RESUMO
BACKGROUND: Lipodystrophy and other fat distribution disorders have been reported in patients receiving protease inhibitor therapy for HIV infection. CASE REPORT: A 50-year-old HIV-positive patient was given protease inhibitor therapy (indinavir) for 6 months when he developed a lipomatous formation in the retrocervical area. Abdominal fat also increased in volume and the subcutaneous fat on the lower limbs decreased. DISCUSSION: We describe the main clinical features of these fat distribution disorders and discuss the pathogenic hypothesis of an interaction between antiprotease activity and hepatic lipoprotein receptor binding.
Assuntos
Tecido Adiposo/patologia , Fármacos Anti-HIV/efeitos adversos , Doenças do Tecido Conjuntivo/induzido quimicamente , Inibidores da Protease de HIV/efeitos adversos , Indinavir/efeitos adversos , Pescoço/patologia , Abdome/patologia , Tecido Adiposo/efeitos dos fármacos , Soropositividade para HIV/tratamento farmacológico , Humanos , Perna (Membro)/patologia , Lipodistrofia/induzido quimicamente , Masculino , Pessoa de Meia-IdadeRESUMO
We describe a case of Henoch-Schönlein purpura in the onset of Toxocara canis infection. The diagnosis was made in a 17-year-old boy based on the association of palpable purpura, oligoarthritis, acute abdominal pain, microhematuria, and cutaneous vasculitis. Toxocariasis, suggested by hypereosinophilia and domestic contact with a puppy, was confirmed by anti-Toxocara IgG and IgE and Western blot. Complete spontaneous resolution occurred within a few days. Transient presence of antinuclear antibodies and the absence of larvae in the skin biopsy favor an immunologic parasite induced disorder. A hypersensitivity vasculitis to Toxocara canis is suggested.
Assuntos
Vasculite por IgA/complicações , Toxocara canis , Toxocaríase/complicações , Adolescente , Animais , Anticorpos Anti-Helmínticos/sangue , Western Blotting , Humanos , Vasculite por IgA/diagnóstico , Vasculite por IgA/patologia , Masculino , Remissão Espontânea , Toxocaríase/diagnósticoAssuntos
Doença de Lyme/epidemiologia , Anticorpos Antibacterianos/sangue , Grupo Borrelia Burgdorferi/isolamento & purificação , Reações Cruzadas , Feminino , Humanos , Doença de Lyme/microbiologia , Masculino , Mali/epidemiologia , Doenças do Sistema Nervoso/microbiologia , Testes Sorológicos , Treponema pallidum/isolamento & purificaçãoRESUMO
Toxocara canis is a common parasite in puppies. The danger to human health has not been properly established. We estimated the current incidence of this pathogen in two western districts of France, Loire-Atlantique and Maine et Loire. Blood samples from 1836 eosino-philic patients were collected and tested by an enzyme-linked immunosorbent assay (ELISA) excretory-secretory Toxocara antigen test. We obtained positive results in 22% of the cases and highly positive results in 7%. The ELISA data seemed to be age-dependent, with older patients having more positive results (P < 0.0001). The interlaboratory distribution of positive test results was statistically significantly different (P < 0.0001), suggesting regional sources. The main clinical expressions of toxocariasis were: asthenia, gastric pain, and pulmonary disease. Individual and collective surveys of this zoonotic disease need to be carried out.
