Assuntos
Anemia Falciforme/tratamento farmacológico , Antibacterianos/uso terapêutico , Microbioma Gastrointestinal/efeitos dos fármacos , Rifaximina/uso terapêutico , Adulto , Analgésicos Opioides/uso terapêutico , Anemia Falciforme/sangue , Anemia Falciforme/microbiologia , Antibacterianos/farmacologia , Senescência Celular , Feminino , Doença da Hemoglobina C/sangue , Doença da Hemoglobina C/tratamento farmacológico , Doença da Hemoglobina C/microbiologia , Humanos , Hidroxiureia/uso terapêutico , Selectina L/análise , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos/química , Dor/tratamento farmacológico , Dor/etiologia , Qualidade de Vida , Receptores CXCR4/análise , Rifaximina/farmacologia , Traço Falciforme/sangue , Traço Falciforme/tratamento farmacológico , Traço Falciforme/microbiologia , Doenças Vasculares/etiologia , Adulto Jovem , Talassemia beta/sangue , Talassemia beta/tratamento farmacológico , Talassemia beta/microbiologiaAssuntos
Anemia Falciforme/microbiologia , Bacteroidetes/isolamento & purificação , Disbiose/microbiologia , Firmicutes/isolamento & purificação , Microbioma Gastrointestinal , Proteobactérias/isolamento & purificação , Adolescente , Adulto , Idoso , Anemia Falciforme/sangue , Anemia Falciforme/complicações , Anemia Falciforme/imunologia , Translocação Bacteriana , Contagem de Células Sanguíneas , Sedimentação Sanguínea , Estudos de Casos e Controles , Criança , Feminino , Hemoglobina Fetal/análise , Hemoglobina Falciforme/análise , Humanos , Masculino , Pessoa de Meia-Idade , Ativação de Neutrófilo , Traço Falciforme/sangue , Traço Falciforme/complicações , Traço Falciforme/imunologia , Traço Falciforme/microbiologia , Adulto JovemAssuntos
Hemoglobinas Anormais , Meningite Pneumocócica/complicações , Traço Falciforme/microbiologia , Tuberculose Meníngea/complicações , Adulto , Antituberculosos/uso terapêutico , Humanos , Masculino , Meningite Pneumocócica/tratamento farmacológico , Traço Falciforme/complicações , Tuberculose Meníngea/tratamento farmacológicoRESUMO
BACKGROUND: Pulmonary infections continue to be a major cause of morbidity and mortality in patients with sickle cell disease (SCD). METHODS: In this study cell-mediated immunity in vitro was evaluated in 62 SCD patients (62 steady state and 16 with acute pneumonia) and compared with 44 normal controls (30 healthy and 14 with acute pneumonia). Lymphocyte blastogenic responses to phytohemagglutinin, tetanus toxoid and Candida albicans antigen were assessed in all subjects. In addition production of tumor necrosis factor, alpha- and gamma-interferon (IFN) were assayed. RESULTS: The results revealed comparable blastogenic responses to all three stimuli in all subjects except SCD patients with pneumonia. This group showed poor responses to all stimuli. The mean counts per minute were decreased 65 to 90% when compared with the other patients. Cytokine production of IFN-alpha and TNF was equivalent in all subjects. Conversely IFN-gamma production in both SCD groups, steady state (35 +/- 6 U/ml) and SCD with pneumonia (14 +/- 6 U/ml), was significantly decreased when compared with those in normal healthy controls (65 +/- 14 U/ml) and with pneumonia (48 +/- 17 U/ml). On analysis of individual titers 15 of 62 (24%) steady state and 10 of 16 (63%) SCD patients with pneumonia were deficient in IFN-gamma production in vitro. CONCLUSIONS: Acute pulmonary infections seem to have a profound effect on cell-mediated immunity in SCD. IFN-gamma deficiency, along with quantitative and qualitative T cell abnormalities, may represent significant factors to explain the frequent and severe infections seen in SCD.
Assuntos
Interferon-alfa/biossíntese , Interferon gama/biossíntese , Ativação Linfocitária , Pneumonia Bacteriana/imunologia , Traço Falciforme/complicações , Fator de Necrose Tumoral alfa/biossíntese , Adolescente , Candida albicans/imunologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Interferon-alfa/sangue , Interferon gama/sangue , Linfócitos/química , Masculino , Fito-Hemaglutininas/imunologia , Traço Falciforme/imunologia , Traço Falciforme/microbiologia , Toxoide Tetânico/imunologiaRESUMO
Acute hematogenous osteomyelitis was detected in a 23-year-old sickle-cell patient after standard radiographs of the right femur showed gas within the medullary cavity. Three anaerobic organisms were cultured from surgically aspirated materials, but no source of infection was found. After surgical drainage and six weeks of intravenous clindamycin therapy, there was clinical improvement and radiographic resolution of the gas formation.
