[Pulmonary histiocytosis X. Report of a case and review of the literature]. / Histiocitosis X pulmonar. Presentación de un caso y revisión de la literatura.

Histiocytosis X or Langerhans cell histiocytosis is an infrequent disease, which consists on proliferation of Langerhans cells. The etiology is unknown. Diagnosis is reached by electron microscope study of the biopsy, in which the Birbeck intracytoplasmatic granules of the Langerhans cells are found and/or by immunohistochemistry procedures able to detect S-100 antigen and CD1 cells. Diagnosis can also be reached with a bronchoalveolar lavage in which CD1 cells will appear in a score higher than 5%. We present the case of a 16 year-old girl that first appeared with a pulmonary lesion with a honey comb X-ray pattern and unsyntomatic mandibular bone affectation. Diagnosis was reached by biopsy study using S-100 antigen detection procedures. We consider this case an important one due to the infrequency of this particular disease.

Histiocitosis X pulmonar. Presentacion de un caso y revision de la literatura / Pulmonary histiocytosis X. A case report and literature review

La histiocitosis X o histiocitosis de células de Langerhans es una enfermedad infrecuente, que consiste en la proliferación de células de Langerhans. Su causa es desconocida. Al diagnóstico se llega mediante el estudio de biopsia de la lesión por microscopía electrónica, detectándose los gránulos de Birbeck intracitoplasmáticos de las células de Langerhans, y/o mediante técnicas inmunohistoquímicas, que detecten la proteina S100 y las células CD1. También es diagnóstico un porcentaje mayor del 5 por ciento de células CD1 en el lavado broncoalveolar. Presentamos el caso de una paciente de 16 años, que se manifestó como una lesión pulmonar con un patrón radiológico en panal de miel y una afectación ósea mandibular asintomática. Al diagnóstico se llegó mediante el estudio de la biopsia pulmonar por técnicas de detección de proteína S100. Consideramos de interés este caso por la infrecuencia de esta enfermedad (AU)

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[Alkaline encrusted cystitis secondary to Proteus mirabilis infection in a HIV infected patient]. / Cistitis alcalina incrustante secundaria a infección por Proteus mirabilis en un paciente VIH.

We described for the first time an alkaline encrusting cystitis in a patient with the acquired immune deficiency. This is an entity characterized by severe dysuria and long standing urinary frequency, alkaline urine and radiographically visible calcification of the urinary bladder. It has been observed in patients with permanent Foley catheter, persistent infections due to microorganisms with urolytic activity, urinary bilharziosis or tuberculosis, or malignant bladder tumors. None of these entities were described and the patient had all conditions for this syndrome.

[Evaluation of Mycobacterium fortuitum acyltrehaloses in the serologic diagnosis of pulmonary tuberculosis]. / Evaluación de aciltrehalosas de Mycobacterium fortuitum en el diagnóstico serológico de tuberculosis pulmonar.

BACKGROUND: Several glycolipids of Mycobacterium tuberculosis are antigenic and their use in the serodiagnosis of pulmonary tuberculosis has been postulated. Acyltrehaloses (SL-IV) are among the strongest antigenic glycolipids of M. tuberculosis; similar compounds have been found in M. fortuitum. The aim of the present study was to evaluate the usefulness of the acyltrehaloses of M. fortuitum in the serodiagnosis of pulmonary tuberculosis. METHODS: Two glycolipids, identified as triacyl- (TAT-MF) and diacyl- (DAT-MF) trehaloses, were studied by an ELISA method. Two independent analyses were carried out. In the first one, IgG and IgM were determined in sera from patients with pulmonary tuberculosis (84-24 bacteriologically not confirmed--), healthy individuals (46) and patients with respiratory pathologies other than pulmonary tuberculosis (38), using TAT-MF. In the second one, IgG was determined in sera from pulmonary tuberculosis patients (34) and from healthy individuals (20), using DAT-MF. RESULTS: The sensitivity of the IgG ELISA using TAT-MF varied, according to the cut-off point, between 79.8 and 39.3%; the specificity values ranged between 83.3 and 98.8%. In sera from bacteriologically not confirmed pulmonary tuberculosis patients the sensitivity was 87.5-45.8%. The sensitivity for IgM was very low using TAM-MF (10.7-2.3%), with specificity values ranging from 77.4 to 100%. The sensitivity and specificity values of IgG using DAT-MF were, respectively, 34.3-9.3% and 90-100%. CONCLUSIONS: The IgG ELISA using TAT-MF has similar values of sensitivity and specificity to those reported for the acyltrehaloses of M. tuberculosis, although this antigen, by itself, can not be used in the serodiagnosis of pulmonary tuberculosis. DAT-MF has no value in the serodiagnosis of pulmonary tuberculosis.

[Pheochromocytoma: a motley tumor]. / Feocromocitoma: un tumor abigarrado.

Four patients admitted to our hospital with different symptomatology are studied: a 9-years-old boy with hyperhidrosis; a 47-years-old woman with arterial hypertension and two young males, 25 and 36-years-old, respectively, with thoracic pain. In all cases, the presence of pheochromocytoma was suspected. One of them died due to left ventricular failure with acute lung edema. The other three patients were diagnosed by hormonal determinations, detecting a supra-renal body with abdominal echography and computerized axial tomography and undergoing surgery. Currently, they are asymptomatic.

[Serodiagnosis in pulmonary tuberculosis. Clinical evaluation]. / Serodiagnóstico en la tuberculosis pulmonar. Valoración clínica.

The IgA, IgG, IgM and IgG subsets antibodies levels were determined in 200 patients with pulmonary tuberculosis and compared to three control groups: 80 healthy individuals (50 with negative PPD skin test, 30 with positive PPD skin test), 30 leprosy patients and 20 patients with different pulmonary diseases. The technique used was an enzyme linked assay. As antigens, purified tuberculin and Ag60 from M. bovis were used. There were not statistically significant differences between antibody levels among all control groups studied, but when we compare the level in control groups with that observed in tuberculous patients, they showed higher levels of IgA, IgG, IgM, IgG2 (p less than 0.01) and IgG4 (p less than 0.05). A definite diagnosis of tuberculosis of the lung should only be established if the patient showed to be positive to IgG plus IgA or IgM and in special cases to IgG1, reaching then a diagnostic efficacy of 90% in a patient population with a 68% of positive smears for acid-fast bacilli.

[Antibodies studied by the ELISA technique in 60 patients with pulmonary tuberculosis. Clinico-immunological correlation]. / Estudio de anticuerpos por la técnica de ELISA en 60 enfermos de tuberculosis pulmonar. Correlación clinicoinmunológica.

The levels of IgG and IgM antibodies were evaluated in 60 patients with pulmonary tuberculosis, who were compared with a group of 30 tuberculin-negative healthy controls and another group of 10 healthy tuberculin-positive individuals. The technique for the quantification of antibodies against M. tuberculosis was an enzyme immunoassay, using purified tuberculin as antigen. The mean (means) IgG and IgM values and their standard deviations (SD), expressed in optical density units, were as follows: for the tuberculin-negative control group: IgG 0.029 +/- 0.013, IgM 0.032 +/- 0.010; for the tuberculin-positive control group: IgG 0.023 +/- 0.007, IgM 0.033 +/- 0.012; and for the group of patients: IgG 0.054 +/- 0.016, IgM 0.051 +/- 0.017. Fifty per cent of patients (30) were positive for IgG, 46.6% (28) were positive for IgM and 28.3% (17) were positive for both immunoglobulins. Those values higher than the mean of control group plus two SD were considered as positive. In the group of tuberculous patients a significant increase of IgG was observed, which was more marked after two weeks of antituberculous chemotherapy in patients with prolonged course. There appears to be a good correlation between the levels of immunoglobulins and the clinical status.