{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:00:55Z","timestamp":1790870455776,"version":"4.1.0"},"reference-count":21,"publisher":"Ordem dos Medicos","issue":"10","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>A hipogamaglobulinemia \u00e9 a altera\u00e7\u00e3o laboratorial mais frequentemente encontrada em doentes com esclerose m\u00faltipla tratados com anticorpos monoclonais anti-CD20, podendo estar associada a um aumento do risco de infe\u00e7\u00f5es. Este protocolo, desenvolvido pela Unidade de Investiga\u00e7\u00e3o e Estudo do L\u00edquido Cefalorraquidiano da Unidade Local de Sa\u00fade de S\u00e3o Jo\u00e3o, prop\u00f5e uma abordagem estruturada para a avalia\u00e7\u00e3o e gest\u00e3o desta condi\u00e7\u00e3o. S\u00e3o apresentadas estrat\u00e9gias de mitiga\u00e7\u00e3o do risco infecioso antes e durante a terap\u00eautica, e s\u00e3o sugeridas as indica\u00e7\u00f5es para o uso da terap\u00eautica de reposi\u00e7\u00e3o com imunoglobulinas. O objetivo \u00e9 apoiar a decis\u00e3o cl\u00ednica, promovendo uma interven\u00e7\u00e3o segura, individualizada e centrada no doente.<\/jats:p>","DOI":"10.20344\/amp.24365","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T15:41:19Z","timestamp":1784130079000},"page":"651-656","source":"Crossref","is-referenced-by-count":0,"title":["Protocolo de Abordagem da Hipogamaglobulinemia Secund\u00e1ria em Doentes com Esclerose M\u00faltipla sob Anticorpos Monoclonais Anti-CD20"],"prefix":"10.20344","volume":"39","author":[{"given":"Andr\u00e9","family":"Aires Fernandes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana L\u00eddia","family":"Neves","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Ferro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mafalda","family":"Seabra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6878-8568","authenticated-orcid":false,"given":"Ricardo","family":"Soares dos Reis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Mendon\u00e7a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6464-7063","authenticated-orcid":false,"given":"C\u00e2ndida","family":"Abreu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Guimar\u00e3es","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7927-0294","authenticated-orcid":false,"given":"Pedro","family":"Abreu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"8464","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"13148","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2021.102988"},{"key":"13149","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1601277"},{"key":"13150","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2020.102279"},{"key":"13151","unstructured":"European Medicines Agency. Ocrevus EPAR Product Information. [consultado 2024 jun 17]. Dispon\u00edvel em: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/EPAR\/ocrevus."},{"key":"13152","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1917246"},{"key":"13153","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606468"},{"key":"13154","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201904"},{"key":"13155","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.592304"},{"key":"13156","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51282"},{"key":"13157","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2024.1500763"},{"key":"13158","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2023.105009"},{"key":"13159","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2022.01.025"},{"key":"13160","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13580"},{"key":"13161","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-021-01117-y"},{"key":"13162","doi-asserted-by":"publisher","DOI":"10.1177\/20552173211065731"},{"key":"13163","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2021.04.011"},{"key":"13164","unstructured":"Dire\u00e7\u00e3o-Geral da Sa\u00fade. Norma 013\/2024 de 19\/12\/2024: atualiza\u00e7\u00e3o da estrat\u00e9gia de vacina\u00e7\u00e3o pneumoc\u00f3cica \u2013 programa nacional de vacina\u00e7\u00e3o e grupos de risco. Lisboa: DGS; 2024."},{"key":"13165","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01757"},{"key":"13166","unstructured":"Associa\u00e7\u00e3o Portuguesa de Urologia. Preven\u00e7\u00e3o da infe\u00e7\u00e3o urin\u00e1ria recorrente. 2018. [consultado 2025 out 02]. Dispon\u00edvel em: https:\/\/apurologia.pt\/wp-content\/uploads\/2018\/10\/prev-infec-urin-recorr.pdf."},{"key":"13167","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmrv.2013.05.004"},{"key":"13168","doi-asserted-by":"publisher","DOI":"10.1016\/j.clml.2023.05.008"}],"container-title":["Acta M\u00e9dica Portuguesa"],"original-title":[],"link":[{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/24365\/15993","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/24365\/15993","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:40:23Z","timestamp":1790869223000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/view\/24365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,15]]},"references-count":21,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2026,10,1]]}},"URL":"https:\/\/doi.org\/10.20344\/amp.24365","relation":{},"ISSN":["1646-0758","0870-399X"],"issn-type":[{"value":"1646-0758","type":"electronic"},{"value":"0870-399X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,7,15]]}}}