Pathologic features of changes of digestive organs and nephros with isolated DRTB and co-infection DRTB/HIV/AIDS
Journal Title: Туберкульоз, легеневі хвороби, ВІЛ-інфекція - Year 2018, Vol 0, Issue 1
Abstract
Objective — based on а retrospective analysis to examine the features of pathological changes of the digestive system and nephros to improve clinical diagnosis of pathological conditions of these organs. Materials and methods. То study the methods used retrospective analysis of 55 medical records and protocols pathologicalanatomical studies of patients with drugresistant tuberculosis (DRТB) and DRТВ/HIV/АІDS. Results and discussion. Among the 55 died patients 37 patients (67.3 %) had only DRТБ (group 1), 18 (32.7 %) — DRТB/НІV/АІDS (group 2). Fatty degeneration of hepatocytes occurs in 100.0 % of patients with isolated DRТВ and coinfection DRТВ/HIV/АІDS; however, the genesis of development is different. When DRТВ/HIV/AIDS steatohepatosis formed by diffuse lymphplasmaeosinophilic infiltration of the stroma of the liver in 55.6 %, interstitial edema in 50.0 % and interlobular cirrhosis in 33.3 % of cases; liver DRТB — «nutmeg» in 73.0 % of cases, indicating that this condition is caused by hemodynamic overload and blood congestion on the right heart. Acid resistance sticks in the liver (22.2 %), in the pancreas (5.6 %) are found only in patients with DRТВ/HIV/АІDS should be treated as the specificity of HIV in patients with DRTB. Necrosis of individual tubules was recorded in 16.2 % of patients with isolated DRTB in the absence of tubular necrosis in patients of the second group (DRTB/HIV/AIDS).Sclerotic changes prevailed in pathoanatomical studies in the first group and reached 51.4 %, which was significantly higher than the results in the second group (33.3 %). However, for patients with coinfection DRТВ/HIV/АІDS interstitial lesions were characterized as effacement of the structure of the kidney section (27.8 %), fосаl microcytosis of tubules (38.9 %) and polycystic kidney disease (5.6 %). Conclusions. The morphological manifestation of tuberculosis of internal organs is the dynamics of immune responses of patients. The сlinіс takes рlасе overdiagnosis pathological changes of the digestive system and nephros damage in patients with isolated DRTB and underdiagnosis violation of these organs in patients соinfected DRТВ/HIV/АІDS needs to improve knowledge phthisiologist of concomitant somatic pathology.
Authors and Affiliations
N. A. Matsehora, S. O. Poliakova, M. N. Yeliseidis
Keywords
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