Nasal eosinophilic angiocentric fibrosis with IgG4-positive plasma cell infiltration.

INTRODUCTION: Eosinophilic angiocentric fibrosis (EAF) is a rare lesion that predominantly affects the upper respiratory tract. Its etiology is unknown and it has been recently associated with the IgG4- related disease (IgG4-RD) spectrum. To the author's knowledge, this is the sixth case report of the relationship between EAF and IgG4-RD. CASE REPORT: We report the case of a 37-year-old woman with nasal deformity and facial pain. The lesion was surgically excised. Histological examination revealed features of EAF with an IgG4/IgG plasma cell ratio ≷73% and 31 IgG4 stained cells per high power field. No clinical or radiological recurrence was detected during follow-up. Serum IgG4 quantification one year after surgery was within normal limits. DISCUSSION: The relationship between both entities may have therapeutic impact because IgG4-RD of the head and neck has a high remission rate with corticosteroids and immunosuppressive therapy. Additional reports of this infrequent disease are necessary to elucidate appropriate treatment and prognosis.

Increased detection of latent tuberculosis by tuberculin skin test and booster phenomenon in early rheumatoid arthritis patients.

The incidence of tuberculosis (TB) in rheumatoid arthritis (RA) patients is up to four times higher when compared to the general population, but their risk increases with the use of TNF-a drugs. Appropriate screening of latent tuberculosis infection (LTBI) and proper management of such cases substantially reduce the incidence of active TB. Tuberculin skin test (TST) is a widely used method for the detection of LTBI. The time of diagnosis of RA as well as the age of the patient might modify the TST performance. We did an observational, comparative study of RA patients with early and established disease, with the objective to know the prevalence of LTBI using the TST and booster test; an induration ≥5 mm was considered reactive. We evaluated 143 patients (83 [58 %] early RA patients). We found 31.3 and 21.7 % TST positivity in early and established RA patients, respectively. With the use of booster test, the positivity increased to 46.5 and 28.8 %, respectively (p = 0.048, OR 1.33, 95 % CI 1.01-1.75). In conclusion, we found that TST and booster test increased LTBI detection in early RA patients, which may suggest that time of RA diagnosis might affect cellular immunity and therefore the TST response.

[Antigens of the human immunodeficiency virus in serum of high risk people in the city of Monterrey]. / Antígenos del virus de inmunodeficiencia humana en el suero de personas del grupo de alto riesgo de la ciudad de Monterrey.

One hundred forty human sera distributed in 2 groups were analyzed. In group I, 50 serum samples from healthy individuals that did not belong to the high-risk acquired immune deficiency syndrome (AIDS) population were included. In group II, there were 90 individuals, most of whom were apparently healthy but were at high risk of getting AIDS through their life styles or by transfusion. Of the 90 persons, 5 had a clinical picture of AIDS. All sera were analyzed by the enzyme - linked immunosorbent assay (ELISA) for the anti VIH antibodies. The positive cases were confirmed by the Western blot assay. In all samples the presence of the human immune deficiency virus antigens was sought. The results showed that the 50 healthy individuals (control group) were negative for both HIV antigens and antibodies. Of the 90 sera for the high-risk group, 50 were negative for antibodies, and 2 of them (4%) were positive for HIV antigens. Forty sera were positive for anti HIV antibody and among them, 5 patients were diagnosed as AIDS, and showed positive for antigen and antibody. The other 35 patients were all positive for HIV antibody and in 8 of them HIV antigen was also present.

A multi-systemic disease (lupus-like) preceding bronchioloalveolar carcinoma.

A patient with a multi-systemic disease (lupus-like) that preceded the onset of a bronchioloalveolar carcinoma is described, and a brief review of the literature is presented. We suggest that this tumor be listed among the neoplasms responsible for multi-systemic diseases with lupus-like characteristics.

Joint contractures and scleroderma-like skin changes in the hands of insulin-dependent juvenile diabetics.

We studied 34 unselected insulin-dependent juvenile diabetics by seeking contractures at the proximal interphalangeal (PIP) joints and scleroderma-like changes of the hands or elsewhere. We found 14 contractures of only the 5th PIP in 7 and of the PIP of other fingers as well in the others. Nine of these patients also had scleroderma-like skin changes. Only one of 34 age and sex matched healthy controls had a minimal contracture of the 5th PIP joint but had no skin changes. All patients found to have these abnormalities had had diabetes for 6 or more years and the difference in the disease duration between those with hand changes and those without was significant (p less than 0.01). There was no correlation of these changes with renal or ocular vascular changes in this small group of patients.

La funcion de los receptores de la histamina H1 y H2 en la respuesta inmune. / The function of H1 and H2 histamine receptors in the immune response

El conocimiento de las diferentes acciones farmacologicas de la histamina en el ser humano, justifican el empleo de sus antagonistas en la practica clinica, principalmente el de la cimetidina, en trastornos gastrointestinales. Sin embargo, poco sabemos acerca de sus efectos secundarios en la respuesta inmune. Por tal motivo, se plantea la necesidad de revisar las evidencias experimentales sobre los dos receptores de la histamina, su distribucion en tejidos y linfocitos, sus bloqueadores especificos y su participacion en la inmunorregulacion. Se proponen tres modelos hipoteticos de la accion farmacologica de la histamina en la respuesta inmune