Janier M, Perroud A M, Revuz J, Wechsler J, Feuilhade M, Poirier J, Caron J P, Touraine R
Ann Dermatol Venereol. 1984;111(1):11-23.
We report a new case of acquired immune-deficiency syndrome (AIDS) in a 43 year-old white homosexual man, characterized by the association of disseminated cutaneo-mucous Kaposi's sarcoma and cerebral toxoplasmosis. This man had Kaposi's sarcoma for about 10 years but evolution became quickly extensive in July 1981. Chlorambucil was prescribed at that time and was the cause of a pancytopenia. Death occurred in July 1982 due to a cerebral mass identified as toxoplasmosis on a left temporal biopsy. This observation is typical of AIDS, a new syndrome which suddenly developed in the last 2 years in the United States in homosexual men, Haitians and hemophiliacs, and is characterized by disseminated Kaposi's sarcoma and/or opportunistic infections, with a very high mortality rate. Severe toxoplasmosis of CNS has been reported in AIDS and appears to result from defects in cellular immunity which permit recrudescence of latent infection. Cerebral biopsy is necessary for the diagnosis of cerebral toxoplasmosis as seroconversion occurs infrequently in immuno-suppressed hosts. AIDS appeared in Western Europe in 1982. Most of the cases were reported in France, Denmark, Belgium and Great Britain. These cases differ from reported cases in the USA: fewer drug or poppers users, fewer homosexual men, an important number of people having lived or travelled in the Kaposi's endemic area (Mediterranean basin and Central Africa). The immunological profile of patients presenting AIDS in Europe doesn't seem to differ from the american profile: serious cellular immunodeficiency and marked increase in the suppressor/cytotoxic cell population. As in the United States, one may suspect, among several hypotheses, that it is caused by one or several transmissible agents now present in France. The nature of these agents, transmissible by sexual contacts and blood, is not yet known: the role of the CMV is now less probable and most of the studies look for the role of other factors such as the HTLV.
我们报告了一例43岁白人同性恋男性获得性免疫缺陷综合征（AIDS）新病例，其特征为播散性皮肤黏膜卡波西肉瘤与脑弓形虫病并存。该男子患卡波西肉瘤约10年，但在1981年7月病情迅速蔓延。当时开了苯丁酸氮芥，导致全血细胞减少。1982年7月因左颞叶活检确诊为弓形虫病的脑肿块而死亡。该病例是AIDS的典型病例，这是一种过去两年在美国同性恋男性、海地人和血友病患者中突然出现的新综合征，其特征为播散性卡波西肉瘤和/或机会性感染，死亡率极高。AIDS患者中曾有中枢神经系统严重弓形虫病的报道，似乎是由于细胞免疫缺陷导致潜伏感染复发所致。脑活检对于脑弓形虫病的诊断是必要的，因为免疫抑制宿主中血清转化很少发生。1982年AIDS出现在西欧。大多数病例在法国、丹麦、比利时和英国被报道。这些病例与美国报道的病例不同：药物或亚硝酸异戊酯使用者较少，同性恋男性较少，有相当数量的人曾在卡波西肉瘤流行地区（地中海盆地和中非）生活或旅行过。在欧洲出现AIDS的患者的免疫特征似乎与美国患者的特征没有差异：严重的细胞免疫缺陷以及抑制/细胞毒性细胞群体显著增加。与美国一样，在几种假设中，人们可能怀疑它是由法国目前存在的一种或几种可传播病原体引起的。这些通过性接触和血液传播的病原体的性质尚不清楚：巨细胞病毒的作用现在可能性较小，大多数研究在寻找其他因素如人类嗜T淋巴细胞病毒的作用。
