A DIFFUSE INFILTRATIVE CD8 LYMPHOCYTOSIS SYNDROME IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION - A HOST IMMUNE-RESPONSE ASSOCIATED WITH HLA-DR5
A DIFFUSE INFILTRATIVE CD8 LYMPHOCYTOSIS SYNDROME IN HUMAN IMMUNODEFICIENCY VIRUS (HIV) INFECTION - A HOST IMMUNE-RESPONSE ASSOCIATED WITH HLA-DR5
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DOI：
10.7326/0003-4819-112-1-3
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发表时间：
1990-01-01
影响因子：
39.2
通讯作者：
WINCHESTER, R
中科院分区：
文献类型：
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作者：
ITESCU, S;BRANCATO, LJ;WINCHESTER, R
描述人类免疫缺陷病毒（HIV）感染者中类似干燥综合征的弥漫性浸润性淋巴细胞疾病的临床、免疫学和免疫遗传学特征。临床病例研究。大学附属医院和门诊部。17例患者的对比样本。17例患者均有双侧腮腺肿大，14例有口干，6例有干眼症。在17例患者中，14例有全身淋巴结病，10例有组织学证实的淋巴细胞性间质性淋巴结炎，4例有神经系统受累，3例有胃肠道淋巴细胞浸润。11例患者的镓扫描均显示唾液腺摄取异常。小唾液腺活检显示，在所有11名受试患者中，每4 mm 2组织中有2个以上淋巴细胞灶，浸润主要由CD 8细胞组成。15例患者有循环CD 8淋巴细胞增多症;这些细胞的主要表型为CD 8 + CD 29+。风湿因子和抗核抗体少见，无患者有抗Ro/SS-A或抗La/SS-B抗体。与对照组（45例中的13例）相比，黑人患者（12例中的10例）中HLA-DR 5的频率明显更高。在544个病人月的研究中，只有一名病人发生了机会性感染，没有人死于艾滋病。一种独特的综合征，主要特征是腮腺肿大，干燥症状和肺部受累发生在HIV感染。这种疾病与CD 8淋巴细胞增多和HLA-DR 5的存在有关，似乎是由遗传决定的宿主对HIV的免疫反应。
To describe the clinical, immunologic, and immunogenetic features of a diffuse infiltrative lymphocytic disorder resembling Sjogren syndrome in persons infected with human immunodeficiency virus (HIV). Clinical case study. University-affiliated hospitals and outpatient clinics. Consecutive sample of 17 patients. All of the 17 patients had bilateral parotid gland enlargement; 14 had xerostomia and 6 had xerophthalmia. Of the 17 patients, 14 had generalized lymphadenopathy, 10 had histologically proved lymphocytic interstitial pneuomonitis, 4 had neurologic involvement, and 3 had lymphocytic infiltration of the gastrointestinal tract. Gallium scanning in all of 11 tested patients showed abnormal salivary gland uptake. Minor salivary gland biopsies showed more than 2 lymphocytic foci per 4 mm2 tissue in all of 11 tested patients, the infiltrate consisting predominantly of CD8 cells. Fifteen patients had circulating CD8 lymphocytosis; the principal phenotype of these cells was CD8 + CD29+. Rheumatoid factor and antinuclear antibodies were infrequent, and none of the patients had anti-Ro/SS-A or anti-La/SS-B antibodies. HLA-DR5 was significantly more frequent in the black patients (10 of 12) compared with controls (13 of 45). Only one patient developed an opportunistic infection during 544 patient-months of study, and none has died of AIDS. A distinct syndrome primarily characterized by parotid gland enlargement, sicca symptoms, and pulmonary involvement occurs in HIV infection. This disorder is associated with CD8 lymphocytosis and the presence of HLA-DR5, and appears to be a genetically determined host immune response to HIV.