIN, Monica Koncke Fiuza; MELO, Renata Brant de Souza; LAZARO, Robson; THOMAZ, Rodrigo Barbosa; KLEINPAUL, Rodrigo; DIAS, Ronaldo Maciel; GOMES, Sidney; LUCATTO, Simone Abrante; ALVES-LEON, Soniza Vieira; FUKUDA, Thiago; RIBEIRO, Taysa Alexandrino Gonsalves Jube; WINCKLER, Thereza Cristina D'avila; FRAGOSO, Yara Dadalti; NASCIMENTO, Osvaldo Jose Moreira do; FERREIRA, Maria Lucia Brito; MENDES, Maria Fernanda; BRUM, Doralina Guimaraes; GLEHN, Felipe Von
    The Scientific Department of Neuroimmunology of the Brazilian Academy of Neurology (DCNI/ABN) and Brazilian Committee for Treatment and Research in Multiple Sclerosis and Neuroimmunological Diseases (BCTRIMS) provide recommendations in this document for vaccination of the population with demyelinating diseases of the central nervous system (CNS) against infections in general and against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19. We emphasize the seriousness of the current situation in view of the spread of COVID-19 in our country. Therefore, reference guides on vaccination for clinicians, patients, and public health authorities are particularly important to prevent some infectious diseases.The DCNI/ABN and BCTRIMS recommend that patients with CNS demyelinating diseases (e.g., MS and NMOSD) be continually monitored for updates to their vaccination schedule, especially at the beginning or before a change in treatment with a disease modifying drug (DMD). It is also important to note that vaccines are safe, and physicians should encourage their use in all patients. Clearly, special care should be taken when live attenuated viruses are involved. Finally, it is important for physicians to verify which DMD the patient is receiving and when the last dose was taken, as each drug may affect the induction of immune response differently.
  • article 24 Citação(ões) na Scopus
    Clinical Features of COVID-19 on Patients With Neuromyelitis Optica Spectrum Disorders
    (2021) APOSTOLOS-PEREIRA, Samira Luisa; FERREIRA, Lis Campos; BOAVENTURA, Mateus; SOUSA, Nise Alessandra de Carvalho; MARTINS, Gabriela Joca; D'ALMEIDA, Jose Arthur; PITOMBEIRA, Milena; MENDES, Lucas Silvestre; FUKUDA, Thiago; CABECA, Hideraldo Luiz Souza; ROCHA, Luciano Chaves; OLIVEIRA, Bianca Santos de; STELLA, Carla Renata Vieira; OLIVEIRA, Enedina Maria Lobato de; AMORIM, Leizian de Souza; CASTRO, Andrea Ferrari de; GOMES NETO, Antonio Pereira; SILVA, Guilherme Diogo; BUENO, Lucas; MACHADO, Maria de Morais; DIAS-CARNEIRO, Rafael Castello; DIAS, Ronaldo Maciel; MOREIRA, Alvaro Porto; PICCOLO, Ana; GRZESIUK, Anderson Kuntz; MUNIZ, Andre; DISSEROL, Caio Diniz; VASCONCELOS, Claudia Ferreira; KAIMEN-MACIEL, Damacio; DINIZ, Denise Sisterolli; COMINI-FROTA, Elizabeth; ROCHA, Fernando Coronetti; SANTOS, Gutemberg Augusto Cruz dos; FRAGOSO, Yara Dadalti; OLIVAL, Guilherme Sciascia do; RUOCCO, Heloisa Helena; SIQUEIRA, Heloise Helena; SATO, Henry Koity; FIGUEIREDO JR., Jose Alexandre; CALIA, Leandro Cortoni; DOURADO JR., Mario Emilio Teixeira; SCOLARI, Leticia; SOARES NETO, Herval Ribeiro; MELGES, Luiz; GONCALVES, Marcus Vinicius Magno; PIMENTEL, Maria Lucia Vellutini; RIBEIRO, Marlise de Castro; ARAMBULA, Omar Gurrola; GAMA, Paulo Diniz da; MENON, Renata Leite; THOMAZ, Rodrigo Barbosa; MORALES, Rogerio de Rizo; SOBREIRA, Silvana; MACHADO, Suzana Nunes; RIBEIRO, Taysa Gonsalves Jube; PEREIRA, Valeria Coelho Santa Rita; COSTA, Vanessa Maia; NOBREGA JUNIOR, Adaucto Wanderley da; ALVES-LEON, Soniza Vieira; PERIN, Marilia Mamprim de Morais; DONADI, Eduardo; ADONI, Tarso; GOMES, Sidney; FERREIRA, Maria Brito; CALLEGARO, Dagoberto; MENDES, Maria Fernanda; BRUM, Doralina; GLEHN, Felipe von
    Background and Objectives To describe the clinical features and disease outcomes of coronavirus disease 2019 (COVID-19) in patients with neuromyelitis optica spectrum disorder (NMOSD). Methods The Neuroimmunology Brazilian Study Group has set up the report of severe acute respiratory syndrome (SARS-CoV2) cases in patients with NMOSD (pwNMOSD) using a designed web-based case report form. All neuroimmunology outpatient centers and individual neurologists were invited to register their patients across the country. Data collected between March 19 and July 25, 2020, were uploaded at the REDONE.br platform. Inclusion criteria were as follows: (1) NMOSD diagnosis according to the 2015 International Panel Criteria and (2) confirmed SARS-CoV2 infection (reverse transcription-polymerase chain reaction or serology) or clinical suspicion of COVID-19, diagnosed according to Center for Disease Control / Council of State and Territorial Epidemiologists (CDC/CSTE) case definition. Demographic and NMOSD-related clinical data, comorbidities, disease-modifying therapy (DMT), COVID-19 clinical features, and severity were described. Results Among the 2,061 pwNMOSD followed up by Brazilian neurologists involved on the registry of COVID-19 in pwNMOSD at the REDONE.br platform, 34 patients (29 women) aged 37 years (range 8-77), with disease onset at 31 years (range 4-69) and disease duration of 6 years (range 0.2-20.5), developed COVID-19 (18 confirmed and 16 probable cases). Most patients exhibited mild disease, being treated at home (77%); 4 patients required admission at intensive care units (severe cases); and 1 patient died. Five of 34 (15%) presented neurologic manifestations (relapse or pseudoexacerbation) during or after SARS-CoV2 infection. Discussion Most NMOSD patients with COVID-19 presented mild disease forms. However, pwNMOSD had much higher odds of hospitalization and intensive care unit admission comparing with the general Brazilian population. The frequency of death was not clearly different. NMOSD disability, DMT type, and comorbidities were not associated with COVID-19 outcome. SARS-CoV2 infection was demonstrated as a risk factor for NMOSD relapses. Collaborative studies using shared NMOSD data are needed to suitably define factors related to COVID-19 severity and neurologic manifestations.
  • article 7 Citação(ões) na Scopus
    A disturbed processing of graviceptive pathways may be involved in the pathophysiology of balance disorders in patients with multiple sclerosis
    (2016) FONSECA, Bruna Antinori Vignola da; PEREIRA, Cristiana Borges; JORGE, Frederico; SIMM, Renata; APOSTOLOS-PEREIRA, Samira; CALLEGARO, Dagoberto
    The purpose of this study was to determine the relationship between perception of verticality and balance disorders in multiple sclerosis patients. We evaluated patients and healthy controls. Patients were divided into two groups according to their risk of fall, with or without risk of fall, measured by a Dynamic Gait Index scale. Graviceptive perception was assessed using the subjective visual vertical test. Patients with risk of fall showed worse perception than those without risk of fall, p < 0.001. Misperception of verticality was correlated with the dynamic gait index scores (p < 0.001), suggesting that the larger the error for verticality judgment, the greater risk for falling. Considering that the perception of verticality is essential for postural control, our results suggested that the disturbed processing of graviceptive pathways may be involved in the pathophysiology of balance disorders in these patients.
  • article 4 Citação(ões) na Scopus
    Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders
    (2021) GOMES, Ana Beatriz Ayroza Galvao Ribeiro; PITOMBEIRA, Milena Sales; SATO, Douglas Kazutoshi; CALLEGARO, Dagoberto; APOSTOLOS-PEREIRA, Samira Luisa
    Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical record review of all patients at the School of Medicine of the University of Sao Paulo (Sao Paulo, Brazil) who fulfilled the 2015 international consensus diagnostic criteria for NMOSD and were treated with azathioprine for at least 10 years. Results: Out of 375 patients assessed for eligibility, 19 were included in this analysis. These patients' median age was 44 years (range=28-61); they were mostly female (17/19) and AQP4-IgG seropositive (18/19). The median disease duration was 15 years (range=10-39) and most patients presented a relapsing clinical course (84.2%). The median duration of treatment was 11.9 years (range=10.0-23.8). The median annualized relapse rates (ARR) pre- and post-treatment with azathioprine were 1 (range=0.1 2) and 0.1 (range=0-0.35); p=0.09. Three patients (15.7%) had records of adverse events during the follow-up, which consisted of chronic B12 vitamin deficiency, pulmonary tuberculosis and breast cancer. Conclusion: Azathioprine may be considered a safe agent for long-term treatment (>10 years) of NMOSD, but continuous vigilance for infections and malignancies is required.
  • article 5 Citação(ões) na Scopus
    Natalizumab treatment in multiple sclerosis: the experience from two Brazilian MS centers
    (2015) OLIVEIRA, Enedina Maria Lobato de; SIMM, Renata Faria; DASIC, Gorana; MORAIS, Marilia Mamprim de; PERREIRA, Samira Luiza dos Apostolos; CALLEGARO, Dagoberto
    Objective: Analyze the demographics, clinical characteristics, efficacy and safety of natalizumab treatment in Brazilian patients with multiple sclerosis (MS) followed up for at least 12 months, in two tertiary MS care centers in Sao Paulo. Method: We evaluated the effect of natalizumab treatment on annualized relapse rate and disability progression in 75 patients with MS treated with natalizumab for at least 12 months. A subgroup analysis was performed to evaluate efficacy of natalizumab treatment in patients with Expanded Disability Status Scale (EDSS) <= 3.0 vs patients with EDSS > 3. Results: Patients treated for at least one year with natalizumab showed a 91% reduction in aRR, as well and an improvement in neurological disability. The impact of natalizumab treatment was greater in patients with EDSS < 3.0. Overall, natalizumab was safe but one patient developed progressive multifocal leukoencephalopathy. Conclusion: Natalizumab as a third line therapy is safe and efficacious, especially in patients with mild neurological disability.
  • article 10 Citação(ões) na Scopus
    Outer Retinal Dysfunction on Multifocal Electroretinography May Help Differentiating Multiple Sclerosis From Neuromyelitis Optica Spectrum Disorder
    (2019) FILGUEIRAS, Thiago G.; OYAMADA, Maria K.; PRETI, Rony C.; APOSTOLOS-PEREIRA, Samira L.; CALLEGARO, Dagoberto; MONTEIRO, Mario L. R.
    Purpose: To evaluate the intermediate and outer retina of patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) using OCT and multifocal electroretinography (mf-ERG). Methods: Patients with MS (n = 30), NMOSD (n = 30), and healthy controls (n = 29) underwent visual field (VF), OCT, and mt-ERG testing. The eyes were distributed into 5 groups: MS with or without history of ON (MS+ON, MS-ON), NMOSD with or without ON (NMOSD+ON, NMOSD-ON), and controls. The thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer was measured. mf-ERG P1 and N1 responses were registered and grouped in 3 sets of rings. The groups were compared using GEE models, and effect size (ES) calculated. Results: Compared to controls, GCL and IPL thickness was significantly smaller in MS+ON (both p < 0.01), MS-ON (p < 0.01 and p = 0.015, respectively), NMOSD+ON (both p < 0.01) and NMOSD-ON (p = 0.03 and p = 0.018, respectively). ES was >0.80. mRNFL was smaller in three of the above groups (p < 0.01, p < 0.001, and p = 0.028; ES > 0.80) but not in MS-ON eyes (p = 0.18). No significant difference was observed for the remaining layers. Compared to controls, P1 and N1 peak times were shorter in MS (p-values in the range 0.049-0.002, ES < 0.50; and 0.049-0.010; ES < 0.50, respectively) but not in NMOSD. These abnormalities were strongly correlated with intermediate and outer retinal layer thickness. Conclusions: mf-ERG data suggest outer retinal abnormalities in MS, but not in NMOSD. Our results may help understand how the two conditions differ regarding retinal damage.
  • article 7 Citação(ões) na Scopus
    Optical coherence tomography evaluation of retinal nerve fiber layer in longitudinally extensive transverse myelitis
    (2011) MOURA, Frederico C.; FERNANDES, Danilo B.; APOSTOLOS-PEREIRA, Samira L.; CALLEGARO, Dagoberto; MARCHIORI, Paulo E.; MONTEIRO, Mario L. R.
    Objective: To compare optical coherence tomography (OCT) measurements on the retinal nerve fiber layer (RNFL) of healthy controls and patients with longitudinally extensive transverse myelitis (LETM) without previous optic neuritis. Method: Twenty-six eyes from 26 patients with LETM and 26 control eyes were subjected to automated perimetry and OCT for comparison of RNFL measurements. Results: The mean deviation values from perimetry were significantly lower in patients with LETM than in controls (p<0.0001). RNFL measurements in the nasal quadrant and in the 3-o'clock segment were significantly smaller in LETM eyes than in controls. (p=0.04 and p=0.006, respectively). No significantly differences in other RNFL measurements were found. Conclusion: Patients with LETM may present localized RNFL loss, particularly on the nasal side of the optic disc, associated with slight visual field defects, even in the absence of previous episodes of optic neuritis. These findings emphasize the fact that patients with LETM may experience attacks of subclinical optic nerve damage.
  • article 4 Citação(ões) na Scopus
    AQP4-IgG NMOSD, MOGAD, and double-seronegative NMOSD: is it possible to depict the antibody subtype using magnetic resonance imaging?
    (2023) FRAGOSO, Diego Cardoso; SALLES, Luana Michelli Oliveira de Paula; PEREIRA, Samira Luisa Apostolos; CALLEGARO, Dagoberto; SATO, Douglas Kazutoshi; RIMKUS, Carolina de Medeiros
    Background There is clinical and radiological overlap among demyelinating diseases. However, their pathophysiological mechanisms are different and carry distinct prognoses and treatment demands.Objective To investigate magnetic resonance imaging (MRI) features of patients with myelin-oligodendrocyte glycoprotein associated disease (MOGAD), antibody against aquaporin-4(AQP-4)-immunoglobulin G-positive neuromyelitis optica spectrum disorder (AQP4-IgG NMOSD), and double-seronegative patients.Methods A cross-sectional retrospective study was performed to analyze the topography and morphology of central nervous system (CNS) lesions. Two neuroradiologists consensually analyzed the brain, orbit, and spinal cord images.Results In total, 68 patients were enrolled in the study (25 with AQP4-IgG-positive NMOSD, 28 with MOGAD, and 15 double-seronegative patients). There were differences in clinical presentation among the groups. The MOGAD group had less brain involvement (39.2%) than the NMOSD group (p = 0.002), mostly in the subcortical/juxtacortical, the midbrain, the middle cerebellar peduncle, and the cerebellum. Double-seronegative patients had more brain involvement (80%) with larger and tumefactive lesion morphology. In addition, double-seronegative patients showed the longest optic neuritis (p = 0.006), which was more prevalent in the intracranial optic nerve compartment. AQP4-IgG-positive NMOSD optic neuritis had a predominant optic-chiasm location, and brain lesions mainly affected hypothalamic regions and the postrema area (MOGAD versus AQP4-IgG-positive NMOSD, p = 0 .013). Furthermore, this group had more spinal cord lesions (78.3%), and bright spotty lesions were a paramount finding to differentiate it from MOGAD (p = 0.003).Conclusion The pooled analysis of lesion topography, morphology, and signal intensity provides critical information to help clinicians form a timely differential diagnosis.