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Sarcoid-like lesions associated with the immune restoration inflammatory syndrome in AIDS: absence of polymerase chain reaction detection of Mycobacterium tuberculosis in granulomas isolated by laser capture microdissection

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Abstract

Highly active antiretroviral therapy (HAART)-treated human immunodeficiency virus (HIV)-positive patients can develop granulomatous lesions within the first few weeks of initiating therapy. This immune syndrome, called immune restoration inflammatory syndrome (IRIS), can induce sarcoid-like lesions in tissues. The pathogenesis of these granulomas is currently unknown because no pathogen has been identified to date in the lesions using morphological and/or microbiological approaches. However, the role of certain microbes, such as Mycobacterium tuberculosis, is still debated. The aim of this study was to look for the presence of M. tuberculosis in sarcoid-like lesions occurring in 14 AIDS patients treated with HAART. We used the PCR DNA amplification method in granulomas microdissected from sections stained by hematoxylin–eosin from formalin-fixed, paraffin-embedded specimens. Results were compared to those obtained from microdissected tuberculosis (TB) granulomas (15 patients) and from microdissected sarcoidosis granulomas (12 patients). M. tuberculosis DNA was undetectable from the microdissected sarcoid-like granulomas, whereas DNA from M. tuberculosis was isolated in all the microdissected TB granulomas and was absent in the microdissected sarcoidosis granulomas. Taken together, these data showed that M. tuberculosis DNA is not associated with the presence of sarcoid-like lesions occurring in HIV-positive patients treated with HAART.

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Acknowledgments

This work was supported by the PHRC Regional 2001 (Centre Hospitalo-Universitaire de Nice) (SL, ES, VH, JM, PD, PH). The authors wish to thank Dr. Michel Mouroux (CHPG, Monaco) for his support and Dr. Ellen Van Obbergen for reading this manuscript.

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Authors and Affiliations

  1. INSERM ERI-21, IFR 50, University of Nice, 06107, Nice, France

    Sandra Lassalle, Véronique Hofman, Catherine Butori, Nicolas Vénissac, Jérôme Mouroux & Paul Hofman

  2. Laboratory of Clinical and Experimental Pathology, Hôpital Pasteur, 30 avenue de la Voie Romaine, 06002, Nice Cedex 01, France

    Sandra Lassalle, Eric Selva, Véronique Hofman, Catherine Butori & Paul Hofman

  3. Department of Thoracic Surgery, University of Nice, 06107, Nice, France

    Nicolas Vénissac & Jérôme Mouroux

  4. Department of Infectious Diseases, University of Nice, 06107, Nice, France

    Pierre Dellamonica

  5. Tissue Biobank Unit, University of Nice, 06107, Nice, France

    Paul Hofman

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  1. Sandra Lassalle
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  2. Eric Selva
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  8. Paul Hofman
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Correspondence to Paul Hofman.

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Lassalle, S., Selva, E., Hofman, V. et al. Sarcoid-like lesions associated with the immune restoration inflammatory syndrome in AIDS: absence of polymerase chain reaction detection of Mycobacterium tuberculosis in granulomas isolated by laser capture microdissection. Virchows Arch 449, 689–696 (2006). https://doi.org/10.1007/s00428-006-0278-2

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  • DOI: https://doi.org/10.1007/s00428-006-0278-2

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