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)

With the resurgence of active tuberculosis in the United States, surgeons may be called upon to participate in the management of primary tuberculosis as well as major complications of the disease. To define the role of surgery in the diagnosis and treatment of tuberculosis in the 1990s, a 5-year retrospective review of 121 tuberculosis patients requiring invasive procedures in the course of their work-up was performed. Mycobacterium tuberculosis was cultured in 68% of patients, and atypical mycobacteria in 19%. Tissue was required to achieve the definitive diagnosis in 36%. Of the 93 patients with pulmonary evidence of tuberculosis, 54% presented with a pulmonary complication, 19 of whom required operative intervention. Extrapulmonary tuberculosis affected 45% of patients, including nine with miliary tuberculosis. Patients testing seropositive for human immunodeficiency virus accounted for 11% of the patients seen, emphasizing that the re-emergence of tuberculosis is not confined to the immunosuppressed.
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PMID:Tuberculosis and the surgeon. 157 8

Multidrug resistance has become an increasingly important problem in the control and prevention of tuberculosis in large urban centers. Although several small outbreaks of multidrug-resistant (MDR) tuberculosis in New York City have been reported, the increase in the number of cases is not fully explained by these recognized outbreaks, and the modes of transmission have not been clearly delineated. Transmission patterns of MDR tuberculosis in New York City, therefore, were studied by stratifying Mycobacterium tuberculosis isolates from 167 newly diagnosed tuberculosis patients according to their DNA restriction fragment length polymorphisms (RFLP). Forty-three (34%) of 127 drug-susceptible isolates and 19 (79%) of 24 multidrug-resistant isolates had RFLP patterns representing possible recent exogenous infection (primary tuberculosis). Patients who had such isolates were more likely to be seropositive for human immunodeficiency virus (58%; p < 0.05), non-Hispanic black (56%; p < 0.005), U.S.-born (57%; p < 0.001), and have MDR tuberculosis (79%; p < 0.0005). In a logistic regression model, primary tuberculosis remained significantly associated with MDR tuberculosis and black race. In contrast to previous reports, in New York City recent exogenous transmission accounts for most new cases of multidrug-resistant tuberculosis.
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PMID:Transmission of multidrug-resistant tuberculosis in a large urban setting. 759 45

The paper discusses the genetic control of and the mechanisms of protective antituberculous immunity following BCG vaccination in inbred mice. The following genetic systems H-2 (B10.M)(H-2f) and B10.SM (H-2v) congenics were not protected with a high dose of BCG vaccine); Xid (X-linked immunodeficiency) CBA/N mice were not protected with regularly protective doses of BCG vaccine; Tbc-1 (I/St mice (Tbc-1s) were hypersensitive to tuberculosis. In two genetic systems (H-2 and xid), a distinct genetic control of susceptibility to primary tuberculosis and efficacy of BCG vaccination was demonstrated.
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PMID:[Genetic aspects of BCG vaccination in experimental tuberculosis]. 767 Mar 36

Tuberculosis, once on the steady decline in the western world, has resurfaced with renewed vigor in the wake of the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) epidemic. People with HIV infection are both more likely to contract primary tuberculosis and at greater risk for reactivation of latent tuberculosis. Tuberculous disease may present with atypical signs and symptoms in HIV-infected hosts because of alterations in the immune system. Superimposed on the virulent interaction of HIV and tuberculosis is the emerging problem of multidrug resistant strains that often resist currently available therapies. HIV-positive health professionals working in high-risk environments pose a special problem, while populations unable to comply with currently available pharmacological therapies pose another. We have many tools available to combat the resurgence of tuberculosis, but new methods of diagnosis and new approaches to treatment are sorely needed.
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PMID:Human immunodeficiency virus infection and tuberculosis: an analysis and a course of action. 806 73

Frequency and risk of tuberculosis were studied among a large group of HIV-infected patients (n = 2556), 869 of whom had AIDS, over a period of ten years (February 1982 through February 1992) at the University Hospital Frankfurt. A total of 148 (5.8%) out of 2.556 patients had tuberculosis. With increasing immunodeficiency, the frequency of tuberculosis rose. The rate of tuberculosis in post-mortem was even higher, i.e. 17.3%. I.v. drug-addict AIDS patients were inflicted with 18.5% considerably more often than homo-/bisexual patients with 12.3%. The same holds true with 25% of tuberculosis infections for AIDS patients from endemic areas as compared with 13% for patients from countries with lower tuberculosis incidence. 18% of patients contracted tuberculosis already at > 200 CD4-positive cells/microliters before AIDS manifestation. Coming from endemic areas, drug addiction and lower number of T-cells signify a high risk for HIV-infected patients to acquire a post-primary or primary tuberculosis, respectively. HIV-infected patients represent a relevant danger of infection for partners and health-care personnel. In contrast to the United States, no increase in the tuberculosis incidence, except for some areas like Frankfurt, has been noted. Preventive measures, which include the IHN prophylaxis for patients with T-cell counts < 150/microliters, should be discussed.
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PMID:[Epidemiology of tuberculosis in patients with HIV infection of the Frankfurt University Clinic]. 832 14

The past decade has seen dramatic developments in serological tests for tuberculosis. The long history of serological tests for tuberculosis is a testimony to the need for a sensitive diagnostic test, especially when the sputum smear is unhelpful. New reagents, both purified antigens and monoclonal antibodies, provide the means to obtain a sensitivity and specificity to rival the tuberculin skin test and equal other commonly used diagnostic blood tests. Evaluation with sera from patients with smear-positive pulmonary tuberculosis has identified one antigen (antigen 5, the 38 kDa antigen) as a potential screening reagent for infectious tuberculosis and another (16 kDa antigen) for monitoring compliance. A monoclonal antibody competition assay anti-38 kDa antibody is the most sensitive serological test for smear-negative tuberculosis so far. Tests for tuberculous meningitis need clinical evaluation. Serological tests for human immunodeficiency virus (HIV)-related tuberculosis are disappointing. In general, antibody levels in primary tuberculosis are low and appear directed towards cytoplasmic antigens, whilst in post-primary disease antibody levels are higher and appear to bind to secreted antigens. No single reagent gives a 100% sensitivity; future research should identify the best combination of antigens for the serodiagnosis of tuberculosis.
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PMID:Serological diagnosis of tuberculosis. 859 May 68

Pulmonary tuberculosis is a major complication of human immunodeficiency virus (HIV) infection. The radiographic manifestations of pulmonary tuberculosis in HIV-infected patients are not typical of those seen in immunologically normal individuals. We sought to determine whether these manifestations provide clues to the pathogenesis of tuberculosis in HIV-infected persons. The radiographic manifestations of pulmonary tuberculosis were reviewed and classified in 82 HIV-positive and 53 HIV-negative tuberculous patients in Gulu, Uganda. Pulmonary presentations of tuberculosis were more acute in HIV-positive patients, and often included hilar or mediastinal adenopathy and pleural effusions, findings typical of primary tuberculosis in immunologically normal individuals. Many patients also had chronic forms of tuberculosis, either alone or in combination with acute disease. The findings of this study support the hypothesis that reactivation of latent infections and progression of pre-existent chronic disease produce a substantial portion of the tuberculosis burden of HIV-positive persons in Uganda. Tuberculosis control efforts should extend beyond efforts at decreasing transmission of new infections.
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PMID:Radiology of pulmonary turberculosis and human immunodeficiency virus infection in Gulu, Uganda. 907 94

The purpose of this study was to review autopsy and gallium scan findings in two different acquired immune deficiency syndrome (AIDS) patient populations who had a confirmed diagnosis of tuberculosis (TB) to identify organs involved and accuracy of clinical diagnosis. The first group was comprised of 29 autopsies between January 1982 and December 1994, including only 18 patients who were diagnosed before death. Organs most commonly involved were the lymph nodes (59%), lungs (56%), spleen (53%), liver (45%), and kidneys (37%). Other opportunistic infections were present in 18 (59%) of autopsies, with more than one opportunistic infection present in 11 (37%) of the autopsies. Lungs were involved in 79% of all autopsies. The second population group included 94 patients with AIDS with a proven diagnosis of TB, only 24 of whom had gallium scans in the period between January 1992 and December 1994. Chest x-ray results were negative in 4 patients (17%); gallium scan results were positive in 16 patients (66%). The reasons for false-negative gallium scan results were due to anti-tuberculous treatment for periods varying from 2-21 months in 7 patients or the presence of extra pulmonary tuberculosis. The sites of TB involvement in the chest were: lung parenchyma in 5 patients (19%, 4 in mid and lower lung, and 1 in upper fields). There was lymph node involvement in all 16 patients (24 locations with mediastinal involvement in 23%, supraclavicular 23%, axillary 11%, retroperitoneal 11%, and inguinal region in 4%. We conclude that (1) tuberculosis in patients with AIDS behaves similar to primary tuberculosis; (2) the combination of chest x-ray and gallium imaging is sensitive for the diagnosis of pulmonary tuberculosis in patients with AIDS; (3) the involvement of mediastinal lymph nodes in gallium scans in the presence or absence of chest x-ray abnormalities should raise the possibility of TB involvement in patients with human immunodeficiency virus; (4) anti-TB treatment decreases the sensitivity of gallium scan.
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PMID:Sites of tuberculous involvement in patients with AIDS. Autopsy findings and evaluation of gallium imaging. 915 31

Tuberculosis of the skin is now becoming one of the rare diseases. However, we can still see it in the patients with immunodeficiency or treated with immunosuppressants for a long time. Diagnosis of this disease is made by the characteristic clinical findings and the results of laboratory findings. This disease is divided into two types: true cutaneous tuberculosis and tuberculid. The former is produced by the proliferation of the tuberculous bacilli in the skin. Lupus vulgaris, tuberculosis verrucosa cutis, cutaneous primary tuberculosis, tuberculosis cutis orificialis and cutaneous miliary tuberculosis are included. The latter type is the skin manifestation of allergic reaction against tuberculous bacilli in the tuberculous lesions of other organs. Culture of tuberculous bacilli from the skin lesions shows usually negative. Erythema induratum Bazin, papulonecrotic tuberculid, penis tuberculid and lichen scrofulosorum are included.
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PMID:[Tuberculosis of the skin]. 988 28

The specific features of immunological responsiveness were studied in 124 Mycobacterium tuberculosis (MBT)-infected children aged 7-14 years in relation to the ecological characteristics of their living area. All the children had early primary tuberculosis infection. The MBT-infected children were found to have first-degree secondary immunodeficiency. The latter was most pronounced in the dwellers of industrial areas, who had T-lymphocytic deficiency, the impaired supopulational composition of T cells, their diminished functional activity, an increased response to specific antigen, as well as dysimmunoglobulinemia, elevated levels of circulating immune complexes. The hyposuppressor types of cellular immunodeficiency and total T lymphopenia were observed in children living in the ecological crisis area. Superinfection and concomitant diseases create conditions for the progression of secondary immunodeficiency and for the development of severe forms of the disease.
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PMID:[Influence of environmental factors on the immunological responsiveness of Mycobacterium tuberculosis-infected children]. 1627 13


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