RESUMO
Ten patients (5 males) affected by epilepsy with cerebral calcifications of unknown etiology mainly located in the posterior regions were subjected to a battery of tests including an intestinal biopsy. Our aim was to establish whether or not the patients also suffered from celiac disease. Celiac diseases was found in 6 patients. This result and the individual cases reported in the literature suggest that this triad of diseases (celiac disease, posterior cerebral calcifications and epilepsy) are casually related. The same HLA phenotype was found in all 10 patients, i.e., including the cases without celiac disease, suggesting an underlying disorder of the immune system. Our results emphasize that particular attention should be paid to a search for celiac disease in all patients with epilepsy and posterior cerebral calcifications.
Assuntos
Encefalopatias/complicações , Calcinose/complicações , Doença Celíaca/complicações , Epilepsia/complicações , Adolescente , Adulto , Encefalopatias/diagnóstico por imagem , Encefalopatias/dietoterapia , Calcinose/diagnóstico por imagem , Calcinose/dietoterapia , Doença Celíaca/dietoterapia , Dieta , Eletroencefalografia , Epilepsia/diagnóstico por imagem , Epilepsia/dietoterapia , Feminino , Glutens , Antígenos HLA/fisiologia , Humanos , Absorção Intestinal/fisiologia , Masculino , Fenótipo , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Nitric oxide (NO) play a pivotal role in many biological processes, as in the vessel tone control, the atherogenesis, the platelets aggregation and the immune system modulation. The physiologic precursor of NO is the L-arginine. Evidence exists that the L-arginine administration can stimulate immune system in children with recurrent infections. This clinical trial was designed to evaluate the effects of oral administration of L-arginine on the number of infective events and on the lymphocytes subsets in children suffering from airways recurrent infections. METHODS: Forty outpatients, 21 male and 19 female, aging from 2 to 13 yrs. Two balanced groups, treated for 60 days with L-arginine or a placebo. Evaluation criteria: number of septic episodes; number of circulating white blood cells, % of the lymphocytes; lymphocytes subsets. STATISTICAL ANALYSIS: Descriptive analysis; inference tests: chi 2; "t" test; variance analysis. Statistical significance: p = 0.05. RESULTS: Fifteen patients treated with L-arginine and five treated with placebo (p < 0.01) were free from infections. The percentage of CD3 and CD4 subsets significantly (p < 0.05) increased in the L-arginine group than in the placebo group, while the CD8 subset significantly decreased. The CD4/CD8 ratio raised from 1.05 +/- 0.29 to 1.51 +/- 0.46 (p < 0.01) in the L-arginine group, from 1.12 +/- 0.16 to 1.27 +/- 0.24 in the placebo group. There were no side effects in both groups. CONCLUSIONS: L-arginine seems able to increase the immune system defences and to protect against the airway infections.