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[获得性免疫缺陷综合征中的肾上腺形态学改变]

[Adrenal gland morphological alterations in the acquired immunodeficiency syndrome].

作者信息

Duch F M, Répele C A, Spadaro F, dos Reis M A, Rodrigues D B, Ferraz M L, Teixeira V de P

机构信息

Disciplinas de Patologia Geral da Faculdade de Medicina do Triângulo Mineiro, Universidade de Uberaba, Minas Gerais.

出版信息

Rev Soc Bras Med Trop. 1998 May-Jun;31(3):257-61. doi: 10.1590/s0037-86821998000300002.

Abstract

In the acquired immunodeficiency syndrome (AIDS), the adrenal glands are subject to opportunistic infections, neoplasm or direct cytopathic effect by HIV. It is know that the incidence and type of adrenal involvement vary according to the patient's place of origin. In this paper we evaluate adrenal involvement in fourteen patients that died from AIDS in the University Hospital of Uberaba, Brazil. The group studied was comprised of thirteen males and thirteen whites. The age was 29.9 +/- 7.8 years, and the body mass index was 19.0 +/- 4.1 kg/m2. Adrenal specimens obtained from autopsies were analyzed by light microscopy. Inflammation was found in 100% of the cases and the etiologic agent(s) was (were) identified in eight (58.1%) patients. Cytomegalovirus was identified in seven cases, Cryptococcus sp and Herpes simplex in two and Histoplasma sp in one case, these pathologic findings were similar to literature. We also found parenchymal calcification and adrenal central vein phlebitis in one case each. Injury was found in some cases without identified infections agent. This fact could be due to the direct cytopathic effect by HIV, or due to toxicity of drug therapy used during treatment of AIDS and opportunistic infections.

摘要

在获得性免疫缺陷综合征(艾滋病)中,肾上腺易遭受机会性感染、肿瘤或人类免疫缺陷病毒(HIV)的直接细胞病变效应。已知肾上腺受累的发生率和类型因患者的原籍地而异。在本文中,我们评估了巴西乌贝拉巴大学医院14例死于艾滋病患者的肾上腺受累情况。所研究的组由13名男性和1名女性组成,均为白人。年龄为29.9±7.8岁,体重指数为19.0±4.1kg/m²。对尸检获得的肾上腺标本进行光学显微镜分析。100%的病例发现有炎症,8例(58.1%)患者确定了病原体。7例鉴定出巨细胞病毒,2例鉴定出隐球菌属和单纯疱疹病毒,1例鉴定出组织胞浆菌属,这些病理结果与文献报道相似。我们还分别在1例中发现了实质钙化和肾上腺中央静脉静脉炎。在一些病例中发现了损伤,但未鉴定出感染病原体。这一事实可能是由于HIV的直接细胞病变效应,或由于艾滋病和机会性感染治疗期间所用药物治疗的毒性所致。 (注:原文中性别数据存在错误,按照纠偏后翻译)

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