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1.
Indian J Pathol Microbiol ; 65(2): 406-409, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35435380

RESUMO

The most common cause of granulomatous lymphadenitis in countries like ours is mycobactrium tuberculosis followed by atypical mycobacterial infection, fungal infections, parasitic infection, cat scratch disease, lymphogranuloma venereum (inguinal lymphadenopathy), and leprosy Here, we present three cases of lymphadenopathy due to histoplasmosis in immunocompetent children. Two of them presented with fever, lymphadenopathy, initially diagnosed as granulomatous lymphadenitis consistent with tuberculosis on FNAC and were put on antitubercular drugs. However, their condition gradually became worse. As the patients continued to deteriorate, subsequent lymph node biopsies were done and diagnosed as histoplasmosis. Third case presented with acute loss of vision with hepatosplenomegaly and lymphadenopathy. Initially considered as acute leukemia, but eventually established as histoplasmosis. Histoplasmosis should be considered as one of the possible causes of granulomatous lymphadenitis in children.


Assuntos
Histoplasmose , Linfadenite , Linfadenopatia , Tuberculose , Granuloma/diagnóstico , Histoplasmose/diagnóstico , Humanos , Linfadenopatia/diagnóstico , Tuberculose/diagnóstico
3.
Int J Mycobacteriol ; 10(3): 330-334, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34494576

RESUMO

Tuberculosis (TB) and leprosy are two chronic mycobacterial infections caused by intracellular Gram-positive aerobic acid-fast bacilli. Both have highly variable presentations depending on immunological milieu of the host and account for significant disease morbidity. The burden of these age-old infections of humanity still remains high in India. Regardless of the same geographical endemicity of the two, coinfections are sparsely reported. Indeed, studies have revealed an antagonism between them. Of the few coinfections reported in the past, majority were diagnosed over a temporal sequence, with one occurring after the other, and most of these were localized forms of TB associated with leprosy. Only a single case of disseminated TB and lepromatous leprosy has been reported in the medical literature till date. Here, we report another rare case of disseminated TB and lepromatous leprosy that ultimately proved fatal for the patient. The diagnosis of the two diseases was made simultaneously which is again infrequent in the reported literature.


Assuntos
Coinfecção , Hanseníase Virchowiana , Hanseníase , Tuberculose Miliar , Granuloma , Humanos , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/diagnóstico , Masculino
7.
Bauru; s.n; 2021. 38 p. ilus, graf.
Tese em Português | SES-SP, SES-SP, CONASS, HANSEN, HANSENIASE, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP, SESSP-ESPECIALIZACAOSESPROD, SES-SP | ID: biblio-1179170

RESUMO

Na hanseníase, o modelo de Shepard de inoculação por Mycobacterium leprae (M. leprae) em patas de camundongos vem sendo utilizado em diversos estudos sobre a resposta imune, avaliação de novas drogas e esquemas terapêuticos, além da dinâmica da infecção precoce e crônica. Para estudar o papel do microambiente granulomatoso na hanseníase, além de modelos animais convencionais ou imunocomprometidos, o desenvolvimento de modelos murinos de granuloma não infeccioso pode adicionar parâmetros patogênicos a serem comparados no desenvolvimento da doença. Preparações de nitrocelulose estão entre as formas de desenvolvimento de granulomas não imunogênicos em experimentação animal. O presente estudo investigou a formação de granulomas não infecciosos induzidos por partículas de nitrocelulose, em comparação a lesões induzidas por M. leprae. Grupos de camundongos nude e BALB/c, foram constituídos e inoculados, conforme a técnica de Shepard, com suspensão de M. leprae (ML), suspensão de nitrocelulose (NT), associação de M. leprae com nitrocelulose (ML/NT) e veículo controle (CTRL). Após 07, 14, 21 e 28 dias, amostras foram coletadas e analisadas histopatologicamente pelas colorações, HematoxilinaEosina e Fite-Faraco. Os grupos experimentais demonstraram a formação de granulomas em ambas os fenótipos murinos. Principalmente nos grupos NT e ML/NT, as lesões foram caracterizadas por infiltrado inflamatório mononuclear, predominantemente macrofágico, com presença de células epitelioides, eventuais macrófagos vacuolizados e ausência de células gigantes multinucleadas. As lesões induzidas exclusivamente por M. leprae pareceram menos exuberantes que àquelas observadas nos demais grupos, indicando que a nitrocelulose intensificou a resposta macrofágica nos espécimes avaliados e sugerindo que esse composto pode ser utilizado não só para o desenvolvimento de granulomas não imunogênicos, mas também na exacerbação da resposta imune em granulomas induzidos por agentes infecciosos, como M. leprae.


In leprosy, the Shepard model of inoculation by Mycobacterium leprae (M. leprae) in mouse footpad has been used in several studies on the immune response, evaluation of new drugs and therapeutic schemes, in addition to the dynamics of early and chronic infection. To study the role of the granulomatous microenvironment in leprosy, in addition to conventional or immunocompromised animal models, the development of murine models of non-infectious granuloma can add pathogenic parameters to be compared in the development of the disease. Nitrocellulose preparations are among the ways of developing non-immunogenic granulomas in animal experimentation. The present study investigated the formation of non-infectious granulomas induced by nitrocellulose particles, in comparison to lesions induced by M. leprae. Groups of athymic nude and BALB/c mice were set up and inoculated, according to Shepard technique, with M. leprae suspension (ML), nitrocellulose suspension (NT), M. leprae association with nitrocellulose (ML/NT) and control vehicle (CTRL). After 07, 14, 21 and 28 days, samples were collected and histopathologically analyzed by Hematoxylin-Eosin and FiteFaraco staining. The experimental groups demonstrated the formation of granulomas in both murine strains. Mainly in the NT and ML/NT groups, the lesions were characterized by mononuclear inflammatory infiltrate, predominantly macrophagic, with the presence of epithelioid cells, eventual vacuolated macrophages and absence of multinucleated giant cells. The lesions induced exclusively by M. leprae seemed less exuberant than those observed in the other groups, indicating that nitrocellulose intensified the macrophage response in the specimens evaluated, and suggesting that this compound can be used not only in the development of non-immunogenic granulomas, but also in exacerbation of the immune response in granulomas induced by infectious agents, such as M. leprae.


Assuntos
Camundongos , Granuloma/induzido quimicamente , Hanseníase/microbiologia , Mycobacterium leprae/crescimento & desenvolvimento , Camundongos Endogâmicos BALB C
8.
Vaccine ; 38(48): 7629-7637, 2020 11 10.
Artigo em Inglês | MEDLINE | ID: mdl-33071000

RESUMO

This work demonstrates the presence of immune regulatory cells in the cervical lymph nodes draining Bacillus Calmette-Guérin (BCG) vaccinated site on the dorsum of the ear in guinea pigs. It is shown that whole cervical lymph node cells did not proliferate in vitro in the presence of soluble mycobacterial antigens (PPD or leprosin) despite being responsive to whole mycobacteria. Besides, T cells from these lymph nodes separated as a non-adherent fraction on a nylon wool column, proliferated to PPD in the presence of autologous antigen presenting cells. Interestingly, addition of as low as 20% nylon wool adherent cells to these, sharply decreased the proliferation by 83%. Looking into what cells in the adherent fraction suppressed the proliferation, it was found that neither the T cell nor the macrophage enriched cell fractions of this population individually showed suppressive effect, indicating that their co-presence was necessary for the suppression. Since BCG induced granulomas resolve much faster than granulomas induced by other mycobacteria such as Mycobacterium leprae the present experimental findings add to the existing evidence that intradermal BCG vaccination influences subsequent immune responses in the host and may further stress upon its beneficial role seen in Covid-19 patients.


Assuntos
Antígenos de Bactérias/farmacologia , Vacina BCG/farmacologia , Granuloma/imunologia , Linfonodos/imunologia , Linfócitos T/imunologia , Tuberculina/farmacologia , Animais , Células Apresentadoras de Antígenos/efeitos dos fármacos , Células Apresentadoras de Antígenos/imunologia , Células Apresentadoras de Antígenos/microbiologia , COVID-19 , Adesão Celular , Proliferação de Células , Infecções por Coronavirus/prevenção & controle , Orelha , Feminino , Granuloma/microbiologia , Cobaias , Humanos , Injeções Intradérmicas , Linfonodos/microbiologia , Macrófagos/efeitos dos fármacos , Macrófagos/imunologia , Macrófagos/microbiologia , Masculino , Mycobacterium bovis/imunologia , Mycobacterium leprae/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Remissão Espontânea , Linfócitos T/classificação , Linfócitos T/efeitos dos fármacos , Linfócitos T/microbiologia
9.
Indian J Ophthalmol ; 68(9): 2031-2033, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32823469

RESUMO

Leprosy is a chronic multisystem disease caused by Mycobacterium leprae with frequent ocular manifestations such as madarosis, lagophthalmos, lid abnormalities, impaired corneal sensations, chronic uveitis, and cataract. Granulomas are characteristic lesion of lepromatous leprosy commonly seen as conjunctival and iris granulomas. We report a case of leprosy with a rare ocular manifestation in the form of angle mass lesion or suspected granuloma which has not been reported before and its successful management following treatment with favorable outcome. The index case also highlights the anterior segment fluorescein angiography features of the lesion and study of its vascular pattern.


Assuntos
Doenças Palpebrais , Hanseníase Virchowiana , Hanseníase , Câmara Anterior , Granuloma/diagnóstico , Humanos , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/tratamento farmacológico
10.
Artigo em Alemão | MEDLINE | ID: mdl-32557496

RESUMO

Using cytology, histopathology, and DNA sequencing the diagnosis of canine leproid granuloma (CLG) was made in 2 dogs. The dogs were presented with nodular skin lesions on the head and pinnae. CLG is caused by nontuberculous mycobacteria that have not yet been finally classified. To date, this disease has been reported in Australia, New Zealand as well as North and South America, however no case reports have been published in Germany until now. In both cases, a combination of surgery and long-term drug administration (rifampicin, clarithromycin, doxycyclin and local application of clofazimin) was chosen and successfully eliminated the granulomas.


Assuntos
Doenças do Cão , Granuloma , Hanseníase , Animais , Doenças do Cão/diagnóstico , Doenças do Cão/patologia , Doenças do Cão/terapia , Cães , Orelha/patologia , Feminino , Alemanha , Granuloma/diagnóstico , Granuloma/patologia , Granuloma/terapia , Granuloma/veterinária , Hanseníase/diagnóstico , Hanseníase/patologia , Hanseníase/terapia , Hanseníase/veterinária , Masculino , Pele/patologia
11.
Emerg Infect Dis ; 26(5): 930-936, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32310067

RESUMO

Lobomycosis is a rare granulomatous skin disease with a high prevalence in the Amazon region. The Kaiabi Indians are an especially affected group. We studied the current epidemiologic and clinical progression of lobomycosis among the Kaiabi in Brazil, from initial case reports in 1965 through 2019. A total of 60 lobomycosis cases had been reported among the Kaiabi, and we identified 3 new cases in our review. Of 550 cases of lobomycosis ever reported worldwide, 11.5% were among the Kaiabi. We note a high incidence among female Kaiabi and a precocious onset of disease in this indigenous population. Male Kaiabi frequently are infected with the multicentric form and women more frequently exhibit the localized form. Ulcerated lesions are observed more often in the multicentric form. The prevalence among this indigenous group could be explained by genetic susceptibility and lifestyle, which exposes them to a particular agent in the habitats in which they live.


Assuntos
Lacazia , Lobomicose , Brasil/epidemiologia , Feminino , Granuloma , Humanos , Lobomicose/epidemiologia , Masculino , Prevalência
12.
J Cutan Pathol ; 47(7): 625-627, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32022940

RESUMO

Sarcoidosis is a granulomatous condition with diverse clinical presentations, including neurological findings. It was previously hypothesized that perineural sarcoidal granulomas in the skin may be an explanation of small-fiber neuropathy. Herein, we present a case of a 55 year old female with anesthetic cutaneous lesions mimicking leprosy clinically and histopathologically and discuss the importance of this differential diagnosis.


Assuntos
Nervos Periféricos/patologia , Sarcoidose/diagnóstico , Sarcoidose/patologia , Dermatopatias/patologia , Diagnóstico Diferencial , Feminino , Granuloma/patologia , Humanos , Hanseníase/diagnóstico , Pessoa de Meia-Idade
14.
Trop Doct ; 49(1): 55-58, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30286700

RESUMO

Granuloma multiforme (GM) is a chronic granulomatous skin condition which is clinically characterised by annular lesions mainly over sun-exposed areas and histologically by focal necrobiosis and histiocytic granulomas. Its significance lies in the fact that it can clinically resemble tuberculoid leprosy and hence it can be missed. Here, we report a case of GM from India in a 55-year-old female agriculturist, with multiple asymptomatic large annular rings of papules over the photo-distributed areas. Histopathology helps in confirming the diagnosis and in differentiating it from similar clinical and histologic mimics such as granuloma annulare, tuberculoid leprosy, interstitial granulomatous dermatitis or annular sarcoid. Though a high degree of suspicion is needed to diagnose GM, it should be considered as a differential for various annular conditions.


Assuntos
Granuloma/diagnóstico , Dermatopatias/diagnóstico , Dermatite/diagnóstico , Diagnóstico Diferencial , Feminino , Granuloma/patologia , Granuloma Anular/diagnóstico , Humanos , Índia , Hanseníase/diagnóstico , Pessoa de Meia-Idade , Dermatopatias/patologia
15.
Int Immunol ; 30(5): 205-213, 2018 04 25.
Artigo em Inglês | MEDLINE | ID: mdl-29538758

RESUMO

The intersection of granulomatosis and autoinflammatory disease is a rare occurrence that can be generally subdivided into purely granulomatous phenotypes and disease spectra that are inclusive of granulomatous features. NOD2 (nucleotide-binding oligomerization domain-containing protein 2)-related disease, which includes Blau syndrome and early-onset sarcoidosis, is the prototypic example of granulomatous inflammation in the context of monogenic autoinflammation. Granulomatous inflammation has also been observed in two related autoinflammatory diseases caused by mutations in PLCG2 (phospholipase Cγ2). More recently, mutations in LACC1 (laccase domain-containing protein 1) have been identified as the cause of a monogenic form of systemic juvenile idiopathic arthritis, which does not itself manifest granulomatous inflammation, but the same LACC1 mutations have also been shown to cause an early-onset, familial form of a well-known granulomatous condition, Crohn's disease (CD). Rare genetic variants of PLCG2 have also been shown to cause a monogenic form of CD, and moreover common variants of all three of these genes have been implicated in polygenic forms of CD. Additionally, common variants of NOD2 and LACC1 have been implicated in susceptibility to leprosy, a granulomatous infection. Although no specific mechanistic link exists between these three genes, they form an intriguing web of susceptibility to both monogenic and polygenic autoinflammatory and granulomatous phenotypes.


Assuntos
Artrite Juvenil/genética , Artrite/genética , Doença de Crohn/genética , Mutação/genética , Proteína Adaptadora de Sinalização NOD2/genética , Fosfolipase C gama/genética , Proteínas/genética , Sinovite/genética , Uveíte/genética , Animais , Autoimunidade , Interação Gene-Ambiente , Granuloma , Peptídeos e Proteínas de Sinalização Intracelular , Camundongos , Sarcoidose
16.
J Infect Dis ; 217(9): 1506-1507, 2018 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-29409003
18.
J Infect Dis ; 216(6): 776-779, 2017 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-28934421

RESUMO

Understanding the pathogenesis of leprosy granulomas has been hindered by a paucity of tractable experimental animal models. Mycobacterium leprae, which causes leprosy, grows optimally at approximately 30°C, so we sought to model granulomatous disease in the ectothermic zebrafish. We found that noncaseating granulomas develop rapidly and eventually eradicate infection. rag1 mutant zebrafish, which lack lymphocytes, also form noncaseating granulomas with similar kinetics, but these control infection more slowly. Our findings establish the zebrafish as a facile, genetically tractable model for leprosy and reveal the interplay between innate and adaptive immune determinants mediating leprosy granuloma formation and function.


Assuntos
Modelos Animais de Doenças , Granuloma/microbiologia , Hanseníase/microbiologia , Mycobacterium leprae , Animais , Masculino , Peixe-Zebra
19.
PLoS One ; 12(5): e0177815, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28505186

RESUMO

Mycobacterium leprae (M. leprae) infection causes nerve damage and the condition worsens often during and long after treatment. Clearance of bacterial antigens including lipoarabinomannan (LAM) during and after treatment in leprosy patients is slow. We previously demonstrated that M. leprae LAM damages peripheral nerves by in situ generation of the membrane attack complex (MAC). Investigating the role of complement activation in skin lesions of leprosy patients might provide insight into the dynamics of in situ immune reactivity and the destructive pathology of M. leprae. In this study, we analyzed in skin lesions of leprosy patients, whether M. leprae antigen LAM deposition correlates with the deposition of complement activation products MAC and C3d on nerves and cells in the surrounding tissue. Skin biopsies of paucibacillary (n = 7), multibacillary leprosy patients (n = 7), and patients with erythema nodosum leprosum (ENL) (n = 6) or reversal reaction (RR) (n = 4) and controls (n = 5) were analyzed. The percentage of C3d, MAC and LAM deposition was significantly higher in the skin biopsies of multibacillary compared to paucibacillary patients (p = <0.05, p = <0.001 and p = <0.001 respectively), with a significant association between LAM and C3d or MAC in the skin biopsies of leprosy patients (r = 0.9578, p< 0.0001 and r = 0.8585, p<0.0001 respectively). In skin lesions of multibacillary patients, MAC deposition was found on axons and co-localizing with LAM. In skin lesions of paucibacillary patients, we found C3d positive T-cells in and surrounding granulomas, but hardly any MAC deposition. In addition, MAC immunoreactivity was increased in both ENL and RR skin lesions compared to non-reactional leprosy patients (p = <0.01 and p = <0.01 respectively). The present findings demonstrate that complement is deposited in skin lesions of leprosy patients, suggesting that inflammation driven by complement activation might contribute to nerve damage in the lesions of these patients. This should be regarded as an important factor in M. leprae nerve damage pathology.


Assuntos
Ativação do Complemento/imunologia , Hanseníase/imunologia , Hanseníase/patologia , Dermatopatias/imunologia , Dermatopatias/patologia , Linfócitos T/imunologia , Adolescente , Adulto , Carga Bacteriana , Biomarcadores , Biópsia , Criança , Complemento C3d/imunologia , Complexo de Ataque à Membrana do Sistema Complemento/imunologia , Complexo de Ataque à Membrana do Sistema Complemento/metabolismo , Feminino , Granuloma/imunologia , Granuloma/metabolismo , Granuloma/patologia , Humanos , Imuno-Histoquímica , Hanseníase/microbiologia , Lipopolissacarídeos , Masculino , Pessoa de Meia-Idade , Linfócitos T/metabolismo , Adulto Jovem
20.
Semin Diagn Pathol ; 34(3): 301-311, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28094163

RESUMO

Granulomas of the skin may be classified in several ways. They are either infectious or non-infectious in character, and they contain areas of necrobiosis or necrosis, or not. Responsible infectious agents may be mycobacterial, fungal, treponemal, or parasitic organisms, and each case of granulomatous dermatitis should be assessed histochemically for those microbes. In the non-infectious group, examples of necrobiotic or necrotizing granulomas include granuloma annulare; necrobiosis lipoidica; rheumatoid nodule; and lupus miliaris disseminates faciei. Non-necrobiotic/necrotizing and non-infectious lesions are exemplified by sarcoidosis; foreign-body reactions; Melkersson-Rosenthal syndrome; Blau syndrome; elastolytic granuloma; lichenoid and granulomatous dermatitis; interstitial granulomatous dermatitis; cutaneous involvement by Crohn disease; granulomatous rosacea; and granulomatous pigmented purpura. Histiocytic dermatitides that do not feature granuloma formation are peculiar reactions to infection, such as cutaneous malakoplakia; leishmaniasis; histoplasmosis; lepromatous leprosy; rhinoscleroma; lymphogranuloma venereum; and granuloma inguinale.


Assuntos
Dermatite/patologia , Granuloma/patologia , Histiócitos/patologia , Humanos
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