Trace elements (selenium, zinc, copper), beta 2 microglobulin levels, CD4, and CD8 cell counts have been determined in 80 HIV1 seropositive patients. The study group consisted of 19 females and 61 males with age mean of 35 +/- 10 yr, at stage IV of infection (CDC--Atlanta classification) and treated by AZT. No severe renal or liver diseases or hypoalbuminemia were observed in this group. Se values were significantly lower than in normal adults, 48.3 +/- 17 micrograms/L vs 71 +/- 12 micrograms/L; Zn was moderately diminished, 1 +/- 0.2 mg/L vs 1.2 +/- 0.2 mg/L, whereas copper values were in the normal range, 1.2 +/- 0.3 mg/L vs 1.1 +/- 0.5 mg/L. Se or Zn deficiency was found in 60 and 30 subjects, respectively. Blood Se and Zn decreases were associated in 23 patients. Moreover, all patients showed higher beta 2 microglobulin values than the upper normal limit of 2.4 mg/L. Negative correlations were found between Zn and beta 2 microglobulin (p < 0.005) and between Se and beta 2 microglobulin (p < 0.05). Moreover, there was a positive correlation between Se and Zn values (p < 0.05). Nineteen subjects died 1 yr later (group I), and 61 remained alive (group II). With respect to the clinical evolution, a significant difference between both groups was found in Se and beta 2 microglobulin levels as well as in CD4 cell counts. The correlations previously observed persisted in group II, whereas no correlation was noted in group I. In addition, the patients of group one had significantly lower Se values, which were below 30 micrograms/L in 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗

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[Electroencephalographic course of severe hepatic coma due to acute hepatitis, treated successfully by repeated exchange transfusions].

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Child↗

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[Invasive Streptococcus pyogenes infection: significance of the detection of pyrogenic exotoxins].

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Adult↗

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[Varicella zoster virus infection after bone marrow transplant. Unusual presentation and importance of prevention].

BACKGROUND: Leukemeia and lymphoproliferative disease are associated with a high risk of varicela-zoster virus (VZV) infection. Although infrequent, visceral involvement can be fatal. We report two cases of patients presenting severe VZV infection after bone marrow transplantation. CASE REPORTS: The first patient was a 42-year old man who received an allogeneic bone marrow transplantation for chronic myelogenous leukemia. A severe graft-versus-host reaction occurred. Three months after discontinuing VZV prophylaxis, VZV transverse myelitis was diagnosed, leading to death despite prompt treatment with acyclovir. The second patient was a 42-year-old woman treated with autologous bone marrow transplantation for lymphoma. She developed acute viral pancreatitis one month after discontinuing VZV prophylaxis. Recovery was achieved with intravenous treatment. DISCUSSION: These two cases illustrate the potential gravity of VZV infection after bone marrow transplantation. These observations point to the need for revisiting the duration of VZV prophylaxis.

Adult↗

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