12 results on '"Silva, Guilherme Diogo"'
Search Results
2. Misdiagnosis in multiple sclerosis in a Brazilian reference center: Clinical, radiological, laboratory profile and failures in the diagnostic process-Cohort study.
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Tieppo EMS, Silva GD, Silva TFFD, Araujo RS, Oliveira MB, Spricigo MGP, Pimentel GA, Campana IG, Castrillo BB, Mendes NT, Teixeira LS, Nunes DM, Rimkus CM, Adoni T, Apóstolos Pereira SL, and Callegaro D
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- Humans, Cohort Studies, Brazil, Diagnostic Errors, Magnetic Resonance Imaging, Multiple Sclerosis diagnostic imaging, Neuromyelitis Optica diagnosis
- Abstract
Background: Multiple sclerosis misdiagnosis remains a problem despite the well-validated McDonald 2017. For proper evaluation of errors in the diagnostic process that lead to misdiagnosis, it is adequate to incorporate patients who are already under regular follow-up at reference centers of demyelinating diseases., Objectives: To evaluate multiple sclerosis misdiagnosis in patients who are on follow-up at a reference center of demyelinating diseases in Brazil., Methods: We designed an observational study including patients in regular follow-up, who were diagnosed with multiple sclerosis at our specialized outpatient clinic in the Hospital of Clinics in the University of Sao Paulo, from 1996 to 2021, and were reassessed for misdiagnosis in 2022. We evaluated demographic information, clinical profile, and complementary exams and classified participants as "established multiple sclerosis," "non-multiple sclerosis, diagnosed," and "non-multiple sclerosis, undiagnosed." Failures in the diagnostic process were assessed by the modified Diagnostic Error Evaluation and Research tool., Results: A total of 201 patients were included. After analysis, 191/201 (95.02%) participants were confirmed as "established multiple sclerosis," 5/201 (2.49%) were defined as "non-multiple sclerosis, diagnosed," and 5/201 (2.49%) were defined as "non-multiple sclerosis, undiagnosed.", Conclusions: Multiple sclerosis misdiagnosis persists in reference centers, emphasizing the need for careful interpretation of clinical findings to prevent errors., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The authors Guilherme Diogo Silva, Mateus Boaventura de Oliveira, Tarso Adoni, Larissa Silva Teixeira, Samira Luisa Apóstolos Pereira, and Dagoberto Callegaro receive regular visits of Biogen, Novartis, EMS, and Roche pharmaceutical companies.
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- 2023
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3. Understanding MOG antibody-associated disease in Brazil.
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Callegaro D and Silva GD
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- Humans, Autoantibodies, Brazil, Myelin-Oligodendrocyte Glycoprotein, Neuromyelitis Optica
- Abstract
Competing Interests: DC: Regular visits from Biogen, Merck, Novartis, EMS, Horizon, and Alexion. Member of the Organizing Committee of the Brazilian Committee on Treatment in Multiple Sclerosis (BCTRIMS); GDS: Regular visits from Biogen, Merck, Novartis, EMS, Horizon, and Alexion.
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- 2023
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4. Real-world application of the 2022 diagnostic criteria for first-ever episode of optic neuritis.
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Terrim S, Silva GD, de Sá E Benevides Falcao FC, Dos Reis Pereira C, de Souza Andrade Benassi T, Fortini I, Gonçalves MRR, Castro LHM, Comerlatti LR, de Medeiros Rimkus C, Adoni T, Pereira SLA, Monteiro ML, and Callegaro D
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- Humans, Retrospective Studies, Diagnosis, Differential, Aquaporin 4, Autoantibodies, Myelin-Oligodendrocyte Glycoprotein, Optic Neuritis diagnosis, Optic Neuritis etiology, Neuromyelitis Optica diagnosis
- Abstract
Optic neuritis (ON) admits diverse differential diagnoses. Petzold proposed diagnostic criteria for ON in 2022, although real-world application of these criteria is missing. We conducted a retrospective review of patients with ON. We classified patients into definite or possible ON, and into groups A (typical neuritis), B (painless), or C (binocular) and estimated the frequency of etiologies for each group. We included 77 patients, with 62% definite and 38% possible ON. CRION and NMOSD-AQP4 negative-ON were less commonly seen in definite ON. Application of the 2022 criteria revealed a lower-than-expected frequency of definite ON, particularly for seronegative non-MS causes., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Elsevier B.V. All rights reserved.)
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- 2023
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5. Risk and characteristics of attacks occurring after vaccination in patients with neuromyelitis optica spectrum disorders: A systematic review and meta-analysis.
- Author
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Silva PBR and Silva GD
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- Male, Humans, Vaccination adverse effects, Autoantibodies, Neuromyelitis Optica complications, Myelitis, Transverse complications, Optic Neuritis complications, Vaccines adverse effects
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Background: Vaccination in patients with neuromyelitis optica spectrum disorders (NMOSD) is challenging because there is a concern that vaccines can lead to clinical attacks. However, little is known about the risk and the characteristics of attacks occurring after vaccination., Methods: We performed a systematic review and meta-analysis using PubMed and Embase databases to estimate a summary frequency of attacks occurring after vaccination and describe the clinical features of theses attacks. We defined attacks occurring after vaccination as typical NMOSD attacks that occurred up to 30 days after vaccine administration. For the frequency of attacks occurring after vaccination, we selected observational studies that reported the number of attacks and total number of patients that received vaccines; for the clinical description of the attacks, case reports and case series were also included., Results: We included 377 participants from 5 studies to estimate the frequency of NMOSD attacks occurring after vaccination. We found a summary frequency of of 2% (95% CI 1-4%, I
2 = 0%). We evaluated 17 studies to identify that 13 different vaccines were associated with NMOSD attacks. A higher-than-expected proportion of males, simultaneous optic neuritis and transverse myelitis attacks, and anti-aquaporin 4 antibody negative cases were identified in vaccine-associated attacks from 24 participants from 17 studies. Nearly two-thirds of attacks occurring after vaccination were an initial event of NMOSD., Conclusion: The frequency of NMOSD attacks occurring after vaccination is low and non-specific to different vaccine technologies. Our work reinforces the safety of vaccine recommendations in patients with NMOSD., Competing Interests: Declaration of Competing Interest We authors have no conflict of interest to declare., (Copyright © 2023. Published by Elsevier B.V.)- Published
- 2023
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6. Estimated prevalence of AQP4 positive neuromyelitis optica spectrum disorder and MOG antibody associated disease in São Paulo, Brazil.
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Silva GD, Apóstolos-Pereira SL, and Callegaro D
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- Humans, Antibodies, Autoantibodies, Brazil epidemiology, Prevalence, Aquaporin 4 genetics, Aquaporin 4 immunology, Multiple Sclerosis epidemiology, Multiple Sclerosis genetics, Multiple Sclerosis immunology, Neuromyelitis Optica epidemiology, Neuromyelitis Optica genetics, Neuromyelitis Optica immunology
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Background: Numerous studies addressed the prevalence of multiple sclerosis, but prevalence studies of NMOSD and, particularly, MOGAD are scarce. We aimed to estimate the prevalence of NMOSD and MOGAD in the city of São Paulo, based on the known prevalence of MS., Methods: In this observational study, we determined the total number of patients with central nervous system demyelinating disease on regular follow-up in a university referral center in São Paulo, from May 2019 to May 2021 according to the diagnosis of multiple sclerosis (MS), NMOSD and MOGAD using the current diagnostic criteria for these diseases. We used the MS: NMOSD and MS: MOGAD ratios to estimate the ratio of these diseases in São Paulo, Brazil., Results: We identified 968 patients with MS, 133 patients with AQP4 positive NMOSD, and 28 patients with MOGAD. We found the MS: NMOSD ratio of 7,28 and the MS: MOGAD ratio of 34,57. We estimated a prevalence of 2,1 per 100,000 inhabitants for NMOSD and of 0,4 per 100,000 inhabitants for MOGAD., Conclusion: The prevalence of NMOSD is high in São Paulo, but the prevalence of MOGAD is low when compared with the prevalence found in most of the studies reported to date., Competing Interests: Declaration of Competing Interest None, (Copyright © 2022 Elsevier B.V. All rights reserved.)
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- 2023
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7. Reducing infection risk in multiple sclerosis and neuromyelitis optica spectrum disorders: a Brazilian reference center's approach.
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Gomes ABAGR, Feo LB, Silva GD, Disserol CCD, Paolilo RB, Lara AN, Tonácio AC, Mendes MF, Pereira SLA, and Callegaro D
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- Humans, Brazil, Disease Susceptibility complications, Multiple Sclerosis drug therapy, Neuromyelitis Optica drug therapy
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Background: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the most common autoimmune diseases of the central nervous system (CNS). They present chronic relapsing courses that demand treatment with disease-modifying drugs (DMDs) to prevent inflammatory activity. Disease-modifying drugs lead to immunomodulation or immunosuppression through diverse mechanisms (e.g., shifting lymphocyte and cytokine profile, suppressing specific lymphocyte subpopulations). Thus, patients are more prone to infectious complications and associated worsening of disease., Objective: To present feasible strategies for mitigating the infection risk of MS and NMOSD treated patients., Methods: Targeted literature review concerning the management of infection risk with an emphasis on vaccination, therapy-specific measures, and particularities of the Brazilian endemic infectious diseases' scenario., Conclusion: We propose a vaccination schedule, infectious screening routine, and prophylactic measures based on the current scientific evidence. Awareness of emergent tropical diseases is necessary due to evidence of demyelinating events and possible parainfectious cases of MS and NMOSD., Competing Interests: Samira Luisa Pereira Apóstolos, Maria Fernanda Mendes, and Dagoberto Callegaro have participated in lectures and developed written educational materials for Biogen, Roche, Merck, and Novartis., (Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
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- 2022
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8. Management of central nervous system demyelinating diseases during the coronavirus disease 2019 pandemic: a practical approach.
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ApÓstolos-Pereira SL, Silva GD, Disserol CCD, Feo LB, Matos AMB, Schoeps VA, Gomes ABAGR, Boaventura M, Mendes MF, and Callegaro D
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- Betacoronavirus, COVID-19, China epidemiology, Coronavirus Infections epidemiology, Disease Susceptibility, Humans, Immunologic Factors therapeutic use, Infectious Disease Transmission, Patient-to-Professional prevention & control, Infectious Disease Transmission, Professional-to-Patient prevention & control, Multiple Sclerosis diagnosis, Neuromyelitis Optica diagnosis, Pandemics, Pneumonia, Viral epidemiology, Risk, SARS-CoV-2, Telemedicine, Coronavirus, Coronavirus Infections prevention & control, Immunosuppressive Agents therapeutic use, Multiple Sclerosis drug therapy, Neuromyelitis Optica drug therapy, Pneumonia, Viral prevention & control
- Abstract
Background: The novel coronavirus disease 2019 (COVID-19) pandemic poses a potential threat to patients with autoimmune disorders, including multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). Such patients are usually treated with immunomodulatory or immunosuppressive agents, which may tamper with the organism's normal response to infections. Currently, no consensus has been reached on how to manage MS and NMOSD patients during the pandemic., Objective: To discuss strategies to manage those patients., Methods: We focus on how to 1) reduce COVID-19 infection risk, such as social distancing, telemedicine, and wider interval between laboratory testing/imaging; 2) manage relapses, such as avoiding treatment of mild relapse and using oral steroids; 3) manage disease-modifying therapies, such as preference for drugs associated with lower infection risk (interferons, glatiramer, teriflunomide, and natalizumab) and extended-interval dosing of natalizumab, when safe; 4) individualize the chosen MS induction-therapy (anti-CD20 monoclonal antibodies, alemtuzumab, and cladribine); 5) manage NMOSD preventive therapies, including initial therapy selection and current treatment maintenance; 6) manage MS/NMOSD patients infected with COVID-19., Conclusions: In the future, real-world case series of MS/NMOSD patients infected with COVID-19 will help us define the best management strategies. For the time being, we rely on expert experience and guidance.
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- 2020
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9. Misdiagnosis in multiple sclerosis in a Brazilian reference center: Clinical, radiological, laboratory profile and failures in the diagnostic process—Cohort study.
- Author
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Tieppo, Eduardo Macedo de Souza, Silva, Guilherme Diogo, Silva, Tomás Fraga Ferreira da, Araujo, Roger Santana de, Oliveira, Mateus Boaventura de, Spricigo, Mariana Gondim Peixoto, Pimentel, Gabriela Almeida, Campana, Igor Gusmão, Castrillo, Bruno Batitucci, Mendes, Natalia Trombini, Teixeira, Larissa Silva, Nunes, Douglas Mendes, Rimkus, Carolina de Medeiros, Adoni, Tarso, Apóstolos Pereira, Samira Luisa, and Callegaro, Dagoberto
- Subjects
MULTIPLE sclerosis ,DIAGNOSTIC errors ,DEMYELINATION ,NEUROMYELITIS optica - Abstract
Background: Multiple sclerosis misdiagnosis remains a problem despite the well-validated McDonald 2017. For proper evaluation of errors in the diagnostic process that lead to misdiagnosis, it is adequate to incorporate patients who are already under regular follow-up at reference centers of demyelinating diseases. Objectives: To evaluate multiple sclerosis misdiagnosis in patients who are on follow-up at a reference center of demyelinating diseases in Brazil. Methods: We designed an observational study including patients in regular follow-up, who were diagnosed with multiple sclerosis at our specialized outpatient clinic in the Hospital of Clinics in the University of Sao Paulo, from 1996 to 2021, and were reassessed for misdiagnosis in 2022. We evaluated demographic information, clinical profile, and complementary exams and classified participants as "established multiple sclerosis," "non-multiple sclerosis, diagnosed," and "non-multiple sclerosis, undiagnosed." Failures in the diagnostic process were assessed by the modified Diagnostic Error Evaluation and Research tool. Results: A total of 201 patients were included. After analysis, 191/201 (95.02%) participants were confirmed as "established multiple sclerosis," 5/201 (2.49%) were defined as "non-multiple sclerosis, diagnosed," and 5/201 (2.49%) were defined as "non-multiple sclerosis, undiagnosed." Conclusions: Multiple sclerosis misdiagnosis persists in reference centers, emphasizing the need for careful interpretation of clinical findings to prevent errors. [ABSTRACT FROM AUTHOR]
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- 2023
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10. Paracentral Acute Middle Maculopathy Associated with Severe Anti-Mog (Myelin Oligodendrocyte Glycoprotein)-Positive Optic Neuritis.
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Fernandes, Rodrigo Dahia, de Souza Andrade, Thais, Preti, Rony C., Zacharias, Leandro C., Silva, Guilherme Diogo, Lucato, Leandro Tavares, Apóstolos-Pereira, Samira L., Callegaro, Dagoberto, and Monteiro, Mário Luiz R.
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MYELIN oligodendrocyte glycoprotein ,OPTIC neuritis ,NEUROMYELITIS optica ,MACULAR degeneration ,OPTICAL coherence tomography ,MULTIPLE sclerosis - Abstract
Retinal complications in patients with inflammatory optic neuritis (ON) are generally related to post-infectious neuroretinitis and are considered uncommon in autoimmune/demyelinating ON, whether isolated or caused by multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD). More recently, however, cases with retinal complications have been reported in subjects positive for myelin oligodendrocyte glycoprotein (MOG) antibodies. We report a 53-year-old woman presenting with severe bilateral ON associated with a focal area of paracentral acute middle maculopathy (PAMM) in one eye. Visual loss recovered remarkably after high-dose intravenous corticosteroid treatment and plasmapheresis, but the PAMM lesion remained visible on both optical coherence tomography and angiography as an ischaemic lesion affecting the middle layers of the retina. The report emphasises the possible occurrence of retinal vascular complications in MOG–related optic neuritis, an important addition to the diagnosis of, and possible differentiation from, MS–related or NMOSD–related ON. [ABSTRACT FROM AUTHOR]
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- 2023
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11. Challenges and insights in immunization in patients with demyelinating diseases: a bench-to-bedside and evidence-based review
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Silva, Guilherme Diogo, Oliveira, Vítor Falcão de, and Mendonça, Leonardo Oliveira
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Vaccines ,Vacinas ,Multiple Sclerosis ,Imunização ,Neuromielite Óptica ,Esclerose Múltipla ,Neuromyelitis Optica ,Immunization ,Doenças Desmielinizantes ,Demyelinating Diseases - Abstract
Background: Infections are among the main causes of death in patients with demyelinating diseases of the central nervous system (CNSDD). Vaccines are effective methods in reducing hospitalization and death from infectious diseases, but they are challenging in patients with CNSDD because of autoimmunity and immunosuppression. Objectives: To summarize the pathophysiological rationale and main evidence for vaccine recommendations in patients with CNSDD. Methods: Specialists with different backgrounds on the subject: a neurologist specialized in demyelinating diseases, an infectious diseases specialist and an immunologist, presented a critical narrative review of vaccination literature in patients with CNSDD, highlighting which vaccines should or should not be administered and the best time for it. Results: Patients with DDSNC are at increased risk of vaccine-preventable viral and bacterial infections. Vaccines can prevent herpes zoster, hepatitis B reactivation, HPV-associated warts and tumors, viral and bacterial pneumonia, and meningitis. Live attenuated virus vaccines should not be used when the patient is on immunosuppression. Vaccines should be avoided during relapses. The greatest vaccine efficacy is given before treatment or at the end of medication. Conclusion: Patients with DDSNC need differentiated immunization in relation to additional vaccines, contraindicated vaccines and timing of vaccination. RESUMO Antecedentes: Infecções estão entre as principais causas de morte de pacientes com doenças desmielinizantes do sistema nervoso central (DDSNC). Vacinas são métodos eficazes para reduzir internação e morte por doenças infecciosas, porém são desafiadoras em pacientes com DDSNC tanto pela autoimunidade quanto pela imunossupressão. Objetivos: Resumir o racional fisiopatológico e as principais evidências para as recomendações de vacinas em pacientes com DDSNC. Métodos: Especialistas com diferentes formações no tema: um neurologista especialista em doenças desmielinizantes, um infectologista e um imunologista, apresentam uma revisão crítica narrativa da Literatura de vacinação em pacientes com DDSNC, com destaque a quais vacinas devem ou não ser administradas e o melhor momento para isso. Resultados: Pacientes com DDSNC têm risco aumentado para infecções imunopreveníveis virais e bacterianas. Vacinas podem prevenir herpes zooster, reativação de hepatite B, verrugas e tumores associados ao HPV, pneumonias virais e bacterianas, além de meningites. Vacinas de vírus vivos atenuados não devem ser usadas quando o paciente está em uso de imunossupressão. Vacinas devem ser evitadas durante surtos. A maior eficácia vacinal é dada antes do tratamento ou ao final de doses de medicações. Conclusão: Os pacientes com DDSNC necessitam de imunização diferenciada em relação a vacinas adicionais, vacinas contraindicadas e melhor momento de vacinação.
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- 2022
12. 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
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Becker, Jefferson, Ferreira, Lis Campos, Damasceno, Alfredo, Bichuetti, Denis Bernardi, Christo, Paulo Pereira, Callegaro, Dagoberto, Peixoto, Marco Aurélio Lana, Sousa, Nise Alessandra De Carvalho, Almeida, Sérgio Monteiro De, Adoni, Tarso, Santiago-Amaral, Juliana, Junqueira, Thiago, Pereira, Samira Luisa Apóstolos, Gomes, Ana Beatriz Ayroza Galvão Ribeiro, Pitombeira, Milena, Paolilo, Renata Barbosa, Grzesiuk, Anderson Kuntz, Piccolo, Ana Claudia, D´Almeida, José Arthur Costa, 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, Cortoni Calia, Leandro, Gonçalves, Marcus Vinícius Magno, Vecino, Maria Cecilia Aragón De, Pimentel, Maria Lucia Vellutini, Ribeiro, Marlise De Castro, Boaventura, Mateus, Parolin, Mônica Koncke Fiuza, Melo, Renata Brant De Souza, Lázaro, Robson, Thomaz, Rodrigo Barbosa, Kleinpaul, Rodrigo, Dias, Ronaldo Maciel, Gomes, Sidney, Lucatto, Simone Abrante, Alves-Leon, Soniza Vieira, Fukuda, Thiago, Ribeiro, Taysa Alexandrino Gonsalves Jubé, Winckler, Thereza Cristina D’ávila, Fragoso, Yara Dadalti, Nascimento, Osvaldo José Moreira Do, Ferreira, Maria Lucia Brito, Mendes, Maria Fernanda, Brum, Doralina Guimarães, Glehn, Felipe Von, Pontifícia Universidade Católica Do Rio Grande Do Sul, Universidade Federal de Sergipe (UFS), Universidade Tiradentes, Universidade Estadual de Campinas (UNICAMP), Universidade Federal de São Paulo (UNIFESP), Universidade Federal de Minas Gerais (UFMG), Universidade de São Paulo (USP), Universidade Federal Do Amazonas, Universidade Federal do Paraná (UFPR), Hospital Sírio Libanês, Escola Bahiana de Medicina e Saúde Pública, Hospital Geral de Fortaleza, Clínica Nossa Senhora das Graças, Hospital Santa Marcelina, Santa Casa, Instituto de Infectologia Emílio Ribas, Fundação Centro Integrado de Apoio Ao Portador de Deficiência, Secretaria de Estado da Saúde, Universidade Federal do Rio de Janeiro (UFRJ), Hospital de Clínicas de Passo Fundo, Universidade Federal de Goiás (UFG), Universidade Estácio de Sá, Hospital São Francisco Na Providência de Deus, Universidade Federal Do Ceará, Associação Brasileira de Esclerose Múltipla, Universidade Federal Fluminense (UFF), Pontifícia Universidade Católica, Instituto de Neurologia de Curitiba, IAMSPE, Private Service, Universidade da Região de Joinville, Hospital Moinhos de Vento, Universidade Federal Ciências da Saúde de Porto Alegre, Faculdade de Medicina de Jundiaí, Hospital Israelita Albert Einstein, Hospital de Base Do Distrito Federal, Hospital Beneficiência Portuguesa, Hospital Regional de Vilhena, Universidade Federal Do Estado Do Rio de Janeiro, Hospital Universitário Prof. Edgar Santos, Universidade Metropolitana de Santos, Hospital da Restauração, Universidade Estadual Paulista (UNESP), and Universidade de Brasília (UnB)
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Vacinação ,Multiple Sclerosis ,Doenças Autoimunes Desmielinizantes do Sistema Nervoso Central ,Neuromielite Óptica ,SARS-CoV-2 ,Esclerose Múltipla ,Vaccination ,Neuromyelitis Optica ,COVID-19 ,Demyelinating Autoimmune Diseases, CNS - Abstract
Made available in DSpace on 2022-04-29T08:46:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-11-01 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. Pontifícia Universidade Católica Do Rio Grande Do Sul, RS Universidade Federal de Sergipe, SE Universidade Tiradentes, SE Universidade de Campinas Faculdade de Ciências Médicas, SP Universidade Federal de São Paulo Escola Paulista de Medicina, SP Universidade Federal de Minas Gerais, MG Universidade de São Paulo Faculdade de Medicina Hospital das Clínicas, SP Universidade Federal Do Amazonas, AM Universidade Federal Do Paraná, PR Hospital Sírio Libanês, SP Escola Bahiana de Medicina e Saúde Pública, BA Hospital Geral de Fortaleza, CE Clínica Nossa Senhora das Graças, MS Hospital Santa Marcelina, SP Santa Casa, MG Instituto de Infectologia Emílio Ribas, SP Fundação Centro Integrado de Apoio Ao Portador de Deficiência, PB Secretaria de Estado da Saúde, DF Universidade Federal Do Rio de Janeiro, RJ Santa Casa, PR Hospital de Clínicas de Passo Fundo, RS Universidade Federal de Goiás, GO Universidade Estácio de Sá, RJ Hospital São Francisco Na Providência de Deus, RJ Universidade Federal Do Ceará, CE Associação Brasileira de Esclerose Múltipla, SP Santa Casa, SP Universidade Federal Fluminense, RJ Pontifícia Universidade Católica, SP Instituto de Neurologia de Curitiba, PR IAMSPE, SP Private Service, SP Universidade da Região de Joinville, SC Hospital Moinhos de Vento, RS Santa Casa, RJ Universidade Federal Ciências da Saúde de Porto Alegre, RS Faculdade de Medicina de Jundiaí, SP Hospital Israelita Albert Einstein, SP Hospital de Base Do Distrito Federal, DF Hospital Beneficiência Portuguesa, SP Hospital Regional de Vilhena, RO Universidade Federal Do Estado Do Rio de Janeiro, RJ Hospital Universitário Prof. Edgar Santos, BA Universidade Metropolitana de Santos, SP Hospital da Restauração, PE Universidade Estadual Paulista Faculdade de Medicina de Botucatu, SP Universidade de Brasília Faculdade de Medicina, DF Universidade Estadual Paulista Faculdade de Medicina de Botucatu, SP
- Published
- 2021
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