CLINICAL CASES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 1999 August;158(4):121-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: English

Osteoporosis, cardiovascular and hematologic disorders, a chronic toxoplasmosis triad and thalidomide

Barbosa Vosgerau J. C.

Centro Municipal de Especialidades, Secretariat of Health from Ponta Grossa

Osteoporosis be­came a now­a­days con­cern for wom­en, how­ev­er it is not re­lat­ed ­just to men­o­pause. Osteoporosis al­so oc­curs in ­males, ­young peo­ple or as­so­ciat­ed to sev­er­al dis­eas­es. Chronic tox­o­plas­mo­sis may af­fect any or­gan, ­even ­joints/­bone tis­sues. It is re­port­ed 3 pa­tients, 2 ­males and 1 fe­male ­with os­te­o­por­o­sis ­that had se­vere ­joints/­bone ­pain un­re­spon­sive to cor­ti­cos­ter­oids, anti­in­flam­a­toires, cal­cium, cal­cit­o­nine ­that re­mit­ted or had a ­marked im­prove­ment ­with spe­cif­ic tox­o­plas­mo­sis med­i­cines and par­tic­u­lar­ly ­when ­these ­drugs ­were as­so­ciat­ed to tha­lid­o­mide 6.5 g/day. The os­te­oar­tic­u­lar ­pain in ­these pa­tients was as­so­ciat­ed to car­di­o­vas­cu­lar and he­mat­o­log­i­cal dis­or­ders as hy­per­ten­sion/hy­po­ten­sion, se­vere con­ges­tive ­heart fail­ure and ar­rhyth­mi­as, sep­tic ­shock hy­per­cho­les­ter­o­le­mia/hy­po­cho­les­ter­o­le­mia, hy­per­trig­ly­cer­i­de­mia, aor­ta cal­cifi­ca­tion, chron­ic ane­mia, eo­sin­o­phil­ia, bas­o­phil­ia, leu­ko­cy­to­sis, neu­tro­pe­nia, neu­tro­fil­ia, throm­bo­cy­to­sis un­re­spon­sives to usu­sal meas­ures. The ­joints/­bone ­pain im­prove­ment was re­lat­ed to car­di­o­vas­cu­lar and he­mat­o­log­ic im­prove­ment as ­well as os­te­oar­tic­u­lar com­plains de­te­ri­ora­tion was re­lat­ed to car­di­o­vas­cu­lar and he­mat­o­log­i­cal de­te­ri­ora­tion. It is pos­tu­lat­ed ­that IFN-γ has a cen­tral ­role in the tox­o­plas­mo­sis pa­thoph­y­sio­lo­gy and ­that ­these dis­or­ders are re­lat­ed to IL-1, IL-2, IFN-γ, TNF-α and IFN-α ­host in­tox­i­ca­tion trig­gered by toxoplasms. It ­seems ­that ­these os­te­oar­tic­u­lar, car­di­o­vas­cu­lar and he­mat­o­log­ic dis­or­ders are not dif­fer­ent dis­eas­es but ­just the ­same re­sponse in dif­fer­ent or­gans to the ­same stim­u­lus- ­host ­high lev­els of cy­to­kines trig­gered by intra­cel­lu­lar patho­gens as toxoplasma.