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Biomedical subjects

P Angritt

Publications and source records attributed to P Angritt.

At least 37 records · Page 2Linked to original sources
PubMed1992

Epstein-Barr virus in Hodgkin's disease from patients with human immunodeficiency virus infection.

The polymerase chain reaction (PCR) technique was used to detect the presence of Epstein-Barr virus (EBV) DNA sequences in Hodgkin's disease specimens from 10 patients who were also positive for the human immunodeficiency virus (HIV). Eight of 10 specimens were positive for EBV, compared to 23 of 57 Hodgkin's disease specimens from patients without HIV infection, suggesting a closer association between Epstein-Barr virus infection and Hodgkin's disease in patients with HIV infection than in the general population.

Adult↗
PubMed1992

Pediatric AIDS and perinatal HIV infection in Zaire: epidemiologic and pathologic findings.

HIV infection in women and children is a special problem in Zaire and in other countries where heterosexual transmission is predominant. Nearly half of the cases of HIV infection are in women 15 to 30 years old and as many as seven infected infants may be born each year. Whether or not infected at birth, these children have mothers, and often fathers, who are infected and likely to die while they are still very young. Such orphaned children, as well as those whose families cannot provide adequate food and health care, add to the problematic economies of developing countries. The problems of children of HIV-infected mothers in developing countries may be compounded further by factors directly related to their mother's disease. Infected mothers who are sick may produce insufficient levels of antibodies and be unable to provide their children with adequate natural passive immunity before birth. Their infants may also receive inadequate levels of breast-milk-derived antibodies possibly enhancing their already increased susceptibility to perinatal infections, and lastly, the volume of breast milk produced by these mothers may be inadequate for the nutrition of these infants. All these factors may further compromise the already difficult task of distinguishing those infants of HIV-infected mothers who are ill because they are infected from those who are ill because of their mother's disease. Regardless of the mechanisms accounting for the increased vulnerability of infants of HIV--seropositive and AIDS-afflicted mothers to perinatal infections, infant mortality can be expected to increase significantly as a direct consequence of the progression of the HIV pandemic throughout Africa and possibly other developing countries; this in populations already with a total under five-years-of-age mortality rate exceeding 15%. The association of chorioamnionitis with HIV seropositivity and with the clinical status of the mother seems to suggest that impaired maternal immunity increases the risk of premature birth, its consequent lower birth weight, and to HIV or other perinatally acquired infections. The identification of women at higher risk of chorioamnionitis and their treatment might provide a means to decrease the risk of premature delivery and possibly reduce the rate of HIV transmission to their infants. The pathologic changes in organs of infants and children with HIV infection require in-depth, systematic study to better define the natural history of perinatal HIV disease and infection.(ABSTRACT TRUNCATED AT 400 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1992

Disseminated microsporidiosis (Encephalitozoon hellem) and acquired immunodeficiency syndrome. Autopsy evidence for respiratory acquisition.

Microsporidia are obligate intracellular protozoal parasites that infect a variety of cell types in a broad range of invertebrates and vertebrates. They have recently come to medical attention due to the increased frequency with which members of two microsporidian genera, Enterocytozoon and Encephalitozoon, are being diagnosed in patients with the acquired immunodeficiency syndrome (AIDS). The majority of published reports of human microsporidiosis describe Enterocytozoon infection of small intestinal enterocytes. In addition, a growing number of AIDS patients have been identified with infection due to the two species of Encephalitozoon-Encephalitozoon cuniculi and Encephalitozoon hellem, observed in conjunctival, corneal, and, recently, sinonasal tissues. However, there are scant data regarding the systemic pathology and epidemiology of these infections. This article describes a patient with AIDS who died with systemic Encephalitozoon infection. The etiologic microsporidian was found to be E hellem by using antemortem biochemical and antigenic analyses. A complete autopsy, the first to be reported in a patient with this infection, revealed organisms in the eyes, urinary tract, and respiratory tract. A surprising observation was the occurrence of numerous organisms within the lining epithelium of almost the entire length of the tracheobronchial tree, suggestive of respiratory acquisition. Detailed light and electron microscopic findings and the biological and diagnostic features of microsporidiosis are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Cutaneous histopathologic, immunohistochemical, and clinical manifestations in patients with hemophagocytic syndrome. Military Medical Consortium for Applied Retroviral Research (MMCARR).

BACKGROUND AND DESIGN: The hemophagocytic syndrome (HPS) is characterized by fever, wasting, generalized lymphadenopathy, hepatosplenomegaly, and pancytopenia, often with associated coagulopathy. The most common cutaneous manifestations are panniculitis and purpura. Cytophagic histiocytic panniculitis fits within the spectrum of HPS, and the most consistent histopathologic feature in HPS is a proliferation of mature histiocytes that exhibit prominent erythrophagocytosis and cytophagocytosis. The clinical spectrum, the underlying causes, and the histopathologic features found in HPS are broad. The characteristic phagocytic histiocytes seen in HPS have been confused with malignant histiocytes in the past, but are now known to be reactive. The clinical findings, histologic, and immunohistochemical features of 10 cases of HPS with cutaneous lesions were reviewed. Immunohistochemical markers included KP-1, beta F-1, UCHL-1, L-26, MAC-387, factor XIIIa, and S100 protein. RESULTS: The HPS was associated with T-cell lymphoma and/or viral infection. Most biopsy specimens showed edema and hemorrhage with a lymphohistiocytic infiltrate and prominent histiocytic cells showing erythrophagocytosis and, in some cases, cytophagocytosis. The histiocytic cells showed positive reactions for KP-1 and negative reactions for the lymphoid markers. In all cases the lymphoid cells showed a mixed pattern with most cells positive for beta F-1 and UCHL-1, and a small percentage positive for L-26. CONCLUSION: In HPS, the prominent phagocytic histiocytes are reactive and are stimulated by T-cell lymphocytes, either neoplastic or in response to viral infection. Many of the findings in the HPS may also be due directly or indirectly to cytokines produced by proliferating T-cell lymphocytes and/or reactive phagocytic histiocytes.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Mycoplasma fermentans (incognitus strain) infection in the kidneys of patients with acquired immunodeficiency syndrome and associated nephropathy: a light microscopic, immunohistochemical, and ultrastructural study.

We studied renal tissues from 203 patients with acquired immunodeficiency syndrome (AIDS). Of the 203 patients, 20 showed light-microscopic changes characteristic of AIDS-associated nephropathy (AAN). Fifteen of the 20 (group A) were examined by immunohistochemistry using Mycoplasma fermentans (incognitus strain)-specific monoclonal antibodies and electron microscopy. Renal tissues from all 15 AAN patients showed positive staining for the incognitus strain mycoplasmal antigens within glomerular endothelial and epithelial cells, glomerular basement membrane, tubular epithelial cells and casts, and mononuclear interstitial cells. Ultrastructural study of these 15 cases revealed mycoplasma-like structures in various locations including glomerular epithelial and endothelial cells, glomerular basement membrane, tubular epithelial cells and casts, and mononuclear interstitial cells. In a parallel study, renal tissues from 15 patients with AIDS with essentially normal renal histology or mild interstitial mononuclear cell infiltration (group B) were also examined. These tissues showed no evidence of incognitus strain mycoplasmal infection in renal parenchymal cells; however, occasional scattered mononuclear interstitial cells were positive for the antigens of this organism. Renal tissues from five patients dying with non-AIDS diseases (group C) showed no staining for the incognitus strain antigens in any location. Therefore, infection of renal parenchymal cells by M fermentans (incognitus strain) in the kidneys of AIDS patients is apparently associated with AAN.

AIDS-Associated Nephropathy↗
PubMed1991

Concurrent epidermal involvement of cytomegalovirus and herpes simplex virus in two HIV-infected patients. Military Medical Consortium for Applied Retroviral Research (MMCARR).

Although cytomegalovirus has previously been reported in cutaneous lesions of patients infected with the human immunodeficiency virus, these reports are not common despite the prevalence of this infection and the significant pathologic characteristics that it induces in HIV disease. Rare reports of possible epidermal involvement by cytomegalovirus have never been fully documented and have been believed by some to represent epidermal involvement by varicella-zoster and/or herpes simplex infections, with dermal involvement of cytomegalovirus. We present two cases of concurrent epidermal involvement by cytomegalovirus and herpes simplex virus documented by immunohistochemical studies and DNA hybridization studies and correlate this with the distinctive morphologic features seen in these two viral infections on routine staining.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Cutaneous lesions of listeriosis in a newborn.

Although HIV-infected patients are commonly infected by organisms that require an intact T cell immune system for control or eradication, there are some exceptions. The intracellular pathogen Listeria monocytogenes is one such organism. Listeriosis occurs primarily in neonates, elderly patients, patients on immune suppressive medications, cancer patients, and during pregnancy. However, listeriosis is an uncommon opportunistic infection in HIV-infected patients. We report a case of listeriosis with cutaneous lesions in a neonate born to an HIV-infected woman.

Humans↗
PubMed1991

Papular eruption of human immunodeficiency virus disease. A review of the clinical, histologic, and immunohistochemical findings in 48 cases. The Military Medical Consortium for Applied Retroviral Research.

The papular eruption (PE) associated with human immunodeficiency virus infection, although described as a distinctive clinicopathologic entity, has shown a wide range of histologic findings ranging from eosinophilic folliculitis to granuloma annulare. We examined 48 cases of the PE in order to define the histologic spectrum of these lesions, and to correlate these findings with clinical presentations. The most distinctive clinical features are the frequency of these lesions in this population, the large number of lesions, pruritus, and the chronic nature of the lesions. Histologically, the distinctive features are the prominent perivascular factor XIIIa-positive dermal dendritic cells, atypical vascular proliferation, and dermal fibrosis sometimes associated with diffuse necrobiotic changes.

Adult↗
PubMed1991

Histopathologic features of HIV-associated skin disease.

The cutaneous lesions that occur in individuals infected with the human immunodeficiency virus are often more severe than those in normal individuals. Of great importance is the fact that many common disorders may show atypical clinical and histologic features, which can lead to misdiagnosis and delayed or inadequate therapy. Therefore, knowledge of pitfalls combined with adequate biopsy and thorough histologic evaluation give the greatest chances of successful diagnosis and treatment.

HIV Infections↗
PubMed1990

Cutaneous histopathologic findings in 'antiphospholipid syndrome'. Correlation with disease, including human immunodeficiency virus disease.

The term antiphospholipid syndrome is used to characterize a complex of clinical and pathologic findings mediated by a group of antibodies formed against a family of antiphospholipids. These antiphospholipid antibodies were originally found in patients with lupus erythematosus in whom the partial thromboplastin time was prolonged and in patients with other autoimmune diseases; subsequently, they have been observed in association with a variety of other conditions, including infections, reactions to drugs, malignant neoplasms, human immunodeficiency virus disease, and as an isolated finding. In recent years, there has been some clarification of the significance of the various tests for antiphospholipid antibodies, including the lupus anticoagulant test and the anticardiolipin antibody tests, in predicting the antiphospholipid syndrome. The mechanism of disease, however, has not been well defined. The most common cutaneous lesion seen in seven patients with lupus anticoagulant and anticardiolipin antibody who have the antiphospholipid syndrome was ulceration due to thrombosis of dermal veins and arteries. Often there is a reactive vascular proliferation around the thrombosed vessels. The presence of primary thrombosis of both veins and arteries in thrombotic disorders is unusual and may provide insight into the mechanism of thrombosis in antiphospholipid syndrome.

AIDS-Related Complex↗
PubMed1989

Pneumocystis carinii infection in the acquired immune deficiency syndrome.

The acquired immune deficiency syndrome (AIDS) pandemic has focused attention on Pneumocystis carinii pneumonia (PCP). Of special significance are the following key issues. (1) PCP in the AIDS patient can be clinically different than in the non-AIDS patient. (2) The morphologic expressions of PCP in both AIDS and non-AIDS patients are considerably more diverse than previously believed. (3) Rapid diagnostic methods that unequivocally demonstrate the PC microorganisms in the tissue and secretions are crucial to patient care. The clinical manifestations of PCP overlap with those of other pulmonary disorders so that its diagnosis requires at least bronchoscopy, if not an open lung biopsy. In biopsy specimens, typical and atypical histologic features allow the recognition of PCP under microscopic examination. The sensitivities of transbronchial biopsies and bronchoalveolar lavage are comparable, and their combination offers the greatest diagnostic yield. This article discusses the clinical and pathologic features of PCP in the AIDS patient, and explores the advantages and pitfalls of the various diagnostic methods for the identification of PC.

Acquired Immunodeficiency Syndrome↗
PubMed1988

AIDS and the mycoses.

Profoundly immunoincompetent, patients with AIDS are vulnerable to myriad opportunistic bacterial, viral, protozoal, and fungal pathogens. Opportunistic infections in patients with AIDS are often severe, persistent, and relapsing despite appropriate therapy. Some infections are virtually untreatable. This article describes the mycotic complications in these patients.

Acquired Immunodeficiency Syndrome↗