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T lymphocyte populations within the lamina propria
Published in Phillip D. Smith, Richard S. Blumberg, Thomas T. MacDonald, Principles of Mucosal Immunology, 2020
Thomas T. MacDonald, Antonio Di Sabatino
There are more T cells in the gut-associated lymphoid tissue (GALT) and intestinal lamina propria and epithelium than in the rest of the body. That they are absolutely essential for health is demonstrated when they are not present, as in children with severe combined immunodeficiency or adults with untreated human immunodeficiency virus-1 (HIV-1) infection: intestinal infections caused by cryptosporidia, Isospora, cytomegalovirus, and other low-grade pathogens result in chronic diarrhea, wasting, and eventually death (Table 7.1). The advent of highly active antiretroviral therapy that helps maintain gut T-cell numbers has seen gut infections and the enteropathy of HIV-1 infection diminish in clinical significance. Gut T cells are also at the forefront of protective responses to more aggressive pathogens such as Salmonella and Shigella. Identifying the pathways that allow gut T cells to react appropriately to commensal microbiota, yet respond to gut pathogens, remains one of the major challenges in biology. At the same time, overreactivity of gut T cells to harmless foods, or the commensal microbiota, underpins food-sensitive enteropathies and inflammatory bowel disease (IBD).
Assessing the role of intestinal absorption, permeability, and nutrition in AIDS patients
Published in Ronald R. Watson, NUTRIENTS and FOODS in AIDS, 2017
Infection with Isospora belli may also cause severe and protracted diarrhea in patients with AIDS. The parasite is the cause of gastrointestinal infection in approximately 1 to 3% of patients with AIDS and diarrhea in the U.S. but in 15 to 19% of patients in developing countries. Clinically, isosporiasis resembles cryptosporidiosis. Watery diarrhea without blood or inflammatory cells, cramping, abdominal pain, weight loss, anorexia, malaise, and fever are usually present. Laboratory findings in isosporiasis may include steatorrhea and, in contrast to cryptosporidiosis, eosinophilia. Although heavily concentrated in the small intestine, Isospora belli can be identified throughout the entire gastrointestinal tract and in other organs.
The Protozoa
Published in Donald L. Price, Procedure Manual for the Diagnosis of Intestinal Parasites, 2017
Infection with Isospora belli usually originates from sources contaminated with feces from infected individuals but autoinfection may also occur since sporulated oocysts have been found in the duodenum. The number of species of Isospora infecting man is questionable. Isospora natalensis, and I. chilensis have been reported. The species formally referred to as I. hominis is now recognized as Sarcocystis hominis.
A systematic review on efficacy, safety, and treatment-durability of low-dose rituximab for the treatment of Pemphigus: special focus on COVID-19 pandemic concerns
Published in Immunopharmacology and Immunotoxicology, 2021
Soheil Tavakolpour, Zeinab Aryanian, Farnoosh Seirafianpour, Milad Dodangeh, Ifa Etesami, Maryam Daneshpazhooh, Kamran Balighi, Hamidreza Mahmoudi, Azadeh Goodarzi
In the study that three weekly consecutive doses of 375 mg/m2 of RTX and one similar dose repeated after 3 months of the third dose was used [24], the most of Side effects occurred during the first infusions; moderate fever and chills (6/24), hypotension (2/24), and hypertension (2/24) which were controlled by either stopping or decreasing the rate of infusion, was seen. In second infusions, patients experienced no infusion reactions. 8% of patients (2/24) developed herpes zoster and the next infusion was deferred till the lesions healed after treatment with an antiviral drug. One of them also developed an extensive tinea corporis. And, a diabetic patient developed a carbuncle that was treated with antibiotics, after that he involved to pulmonary embolism (a month following the first three infusions) and was treated successfully in an ICU setting. One patient developed recurrent diarrhea with weight loss of 10 kg within a month and was diagnosed with Isospora diarrhea that was treated successfully with cotrimoxazole.
Enterovirus-associated hemophagocytic lymphohistiocytosis with multiorgan failure
Published in Baylor University Medical Center Proceedings, 2020
Azaan Ramani, Sivakumar Sudhakaran, Robert S. Rahimi, Joseph Guileyardo, Uriel S. Sandkovsky
His symptoms persisted, and follow-up laboratory tests revealed worsening liver enzymes, which prompted repeat hospitalization. At the time of admission, his aspartate aminotransferase was 5451 IU/L; alanine aminotransferase, 3818 IU/L; alkaline phosphatase, 701 IU/L; and total bilirubin, 10.9 mg/dL. Upon admission, prednisone was continued and the patient was started on antibiotics empirically. An extensive infectious workup was negative, including blood cultures, cryptococcal antigen, Histoplasma urine and serum antigen, Leptospira antibody, and Coccidioides serum antibody by enzyme-linked immunosorbent assay. Stool polymerase chain reaction (PCR) and cultures were negative for Salmonella, Shigella, Escherichia coli, Campylobacter, Vibrio, and Yersinia. Stool smear and PCR for Cryptosporidium, Cyclospora, and Isospora was also negative. Serum PCR was negative for herpes simplex, varicella zoster, cytomegalovirus, adenovirus, and influenza. Treponema pallidum particle agglutination assay was negative for syphilis. Enterovirus was detected in the plasma and respiratory panel by PCR.
CD40 ligand deficiency: treatment strategies and novel therapeutic perspectives
Published in Expert Review of Clinical Immunology, 2019
Tabata T. França, Lucila A. Barreiros, Basel K. al-Ramadi, Hans D. Ochs, Otavio Cabral-Marques, Antonio Condino-Neto
Gastrointestinal manifestations are the second most common clinical feature, occurring in about half of the patients [38], with protracted or recurrent diarrhea often associated with failure to thrive [14,22,49]. Severe diarrhea is frequently caused by Cryptosporidium sp., although other pathogens such as Giardia lamblia, Campylobacter jejuni, Salmonella sp., Entamoeba histolytica, Isospora beli, Microsporidium sp., and rotavirus have also been reported [14,20,24,40]. Cryptosporidium sp. infections are frequently associated with ascending sclerosing cholangitis, cirrhosis, cholangiopathy [14,22], and gastrointestinal malignancies [50], which are severe complications that may lead to hepatic failure and require liver transplantation [14,22,50].