Computed Tomography and Ultrasonography of the Adrenal Glands in Paracoccidioidomycosis. Comparison with Cortisol and Aldosterone Responses to ACTH Stimulation

Tendrich, Mauro; Luca, Veronica De; Tourinho, E. K.; Wanke, Bodo; Cuba, jenny Edith Laura; Buescu, Alexandru; Pereira, A; El-Andere, W.; Wajchenberg, B. L.

doi:10.4269/ajtmh.1991.44.83

Cited by 13 publications

(6 citation statements)

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“…26,27 Advancements in imaging technologies, as CT, led to the description of more adrenal lesions, with no correlation to hormonal disfunction. 28 Some patients developed adrenal insufficiency during treatment, probably due to scars resulting from the healing process.…”

Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis: Epidemiological and Clinical Aspects in 546 Cases Studied in the State of Espírito Santo, Brazil

Peçanha

Ferreira

Peçanha

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Paracoccidioidomycosis (PCM) is an endemic disease in the southeast region of Brazil, which includes the state of Espírito Santo (ES). This historic case series analyses 546 patients treated in this state from 1978 to 2012. Patients aged from 7 to 83 years, 509 males and 37 females, yielding a ratio of 13.7:1. Most of the patients (81.4%) originated from rural areas in ES, 71.0% being farmers. A higher concentration of cases was observed in municipalities located along the western range of the state. Sixty patients (11.0%) had an acute/subacute form of the disease, 485 (88.9%) had a chronic form, and one had a subclinical form. The most affected organs included the lungs, oropharyngeal mucosa, lymph nodes, skin, and larynx. The diagnosis was confirmed by histopathology in 252 (46.2%) cases, direct examination in 168 (30.7%), both exams in 111 (20.3%) and serology in 15 (2.8%). Tuberculosis, acquired immune deficiency syndrome, leishmaniasis, and intestinal parasites were the most frequently associated infectious diseases. From 328 patients followed up, total regression of the lesions was observed in 17.4%, partial regression in 77.4%, and no regression in 17 (5.2%) cases. Regarding the number of cases in this series, ES emerges as an important endemic area for PCM in Brazil.

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Section: Discussionmentioning

confidence: 99%

Paracoccidioidomycosis: Epidemiological and Clinical Aspects in 546 Cases Studied in the State of Espírito Santo, Brazil

Peçanha

Ferreira

Peçanha

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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“…The plasma ACTH levels are high in patients with PCM and clinical manifestations compatible with Addison’s disease [ 251 ], suggesting that the measurement of ACTH might be useful for early diagnosis of chronic adrenal insufficiency.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Paracoccidioidomycosis: Current Perspectives from Brazil

et al. 2017

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Background:This review article summarizes and updates the knowledge on paracoccidioidomycosis. P lutzii and the cryptic species of P. brasiliensis and their geographical distribution in Latin America, explaining the difficulties observed in the serological diagnosis.Objectives:Emphasis has been placed on some genetic factors as predisposing condition for paracoccidioidomycosis. Veterinary aspects were focused, showing the wide distribution of infection among animals. The cell-mediated immunity was better characterized, incorporating the recent findings.Methods:Serological methods for diagnosis were also compared for their parameters of accuracy, including the analysis of relapse.Results:Clinical forms have been better classified in order to include the pictures less frequently observesiod.Conclusion:Itraconazole and the trimethoprim-sulfamethoxazole combination was compared regarding efficacy, effectiveness and safety, demonstrating that azole should be the first choice in the treatment of paracoccidioidomycosis.

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“…In the chronic multifocal form, the symptoms are variable and referred to more than one organ or system. Most frequently, lesions occur in the oral and nasal mucosa, skin, lymph nodes, and adrenal glands (1,8,113,163,168,265,316). Table 2 presents the frequency of organic involvement according to three series of cases published by different investigators (56,168,212).…”

Section: Diseasementioning

confidence: 99%