1
|
Souza L, Gurgel-Giannetti J, Sampaio G, Wang J, Scliar M, Zatz M, Vainzof M. LIMB GIRDLE MUSCULAR DYSTROPHIES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
2
|
Abstract
Summary Introduction. The incidence of food-induced anaphylaxis (FIA) is increasing in young children. Although the commonest culprits are cow's milk and egg, FIA to tree nuts (TNs) have been increasing. Objective. Characterization of children referred to our allergy department due to TNs-induced anaphylaxis (TNs-FIA) during preschool age. Materials and methods. We have retrospectively included 25 children with clinical history of preschool TNs-FIA, proven by allergological work-up. TNs sensitization was assessed by skin prick tests and/or specific IgE. Results. The mean age of the first anaphylactic episode was 3.1±1.2 years. The majority (92%) had an allergic disease (52% asthma). The implicated TNs were cashew (11 children), walnut (8), pine nut (5), hazelnut (2) and almond (1). The reaction occurred after the first known ingestion in 68%. In 92%, symptoms appeared within 30 minutes after exposure. The most frequent clinical symptoms were mucocutaneous (96%), respiratory (80%) and gastrointestinal (52%). Twenty-one children were admitted to the emergency department, although only 48% were treated with epinephrine. An underneath IgE-mediated mechanism was proven in all cases. Immunologic cross-reactivity with other TNs was identified in 84%, and with peanut in 36%. Overall, in our center, TNs-FIA represents 18% of all causes of FIA. Conclusions. In preschool age children with TNs-FIA, cashew and walnut were the commonest implicated nuts. Most reactions occurred briefly after exposure to minimal amounts of TNs, demonstrating the high potency of these allergens. About one-third also had peanut sensitization. Potentially life-threatening TNs allergy can occur early in childhood and adequate management should be undertaken.
Collapse
Affiliation(s)
- J Matias
- Pediatric Department, Garcia de Orta Hospital, Almada, Portugal
| | - A Gaspar
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - L M Borrego
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
- CEDOC, Chronic Diseases Research Center, Immunology, NOVA Medical School - Faculdade de Ciências Médicas, Lisbon, Portugal
| | - S Piedade
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - G Pires
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - C Arede
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - G Sampaio
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - M Morais Almeida
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| |
Collapse
|
3
|
Gaspar Â, Santos N, Piedade S, Santa-Marta C, Pires G, Sampaio G, Arêde C, Borrego LM, Morais-Almeida M. One-year survey of paediatric anaphylaxis in an allergy department. Eur Ann Allergy Clin Immunol 2015; 47:197-205. [PMID: 26549337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM To determine the frequency of anaphylaxis in an allergy outpatient department, allowing a better understanding regarding aetiology, clinical manifestations and management, in children and adolescents. METHODS From among 3646 patients up to 18 years old observed during one-year period, we included those with history of anaphylaxis reported by allergists. RESULTS Sixty-four children had history of anaphylaxis (prevalence of 1.8%), with mean age 8.1±5.5 years, 61% being male. Median age of the first anaphylactic episode was 3 years (1 month-17 years). The majority of patients had food-induced anaphylaxis (84%): milk 22, egg 7, peanut 6, tree nuts 6, fresh fruits 6, crustaceans 4, fish 4 and wheat 2. Food-associated exercise-induced anaphylaxis was reported in 2 adolescents. Drug-induced anaphylaxis occurred in 8%: 4 non-steroidal anti-inflammatory drugs and 1 amoxicillin. Three children had cold-induced anaphylaxis, one adolescent had anaphylaxis to latex and one child had anaphylaxis to insect sting. The majority (73%) had no previous diagnosis of the etiologic factor. Symptoms reported were mainly mucocutaneous (94%) and respiratory (84%), followed by gastrointestinal (42%) and cardiovascular (25%). Fifty-one patients were admitted to the emergency department, although only 33% were treated with epinephrine. Recurrence of anaphylaxis occurred in 26 patients (3 or more episodes in 14). CONCLUSIONS In our paediatric population, the main triggering agent of anaphylaxis was IgE-mediated food allergy. Epinephrine is underused, as reported by others. Often, children have several episodes before being assessed by an allergist. We stress the importance of systematic notification and improvement of educational programmes in order to achieve a better preventive and therapeutic management of this life-threatening entity.
Collapse
Affiliation(s)
- Â Gaspar
- Immunoallergy Department CUF Descobertas Hospital 1998-018 Lisbon, Portugal. E-mail:
| | - N Santos
- Immunoallergy Department, Centro Hospitalar de São João, Porto, Portugal
| | - S Piedade
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - C Santa-Marta
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - G Pires
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - G Sampaio
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - C Arêde
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | - L M Borrego
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal. CEDOC, NOVA Medical School, Lisbon, Portugal
| | - M Morais-Almeida
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal. CINTESIS, Center for Research in Health Technologies and Information Systems, Porto, Portugal
| |
Collapse
|
4
|
Gurgel-Giannetti J, Ribeiro B, Uliana L, Sampaio G, Giannetti A, Van der Linden V, Vainzof M. Steroid benefit in a laminopathy-congenital muscular dystrophy patient with dropped head syndrome: A 10-year follow-up. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Sampaio G, Piedade S, Morais-Almeida M. Safety and efficacy of oral desensitization to swordfish in children with persistent and multiple fish allergy. Clin Transl Allergy 2013. [PMCID: PMC3723825 DOI: 10.1186/2045-7022-3-s3-p21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
6
|
Piedade S, Sampaio G, Gaspar Â, Arêde C, Borrego LM, Santa-Marta C, Morais-Almeida M. Safety and efficacy of a sublingual-oral desensitization protocol in cow’s milk allergy treatment. Clin Transl Allergy 2013. [PMCID: PMC3723920 DOI: 10.1186/2045-7022-3-s3-p24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
7
|
Santos N, Gaspar A, Livramento S, Sampaio G, Morais-Almeida M. Aspirin desensitization in a woman with inherited thrombophilia and recurrent miscarriage. Eur Ann Allergy Clin Immunol 2012; 44:256-257. [PMID: 23441445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Women with inherited thrombophilia and recurrent miscarriage might benefit from preconceptional antiagreggation with low-dose acetylsalicylic acid (ASA), but concerns about severe adverse reactions may prevent physicians from performing this treatment in patients with ASA hypersensitivity. We report the first known case of ASA desensitization in a 41-year-old woman with inherited thrombophilia, who had homozygosity (4G/4G polymorphism) of the plasminogen activator inhibitor-1 (PAI-1) gene and first trimester recurrent miscarriage, and had previously presented with anaphylaxis to ASA. Desensitization was completed despite one self-limited adverse reaction, and the patient has maintained a daily ASA intake of 100 mg with good tolerance.
Collapse
Affiliation(s)
- N Santos
- Immunoallergy Department, CUF Descobertas Hospital, Lisbon, Portugal
| | | | | | | | | |
Collapse
|
8
|
Affiliation(s)
- G Sampaio
- Hospital Dona Estefânia, Serviço de Imunoalergologia, Rua Jacinta Marto, 1169-045 Lisboa, Portugal
| | | | | | | | | |
Collapse
|
9
|
Ribeiro RC, Sandrini F, Figueiredo B, Zambetti GP, Michalkiewicz E, Lafferty AR, DeLacerda L, Rabin M, Cadwell C, Sampaio G, Cat I, Stratakis CA, Sandrini R. An inherited p53 mutation that contributes in a tissue-specific manner to pediatric adrenal cortical carcinoma. Proc Natl Acad Sci U S A 2001; 98:9330-5. [PMID: 11481490 PMCID: PMC55420 DOI: 10.1073/pnas.161479898] [Citation(s) in RCA: 347] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The incidence of pediatric adrenal cortical carcinoma (ACC) in southern Brazil is 10-15 times higher than that of pediatric ACC worldwide. Because childhood ACC is associated with Li-Fraumeni syndrome, we examined the cancer history and p53 status of 36 Brazilian patients and their families. Remarkably, 35 of 36 patients had an identical germ-line point mutation of p53 encoding an R337H amino acid substitution. Differences within intragenic polymorphic markers demonstrated that at least some mutant alleles arose independently, thus eliminating a founder effect. In tumor cells, the wild-type allele was deleted, and mutant p53 protein accumulated within the nuclei. Although these features are consistent with Li-Fraumeni syndrome-associated adrenal tumors, there was no history of increased cancer incidence among family members. Therefore, this inherited R337H p53 mutation represents a low-penetrance p53 allele that contributes in a tissue-specific manner to the development of pediatric ACC.
Collapse
Affiliation(s)
- R C Ribeiro
- Department of Hematology-Oncology, St. Jude Children's Research Hospital, 332 North Lauderdale, Memphis, TN 38105, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
Childhood adrenocortical tumors (ACT) are rare. In the USA, only about 25 new cases occur each year. In Southern Brazil, however, approximately 10 times that many cases are diagnosed each year. Most cases occur in the contiguous states of São Paulo and Paraná. The cause of this higher rate has not been identified. Familial genetic predisposition to cancer (p53 mutations) and selected genetic syndromes (Beckwith-Wiedemann syndrome) have been associated with childhood ACT in general but not with the Brazilian counterpart. Most of the affected children are young girls with classic endocrine syndromes (virilizing and/or Cushing). Levels of urinary 17-ketosteroids and plasma dehydroepiandrosterone sulfate (DHEA-S), which are abnormal in approximately 90% of the cases, provide the pivotal clue to a diagnosis of ACT. Typical imaging findings of pediatric ACT consist of a large, well-defined suprarenal tumor containing calcifications with a thin capsule and central necrosis or hemorrhage. The pathologic classification of pediatric ACT is troublesome. Even an experienced pathologist can find it difficult to differentiate carcinoma from adenoma. Surgery is the single most important procedure in the successful treatment of ACT. The role of chemotherapy in the management of childhood ACT has not been established although occasional tumors are responsive to mitotane or cisplatin-containing regimens. Because of the heterogeneity and rarity of the disease, prognostic factors have been difficult to establish in pediatric ACT. Patients with incomplete tumor resection or with metastatic disease at diagnosis have a dismal prognosis. In patients with localized and completely resected tumors, the size of the tumor has predictive value. Patients with large tumors have a much higher relapse rate than those with small tumors.
Collapse
Affiliation(s)
- R C Ribeiro
- Department of Hematology-Oncology, College of Medicine, University of Tennessee, Memphis, TN 38105, USA.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Noronha LD, Sampaio G, Bruck I, Reis-Filho JS, Montemór-Netto MR, Bleggi-Torres LF, Faoro LN, Gasparetto EL, Antoniuk S, Kasting G. [Krabbe s disease - case report]. J Pediatr (Rio J) 2000; 76:79-82. [PMID: 14647705 DOI: 10.2223/jped.37] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE: Report a case of Krabbés disease with necropsy. METHODS: Review of medical and necropsy records. RESULTS: An 8 months-old male patient developed tremors, swallowing difficulty and excessive salivation for 4 months prior to admission, evolving with vomiting and fever. Physical examination showed microcephaly and diffuse pigmentation of the retinae. Neurological examination showed flexion of upper limbs with spastic hyperthony, symmetrical global hyperreflexia, nystagmus and spontaneous spasms. EEG showed multifocal irritative activity. There was increase in both CSF protein and gamaglobulin. The patient evolved with transitory hyperthermia, vomiting and pneumopathy, dying on the 23rd day after admission. Post mortem studies revealed microcephaly with widening of brain sulci. Histological examination revealed several globoid cells in the deep portion of the white matter, reactive gliosis and demyelination. CONCLUSIONS: These findings were similar to those in the world literature, indicating a poor prognosis due to substantial brain damage.
Collapse
Affiliation(s)
- L D Noronha
- Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Abstract
OBJECTIVE: Describe the morbidity associated with a rare disease due to an embryological defect. METHODS: Retrospective revision of medical and necropsy reports. Bibliographic research using MEDLINE, LILACS and Index Medicus databases. RESULTS: 1 year-old male patient, admitted with generalized tonic-clonic seizures, evolving to deep coma and death in a few hours. Necropsy showed diffuse leptomeningeal malignant melanoma in brain stem, cerebellum, spinal cord and temporal lobe associated with a giant melanocytic nevus and satellite lesions. CONCLUSIONS: Neurocutaneous melanosis is a rare congenital syndrome characterized by the presence of large and/or multiple melanocytic nevi and pigmented tumors of the leptomeninges. It has a poor prognosis as demonstrated by the present report. It's physiopathology is believed to be due to a migration defect of the cells arising from the primitive neural crest. In these cases, an early diagnosis may improve the survival time.
Collapse
Affiliation(s)
- L Noronha
- Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil
| | | | | | | | | | | | | |
Collapse
|