Assuntos
Erupções Liquenoides/diagnóstico , Erupções Liquenoides/patologia , Gêmeos , Braço , Criança , Feminino , Humanos , Perna (Membro)RESUMO
Thalidomide is the best known human teratogen. Although withdrawn from the market in 1961, thalidomide was remarketed after 1965 in several countries, for the treatment of erythema nodosum leprosum. Thalidomide has a potent immunomodulatory property and has now a number of approved and off-label uses in dermatologic, oncologic, infectious and gastrointestinal conditions. In the U.S., FDA approved the use of thalidomide in 1998, but no cases of thalidomide embriophaty were registered after that. Since 1996 no new cases were reported in Latin America. However, the Teratogen Information Service (TIS) Porto Alegre, recorded three new cases of thalidomide embriophaty born in Brazil since 2005. Considering that these three cases were not registered through a systematic surveillance system, but that came to our attention through a series of coincidental random events, it can be assumed that the actual occurrence of affected babies by thalidomide continues being as frequent as denounced ten years ago.
Assuntos
Anormalidades Induzidas por Medicamentos/etiologia , Talidomida/toxicidade , Anormalidades Múltiplas/induzido quimicamente , Adolescente , Adulto , Brasil , Contraindicações , Feminino , Humanos , Recém-Nascido , Deformidades Congênitas dos Membros/induzido quimicamente , Masculino , Gravidez , Sistema de Registros , Teratogênicos/toxicidade , GêmeosAssuntos
Doenças Genéticas Inatas/epidemiologia , Saúde Pública , Adoção , Adulto , Idoso , Pressão Sanguínea , Doenças Cardiovasculares/genética , Criança , Características Culturais , Diabetes Mellitus/genética , Suscetibilidade a Doenças , Síndrome de Down/genética , Exposição Ambiental , Feminino , Doenças Genéticas Inatas/fisiopatologia , Ligação Genética , Genótipo , Antígenos HLA/genética , Humanos , Recém-Nascido , Hanseníase/genética , Masculino , Transtornos Mentais/genética , Pessoa de Meia-Idade , Neoplasias/genética , Doenças do Sistema Nervoso/genética , Linhagem , Gravidez , Relações entre Irmãos , Conglomerados Espaço-Temporais , GêmeosRESUMO
This review examines the evidence for involvement of MHC-associated factors in host immune response to Mycobacterium leprae, by collating HLA studies of sporadic and familial leprosy and discussing possible HLA-related immunological mechanisms in determining host response. Formal linkage analysis of 109 multiple-case families with data available for HLA haplotype segregation showed that under a three-allele recessive model for susceptibility to leprosy, linkage was observed between the HLA complex and a leprosy susceptibility locus at a recombination fraction of 20%. The significance of the linkage relationship was confined to families with at least two tuberculoid leprosy offspring and neither parent affected. When one parent was affected, with leprosy of any clinical type, lod scores could neither implicate nor exclude linkage between HLA and leprosy susceptibility and this apparent paradox can be explained by the presence of an additional, non-HLA linked susceptibility locus for leprosy.
Assuntos
Antígenos HLA/imunologia , Hanseníase/imunologia , Complexo Principal de Histocompatibilidade , Antígenos de Bactérias/imunologia , Suscetibilidade a Doenças , Feminino , Humanos , Imunidade Celular , Hanseníase/genética , Macrófagos/imunologia , Mycobacterium leprae/imunologia , Linhagem , Fagocitose , Gravidez , GêmeosRESUMO
Hansen's disease with pregnancy is an uncommon concurrence in the United States. The clinical courses of 62 pregnancies in 26 treated patients with various types of Hansen's disease are reported. In general, patients with Hansen's disease do well in pregnancy. However, the subgroups of active lepromatous and dimorphous types have an increased incidence of obstetric and disease complications. Additional important observations include a high incidence of false-positive biologic tests for syphilis, with the possibility that the FTA-ABS test may also be falsely positive in pregnant patients with Hansen's disease. Sulfone drugs may be used safely during pregnancy. There is a low incidence of congenital malformations, but an unusually high incidence of twinning in this small group of patients.