Résumé
Abstract We describe the first report of a patient with chronic mucocutaneous candidiasis associated with disseminated and recurrent paracoccidioidomycosis. The investigation demonstrated that the patient had a mannose receptor deficiency, which would explain the patient's susceptibility to chronic infection by Candida spp. and systemic infection by paracoccidioidomycosis. Mannose receptors are responsible for an important link between macrophages and fungal cells during phagocytosis. Deficiency of this receptor could explain the susceptibility to both fungal species, suggesting the impediment of the phagocytosis of these fungi in our patient.
Sujets)
Humains , Blastomycose sud-américaine/complications , Blastomycose sud-américaine/diagnostic , Candidose mucocutanée chronique/complications , Candidose mucocutanée chronique/génétique , Récepteurs de surface cellulaire , Lectines de type C , Lectines liant le mannoseRésumé
La candidiasis mucocutánea crónica (CMC) es una inmunodeficienciaprimaria que se caracteriza por infecciones candidiásicaspersistentes o recurrentes en piel, uñas o membranas mucosas. La CMC puede asociarse con endocrinopatías, comohipoparatiroidismo, enfermedad de Addison, hipotiroidismo, diabetes mellitus de tipo 1 o hipogonadismo; otras patologías asociadas son enfermedades autoinmunitarias, como gastritis autoinmunitarias y hepatitis autoinmunitaria. Se presentauna paciente con CMC con déficit específico de linfocitos T ycélulas NK, sin otra enfermedad asociada.
Sujets)
Humains , Mâle , Femelle , Enfant , Maladies auto-immunes , Candida albicans , Candidose mucocutanée chronique/complications , Candidose mucocutanée chronique/diagnostic , Candidose mucocutanée chronique/étiologie , Candidose mucocutanée chronique/thérapie , Maladies endocriniennesRésumé
Chronic mucocutaneous candidiasis is a immuno deficiency disorder primarily due to T cell dysfunction characterized by persistent candidal infection of mucous membrane, skin, scalp and nails. Chronic mucous membrane candidiasis has an onset in infancy or childhood; the primary affected site is the oral cavity; however, lesions may occur on trunk, hands, feet and scalp. This paper describes a 12-year-old girl with candidial infection of the oral mucosa and extra oral involvement of fingers, nails, toes and intertragus area.
Sujets)
Antifongiques/usage thérapeutique , Auto-immunité , Candidose mucocutanée chronique/complications , Candidose buccale/traitement médicamenteux , Enfant , Femelle , Anomalies morphologiques acquises du pied/traitement médicamenteux , Anomalies morphologiques acquises de la main/traitement médicamenteux , Humains , Kétoconazole/usage thérapeutique , Onychopathies/traitement médicamenteux , RécidiveSujets)
Humains , Mâle , Adulte , Arthrite/étiologie , Candidose mucocutanée chronique/complications , Amphotéricine B/usage thérapeutique , Arthrite/complications , Arthrite/diagnostic , Arthrite/traitement médicamenteux , Candida albicans/isolement et purification , Candidose mucocutanée chronique/diagnostic , Candidose mucocutanée chronique/traitement médicamenteux , Injections articulaires/effets indésirables , Uvéite/étiologieRésumé
A ocorrência de candidíase mucocutânea crónica e hipoparatireoidismo (síndrome poliglandular auto-imune do tipo I) é descrita em uma paciente de 13 anos. Além de candidíase desde os 3 anos, apresentava convulsöes desde os 6 anos, cataraata aos 9 anos, alteraçöes dentárias e calcificaçöes dos gánglios da base. Os exame laboratoriais confirmaram o diagnóstico de hipoparatireoidismo. Este quadro era acompanhado por uma malabsorçäo intestinal, levando a paciente a um estado de desnutriçäo progressiva, com hipoalbuminemia importante e anemia. Embora a fisiopatologia da malabsorçäo, nesses casos, ainda näo esteja esclarecida, a resposta terapêutica à pancreatina, na presente observaçäo, foi sugestiva de haver insuficiência pancreática, mesmo porque a provada d-xilose foi normal e a biopsia do delgado inespressiva