Comprometimento da medula óssea e eosinofilia na paracoccidioidomicose

Shikanai-Yasuda, Maria Aparecida; Higaki, Yasuki; Uip, David Éverson; Mori, Naoko; Negro, G. Del; Melo, Natalina Takahashi de; Hutzler, R U; Neto, Vicente Amato

doi:10.1590/s0036-46651992000200002

Cited by 31 publications

(19 citation statements)

References 15 publications

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“…) patients. 17 A second study was a case report of a six-yearold boy with paracoccidioidomycosis who had eosinophilia in the bone marrow and the blood. 29 Another study on the in vitro response of lymphocytes from patients with paracoccidioidomycosis showed an inverse correlation of P. brasiliensis antigen response with eosinophil levels and anti-P. brasiliensis antibody levels.…”

Section: Discussionmentioning

confidence: 99%

“…15,16 One report on paracoccidioidomycosis showed peripheral blood eosinophilia in the three patients studied. 17 Eosinophils contain several cationic proteins, including major basic protein (MBP), eosinophil-derived neurotoxin (EDN), eosinophil cationic protein (ECP), and eosinophil peroxidase (EPO). 18 Major basic protein is toxic to mammalian cells, 19 parasites, 8,10,12 and bacteria in vitro.…”

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confidence: 99%

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Localization of eosinophil granule major basic protein in paracoccidioidomycosis lesions.

Wagner

Franco

Kephart

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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Abstract. Paracoccidioidomycosis is a chronic granulomatous disease caused by the fungus Paracoccidioides brasiliensis. Although eosinophils have long been associated with the immune defense against helminths, the role of eosinophils in the immune response to fungal diseases is not as well studied. The eosinophil granule major basic protein is toxic to helminths and mammalian cells in vitro, and its release has been used as a marker of eosinophil localization and degranulation. To determine whether eosinophil infiltration and degranulation, as evidenced by the deposition of major basic protein, occur in lesions of P. brasiliensis, we used an immunofluorescence technique to localize the P. brasiliensis organisms and eosinophils and major basic protein. Initially, all tissues were stained with polyclonal antibody to major basic protein; subsequently, colocalization of major basic protein and P. brasiliensis by double staining with mouse and rabbit antibodies, respectively, was performed. Nine biopsy tissues from seven patients were analyzed. All nine biopsies showed infiltration of intact eosinophils using both the monoclonal and the polyclonal anti-major basic protein antibodies, along with the presence of P. brasiliensis. Furthermore, using the polyclonal antimajor basic protein antibody, nine of nine tissues showed extracellular major basic protein deposition (granular or diffuse fluorescence staining outside of intact eosinophils). The double staining procedure using the anti-major basic protein monoclonal antibody showed extracellular deposition in five of eight biopsies; in these five biopsies, approximately 60% of the areas containing P. brasiliensis had extracellular major basic protein deposited on the organisms. These observations support the hypothesis that the eosinophil, through toxic granule proteins such as major basic protein, participates in the pathophysiology of paracoccidioidomycosis.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Localization of eosinophil granule major basic protein in paracoccidioidomycosis lesions.

Wagner

Franco

Kephart

et al. 1998

The American Journal of Tropical Medicine and Hygiene

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“…Hypereosinophilia in this disease has been attributed to high levels of cytokines, particularly IL-5, which are accompanied by Th2 cell immune response and disseminated injury. (13,16) In the case reported here, incipient cervical lymph node enlargement and splenomegaly suggest extrapulmonary dissemination of P. brasiliensis and possible progression to the acute form of paracoccidioidomycosis. It is interesting that hypereosinophilia resolved rapidly with antifungal therapy, as has been observed in similar cases.…”

Section: Discussionmentioning

confidence: 63%

“…(14,15) Hypereosinophilia sometimes occurs in acute or subacute paracoccidioidomycosis in children (6,14) and in young adults. (16) On chest X-rays, 3 of 7 children with more than 5,000 eosinophils/µL of blood presented pulmonary condensation or perihilar infiltrate, (14) possibly corresponding to initial lung injury in patients with disseminated paracoccidioidomycosis. Hypereosinophilia in this disease has been attributed to high levels of cytokines, particularly IL-5, which are accompanied by Th2 cell immune response and disseminated injury.…”

Section: Discussionmentioning

confidence: 99%

“…It is interesting that hypereosinophilia resolved rapidly with antifungal therapy, as has been observed in similar cases. (16) Cases with initial injury caused by P. brasiliensis are indicators of the ecoepidemiology of paracoccidioidomycosis. The acquisition of this infection by the patient probably occurred in the journey between the cities of Ribeirão Preto e São José do Rio Pardo, both located in regions where paracoccidioidomycosis is hyperendemic.…”

Section: Discussionmentioning

confidence: 99%

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Complexo primário da paracoccidioidomicose e hipereosinofilia

Martínez¹,

Moya²

2009

J. bras. pneumol.

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paracoccidioidomycosis is more poorly characterized, either due to the fact that it is uncommon in its acute or subacute form or due to the scarcity of cases of regressive forms or symptomatic infection. (3,4) The primary complex resulting from infection with P. brasiliensis has rarely been observed in children (5,6) or in immunocompromised adults.Here, we report the case of a young adult who presented with lung injury, hilar lymph node enlargement and hypereosinophilia as manifestations of the initial phase of this fungal infection. Case reportA 28-year-old white male, who was a physician and a resident of the city of Ribeirão Preto, Brazil, presented with a three-month history of daily fever (37.5-38.5°C). He also presented with intense nonproductive cough, chest pain IntroductionInfection with Paracoccidioides brasiliensis is acquired via the airways and occurs in endemic areas in South America. In most individuals, the infection resolves spontaneously, leaving a scarring lung or lymphatic injury where the fungus can remain latent.(1) Some of those infected develop a self-limiting disease (regressive form of paracoccidioidomycosis), which is poorly understood, or a generalized disease, which predominantly affects the lymphatic system, the macrophagic-monocytic system and the skin (acute or subacute form). In adults over 30 years of age, it is known that reactivation of latent foci of P. brasiliensis result in injury to the lungs, the oropharyngeal mucosa and other tissues (chronic form).(2)The chronic form of the lung disease is progressive and, on X-rays, typically appears as bilateral diffuse reticulomicronodular interstitial infiltrate. AbstractPrimary infection with Paracoccidioides brasiliensis has rarely been observed. A 28-year-old male patient presented with a three-month history of fever, respiratory symptoms and malaise. Chest X-rays revealed bilateral apical infiltrates, right pleuritis and hilar lymphadenomegaly. The patient presented with leukocytosis, severe eosinophilia and increasing titers of anti-P. brasiliensis antibodies in serum. To our knowledge, this is the first report of the primary pulmonary lymph node complex of paracoccidioidomycosis accompanied by hypereosinophilia and affecting a previously healthy adult.Keywords: Paracoccidioidomycosis; Eosinophilia; Lung diseases, fungal. ResumoA infecção primária por Paracoccidioides brasiliensis é observada raramente. Um paciente masculino de 28 anos de idade apresentou febre, sintomas respiratórios e indisposição durante três meses. Exames radiológicos evidenciaram infiltrado pulmonar apical bilateral, pleurite à direita e linfadenomegalia hilar. O paciente apresentava leucocitose, intensa eosinofilia e títulos crescentes de anticorpos séricos anti-P. brasiliensis. Até onde sabemos, este é o primeiro relato do complexo primário da paracoccidioidomicose, associado com hipereosinofilia, apresentado por um adulto previamente hígido.

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Paracoccidioidomycosis

Benard¹,

Franco²

2010

Topley &Amp; Wilson's Microbiology and Microbial Infections

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Comprometimento da medula óssea e eosinofilia na paracoccidioidomicose

Cited by 31 publications

References 15 publications

Localization of eosinophil granule major basic protein in paracoccidioidomycosis lesions.

Localization of eosinophil granule major basic protein in paracoccidioidomycosis lesions.

Complexo primário da paracoccidioidomicose e hipereosinofilia

Paracoccidioidomycosis

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