RESUMEN
La diarrea crónica puede manifestarse hasta en un 60% de los pacientes que presentan compromiso del compartimiento inmunológico humoral, específicamente en la hipogammaglobulinemia común variable (HCV). Presentamos 3 casos con HCV de aparición tardía, en quienes la diarrea crónica fue el síntoma cardinal del cuadro clínico. Los estudios inmunodiagnósticos revelaron niveles no cuantificables o subnormales tanto de Inmunoglobulina G como de M y A, con complemento hemolítico total preservado, y pantalla autoinmune negativa. La exploración del compartimiento celular demostró elevado número de linfocitos T supresores (CD8) con hiporespuesta de la población linfocitaria total frente a mitógenos policionales tipo PHA. El abordaje clínico de los pacientes con HCV debe ser practicado por un equipo multiespecializado conformado por el inmunólogo clínico, el gastroenterólogo y el infectólogo.
Asunto(s)
Adulto , Persona de Mediana Edad , Humanos , Agammaglobulinemia/patología , Diarrea/diagnóstico , gammaglobulinas , Inmunoglobulinas , Seroglobulinas , Linfocitos T ReguladoresRESUMEN
A prospective study was begun on the immunopathogenic characteristics of infection with human immunodeficiency virus (HIV) in order to elucidate the natural history of the disease induced by the virus in Venezuela. The results of a study of 240 individuals with variety of clinical manifestations are presented. The most important findings were depletion of the CD3+, CD4+ subpopulation in most individuals studied, including asymptomatic carriers; significant reduction of the large granular lymphocyte (CD3-, CD16+) pool in AIDS cases; decrease in cytotoxic activity in relation to the viral infection, along with an increase induced by recombinant interleukin 2; and reduction of the CD4 subpopulation in patients with free serum antigen. It is of utmost importance that ongoing research projects to clarity the immunopathogenic mechanisms of HIV be continued so that the characteristics peculiar to HIV infection may be determined, since they can affect clinical manifestation and the desease's development in the Venezuelan population
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/inmunología , Síndrome de Inmunodeficiencia Adquirida/patología , Virus Linfotrópico T Tipo 1 Humano/aislamiento & purificación , VenezuelaRESUMEN
A prospective study was begun on the immunopathogenic characteristics of infection with human immunodeficiency virus (HIV) in order to elucidate the natural history of the disease induced by the virus in Venezuela. The results of a study of 240 individuals with variety of clinical manifestations are presented. The most important findings were depletion of the CD3+, CD4+ subpopulation in most individuals studied, including asymptomatic carriers; significant reduction of the large granular lymphocyte (CD3-, CD16+) pool in AIDS cases; decrease in cytotoxic activity in relation to the viral infection, along with an increase induced by recombinant interleukin 2; and reduction of the CD4 subpopulation in patients with free serum antigen. It is of utmost importance that ongoing research projects to clarity the immonopathogenic mechanisms of HIV be continued so that the characteristics peculiar to HIV infection may be determined, since they can affect clinical manifestation and the desease's development in the Venezuelan population