Timoma e inmunodeficiencia en un niño / Thymoma and immunodeficiency in an infant

Las inmunodeficiencias primarias más frecuentes son las humorales, en las que predominan las deficiencias de anticuerpos, y entre éstas las inmunodeficiencias con timoma son raras. En este trabajo se presenta un paciente masculino de 3 años de edad, sin antecedentes familiares de inmunodeficiencia, que a los 21 días de nacido presentó varicela afebril. A partir de un año de edad comenzó a presentar episodios frecuentes de infecciones de vías respiratorias altas (faringoamigdalitis, rinitis purulenta), y bajas como neumonías, o reacciones alérgicas a las picadas de insectos que se infectaban secundariamente. Los estudios inmunológicos revelaron una disminución de las concentraciones séricas de IgG, IgA, (IgG 7.4 g/l, IgA 0.52 g/l), IgM normal (IgM 1g/l) y niveles elevados de IgE (>200u/ml). El estudio radiológico mostró en el mediastino anterior una masa relacionada con el timo. El paciente recibió tratamiento con factor de transferencia, gammaglobulina y se realizó la timectomia por videotoracoscopía. El estudio histológico evidenció un timoma linfocítico benigno. Los linfocitos T CD2+, CD3+, CD8+ estaban disminuidos en el preoperatorio, mientras que en el post operatorio los linfocitos CD2+, CD4+ estaban disminuidos y los CD8+ aumentados

The most frequent primary immunodeficiency is the humoral, where the deficiency of antibodies prevails; among these, the immunodeficiency with thymoma is rare. In this work, a 3- yearold male is presented, without family antecedents of immunodeficiency, which 21 days after birth presented Chicken pox without fever. In the first year of age, he began to present frequent episodes of infections of the upper and the lower respiratory tract: tonsillitis, purulent rhinitis, and pneumonias. He also presented an allergic reaction to insect bites that became infected secondarily. The immunologic studies revealed a decrease of the seric concentrations of IgG, IgA (IgG 7.4 g/l, IgA 0.52 g/l), normal IgM values (IgM 1 g/l) and high levels of IgE (> 200u/ ml). The amount of CD2+, CD3+ and CD8+ T lymphocytes were diminished pre surgery. After surgery, the levels of CD2+, and CD4+ lymphocytes were diminished and those of CD8+ lymphocytes increased. The radiological study showed an anterior, mediastinal mass related to the thymus. The patient received treatment with transfer factor, gammaglobulin and underwent resection of the thymoma for videothoracoscopy. The histology study evidenced a benign lymphocytic thymoma

[A simple kidney cyst in childhood]. / Quiste renal simple en la infancia.

OBJECTIVE: To report on a 6-year-old patient with an infected simple renal cyst. METHODS/RESULTS: A 6-year-old girl was admitted on three occasions for acute infectious syndrome and right lumboabdominal pain. The ultrasound scans showed a simple cyst in the right kidney which contained cellular elements. The patient was treated with antimicrobials on each occasion and the symptoms disappeared a few days later. On her third admission surgery was decided due to the recurrent clinical symptoms, a persistently high erythrocyte sedimentation rate and the presence of intracystic cellular elements, which raised the suspicion of intracystic abscess or tumor. The patient was submitted to surgery; the cyst was drained, resected and the internal wall marsupialized. The postoperative period was unremarkable and the patient is asymptomatic 10 months after surgery. CONCLUSION: The case described herein is uncommon; to our knowledge, a similar case has not been reported in the literature.

Environmental exposure to chromium compounds in the valley of León, México.

The effects on the environment and health of the operation of a chromate compounds factory and tanneries in the León valley in central México are discussed. Sampling and analysis of chromium were performed in water, soil, and human urine. Groundwater has been polluted in an area of about 5 km2 by the leaching of a solid factory waste, which results in concentrations up to 50 mg/l of hexavalent chromium. The plume shape and extension appear to be controlled by the prevailing well extraction regime. Total chromium was detected in the soil around the factory as a result of both aerial transport and deposition of dust produced in the chromate process and irrigation with tannery-contaminated water. Analysis of the impact of chromium in air and water on populations with various degrees of exposure revealed that highly harmful health effects were not observed.