Bricaire F, Marche C, Zoubi D, Perronne C, Matheron S, Rouveix E, Vittecoq D
Hôpital Claude-Bernard, Paris.
Ann Med Interne (Paris). 1987;138(8):607-9.
Systematic autopsy studies of 100 patients with AIDS confirmed a high incidence of adrenal lesions. Eighty eight cases were analysed, 79 men and 9 women; 57 had opportunist infection alone, 6 had Kaposi sarcomas and 30 had an association of both pathologies. The adrenal glands were normal in 19 cases and abnormal in 64 cases. One case has non-specific spongiocytic depletion and 4 were uninterpretable because of necrosis. The main adrenocortical changes were inflammatory (N = 37) or necrotic (N = 22). The commonest sites were in the adrenal medulla in the cortex or at the cortico-medullary junction. There was a high incidence of cytomegalic inclusion bodies (44 cases). In 7 cases specific lesions were observed; cryptococcus (1), toxoplasmosis (1), tuberculosis (2), Kaposi (3). Adrenal insufficiency was diagnosed before death in only 3 cases.
对100例艾滋病患者进行的系统尸检研究证实肾上腺病变的发生率很高。分析了88例患者,其中男性79例,女性9例;57例仅有机会性感染,6例有卡波西肉瘤,30例同时存在这两种病变。19例肾上腺正常,64例异常。1例有非特异性海绵状细胞耗竭,4例因坏死无法解读。主要的肾上腺皮质改变为炎症性(n = 37)或坏死性(n = 22)。最常见的部位是肾上腺髓质、皮质或皮质 - 髓质交界处。巨细胞包涵体的发生率很高(44例)。7例观察到特异性病变;隐球菌(1例)、弓形虫病(1例)、结核病(2例)、卡波西肉瘤(3例)。仅3例在死亡前被诊断为肾上腺功能不全。