Contrasting frequencies of antitumor and anti-vaccine T cells in metastases of a melanoma patient vaccinated with a MAGE tumor antigen

Melanoma patients have high frequencies of T cells directed against antigens of their tumor. The frequency of these antitumor T cells in the blood is usually well above that of the anti-vaccine T cells observed after vaccination with tumor antigens. In a patient vaccinated with a MAGE-3 antigen presented by HLA-A1, we measured the frequencies of anti-vaccine and antitumor T cells in several metastases to evaluate their respective potential contribution to tumor rejection. The frequency of anti–MAGE-3.A1 T cells was 1.5 × 10−5 of CD8 T cells in an invaded lymph node, sixfold higher than in the blood. An antitumor cytotoxic T lymphocyte (CTL) recognizing a MAGE-C2 antigen showed a much higher enrichment with a frequency of ∼10%, 1,000 times higher than its blood frequency. Several other antitumor T clonotypes had frequencies >1%. Similar findings were made on a regressing cutaneous metastasis. Thus, antitumor T cells were ∼10,000 times more frequent than anti-vaccine T cells inside metastases, representing the majority of T cells present there. This suggests that the anti-vaccine CTLs are not the effectors that kill the bulk of the tumor cells, but that their interaction with the tumor generates conditions enabling the stimulation of large numbers of antitumor CTLs that proceed to destroy the tumor cells. Naive T cells appear to be stimulated in the course of this process as new antitumor clonotypes arise after vaccination

Maladie de Kikuchi-Fujimoto : À propos d'un cas

Nous rapportons un cas de maladie de Kikuchi-Fujimoto, affection rare, peu connue des cliniciens, définie comme une lymphadénite nécrosante touchant de manière prépondérante les sujets jeunes de sexe féminin. À propos de cette observation, une brève revue de cette maladie est proposée ainsi que les principaux diagnostics différentiels à évoquer

Unexpected discovery of asymptomatic polycythemia vera in a patient with papulopustular rosacea caused by Demodex: A fortuitous association?

Herein, we follow the case of a patient suffering from papulopustular rosacea caused by Demodex associated with polycythemia vera (PV), which was fortuitously diagnosed. Facial erythrosis must spark a suspicion of PV even if the case appears to be papulopustular rosacea caused by Demodex. This observation underlines the distinctive physiopathological processes of papulopustular rosacea caused by Demodex and that of PV; however, the dermatological clinical signs are similar. A skin biopsy does not allow us to differentiate the two pathological processes since only a blood sample analysis may exclude a diagnosis of PV. This case stresses the potential advantage of conducting systematic blood analyses for every patient presenting with clinical signs of rosacea, even of erythrodermic rosacea that does not respond to the classical therapeutics, to exclude the possibility of underlying asymptomatic PV. Dermatologists must be aware of the nonspecific dermal manifestations of this potentially fatal hematologic disorder

CMV enteritis causing massive intestinal hemorrhage in an elderly patient.

Background. Cytomegalovirus (CMV) disease is rare in previously immunocompetent patients. We report a case of CMV enteritis complicated by massive intestinal bleeding. Case History. A 72-year-old immunocompetent patient was admitted for diarrhea and abdominal pain. Aspecific pattern of duodenitis was found at abdomen computed tomography and on biopsies during endoscopy. A diagnosis of vasculitis was suspected on the basis of the clinical and biological course (skin lesions, arthralgias, proteinuria, low complement C3 and C4 fractions, etc.) and pulse steroid therapy was prescribed. The patient developed multiple episodes of intestinal bleeding with shock and required urgent laparotomy. Jejunitis due to CMV vasculitis was proven by histological examination of the operative specimen. Treatment with ganciclovir was initiated. No bleeding recurrence was noted. No other lesions from CMV infection were observed. The patient died from unrelated complications. Discussion. CMV enteritis is a rare cause of intestinal bleeding particularly in previously immunocompetent patients. Aging could be accompanied by a relative immune weakness and specific antiviral therapy seems to be indicated

An unusual cause of obstructive sleep apnea syndrome

The histopathologic examination is important after tonsillectomy, irrespective to the surgical indication.info:eu-repo/semantics/publishe

Extramedullary haemopoiesis and spinal cord compression.

Ethiopia's average life expectancy has improved by more than 18 years from 1990 to 2015. This initiated interest to study the gain in life expectancy with respect to age structure and cause of death. Applying a life expectancy decomposition technique on secondary data obtained from the Institute of Health Metrics and Evaluation, the study found that the burden of disease in Ethiopia has declined from 626.18 in 1990 to 225.69 in 2015 per 1000 population measured in age-standardized rate of life years lost. The major causes of burden in 1990; namely lower respiratory tract infections, neonatal disorders, diarrheal diseases and neglected tropical diseases at rates of 89.2, 63.2, 61.2, and 42.2 age-standardized years of life lost per 1000 population respectively; have shown a fast decline in 2015. Deaths from neglected tropical disease showed 94.95% reduction, contributing to 5.71(27.30%) years gain in life expectancy followed by lower respiratory tract infection and diarrheal disease contributing about 4.65 years (22.23%) and 1.48 years (7.10%) respectively. On the other hand, about 3.3 (15.73%) years and 6.4 (30.71%) years of increase in life expectancy are achieved through improved longevity in infants and children aged 1-4 years respectively. In conclusion, the study found that reductions in under-five child mortality and decline in burden of major communicable diseases could explain the major gain in life expectancy. However, findings also revealed that the prevalence of non-communicable diseases and injuries are on the rise calling for the need to be addressed by the public health system

An unusual cause of obstructive sleep apnea syndrome.

The histopathologic examination is important after tonsillectomy, irrespective to the surgical indication.info:eu-repo/semantics/publishe