Cases reported "Hypersensitivity, Delayed"

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1/3. Mycobacterium avium infection and immune restoration disease after highly active antiretroviral therapy in a patient with hiv and normal CD4 counts.

    A patient infected with hiv who had normal CD4 T-cell counts developed mycobacterium avium complex lymphadenitis associated with restoration of delayed-type hypersensitivity responses to mycobacterial antigens after commencing highly active antiretroviral therapy (Mycobacterium avium immune restoration disease). This case provides further evidence that delayed-type hypersensitivity responses and CD4 T-cell counts are independent indicators of the cellular immune defects induced by hiv infection and that Mycobacterium avium immune restoration disease may occur in patients with persistently normal CD4 T-cell counts.
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keywords = avium
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2/3. leprosy and AIDS: two cases of increasing inflammatory reactions at the start of highly active antiretroviral therapy.

    Reported here are the cases of two hiv-positive patients with skin lesions suggestive of leprosy, based on clinical and pathological analysis, which worsened during the few weeks following initiation of highly active antiretroviral therapy. The lesions improved after a few weeks of multidrug therapy for leprosy. mycobacterium leprae was confirmed by polymerase chain reaction analysis of blood in case 1 and of a biopsy sample in case 2. Neither mycobacterium avium complex nucleic acid, which is usually associated with immune restoration syndrome, nor mycobacterial cutaneous manifestations were detected in either case.
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ranking = 0.14285714285714
keywords = avium
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3/3. Deficiency of immunity to Mycobacterium avium that can be restored by allogeneic lymphocytes.

    A 3-year-old girl developed a disseminated Mycobacterium avium infection despite treatment with eight antimycobacterial drugs. She had no pre-existent general humoral or cellular immunodeficiency. In the course of the disease B lymphocyte areas in the lymphoid tissues were replaced by histiocytes and an IgM and iga deficiency evolved. The patient still made antibodies to concomitant micro-organisms and to transfused blood cells. Peripheral blood mononuclear cells (PBMC) had normal responses to mitogens and various antigens in vitro. However, she lacked any response to mycobacterial antigens, in vivo and in vitro. The defect appeared not to be dependent on immunosuppression by lymphocytes or monocytes or on deficient antigen presentation by monocytes. because a genetic origin could not be substantiated, acquired immunological paralysis for mycobacterial antigens was the most likely explanation. Addition of irradiated PBMC from her HLA-A, -B, -C and -DR phenotypically identical father, transferred a response to mycobacterial antigens of the patient's PBMC in vitro. We concluded that the disseminated M. avium infection was accompanied by a selective deficiency of the lymphocyte response to mycobacterial antigens which could be restored by allogeneic antigen responsive lymphocytes.
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ranking = 0.85714285714286
keywords = avium
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