While several studies have been conducted on the immune cell populations in systemic lupus erythematosus (SLE) and Parkinson's disease (PD) patients, very few works have focused on the relationship between both diseases. Being a purely autoimmune disease, SLE is known to exhibit high levels of proinflammatory cells. On the other hand, neuroinflammation is a key contributor to the death of dopaminergic neurons in PD. Herein, we report the case of a patient suffering from both SLE and PD, comparing it with a patient suffering from PD only. Our results are informative, showing decreased levels of regulatory populations like CD8+regs and functional Bregs in the SLE/PD patient. In contrast, the levels of tolerogenic dendritic cells were up to 10 times higher in this patient. Additionally, the levels of Tr1, Th3, and functional CD8 cells, as well as those of M2-like monocytes, were higher in the SLE/PD patient. Regarding the inflammatory response, increased levels of total CD8+ T cells and CD40-expressing DCs were observed. In conclusion, significant changes in the levels of immune cell populations were observed in a patient suffering from SLE and PD, suggesting that the immune response could impact the pathophysiology of PD.
Background:
Glioblastoma multiforme represents approximately 60% of all brain tumors in adults. This malignancy shows a high level of biological and genetic heterogeneity associated with exceptional aggressiveness, leading to poor patient survival. One of the less common presentations is the appearance of primary multifocal lesions, which are linked with a worse prognosis. Among the multiple triggering factors in glioma progression, the administration of sex steroids and their analogs has been studied, but their role remains unclear to date.
Case Description:
A 43-year-old transgender woman who has a personal pathological history of receiving intramuscular (IM) hormone treatment for 27 years based on algestone/estradiol 150 mg/10 mg/mL. Three months ago, the patient suddenly experienced hemiplegia and hemiparesis in her right lower extremity, followed by a myoclonic focal epileptic seizure, vertigo, and a right frontal headache with a visual analog scale of 10/10. Magnetic resonance imaging images revealed an intra-axial mass with poorly defined, heterogeneous borders, and thick borders with perilesional edema in the left parietal lobe, as well as a rounded hypodense image with well-defined walls in the right internal capsule. The tumor was resected, and samples were sent to the pathology department, which confirmed the diagnosis of wild-type glioblastoma.
Conclusion:
This report identifies prolonged use of steroid-based hormone replacement therapy as the only predisposing factor in the oncogenesis of multifocal glioblastoma. It is an example that highlights the importance for physicians not to consider pathologies related to the human immunodeficiency virus rather than neoplasms in transgender patients in view of progressive neurological deterioration.
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