Assuntos
Infecções por Herpesviridae/imunologia , Herpesvirus Humano 8/imunologia , Sarcoma de Kaposi/virologia , Neoplasias Cutâneas/virologia , Antígenos Virais de Tumores , Antivirais/uso terapêutico , Criança , Soronegatividade para HIV , Infecções por Herpesviridae/complicações , Humanos , Interferon-alfa/uso terapêutico , Masculino , Sarcoma de Kaposi/tratamento farmacológico , Sarcoma de Kaposi/imunologia , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/imunologiaRESUMO
The simultaneous presence of infectious organisms within cutaneous lesions of Kaposi sarcoma in persons with AIDS has been demonstrated. We describe a patient with concurrent leprosy and Kaposi sarcoma presenting as an immune reconstitution inflammatory syndrome in the setting of AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Hanseníase/complicações , Sarcoma de Kaposi/complicações , Neoplasias Cutâneas/complicações , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/imunologia , Terapia Antirretroviral de Alta Atividade , Feminino , Humanos , Hanseníase/imunologia , Hanseníase/patologia , Pessoa de Meia-Idade , Sarcoma de Kaposi/imunologia , Sarcoma de Kaposi/patologia , Pele/patologia , Neoplasias Cutâneas/imunologia , Neoplasias Cutâneas/patologiaRESUMO
PIP: African Kaposi's sarcoma (KS) remains a medical curiosity which continues to intrigue and elude medical science. While impaired cell-mediated immunity has been associated with some subtypes of African KS before and after the advent of AIDS, its role in the pathogenesis of African KS has never been defined. Determining the role of host immunity in the pathogenesis of African KS could, however, yield important insights into the tumor. The author notes that immune impairment from causes other than AIDS could exert similar influences upon the biological and clinical behavior of African KS. Unfortunately, preoccupation with the relationship between AIDS and atypical KS has overshadowed interest in the relation between immunosuppression in general and African KS. That different morphologic subtypes of African KS have identical histology suggests that they are manifestations of the same disease. Clinical manifestations of African KS in a susceptible host is probably determined by a complex interplay between host immunity and putative cofactors such as infectious agents, KS antigens, hormones, and genetic and environmental factors. African KS has a clinical spectrum ranging from localized to generalized. Hosts with relatively good cellular immunity develop localized lesions, while hosts with markedly impaired immunity develop generalized cutaneous or lymphadenopathic KS. The author draws an analogy with leprosy to help clarify the role of host immunity in the clinical manifestations and behavior of African KS.^ieng