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1.
Clin Exp Immunol ; 137(3): 578-83, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15320909

ABSTRACT

Common variable immunodeficiency (CVID) is a heterogeneous immunodeficiency that is accompanied by granulomatous lesions in 5-10% of cases. Why some patients develop granulomatous disease remains unclear. Here we describe a 12-year-old previously healthy girl who presented with pancytopenia and granulomatous lymphoproliferation subsequent to infection with Toxoplasma gondii. Loosely arranged non-fibrosing granulomas were observed in the liver, lymph nodes and lung, but no Toxoplasma tachyzoites could be demonstrated and polymerase chain reaction (PCR) and culture were negative for Toxoplasma and a wide range of other pathogens. While the patient had a normal peripheral B cell status at presentation, the development of CVID could be observed during the following months, leading to a loss of memory B cells. This was accompanied by an increasingly activated CD4(+) T cell compartment and high serum levels of angiotensin-converting enzyme (ACE), tumour necrosis factor (TNF) and sCD25. Steroid therapy reduced pancytopenia, granulomatous lymphoproliferation and cytokine elevations, but did not improve the B cell status. This is the first report of an association of Toxoplasma infection with granulomatous CVID and provides one of the rare examples where the onset of CVID could be documented subsequent to an infectious disease.


Subject(s)
Common Variable Immunodeficiency/parasitology , Lymphomatoid Granulomatosis/parasitology , Toxoplasmosis/immunology , Acute Disease , B-Lymphocytes/immunology , CD4-Positive T-Lymphocytes/immunology , Child , Common Variable Immunodeficiency/immunology , Female , Humans , Immunohistochemistry , Liver/immunology , Lung/immunology , Lymph Nodes/immunology , Lymphocyte Activation , Lymphocyte Count , Lymphomatoid Granulomatosis/immunology
2.
Hum Psychopharmacol ; 17(7): 357-9, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12415556

ABSTRACT

Psychiatric disorders due to quinacrine for antiparasitic therapy represent an infrequent, but serious, complication. The remarkable course of a 12-year-old boy with common variable immunodeficiency who developed severe psychiatric reactions following quinacrine therapy for his resistant chronic giardiasis is presented. The broad clinical spectrum of quinacrine-associated neuropsychiatric disturbances has been emphasized for the clinicians.


Subject(s)
Antiprotozoal Agents/adverse effects , Common Variable Immunodeficiency/complications , Giardiasis/complications , Psychoses, Substance-Induced/psychology , Quinacrine/adverse effects , Anti-Anxiety Agents/therapeutic use , Antiprotozoal Agents/therapeutic use , Antipsychotic Agents/therapeutic use , Benzodiazepines , Child , Chronic Disease , Common Variable Immunodeficiency/parasitology , Common Variable Immunodeficiency/psychology , Drug Resistance , Giardiasis/parasitology , Giardiasis/psychology , Haloperidol/therapeutic use , Humans , Male , Quinacrine/therapeutic use
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