Débora Lucia Seguro Danilovic

Universidade de São Paulo

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Suemi Marui

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Ana O. Hoff

Instituto do Câncer do Estado de São Paulo

Berenice B. Mendonça

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Maria Cristina Chammas

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

R. Y. A. Camargo

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Ricardo Miguel Costa de Freitas

Universidade Estadual de Santa Cruz

Nathalie Oliveira de Santana

Universidade Federal de Sergipe

Cláudia Kliemann Schmerling

Instituto do Câncer do Estado de São Paulo

Felipe Augusto Brasileiro Vanderlei

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

Vinícius Neves Marcos

Universidade Federal de Juiz de Fora

Cooperative Institutions

Universidade de São Paulo

118

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo

112

Instituto do Câncer do Estado de São Paulo

Universidade Brasil

Hospital Universitário da Universidade de São Paulo

Hospital de Clínicas

Centro Universitário das Faculdades Metropolitanas Unidas

Hospital São Paulo

Universidade Federal de São Paulo

Hospital Sírio-Libanês

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Thyroid disturbance related to chronic hepatitis C infection: role of CXCL10

Endocrine Journal (2013)

Débora Lucia Seguro Danilovic Maria Cássia Mendes-Corrêa Maria Cristina Chammas Héverton Zambrini Raffaelle Kasprowicz Barros

Association between autoimmune thyroid diseases (AITD) and hepatitis C is controversial, but may occur or worsen during alpha-interferon treatment. The mechanism responsible for autoimmune diseases in infected patients has not been fully elucidated. This study aims to evaluate the frequency of AITD in chronic hepatitis C and the association of chemokine (CXC motif) ligand 10 (CXCL10) and AITD. One hundred and three patients with chronic hepatitis C and 96 controls were prospectively selected to clinical, hormonal, thyroid autoimmunity and ultrasound exams, besides thyroxine-binding globulin (TBG) and CXCL10 measurements and hepatic biopsies. The frequency of AITD among infected subjects was similar to controls. TT3 and TT4 distributions were right shifted, as was TBG, which correlated to both of them. Thyroid heterogeneity and hypoechogenicity were associated with AITD. Increased vascularization was more prevalent in chronic hepatitis C.CXCL10 was higher in infected patients (p=0.007) but was not related to thyroid dysfunction. Increase in CXCL10 levels were consistent with hepatic necroinflammatory activity (p=0.011). In summary, no association was found between chronic hepatitis C and AITD. Infected subjects had higher TT3 and TT4 which were correlated to TBG. Increased CXCL10 was not associated to thyroid dysfunction in HCV-infected population.

Viral Hepatitis

Hepatitis C

Autoimmune Hepatitis

10.1507/endocrj.ej12-0321

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Citations (9)

Thymic hyperplasia in Graves' disease

Clinics (2011)

Débora Lucia Seguro Danilovic Regina Matsunaga Martin Pedro Caruso Suemi Marui

Over the last year, a 40-year-old man had complainedof weekly episodes of facial flushing, diaphoresis,irritability,and diarrhea, which were triggered by emo-tional stress or exercise. He also presented with chestdiscomfort and had lost 6kg. He had poorly controlledessential hypertension that had lasted over the last sixyears. On examination, his systolic blood pressure was160 mm Hg, his diastolic blood pressure was 110 mmHg, his heart rate was 110 beats/min, and his body massindex was 32 kg/m

Irritability

10.1590/s1807-59322011001200027

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Citations (3)

46,XY Disorders of Sex Development (46,XY DSD) due to Androgen Receptor Defects: Androgen Insensitivity Syndrome

Advances in experimental medicine and biology (2011)

Ivo J.P. Arnhold Karla Melo Elaine Maria Frade Costa Débora Lucia Seguro Danilovic Marlene Inácio

Gynecomastia

Pubic hair

Androgen insensitivity syndrome

10.1007/978-1-4419-8002-1_14

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Citations (15)

Diagnostic performance of thyroid ultrasound in Hürthle cell carcinomas

Figshare (2019)

Nathalie Oliveira de Santana Ricardo Miguel Costa de Freitas Vinícius Neves Marcos Maria Cristina Chammas R. Y. A. Camargo

ABSTRACT Objective Hürthle cell carcinomas (HCCs) of the thyroid have been recently reclassified as a separate entity due to their distinct clinical and molecular profiles. Few studies have assessed the ability of preoperative characteristics in differentiating HCCs from Hürthle cell adenomas (HCAs) due to the low prevalence of both lesions. This study aimed to compare the preoperative features of HCCs and HCAs and evaluate the diagnostic performance of ultrasound in distinguishing between both. Subjetcs and methods Retrospective study including 101 patients (52 HCCs and 49 HCAs) who underwent thyroid surgery from 2000 to 2016. Clinical, ultrasonographic, and histological data were reviewed. Diagnostic performance of suspicious sonographic features was analyzed in 51 cases (24 HCCs and 27 HCAs). Results Hürthle cell neoplasms were predominant in females. Subjects ≥ 55 years represented 58% of the cases of HCCs and 53% of those of HCAs. Carcinomas were significantly larger (p < 0.001), and a tumor size ≥ 4 cm significantly increased the risk of malignancy (odds ratio 3.67). Other clinical, cytologic, and sonographic data were similar between HCCs and HCAs. Among the HCCs, the lesions were purely solid in 54.2%, hypoechoic in 37.5%, and had coarse calcifications in 12.5%, microcalcifications in 8.3%, irregular contours in 4.2%, and a taller-than-wide shape in 16.7%. Predominantly/exclusive intranodular vascularization was observed in 52.6%. Overall, 58% of the HCCs were classified as TI-RADS 4 or 5 compared with 48% of the HCAs. TI-RADS 4 or 5 had a specificity of only 51.8% and a positive likelihood ratio of 1.21. Conclusions Apart from the lesion size, no other preoperative feature adequately distinguished HCCs from HCAs. Sonographic characteristics raising suspicion for malignancy, which are mostly present in papillary carcinomas, were infrequent in HCCs. New tools must be developed to improve preoperative diagnosis and deferral of surgery in cases of adenomas.

10.6084/m9.figshare.8988200

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Uma rara causa de dispnéia com apresentação singular na tomografia computadorizada de tórax: síndrome de ativação macrofágica

Jornal Brasileiro de Pneumologia (2008)

Rodrigo Antônio Brandão-Neto Alfredo Nicodemos Cruz Santana Débora Lucia Seguro Danilovic Fabı́ola Del Carlo Bernardi Carmen Sílvia Valente Barbas

A síndrome de ativação macrofágica é uma doença rara e potencialmente fatal. Ela ocorre devido a uma alteração no sistema imunológico, com excessiva proliferação de macrófagos, geralmente causando hepatoesplenomegalia, pancitopenia e disfunção hepática. Neste artigo, relatamos uma raríssima apresentação da síndrome de ativação macrofágica como insuficiência respiratória, bem como a primeira descrição de nódulo escavado, vidro fosco e consolidação na tomografia computadorizada de alta resolução de pulmão (simulando uma pneumonia ou hemorragia alveolar) e o sucesso terapêutico com o uso de imunoglobulina humana. Assim, sugerimos que a síndrome de ativação macrofágica seja colocada no diagnóstico diferencial de causas de insuficiência respiratória e que o rápido diagnóstico e tratamento seja imperativo para a boa evolução do paciente.

Macrophage Activation Syndrome

Hepatosplenomegaly

Immune Dysregulation

10.1590/s1806-37132008000200009

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Neoadjuvant Treatment of Locally Advanced Thyroid Cancer: A Preliminary Latin American Experience

Thyroid (2024)

Fabián Pitoia Erika Abelleira Alejandro Román‐González Débora Lucia Seguro Danilovic Rafael Selbach Scheffel

Surgical resection is not always achievable in thyroid cancer patients. Neoadjuvant therapy is rarely used, but recent trends favor multikinase inhibitors or selective tyrosine kinase inhibitors. These aim to reduce tumor volume, enabling previously unfeasible surgeries.

Neoadjuvant Therapy

10.1089/thy.2024.0090

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Citations (6)

Influência da suplementação na dieta de ratos dos aminoácidos sulfurados metionina e cistina sobre a tolerância à glicose, leptinemia e composição corpórea.

Irene Kazue Miura Dalva Marreiro Rocha M. R. S. Correia R. T. Fukui G. C. U. Tostes

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Thyroid hormonal disturbances related to treatment of hepatitis C with interferon-alpha and ribavirin

Clinics (2011)

Débora Lucia Seguro Danilovic Maria Cássia Mendes-Corrêa Maria Cristina Chammas Héverton Zambrini Suemi Marui

To characterize thyroid disturbances induced by interferon-alpha and ribavirin therapy in patients with chronic hepatitis C. Interferon-alpha is used to treat chronic hepatitis C infections. This compound commonly induces both autoimmune and non-autoimmune thyroiditis. We prospectively selected 26 patients with chronic hepatitis C infections. Clinical examinations, hormonal evaluations, and color-flow Doppler ultrasonography of the thyroid were performed before and during antiviral therapy. Of the patients in our study, 54% had no thyroid disorders associated with the interferon-alpha therapy but showed reduced levels of total T3 along with a decrease in serum alanine aminotransferase. Total T4 levels were also reduced at 3 and 12 months, but free T4 and thyroid stimulating hormone (TSH) levels remained stable. A total of 19% of the subjects had autoimmune interferon-induced thyroiditis, which is characterized by an emerge of antithyroid antibodies or overt hypothyroidism. Additionally, 16% had non-autoimmune thyroiditis, which presents as destructive thyroiditis or subclinical hypothyroidism, and 11% remained in a state of euthyroidism despite the prior existence of antithyroidal antibodies. Thyrotoxicosis with destructive thyroiditis was diagnosed within three months of therapy, and ultrasonography of these patients revealed thyroid shrinkage and discordant change in the vascular patterns. Decreases in the total T3 and total T4 levels may be related to improvements in the hepatocellular lesions or inflammatory changes similar to those associated with nonthyroidal illnesses. The immune mechanisms and direct effects of interferon-alpha can be associated with thyroiditis. Interferon-alpha and ribavirin induce autoimmune and non-autoimmune thyroiditis and hormonal changes (such as decreased total T3 and total T4 levels), which occur despite stable free T4 and TSH levels. A thyroid hormonal evaluation, including the analysis of the free T4, TSH, and antithyroid antibody levels, should be mandatory before therapy, and an early re-evaluation within three months of treatment is necessary as an appropriate follow-up.

Alpha (finance)

Hepatitis C

10.1590/s1807-59322011001000014

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Citations (9)

Factitious Thyrotoxicosis Induced by Mesotherapy: A Case Report

Thyroid (2008)

Débora Lucia Seguro Danilovic W Bloise Meyer Knobel Suemi Marui

Context: Mesotherapy consists of cutaneous injections of a mixture of compounds and has recently been used for cosmetic purposes to reduce local fat and cellulite. To date, several reports have described only local adverse events related to this therapy. We describe the first report of a female patient who developed thyrotoxicosis due to cosmetic mesotherapy with triiodothyroacetic acid in its formulation. Apart from mechanical rupture of the epidermal barrier, a disturbance of type III deiodinase activity or skin fibroblast paracrine function and vascular alterations related to simultaneously injected vasoactive compounds were observed. These findings could be related to thyroid hormone metabolite absorption and systemic consequences in the reported case. Conclusion: We describe factitious thyrotoxicosis induced by mesotherapy, to raise awareness of a systemic adverse effect resulting from this widespread cosmetic practice.

10.1089/thy.2007.0233

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Citations (19)

Thyroid collision tumor containing oncocytic carcinoma, classical and hobnail variants of papillary carcinoma and areas of poorly differentiated carcinoma

Archives of Endocrinology and Metabolism (2021)

Marcos Tadashi Kakitani Toyoshima Regina Barros Domingues Iberê Cauduro Soares Débora Lucia Seguro Danilovic Larissa Costa Amorim

Collision tumors are rare and may comprise components with different behavior, treatments, and prognosis. We report an unprecedented case of aggressive thyroid collision tumor containing widely invasive oncocytic carcinoma (OC), classical and hobnail (HPTC) variants of papillary carcinoma, and poorly differentiated carcinoma (PDTC). The patient underwent total thyroidectomy, radioactive iodine therapy, and within months progressed with local recurrence, and pulmonary metastases requiring neck dissection, external radiotherapy and systemic treatment with sorafenib. The rapid progression, dedifferentiated metastatic lesions, and failure to treatments resulted in the patient's death. The great variety of histological types and the evolution of this case were a challenge for the management of metastatic disease. Widely invasive OC, HPTC and PDTC are considered to have a worse prognosis. HPTC has never been reported as a component of a collision tumor. HPTC and PDTC should call attention to a possible higher-grade transformation.

Neck dissection

10.20945/2359-3997000000389

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Citations (10)