Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of Leydig-cell testicular tumour in a 32-year-old intravenous drug abuser bearing HIV-infection and pulmonary tuberculosis. The testicular mass was initially interpreted as genital tuberculosis and the diagnosis was made by aspiration cytology. Radical orchiectomy was performed and pathology revealed a Leydig-cell tumour. Gynecomastia was found as a possible sign of endocrine activity. Although testicular malignancies in men with human immunodeficiency virus are increasingly reported, this is the first case of Leydig-cell neoplasia associated to HIV-infection.
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PMID:Leydig cell tumour in a man with human immunodeficiency virus. 857 85

Breast pathology that is characteristic of patients infected with human immunodeficiency virus (HIV) has not been addressed in the literature. HIV may directly and indirectly affect the glandular, mesenchymal, and intramammary lymphoid tissue in seropositive patients. Likely infections in this setting include tuberculous mastitis and pyogenic abscesses that may lead to fatal septicemia. Benign stromal changes include gynecomastia, adipose tissue deposition as part of the fat maldistribution syndrome, and pseudoangiomatous stromal hyperplasia. Breast carcinoma in HIV-infected patients occurs at a relatively early age, with increased bilateral disease, unusual histology, and early metastatic spread with a poor outcome. However, the link between breast cancer and HIV remains controversial. Kaposi's sarcoma and non-Hodgkin's lymphoma may also be localized to the breast in patients with acquired immunodeficiency syndrome (AIDS). This article reviews benign and malignant breast diseases that are likely to be encountered in patients with HIV/AIDS.
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PMID:Pathology of the breast associated with HIV/AIDS. 1210 Jan 17

Breast enlargement, a condition that was rarely reported in the era before highly active antiretroviral therapy, is emerging as a problem in the treatment of male human immunodeficiency virus (HIV)-infected patients. Evaluation of this condition must distinguish between gynecomastia (proliferation of ducts and periductal stroma), lipomastia (adipose-tissue deposition), and malignancy. We describe 13 HIV-infected men, all of whom had exposure to antiretroviral therapy, who presented with breast enlargement. Nine of these patients had gynecomastia, only 1 had lipomastia, and 3 had lymphoma (2 had non-Hodgkin lymphoma and 1 had Hodgkin disease). Gynecomastia was unilateral in all but a single case. In addition, all but 1 of our patients with gynecomastia had prolonged exposure to protease inhibitors. Six patients had potential causes of gynecomastia other than antiretroviral therapy, including liver disease (in 2 patients), mild hypogonadism (in 1), long-term marijuana use (in 2), and use of medications that have known associations with gynecomastia (in 3). Although most causes of breast enlargement in HIV-infected men are likely to be benign, malignancies other than carcinoma are of concern.
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PMID:Breast enlargement in 13 men who were seropositive for human immunodeficiency virus. 1238 46

Gynaecomastia is a rarely reported adverse drug reaction due to isoniazid therapy. We describe a 25-year-old, human immunodeficiency virus (HIV)--negative man, who was started on antituberculosis treatment (ATT) with isoniazid (H), rifampicin (R), pyrazinamide (Z) and ethambutol (E) in the combination RHZE for the first two months and RH there on. After four months, while receiving RH, he developed painful bilateral gynaecomastia. ATT had to be stopped because of this adverse drug reaction. Gynaecomastia, however, persisted even after three months of cessation of therapy. A year later, the patient reported complete disappearance of pain and swelling, although right breast continued to appear larger than the left.
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PMID:Isoniazid associated, painful, bilateral gynaecomastia. 1296 65

A 54-year-old man of Persian origin presented to our department with a 1-year history of ulcers on the right leg that had been unresponsive to numerous topical treatments, accompanied by lymphedema of the right leg. Medical history included hypergonadotropic hypogonadism, which had not been further investigated. He was treated for 20 years with testosterone IM once monthly, which he stopped a year before the current hospitalization for unclear reasons. The patient reported no congenital lymphedema. Physical examination revealed two deep skin ulcers (Figure 1) on the right leg measuring 10 cm in diameter with raised irregular inflammatory borders and a boggy, necrotic base discharging a purulent hemorrhagic exudate. Bilateral leg pitting edema and right lymphangitis with lymphadenitis were noted. He had low head hair implantment, sparse hair on the body and head, hyperpigmentation on both legs, onychodystrophia of the toenails (mainly the large toe and less prominent on the other toes), which was atrophic lichen-planus-like in appearance and needed no trimming (Figure 2), normal hand nails, oral thrush, and angular cheilitis. Other physical findings were gynecomastia, pectus excavatum, small and firm testicles, long extremities, asymmetrical goiter, systolic murmur 2/6 in left sternal border, and slow and inappropriate behavior. The patient's temperature on admission was 39 degrees C. Blood cultures were negative for bacterial growth. Results of laboratory investigations included hemoglobin (11.2 g/dL), hematocrit (26.8%), normal mean corpuscular volume and mean corpuscular hemoglobin volume, and red blood cell distribution width (16%). Blood smear showed spherocytes, slight hypochromia, anisocytosis, macrocytosis, and microcytosis. Blood chemistry values were taken for iron (4 micro g/dL [normal range 40-150 micro g/dL]), transferrin (193 mg/dL [normal range 220-400 mg/dL]), ferritin (1128 ng/mL [normal range 14-160 ng/mL]), transferrin saturation (1.5% [normal range 20%-55%]), serum folate (within normal limits), and vitamin B12 (within normal limits). Direct Coombs' test equaled positive 2 + IgG. All these values indicated anemia of chronic diseases combined with hemolytic anemia. Further blood work-up tested antinuclear antibody (positive <1:80 homogeneous pattern), rheumatoid factors (143 IU/mL [positive >8.5 IU/mL]), C-reactive protein (286 mg/L [normal range 0-5 mg/L]), anticardiolipin IgM antibody (9.0 monophosphoryl lipid U/mL [normal range 0-7.00 MPL U/mL]) and antithrombin III activity (135% [normal range 74%-114%]). Results of other blood tests were within normal limits or negative, including lupus anticoagulant, beta2 glycoprotein, anticardiolipin IgG Ab, anti-ss DNA Ab, C3, C4, anti-RO, anti-LA, anti-SC-70, anti-SM Ab, P-ANCA, C-ANCA, TSH, FT4, anti-T microsomal, antithyroglobulin, protein C activity, protein S free, cryoglobulins, serum immunoelectrophoresis, VDRL, hepatitis C antibodies, hepatitis B antigen, and human immunodeficiency virus. Endocrinological work-up examined luteinizing hormone (22.9 mIU/mL [normal range for adult men 0.8-6 mIU/mL]), follicle stimulating hormone (49.7 mIU/mL [normal range for adult men 1-11 mIU/mL]), testosterone (0.24 ng/mL [normal range for adult men 2.5-8.0 ng/mL]), bioavailable testosterone (0.02 ng/mL [normal range for adult men >0.6 ng/mL]), and percent bioavailable test (8.1% [normal value >20%]). These results indicate hypergonadotropic hypogonadism. Plasminogen activator inhibitor 1 was 6 U (normal value 5-20 U/mL). Karyotyping performed by G-banding technique revealed a 47 XXY karyotype, which is diagnostic of Klinefelter's syndrome. Doppler ultrasound of the leg ulcers disclosed partial thrombus in the distal right femoral vein. X-rays and bone scan displayed osteomyelitis along the right tibia. Histological examination of a 4-mm punch biopsy from the ulcer border revealed hyperkeratosis, acanthosis, hypergranulosis, and mixed inflammatory infiltrate containing eosinophils compatible with chronic ulcer. Multiple vessels were seen, compatible with a healing process. Direct immunofluorescence of the biopsy revealed granular IgM in the dermo-epidermal junction. Indirect immunofluorescence was negative. Thyroid function tests showed normal thyroid stimulating hormone and free throxine4. Multinodular goiter was seen on thyroid scan and ultrasound. Thyroid fine needle aspiration was compatible with multinodular goiter (normal follicular cells, free colloid, macrophages with pigment). IV treatment with amoxicillin-clavulanic acid 1 g t.i.d. was administered for 2 weeks, with a decrease in temperature and normalization of the leukocyte level. Oral antibiotic treatment with amoxicillin-clavulanic acid was continued for 10 more days, followed by 25 days of ciprofloxacin for the osteomyelitis. Local treatment included saline soakings followed by application of Promogran (Johnson & Johnson, New Brunswick, NJ) and Kaltostat (ConvaTec Ltd., a Bristol-Myers Squibb Company, New York, NY) with slight improvement. At the same time, the patient was treated with warfarin sodium due to deep vein thrombosis under international normalized ratio 2-3. The patient was treated with IM testosterone once monthly for 1 year, which resulted in a reduction in the diameter and depth of the leg ulcers (Figure 3). Blood tests were not performed for follow-up of the immune state.
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PMID:Klinefelter's syndrome presenting with leg ulcers. 1536 65

Endocrine complications of human immunodeficiency virus (HIV) and its treatment are being increasingly recognized. We discuss the diagnosis and management of an HIV seropositive man who presented with bilateral gynaecomastia and 'hyperprolactinaemia' due to macroprolactin within six months of starting antiretroviral therapy. We suggest that the gynaecomastia may be a feature of immune reconstitution disease. Measurement of serum prolactin in the investigation of gynaecomastia should be reserved for those with hypogonadotrophic hypogonadism. Since macroprolactin contributes to circulating prolactin in HIV-seropositive subjects, hyperprolactinaemic samples in these patients should be tested for macroprolactin.
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PMID:Gynaecomastia, hyperprolactinaemia and HIV infection. 1598 31

Breast enlargement in men and women is a documented feature of the highly active antiretroviral therapy- associated human immunodeficiency virus lipodystrophy syndrome. The exact underlying histomorphological features of this condition are speculative because most cases are diagnosed on clinical grounds with or without radiographic confirmation. The main documented causes of breast enlargement in men on highly active antiretroviral therapy include gynecomastia and lipomastia; however, biopsy-confirmed lipomastia is a rarely described phenomenon, with only 1 such case being described to date. In documenting 2 patients who underwent bilateral mastectomy for clinical gynecomastia of unknown cause, we emphasize the need for a greater degree of clinicopathological awareness of highly active antiretroviral therapy-associated lipomastia and the role of the histopathologist in the informed management of patients afflicted with human immunodeficiency virus infection on highly active antiretroviral therapy.
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PMID:Bilateral lipomastia in men: a side effect of highly active antiretroviral therapy. 1841 74

We describe the case of a 24-year-old hemophilic man who had been a human immunodeficiency virus (HIV)-positive for the past 22 years and presented to our hospital with bilateral breast enlargement with the presence of microcalcifications. Etiology of breast enlargement in male HIV population and differential diagnosis between true gynecomastia and lipomastia are also discussed.
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PMID:HIV-infected hemophilia a patient presenting with gynecomastia. 1986 78

Exfoliative and aspiration cytologies play a major role in the management of patients with human immunodeficiency virus infection. Common cytology samples include cervicovaginal and anal Papanicolaou tests, fine needle aspirations, respiratory specimens, body fluids, Tzanck preparations, and touch preparations from brain specimens. While the cytopathologists need to be aware of specific infections and neoplasms likely to be encountered in this setting, they should be aware of the current shift in the pattern of human immunodeficiency virus-related diseases, as human immunodeficiency virus patients are living longer with highly active antiretroviral therapy and suffering fewer opportunistic infections with better antimicrobial prophylaxis. There is a rise in nonhuman immunodeficiency virus-defining cancers (e.g., anal cancer, Hodgkin's lymphoma) and entities (e.g., gynecomastia) from drug-related side effects. Given that fine needle aspiration is a valuable, noninvasive, and cost-effective tool, it is frequently employed in the evaluation and diagnosis of human immunodeficiency virus-related diseases. Anal Papanicolaou tests are also increasing as a result of enhanced screening of human immunodeficiency virus-positive patients for cancer. This paper covers the broad spectrum of disease entities likely to be encountered with human immunodeficiency virus-related cytopathology.
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PMID:Review of HIV-Related Cytopathology. 2155 99

Male breast cancer is rare and few cases of breast cancer in human immunodeficiency virus (HIV)-infected patients are reported. We describe the case of breast cancer in a 65-year-old HIV-positive man who presented a nodule near the nipple of his left breast. He did not report risk factors for breast cancer, but he had liver cirrhosis. Biopsy of the lesion revealed a ductal carcinoma and he was submitted to mastectomy and axillary dissection. Staging resulted in pT1c/pN1a/M0; it was positive for the presence of oestrogen/progesterone receptors, negative for the human epidermal growth factor receptor-22. He was also treated with local radiotherapy and tamoxifen. At cancer diagnosis, he received highly active antiretroviral therapy (HAART) with undetectable HIV viral load, and his CD4+ T-cell count was 445 cells/mm(3). Patients with HIV infection have a higher cancer risk due to immunosuppression: it concerns not only malignancies related to human acquired immunodeficiency syndrome (AIDS), but also other cancers. A heightened awareness of male breast cancer by HIV specialists is needed, especially for particular risk categories, such as trans-sexuals who take oestrogen therapies, and for the presence of breast conditions, such as gynecomastia, usually considered as part of the lipodystrophy syndrome.
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PMID:Male breast cancer in an HIV-infected patient: a case report. 2329 69


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