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A L Bittencourt

Publications and source records attributed to A L Bittencourt.

At least 19 recordsLinked to original sources
PubMed2007

Infiltrating giant cellular blue naevus.

INTRODUCTION: Cellular blue naevi (CBN) measure 1-2 cm in diameter and affect the dermis, occasionally extending into the subcutaneous fat. The case of a 14-year-old boy with a giant CBN (GCBN) involving the right half of the face, the jugal mucosa and the lower eyelid with a tumour that had infiltrated the bone and the maxillary and ethmoidal sinuses is reported. METHODS: Biopsies were taken from the skin, jugal mucosa and maxillary sinus. The following markers were used in the immunohistochemical evaluation: CD34, CD56, HMB-45, anti-S100, A-103, Melan A and MIB-1. RESULTS: The biopsy specimens showed a biphasic pattern affecting the lower dermis, subcutaneous fat, skeletal muscle, bone, jugal mucosa and maxillary sinus, but there was no histological evidence of malignancy. The tumour cells were CD34-, CD56-, HMB45+, anti-S100+ and A-103+. Melan A was focally expressed. No positive MIB-1 cells were identified. DISCUSSION: The present case shows that GCBN may infiltrate deeply, with no evidence of malignancy.

Adolescent↗
PubMed2002

B-cell infiltration and frequency of cytokine producing cells differ between localized and disseminated human cutaneous leishmaniases.

Biopsies from human localized cutaneous lesions (LCL n = 7) or disseminated lesions (DL n = 8) cases were characterized according to cellular infiltration,frequency of cytokine (IFN-gamma, TNF-alpha) or iNOS enzyme producing cells. LCL, the most usual form of the disease with usually one or two lesions, exhibits extensive tissue damage. DL is a rare form with widespread lesions throughout the body; exhibiting poor parasite containment but less tissue damage. We demonstrated that LCL lesions exhibit higher frequency of B lymphocytes and a higher intensity of IFN-gamma expression. In both forms of the disease CD8+ were found in higher frequency than CD4+ T cells. Frequency of TNF-alpha and iNOS producing cells, as well as the frequency of CD68+ macrophages, did not differ between LCL and DL. Our findings reinforce the link between an efficient control of parasite and tissue damage, implicating higher frequency of IFN-gamma producing cells, as well as its possible counteraction by infiltrated B cells and hence possible humoral immune response in situ.

Adolescent↗
PubMed2001

Human T-cell lymphotropic virus type 1 infection among pregnant women in northeastern Brazil.

An evaluation of human T-cell lymphotropic virus type 1 (HTLV-1) infection among 6754 pregnant women in Salvador, Bahia, Brazil using enzyme-linked immunosorbent assay, Western blot analysis, and polymerase chain reaction assay found a rate of infection of 0.84% (57 of 6754 women). Epidemiologic and obstetric data on the HTLV-1-positive pregnant women were analyzed and compared with data on a control group of HTLV-1-negative pregnant women. The mean age of the HTLV-1-positive women was 26.2 years. All were seronegative for HIV and syphilis, and only 2 reported a past history of sexually transmitted infection and more than 10 sexual partners. Of the HTLV-1-positive women, 88.5% were breast-fed, 4% were bottle fed, and 7.5% did not know. Six women had received blood transfusions, and only 1 reported intravenous drug use. Fifty-two HTLV-1-positive women could be followed: 45 had full-term deliveries, 5 had premature deliveries, and 2 had abortions. Our results indicate that (1) the frequency of HTLV-1 infection among pregnant women is relatively high in Salvador, Bahia, Brazil; (2) maternal infection was probably acquired more frequently through breast-feeding, but the sexual route was certainly the second most important means of transmission; (3) HTLV-1-positive women had a history of eczema-like infections in childhood more frequently than the control group; (4) HTLV-1 infection did not interfere in the course of pregnancy; and (5) no associated congenital infections were observed in the HTLV-1-positive women.

Adolescent↗
PubMed2000

Immunohistochemical characterization of the inflammatory infiltrate in placental Chagas' disease: a qualitative and quantitative analysis.

Chagas' disease, a systemic illness endemic to some regions of South America, is caused by the protozoan Trypanosoma cruzi. Transplacental infection may occur during any phase and cause fetal death. This study is the first to characterize the inflammatory cells in chagasic villitis by immunohistochemistry. Paraffin sections of 8 placentas with villitis by T. cruzi (4 live births and 4 stillbirths), as well as 8 control placentas without inflammation, were stained with hematoxylin and eosin, monoclonal antibodies for CD45RO, CD20, CD45RO/OPD4, CD8, HNKI, CD15, MAC387, and CD68 proteins, and a polyclonal antibody for S-100 protein. Quantification of positive cells was performed in 3 different high-power fields. In all cases of chagasic villitis, the inflammatory infiltrate was composed mainly of CD68+ macrophages, T lymphocytes, and a few natural killer cells. Among T cells, CD8+ cells outnumbered CD4+ cells in all placentas (CD4+:CD8+ ratios ranged from 0.04 to 0.38). B cells were absent or rare. In stillbirths, villitis was diffuse and severe with numerous T. cruzi, while in live births it was focal with few parasites. Other features that characterized villitis in stillbirths were 1) frequent trophoblastic necrosis, 2) presence of MAC387+ macrophages and CD15+ granulocytes attached to the sites of trophoblastic necrosis, 3) low CD4+: CD8+ ratios in most cases, 4) increased numbers of S-100 positive cells in the villous stroma. In conclusion, CD68+ macrophages and CD8+ T lymphocytes were the major cell population in villitis caused by T. cruzi. However, the pattern of inflammatory reaction differed between stillbirths and live births and was probably related to the number of parasites in the placental villi.

Animals↗
PubMed1999

Adult T-cell leukemia/lymphoma in northeastern Brazil: a clinical, histopathologic, and molecular study.

The state of Bahia in the northeastern coast of Brazil is a region in which HTLV-I infection is endemic. This study investigated the characteristics of 28 HTLV-I-associated lymphomas/leukemias in this region. HTLV-I-infection diagnosis was based on serologic study, Southern blot analysis, and polymerase chain reaction (PCR) in neoplastic tissue. The main clinical differences between these lymphomas and adult T-cell leukemia (ATL) cases from other endemic areas were as follows. The mean age was 47 years; 20% of the cases occurred in young adults; and a predominance was found among male subjects (2:1), blacks, and of those of mixed race (96%). Histologically, 20 cases were T-cell pleomorphic leukemia/lymphoma, 5 were Mycosis fungoides-like cutaneous lymphoma, and 3 were CD30+ large-cell anaplastic lymphoma. Immunohistochemistry demonstrated 4 cases of CD8+ lymphoma. Proviral genomic sequences were demonstrated by PCR in 9 lymph node biopsy specimens and in 3 skin biopsy specimens. Southern blot was performed and was positive in 8 cases.

Adolescent↗
PubMed1999

Immunochemotherapy with interferon-gamma and multidrug therapy for multibacillary leprosy.

Treatment for multibacillary leprosy is presently performed with a multidrug therapy (MDT) scheme maintained for 2 years. Leprosy treatment however can benefit from the reduction of length. The lack of interferon-gamma (IFN-gamma) production by lepromatous leprosy (LL) patients' lymphocytes lead us to use this cytokine in the treatment of multibacillary leprosy associated with MDT in the treatment of multibacillary leprosy, and monitor several clinical and immunological parameters during the course of treatment. A total of 20 multibacillary leprosy patients were evaluated, 10 treated with MDT alone, and 10 treated with MDT + 10 daily doses of 2 x 10(6) international units (IU) of recombinant human IFN-gamma/m2 followed by 10 daily doses of 10(7) IU IFN-gamma/m2, intramuscularly, during the first 20 days of MDT. IFN-gamma was well tolerated and did not cause any increase in the rate of leprosy reactions development during treatment. Decrease of bacillary load, fall of anti-Mycobacterium leprae IgG serum antibodies, changes of histological pattern, as well as changes in lymphocyte proliferation assay in response to mitogens (PHA or PWM), M. leprae antigen or PPD was similar in both groups of patients. Among several soluble immunological markers measured before and 30 days after beginning of treatment, levels of soluble IL-2R receptor increased in patients treated with MDT plus IFN-gamma whereas decreased in patients treated with MDT alone. Soluble ICAM-1 levels decreased in the MDT group but did not change in the MDT + IFN-gamma treated patients. Soluble CD4 and soluble CD8 markers did not change significantly in either group of patients. Neopterin, a marker of macrophage activation, increased in all but one patient treated with MDT + IFN-gamma but in none treated with MDT alone, indicating that IFN-gamma was active in vivo. Our findings indicate that despite being able to promote macrophage activation in multibacillary leprosy patients a short course of systemically administered IFN-gamma is not able to change the clinical course of a long standing disease such as leprosy.

Adolescent↗
PubMed1997

Mazindol and lidocaine are antinociceptives in the mouse formalin model: involvement of dopamine receptor.

The antinociceptive potential of mazindol, an anorectic drug, and lidocaine, an amide-type local anesthetic, were investigated in the mouse formalin test with concurrent motor function assessment. In addition, the role of dopamine and opioid receptors in mediation of the antinociceptive action of these drugs was examined. The i.p. injection of mazindol (1.25-10 mg/kg) and lidocaine (10-30 mg/kg) induced significant antinociceptive responses in both phases of the test. Cocaine (20 mg/kg, i.p.), used as positive control, also inhibited the pain responses caused by formalin. Haloperidol (0.2 mg/kg, i.p.), and sulpiride (5 mg/kg, i.p.), a dopamine D2 receptor antagonist, reduced the antinociceptive actions of mazindol and cocaine, while SCH 23390, R(+)-7-chloro 8-hydroxy-3methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3 benzazepine (0.03 mg/kg, i.p.), a dopamine D1 receptor antagonist, did not affect these responses. Only the antinociception associated with mazindol was reversed by naloxone (2 mg/kg, i.p.). The same pretreatments failed to modify lidocaine-induced antinociception. The drug conditions used in this study did not reveal any motor impairment in the rotarod test. These observations suggest an involvement of dopaminergic mechanisms, mainly via dopamine D2 receptors, in the antinociceptive action of mazindol in the formalin test, but the nature of mechanisms involved in the lidocaine responses remains unsolved.

Anesthetics, Local↗
PubMed1995

Polar and subpolar diffuse cutaneous leishmaniasis in Brazil: clinical and immunopathologic aspects.

BACKGROUND: Diffuse cutaneous leishmaniasis (DCL) is a rare manifestation of human leishmaniasis, characterized by multiple, slowly progressive nodules or plaques without ulceration, involving almost the entire body. It has been suggested, that DCL results from a lack of cell-mediated immunity to leishmanial antigen, leading to uncontrolled parasite growth. METHODS: We have performed detailed clinical, histopathologic, and immunologic investigations in six patients with DCL. Biopsies were taken from the nodules, processed, and examined for determination of the macrophagic pattern present, based on the intensity of vacuolation and the frequency of vacuolated cells, the parasite index, and the presence of eosinophils. Immunologically, patients were evaluated by their response to intradermal skin test to PPD or leishmania antigen, determination of antileishmania antibodies by immunofluorescent assay, and lymphocyte proliferation assay. RESULTS: There seemed to be a negative relation between nodules and skin ulcerations, whereas the highest number of parasites were observed in patients with the greatest number of vacuolated macrophages. The delayed hypersensitivity skin test to leishmanial antigen was negative, and antileishmania IgG antibodies were positive in all patients. CONCLUSIONS: Although all cases fulfill the criteria for being classified as DCL, they present a wide spectrum. Three cases were clearly at the unresponsive pole, and three other cases belonged to the subpolar form of DCL, exhibiting varying weak signs of antiparasite responsiveness.

Adolescent↗
PubMed1995

Transforming growth factor-beta in human cutaneous leishmaniasis.

Transforming growth factor (TGF)-beta has several downregulatory functions on the immune system: inhibition of interleukin-2 receptor induction, decrease of interferon-gamma-induced class II antigen expression, inhibition of macrophage activation, as well as cytotoxic and lymphokine-activated killer cell generation. TGF-beta has also been recognized as an important immunoregulator in murine leishmaniasis, for which it increases susceptibility to disease. In the present study we evaluate the involvement of TGF-beta in human leishmaniasis in vitro and in patients with cutaneous leishmaniasis. Human macrophages produce active TGF-beta after infection by Leishmania amazonensis (480 +/- 44.7 pg/ml; mean +/- SEM), L. donovani chagasi (295 +/- 7.6 pg/ml), or L. braziliensis (196 +/- 15.7 pg/ml). When TGF-beta was added to cultures of human macrophages infected with L. braziliensis it led to an increase of approximately 50% in parasite numbers as compared with untreated cultures. Exogenous TGF-beta added to macrophage cultures was able to reverse the effect of interferon-gamma in controlling Leishmania growth. Even at 100 IU/ml interferon-gamma the presence of TGF-beta increases the number of intracellular parasites. On the other hand, TNF-alpha at high concentration (100 IU/ml) totally blunts the suppressive effect of TGF-beta. Immunostaining for TGF-beta was observed in the dermis, produced by fibroblasts and occasionally by inflammatory cells in the biopsies from human leishmaniasis lesions, being present in most of the biopsies taken from patients with early cutaneous leishmaniasis (less than 2 months of ulcer development) and in cases of active mucosal leishmaniasis. Taken together these observations suggest an important role for TGF-beta in human leishmaniasis, with its production by infected macrophages being probably related to parasite establishment in the early stages of the disease.

Animals↗
PubMed1994

Cytomorphology and immunocytochemistry in the diagnosis of non-Hodgkin lymphomas.

1. Lymph node aspirates from 17 patients with an initial cytologic diagnosis of lymphoma (11 cases) or with suspected lymphoma (6 cases) were studied by immunocytochemistry, which led to a final diagnosis. Immunocytochemical staining demonstrated a B-cell phenotype in 10 cases, one case of anaplastic large cell Ki-1+ lymphoma, one lymphoblastic lymphoma negative for B and T cell markers, one large-cell unclassified lymphoma, and one inconclusive case. Three of the cases with suspected lymphoma were diagnosed as reactive lymphadenitis. 2. Combined cytomorphology and cytochemistry permitted a conclusive diagnosis in 13 out of 14 cases of lymphoma. Histology and immunohistochemistry confirmed the cytologic diagnosis. The inconclusive case was diagnosed as a T pleomorphic, small-cell lymphoma by histology. 3. The accuracy of cytomorphology associated with immunocytochemistry is high. However, the diagnosis of low-grade lymphomas, especially of a T phenotype may be difficult.

Biopsy, Needle↗
PubMed1993

Leishmaniasis recidiva cutis in American cutaneous leishmaniasis.

BACKGROUND: Leishmaniasis recidiva cutis (LRC) consists of active lesions around or inside the scar of classical cutaneous leishmaniasis (CL). In the literature it is considered as an hyperergic form of CL because the patients show a strong response to intradermal testing with leishmania antigen and, histologically, the parasites are scarce or absent; a well-organized granuloma is always observed. METHODS: Three patients from Bahia (Brazil) with LRC were evaluated by clinical examination, biopsies, skin tests with leishmania antigen, serology, and culture. In addition, a specific lymphocyte blastogenesis test was done and the species of leishmania characterized. RESULTS: The disease was caused by both L. amazonensis and L. braziliensis and serological titers varied from 1/16 to 1/64. The patients presented histologic and immunologic aspects different from those referred to in the literature. From four biopsies obtained only two presented a granulomatous reaction and parasites varied from absent to a parasite index 3. In one patient an absence of T cell response to leishmania antigen was observed in the first evaluation with restoration of the response after cure. In the other two, the degree of the specific proliferative response was lower than that usually observed in patients with classical CL. CONCLUSIONS: These findings indicate that New World LRC can not be considered a hyperergic form of CL. With respect to its clinical aspects and response to treatment, LRC must be considered as an entity different from the classical CL.

Adult↗
PubMed1992

Diffuse cutaneous leishmaniasis with atypical aspects.

A 16-year-old man had long-standing diffuse cutaneous leishmaniasis with the following characteristics: diffuse infiltrated lesions rich in amastigotes, absence of mucosal involvement, and lack of parasite-specific cell-mediated immune response. In situ identification of Leishmania mexicana amazonensis was achieved by the use of monoclonal antibodies. Clinically, as an atypical finding there was deep and extensive ulceration in the lower limbs. Histologically, an atypical characteristic was the presence of a high number of eosinophils in the infiltrate predominantly in the ulcerated lesion. Ultrastructurally, parasitized and lysed eosinophils with dispersion of their granules were seen in the vicinity of parasitized or lysed macrophages.

Adolescent↗
PubMed1992

Ki-1 large cell lymphoma with regressing lesions in a child.

An 8-year-old boy was seen with a cutaneous Ki-1 anaplastic, large cell lymphoma with multiple lesions. Some of the lesions showed spontaneous regression. During more than seven years of disease no systemic involvement was observed, but recurrent, self-healing lesions did appear. Histopathologic examination of five lesions revealed a variety of findings, from an inflammatory infiltrate to a highly anaplastic pattern. The neoplastic cells expressed Ki-1 and leukocyte common antigens. Ultrastructurally, those cells showed ruffled indentations. The differential diagnosis includes microvillous malignant lymphoma. The patient has had a four-year follow-up without relapses.

Abdominal Neoplasms↗
PubMed1991

Basidiobolomycosis: a case report.

A case of subcutaneous entomophthoromycosis caused by Basidiobolus haptosporus in a five year-old child was presented. The case has unusual aspects: extensive ulceration, caseation necrosis and a lack of response to potassium iodide. The lesion was cured using an association of potassium iodide and ketoconazole.

Child, Preschool↗
PubMed1990

[Chronic Chagas cardiopathy in patients aged 12 to 15 years].

PURPOSE: A comparison between pathological features of chronic chagasic cardiomyopathy (CCC) in adolescents and adults. PATIENTS AND METHODS: Adolescents under the age of 15, with amastigote trypanosomal forms in the myocardium, a positive xenodiagnosis and/or serology for trypanosoma cruzi infection, were selected from 4.583 necropsies performed between 1958-86 at the Professor Edgard Santos Hospital in Bahia, Brazil. RESULTS: Nine CCC cases between the ages of 12 and 15 years were identified. Mean heart weight was under twice normal. Intracardiac thrombi were present in five (55.6%), apical left ventricle aneurysm in four (44.4%) and parasites in the myocardium in three (33.3%) cases. Systemic or pulmonary thromboembolism was found in six (66.7%) patients. Mitral regurgitation was present in six (66.7%) cases, two with valvar anatomic alterations. CONCLUSION: Pathological features of CCC in adolescents did not differ from those found in adult patients.

Adolescent↗
PubMed1988

[Entomophthoromycosis. Review].

A review of the published reports on entomophthoromycosis (rhynoentomophthoromycosis and basidiobolomycosis) is presented. Geographic distribution, clinical, pathologic, mycologic and therapeutic aspects are emphasized. Primary and secondary visceral involvement are discussed. Data concerning 33 Latin American cases are analysed: 21 cases of rhynoentomophthoromycosis and 11 of basidiobolomycosis. Of these cases, 84% were described in Brazil and of the seven reported cases with primary visceral involvement reported in the world literature six were from Brazil. The importance of an early diagnosis of these infections is asserted specially in view of the resulting deformities and even death.

Dermatomycoses↗
PubMed1987

[Recurrent polychondritis (report of a case)].

A case of relapsing polychondritis with atrophic lesions in nose and ears and conjunctivitis is presented. The patient was treated with dapsone during 18 months with remission of the acute breaks.

Atrophy↗