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)

A 3-year-old 4-kg neutered male domestic shorthair cat died within 5 days after onset of fever and respiratory distress. At necropsy, all tissues were icteric, and the liver had a diffuse reticular pattern. Histologically, hepatitis and encephalitis were associated with Toxoplasma gondii tachyzoites. Toxoplasma gondii female gamonts and oocysts were found in epithelial cells of intact villi and in epithelial cells desquamated into the lumen. Finding of acute hepatitis and T gondii oocysts in an adult cat without detectable immunodeficiency is unusual, because adult cats rarely have clinical signs of toxoplasmosis during the oocyst-shedding phase.
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PMID:Acute primary toxoplasmic hepatitis in an adult cat shedding Toxoplasma gondii oocysts. 227 58

A 5-month-old white girl having persistent oral candidiasis was brought to medical attention because of acute respiratory distress, pneumonia, and hypoxia that worsened despite supportive care and antibiotics. Bronchial lavage fluid yielded Pneumocystis carinii. The diagnosis of acquired immunodeficiency syndrome (AIDS) was suspected, although enzyme-linked immunosorbent assay (ELISA) and Western blot tests were both negative for human immunodeficiency virus (HIV) antibody. Immunologic evaluation included the following results: a low normal CD4/CD8 ratio 0.88, CD4 lymphocytes 493/microL, and elevated IgA 539 mg/dL and IgM 175 mg/dL with normal IgG 492 mg/dL. Lymphocyte stimulation study results were depressed. Lymphocytes sent for culture were subsequently positive for HIV. The mother was HIV antibody positive by enzyme-linked immunosorbent assay and Western blot but belonged to no high-risk group and was asymptomatic except for chronic diarrhea. The father was HIV antibody negative. The patient was treated with pentamidine and IV gamma-globulin with good clinical response and a rapid decrease of IgM and IgA toward normal values. Subsequent candidal pneumonia and candidal esophagitis were treated successfully with amphotericin B. The patient has received prophylactic IV gamma-globulin infusions for 6 months and remains HIV negative by enzyme-linked immunosorbent assay and Western blot. This case of pediatric AIDS highlights the need to consider HIV infection in the differential diagnosis of any child with physical findings or illnesses suggestive of AIDS-related complex or AIDS, even when HIV serologic findings are negative and parents belong to no high-risk group. Parental testing for HIV antibody is suggested in such cases.
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PMID:Pediatric acquired immunodeficiency syndrome with negative human immunodeficiency virus antibody response by enzyme-linked immunosorbent assay and Western blot. 244 52

The World Health Organization (WHO) clinical case definition for pediatric acquired immunodeficiency syndrome (AIDS) was evaluated over a 1-month period in 221 consecutive hospitalized children in Kigali, Rwanda. The median age of the children studied was 18 months (range, 1 month-14 years); 55% were boys. 34 (15%) of these 221 children were seropositive for the human immunodeficiency virus (HIV). Although the specificity of the WHO case definition was high (92%), its sensitivity was only 41% and the positive predictive value was 48%. The following individual signs had a positive predictive value at least equal to the complete WHO case definition: chronic diarrhea (47%), respiratory distress secondary to lower respiratory tract infection (50%), oral candidiasis (53%), parotitis (67%), generalized lymphadenopathy (88%), and herpes zoster infection (100%). Logistic regression analysis on the 9 variables included in the WHO case definition indicated that confirmed maternal HIV infection was the best predictive variable for HIV seropositivity in children. When maternal serological status (rarely available in Rwanda) was excluded from the analysis and a stepwise logistic regression analysis was performed on the 18 clinical signs and symptoms for which data had been collected, respiratory distress, chronic diarrhea, and generalized lymphadenopathy emerged as the signs contributing the most. On the basis of these findings, a simplified clinical case definition of pediatric AIDS is proposed for settings where resources are limited and HIV seroprevalence is high. According to this definition, pediatric AIDS should be suspected in a child presenting with 1 or both of the following clinical signs: respiratory distress secondary to lower respiratory tract infection and/or generalized lymphadenopathy. However, it is necessary to test this definition on a larger scale in Central Africa and in other parts of the world with different rates of HIV seroprevalence.
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PMID:Evaluation and simplification of the World Health Organization clinical case definition for paediatric AIDS. 250 Sep 55

Twelve children with laboratory evidence of human immunodeficiency virus (HIV) infection underwent diagnostic flexible bronchoscopy with washings or bronchoalveolar lavage at Bellevue Hospital Center from October 1987 to April 1989. The patients included 7 boys and 5 girls ranging from age 3.5 months to 10 years 5 months. Indications for bronchoscopy included respiratory distress with or without focal changes on chest radiograph in 11 patients, and persistent but asymptomatic right middle lobe collapse in one child. The etiology of pneumonia was diagnosed in 7 children and included Pneumocystis carinii, (PCP) (17%), Streptococcus viridans (17%), mechanical obstruction (17%) and cytomegalovirus (CMV) (8%). Bronchoscopy was non-diagnostic in 5 cases. Techniques for maximal yield of information using flexible bronchoscopy in HIV-positive children are discussed.
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PMID:Diagnostic flexible bronchoscopy in human immunodeficiency virus (HIV)-positive children. 262 88

The causative agent of acquired immunodeficiency syndrome is a retrovirus, human T lymphotropic virus type III/lymphadenopathy-associated virus, now known as human immunodeficiency virus (HIV). Infection of children with HIV results in a wide spectrum of clinical manifestations, ranging from asymptomatic to symptomatic, with the severest disease forms including neurologic deterioration, opportunistic infections and malignancy. This virus infects preferentially T cells bearing the CD4 receptors and also seems to exhibit preference for the central nervous system. The predominant route of infection in children is transplacental, and most affected children are infected at the time of birth. For women who give birth to infants with congenital infection with HIV, the main risk factor is intravenous drug abuse; a smaller percentage of these women acquire the infection via sexual contact and a few are infected via blood transfusions. Estimates for the incidence of transmission of the virus from an infected mother to her offspring vary from about 20 to 70%. Infection in most children and adults is documented by serologic testing, inasmuch as almost all infected people are HIV antibody-positive. Mothers of congenitally affected children are always HIV antibody-positive and also frequently have immune abnormalities. Women who give birth to infected children may, however, be asymptomatic in 50% of instances or more. Because antibodies to HIV are predominantly of the IgG class, they cross the placenta. All infants born to infected women therefore acquire passively transferred antibodies to HIV irrespective of whether or not the infants are infected with the virus itself. These passively transferred antibodies may sometimes persist for as long as 15 months. Thus in infants and children under 15 months of age in the absence of symptoms, the only definitive way to establish diagnosis is by viral isolation or viral antigen detection. Clinically the HIV-infected children can be divided into two groups, symptomatic and asymptomatic. Among the symptomatic group the main diagnostic specific features are: (1) opportunistic infection, e.g. with Pneumocystis carinii pneumonia; (2) interstitial pneumonitis with respiratory distress resulting from lymphocytic interstitial pneumonitis; (3) microcephaly and other neurologic abnormalities; (4) recurrent bacterial infections.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Human immunodeficiency virus infection in children: nature of immunodeficiency, clinical spectrum and management. 304 60

During the year 1985, 462 cases of septicemia were collected by SES group; 417 observations could be exploited. 73 patients died (17.3%). The statistical analysis of epidemiological and clinical data argued to factors correlated with high mortality rate: a shock, an acute respiratory distress syndrome, a pulmonary portal of entry lead to a high mortality rate. The fatal outcome increased with the age of the patients. A documented immunodeficiency (granulopenia, cytotoxic chemotherapy...), a previous broncho-pulmonary, neurologic or cardiovascular disease were factors of risk. The pulmonary or cutaneous localisations occurring within a septicemic phase were significantly related to death. Among fatal cases of bacteremia, 25% were Staphylococci, 25% Enterobacteria, 20% Pneumococci, 7% Pseudomonas. Pseudomonas, then Pneumococcus, then Staphylococcus bacteremias looks to have a worse prognosis. The more serious cases were prescribed several antibiotics, significantly much more than the mild cases. These results are compared with the results of former series; the main prognosis factors of actual septicemia are elicited in here.
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PMID:[Fatal septicemias: factors of mortality. Analysis of 72 fatal cases in the series of 462 case reports collected by the Septicemia Expert System group in 1985]. 330 21

The 1st case of acquired immunodeficiency syndrome (AIDS) in Malaysia was detected in 1987, 1 year after the Ministry of Health established a national AIDS task force. The patient was a 45-year-old Chinese man of Malaysian origin who had been living overseas for the past 30 years. The patient denied any homosexual relationships, blood transfusions, of intravenous drug use; however, he reported multiple sexual partners 10 years prior to developing AIDS. At hospital admission, the patient was in acute respiratory distress and Pneumocystis carinii was isolated from his sputum. The enzyme-linked immunosorbent assay and Western blot tests revealed antibodies to human immunodeficiency virus (HIV). The T- helper/T-suppressor cell ratio was inverted, 16:51%. There were no antibodies to cytomegalovirus or toxoplasmosis. The patient showed rapid clinical improvement after treatment with co-trimoxazole and was released from the hospital 2 weeks after admission. Although this is the 1st case of full-blown AIDS in Malaysia, individuals with antibodies to HIV have been identified.
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PMID:The acquired immune deficiency syndrome: a report of the first case in Malaysia. 350 33

A newborn presented with respiratory distress syndrome that was felt to be both clinically and roentgenographically typical of hyaline membrane disease. At autopsy, the lungs were firm, dry, and bulky, and sections from all lobes revealed mucin-negative, periodic acid-Schiff-positive, diastase-resistant material typical of pulmonary alveolar proteinosis. Electron microscopy documented the lamellar structure of the intra-alveolar material. There was no clinical or autopsy evidence of immunodeficiency.
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PMID:Pulmonary alveolar proteinosis in the newborn. 383 81

Of 67 infants enrolled in a prospective study of infant pneumonia ten (14%) had evidence of Pneumocystis carinii infection. Diagnosis was achieved by demonstrating circulating P carinii antigens by counterimmunoelectrophoresis in all ten cases and by histopathology in the only infant who underwent an open lung biopsy. Antigenemia did not occur in 64 control infants (P = .003), nor in 57 patients of similar age who were hospitalized with pneumonitis due to Chlamydia trachomatis, respiratory syncytial virus, cytomegalovirus, adenovirus, and influenza A and influenza B viruses. None of the ten infants with P carinii pneumonitis had evidence of a primary immunodeficiency nor had any received immunosuppressive medication. These patients were hospitalized at a mean age of 6 weeks (range 2 to 12) and their illness was characterized by its afebrile course, presentation in crisis with severe respiratory distress, apnea, tachypnea, cough, increased IgM, and bilateral pulmonary infiltrates with hyperaeration. The clinical features of P carinii pneumonitis were indistinguishable from those of C trachomatis and cytomegalovirus pneumonia. Treatment with trimethoprim-sulfamethoxazole was associated wtih rapid disappearance of circulating antigens; however, the small number of patients studied did not permit an analysis of its clinical efficacy. These results indicate that P carinii singly or in combination with other infectious agents may be an important cause of pneumonitis in young, immunocompetent infants with no underlying illnesses.
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PMID:Pneumocystis carinii pneumonitis in young immunocompetent infants. 696 88

Delayed hypersensitivity skin testing was performed in 129 critically ill patients. Six intradermal antigens were used: tuberculin, candidin, varidase, epidermophytin, trichophytin and CCB (a polyvalent microbial vaccine from the Pasteur Institute). The response was judged as positive when one test or more were positive. Patients were devided in four groups: group A (40 cases): non-infected patients, a priori without immunodeficiency; group B (14 cases); suspected of immunodeficiency (cancers, hemopathies, collagen diseases receiving corticosteroids); group C (24 cases): decompensated chronic respiratory insufficienceis; group D (50 cases): overwhelming sepsis (septicaemias, septic acute respiratory distress syndromes, thoracic empyemas, purulent meningitis, peritonitis, mediastinitis). A significant diminution of delayed hypersensitivity was observed in groups B, C and D. No relation was found between delayed hypertensitivity and prognosis in groups C and D.
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PMID:[Cell-mediated immunity study by skin testing in 129 critically ill patients (author's transl)]. 698 93


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