RESUMEN
In the last 15 years, 3 cases of concurrent Ulcerative Colitis with Neurofibromatosis Type 1 have been described in adults and adolescents, but not in children; although it may be a casual finding, a com mon pathogenic pathway between both diseases is postulated, based on mast cell dysregulation in the gastrointestinal tract. OBJECTIVE: To report the clinical case of a toddler with onset of concomitant Ulcerative Colitis with CMV infection, with history of Neurofibromatosis Type 1, and to discuss the common origin between both diseases. CLINICAL CASE: We describe the case of a 2-and-a-half-year-old toddler with history of Neurofibromatosis Type 1 who presented with bloody diarrhea. On endos copic examination, the mucosa from the anal margin to the cecum was erythematous, with loss of vascular transparency. Biopsies of colonic mucosa showed signs of chronic inflammation, consistent with the diagnosis of Ulcerative Colitis, and CMV infection was diagnosed by PCR. CONCLUSION: Previous studies have suggested that mast cells may have a pathogenic role in the development of UC, however, the clinical significance of these findings is unknown. Future research is needed to further investigate the role of mast cells in the development of UC and to confirm a genetic association bet ween the two diseases.
Asunto(s)
Colitis Ulcerosa , Infecciones por Citomegalovirus , Neurofibromatosis 1 , Adulto , Adolescente , Humanos , Preescolar , Colitis Ulcerosa/complicaciones , Colitis Ulcerosa/diagnóstico , Neurofibromatosis 1/complicaciones , Neurofibromatosis 1/diagnóstico , Neurofibromatosis 1/patología , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/patología , Mucosa Intestinal/patologíaRESUMEN
Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are viruses globally distributed that have been associated with the development and prognosis of many pathologies, including hematological diseases. This study aimed to characterize the epidemiological profile of EBV infection and the infection-correlated hepatic manifestations in patients with hematological diseases of the northern Brazilian state of Amazonas. A total of 228 patients were serologically tested for the presence of anti-EBV and anti-CMV IgG antibodies through an enzyme-linked immunosorbent assay. The coinfection with CMV, sociodemographic and laboratory records of all patients were also assessed. The overall prevalence observed among the study population for EBV infection and EBV/CMV coinfection was 85.09% (95% CI: 0.80-0.90) and 78.51% (95% CI: 0.73-0.84), respectively. The age group 31-40 years old were more susceptible to EBV/CMV coinfection (95% CI: 1.59-93.41, p = 0.011), while young people aged 1-10 years old were less affected for both EBV infection (CI 95%; 0.66-0.91, p = 0.001) and EBV/CMV coinfection (95% CI: 0.52-0.81, p < 0.0001). High serum levels of the liver biomarker ferritin were associated with EBV infection (95% CI: 1.03-1.54, p = 0.031) and EBV/CMV coinfection (95% CI: 1.02-1.70, p = 0.038). Our findings indicated that the elevated prevalence of EBV infection is not associated with the hematological diseases or transfusion rates, but with the socioeconomic status of the study population. Also, this study suggests that the EBV infection and its coinfection with CMV are related to the increase of serum ferritin levels.
Asunto(s)
Anemia/epidemiología , Anticuerpos Antivirales/sangre , Infecciones por Citomegalovirus/epidemiología , Infecciones por Virus de Epstein-Barr/epidemiología , Ferritinas/sangre , Leucemia/epidemiología , Linfoma/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Anemia/inmunología , Anemia/patología , Anemia/virología , Biomarcadores/sangre , Transfusión Sanguínea/estadística & datos numéricos , Brasil/epidemiología , Niño , Preescolar , Coinfección , Citomegalovirus/crecimiento & desarrollo , Citomegalovirus/patogenicidad , Infecciones por Citomegalovirus/inmunología , Infecciones por Citomegalovirus/patología , Infecciones por Citomegalovirus/virología , Infecciones por Virus de Epstein-Barr/inmunología , Infecciones por Virus de Epstein-Barr/patología , Infecciones por Virus de Epstein-Barr/virología , Femenino , Herpesvirus Humano 4/crecimiento & desarrollo , Herpesvirus Humano 4/patogenicidad , Humanos , Inmunoglobulina G/sangre , Lactante , Recién Nacido , Leucemia/inmunología , Leucemia/patología , Leucemia/virología , Hígado/inmunología , Hígado/patología , Hígado/virología , Linfoma/inmunología , Linfoma/patología , Linfoma/virología , Masculino , Persona de Mediana Edad , Prevalencia , Clase SocialAsunto(s)
Infecciones por Citomegalovirus/congénito , Infecciones por Citomegalovirus/diagnóstico , Citomegalovirus/aislamiento & purificación , Pruebas Diagnósticas de Rutina/métodos , Tamizaje Masivo/métodos , Tamizaje Masivo/organización & administración , Brasil , Infecciones por Citomegalovirus/patología , Infecciones por Citomegalovirus/virología , Francia , HumanosRESUMEN
Malignant gliomas are the most common types of incurable primary brain tumours. Therefore, to better clarify the aetiology and pathogenesis of the disease and analyse the risk factors involved, several researchers have highlighted a possible link to human cytomegalovirus (HCMV). Regarding this potential link, the numbers of studies and controversies concerning the relationship between HCMV infections and malignant gliomas have significantly increased. Therefore, we conducted a meta-analysis of observational studies to summarize and pool the available results on the association of HCMV in patients with glioma. Our meta-analysis was based on the PRISMA algorithm, using fixed/random models through STATA IC 13.1 software. Thus, 32 studies were included with a total of 2,190 participants/specimens (glioma, n = 1,871; non-glioma, n = 319). The overall estimate of combined HCMV frequency in patients with glioma was 63% (95% confidence interval [CI]: 56-70). There was an association between HCMV infection and glioma (adjusted OR = 3, 95% CI: 1.7-5.3). The pooled subgroup analysis of viral markers also showed a positive association between the pp65 protein (OR = 3.1, 95% CI: 1.8-5), and gB nucleic acids (OR = 3.1, 95% CI: 1.1-8). For the viral marker IE1-72 protein, the pooled frequency and association results were higher. However, there was no correlation of higher viral association according to the histological subtypes and low/high grade of gliomas. In conclusion, the available evidence suggests an association between HCMV and glioma. Consequently, precautions should be taken, as discussed in this report.
Asunto(s)
Neoplasias Encefálicas/virología , Infecciones por Citomegalovirus/patología , Citomegalovirus/aislamiento & purificación , Glioma/virología , Neoplasias Encefálicas/patología , Citomegalovirus/genética , Glioma/patología , Humanos , Proteínas Inmediatas-Precoces/genéticaAsunto(s)
Coinfección/complicaciones , Colitis/complicaciones , Infecciones por Citomegalovirus/complicaciones , Hemorragia Gastrointestinal/etiología , Huésped Inmunocomprometido , Micosis/complicaciones , Recto/patología , Anciano , Coinfección/patología , Colitis/patología , Colonoscopía , Infecciones por Citomegalovirus/patología , Hemorragia Gastrointestinal/patología , Histocitoquímica , Humanos , Masculino , Micosis/patologíaRESUMEN
Various infectious diseases can hyper-stimulate the immune system, causing hemophagocytic syndrome (HPS). Little is known regarding the accuracy of diagnostic criteria and epidemiological triggering factors in the acquired immunodeficiency syndrome (AIDS) setting. We investigated the major infectious disease triggers of HPS in patients living with human immunodeficiency virus (HIV)/AIDS and determined the accuracy of bone marrow aspiration (BMA). The inclusion criteria were (i) confirmed HIV diagnosis, (ii) bone marrow aspiration, and (iii) a minimum of four HPS criteria. Patients were further classified into those with four presumed HPS criteria, or ≥ 5 confirmed criteria. The disease triggers, accuracy of bone marrow aspiration, and prognosis markers were examined. Presumed HPS was observed in 15/36 patients (41%), and confirmed HPS in 58% (n = 21). The major etiological triggers were infection with Mycobacterium (34%), Cytomegalovirus (14%), Cryptococcus neoformans (11%), and hematological or tumoral disease (11%). BMA demonstrated 93% specificity on screening diagnosis (odds ratio [OR] 12.7, 95% confidence interval [CI] 1.4-115.1, P = 0.01). Ferritin > 5000 ng/mL correlated with probability of death in univariate analysis (OR 6.00, 95% CI 1.33-27.05, P = 0.02). Ferritin performance as test of death probability presented area under the curve as 0.74 (95% CI 0.56-0.91, P = 0.016). However, neither cluster of differentiation for lymphocyte count nor HIV viral load correlated with patient deaths. Mycobacterium spp. and Cytomegalovirus were the main factors triggering HPS, followed by Cryptococcus neoformans, and hematological and tumoral diseases. High ferritin levels were associated with increased death probability. High specificity was noted with BMA.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida , Linfohistiocitosis Hemofagocítica , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/microbiología , Síndrome de Inmunodeficiencia Adquirida/patología , Síndrome de Inmunodeficiencia Adquirida/virología , Adulto , Médula Ósea/metabolismo , Médula Ósea/microbiología , Médula Ósea/patología , Médula Ósea/virología , Criptococosis/epidemiología , Criptococosis/microbiología , Criptococosis/patología , Criptococosis/virología , Cryptococcus neoformans , Citomegalovirus , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/microbiología , Infecciones por Citomegalovirus/patología , Infecciones por Citomegalovirus/virología , Femenino , VIH-1 , Humanos , Linfohistiocitosis Hemofagocítica/epidemiología , Linfohistiocitosis Hemofagocítica/microbiología , Linfohistiocitosis Hemofagocítica/patología , Linfohistiocitosis Hemofagocítica/virología , Masculino , Mycobacterium , Infecciones por Mycobacterium/epidemiología , Infecciones por Mycobacterium/microbiología , Infecciones por Mycobacterium/patología , Infecciones por Mycobacterium/virología , Estudios RetrospectivosRESUMEN
Disseminated human cytomegalovirus (CMV) disease occurs mainly as a congenital infection and among immunocompromised hosts. Patients with acquired immunodeficiency syndrome (AIDS) are at increased risk for CMV infection, and the most prevalent clinical manifestation is retinitis, followed by colitis, esophagitis, pneumonitis, and encephalitis. CMV oophoritis is poorly described in the literature with some cases reported in patients with hematological or solid malignancies, bone marrow or solid organ transplantation, immunosuppressive therapy, and advanced AIDS cases. We report the case of a 61-year-old woman with a recent diagnosis of AIDS, which was associated with a wasting syndrome. The patient presented with abdominal pain, headache, cutaneous vesicular lesions on the abdomen, anemia, lymphopenia, and hyponatremia; she died suddenly on the fourth day of hospitalization. The autopsy was performed and demonstrated disseminated CMV infection with hemorrhagic encephalitis as the immediate cause of death. Additionally, pneumonitis, extensive adrenalitis, ulcerated enteritis, focal hepatitis, and necrotizing oophoritis were found.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Infecciones por Citomegalovirus/complicaciones , Autopsia , Infecciones por Citomegalovirus/patología , Encefalitis/patología , Resultado Fatal , Ooforitis/complicacionesRESUMEN
Resumen La principal complicación a largo plazo en trasplantados de pulmón es la disfunción crónica de injerto identificado como bronquiolitis obliterante, existiendo un nuevo patrón denominado Disfunción de Injerto Restrictivo. Objetivo: Evaluar seguimiento espirométrico, radiológico y clínico entre pacientes con síndrome de bronquiolitis obliterante (SBO) y Disfunción de Injerto Restrictivo (DIR) post trasplante pulmonar. Metodología: Se revisaron registros clínicos de trasplantados pulmonares desde 1999 hasta 2017. Se efectuó seguimiento espirométrico e imágenes por tomografía de tórax y factores asociados: infección por Citomegalovirus(CMV), reflujo gastro-esofágico (RGE) y episodios de rechazo agudo. Se analizó sobrevida por Kaplan Meier. Resultados: De 88 pacientes trasplantados de pulmón, 40 desarrollaron disfunción crónica de injerto: 31 (80%) presentaron SBO y 9 (20%) tuvieron DIR. Edad promedio: 47 años en SBO y 46 años en DIR. Siendo fibrosis pulmonar la patología basal predominante en ambos. En SBO se consignaron 14 episodios de rechazo agudo (50%), infección por CMV en 18% y RGE activo en 26%. En la serie DIR hubo 5 episodios de rechazo agudo (62%), 13% de infección por CMV y 67% de RGE activo 6 (p = 0,02). En el seguimiento a 1-2-4-5 años el promedio del VEF1 en SBO fue: 67,3,65, 60 y 48% del valor predicho y en DIR fue 61, 65, 62 y 45% respectivamente. Las imágenes tomográficas en SBO mostraron: hiperinflación y en DIR: fibrosis pleuropulmonar superior. La sobrevida fue de 96,9 meses en SBO y 65,6 meses en DIR (p = 0,06). Conclusions: La disfunción restrictiva presentó menor sobrevida que SBO. RGE se asoció a rechazo restrictivo. La tomografía de tórax difiere en ambos tipos de rechazo crónico.
The main long-term complication in lung transplant patients is chronic graft dysfunction identified as bronchiolitis obliterans, and there is a new pattern called Restrictive Graft Dysfunction. Objective: To evaluate spirometric, radiological and clinical follow-up among patients with bronchiolitis obliterans syndrome (BOS) and Restrictive Allograft Syndrome (RAS) after lung transplantation. Methodology: Lung transplant recipients ' clinical records were reviewed from 1999 to 2017. We carried out a follow up of spirometry, chest tomography imaging and associated factors: cytomegalovirus (CMV) infection, gastroesophageal reflux (GER) and episodes of acute rejection. Survival was analyzed by Kaplan Meier. Results: Out of 88 lung transplant patients, 40 developed chronic graft dysfunction: 31 (80%) presented BOS and 9 (20%) had RAS. Mean age: 47 yr.o. in BOS and 46 yr. o. in RAS. Lung fibrosis was the primary pathology predominant in both conditions. In BOS were reported 14 episodes of acute rejection (50%), CMV infection in 18% and active GER in 26%. In RAS there were 5 episodes of acute rejection (62%), CMV infection in 13% and active GER in 67% (p = 0.02). VEF1 follow-up at 1-2-4-5 years averaged 67, 65, 60 and 8% of reference value in BOS and 61, 65, 62 and 45% in RAS respectively. CT scans showed hyperinflation in BOS and upper pleuropulmonary fibrosis in RAS. BOS survival time was 96.9 months versus 65.6 months in RAS (p = 0.06). Conclusiones: Restrictive dysfunction presented a lower survival rate than BOS. GER was associated with restrictive rejection. Chest tomography differs in both types of chronic rejection.
Asunto(s)
Humanos , Adulto , Bronquiolitis Obliterante/etiología , Bronquiolitis Obliterante/diagnóstico por imagen , Reflujo Gastroesofágico/diagnóstico , Trasplante de Pulmón/métodos , Infecciones por Citomegalovirus/virología , Disfunción Primaria del Injerto/etiología , Aloinjertos , Tórax/diagnóstico por imagen , Bronquiolitis Obliterante/patología , Reflujo Gastroesofágico/complicaciones , Tomografía Computarizada por Rayos X , Tasa de Supervivencia , Caminata , Dados Estadísticos , Infecciones por Citomegalovirus/patología , Infecciones por Citomegalovirus/epidemiología , Disfunción Primaria del Injerto/patologíaRESUMEN
Pemphigus vulgaris is an autoimmune disease characterized by the formation of suprabasal intra-epidermal blisters on the skin and mucosal surfaces. Infectious diseases are the main cause of death in patients with pemphigus due to the disrupture of the physiological skin barrier, immune dysregulation, and the use of immunosuppressive medications leaving the patient prone to acquire opportunistic infections. We report the case of a 67-year-old woman diagnosed with pemphigus vulgaris, who was irregularly taking prednisone and mycophenolate mofetil. She was hospitalized because of a 1-month history of watery diarrhea and oral ulcers. Unfortunately, the patient died suddenly on the ward. The autopsy revealed a bilateral saddle pulmonary embolism, Gram-positive cocci bronchopneumonia, and gastrointestinal cytomegalovirus infection, causing extensive gastrointestinal mucosal ulcers.
Asunto(s)
Humanos , Femenino , Anciano , Bronconeumonía/patología , Infecciones por Citomegalovirus/patología , Enfermedades Gastrointestinales/patología , Pénfigo/complicaciones , Pénfigo/patología , Embolia Pulmonar/patología , Corticoesteroides , Autopsia , Enfermedades Transmisibles/mortalidad , Diarrea , Resultado Fatal , Ácido Micofenólico , Úlceras BucalesRESUMEN
Cytomegalovirus is an opportunistic virus that commonly affects immunosuppressed patients. Cutaneous involvement by this virus is rare and occurs in significantly immunocompromised hosts, with a poor prognosis. Skin ulcers may represent the first sign of systemic infection by cytomegalovirus in these patients. Herein, a case of a systemic infection by Cytomegalovirus presenting as genital and oral ulcers in a kidney-transplant recipient is reported.
Asunto(s)
Infecciones por Citomegalovirus/patología , Inmunocompetencia , Trasplante de Riñón/efectos adversos , Enfermedades Cutáneas Virales/patología , Anciano , Infecciones por Citomegalovirus/inmunología , Humanos , Masculino , Reacción en Cadena de la Polimerasa , Enfermedades Cutáneas Virales/inmunología , Úlcera Cutánea/patología , Úlcera Cutánea/virologíaRESUMEN
Abstract Cytomegalovirus is an opportunistic virus that commonly affects immunosuppressed patients. Cutaneous involvement by this virus is rare and occurs in significantly immunocompromised hosts, with a poor prognosis. Skin ulcers may represent the first sign of systemic infection by cytomegalovirus in these patients. Herein, a case of a systemic infection by Cytomegalovirus presenting as genital and oral ulcers in a kidney-transplant recipient is reported.
Asunto(s)
Anciano , Humanos , Masculino , Infecciones por Citomegalovirus/patología , Inmunocompetencia , Trasplante de Riñón/efectos adversos , Enfermedades Cutáneas Virales/patología , Infecciones por Citomegalovirus/inmunología , Reacción en Cadena de la Polimerasa , Enfermedades Cutáneas Virales/inmunología , Úlcera Cutánea/patología , Úlcera Cutánea/virologíaRESUMEN
BACKGROUND: Cytomegalovirus is highly prevalent virus and usually occurs in immunocompromised patients. The pathophysiology and treatment of inflammatory bowel disease often induce a state of immunosuppression. Because this, there are still doubts and controversies about the relationship between inflammatory bowel disease and cytomegalovirus. AIM: Evaluate the frequency of cytomegalovirus in patients with inflammatory bowel disease and identify correlations. METHODS: Patients with inflammatory bowel disease underwent an interview, review of records and collection of blood and fecal samples. The search for cytomegalovirus was performed by IgG and IgM blood serology, by real-time PCR in the blood and by qualitative PCR in feces. Results were correlated with red blood cell levels, C-reactive protein levels, erythrocyte sedimentation rates and fecal calprotectin levels for each patient. RESULTS: Among the 400 eligible patients, 249 had Crohn's disease, and 151 had ulcerative colitis. In the group of Crohn's disease, 67 of the patients had moderate or severe disease, but 126 patients presented with active disease, based on the evaluation of the fecal calprotectin. In patients with ulcerative colitis, only 21 patients had moderate disease, but 76 patients presented with active disease, based on the evaluation of the fecal calprotectin. A large majority of patients had positive CMV IgG. Overall, 10 patients had positive CMV IgM, and 9 patients had a positive qualitative detection of CMV DNA by PCR in the feces. All 400 patients returned negative results after the quantitative detection of CMV DNA in blood by real-time PCR. Analyzing the 19 patients with active infections, we only found that such an association occurred with the use of combined therapy (anti-TNF-alpha + azathioprine). CONCLUSION: The findings show that latent cytomegalovirus infections are frequent and active cytomegalovirus infection is rare. We did not find any association between an active infection of CMV and inflammatory bowel disease activity.
Asunto(s)
Infecciones por Citomegalovirus/patología , Inflamación/patología , Enfermedades Inflamatorias del Intestino/patología , Intestinos/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Citomegalovirus/aislamiento & purificación , Infecciones por Citomegalovirus/complicaciones , Femenino , Humanos , Huésped Inmunocomprometido , Inflamación/complicaciones , Inflamación/virología , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/virología , Intestinos/virología , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
UNLABELLED: Cytomegalovirus (CMV) is a prevalent pathogen in the immunocompromised host and invasive pneumonia is a feared complication of the virus in this population. In this pediatric case series we characterized CMV lung infection in 15 non-HIV infected children (median age 3 years; IQR 0.2-4.9 years), using current molecular and imaging diagnostic modalities, in combination with respiratory signs and symptoms. The most prominent clinical and laboratory findings included cough (100%), hypoxemia (100%), diffuse adventitious breath sounds (100%) and increased respiratory effort (93%). All patients had abnormal lung images characterized by ground glass opacity/consolidation in 80% of cases. CMV was detected in the lung either by CMV PCR in bronchoalveolar lavage (82% detection rate) or histology/immunohistochemistry in lung biopsy (100% detection rate). CMV caused respiratory failure in 47% of children infected and the overall mortality rate was 13.3%. CONCLUSION: CMV pneumonia is a potential lethal disease in non-HIV infected children that requires a high-index of suspicion. Common clinical and radiological patterns such as hypoxemia, diffuse adventitious lung sounds and ground-glass pulmonary opacities may allow early identification of CMV lung infection in the pediatric population, which may lead to prompt initiation of antiviral therapy and better clinical outcomes.
Asunto(s)
Infecciones por Citomegalovirus/patología , Infecciones por Citomegalovirus/virología , Citomegalovirus/aislamiento & purificación , Neumonía Viral/patología , Neumonía Viral/virología , Adolescente , Niño , Preescolar , Infecciones por Citomegalovirus/epidemiología , Infecciones por Citomegalovirus/microbiología , Femenino , Infecciones por VIH , Humanos , Lactante , Recién Nacido , Pulmón/diagnóstico por imagen , Pulmón/patología , Pulmón/virología , Masculino , Neumonía Viral/epidemiología , Neumonía Viral/microbiología , Radiografía , Insuficiencia Respiratoria/epidemiología , Análisis de SupervivenciaRESUMEN
Cytomegalovirus (CMV) infection is usually asymptomatic in immunocompetent patients. A mononucleosis-like syndrome may develop in some patients. Various organ involvements (eg: encephalitis, meningitis, retinitis, myocarditis, pneumonia, hepatitis, enterocolitis, neuritis), which rarely occur in immunocompetent patients, have also been reported. Cutaneous necrotizing vasculitis caused by CMV infection has been reported very rarely in the literature. Here, a case with a very rare clinical form of CMV infection, presenting with persistent fever and livedo reticularis on the extremities and cutaneous necrotizing vasculitis of the toes, is described, and the relevant literature is reviewed. This case report aims to highlight the possibility of CMV infection to be a cause of cutaneous necrotizing vasculitis.
Asunto(s)
Adolescente , Femenino , Humanos , Infecciones por Citomegalovirus/patología , Dedos del Pie/patología , Vasculitis/patología , Biopsia , Necrosis/patología , Necrosis/virología , Dedos del Pie/virología , Vasculitis/virologíaRESUMEN
Cytomegalovirus (CMV) infection is usually asymptomatic in immunocompetent patients. A mononucleosis-like syndrome may develop in some patients. Various organ involvements (e.g.: encephalitis, meningitis, retinitis, myocarditis, pneumonia, hepatitis, enterocolitis, neuritis), which rarely occur in immunocompetent patients, have also been reported. Cutaneous necrotizing vasculitis caused by CMV infection has been reported very rarely in the literature. Here, a case with a very rare clinical form of CMV infection, presenting with persistent fever and livedo reticularis on the extremities and cutaneous necrotizing vasculitis of the toes, is described, and the relevant literature is reviewed. This case report aims to highlight the possibility of CMV infection to be a cause of cutaneous necrotizing vasculitis.
Asunto(s)
Infecciones por Citomegalovirus/patología , Dedos del Pie/patología , Vasculitis/patología , Adolescente , Biopsia , Femenino , Humanos , Necrosis/patología , Necrosis/virología , Dedos del Pie/virología , Vasculitis/virologíaRESUMEN
OBJECTIVE: To analyse and compare the expression of Palate, Lung, and Nasal Epithelium Clone (PLUNC) proteins in salivary glands from patients with and without AIDS (control group) using autopsy material. METHODS: We analysed the expression of PLUNCs using immunohistochemistry in parotid (n = 45), submandibular (n = 47) and sublingual gland (n = 37) samples of AIDS patients [30 with normal histology, 21 with mycobacteriosis, 14 with cytomegalovirus (CMV) infection, 30 with chronic non-specific sialadenitis, and 30 HIV-negative controls. In situ hybridization (ISH) for SPLUNC 2 in the HIV-negative group was performed. RESULTS: SPLUNC 1 expression was detected in the mucous acini of submandibular and sublingual glands, and SPLUNC 2 were seen in the serous cells. LPLUNC 1 expression was only positive in the salivary ducts. There was a higher expression of SPLUNC 2 in AIDS patients with CMV infection and mycobacteriosis when compared with all other groups. The intensity of staining for SPLUNC 2 was greater around the lesions than the peripheral ones. ISH for SPLUNC 2 showed perinuclear positivity in the serous cells in all HIV-negative cases. CONCLUSIONS: SPLUNC 1 and LPLUNC 1 proteins were similarly expressed in the salivary glands of AIDS patients and non-HIV patients. CMV infection and mycobacteriosis increase SPLUNC 2 expression in serous cells in the salivary gland of AIDS patients.