RESUMEN
INTRODUCTION: Langerhans cell pulmonary histiocytosis is a rare disease, primarily enhanced by smoking, and of unclear mechanism. OBSERVATION: A 42 year-old man, smoking 25 packs-years, was infected by a type 1 human immunodeficiency virus (HIV-1). He successively developed pulmonary emphysema, Langerhans cell pulmonary histiocytosis and alveolar bronchial carcinoma of the lower right pulmonary lobe, which was fatal. DISCUSSION: We discuss the concomitance of pulmonary histiocytosis and alveolar bronchial carcinoma, exceptional in the literature, and the eventual enhancing role of HIV-1 infection. The principal incriminating factor in pulmonary histiocytosis probably remains smoking, but the HIV-1 infection may have participated in the emergence of the neoplastic pathology.
Asunto(s)
Adenocarcinoma Bronquioloalveolar/diagnóstico , Carcinoma Adenoide Quístico/diagnóstico , Infecciones por VIH/diagnóstico , VIH-1 , Histiocitosis de Células de Langerhans/diagnóstico , Enfermedades Pulmonares/diagnóstico , Neoplasias Pulmonares/diagnóstico , Adenocarcinoma Bronquioloalveolar/patología , Adulto , Biopsia , Carcinoma Adenoide Quístico/patología , Progresión de la Enfermedad , Infecciones por VIH/patología , Histiocitosis de Células de Langerhans/patología , Humanos , Enfermedades Pulmonares/patología , Neoplasias Pulmonares/patología , Masculino , Enfisema Pulmonar/diagnóstico , Enfisema Pulmonar/patología , Fibrosis Pulmonar/diagnóstico , Fibrosis Pulmonar/patología , Fumar/efectos adversos , Toracoscopía , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: Considering the importance to public health and the frequency with which drug addicts are imprisoned, we studied the prevalence of human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV), as well as drug addiction of patients admitted to the Elsau prison in Strasbourg (France). METHODS: The prospective study included all entering inmates from 1 September to 31 October 1997 (270 persons) to whom HIV, HBV and HCV blood tests were offered as well as a questionnaire on their drug addiction. RESULTS: Thirty-six percent of the entering inmates were drug addicts, of whom 1% were HIV positive, 11.2% HBV positive and 30% HCV positive, compared to, respectively, 0.6, 9.9 and 6.4% for non-drug addicts. Ninety-five of the 98 patients used several drugs, including buprenorphine for 53 patients. At the beginning of this study, buprenorphine had been available in France for 9 months. CONCLUSION: The results are to be taken seriously regarding the misuse of this product in this selected population (intravenous use, multiple drug use, dealing).
