Human T-Lymphotropic Virus 1 Adult T-Cell Lymphoma With Giardia and Strongyloides Parasitism
Notice bibliographique
Résumé
A 40-year-old man originally from Togo, West Africa, developed a 2-month history of abdominal cramps, diarrhea, and weight loss, 4 years after immigrating to Canada. The patient was seropositive for human T-lymphotropic virus 1 (HTLV-1). No human immunodeficiency virus 1 or human immunodeficiency virus 2 antibodies were detected. The patient's complete blood count values were within laboratory reference intervals, and there specifically was no evidence of adult T-cell leukemia. Upper endoscopy revealed only esophageal candidiasis, which was confirmed histologically. Duodenal biopsies contained clusters of lymphocytes with large pleomorphic nuclei that infiltrated mucosa, including glandular epithelium, and submucosa (Figure, large arrow). These lymphocytes stained with antibodies directed against CD45RO and showed no immunoreactivity for CD20. Adult T-cell lymphoma was diagnosed and was also found involving the stomach. In addition to the diffuse neoplastic process, Giardia lamblia (small arrow) and Strongyloides stercoralis parasites were identified in duodenal biopsies. Occasional cytomegalovirus inclusions within gastric glandular epithelium were also present. Stool examination for ova and parasites revealed S stercoralis rhabditiform larvae, eggs, and parasitic females. Giardia lamblia cysts and trophozoites were also identified. No filariform Strongyloides larvae were present.Human T-lymphotropic virus 1 is an oncogenic retrovirus with a global distribution that is endemic to Southeast Asia, southwestern Japan, the Caribbean, the southeastern United States, and West Africa.1,2 Environmental cofactors, such as Strongyloides parasitism, have been suggested as possible contributing mechanisms to HTLV-1–associated leukemogenesis.3 It is controversial whether HTLV-1 carriers are at increased risk for Strongyloides infection.1 Human T-lymphotropic virus 1–infected patients with adult T-cell leukemia/lymphoma, however, are immunocompromised and specifically have defects of cell-mediated immunity.2 These patients are at increased risk for multiple opportunistic infections, including cytomegalovirus, herpes zoster, disseminated herpes simplex, Pneumocystis carinii, Cryptococcus, Candida, and enteric parasites, such as Strongyloides.2,4 Immunocompromised hosts with Strongyloides infections may develop autoinfection and disseminated strongyloidiasis as a result of direct transformation of rhabditiform larvae to filariform larvae within the gastrointestinal tract.1 Hosts infected with Strongyloides, like our patient, may have long periods of asymptomatic disease and may only become symptomatic with waning immunocompetence and heavy worm burdens. Persistent Strongyloides infections lasting decades have been reported as a result of continued autoinfection.1 In summary, this case illustrates that patients with HTLV-1–associated adult T-cell lymphoma/leukemia may develop multiple, clinically significant, opportunistic infections secondary to their immunocompromised state.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,004 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».