RESUMEN
BACKGROUND AND OBJECTIVE: Cellular immunity abnormalities are associated with sarcoidosis. Normal cellular immunity is required for adequate humoral immunity; therefore, a decreased humoral immune response is possible in patients with sarcoidosis. We evaluated humoral immunity by vaccinating patients with sarcoidosis against tetanus. PATIENTS AND METHOD: We screened 60 patients with sarcoidosis (42 females, average age 39 +/- 11 years) and 40 healthy subjects as a control (23 females, average age 38 +/- 9 years). Of the 51 sarcoidosis patients and 33 controls that did not have sufficient tetanus antibody titers, 48 patients and 31 controls agreed to be vaccinated and were included in the vaccination program. Blood serum samples were collected from the subjects before and after vaccination and evaluated for tetanus toxoid IgG antibodies with an enzyme-linked immunosorbent assay (ELISA). RESULTS: As a result of the vaccination, 24 of the sarcoidosis patients (50%) and 7 of the controls (23%) had insufficient antibody responses (p = 0.019). No relationship was found in sarcoidosis patients between the rate of having sufficient antibody levels and disease duration, activation state, and radiographic staging of the disease. Conversely, mean lymphocyte numbers were significantly lower in patients with insufficient tetanus antibody levels (p = 0.013). CONCLUSION: Tetanus vaccinations in sarcoidosis patients are less effective than in healthy controls, suggesting that patients with sarcoidosis have a hyporesponsive humoral immune system.
Asunto(s)
Inmunidad Celular , Inmunidad Humoral , Sarcoidosis/inmunología , Toxoide Tetánico/inmunología , Adulto , Anticuerpos Antivirales/sangre , Estudios de Casos y Controles , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Recuento de Linfocitos , Linfocitos/inmunología , Masculino , Persona de Mediana Edad , Toxoide Tetánico/administración & dosificación , VacunaciónRESUMEN
INTRODUCTION: Pulmonary tuberculosis and lung cancer are still important public health problems and can occur simultaneously. In this article, we present the case of a 38-year-old patient treated for smear positive pulmonary tuberculosis. CASE REPORT: During the third month of treatment, the patient developed respiratory distress and was found to have total atelectasis of the left lung. At rigid bronchoscopy, a lesion obstructing the left main bronchus was removed with a diode laser. Oncological treatment was started following the histological diagnosis of small cell bronchial carcinoma. CONCLUSION: Pulmonary tuberculosis and bronchial carcinoma can occur at the same time and cause diagnostic confusion. The possibility should be considered in situations where both diseases are endemic.