Subject(s)
Antibodies, Bacterial/immunology , Antibody Formation/immunology , Immunologic Deficiency Syndromes/immunology , Polysaccharides, Bacterial/immunology , Salmonella typhi/immunology , Typhoid-Paratyphoid Vaccines/immunology , Adult , Agammaglobulinemia/immunology , Aged , Common Variable Immunodeficiency/immunology , Enzyme-Linked Immunosorbent Assay , Female , Host-Pathogen Interactions/drug effects , Host-Pathogen Interactions/immunology , Humans , Immunoglobulin G/immunology , Male , Middle Aged , Prospective Studies , Salmonella typhi/physiology , Typhoid Fever/immunology , Typhoid Fever/microbiology , Typhoid Fever/prevention & control , Typhoid-Paratyphoid Vaccines/administration & dosage , Vaccination/methods , Young AdultABSTRACT
AIMS: Several studies have suggested that abnormalities in the small-intestinal microbiota might be involved in the development or the pathogenesis of celiac disease (CD). The objective of this study was to characterize and compare the composition of the duodenal microbiota between CD patients and non-CD controls. METHOD AND RESULTS: Bacterial communities were identified by pyrosequencing of 16S rRNA extracted from duodenal biopsies. The sequences analysis showed that the majority of the reads were classified within two phyla: Firmicutes and Proteobacteria. Bacterial richness and diversity were higher in non-CD controls than in untreated CD patients, but the differences were not statistically significant. The principal coordinates analysis revealed that bacterial communities of non-CD controls and untreated CD patients were dispersed without forming a clear group according to diagnosis of CD. CONCLUSIONS: There are no statistically significant differences in the upper small intestinal composition of bacterial communities between untreated CD patients and non-CD controls. SIGNIFICANCE AND IMPACT OF THE STUDY: This pyrosequencing analysis reveals a global picture of the duodenal microbiota that could be useful in future trials investigating the role of the microbiota in CD.
Subject(s)
Bacteria/isolation & purification , Celiac Disease/microbiology , Duodenum/microbiology , Gastrointestinal Microbiome , RNA, Ribosomal, 16S/genetics , Adult , Bacteria/classification , Bacteria/genetics , Case-Control Studies , Female , Humans , Intestine, Small/microbiology , Male , Middle AgedABSTRACT
La linfohistiocitosis hemofagocítica es un síndrome clinicopatológico de evolución potencialmente fatal, en el que una respuesta inmune no controlada e ineficaz conduce a hiperinflamación. Puede aparecer como una enfermedad familiar o esporádica, asociado a diferentes factores desencadenantes: infecciones, neoplasias, enfermedades autoinmunes o inmunodeficiencias adquiridas, pero la asociación más consistente es con infecciones virales, especialmente el virus de Epstein-Barr. Las principales características clínicas son fiebre, disfunción hepática, coagulopatía y pancitopenia. El diagnóstico es difícil debido a la rareza de este síndrome y a la falta de especificidad de los hallazgos clínicos, sin embargo, un diagnóstico y tratamiento precoces son importantes para disminuir la mortalidad. El tratamiento debe ser dirigido al control de la enfermedad subyacente y a suprimir la respuesta inflamatoria exagerada mediante el uso de inmunosupresores (AU)
Hemophagocytic lymphohistiocytosis is a frequently fatal clinicopathologic syndrome in which an uncontrolled and ineffective immune response leads to severe hyperinflammation. It may occur as either a familial disorder or a sporadic condition in association with a variety of triggers: infections, malignancies, autoimmune diseases, and acquired immune deficiencies. However, the most consistent association is with viral infections, especially Epstein-Barr virus. The main clinical features are fever, liver dysfunction, coagulation abnormalities and pancytopenia. Early diagnosis and treatment are important to reducing mortality, but the diagnosis is difficult because of the rarity of the syndrome and the lack of specificity of the clinical findings. Treatment should be directed towards treating the underlying disease and to suppressing the exaggerated inflammatory response through the use of immunosuppressive agents (AU)
Subject(s)
Humans , Male , Female , Lymphohistiocytosis, Hemophagocytic/complications , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/physiopathology , Virus Diseases/complications , Virus Diseases/diagnosis , Perforin , Epstein-Barr Virus Infections/complications , Epstein-Barr Virus Infections/diagnosis , Immunosuppressive Agents/therapeutic use , Lymphohistiocytosis, Hemophagocytic/mortality , Virus Diseases/mortality , Virus Diseases/physiopathology , Fever/complications , Fever/etiology , Liver Diseases/complications , Pancytopenia/complications , Blood Coagulation Disorders/complicationsABSTRACT
Hemophagocytic lymphohistiocytosis is a frequently fatal clinicopathologic syndrome in which an uncontrolled and ineffective immune response leads to severe hyperinflammation. It may occur as either a familial disorder or a sporadic condition in association with a variety of triggers: infections, malignancies, autoimmune diseases, and acquired immune deficiencies. However, the most consistent association is with viral infections, especially Epstein-Barr virus. The main clinical features are fever, liver dysfunction, coagulation abnormalities and pancytopenia. Early diagnosis and treatment are important to reducing mortality, but the diagnosis is difficult because of the rarity of the syndrome and the lack of specificity of the clinical findings. Treatment should be directed towards treating the underlying disease and to suppressing the exaggerated inflammatory response through the use of immunosuppressive agents.
ABSTRACT
Acute generalized exanthematous pustulosis (AGEP) is a rare, severe, pustular, cutaneous reaction. We report a case in which a patient developed AGEP after the intake of 3 different antitussive agents containing dextromethorphan as the only ingredient in common.
Subject(s)
Acute Generalized Exanthematous Pustulosis/etiology , Antitussive Agents/adverse effects , Dextromethorphan/adverse effects , Acute Generalized Exanthematous Pustulosis/pathology , Adult , Diagnosis, Differential , Female , Humans , Psoriasis/diagnosisABSTRACT
Objetivo: Describir el grado de coincidencia con el diagnóstico de presunción así como los resultados clínicos obtenidos a largo plazo tras el tratamiento antituberculoso (ATT) en un grupo de pacientes con uveítis tuberculosas presuntas (UTBP) que afectaban al segmento posterior. Métodos: Estudio retrospectivo. Serie de pacientes. Resultados: Se incluyeron a 17 pacientes con distintos tipos de uveítis del segmento posterior, crónicas, refractarias o de reciente diagnóstico y diversas manifestaciones clínicas, en los que, tras establecerse el diagnóstico de UTBP, se completó ATT. La media de seguimiento fue de 34 meses (rango 2-60). Hubo control de la inflamación en 14/17 pacientes (82,3%) durante el periodo de tratamiento y solo 4/17 pacientes (23,5%) experimentaron una recidiva de su enfermedad a lo largo del periodo de seguimiento tras ATT. Todos los pacientes que sufrieron recidivas (4/4), pero ninguno de los que no las sufrieron (0/13) requirieron terapia inmunosupresora de algún tipo tras ATT. La respuesta al ATT sirvió para confirmar el diagnóstico de UTBP en 14/17 pacientes (82,3%). Conclusiones: En pacientes con sospecha de UTBP que afecta al segmento posterior, el ATT puede ser una eficaz medida para confirmar el diagnóstico y resolver el cuadro inflamatorio. En este contexto, el ATT puede ofrecer otras potenciales ventajas como prevenir futuras reactivaciones de tuberculosis secundarias a tratamiento inmunosupresor o disminuir la frecuencia o la severidad de recaídas en algunos pacientes. La confirmación de estas y otras ventajas requiere trabajos prospectivos, aleatorizados con mayor número de pacientes (AU)
Objective: To determine the level of agreement with the presumed diagnosis and long term clinical outcomes after antituberculous therapy (ATT) in a group of patients with presumed tuberculous uveitis (PTU) affecting the posterior segment. Methods: Retrospective case series. Results: A total of 17 patients with chronic refractory or newly diagnosed uveitis affecting the posterior segment were included. All included patients were diagnosed with PTU and received ATT. Median follow-up after ATT was 34 months (range 2-60). Complete control of inflammation was observed in 14/17 patients (82.3%) during the treatment period, and only 4/17 patients (23.5%) had a uveitis relapse over the entire follow-up period after ATT. All patients who had uveitis relapses (4/4), but none from the remaining group (0/13), required immunosuppressive therapy of some kind after ATT. The response to ATT was able to confirm diagnosis of PTU in 14/17 (82.3%) included patients. Conclusion: When a clinical suspicion of PTU affecting the posterior segment exists, ATT may be highly effective for both confirming the diagnosis and resolving the inflammatory process. Thus, ATT may offer additional advantages, such as preventing latent-tuberculosis reactivations due to immunosuppressive therapy, and decreasing the number and/or severity of uveitis relapses in some patients. Prospective, randomized studies including a larger number of patients are required to support these and other potential advantages of ATT in such patients (AU)
Subject(s)
Humans , Uveitis, Posterior/drug therapy , Tuberculosis, Ocular/drug therapy , Mycobacterium tuberculosis/pathogenicity , Choroiditis/etiology , Antitubercular Agents/therapeutic use , Retrospective StudiesABSTRACT
OBJECTIVE: To determine the level of agreement with the presumed diagnosis and long term clinical outcomes after antituberculous therapy (ATT) in a group of patients with presumed tuberculous uveitis (PTU) affecting the posterior segment. METHODS: Retrospective case series. RESULTS: A total of 17 patients with chronic refractory or newly diagnosed uveitis affecting the posterior segment were included. All included patients were diagnosed with PTU and received ATT. Median follow-up after ATT was 34 months (range 2-60). Complete control of inflammation was observed in 14/17 patients (82.3%) during the treatment period, and only 4/17 patients (23.5%) had a uveitis relapse over the entire follow-up period after ATT. All patients who had uveitis relapses (4/4), but none from the remaining group (0/13), required immunosuppressive therapy of some kind after ATT. The response to ATT was able to confirm diagnosis of PTU in 14/17 (82.3%) included patients. CONCLUSION: When a clinical suspicion of PTU affecting the posterior segment exists, ATT may be highly effective for both confirming the diagnosis and resolving the inflammatory process. Thus, ATT may offer additional advantages, such as preventing latent-tuberculosis reactivations due to immunosuppressive therapy, and decreasing the number and/or severity of uveitis relapses in some patients. Prospective, randomized studies including a larger number of patients are required to support these and other potential advantages of ATT in such patients.
Subject(s)
Antitubercular Agents/therapeutic use , Tuberculosis, Ocular/drug therapy , Uveitis, Posterior/drug therapy , Anti-Bacterial Agents/therapeutic use , Drug Therapy, Combination , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Isoniazid/therapeutic use , Panuveitis/diagnosis , Panuveitis/drug therapy , Pyrazinamide/therapeutic use , Recurrence , Remission Induction , Retrospective Studies , Rifampin/therapeutic use , Treatment Outcome , Tuberculosis, Ocular/diagnosis , Uveitis, Posterior/diagnosisABSTRACT
Caso clínicoSe presentan cuatro casos de pacientes con deterioro de agudeza visual y lesiones retinocoroideas compatibles con toxoplasmosis ocular en los que el diagnóstico de retinocoroiditis toxoplásmica activa o membrana neovascular coroidea se basó en un cribaje diagnóstico específicamente diseñado para ello.DiscusiónEn el contexto de un cuadro clínico compatible, con cicatrices coriorretinianas sugestivas e inflamación escasa o ausente, las membranas coroideas neovasculares pueden simular cuadros de retinocoroiditis toxoplásmica activa y viceversa. Un exhaustivo estudio oftalmológico, serológico e inmunológico (del humor acuoso) puede facilitar el diagnóstico, permitiendo una adecuada toma de decisión terapéutica(AU)
Clinical caseWe report four patients with both decreased visual acuity and retinochoroidal lesions compatible with ocular toxoplasmosis in which a diagnosis of active toxoplasmic retinochoroiditis or choroidal neovascular membrane was made based on a specifically designed diagnostic screening.DiscussionIn the context of a compatible clinical picture, with retinochoroidal scars and low grade or absence of inflammation, choroidal neovascular membranes may mimic active toxoplasmic retinochoroiditis and vice-versa. A thorough ophthalmic, serological, and immunological examination (in ocular fluids) may help in the differential diagnosis allowing for proper therapeutic decision-making(AU)
Subject(s)
Humans , Female , Adult , Choroiditis/pathology , Choroidal Neovascularization/etiology , Toxoplasmosis, Ocular/complications , Uveitis/etiology , Antibodies, Monoclonal/therapeutic useABSTRACT
CLINICAL CASE: We report four patients with both decreased visual acuity and retinochoroidal lesions compatible with ocular toxoplasmosis in which a diagnosis of active toxoplasmic retinochoroiditis or choroidal neovascular membrane was made based on a specifically designed diagnostic screening. DISCUSSION: In the context of a compatible clinical picture, with retinochoroidal scars and low grade or absence of inflammation, choroidal neovascular membranes may mimic active toxoplasmic retinochoroiditis and vice-versa. A thorough ophthalmic, serological, and immunological examination (in ocular fluids) may help in the differential diagnosis allowing for proper therapeutic decision-making.
Subject(s)
Antibodies, Protozoan/blood , Chorioretinitis/diagnosis , Choroidal Neovascularization/diagnosis , Toxoplasma/immunology , Toxoplasmosis, Ocular/diagnosis , Adult , Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Antibodies, Monoclonal, Humanized , Bevacizumab , Chorioretinitis/blood , Chorioretinitis/complications , Chorioretinitis/drug therapy , Chorioretinitis/pathology , Choroidal Neovascularization/blood , Choroidal Neovascularization/drug therapy , Choroidal Neovascularization/etiology , Cicatrix/etiology , Cicatrix/pathology , Coccidiostats/therapeutic use , Diagnosis, Differential , Female , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Macula Lutea/pathology , Macular Edema/etiology , Male , Recurrence , Toxoplasmosis, Ocular/blood , Toxoplasmosis, Ocular/complications , Toxoplasmosis, Ocular/drug therapy , Toxoplasmosis, Ocular/pathology , Visual Acuity , Young AdultABSTRACT
CLINICAL CASE: We report the case of a 74-year-old female who developed a necrotizing sclerokeratitis affecting her left eye after uncomplicated cataract surgery. She had no previous history of systemic autoimmune disease. Histopathology of the lesion revealed necrotic granulomatosis with an increased number of plasma cells. DISCUSSION: Surgically induced necrotizing sclerokeratitis (SINS) is a serious entity which requires prompt and aggressive therapy to prevent its potential devastating ocular consequences. Conjunctival resection and amniotic membrane grafting may be necessary to temporarily interrupt local immunologic events in severe cases. However, associated systemic immunomodulatory therapy seems to be mandatory (Arch Soc Esp Oftalmol 2009; 84: 577-580).
Subject(s)
Amnion/transplantation , Immunosuppressive Agents/therapeutic use , Keratitis/therapy , Postoperative Complications/therapy , Scleral Diseases/therapy , Aged , Combined Modality Therapy , Female , Humans , Keratitis/etiology , Keratitis/pathology , Necrosis , Postoperative Complications/etiology , Remission Induction , Scleral Diseases/etiology , Scleral Diseases/pathologyABSTRACT
Caso clínico: Presentamos el caso de una mujer de74 años que desarrolló una escleroqueratitis necrotizanteen su ojo izquierdo tras cirugía de cataratano complicada. No tenía antecedentes de enfermedadautoinmune sistémica. El análisis histopatológicode la lesión mostró granulomatosis necrotizantecon abundantes células plasmáticas.Discusión: La escleroqueratitis necrotizante inducidapor cirugía (ENIC) es una grave afección querequiere tratamiento precoz y agresivo tratando deprevenir sus potencialmente devastadoras consecuencias.La resección conjuntival junto conimplante de membrana amniótica pueden ser necesariaspara interrumpir temporalmente el procesoinmunológico local. No obstante, es esencial asociarun tratamiento inmunosupresor sistémico(AU)
Clinical case: We report the case of a 74-year-oldfemale who developed a necrotizing sclerokeratitisaffecting her left eye after uncomplicated cataractsurgery. She had no previous history of systemicautoimmune disease. Histopathology of the lesionrevealed necrotic granulomatosis with an increasednumber of plasma cells.Discussion: Surgically induced necrotizing sclerokeratitis(SINS) is a serious entity which requiresprompt and aggressive therapy to prevent its potentialdevastating ocular consequences. Conjunctivalresection and amniotic membrane grafting may benecessary to temporarily interrupt local immunologicevents in severe cases. However, associated systemicimmunomodulatory therapy seems to be mandatory(AU)
Subject(s)
Humans , Female , Aged , Scleritis , Scleritis/diagnosis , Scleritis/etiology , Scleritis/surgery , Scleritis/therapy , Amnion/transplantation , Immunosuppressive Agents , Cataract , Cataract Extraction , Cataract Extraction/adverse effects , Uveitis , Intraoperative Complications , Intraoperative Complications/therapyABSTRACT
CASE REPORT: The case of a 64-year-old patient with bilateral, progressive and painless diminution of visual acuity is presented. Ophthalmologic evaluation revealed optic neuritis and vitreous cells in both eyes, at different stages. Suspecting a paraneoplastic optic neuritis, the study of antibodies was requested. This showed positivity to the marker CRMP-5-IgG. After mediastinoscopy, a small cell lung carcinoma was diagnosed. DISCUSSION: Autoantibody CRMP-5-IgG defines a paraneoplastic entity of combined optic neuritis and vitreous inflammatory cells. The serological positivity avoids the vitreous biopsy and expedites the search for cancer. In our case, it allowed the diagnosis a previously unidentified tumor.
Subject(s)
Autoantibodies/analysis , Carcinoma, Small Cell/complications , Immunoglobulin G/analysis , Lung Neoplasms/complications , Nerve Tissue Proteins/analysis , Optic Neuritis/diagnosis , Optic Neuritis/etiology , Paraneoplastic Syndromes/diagnosis , Paraneoplastic Syndromes/etiology , Humans , Hydrolases , Male , Microtubule-Associated Proteins , Middle AgedABSTRACT
Antecedentes: Los anticuerpos antitransglutaminasa tisular IgA (ATGA) se han propuesto como una prueba válida para el diagnóstico y el seguimiento de la enfermedad celíaca. Objetivo: Comparar la eficacia de los ATGA con los distintos anticuerpos clásicamente utilizados en el diagnóstico. Material y método: Se seleccionó a los pacientes sometidos a una biopsia duodenal por sospecha de enfermedad celíaca y a los que simultáneamente se realizó una serología completa en el momento del diagnóstico, en la que se incluyó anticuerpos antiendomisio IgA, ATGA, antigliadina IgG e IgA. Se estableció el valor diagnóstico de cada uno de ellos en función del diagnóstico final, se tomó como patrón la biopsia intestinal. Resultados: Se seleccionó a 122 pacientes con biopsia duodenal y marcadores serológicos para enfermedad celíaca; 36 eran niños (< 14 años) y 86 eran adultos. Se diagnosticó 41 casos, de los que 26 eran niños y 15 adultos. De los 15 adultos solamente 2 (13%) presentaban una clínica de malabsorción típica. La sensibilidad y la especificidad de los ATGA fueron del 100 y el 98%, respectivamente, comparadas con las de los anticuerpos antiendomisio IgA (el 97 y el 98%), de la antigliadina IgA (el 85 y el 97%) y de la antigliadina IgG (el 97 y el 92%). Conclusiones: Los ATGA presentan un elevado rendimiento diagnóstico en la enfermedad celíaca. Pueden ser de utilidad como prueba de cribado para seleccionar a los candidatos a biopsia duodenal
Background: Anti-transglutaminase antibodies have been proposed as a useful tool in the diagnosis and follow-up of celiac disease. Aim: To compare anti-transglutaminase antibodies with the classical antibodies used to diagnose celiac disease. Material and method: Patients who underwent duodenal biopsy for suspected celiac disease were selected if they had the following serum antibody samples: antiendomysial IgA, anti-transglutaminase IgA, antigliadin IgG, and antigliadin IgA. A diagnostic value of each of these antibodies was established according to the final diagnosis, taking the duodenal biopsy as the reference. Results: One hundred twenty-two patients with duodenal biopsy and serologic markers for celiac disease were selected. Thirty-six patients were children (< 14 years-old) and 86 were adults. A diagnosis of celiac disease was made in 41 patients (26 children and 15 adults). Of the 15 adults, only 2 (13%) presented typical malabsorption syndrome. The sensitivity and specificity of anti-transglutaminase antibodies was 100% and 98% respectively compared with values of 97% and 98% for antiendomysial IgA, 85% and 97% for antigliadin IgA, and 97% and 92% for antigliadin IgG antibodies. Conclusions: The diagnostic value of anti-transglutaminase antibodies is high in celiac disease. These antibodies may be useful as a screening test to select candidates for duodenal biopsy
Subject(s)
Humans , Autoantibodies/immunology , Autoantigens/immunology , Celiac Disease/diagnosis , Immunoglobulin A/immunology , Transglutaminases/immunology , GTP-Binding Proteins/immunology , Antibody Specificity , Atrophy , Biopsy , Celiac Disease/immunology , Celiac Disease/pathology , Duodenum/pathology , Gliadin/immunology , Hyperplasia , Immunoglobulin G/immunology , Muscle Fibers, Skeletal/immunology , Muscle Fibers, Skeletal/ultrastructure , Sensitivity and Specificity , Predictive Value of TestsABSTRACT
BACKGROUND: Anti-transglutaminase antibodies have been proposed as a useful tool in the diagnosis and follow-up of celiac disease. AIM: To compare anti-transglutaminase antibodies with the classical antibodies used to diagnose celiac disease. MATERIAL AND METHOD: Patients who underwent duodenal biopsy for suspected celiac disease were selected if they had the following serum antibody samples: antiendomysial IgA, anti-transglutaminase IgA, antigliadin IgG, and antigliadin IgA. A diagnostic value of each of these antibodies was established according to the final diagnosis, taking the duodenal biopsy as the reference. RESULTS: One hundred twenty-two patients with duodenal biopsy and serologic markers for celiac disease were selected. Thirty-six patients were children (< 14 years-old) and 86 were adults. A diagnosis of celiac disease was made in 41 patients (26 children and 15 adults). Of the 15 adults, only 2 (13%) presented typical malabsorption syndrome. The sensitivity and specificity of anti-transglutaminase antibodies was 100% and 98% respectively compared with values of 97% and 98% for antiendomysial IgA, 85% and 97% for antigliadin IgA, and 97% and 92% for antigliadin IgG antibodies. CONCLUSIONS: The diagnostic value of anti-transglutaminase antibodies is high in celiac disease. These antibodies may be useful as a screening test to select candidates for duodenal biopsy.
Subject(s)
Autoantibodies/immunology , Autoantigens/immunology , Celiac Disease/diagnosis , GTP-Binding Proteins/immunology , Immunoglobulin A/immunology , Transglutaminases/immunology , Adult , Antibody Specificity , Atrophy , Biopsy , Celiac Disease/immunology , Celiac Disease/pathology , Child , Child, Preschool , Duodenum/pathology , Female , Gliadin/immunology , Humans , Hyperplasia , Immunoglobulin G/immunology , Infant , Male , Middle Aged , Muscle Fibers, Skeletal/immunology , Muscle Fibers, Skeletal/ultrastructure , Predictive Value of Tests , Protein Glutamine gamma Glutamyltransferase 2 , Sensitivity and SpecificityABSTRACT
Introducción: La infección urinaria es una patología muy frecuente en niños, y su diagnóstico y tratamiento precoces dependen de la sospecha clínica y la aplicación de parámetros analíticos. Algunas citocinas han despertado un gran interés en este terreno. Objetivo: Conocer los niveles de las interleucinas (IL) 6 y 8 en sangre y orina en niños sanos, y establecer el rango de normalidad de nuestro laboratorio. Material y métodos: Estudio observacional transversal, descriptivo y analítico, en niños sanos sin infección urinaria. Se analizan las variables sexo, edad, niño mayor o menor de 1 año, y nivel de IL 6 y 8 en sangre y orina (mediante ELISA). Se calcula la estadística básica de las variables cuantitativas. La comparación entre muestras independientes se llevó a cabo con el test U de Mann-Whitney, y la correlación entre las mismas con el test de Pearson. Se consideró un error alfa del 5% (SPSS 9.0). El límite superior de normalidad de las IL se estableció en la media más 2 desviaciones estándar (95% de la población). Resultados: Estudiamos 52 niños (40 varones, 76,92%) con una edad media de 51,31 + 47,98 meses (1-149 meses), sin diferencias en su distribución por sexo y grupos de edad inferior o superior a un año. Los niveles medios de IL (e intervalo de confianza IC: 95%), y el límite superior de la normalidad, fueron respectivamente, para IL-6 suero: 0,49 (IC: 0-1,05), y 3,95 pg/mL; IL-6 orina: 0,17 (IC: 0-0,51), 1,83 pg/mL; IL-8 suero: 136,66 (IC: 0,74-272,58), 974,58 pg/mL; IL-8 orina: 47,23 (14,71-79,75), 242,39 pg/mL. No hubo diferencias entre ambos sexos ni grupos de edad, salvo niveles medios de IL-8 urinaria más elevados en menores de 1 año, con una correlación negativa entre dicha variable y edad (p<0,05). Asimismo, existe una correlación positiva y muy significativa de IL-6 y 8 en orina (p<0,001) y de IL-8 entre suero y orina (p<0,01). Conclusiones: En niños sanos, no se observaron diferencias según sexos en los niveles de IL-6 y 8, pero la producción de IL-8 en orina es mayor en niños más pequeños. Adiferencia de la IL-6, se detectan niveles significativos de IL-8 en suero y orina de niños sanos, cuestionando su validez en el diagnóstico de infección. Finalmente, existe en condiciones normales una excelente correlación entre IL-6 y 8 en orina
Objective: To determine the interleukins (IL) 6 and 8 levels in serum and urine in the healthy pediatric population, and to establish our laboratory reference values, whit the purpose of subsequently to apply this determination to diagnosis of urinary tract infection. Material and methods: Observational, transversal, descriptive and analytical study, in healthy children without urinary tract infection. We analyse the following variables: sex, age, to be oldest or youngest than 1 year, and IL-6 and IL-8 levels in serum and urine (ELISA). We evaluate the basic statistics for quantitative variables. It compare the independent samples by means of Mann-Whitney U test, and its correlation with the Pearson test. We consider an alpha-error of 5% (SPSS 9.0). The upper limit of normality was established in two standard deviation more than the mean (95% of population). Results:We have studied 52 children (40 males, 76.92%). The mean of age was 51.31 + 47.98 months (1-149 months), and it didnt have differences according to sex, or to be oldest and youngest than 1 year of age. The mean values of IL (and confidence interval IC: 95%), and the upper limit of normality, respectively were for serum IL-6: 0.49 (IC: 0-1,05), and 3.95 pg/mL; urine IL-6: 0,17 (IC: 0-0,51), 1,83 pg/mL; serum IL-8: 136,66 (IC: 0,74-272,58), 974,58 pg/mL; and urine IL-8: 47,23 (14,71-79,75), 242,39 pg/mL. It didnt have differences neither between both sex nor age groups, except urine IL-8 mean levels greater in youngest of 1 year of age, with a negative correlation between this variable and age (p<0,05). Moreover, it exist a positive and very significant correlation of urine IL-6 and 8 (p<0,001), and serum and urine IL-8 (p<0,01). Conclusions: In healthy pediatric population, it didnt observe differences according to sex in IL-6 and IL-8 levels, but the urine IL-8 production is greater in more little children. It observe significant serum and urine IL-8 levels in healthy children, making questionable its validity in urinary tract infection diagnosis. Finally, it exist an excellent correlation between urinary IL-6 and IL-8 in normal conditions
Subject(s)
Male , Female , Infant , Child , Child, Preschool , Humans , Interleukin-8/blood , Interleukin-8/urine , Interleukin-6/blood , Interleukin-6/urine , Biomarkers/blood , Biomarkers/urine , Cross-Sectional Studies , Reproducibility of Results , Reference Values , Enzyme-Linked Immunosorbent AssayABSTRACT
Sialoadhesin (sheep erythrocyte receptor, SER) is a macrophage-restricted adhesion molecule that binds certain sialylated ligands. It is borne by bone marrow stromal macrophages, promoting the interaction with developing myeloid cells, and by a subset of tissue macrophages involved in antigen presentation and activation of tumor-reactive T cells. The expression of sialoadhesin on SER+ macrophages is not constitutive but requires the continuous supply of a sialoadhesin-inducing serum factor. Tumor growth is often associated with marked alterations of myelopoiesis and impairment of T cell activation; yet the expression of sialoadhesin in macrophages derived from tumor bearers has not been addressed. The aim of this study was to assess whether Ehrlich tumor (ET) - a murine mammary carcinoma - growth may modify the sialoadhesin expression by bone marrow macrophages and/or sialoadhesin-inducing activity in ET-bearing sera. Moreover, putative functional sialoadhesin inhibitors produced by ET cells were tested. The results indicate that bone marrow cells from ET bearers show a seven- to eight-fold decrease in SER+ cells as detected by flow cytometry. This is accompanied by an overall decrease in sheep erythrocyte binding to tumor-bearer-derived bone marrow cells, but also by lower numbers of plastic-adherent cells. Functional sialoadhesin expression is preserved at the single-cell level and no inhibitors are found in ET-bearing sera or ET cell culture supernatants. Tumor progression does not impair the sialoadhesin-inducing activity of ET-bearing sera, or the ability of SER- macrophages (e.g. peritoneal macrophages) to respond to such an induction. In conclusion, while SER+ macrophages are greatly decreased in bone marrow from ET bearers, this is not due to a down-regulation of sialoadhesin expression, nor to an impairment of sialoadhesin-inducing factor or to the presence of sialoadhesin-binding moieties of tumor origin, but, more likely, to a decrease of fully mature macrophages.
Subject(s)
Bone Marrow Cells/metabolism , Carcinoma, Ehrlich Tumor/blood , Macrophages/metabolism , Membrane Glycoproteins/biosynthesis , Neoplasm Proteins/biosynthesis , Receptors, Immunologic/biosynthesis , Animals , Bone Marrow Cells/pathology , Cell Adhesion , Cells, Cultured , Culture Media, Conditioned/pharmacology , Disease Progression , Macrophages/pathology , Macrophages, Peritoneal/metabolism , Membrane Glycoproteins/genetics , Mice , Mice, Inbred C57BL , Neoplasm Proteins/genetics , Plastics , Receptors, Immunologic/genetics , Rosette Formation , Sialic Acid Binding Ig-like Lectin 1ABSTRACT
BACKGROUND: Selective depletion of CD4+ T lymphocytes is common in both primary and secondary immunodeficiencies. Idiopathic CD4+ T lymphocytopenia (ICL) cases are defined as a persistent CD4+ T lymphocyte count of less than 300x10(6) cells/L and/or less than 20% of the total T-cell count. METHOD: A 40-year-old woman, with a history of psoriasis and paracetamol allergy, presented with persistent warts of the hands and condylomas of the ano-genitalia. Histological and virological analysis was carried out on genital and cutaneous lesions and peripheral blood. RESULTS: Serology for HIV-1, HIV-2, Epstein-Barr virus and parvovirus B19 were negative. There was lymphopenia of 10% CD4+ cells, with normal numbers of total leukocytes; there were no other-abnormal immunological findings. DNA analysis of cutaneous lesions revealed HPV-49 and HPV-3 in the hands and HPV-6 in the genital region. CONCLUSIONS: The cause of the ICL in this patient is unknown. HPV is not known to be an immunosuppressive agent; it remains to be determined whether the HPV-associated lesions are the cause or the result of immunosuppression.
