ANTONIO CARLOS PASTORINO

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Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/36 - Laboratório de Pediatria Clínica, Hospital das Clínicas, Faculdade de Medicina

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Agora exibindo 1 - 10 de 29
  • conferenceObject
    Activated PI3K-Delta Syndrome (APDS): A Monogenic Cause of VEO-IBD That Impacts on Treatment
    (2019) LINDOSO, Livia; DEBONI, Mariana; DORNA, Mayra Barros; CASTRO, Ana Paula Moschione; PASTORINO, Antonio Carlos; TOMA, Ricardo
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    Evolution of milk-specific IgE antibody levels and its fractions during tolerance development in cow's milk allergic patients
    (2012) BECK, C.; CASTRO, A.; GUSHKEN, A.; WATANABE, L.; BRANDAO, A.; YONAMINE, G.; PASTORINO, A.; JACOB, C.
    Background: Food allergy affects about 6% of children and cow’s milk (CM) is the most important allergen. The majority of patients used to become tolerant during the first 3 years of life, but nowadays tolerance is being achieved later. Casein (C), alpha-lactalbumin (α) and beta-lactoglobulin (β) are considered as some of the major allergens. Until now, no study has evaluated the correlation among the whole cow’s milk (WCM) IgE antibody levels (IgE ab) and its fractions (C, α and β) during the tolerance development in CMA patients. Method: It was a retrospective study that included patients with previous diagnosis of CMA who developed tolerance during follow-up. It was included 31 IgE-mediated CMA patients (19 male: 12 female), median age of the first symptoms was 1 year. CMA was defined as a positive double blind placebo-controlled food challenge, open challenge or confirmed anaphylaxis plus cow’s milk-specific IgE positive (higher than 3.5 JU/l or positive skin prick test), and tolerance was defined as acceptance of cow milk without previous symptoms. Specific IgE analysis to WCM, α, β, and C were performed at three moments: initial (time 1), in the middle of the follow-up (time 2) and at the tolerance diagnosis (time 3). The chosen point during follow-up was that which corresponded to half of the period until tolerance was reached. The correlations among whole mil IgE ab and its fractions in those moments were evaluated with Spearman correlation test. Result: Ther values for whole cow’s milk IgE ab and each fraction according Spearman test are described in the following Table 1 Among all analysis, the correlation between whole cow’s milk and casein IgE ab and whole cow’s milk and alfalacto-albumin IgE ab showed adequater values at all moments of evaluations. Conclusion: These results can indicate that casein and alfalacto-albumin IgE ab showed similar behavior to WCM, and then the sequential evaluation through whole cow’s milk IgE ab levels may be enough for monitoring CMA patients until the tolerance development. Time Alpha-lactalbumin IgE ab Beta-lactoglobulin IgE ab Casein IgE ab 1 0.81 (0.63–0.90) 0.71 (0.46–0.85) 0.81 (0.64–0.91) 2 0.82 (0.65–0.91) 0.66 (0.39–0.82) 0.82 (0.65–0.91) 3 0.82 (0.64–0.91) 0.79 (0.60–0.90) 0.76 (0.54–0.90)
  • conferenceObject
    Activated Phosphoinositide 3-Kinase Syndrome (APDS): a Diagnosis to be Aware of
    (2017) BARP, M. F.; SILVA, P. A.; SILVA, P. F.; DORNA, M. B.; CASTRO, A. P. B. M.; SANTOS, C. J. N.; PASTORINO, A. C.
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    Hematopoietic Stem Cell Transplantation for Chronic Granulomatous Disease in a Single Institution in Brazil. Reproducing Good Results with a Reduced Toxicity Regimen
    (2017) FERNANDES, Juliana Folloni; MANTOVANI, Luiz Fernando Alves Lima; VENANCIO, Angela Mandelli; DORNA, Mayra; PASTORINO, Antonio Carlos; VASCONCELOS, Dewton; NETO, Antonio Condino; MOURA, Ana Carla Augusto; COLLASSANTI, Maria Dulce; ZANICHELLI, Maria Aparecida; CARNEIRO-SAMPAIO, Magda; ROCHA, Vanderson G.; ODONE FILHO, Vicente
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    Sensitisation to foods and dust mite in Brazilian pediatric patients with atopic dermatitis
    (2012) SWENSSON, A.; CASTRO, A.; CASAGRANDE, R.; BITTENCOURT, T.; YONAMINE, G.; PASTORINO, A.; JACOB, C.
    Background: Atopic dermatitis (AD) is a complex disease that can be or not related to atopy. The IgE levels and the presence of sensitisation has been associated to AD severity. The aim of this study is to evaluate the allergen sensitisation profile in patients with moderate or severe atopic dermatitis in Brazilian patients from an allergy reference center. Methods: About 66 patients with diagnosis of atopic dermatitis according Hanifin e Rajka criteria (mean age 10 years) followed at a reference center for allergic disease in pediatric patients were included. The severity was evaluated according SCORAD (SCORing Atopic Dermatitis) criteria. Specific IgE was measured to the following allergens: Blomia tropicalis, D peteronyssinus, egg white, cow’s milk and its fractions. Sensitisation was considered positive when the ImmunoCAP values were ¡Y 0.35 kU/l and multi sensitisation was considered when patients presented positive specific IgE for all allergens tested. Table 1 Hapten Total, positive (n,%) Total, clinically relevant (n,%) Children, positive (n,%) Children, clinically relevant (n,%) Adolescents, positive (n,%) Adolescents, clinically relevant (n,%) Nickel sulphate 5% pet. 44 (34.6) 36 (28.3) 19 (29.7) 14 (21.9) 25 (39.7) 22 (34.9) Cobalt chloride 1% pet. 28 (22.0) 15 (11.8) 16 (25.0) 9 (14.1) 12 (19.0) 6 (9.5) Potassium dichromate 0.5% pet. 26 (20.5) 15 (11.8) 19 (29.7) 10 (15.6) 7 (11.1) 5 (7.9) Paraphenylenediamine 1% pet. 12 (9.4) 6 (4.7) 8 (12.5) 5 (7.8) 4 (6.3) 1 (1.6) Propolis 10% pet. 12 (9.4) 5 (3.9) 11 (17.2) 5 (7.8) 1 (1.6) 0 (0.0) Palladium chloride 2% pet. 12 (9.4) 4 (3.1) 6 (9.4) 2 (3.1) 6 (9.5) 2 (3.2) Fragrance Mix I 18% pet. 10 (7.9) 4 (3.1) 4 (6.3) 2 (3.1) 6 (9.5) 2 (3.2) Neomycin sulphate 20% pet. 6 (4.7) 2 (1.6) 4 (6.3) 2 (3.1) 2 (3.2) 0 (0.0) Balsam of Peru (Myroxylon pereirae ) 25% pet. 6 (4.7) 1 (0.8) 4 (6.3) 1 (1.6) 2 (3.2) 0 (0.0) Colophonium 20% pet. 5 (3.9) 4 (3.1) 2 (3.1) 2 (3.1) 3 (4.8) 2 (3.2) Wool alcohols (lanolin) 30% pet. 5 (3.9) 3 (2.4) 3 (4.7) 3 (4.7) 2 (3.2) 0 (0.0) Paraben Mix 16% pet. 4 (3.1) 4 (3.1) 3 (4.7) 3 (4.7) 1 (1.6) 1 (1.6) Kathon CG (MI/MCI) 0.01% aqua 4 (3.1) 2 (1.6) 3 (4.7) 2 (3.1) 1 (1.6) 0 (0.0) Results: Among 66 patients included, 12 presented severe AD and 54 moderated. Sixty two of the 66 (93%) patients studied showed positive sensitization to any of the allergens, being aeroallergens the most prevalent (53/56), followed by egg white (29/53) and milk (31/66). Serum levels of specific IgE to aerollergens were significantly higher than for food allergens (P< 0.001). Specific IgE levels did not differ according severity (P> 0.05 for all allergens evaluated About 23 patients presented multi sensitization (17 moderate and six severe) without significant difference between both groups. Conclusion: There was an elevate rate of sensitisation in this group of patients being aeroallergens the most frequent and with higher specific IgE levels. AD severity did not contribute to increase sensitisation. More studies should be performed in order to evaluate if these findings can lead to specific therapeutic strategies as specific immunotherapy or food avoidance.
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    Pulmonary Morphologic and Functional Abnormalities in Patients with Primary Hypogammaglobulinemia
    (2012) DORNA, Mayra de Barros; CASTRO, Ana Paula B. Moschione; PASTORINO, Antonio Carlos; CARNEIRO-SAMPAIO, Magda M. Sales; JACOB, Cristina Miuki Abe
    Retrospective evaluation of 30 patients (21 M) aged 4.6–23.4 y (median 16.7 y) with predominantly humoral PID(9IDCV;14XLA;7HIGM).Mediantimeof follow-up9.2y(1.8–17.5). Median age of symptoms’ onset8mo(1–96 mo), age at diagnosis 5.8 y (7–175 mo) and diagnostic delay 4.7 y (0.2–13 y). Pneumonia was the main manifestation before diagnosis (24/30 patients) with frequency of 0.6/patient/year. After beginning IVIG, frequency of pneumonias decreased to 0.1 (p<0.001) and the frequency of sinusitis increased from0to0.55(p<0.001). Higher age at diagnosis and longer diagnostic delay were associated to bronchiectasis at diagnosis (p=0.016 and p<0.001). Seven patients developed bronchiectasis during follow-up. Spirometry (23/30 patients), 1–15 y after IVIG was abnormal in 13 (9 obstructive; 4 restrictive). Humoral PID often affects respiratory tract and IVIG reduces complications but pulmonary monitoring is essential to guarantee adequate therapeutic interventions.
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    Granulocyte Transfusion in Patients with CGD: an Effective Alternative for Severe Refractory Infections
    (2017) GERHARDT, C. M. B.; PAIVA, B. M. G. P.; SANTOS, C. J. N.; CASTRO, A. P. B. M.; DORNA, M. B.; PASTORINO, A. C.
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    Hemophagocytic Syndrome Following Oral Rotavirus and Poliovirus Vaccination in Brazilian Perforin-deficient Twins
    (2013) JACOB, C. Miuki Abe; SANTOS, C. N.; PASTORINO, A. C.; DORNA, M. B.; FERNANDES, J. Fi; CASTRO, A. P. Bm; ROCHA, V.; HAMERCHLAK, N.; SAINT-BASILE, G. de; CARNEIRO-SAMPAIO, M.
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    The Most Frequent Primary Immunodeficiency Diseases (PIDDs) in Different Age Groups
    (2013) CARNEIRO-SAMPAIO, M.; JACOB, C. M. Abe; PASTORINO, A. C.; WATANABE, L.; DORNA, M.; DORIA-FILHO, U.; KOKRON, C. M.; TOLEDO-BARROS, M.; MORAES-VASCONCELOS, D.; DUARTE, A.
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    SERIOUS OPHTHALMOLOGIC COMPLICATIONS OF PRIMARY IMMUNODEFICIENCY PATIENTS
    (2012) ALVAREZ, H. T.; SUZUKI, A. C. F.; TAKIUTI, J. H.; FERRIANI, M. P.; DORNA, M.; SANTOS, C.; PASTORINO, A. C.; CASTRO, A. P. B.; CARNEIRO-SAMPAIO, M.; JACOB, C. M.
    Introduction: Primary immunodeficiencies (PID) are genetic diseases characterized by high susceptibility to infections. Although the manifestations affect all organs, there are few reports about ocular complications. Objective: To describe four patients with serious ophthalmologic complications in Brazilian patients followed at a reference center for PID. Methods: It was a retrospective study including patients with ocular serious complains. Medical records of 4 PID patients were evaluated for clinical data and the PID diagnosis was based on the PAGID/ ESID criteria. These patients underwent to ophthalmologic evaluation, including visual acuity, biomicroscopy and fundus examination. Ophthalmologic evaluation was done routinely only for AT and CHS diagnosis. Results: The PIDs patients included were: HLH, GCD, CMC and A-T. The HLH patient had a heterozygous mutation at the perforin gene (FHL type 2), CMC patient had a heterozygous mutation at STAT1. Ocular complains were: ocular pain, hyperemia, eyelids edema and strabismus and the characteristics of each patient were: - Female, 13y, CMC- conjunctivitis and eyelids edema with infraorbital infected papules. - Female, 6 mo, HLH- acute strabismus in consequence of neurological involvement by HLH. - Male, 15y, AT- herpes conjunctivitis and loss of vision in left eye. - Male, 9y CGD - Conjunctivitis in the left eye, progressing to edema and proptosis. The diagnosis was endophthalmitis granulomatous with loss of vision in left eye. Conclusion: Although not common in PID patients, the ocular complications may lead to loss of vision. The ophthalmologic evaluation would be routinely recommended for all PID patients to avoid important sequels.