title: Pathologic findings in the adrenal glands of autopsied patients with acquired immunodeficiency syndrome.
abstract: A morphologic evaluation was carried out on adrenal glands from 128 autopsied patients with the acquired immunodeficiency syndrome (AIDS). The adrenal gland was compromised in 99.2% of the cases, with distinct pathological features and infectious agents. Inflammatory infiltrates were observed in 99.2% of the cases with a predominance of mononuclear cells in 97.4%, affecting mainly the medulla. Necrosis, fibrosis, hemorrhages and neoplasias were observed. We also described 3 (2.3%) cases of calcification located in the adrenal gland central vein (AGCV). This is seldom mentioned in the literature. Cytomegalovirus was the most frequent infectious agent, observed in 48.4% of cases. Balamuthia mandrillaris, a free living ameba, was found in one case affecting the entire gland. We also found a nest of Trypanosoma cruzi in the musculature of the AGCV. The presence of the nest of T cruzi in AGCV may play a role in the reactivation of this infection in immunosuppressed individuals. Pathologic processes and opportunistic infections may contribute to the alterations in the adrenal gland that lead to multiple organ failure observed in terminal AIDS patients.
authors.affiliation: School of Medicine of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Denise
authors.initials: D
authors.lastname: Rodrigues
authors.forename: Marlene
authors.initials: M
authors.lastname: Reis
authors.forename: Vicente
authors.initials: V
authors.lastname: Teixeira
authors.forename: Mário
authors.initials: M
authors.lastname: Silva-Vergara
authors.forename: Dalmo Correia
authors.initials: DC
authors.lastname: Filho
authors.forename: Sheila
authors.initials: S
authors.lastname: Adad
authors.forename: Javier
authors.initials: J
authors.lastname: Lazo
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000382:microbiology / Q000473:pathology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D000307:Adrenal Gland Diseases / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D000311:Adrenal Glands / Q000098:blood supply / Q000382:microbiology / Q000473:pathology*; D000328:Adult; D002114:Calcinosis / Q000150:complications / Q000473:pathology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D009102:Multiple Organ Failure; D014680:Veins / Q000473:pathology