Lues maligna in an HIV-infected patient

Descrevemos um caso de sífilis maligna em um paciente de 42 anos com infecção pelo HIV e pelo vírus da hepatite B. O paciente, com lesões cutâneas clássicas de lues maligna e VDRL positivo no soro e no líquor, teve uma resposta excelente ao tratamento com penicilina cristalina. O VDRL sérico, que no diagnóstico era de 1:64, aumentou três meses depois para 1:2.048 e diminuiu para 1:8 após 15 meses.

significance of anticardiolipin antibodies in recurrent abortion

The levels of anticardiolipin antibodies were investigated in the sera of 40 women with recurrent spontaneous unexplained abortion, coming for antenatal care. The difference in AC values between patients and control was statistically insignificant. Also, no difference of significance was observed between primary and secondary aborters. However, the incidence of AC positivity rose as the number of abortions increased, a finding of statistical significance [r = 309, P < 02]. Platelet counts tended to be lower in the patients group irrespectively to category, yet without statistical significance. AC positivity was exclusive to the GPL fraction of anticardiolipins. The significance of AC antibodies in recurrent unexplained abortion is further confirmed, with assertion of the importance of GPL over MPL

Clinical and histopathological features of secondary syphilis.

Fifty-four patients with secondary syphilis were studied in regard to the clinical manifestations, response to treatment and histopathology of the skin lesions. The correlation between the skin lesions and histopathology, between the duration of skin lesions and VDRL titer, between type of skin lesions and VDRL titer were also determined. The clinical manifestations varied from macular, maculopapular, papular, papulosquamous and urticarial lesions. The hair loss usually occurred on the scalp, but the eyebrows or even total body hair loss could occur. The response to treatment was good, only one patient relapsed. The histopathology was related to the clinical manifestations, there was sparse inflammatory cell infiltration in the dermis in macular lesions, but more dense infiltration as well as more epidermal change in papular and papulosquamous lesions. There were significant correlation between the duration of skin lesions and VDRL titer, but no correlation between types of skin lesions and VDRL titer.

Anticuerpos anti cardiolipinas (ACL) en pacientes (PTS) con lupus eritematoso sistémico (LES) / Cardiolipins antibodies (ACA) in patients with Systemic Lupus erythematosus (LES)

En 60 pacientes con LES se determinaron ACL y otros auto-anticuerpos (ANA, aDNA, SM, RNP, RO, LA) ppara establecer correlaciones clínico-serológicas. Todos los pacientes reunían 4 o más criterios para el diagnóstico de LES. Los datos se obtuvieron por revisión de Historias Clínicas y seguimiento prospectivo; los ACL se determinaron con la técnica de ELISA expresándose los resultados en Unidades GPL. Consideramos negativos los títulos 0 - 20 GPL; títulos intermedios 20-40 GPL y títulos altos > 40 GPL. 30/60 (50%) pacientes fueron ACL negativos 13/60 (21,7%) tuvieron títulos intermedios y 17/60 (28,3%) títulos altos. El grupo de pacientes con ACL > 40 GPL tuvo un incremento significativo en la frecuencia de: F. de Raynaud (p:. 001); vasculitis (p: 001) comparado con el grupo ACL negativo. El grupo de valores intermedios (20 - 40 GPL) mostró una tendencia similar aunque sin alcanzar significación estadística. No hubo correlación entre ACL y otros auto-anticuerpos. En pacientes con LES los títulos altos de ACL (> 40 GPL) se asocian con F. de Raynaud, vasculitis, cefaleas y tromboembolismo