Estudo da micobacteriose pulmonar em pacientes autopsiados com e sem AIDS : avaliação histopatologica, imunohistoquimica e caracterização das especies de micobacterias por PCR

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Introduction: Micobacteriosis (MB) is one of the main causes of deaths around the world and its incidence has been increased significantly with the emergence of the AIDS. Objectives: Our aims were to compare the pattern of the inflammatory response in the pulmonary MBs (PMB) between two groups (Group I: PMB; Group II: PMB/AIDS), and to identify the mycobacterium species using PCR technique.Material and Methods: 16 cases of PMB for group I and 59 cases for group II had been selected from autopsied patients in the Department of Pathology of the FMUSP between 1975 to 2004. We performed H&E and Ziehl-Neelsen (ZN) for the histopathology study, and for the immunohistochemical study we use Anti-BCG antibodies, CD4, CD8, CD15, CD20 and CD68. We select 20 cases of PMB distributed equally in the both groups for the identification of the M. tuberculosis and M. avium. Results: The mean age was 28,52 years + 18, 21 and 36,2 years + 10,36 for the group I and group II, respectively. The histopathology analysis showed well-organized granulomas in 15 cases of the group I, while the group II exhibited a predominance of the poorly organized granulomas. The ZN was positive in 82,35% of the cases in the group I and 84.75% in the group II. The immunohistochemistry for BCG was positive in all cases of the both groups. Group I presented a strong prevalence of TCD4 lymphocytes (37,65%), followed by TCD8 lymphocytes (26,85%), macrophages (23,71%), B lymphocytes (7,31%) and neutrophils (4,4%). The group II displayed a predominance of macrophages (50,28%), followed by TCD8 lymphocytes (23,75%), TCD4 lymphocytes (20,05%), B lymphocytes (4,47%) and neutrophils (1,45%). The species of M. tuberculosis was identified in 8 cases of both the groups. The species of M. avium was only found in one case of the group II. Conclusion: With the advent of the AIDS it had a change in the immunologic profile of the MBP because of the depletion of lymphocytes TCD4. The antibody anti-BCG can be useful to identify cases of PMB that had been negatives for ZN. The PMB was mainly caused by M. tuberculosis in both groups

ASSUNTO(S)

diagnostico aids (disease) diagnosis pulmonary aids (doença) micobacterias tuberculosis pulmonar mycobacteria tuberculosis

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