RESUMEN
Based on many years of experience in 2009, we developed the original concept of a mixed approach to the treatment of infectious diseases in patients. During 2.5 years(from 2013 to June 2015) to have applied for consultative-diagnostic help of 3965 patients who had not verified the primary diagnosis. The basic principle of verification of the pathology of the removal of various causes immunosuppression. Based on our extensive, research and observation was often found in patients ascaridosis (55%) and giardiasis (65%), as a possible cause of immunosuppression. In 13% of patients was found the mucosal candidiasis. Among frequently and chronically ill persons we identified the active forms of Epstein-Barr virus (quantitative polymerase chain reaction in saliva) in 40%. The criterion for assessing performance immunogram was a decrease of two sigmal deviation from the lower age limit. In the study of neutrophil myeloperoxidase content observed decline (< 60%) in 99 (9.7%) of 1015 patients, indicating a fairly common cause of long-term permit infection in the tissues and persistence C. albicans. In the study of lymphocyte subpopulations often demonstrated reduction in the number of natural killer cells (26.7% of subjects), which shows a decline of one of the most important factors of congenital immunity. Among the humoral immune disorders often noted the decrease of total IgG (2.4%) and its subclass IgG1 (22.1%), indicating a significant diagnostic value determination of IgG subclasses it even with normal serum total. Thus, approximately 76% of patients often suffer set of a decrease immunity. Patients developed with mixed infections caused by various bacterial, fungal, viral and protozoan agents and worms. Immunological study of patients should be redynamics after eliminating the causes immunosuppression and sanitation foci of infection. Only multi-level examination of the patient will determine the final diagnosis and adequate treatment.
Asunto(s)
Ascariasis/diagnóstico , Candidiasis/diagnóstico , Errores Diagnósticos/prevención & control , Infecciones por Virus de Epstein-Barr/diagnóstico , Giardiasis/diagnóstico , Huésped Inmunocomprometido , Animales , Antifúngicos/uso terapéutico , Antiparasitarios/uso terapéutico , Antivirales/uso terapéutico , Ascariasis/tratamiento farmacológico , Ascariasis/inmunología , Ascariasis/parasitología , Ascaris/patogenicidad , Ascaris/fisiología , Candida albicans/patogenicidad , Candida albicans/fisiología , Candidiasis/tratamiento farmacológico , Candidiasis/inmunología , Candidiasis/microbiología , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Infecciones por Virus de Epstein-Barr/inmunología , Infecciones por Virus de Epstein-Barr/virología , Femenino , Giardia lamblia/patogenicidad , Giardia lamblia/fisiología , Giardiasis/tratamiento farmacológico , Giardiasis/inmunología , Giardiasis/parasitología , Herpesvirus Humano 4/patogenicidad , Herpesvirus Humano 4/fisiología , Humanos , Inmunoglobulina G/biosíntesis , Factores Inmunológicos/uso terapéutico , Terapia de Inmunosupresión , Células Asesinas Naturales/inmunología , Células Asesinas Naturales/patología , Masculino , Neutrófilos/inmunología , Neutrófilos/patología , Peroxidasa/biosíntesis , Peroxidasa/inmunologíaRESUMEN
Diagnostic criteria of sarcoidosis were offered in the 60-ies of XX century, however today the problem of sarcoidosis is difficult for understanding the different specialists and early detection. The development of laboratory diagnostic of viral infections and introduction of polymerase chain reaction (PCR) has greatly improved the level of diagnosis of herpes infections, reveal the previously unknown etiology of many diseases: sarcoidosis (granulomatosis), migraine, multiple sclerosis, cystic prenatal brain damage, convulsions, Hodgkin's disease and others. Sarcoidosis is the set of clinical symptoms (fatigue, shortness of breath, coughing, heaviness in the chest), laboratory, radiological and histopathological data that allow the doctor to diagnose, predict prognosis and treatment policy. Most often, sarcoidosis affects the lungs and thoracic lymph nodes. In the last period for 2011-2013 in 2930 immunologically tested patients the sarcoidosis was confirmed in 146. Primarily these patients were exposed to different diagnosis--COPD, pneumonia, tuberculosis, lung cancer. Among patients with sarcoidosis on the first place in frequency of detection were EBV and HHV-6. We were the first in 2000, described the Epstein-Barr virus as the causative factor of sarcoidosis, and has been hypothesized the immunopathology of sarcoidosis and principles of individual immunotherapy with a resolution of the granulomatous process in 92 % of cases. Subsequently, this association has been and illustrates the relationship to other viruses (HHV-6, HHV-8) demonstrated by other authors.
Asunto(s)
Infecciones por Virus de Epstein-Barr/etiología , Granuloma/etiología , Infecciones por Roseolovirus/etiología , Sarcoidosis/etiología , Adulto , Preescolar , Citocinas/inmunología , Diagnóstico Diferencial , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Infecciones por Virus de Epstein-Barr/inmunología , Infecciones por Virus de Epstein-Barr/virología , Granuloma/tratamiento farmacológico , Granuloma/inmunología , Granuloma/virología , Herpesvirus Humano 4/aislamiento & purificación , Herpesvirus Humano 6/aislamiento & purificación , Humanos , Masculino , Persona de Mediana Edad , Infecciones por Roseolovirus/tratamiento farmacológico , Infecciones por Roseolovirus/inmunología , Infecciones por Roseolovirus/virología , Sarcoidosis/tratamiento farmacológico , Sarcoidosis/inmunología , Sarcoidosis/virología , Resultado del TratamientoRESUMEN
In general practice of clinical immunologists must be use the detection of immunoglobulin G subclasses in cases with symptoms of recurrent and chronic infectious diseases with normal serum IgG. Thus, these patients are not examined and they are under treatment. Over the years, these patients has a sharp decrease in IgG subclasses, which is accompanied by a long course of various infectious processes and complications. Therefore; early diagnosis, early treatment and prevention of complications immunodeficiency knowledge-based clinical immunologists and general practitioners of modern diagnostic methods.
Asunto(s)
Infecciones Bacterianas/sangre , Infecciones Bacterianas/inmunología , Inmunoglobulina G/sangre , Síndromes de Inmunodeficiencia/sangre , Síndromes de Inmunodeficiencia/inmunología , Adulto , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/microbiología , Diagnóstico Diferencial , Humanos , Inmunidad Humoral , Síndromes de Inmunodeficiencia/etiologíaRESUMEN
The publication covers the world-known Gell and Coombs classification of immunopathological reactions, last revised, in the context of immunodeficiencies theory. A great attention is paid to the description of protective immune reactions, allergic and autoimmune complications, being developed according to one or another mechanism, defined in the classification. The strong and weak points of the classification were marked and the promising trends to carry out further scientific enquiry were emphasized. Primary immunodeficiencies were considered in detail as natural models of immunopathological complications. The problems of immunodiagnosis and immunotherapy were discussed.