RESUMO
Niemann-Pick type C (NPC), a lysosomal storage disorder, is mainly caused by mutations in the NPC1 gene. Niemann-Pick type C patients and mice show intracellular cholesterol accumulation leading to hepatic failure with increased inflammatory response. The complement cascade, which belongs to the innate immunity response, recognizes danger signals from injured tissues. We aimed to determine whether there is activation of the complement system in the liver of the NPC mouse and to assess the relationship between C3 activation, a final component of the pathway, and NPC liver pathology. Niemann-Pick type C mice showed high levels of C3 staining in the liver which unexpectedly decreased with aging. Using an inducible NPC1 hepatocyte rescue mouse model, we restored NPC1 expression for a short time in young mice. We found C3 positive cells only in non-rescued cells, suggesting that C3 activation in NPC cells is reversible. Then, we studied the effect of C3 ablation on NPC liver damage at two postnatal time points, P56 and P72. Deletion of C3 reduced the presence of hepatic CD68-positive cells at postnatal day 56 and prevented the increase of transaminase levels in the blood of NPC mice. These positive effects were abrogated at P72, indicating that the complement cascade participates only during the early stages of liver damage in NPC mice, and that its inhibition may serve as a new potential therapeutic strategy for the disease.
Assuntos
Complemento C3/metabolismo , Fígado/patologia , Doença de Niemann-Pick Tipo C/imunologia , Envelhecimento/patologia , Animais , Células Espumosas/metabolismo , Células Espumosas/patologia , Camundongos Endogâmicos C57BLRESUMO
Patients with lepromatous leprosy that have received treatment for many years usually get follow up biopsies for persistent skin lesions or positive bacilloscopy even if the values are lower than in the initial bacilloscopy. We report the case of a 48-year old woman with long-standing lepromatous leprosy of 15 years of evolution, with a bacterial index of 4 in the direct smear and the initial skin biopsy. The patient was treated with multidrug therapy for 32 months although the treatment recommended by the World Health Organization (WHO) is only for 12 months. A skin biopsy was taken to determine if there was an active disease. We observed a diffuse dermal inflammation with numerous foreign body giant cells and vacuolated macrophages (Virchow´s cells). These cells contained granular acid-fast material that was also positive with immunohistochemistry for BCG. There were fragmented bacilli and the BI was 2. These cells were also strongly positive for CD68. The biopsy was interpreted as a residual form of lepromatous leprosy that did not require further multidrug therapy. We have observed similar histological profiles in several cases. The lack of clinical data makes it a histological challenge. The accumulation of lipids in these giant cells is due to bacillary destruction and fusion of vacuolated macrophages. We discuss here the role of bacillary and host lipids in the pathogenesis of lepromatous leprosy. We concluded that there was no need to extend the 12-month multidrug therapy recommended by WHO.
Los pacientes con lepra lepromatosa (LL) que han recibido tratamiento durante años, usualmente tienen seguimiento con biopsias de piel para lesiones persistentes o con baciloscopia positiva, con valores menores a los iniciales. Presentamos una mujer de 48 años con LL de 15 años de evolución, con índice bacilar (IB) 4 en el extendido directo y en la biopsia, que recibió terapia multidroga durante 32 meses, aunque el tratamiento recomendado por la Organización mundial de la salud (OMS) es de 12 meses. Se tomó una biopsia de piel para determinar si la enfermedad estaba activa. Se observó inflamación dérmica difusa con numerosas células gigantes tipo cuerpo extraño y macrófagos vacuolados (células de Virchow). Estas células, CD68 positivas, contenían material granular ácido-alcohol resistente, positivo con inmunohistoquímica para BCG. Se encontraron bacilos fragmentados y el IB fue de 2. Se interpretó como una forma residual de LL y que la paciente no requería MDT adicional. Este perfil histológico lo hemos observado en casos similares. Sin datos clínicos estas biopsias son un reto diagnóstico. La acumulación de lípidos en estas células gigantes se debe a la destrucción bacilar y a la fusión de macrófagos vacuolados. Revisamos el papel de los lípidos del bacilo y del huésped en la patogénesis de la LL. En estos casos no es necesario extender los 12 meses de MDT recomendados por la OMS. En el seguimiento de los pacientes se recomienda contar con los hallazgos clínicos, la baciloscopia, la biopsia anual de piel y los títulos IgM anti-glicolípido fenólico.
Assuntos
Células Espumosas/patologia , Células Gigantes de Corpo Estranho/patologia , Hanseníase Virchowiana/patologia , Pele/patologia , Antígenos CD/análise , Antígenos de Diferenciação Mielomonocítica/análise , Biópsia , Parede Celular/química , Quimioterapia Combinada , Feminino , Células Espumosas/química , Células Espumosas/microbiologia , Células Gigantes de Corpo Estranho/química , Células Gigantes de Corpo Estranho/microbiologia , Interações Hospedeiro-Patógeno , Humanos , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/tratamento farmacológico , Lipídeos/análise , Pessoa de Meia-Idade , Mycobacterium leprae/química , Mycobacterium leprae/isolamento & purificação , Pele/microbiologia , VacúolosRESUMO
Resumen Los pacientes con lepra lepromatosa que han recibido tratamiento durante años, usualmente requieren seguimiento con biopsias de piel para detectar lesiones persistentes o si la baciloscopia es positiva, incluso si los valores son menores que los iniciales. Se presenta el caso de una mujer de 48 años de edad con lepra lepromatosa de 15 años de evolución, índice bacilar de 4 en el extendido directo y en la biopsia, que recibió tratamiento con múltiples medicamentos durante 32 meses, aunque lo recomendado por la Organización Mundial de la Salud (OMS) es una duración de 12 meses. Se tomó una biopsia de piel para determinar si la enfermedad estaba activa. Se observó inflamación dérmica difusa con numerosas células gigantes de tipo cuerpo extraño y macrófagos vacuolados (células de Virchow). Estas células, CD68 positivas, contenían material granular ácido-alcohol resistente positivo con inmunohistoquímica para BCG. Se encontraron bacilos fragmentados y el índice bacilar fue de 2. Se interpretó como una forma residual de lepra lepromatosa y se concluyó que la paciente no requería prolongar el tratamiento con múltiples medicamentos. Este perfil histológico se ha observado en casos similares, pero sin datos clínicos estas biopsias representan un reto diagnóstico. La acumulación de lípidos en estas células gigantes se debe a la destrucción bacilar y a la fusión de macrófagos vacuolados. Se revisó el papel de los lípidos del bacilo y del huésped en la patogenia de la lepra lepromatosa. En estos casos, no es necesario extender los 12 meses de tratamiento con múltiples medicamentos recomendados por la OMS. En el seguimiento de los pacientes, se recomienda contar con los hallazgos clínicos, la baciloscopia, la biopsia anual de piel y los títulos IgM antiglucolípido fenólico.
Abstract Patients with lepromatous leprosy that have received treatment for many years usually get follow up biopsies for persistent skin lesions or positive bacilloscopy even if the values are lower than in the initial bacilloscopy. We report the case of a 48-year old woman with long-standing lepromatous leprosy of 15 years of evolution, with a bacterial index of 4 in the direct smear and the initial skin biopsy. The patient was treated with multidrug therapy for 32 months although the treatment recommended by the World Health Organization (WHO) is only for 12 months. A skin biopsy was taken to determine if there was an active disease. We observed a diffuse dermal inflammation with numerous foreign body giant cells and vacuolated macrophages (Virchow´s cells). These cells contained granular acid-fast material that was also positive with immunohistochemistry for BCG. There were fragmented bacilli and the BI was 2. These cells were also strongly positive for CD68. The biopsy was interpreted as a residual form of lepromatous leprosy that did not require further multidrug therapy. We have observed similar histological profiles in several cases. The lack of clinical data makes it a histological challenge. The accumulation of lipids in these giant cells is due to bacillary destruction and fusion of vacuolated macrophages. We discuss here the role of bacillary and host lipids in the pathogenesis of lepromatous leprosy. We concluded that there was no need to extend the 12-month multidrug therapy recommended by WHO. Clinical findings, bacilloscopy, annual skin biopsy, and anti-phenolic glycolipid-I IgM titers are recommended procedures for the follow-up of these patients.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Pele/patologia , Hanseníase Virchowiana/patologia , Células Gigantes de Corpo Estranho/patologia , Células Espumosas/patologia , Pele/microbiologia , Vacúolos , Biópsia , Antígenos de Diferenciação Mielomonocítica/análise , Hanseníase Virchowiana/tratamento farmacológico , Antígenos CD/análise , Células Gigantes de Corpo Estranho/microbiologia , Células Gigantes de Corpo Estranho/química , Parede Celular/química , Quimioterapia Combinada , Interações Hospedeiro-Patógeno , Células Espumosas/microbiologia , Células Espumosas/química , Hansenostáticos/uso terapêutico , Lipídeos/análise , Mycobacterium leprae/isolamento & purificação , Mycobacterium leprae/químicaRESUMO
Oxidized low-density lipoprotein (oxLDL) is a well-recognized proatherogenic particle that functions in atherosclerosis. In this study, we established conditions to generate human oxLDL, characterized according to the grade of lipid and protein oxidation, particle size and oxylipin content. The induction effect of the cellular proatherogenic response was assessed in foam cells by using an oxLDL-macrophage interaction model. Uptake of oxLDL, reactive oxygen species production and expression of oxLDL receptors (CD36, SR-A and LOX-1) were significantly increased in THP-1 macrophages. Analyses of 35 oxylipins revealed that isoprostanes (IsoP) and prostaglandins (PGs) derived from the oxidation of arachidonic, dihomo gamma-linolenic and eicosapentaenoic acids were strongly and significantly induced in macrophages stimulated with oxLDL. Importantly, the main metabolites responsible for the THP1-macrophage response to oxLDL exposure were the oxidative stress markers 5-epi-5-F2t-IsoP, 15-E1t-IsoP, 8-F3t-IsoP and 15-keto-15-F2t-IsoP as well as inflammatory markers PGDM, 17-trans-PGF3α, and 11ß-PGF2α, all of which are reported here, for the first time, to function in the interaction of oxLDL with THP-1 macrophages. By contrast, a salvage pathway mediated by anti-inflammatory PGs (PGE1 and 17-trans-PGF3α) was also identified, suggesting a response to oxLDL-induced injury. In conclusion, when THP-1 macrophages were treated with oxLDL, a specific induction of biomarkers related to oxidative stress and inflammation was triggered. This work contributes to our understanding of initial atherogenic events mediated by oxLDL-macrophage interactions and helps to generate new approaches for their modulation.
Assuntos
Biomarcadores/metabolismo , Inflamação/genética , Lipoproteínas LDL/genética , Estresse Oxidativo/genética , Aterosclerose/genética , Aterosclerose/metabolismo , Aterosclerose/patologia , Antígenos CD36/genética , Linhagem Celular , Células Espumosas/metabolismo , Células Espumosas/patologia , Humanos , Inflamação/metabolismo , Inflamação/patologia , Macrófagos/metabolismo , Macrófagos/patologia , Espécies Reativas de Oxigênio/metabolismo , Receptores Depuradores Classe E/genética , Fatores de Processamento de Serina-Arginina/genéticaRESUMO
This study analyzes the available evidence on the adequacy of economic evaluation for decision-making on the incorporation or exclusion of technologies for rare diseases. The authors conducted a structured literature review in MEDLINE via PubMed, CRD, LILACS, SciELO, and Google Scholar (gray literature). Economic evaluation studies had their origins in Welfare Economics, in which individuals maximize their utilities based on allocative efficiency. There is no widely accepted criterion in the literature to weigh the expected utilities, in the sense of assigning more weight to individuals with greater health needs. Thus, economic evaluation studies do not usually weigh utilities asymmetrically (that is, everyone is treated equally, which in Brazil is also a Constitutional principle). Healthcare systems have ratified the use of economic evaluation as the main tool to assist decision-making. However, this approach does not rule out the use of other methodologies to complement cost-effectiveness studies, such as Person Trade-Off and Rule of Rescue.
El objetivo fue sistematizar las evidencias disponibles sobre la pertinencia de utilizar la evaluación económica para la incorporación/exclusión de tecnología en enfermedades raras. Se realizó una revisión sistemática de la literatura en MEDLINE vía PubMed, CRD, LILACS, SciELO y Google Académico (literatura gris). Los estudios de evaluación económica se originan de la Economía del Bienestar, en la que los individuos maximizan sus utilidades, basándose en la eficiencia de asignación. No existe un criterio ampliamente aceptado para examinar las utilidades, a fin de dar más peso a los individuos con mayores necesidades. Generalmente, los estudios no equilibran asimétricamente las utilidades, todas son consideradas iguales, lo que en Brasil es también un principio constitucional. Los sistemas de salud han ratificado el uso de la evaluación económica como la principal herramienta para ayudar en la toma de decisiones. Sin embargo, este abordaje no excluye el uso de otras metodologías complementarias a los estudios de coste-efectividad, como la técnica de compensación personal o la regla del rescate.
O objetivo deste estudo foi analisar as evidências disponíveis sobre a adequação do uso de avaliação econômica sobre incorporação/exclusão de tecnologias para doenças raras. Foi realizada uma revisão estruturada da literatura, nas bases MEDLINE, via PubMed, CRD, LILACS, SciELO e Google Acadêmico (literatura cinzenta). Os estudos de avaliação econômica têm origem na Economia do Bem-Estar, na qual os indivíduos maximizam suas utilidades, fundamentando-se na eficiência alocativa. Não há um critério amplamente aceito para ponderar as utilidades esperadas, no sentido de dar mais peso aos indivíduos com maiores necessidades em saúde. Geralmente não se ponderam assimetricamente as utilidades; todas são tratadas de forma igualitária, que, no caso brasileiro, também é um princípio constitucional. Os sistemas de saúde têm ratificado o uso de avaliação econômica como principal instrumento para auxiliar na tomada de decisão. No entanto, essa postura não exclui o uso de outras metodologias complementares aos estudos de custo-efetividade, como Person Trade-Off e regra de resgate.
Assuntos
Animais , Humanos , Camundongos , Aterosclerose/enzimologia , Aterosclerose/patologia , Células Espumosas/enzimologia , Metaloproteinases da Matriz/metabolismo , Ruptura Aórtica/etiologia , Ruptura Aórtica/prevenção & controle , Aterosclerose/complicações , Aterosclerose/imunologia , Células Espumosas/patologia , Regulação Enzimológica da Expressão Gênica , Metabolismo dos Lipídeos , Modelos Imunológicos , Metaloproteinases da Matriz/genética , Infarto do Miocárdio/complicações , Infarto do Miocárdio/enzimologia , Infarto do Miocárdio/imunologia , Infarto do Miocárdio/patologia , Miócitos de Músculo Liso/patologia , Inibidores Teciduais de Metaloproteinases/imunologia , Inibidores Teciduais de Metaloproteinases/metabolismoRESUMO
El xantoma intraóseo (XIO) es un tumor óseo benigno extremadamente raro. En la histología se caracteriza por presentar macrófagos mononucleares, abundantes células espumosas y células gigantes multinucleadas. Puede aparecer asociado a otras enfermedades (XIO secundario), principalmente a desórdenes lipídicos, o en forma aislada (XIO primario). Los XIO son lesiones líticas expansivas que a menudo se encuentran en pacientes con condiciones hiperlipidémicas. En la mayoría de los casos la evaluación inicial se realiza con radiografía, aunque otros procedimientos pueden ser necesarios para confirmar el diagnóstico. Se presenta el caso de un hombre de 48 años que consultó por lumbalgia con irradiación al miembro inferior derecho e impotencia funcional de 3 meses de evolución. Tenía hallazgos imagenológicos de XIO en el hueso ilíaco derecho, sin hiperlipidemia o lesiones preexistentes. Se llevó a cabo la extirpación total del tumor y el posterior estudio histopatológico de la pieza operatoria confirmó el diagnóstico. El tratamiento resultó exitoso. El objetivo de este artículo es describir los hallazgos clínicos e imagenológicos (radiografía, resonancia magnética, tomografía computada y medicina nuclear) de un XIO primario y su tratamiento. Además, realizamos una breve revisión de la literatura.
Abstract Intraosseous xanthoma is an extremely rare benign bone tumor. Histology shows mononuclear macrophages, abundant foam cells and multinucleated giant cells. The intraosseous xanthoma may appear associated with other diseases (secondary intraosseous xanthoma), mainly lipid disorders or without an underlying lipid disorder (primary intraosseous xanthoma). The intraosseous xanthoma is a lytic, expansive tumor, often seen in patients with hyperlipidemic conditions. In most cases, the initial evaluation is performed with X-ray, although other procedures may be necessary to confirm the diagnosis. We report the case of a man aged 48, who consulted for back pain radiating to the right leg and functional disability 3 months duration, with imaging findings in the right iliac XIO in the absence of pre-existing injuries or hyperlipidemic conditions, so surgery for total removal of the tumor was performed with histological examination of the surgical specimen, confirming the preoperative diagnosis of XIO. Such treatment resulted curative. The aim of this article is to describe the clinical, imaging findings (RX, MRI, CT, nuclear medicine) and the course of treatment of a committing the iliac primary intraosseous xanthoma a and a normolipidemic patient brief review of the literature.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Ósseas/diagnóstico por imagem , Xantomatose/diagnóstico por imagem , Pelve/diagnóstico por imagem , Radiografia , Tomografia Computadorizada por Raios X , Células Espumosas/patologia , Quadril/diagnóstico por imagemRESUMO
Premature atherosclerosis represents the main cause of mortality among end-stage renal disease patients (ESRD). Increased inflammation and oxidative stress are involved in initiation and progression of the atherosclerotic plaque. As foam cells are capable of producing significant amounts of inflammatory mediators and free radicals, we hypothesized that foam cells from uremic patients could produce more inflammation and oxidative stress than foam cells from normal people and be, somehow, involved in the accelerated atherosclerosis of uremia. To test this hypothesis, the levels of a few markers of inflammation and oxidative stress: Tumor necrosis factor-α, inducible nitric oxide synthase, malondialdehyde, nitric oxide by-products were measured in the supernatants of macrophage-derived foam cells cultures from 18 hemodialysis patients and 18 apparently healthy individuals controls. Malondialdehyde levels in the supernatant of cell cultures (macrophages stimulated or not with native and oxidized lipoprotein) were significantly increased in uremic patients; no statistically significant difference was found between the supernatant concentrations of nitric oxide by-products, inducible nitric oxide synthase activity, and tumor necrosis factor-α between patients and controls. Our results, obtained with human macrophages and macrophage-derived foam cells, are compatible with the theory that increased cellular oxidative stress and inflammatory activity in ESRD patients could accelerate the atherosclerotic process. The present culture protocol showed it is possible to use human mononuclear cells to evaluate the oxidative metabolism of foam cells, which are considered to be the initial step of atherosclerotic lesions.
Assuntos
Células Espumosas/metabolismo , Falência Renal Crônica/metabolismo , Falência Renal Crônica/terapia , Macrófagos/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Estresse Oxidativo/fisiologia , Diálise Renal/efeitos adversos , Adulto , Aterosclerose/metabolismo , Aterosclerose/patologia , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Células Cultivadas , Feminino , Células Espumosas/patologia , Expressão Gênica , Humanos , Falência Renal Crônica/patologia , Masculino , Óxido Nítrico/biossíntese , Óxido Nítrico Sintase Tipo II/biossíntese , Óxido Nítrico Sintase Tipo II/genética , RNA Mensageiro/biossíntese , RNA Mensageiro/genética , Diálise Renal/métodos , Fator de Necrose Tumoral alfa/biossínteseRESUMO
INTRODUCTION: Damage of testicles is frequent in lepromatous leprosy and worsened by the presence of erythema nodosum leprosum. Objective. A patient is presented who developed lepromatous leprosy and erythema nodosum leprosum with major testicular compromise. MATERIAL AND METHODS: The 28-year-old male patient had lepromatous leprosy since age 22. During a polychemotherapy treatment for the lepromatous leprosy, he presented chronic erythema nodosum leprosum that affected both testicles; he did not respond to the conventional treatment. A left orchidectomy was performed to treat the persistent pain. RESULTS: The extracted testis evidenced the following: tubular atrophy, extensive fibrosis, cumulus of foamy macrophages without rods, focal Leydig cell hyperplasia, linfocitary and granulomatous arteritis and endarteritis of small and medium size vessels. These changes were also observed in the epididymis. Two years after the polychemoterapy and the orchidectomy, the patient exhibited azoospermy, normal total testosterone, slightly diminished free testosterone and elevated levels of luteinizing hormone and follicle-stimulating hormone. No loss of libido or sexual activity was reported. General concepts of erythema nodosum leprosum were reviewed, as well as the pathologic changes produced by leprosy in the testis. CONCLUSION: Lepromatous leprosy may lead to hypogonadism. This condition is recommended for inclusion in leprosy diagnostic programs in order to detect and treat the consequences of the possible hypogonadism.
Assuntos
Eritema Nodoso/etiologia , Hipogonadismo/etiologia , Hanseníase Virchowiana/complicações , Doenças Testiculares/etiologia , Adulto , Atrofia , Azoospermia/etiologia , Clofazimina/uso terapêutico , Dapsona/uso terapêutico , Epididimo/patologia , Eritema Nodoso/patologia , Eritema Nodoso/cirurgia , Fibrose , Células Espumosas/patologia , Hormônio Foliculoestimulante/sangue , Humanos , Hiperplasia , Hipogonadismo/sangue , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/classificação , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Virchowiana/imunologia , Hanseníase Virchowiana/patologia , Células Intersticiais do Testículo/patologia , Hormônio Luteinizante/sangue , Masculino , Orquiectomia , Rifampina/uso terapêutico , Doenças Testiculares/patologia , Doenças Testiculares/cirurgia , Testosterona/sangue , Talidomida/uso terapêuticoRESUMO
Introducción. La afección testicular es frecuente en la lepra lepromatosa, daño que se incrementa cuando cursa con eritema nudoso leproso. Objetivo. Presentar un paciente con lepra lepromatosa y eritema nudoso leproso con grave compromiso testicular. Materiales y métodos. Se estudió un hombre de 28 años con lepra lepromatosa desde los 22, que durante la poliquimioterapia para la lepra presentó eritema nudoso leproso crónico que afectó ambos testículos y no respondió al manejo convencional. El dolor persistente obligó a practicar orquidectomía izquierda. Resultados. Este testículo presentaba atrofia tubular y fibrosis notorias, conglomerados de macrófagos espumosos, sin bacilos, hiperplasia focal de células de Leydig, endarteritis y arteritis linfocitaria y granulomatosa de vasos pequeños y medianos; estos cambios también estaban presentes en el epidídimo. Un estudio llevado a cabo dos años después de terminar su tratamiento y de la orquidectomía izquierda, demostró azoospermia, testosterona total normal, testosterona libre discretamente disminuida y hormonas lutropina (luteinizante) y folitropina (estimulante del folículo) elevadas. No había disminución de la libido ni de su actividad sexual. Se revisaron los conceptos generales sobre el eritema nudoso leproso y las alteraciones que la lepra produce en el testículo. Conclusión. La lepra lepromatosa puede conducir a hipogonadismo. Los programas de lepra deben contemplar esta complicación para corregir y evitar sus secuelas.
Introduction. Damage of testicles is frequent in lepromatous leprosy and worsened by the presence of erythema nodosum leprosum. Objective. A patient is presented who developed lepromatous leprosy and erythema nodosum leprosum with major testicular compromise. Material and methods. The 28-year-old male patient had lepromatous leprosy since age 22. During a polychemotherapy treatment for the lepromatous leprosy, he presented chronic erythema nodosum leprosum that affected both testicles; he did not respond to the conventional treatment. A left orchidectomy was performed to treat the persistent pain. Results. The extracted testis evidenced the following: tubular atrophy, extensive fibrosis, cumulus of foamy macrophages without rods, focal Leydig cell hyperplasia, linfocitary and granulomatous arteritis and endarteritis of small and medium size vessels. These changes were also observed in the epididymis. Two years after the polychemoterapy and the orchidectomy, the patient exhibited azoospermy, normal total testosterone, slightly diminished free testosterone and elevated levels of luteinizing hormone and follicle-stimulating hormone. No loss of libido or sexual activity was reported. General concepts of erythema nodosum leprosum were reviewed, as well as the pathologic changes produced by leprosy in the testis. Conclusion. Lepromatous leprosy may lead to hypogonadism. This condition is recommended for inclusion in leprosy diagnostic programs in order to detect and treat the consequences of the possible hypogonadism.
Assuntos
Adulto , Humanos , Masculino , Eritema Nodoso/etiologia , Hipogonadismo/etiologia , Hanseníase Virchowiana/complicações , Doenças Testiculares/etiologia , Atrofia , Azoospermia/etiologia , Clofazimina/uso terapêutico , Dapsona/uso terapêutico , Epididimo/patologia , Eritema Nodoso/patologia , Eritema Nodoso/cirurgia , Fibrose , Células Espumosas/patologia , Hormônio Foliculoestimulante/sangue , Hiperplasia , Hipogonadismo/sangue , Hansenostáticos/uso terapêutico , Hanseníase Virchowiana/classificação , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Virchowiana/imunologia , Hanseníase Virchowiana/patologia , Células Intersticiais do Testículo/patologia , Hormônio Luteinizante/sangue , Orquiectomia , Rifampina/uso terapêutico , Doenças Testiculares/patologia , Doenças Testiculares/cirurgia , Testosterona/sangue , Talidomida/uso terapêuticoRESUMO
The aim of this study was to investigate the histopathological features of radicular cysts (RCs) diagnosed in a Brazilian population. Seventy-three cases of RCs, from a total of 1480 biopsies diagnosed between 2001 and 2008 at the Laboratory of Oral Surgical Pathology of the Dental School of the Federal University of Bahia were investigated regarding their histopathological features. Morphological results showed that exocytosis (n = 50), spongiosis (n = 40), acanthosis (n = 28), atrophic epithelium (n = 27) and apoptotic bodies (n = 21) were the most common findings. Other morphological findings included: foamy macrophages (n = 10), Russell's bodies (n = 7), cholesterol crystals (n = 7) and glandular-like odontogenic epithelial rests (n = 1). Evidence of exogenous material was seen in 16 samples. It was concluded that the clinical and histopathological findings observed in Brazilian patients were comparable with those described for other populations.