RESUMO
BACKGROUND: A clinical, histologic, immunohistochemical, serological and evolutive review was carried out in 12 cases of Kaposi's sarcoma, representing 5.5% (12/217) of the HIV positive patients consecutively seen during an 18 month period. METHODS: The patients were clinically examined and staging was assessed. Skin biopsy was performed in all cases, and of healthy perilesional skin in eight, with HE and Perls stains. Immunohistochemical study of the skin lesions was carried out with monoclonal anti-collagen, anti-laminin, anti-HLA-DR, OKM5 and UEA-I antibodies. Statistical analysis was carried out with chi-square and Student's tests. RESULTS: There were 11 homosexual males and a prostitute parenteral drugs addicted female. The clinical presentation spectrum ranged from a single longitudinal lesion to multiple disseminated lesions in the whole skin and mucosae. Visceral or lymph node involvement was shown in three cases. Histological study also showed a spectrum of lesions from initial endothelial proliferation in perilesional healthy skin areas to mixed fusocellular and endothelial proliferation in nodular lesions. The immunohistochemical study with the appropriate monoclonal antibodies demonstrated the endothelial origin of cellular components. Some laboratory parameters (beta-2-microglobulin, total lymphocytes/mm3, total CD4 cells/mm3) were useful for prognostic evaluation at the time of diagnosis. CONCLUSIONS: KS associated with HIV infection is a vascular hyperplasia of endothelial origin virtually exclusive of homosexual males. Although the diagnose of KS does not determine by itself the vital prognosis of these patients, some laboratory parameters at the time of diagnosis are useful for the prognosis of HIV infection.
Assuntos
Infecções por HIV/complicações , Sarcoma de Kaposi/etiologia , Neoplasias Cutâneas/etiologia , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Feminino , Soropositividade para HIV/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Sarcoma de Kaposi/diagnóstico , Sarcoma de Kaposi/patologia , Pele/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/patologiaRESUMO
We study 37 children with mothers infected by human immunodeficiency virus type 1 (HIV-1) at birth and over the following three years. HIV-1 serology of these patients is reported, i.e., HIV-1 antigen p24 and antibodies using two commercially available enzymatic methods and Western blot. Throughout follow-up, IgG antibodies to HIV-1 showed a statistically significant tendency to decrease (p less than 0.001). After 12 months, 70% of the children lacked HIV-1 antibody banding by Western blot; this was taken to constitute a definitive criterion of lack of antibodies to HIV-1. Five children presented p24 antigenemia during the study, four persistently so. Of the patients over 18 months of age, 8 presented HIV-1 infection symptoms (30.7%), and three suffered AIDS (11.5%).
Assuntos
Síndrome da Imunodeficiência Adquirida/transmissão , Soropositividade para HIV , HIV-1/imunologia , Síndrome da Imunodeficiência Adquirida/imunologia , Pré-Escolar , Feminino , Anticorpos Anti-HIV/imunologia , Humanos , Lactente , Recém-Nascido , Masculino , Troca Materno-Fetal , GravidezRESUMO
The authors value the parameters of diagnostic efficacy in a preliminary study of anti-endomysium antibodies (EmA), in the diagnostic and follow-up of patients with gluten sensitive enteropathy. The study was made with 84 subjects distributed into four groups. Group I consisted of 21 patients with gluten sensitive enteropathy (GSE) who were eating gluten at the time of diagnosis. Group II consisted of 20 patients with gluten sensitive enteropathy with different periods of time of gluten free diet. Group III consisted of 16 subjects with non-evolutive neuropathies and without intestinal disease. This group was considered as controls. Group IV consisted of 27 patients with toddler diarrhoea. The sensitivity, specificity, positive predictive value, negative predictive value and efficiency were 100%.