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)

Clinical studies have indicated that pancreatitis is a common cause of morbidity in patients with acquired immunodeficiency syndrome (AIDS). In order to assess the morphologic basis of this pancreatic disease, we reviewed 82 autopsies performed on AIDS patients at The Johns Hopkins Hospital. Pancreatic lesions were detected in 52 (65%) of these, and could be classified into three broad categories: acinar dilatation by inspissated secretions (24 cases), acute pancreatitis (recent or remote, 18 cases), and opportunistic infections or cancers affecting the pancreas (23 cases). To better assess the importance of these lesions, particularly the acinar dilatation, 82 age-race-sex-matched controls were evaluated in a blinded comparison. The frequency of acinar dilatation and acute pancreatitis was similar in cases and controls. Only one control was found to have an opportunistic infection, and no opportunistic cancer was detected in controls. There were no unexplained lesions found in the AIDS cases which might be attributed to direct human immunodeficiency virus (HIV) infection. These data confirm clinical reports that the pancreas is frequently affected in AIDS patients. We propose that the clinical evidence of pancreatitis reported in these patients may be due to the frequent opportunistic lesions demonstrated by this series.
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PMID:The spectrum of pancreatic pathology in patients with AIDS. 230 20

To confirm the presence of exercise dysfunction in patients seropositive for the human immunodeficiency virus (HIV), 32 such patients without AIDS were evaluated with cardiopulmonary exercise testing, pulmonary function testing, bronchoalveolar lavage, chest roentgenography, and gallium scanning. No evidence of pulmonary opportunistic infection was found. When compared to an otherwise similar group of HIV-seronegative controls, the patients exercised to a significantly lower workload (195 +/- 30 versus 227 +/- 31 W, p less than 0.001). The ventilatory anaerobic threshold (VAT) values were also significantly lower for the patients (49.2 +/- 13.0 versus 61.9 +/- 9.1% of maximum predicted VO2, p less than 0.001). Nine of the patients had VAT values less than the 95% confidence interval for the controls. This subgroup exercised to a significantly lower maximum VO2 (69.9 +/- 11.2 versus 95.9 +/- 17.5% of maximum predicted VO2, p less than 0.001) and workload (165 +/- 21 versus 227 +/- 31 W) when compared to the control group. These patients demonstrated a mild tachypnea throughout exercise relative to the controls and had a significant increase in the slope of the heart rate to VO2 relationship. These findings are most consistent with a limitation of oxygen delivery to exercising muscles, which may represent occult cardiac disease in this group.
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PMID:Exercise dysfunction in patients seropositive for the human immunodeficiency virus. 231 95

Small noncleaved cell lymphoma (SNCCL), a rare lymphoma in adults, is associated with not only a rapid complete response (CR) to chemotherapy but also with the potential to rapidly relapse both systemically and in the CNS. We treated 44 assessable adults with two similar protocols, consisting of three sequential chemotherapy combinations and intrathecal prophylaxis with methotrexate and cytarabine. The overall CR rate was 80%; it was 100% in patients with Ann Arbor (AA) stages I-III disease and 57% in those with stage IV disease. The overall survival (OS) rate at 5 years was 52%. The overall 5-year freedom from tumor mortality (FTM) rate was 63%; it was 95% for patients with AA stages I-III disease, and 29% for those with stage IV disease. Stepwise multivariate analysis of factors associated with remission duration and survival indicated that advanced-disease stage and age of 40 years or over were predictors of poor prognosis. Twelve patients with positive human immunodeficiency virus (HIV) serology were also included in this series. They had an 83% CR rate and an 83% 5-year FTM, but only a 36% 5-year OS; most deaths were secondary to opportunistic infection. Histologic subtype (Burkitt's lymphoma [BL] or non-Burkitt's lymphoma [NBL]) did not correlate with patient age, site of tumor presentation, response to therapy, or survival. Both protocols achieved comparable results. The approach used in these protocols is highly effective for patients with early staged disease, regardless of their HIV status; however, better therapy is necessary for those with SNCCL presenting in an advanced stage.
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PMID:Small noncleaved cell lymphoma in adults: superior results for stages I-III disease. 231 30

To evaluate bronchoalveolar lavage (BAL) findings in patients infected with human immunodeficiency virus (HIV), 39 patients seropositive for the virus but with no history of opportunistic infection were studied. Opportunistic organisms such as Pneumocystis carinii were not found in any of the 35 BAL fluids sent for special stains and cultures. Three of 16 (18 percent) BAL fluids sent for HIV culture were positive compared with a 60.9 percent blood HIV culture positivity in the same group. To evaluate cellular recovery, the patients were divided into Walter Reed (WR) groups 1 and 2 (blood CD4 greater than or equal to 400/cu mm) and WR3 to WR5 (blood CD4 less than 400/cu mm). Compared with ten nonsmoking healthy controls, the WR1 and WR2 group had a greater overall cellular recovery but this was not statistically significant when the smokers were excluded. There was no difference in macrophage or lymphocyte percentages in either patient group compared with controls. T-cell subset analysis of a small group of WR1 to WR5 patient BAL fluids revealed no difference in CD4 numbers or the CD4/CD8 rate between WR1 and WR2 and WR3 to WR5 patients. We conclude that opportunistic pulmonary infection is unlikely in HIV-seropositive patients with normal chest roentgenograms despite symptoms of dyspnea on exertion. Also, HIV can be isolated from BAL fluid from these patients although not as often as from blood. Finally, there appears to be no distinct progression in BAL cellular findings before the onset of acquired immunodeficiency syndrome.
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PMID:Bronchoalveolar lavage findings in patients seropositive for the human immunodeficiency virus (HIV). 233

Although the clinical and epidemiologic features of progressive disseminated histoplasmosis (PDH) in the acquired immunodeficiency syndrome (AIDS) have been well described, the pathologic and pulmonary aspects remain to be fully defined. A retrospective review of three patients and a prospective study of four more with PDH and AIDS recently admitted to an inner city hospital in a non-endemic area were used to elucidate these features more fully. All patients were men aged 23 to 46 years, born in endemic areas, who had immigrated to the US seven to 15 years before the onset of their illnesses. Five had been exposed to human immunodeficiency virus (HIV) through intravenous drug use (one was also a homosexual), and two through heterosexual contacts. Respiratory symptoms were evident in five of the seven patients, fever in seven, weight loss in seven, hepatomegaly in four, splenomegaly in three, peripheral adenopathy in three, and gastrointestinal symptoms in three. PDH was the initial or only opportunistic infection in five patients. Bilateral nodular infiltrates (4/7), bilateral interstitial infiltrates (2/7), and mediastinal adenopathy associated with pleural effusion (1/7) were the chest roentgenographic findings. Histoplasma capsulatum was isolated from five of five bronchoalveolar lavages, four of four transbronchial biopsies, one of one endobronchial biopsy, one of one brushing, one of one pleural biopsy, three of three lymph node biopsies, two of two bone marrow biopsies, one of one liver biopsy, and three of four peripheral blood smears. Granuloma formation was seen in only three of 12 biopsies. There were ten or more fungi per monocyte in almost all tissues, some with extracellular forms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Disseminated histoplasmosis in AIDS. Clinicopathologic features in seven patients from a non-endemic area. 234 42

Progressive multifocal leukoencephalopathy is a virtually always opportunistic infection of central nervous system caused by papova viruses, which clinically presents with symptoms and signs of involvement of different encephalic levels. We report a case with a double interest: on the one hand, both clinical features and lesions were limited to the brainstem and cerebellum; on the other hand, the disease developed in a previously healthy female in whom laboratory evidence of immunodeficiency of unknown origin was demonstrated. A reason for immunodeficiency was also not found at autopsy, being speculated that it could have been iatrogenically associated with antidepressant drugs.
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PMID:[Progressive multifocal leukoencephalopathy associated with leukopenia of unknown (iatrogenic?) origin]. 236 Oct 27

Remission rate of leukemia has been improved by development of recent antileukemic chemotherapy. But opportunistic infection in secondary immunodeficiency has increased. Especially pulmonary mycoses often occurs and its prognosis is poor. But if patient with leukemia complicates pulmonary mycoses, it should be cured as soon as possible and antileukemic chemotherapy should be continued. We successfully performed surgical treatment for 2 pulmonary aspergillosis, which were complicated in stage of remission induction of acute leukemia.
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PMID:[Two resected cases of pulmonary aspergilloma in acute leukemia]. 237 11

Opportunistic infection with the causative agent of cat scratch disease may be responsible for an unusual vascular proliferative lesion, referred to as bacillary epithelioid angiomatosis, previously described only in human immunodeficiency virus (HIV)-infected patients. We present a case of an HIV-infected patient with bacillary epithelioid angiomatosis involving the liver and bone marrow causing progressive hepatic failure. We also report a case of a cardiac transplant recipient with hepatic and splenic bacillary epithelioid angiomatosis manifesting as a fever of unknown origin, a previously unreported event in a non-HIV-infected patient. These cases represent the first documentation of bacillary epithelioid angiomatosis with visualization of cat scratch-like organisms involving internal organs.
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PMID:Visceral bacillary epithelioid angiomatosis: possible manifestations of disseminated cat scratch disease in the immunocompromised host: a report of two cases. 238 68

We describe the Kaposi's sarcoma (KS) experience in three cohorts of homosexual men, subjects with hemophilia, and human immunodeficiency virus type 1 (HIV-1) seroconverters. The risk of KS was higher in HIV-1-infected homosexual men from New York City as compared with Washington, D.C. and was very low in the hemophilia subjects. While KS accounted for a decreasing proportion of AIDS cases in homosexual men, the absolute risk per year did not diminish. Survival was similar after diagnosis of KS vs. opportunistic infection including Pneumocystis carinii pneumonia. Percent CD4+ and CD8+ T cells, and beta 2-microglobulin levels were less abnormal in subjects who later developed KS than in those who developed opportunistic infections; conversely, serum neopterin abnormalities were greater in those who developed KS. The additional risk of KS in homosexual men may explain their apparently higher incidence of AIDS. Further investigation of the differences in intermediate markers of KS and opportunistic infections may shed light on the pathogenesis of these particular manifestations of AIDS.
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PMID:Kaposi's sarcoma in three HIV-1-infected cohorts. 239 84

Pneumocystis carinii has taken on new importance with the emergence of the human immunodeficiency virus. It is the most common life-threatening opportunistic infection in the acquired immunodeficiency syndrome and eventually develops in 80% or more of those not receiving primary prophylaxis. This review focuses on the clinical presentation, diagnosis, treatment, and prophylaxis of P carinii pneumonia in patients with human immunodeficiency virus infection.
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PMID:Pneumocystis carinii pneumonia in human immunodeficiency virus-infected patients. 198 99


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