RESUMO
Meningitis is a common evolution in progressive disseminated histoplasmosis in children, and is asymptomatic in many cases. In leukemia, the impaired of the T cells function can predispose to the disseminated form. The attributed mortality rate in this case is 20 percent-40 percent and the relapse rate is as high as 50 percent; therefore, prolonged treatment may be emphasized. We have described a child with acute myeloid leukemia (AML), that developed skin lesions and asymptomatic chronic meningitis, with a good evolution after prolonged treatment with amphotericin B deoxycholate followed by fluconazole.
Assuntos
Adolescente , Humanos , Masculino , Histoplasmose/diagnóstico , Leucemia Mieloide/imunologia , Meningite Fúngica/diagnóstico , Doença Aguda , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Doença Crônica , Combinação de Medicamentos , Quimioterapia Combinada , Ácido Desoxicólico/uso terapêutico , Fluconazol/uso terapêutico , Histoplasmose/tratamento farmacológico , Hospedeiro Imunocomprometido , Leucemia Mieloide/microbiologia , Meningite Fúngica/tratamento farmacológico , Meningite Fúngica/microbiologia , Resultado do TratamentoRESUMO
Meningitis is a common evolution in progressive disseminated histoplasmosis in children, and is asymptomatic in many cases. In leukemia, the impaired of the T cells function can predispose to the disseminated form. The attributed mortality rate in this case is 20%-40% and the relapse rate is as high as 50%; therefore, prolonged treatment may be emphasized. We have described a child with acute myeloid leukemia (AML), that developed skin lesions and asymptomatic chronic meningitis, with a good evolution after prolonged treatment with amphotericin B deoxycholate followed by fluconazole.
Assuntos
Histoplasmose/diagnóstico , Leucemia Mieloide/imunologia , Meningite Fúngica/diagnóstico , Doença Aguda , Adolescente , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Doença Crônica , Ácido Desoxicólico/uso terapêutico , Combinação de Medicamentos , Quimioterapia Combinada , Fluconazol/uso terapêutico , Histoplasmose/tratamento farmacológico , Humanos , Hospedeiro Imunocomprometido , Leucemia Mieloide/microbiologia , Masculino , Meningite Fúngica/tratamento farmacológico , Meningite Fúngica/microbiologia , Resultado do TratamentoRESUMO
Samples of Schistosoma mansoni soluble adult worm proteins (SWAP) were iodinated with 4-15 mumol I/mg protein using iodine monochloride. The capacity to elicit immediate hypersensitivity reactions of the iodinated derivatives was compared to that of the native SWAP preparations. The degranulation of mast cells from infected mice decreased with increasing iodine incorporation and was absent in fully iodinated samples containing 15 mumol I/mg protein. The response of guinea pigs and humans to the intradermal test with iodinated SWAP also decreased in proportion to iodine incorporation, and no responses were obtained with fully iodinated samples. No false-positive tests were observed. Antibodies to the fully iodinated extracts generated in C57BL/10 mice reacted by ELISA with the unmodified proteins and by immunoprecipitation on agar gel. The immunoprecipitation pattern suggested that some epitopes were altered by iodination.
Assuntos
Anticorpos Anti-Helmínticos/biossíntese , Proteínas de Helminto/imunologia , Hipersensibilidade Imediata/imunologia , Schistosoma mansoni/imunologia , Animais , Doença de Chagas/imunologia , Cloretos , Ensaio de Imunoadsorção Enzimática , Iodetos , Camundongos , Camundongos Endogâmicos C57BL , Testes de PrecipitinaRESUMO
Samples of Schistosoma mansoni soluble adult worm proteins (SWAP) were iodinated with 4-15 µmolI/mg protein using iodine monochloride. The capacity to elicit immediate hypersensitivity reactions of the iodinated derivatives was compared to that of the native SWAP preparations. The degranulation of mast clls from infected mice decreased with increasing iodine incorporation and was absent in fully iodinated samples containing 15 µmol I/mg protein. The response of guinea pigs and humans to the intradermal test with iodinated SWAP also decrease in proportion to iodine incorporation, and no responses were obtained with fully iodinated samples. No false-positive tests were observed. Antibodies to the folly iodinated extracts generated in C57BL/10 mice reacted by ELISA with the unmodified proteins and by immunoprecipitation on agar gel. The immunoprecicpitation pattern suggested that some epitopes were altered by iodination
Assuntos
Anticorpos Anti-Helmínticos/biossíntese , Hipersensibilidade Imediata , Proteínas de Helminto/farmacologia , Schistosoma mansoni/imunologia , Doença de Chagas/imunologia , Cloretos , Ensaio de Imunoadsorção Enzimática , Iodetos , Testes de PrecipitinaRESUMO
Os soros de 472 brasileiros, confirmados como sendo positivos ou negativos em relacao a presenca de anticorpos anti-HIV e compreendendo todo o espectro clinico da infeccao, foram utilizados na avaliaco de seis ensaios imunoenzimaticos comerciais (ELISA), bem como de quatro testes alternativos tais como imunofluorescencia indireta (IFI), hemaglutinacao passiva (HP), dot blot e Karpas AIDS cell test. As sensibilidades variaram de 100 por cento (ELISA Abbott e Roche) a 84,2 por cento (HP) e as especificidades variaram de 99,3 por cento (IFI) a 80,2 por cento (HP). A sensibilidade e especificidade da HP e a sensibilidade do Karpas AIDS cell test foram significativamente menores que os outros ensaios. Embora a IFI e o dot blot tivessem apresentado uma boa sensibilidade e especificidade, os ensaios imunoenzimaticos (ELISA) foram mais adequados para serem utilizados em triagem quando outros parametros tais como facilidade de leitura e interpretacao dos resultados e duracao dos ensaios foram considerados
Assuntos
Humanos , Ensaio de Imunoadsorção Enzimática , Anticorpos Anti-HIV/análise , Western Blotting , Brasil , Ensaio de Imunoadsorção Enzimática , Estudo de Avaliação , Imunofluorescência , Testes de HemaglutinaçãoRESUMO
Sera from 472 Brazilian subjects, confirmed to be either positive or negative for HIV antibodies and comprising the total clinical spectrum of HIV infection, were utilized in the evaluation of six commercially available enzyme-linked immunosorbent assays (ELISA), as well as of four alternative assays, namely indirect immunofluorescence (IIF), passive hemagglutination (PHA), dot blot and Karpas AIDS cell test. The sensitivities ranged from 100% (Abbott and Roche ELISA) to 84.2% (PHA) and the specificities ranged from 99.3% (IIF) to 80.2% (PHA). The sensitivity and specificity of the PHA and the sensitivity of the Karpas cell test were significantly lower than those of the other tests. Although the IFF and dot blot had good sensitivities and specificities, the six ELISA were more attractive than those tests when other parameters such as ease of reading and duration of assay were considered.
PIP: 6 commercially available ELISA kits and 4 new Brazilian made methods for detecting HIV were compared on 2 panels of sera, 292 from AIDS patients, HIV-positives and negatives, and 180 sera from asymptomatic blood donors, including 90 HIV-positives. The kits tested were 5 ELISAs: Roche Diagnostica (Basel), Hoechst Enzygnostic (Sao Paulo), Virgo Electronuclionics (Columbia MD), Organon Teknika (Boxtel, Netherlands), Salck Industria e Comercio de Produtos Biologicos (Sao Paulo), and a passive hemagglutination test, (Salck Ind), and indirect immunofluorescence IIF (Virgo electronucleonics, Columbia), a dot blot (Embrabio, Empressa Brasiliera de Biotecnologia Ltda, Sao Paolo) and Karpas AIDS cell test, Fujichemical Industries Ltd (Chokeiji, Takaoka, Japan). The sensitivities ranged from 84.2% to 100% with no significant differences in sera from panel A. In panel B, the sensitivity of the PHA test was significantly lower than that of the ELISA and the AIDS cell tests. The specificities of the PHA and the AIDS cell tests were also lower than that of the ELISA. The costs of all the tests were similar, but the equipment needs varied. The simplest tests to perform were the dot blot assay, PHA and Karpas AIDS cell test. The Hoechst ELISA is simpler because it does not require dilution of the serum. The dot takes too long for use in a blood bank, 16-18 hours. Immunofluorescence tests would be practical in countries already screening blood for malaria or Changes disease. Brazil is not doing so on a large scale due to lack of political will. In countries with high incidence of malaria, Chagas disease, leishmania, hepatitis and leprosy, HIV test need to be tested on local sera because of possible B cell activation.