RESUMO
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.
Assuntos
Adenocarcinoma Bronquioloalveolar/diagnóstico , Carcinoma Adenoide Cístico/diagnóstico , Infecções por HIV/diagnóstico , HIV-1 , Histiocitose de Células de Langerhans/diagnóstico , Pneumopatias/diagnóstico , Neoplasias Pulmonares/diagnóstico , Adenocarcinoma Bronquioloalveolar/patologia , Adulto , Biópsia , Carcinoma Adenoide Cístico/patologia , Progressão da Doença , Infecções por HIV/patologia , Histiocitose de Células de Langerhans/patologia , Humanos , Pneumopatias/patologia , Neoplasias Pulmonares/patologia , Masculino , Enfisema Pulmonar/diagnóstico , Enfisema Pulmonar/patologia , Fibrose Pulmonar/diagnóstico , Fibrose Pulmonar/patologia , Fumar/efeitos adversos , Toracoscopia , Tomografia Computadorizada por Raios XRESUMO
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).