RESUMO
BACKGROUND: Progressive hemifacial atrophy or Parry-Romberg Syndrome (PRS) is a rare, acquired, progressive dysplasia of subcutaneous tissue and bone characterized by unilateral facial involvement. Its etiology is unknown, but theories about its pathogenesis include infectious, degenerative, autoimmune, and traumatic causes among others. The causal relationship of PRS and linear morphea en coup de sabre (LMCS) with Borrelia burgdorferi infection remains controversial. Our goal was to serologically determine anti-B. burgdorferi antibodies in patients diagnosed with PRS and LMCS to establish a possible association as a causative agent. METHODS: We conducted a serology study with patients belonging to a group of 21 individuals diagnosed with PRS, six with LMCS, and 21 matched controls. Anti-Borrelia IgG antibodies were determined by ELISA. A descriptive statistical analysis and Fischer's exact test were done. RESULTS: In serological tests, only two cases had borderline values and were further analyzed by Western blot with non-confirmatory results. For both the PRS and LMCS group, the association test was not significant, suggesting a lack of association between PRS or LMCS and the presence of anti-Borrelia antibodies. CONCLUSION: In Mexico there are no previous studies on Borrelia infection and its relationship between PRS or LMCS. Our result showed a lack of association of either clinical entities with anti-Borrelia-antibodies. Former reports of this association may suggest coincidental findings without causal relationship.
Assuntos
Anticorpos Antibacterianos/sangue , Borrelia burgdorferi/imunologia , Hemiatrofia Facial/imunologia , Imunoglobulina G/sangue , Esclerodermia Localizada/imunologia , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Criança , Hemiatrofia Facial/epidemiologia , Hemiatrofia Facial/microbiologia , Feminino , Humanos , Doença de Lyme/complicações , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Esclerodermia Localizada/epidemiologia , Esclerodermia Localizada/microbiologia , Estudos Soroepidemiológicos , Adulto JovemRESUMO
La Atrofia Hemifacial Progresiva (AHP) o Síndrome Parry Romberg, es una enfermedad degenerativa rara, caracterizada por una lenta y progresiva atrofia facial unilateral que afecta al tejido celular subcutáneo, cartílago, tejido graso y estructuras óseas subyacentes, que frecuentemente se solapa con una condición conocida como esclerodermia lineal en corte de sable. Hasta donde se conoce no se ha reportado en la literatura la asociación de este síndrome a algún tipo de inmunodeficiencia. Se presenta el caso de un niño de 5 años con AHP, con historia de procesos infecciosos recurrentes, algunos graves, desde que tenía 7 meses de nacido. En el estudio inmunológico se observó la presencia de anticuerpos antinucleares con patrón homogéneo y de anticuerpos anti-DNA de doble cadena. La cuantificación de las subpoblaciones linfocitarias mostró una disminución de los valores de células T/CD3+ y T/CD4+, con valor normal de células B/CD19+. Se diagnosticó una inmunodeficiencia de células T. El hallazgo de una inmunodeficiencia celular en un paciente con AHP es expresión de la gran variabilidad clínica de esta enfermedad y de la importancia que tiene su diagnóstico temprano
The progressive hemifacial atrophy (AHP) or Parry Romberg syndrome, is a rare degenerative disease, characterized by slowly progressive unilateral facial atrophy involving the subcutaneous tissue, cartilage, fat tissue and underlying bone structures, which often overlaps with a condition known as linear scleroderma en coup of sabre. To our knowledge has not been reported the association between immunodeficiency and this syndrome. We report the case of a child of 5 years with AHP, with a history of recurrent infectious processes, some serious, since he was 7 months old. The immunological study showed T cell immunodeficiency, lymphocyte subpopulations showed T/CD4 T/CD3 + cells values decreased and normal value B/CD19 + cells. The presence of antinuclear homogeneous pattern and anti-dsDNA antibodies confirm de autoimmune disorders described in these patients. The cellular immunodeficiency with AHP is an expression of great clinical variability of this disease and the importance of early diagnosis