Rodrigo Antônio Brandão-Neto

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

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Alfredo Nicodemos Cruz Santana

Escola Superior de Ciências da Saúde

Carmen Sílvia Valente Barbas

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

Fabı́ola Del Carlo Bernardi

Faculdade de Ciências Médicas da Santa Casa de São Paulo

Berenice B. Mendonça

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

Augusto Scalabrini-Neto

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

Irineu Tadeu Velasco

Universidade de São Paulo

Débora Lucia Seguro Danilovic

Universidade de São Paulo

Herlon Saraiva Martins

Universidade de São Paulo

Alessandra C. Goulart

Hospital Universitário da Universidade de São Paulo

Murilo Chiamolera

Hospital Israelita Albert Einstein

Cooperative Institutions

Universidade de São Paulo

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

Hospital de Clínicas

GTx (United States)

Hospital Universitário da Universidade de São Paulo

Instituto do Coração

Universidade Brasil

Centro Universitário das Faculdades Metropolitanas Unidas

Hospital do Coração

Hospital Israelita Albert Einstein

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Síndrome da Apnéia Obstrutiva do Sono e sua Relação com a Hipertensão Arterial Sistêmica: Evidências Atuais

Arquivos Brasileiros de Cardiologia (2002)

Luciano F. Drager Renata Teixeira Ladeira Rodrigo Antônio Brandão-Neto Geraldo Lorenzi‐Filho Isabela M. Benseñor

a Hipertensão Arterial Sistêmica

10.1590/s0066-782x2002000500013

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Citations (25)

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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Citations (7)

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

10.1590/s1806-37132008023400009

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A very rare cause of dyspnea with a unique presentation on a computed tomography scan of the chest: macrophage activation syndrome* Uma rara causa de dispnéia com apresentação singular na tomografia computadorizada de tórax: síndrome de ativação macrofágica

Rodrigo Antônio Brandão-Neto Alfredo Nicodemos Alfredo Nicodemos Cruz Santana Debora Lucia Seguro Danilovic

Macrophage activation syndrome is a rare and potentially life-threatening disease. It occurs due to immune dysregulation manifested as excessive macrophage proliferation, typically causing hepatosplenomegaly, pancytopenia and hepatic dysfunction. Here, we report an unusual case of macrophage activation syndrome presenting as dyspnea, as well as (reported here for the first time) high resolution computed tomography findings of an excavated nodule, diffuse ground glass opacities and consolidations (mimicking severe pneumonia or alveolar hemorrhage). The patient was successfully treated with human immunoglobulin. We recommend that macrophage activation syndrome be considered in the differential diagnosis of respiratory failure. Rapid diagnosis and treatment are essential to achieving favorable outcomes in patients with this syndrome.

Macrophage Activation Syndrome

Rare disease

Hepatosplenomegaly

High-resolution computed tomography

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McKittrick-Wheelock syndrome: a cause of severe hydro-electrolyte disorders in ED

The American Journal of Emergency Medicine (2007)

Herlon Saraiva Martins Rodrigo Antônio Brandão-Neto André Laranjeira de Carvalho Alfredo Nicodemos Cruz Santana Francisco J.B. Aguiar

Lupus anticoagulant

Prothrombin time

Thrombin Generation

10.1016/j.ajem.2007.03.002

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Citations (11)

Uma rara causa de dispnéia com apresentação singular na tomografia computadorizada de tórax: síndrome de ativação macrofágica A very rare cause of dyspnea with a unique presentation on a computed tomography scan of the chest: macrophage activation syndrome

DOAJ (DOAJ: Directory of Open Access Journals) (2008)

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

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Bone marrow necrosis successfully treated with corticosteroid

European Journal Of Haematology (2004)

Alfredo Nicodemos Cruz Santana Renata G. Ramos Eduardo Fernandes Zanandrea Rodrigo Antônio Brandão-Neto

Abstract: A 60‐yr‐old white woman with CREST syndrome (calcinosis cutis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, telangectasia), idiophatic portal hypertension and esophageal varices presented with a 2‐month history of bone pain and severe anemia, requiring erythrocyte transfusion every 5–7 d. Initial laboratory findings were hemoglobin (Hb) 4.4 g/dL, platelets 15 × 10 9 /L, white blood cell count (WBC) 2.7 × 10 9 /L. Bone marrow biopsy showed large areas of BMN, and cultures of bone marrow aspirate were negative. The patient was started on intravenous pulse methylprednisolone (1000 mg/d for 3 d) followed by oral prednisone (1 mg/kg/d), and did not require erythrocyte transfusion thereafter. On the 40th day, our patient had Hb 11.6 g/dL, platelets 120 × 10 9 /L, WBC 6.2 × 10 9 /L. Here, we describe the first report of BMN in a patient with CREST syndrome, the first description of successful treatment with intravenous pulse corticosteroid and discuss the possible immune mechanisms involved in the present case.

Bone Marrow Diseases

10.1111/j.1600-0609.2004.00323.x

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The role of pneumonia scores in the emergency room in patients infected by 2009 H1N1 infection

European Journal of Emergency Medicine (2011)

Rodrigo Antônio Brandão-Neto Alessandra C. Goulart Alfredo Nicodemos Cruz Santana Herlon Saraiva Martins Sabrina Correa Costa Ribeiro

Despite the severity of pneumonia in patients with pandemic influenza A infection (H1N1), no validated risk scores associated with H1N1 pneumonia were tested. In this prospective observational study, we analyzed data of consecutive patients in our emergency room, hospitalized because of pneumonia between July and August 2009 in a public hospital in Brazil. The following pneumonia scoring systems were applied: the SMART-COP rule; the Pneumonia Severity Index; and the CURB-65 rule. Of 105 patients with pneumonia, 53 had H1N1 infection. Among them, only 9.5% that had a low risk according to SMART-COP were admitted to ICU, compared with 36.8% of those with the Pneumonia Severity Index score of 1-2 and 49% of those with CURB-65 score of 0-1. The SMART-COP had an accuracy of 83% to predict ICU admission. The SMART-COP rule presented the best performance to indicate ICU admission in patients with H1N1 pneumonia.

Pneumonia severity index

2019-20 coronavirus outbreak

10.1097/mej.0b013e328349ed85

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Assessment scores in H1N1 infection

Critical Care (2011)

Rodrigo Antônio Brandão-Neto Alessandra C. Goulart Alfredo Nicodemos Cruz Santana Augusto Scalabrini-Neto Irineu Velasco

The usefulness of assessment scores in H1N1 patients is still undefined, the authors compare the STSS score used in the article of Adenjii and Cussak and compare with SMART-COP in a sample of 53 patients

10.1186/cc10535

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Citations (1)

Implementation of a horizontal intensive care team can impact efficiency in an emergency observation unit in Brazil

Critical Care (2015)

Sabrina Corrêa da Costa Ribeiro Carol Petrini Lucas Oliveira Marino Rodrigo Antônio Brandão-Neto

Emergency department observation units are often used to monitor critical patients in a situation of constant emergency department overcrowding and lack of intensive care beds. However, those units are often understaffed and might not have enough personnel and equipment to provide the same quality of care as a conventional ICU.

10.1186/cc14600

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Citations (6)