Alemán C, Alegre J, Suriñach J M, Jufresa J, Falcó V, Fernández de Sevilla T
Servicio de Medicina Interna, Hospital General Universitario Valle Hebrón, Barcelona.
Rev Clin Esp. 1996 Jun;196(6):375-7.
To study the clinical and immunological features of esophageal candidiasis in patients with no changes in cellular immunity.
Seven patients with the endoscopic diagnosis of esophageal candidiasis were studied and in no patient were changes in cellular immunity detected. An investigation was carried out of the presence of antibodies to the human immunodeficiency virus antigen, lymphocyte populations, complement, and immunoglobulins.
Seven male patients with a mean age of 57 years (range: 43-67 years) and no underlying diseases were studied. The symptom at presentation in all cases was dysphagia and odynophagia of several days; two patients had also retro-sternal pain and one of them upper digestive hemorrhage. The digestive endoscopy showed white confluent patches highly suggestive of esophageal candidiasis. Therapy with intravenous fluconazole was started and both the clinical course and endoscopic lesions had a favorable outcome. Antibodies and antigen of human immunodeficiency virus were negative. Lymphocyte populations, complement, and immunoglobulins were normal in all patients but one, in whom a severe IgG hypogammaglobulinemia was detected.
Esophageal candidiasis, though rare, is an entity to be considered in immunocompetent patients or with no changes in cellular immunity.
研究细胞免疫无变化的患者食管念珠菌病的临床和免疫学特征。
对7例经内镜诊断为食管念珠菌病的患者进行研究，所有患者均未检测到细胞免疫变化。对人类免疫缺陷病毒抗原抗体、淋巴细胞亚群、补体及免疫球蛋白进行检测。
研究对象为7例男性患者，平均年龄57岁（范围：43 - 67岁），无基础疾病。所有患者就诊时的症状均为持续数天的吞咽困难和吞咽痛；2例患者伴有胸骨后疼痛，其中1例有上消化道出血。消化内镜检查显示白色融合斑，高度提示食管念珠菌病。开始静脉滴注氟康唑治疗，临床病程和内镜下病变均有良好转归。人类免疫缺陷病毒抗体和抗原均为阴性。除1例检测到严重IgG低丙种球蛋白血症外，所有患者的淋巴细胞亚群、补体及免疫球蛋白均正常。
食管念珠菌病虽罕见，但在免疫功能正常或细胞免疫无变化的患者中也应予以考虑。
