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Copyright of Revista Paulista de Pediatria is the property of Assocoacao de Pediatria de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We report the case of a 6-year-old boy that presented with enlarged lymph nodes on his neck. He complained of tiredness and discouragement, which worsened during feverish periods. There were no relevant laboratory test abnormalities and serological tests were not reactive. Bartonella henselae DNA was detected by species-specific nested polymerase chain reaction. After treatment, the patient progressed with no fever or lymphadenopathy. Bartonellosis is a group of infectious diseases caused by bacteria of the genus Bartonella. This case report is a useful reminder to clinicians that long-term fever of unknown origin can be related to B. henselae infection, even if the specific serology is not reactive. [ABSTRACT FROM AUTHOR]

Copyright of Revista Paulista de Pediatria is the property of Assocoacao de Pediatria de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Paulista de Pediatria is the property of Assocoacao de Pediatria de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Paulista de Pediatria is the property of Assocoacao de Pediatria de Sao Paulo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

O acidente vascular encefálico isquêmico (AVEi), embora pouco frequente em crianças, possui alta morbimortalidade. Doenças hematológicas representam de 4 a 6% das causas de lesões cerebrais isquêmicas. Dentro desse contexto, a leucemia é uma das causas de AVEi em pediatria. Relatamos aqui um caso raro de AVEi como manifestação clínica inicial de leucemia em um paciente pediátrico. RDN, 4 anos, com história súbita de afasia, hemiparesia a direita, desvio de rima labial e dificuldade de deambulação. Exame neurológico inicial com hemiplegia à direita. Tomografia computadorizada de crânio apresentou hipodensidade frontal à esquerda e o hemograma mostrou 50 mil plaquetas, 1240 leucócitos e 11 g/dL de hemoglobina. Ressonância nuclear magnética evidenciou isquemia em território de artéria cerebral média, desvio da linha média e herniação de uncus. Na UTI pediátrica evoluiu com clínica de hipertensão intracraniana sendo submetido a craniectomia descompressiva. Observado presença de blastos no sangue periférico no 5° dia de internação, ocorrendo óbito após 2 dias. Diagnóstico de leucemia mielóide aguda confirmado por necropsia. As neoplasias hematológicas possuem associação com lesões isquêmicas em sistema nervoso central. Leucoestase e plaquetopenia, comumente presentes nestes casos, são fatores que podem comprometer a perfusão cerebral adequada. Além das neoplasias hematológicas, outras causas de AVEi são: malformações arteriovenosas congênitas, distúrbios de coagulação e fenômenos tromboembólicos. Assim sendo, a leucemia deve ser sempre considerada entre os diagnósticos etiológicos do AVEi na faixa etária pediátrica. Além disso, o diagnóstico das neoplasias hematológicas deve ser afastado em todos os pacientes portadores de pancitopenia. [ABSTRACT FROM AUTHOR]

• Patients with severe forms of PCM present high levels of IL-27 in serum. • IL-27 was detected in lesions of patients with PCM. • The frequency of Tr1 cells is higher in AF patients when compared to CF patients. • Pb18 yeast cells induce IL-27 production by DCs and macrophages. • Pb18 yeast cells are capable of inducing Tr1 cells polarization. Interleukin-27, a cytokine of the IL-12 family, is secreted by antigen-presenting cells such as macrophages and dendritic cells (DCs). Recent studies suggest an anti-inflammatory role for IL-27 by inducing IL-10 producing Tr1 cells capable of inhibiting Th1 and Th17 type responses. Our study aimed to investigate the involvement of IL-27 and Tr1 cells in the immunomodulation of paracoccidioidomycosis (PCM), the most prevalent systemic mycosis in Brazil. The presence of IL-27 was evaluated in serum and biopsies of patients with PCM by ELISA, immunohistochemistry, and immunofluorescence. The presence of Tr1 in peripheral blood was analyzed by flow cytometry. In vitro assays were performed to verify the ability of P. brasiliensis yeast to induce IL-27 production by DCs and macrophages, as well as the polarization of lymphocytes to the Tr1 phenotype. Patients with the acute form and severe chronic form, the most severe and disseminated forms of PCM, presented higher serum concentrations of IL-27 and higher percentage of Tr1 cells compared to patients with mild chronic form. IL-27 was also detected in lesions of patients with PCM and associated with DCs and macrophages. P. brasiliensis Pb18 yeasts were able to induce IL-27 production by both DCs and macrophages. We found that DCs pulsed with Pb18 were able to induce Tr1 lymphocytes in vitro. Our data suggest that IL-27 and Tr1 cells could contribute to the deficient immune response to P. brasiliensis that leads to severe and disseminated forms of the disease. [ABSTRACT FROM AUTHOR]