RÉSUMÉ
AIM: To evaluate clinical, biological and immunological features of patients with increased duodenal intraepithelial lymphocytes (IELs), and its relation to Helicobacter pylori (HP) and coeliac disease (CD). METHODS: We have studied all patients accrued over a 4-year period with increased duodenal IELs. Those patients were recalled for biological and immunological evaluation and a second endoscopy. RESULTS: Twenty-three from a total of 639 patients were identified and 17 of them were included in the study. The median duodenal IEL count was 59 per 100 epithelial cells. Twelve (71%) patients were HP+; eight of them received HP eradication. At the second endoscopy the duodenal IEL count was significantly lower 2 months after HP eradication (73 versus 28), while the IEL count was unchanged in those patients seronegative for HP (n = 5) or those in whom it was not eradicated (n = 4) (55 versus 55). No patient had coeliac antibodies, four expressed HLA-DQ2, lower than in the general population, and the prevalence of CD was 2% (12/639 patients). CONCLUSION: In some cases an increased duodenal IEL count may be due to an inappropriate host response to HP. HP screening and eradication should be considered before recommending a gluten-free diet.
Sujet(s)
Antibactériens/usage thérapeutique , Duodénum/effets des médicaments et des substances chimiques , Infections à Helicobacter/traitement médicamenteux , Helicobacter pylori/effets des médicaments et des substances chimiques , Hyperlymphocytose/prévention et contrôle , Biopsie , Maladie coeliaque/complications , Maladie coeliaque/immunologie , Numération cellulaire , Duodénum/microbiologie , Duodénum/anatomopathologie , Endoscopie gastrointestinale , Épithélium/effets des médicaments et des substances chimiques , Épithélium/microbiologie , Épithélium/anatomopathologie , Femelle , Antigènes HLA-DQ/immunologie , Chaines bêta des antigènes HLA-DQ , Antigène HLA-DR4/immunologie , Infections à Helicobacter/complications , Infections à Helicobacter/microbiologie , Humains , Lymphocytes/anatomopathologie , Hyperlymphocytose/étiologie , Hyperlymphocytose/anatomopathologie , Mâle , Estomac/effets des médicaments et des substances chimiques , Estomac/microbiologie , Estomac/anatomopathologieRÉSUMÉ
We report a case of aspergillous bronchitis in an immunocompetent patient, recalling the clinical signs, laboratory findings and therapeutic management of this uncommon bronchopulmonary disorder related to aspergillus.
Sujet(s)
Aspergillose/complications , Aspergillose/immunologie , Aspergillus fumigatus , Bronchite/microbiologie , Immunocompétence/immunologie , Antifongiques/usage thérapeutique , Aspergillose/diagnostic , Aspergillose/traitement médicamenteux , Biopsie , Bronchoscopie , Toux/microbiologie , Fatigue/microbiologie , Fièvre/microbiologie , Humains , Itraconazole/usage thérapeutique , Mâle , Adulte d'âge moyenRÉSUMÉ
We report 3 cases of undifferentiated carcinomas of nasopharyngeal type (UCNT) found in unusual sites and compare them with histologically identical tumors found in the nasopharynx. Using viral serology and viral marquers found in the tumor cells, we looked for a link with the Epstein Barr Virus (EBV) which exists in the nasopharyngeal site. It appears that UCNT found in unusual sites have a poorer prognostic than the same nasopharyngeal tumors; no link was found with EBV. The number of published cases is too small to form a conclusion, therefore, we propose a systematic search for EBV, presenting our protocol, each time is discovered UCNT in an unusual site.
Sujet(s)
Carcinomes/anatomopathologie , Tumeurs de la tête et du cou/anatomopathologie , Sujet âgé , Carcinomes/secondaire , Carcinomes/virologie , Issue fatale , Infections à Herpesviridae/diagnostic , Herpèsvirus humain de type 4/isolement et purification , Humains , Tumeurs du larynx/anatomopathologie , Mâle , Adulte d'âge moyen , Tumeurs du rhinopharynx/anatomopathologie , Tumeurs du rhinopharynx/virologie , Pronostic , Tumeurs des tissus mous/anatomopathologie , Tumeurs de l'amygdale/anatomopathologie , Infections à virus oncogènes/diagnosticRÉSUMÉ
We report a case of cryptococcal chorioretinitis discovered at ophthalmological examination of a 68-year-old woman with acquired immune deficiency syndrome. This localization revealed cryptococcal septicemia, without involvement of the central nervous system unlike most cases reported. Therapy with fluconazole (400 mg per day) led to gradual regression of the chorioretinal lesion.