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)

Primary central nervous system lymphoma constitutes one of the criteria for the acquired immune deficiency syndrome (AIDS), yet a paucity of information is currently available regarding the clinical, immunologic, or pathologic features of these patients. Six homosexual men presenting with primary central nervous system lymphoma were evaluated. Five of these patients presented with altered mental status. All lymphomas were intracranial. B cell immunoblastic sarcoma was found in five. Immune phenotyping studies performed in five patients revealed monoclonal lambda light chain in three, whereas one expressed only IgG heavy chain, and one demonstrated another B cell (LN-1) surface antigen. Hypodense, contrast-enhancing lesions were apparent on computed axial tomographic scanning of the brain, in sharp contrast to isodense or hyperdense lesions reported in primary central nervous system lymphomas without underlying immunodeficiency. Immunologic abnormalities in these patients were similar to those in AIDS presenting as Kaposi's sarcoma or with opportunistic infections. In spite of therapeutic interventions, survival was short, and only one patient is currently alive.
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PMID:Primary central nervous system lymphoma in homosexual men. Clinical, immunologic, and pathologic features. 387 74

Primary central nervous system lymphoma is a rare presentation of lymphoma and is usually seen in adults, often in association with immunodeficiency. Evaluation of these patients classically shows discrete intracranial lesions, and long-term prognosis despite treatment is poor. The case of a child is presented who had no identifiable predisposing factors, no radiologic evidence of intracranial mass, no evidence of systemic disease, and in whom the diagnosis of primary CNS lymphoma was made based on documentation of a monoclonal population of malignant B-cells in the cerebrospinal fluid. The patient, in whom irreversible blindness developed, was treated with a combination of cranial radiation, and intrathecal and systemic chemotherapy, and is currently alive and disease-free 15 months after diagnosis.
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PMID:Primary central nervous system lymphoma without intracranial mass in a child. Diagnosis by documentation of monoclonality. 387 78

Tissue from primary central nervous system lymphoma (PCNSL) which developed in five patients with acquired immuno deficiency syndrome (AIDS), nine patients without immunodeficiency, and two Epstein-Barr virus (EBV)-positive control cell lines (B95-8 and Raji) were examined for the presence of EBER-1 RNA. The tissues were hybridized with digoxigenin-labeled sense or anti-sense EBER-1 riboprobes. In all five AIDS-related PCNSLs, strong hybridization signals were found with the EBER-1 anti-sense probe. Signals could be eliminated by preincubation of the tissues with RNase-A. Hybridization with the EBER-1 sense probe showed no signal. All PCNSLs from immunocompetent patients (five paraffin-embedded, four frozen) showed no hybridization signals with EBER-1 sense or antisense probe but good hybridization signals with probes to immunoglobulin kappa or lambda light chain indicating RNA preservation. The paraffin-embedded B95-8-positive control cell-line showed positive hybridization in most cells with the anti-sense EBER-1 probe, and up to one percent of the cells had a weak signal with the sense probe. Most Raji cells showed a uniform signal with the anti-sense EBER-1 probe only. We conclude that, PCNSLs that arise in AIDS patients are associated with latent EBV infections, whereas PCNSLs from immunocompetent patients are not indicating a probable role for EBV in pathogenesis of these tumors.
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PMID:Detection of Eber-1 RNA in primary brain lymphomas in immunocompetent and immunocompromised patients. 780 83

Involvement of the central nervous system (CNS) in patients with acquired immune deficiency syndrome (AIDS) is an increasing clinical problem. The most common brain complications are toxoplasmosis (50-70 per cent), primary CNS lymphoma (20-30 per cent) and progressive multifocal leucoencephalopathy (10-20 per cent). Almost two-thirds of these conditions can be treated, early diagnosis and therapy leading to survival with a good quality of life. Although clinical and neuroradiological criteria alone may have high predictive value, they are not sufficient to distinguish the broad spectrum of diseases reliably. Consequently, biopsy appears necessary for definite diagnosis in some cases. The potential role and timing of brain biopsy have been assessed. Twenty-four of 50 human immunodeficiency virus-seropositive patients with focal cerebral lesions were considered for biopsy between October 1991 and December 1992. Twelve underwent brain biopsy, seven stereotactic and five ultrasonographically guided. A diagnosis was achieved in 11 patients: six primary lymphoma, three progressive multifocal leucoencephalopathy, and one mycotic and one tuberculous abscess. Both techniques proved to be safe and reliable, with a 92 per cent diagnostic rate. These data confirm the usefulness of biopsy in patients with AIDS with its wide range of associated cerebral lesions that require different aggressive treatments. On the basis of this preliminary experience and reports in the literature, it is considered that brain biopsy is indicated for patients with focal enhancing cerebral mass lesions seen on computed tomography and magnetic resonance imaging who do not respond to an appropriate trial of empirical antitoxoplasmosis therapy and for those showing rapid clinical deterioration in whom imaging and serology do not suggest toxoplasmosis.
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PMID:Experience with brain biopsy in acquired immune deficiency syndrome-related focal lesions of the central nervous system. 782 Apr 87

Complications of human immunodeficiency virus type 1 infection and acquired immunodeficiency syndrome may involve any level of the central or peripheral nervous system. Acute encephalitis, aseptic meningitis and acute demyelinating polyneuropathy may occur early in the course of HIV infection, while dementia, central nervous system-related cancer, opportunistic infections and autonomic neuropathy typically present later. Headache and mental status changes are common early manifestations of central nervous system involvement. Most severe headaches are related to an identifiable cause, including a mass lesion, opportunistic cerebral infection and medication side effect. Memory deficits, concentration difficulties and abnormalities on mental status testing may represent early AIDS dementia complex (HIV encephalopathy), the most common neurologic complication. In patients with AIDs, the differential diagnosis of cerebral mass lesions on computed tomography or magnetic resonance imaging includes cerebral toxoplasmosis, tuberculous or fungal abscess, focal viral encephalitis, metastatic resonance imaging includes cerebral toxoplasmosis, tuberculous or fungal abscess, focal viral encephalitis, metastatic Kaposi's sarcoma and primary CNS lymphoma. Peripheral neuromuscular disease, including distal symmetric polyneuropathy, autonomic neuropathy, and HIV and chronic zidovudine myopathy, affects 15 to 40 percent of all persons with HIV infection or AIDS.
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PMID:Common neurologic complications of HIV-1 infection and AIDS. 784 35

The development of cancer in the setting of human immunodeficiency virus (HIV) infection is a devastating event and highlights the role of impaired immunity in the generation of various neoplasms. Improved strategies to suppress viral replication and prevent opportunistic infections generally have enabled patients with HIV to live longer and more productively. Unfortunately, acquired immune deficiency syndrome (AIDS)-associated neoplasia is increasing. Kaposi's sarcoma (KS), primary central nervous system lymphoma, intermediate- and high-grade B-cell lymphoma, and invasive cervical carcinoma are AIDS-defining conditions and the most commonly encountered malignancies. Recent information suggests an indirect role for HIV in the pathogenesis of these tumors. Effective treatment involves addressing complex variables encountered specifically in patients with AIDS. This review focuses on the epidemiology, pathogenesis, and treatment of KS and non-Hodgkin's lymphoma.
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PMID:Human immunodeficiency virus-associated neoplasms: epidemiology, pathogenesis, and review of current therapy. 785 57

To determine the frequency and pattern of neurological complications of T-cell lymphoma (TCL), we retrospectively reviewed the medical records of 316 patients with TCL diagnosed between January 1984 and May 1991. Disease entities not included in this study were lymphoblastic lymphoma, primary central nervous system lymphoma, CD30-positive anaplastic large cell lymphoma, and lymphomas secondary to human immunodeficiency virus or human T-cell lymphotropic virus type I. Cases were classified as having direct complications (parenchymal, leptomeningeal, epidural, or peripheral) or indirect complications (paraneoplastic, disease related, or treatment related). Preexisting neurological conditions were excluded. The overall rate of neurological complications was 7.9%. The frequency of neurological complications in peripheral TCL and cutaneous TCL was 17% and 3%, respectively, with at least half of the neurological complications in both conditions due to direct involvement of the nervous system. Direct neurological complications of TCL were primarily due to leptomeningeal and parenchymal involvement. There were no cases of epidural spinal cord disease.
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PMID:Neurological complications of peripheral and cutaneous T-cell lymphomas. 794 94

Brain mass lesions (BML) occurred in 10% of patients infected by the human immunodeficiency virus (HIV), as expression of severe and sometimes treatable diseases. However, the management of them is not well established. We analyzed, retrospectively, 26 brain biopsies (22 estereotaxic) in patients with HIV infection and BML to know their usefulness and safety. The inclusion criteria were: Failure of the anti-Toxoplasma empirical treatment, atypical scan appearance for toxoplasmosis, or severe neurological picture. Brain biopsy yielded a diagnosis in 19 patients (73.1%): Progressive multifocal leukoencephalopathy (n = 8; 30.8%), primary central nervous system lymphoma (n = 6; 23.1%), mycobacteriosis (n = 2; 7.7%), toxoplasmosis (n = 2; 7.7%), criptococcosis (n = 1), cryptosporidiosis (n = 1) and HIV-encephalitis (n = 1). In one case there was a multiple diagnosis: mycobacteriosis, toxoplasmosis, and lymphoma. Brain biopsy results decided a change in therapy in 65.4%, the resolution or improvement of the neurological process in 30.8%, and the determination of the prognosis in 30.8%. In 8 cases (30.7%) there were biopsy complications, with secondary mortality in one. Brain biopsy of BML in HIV-infected patients is a diagnostic method with a high overall diagnostic rentability and uncommon non reversible complications, offering the possibility to prescribe a specific and potentially curative treatment.
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PMID:[Usefulness of cerebral biopsy in focal cerebral lesions in patients with human immunodeficiency virus infection]. 908 92

We report an autopsy case of preclinical primary central nervous system (CNS) lymphoma. The case was an 89-year-old female who died of rupture of a thoracic aortic aneurysm. No neurological abnormalities were found throughout our clinical observation. Serum anti-human T-cell leukemia virus type 1 and anti-human immunodeficiency virus were negative. Grossly, the brain was normal except for a small solid tumor, 6 by 6 by 2.5 mm, in the lateral ventricular wall at the left hippocampal fimbria, and multiple smaller disseminated nodules. Histological examination revealed multiple microscopic disseminated foci throughout the brain, including the cerebral subcortical white matter, basal nucleus, thalamus, brainstem and cerebellum. Histological classification is of lymphoblastic type non-Hodgkin's lymphoma of high-grade malignancy. Lymphoma cells are positive for leukocyte common antigen and L-26, indicating a B cell phenotype. In situ hybridization with Epstein-Barr viral probes is negative. It is concluded that this case may represent a relatively early preclinical stage of multifocal type of primary CNS lymphoma.
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PMID:Preclinical primary central nervous system lymphoma. 910 Nov 10

Chance of opportunistic infections in hospitals is increasing year by year, because of the steady increase in the number of compromised hosts. Opportunistic infections in the nervous system include fungal, protozoal, bacterial and viral infections. Cytomegalovirus and herpes virus (HSV1 and HSV2) cause encephalitis, myelitis and radiculoneuritis. Varicella-zoster virus (VZV) often causes herpes zoster, which sometimes disseminates when immunodeficiency is severe. VZV also causes encephalitis. Progressive multifocal leukoencephalopathy (PML) is caused by JC virus in severely compromised hosts. HIV encephalopathy or AIDS dementia complex is one of late stage complications of HIV infection. Prevalence of PML and HIV encephalopathy among AIDS patients tend to increase as other opportunistic infections became controllable recently. Primary CNS lymphoma in immunocompromised hosts is supposed to be caused by EB virus and/or Kaposi's sarcoma-associated herpes virus (KSHV, HHV8). In this sense, CNS lymphoma and Kaposi's sarcoma can be defined as virus infection-related condition.
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PMID:[Virus-related neurological disorders complicating in compromised hosts]. 910


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