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R Bruns

Publications and source records attributed to R Bruns.

At least 55 records · Page 3Linked to original sources

[Human Parvovirus B19--really only fifth disease? Unusual disease course in children and adolescents].

The human parvovirus B19 agent causes infectious erythema (fifth disease). However, a wide range of other pathological manifestations may also be seen: atypical exanthema, ARD (also obstructive forms, e.g. bronchiolitis), acute gastroenteritis, chronic anemia or aplastic crises (in constitutional or malignant hematological diseases or immunological deficiency), arthralgia/arthritis (e.g. rheumatoid arthritis, jcA), diseases of the central nervous systems (e.g. febrile convulsions in young children), lymphadenopathies (e.g. lymphadenitis mesenterialis or pseudoappendicitis); prenatal infection can lead to fetal death (not malformations!). Infection occurring concomitantly with vaccination may suggest complications of the latter. To clarify the true etiological situation, modern laboratory investigations are then required. Vaccination against parvovirus B19 (initially indicated in the case of non-immune girls and women wanting children) is a desirable future development.

Adolescent↗

[Seroprevalence of antibodies to human herpesvirus 6 (exanthema subitum; critical 3-day fever-exanthema in young children) in the population of Northern Germany].

We tested 989 sera of all age groups (patients and blood donors) from north eastern Germany (West Pomerania and Mecklenburg) and found 820 cases (82.9%) of specific human herpes virus type 6 (HHV 6) antibodies (IgG) gy indirect immunofluorescent assay. The seroprevalence rose to 83.6% when the 7 HHV 6-IgM positive results (0.7%) were included; moreover a further 23 sera (2.3%) showed specific HHV 6 antibodies of both classes (IgM and IgG). The antibody prevalence was constantly high at 90% from the age of 8 months up to the 71-80 years group, and it only decreased in the age group over 80. 93.2% of the newborn infants showed HHV 6-IgG antibodies (of maternal origin) in the cord blood; this prevalence is identical with that for females of reproductive age (92.7% in the 3rd decade, 93.7% in the 4th decade). No sex differences in seroprevalence were observed. The main immunization occurs in the first year of life but infection with HHV 6 at a later age is also well documented. We found the lowest seroprevalence in the 3rd and 4th postnatal months (when maternal immunity had disappeared); later the seroprevalence of specific antibodies rose very rapidly and by the 8th month the rate was the same as for the adult group. The theoretical possibility of prenatal infection due to HHV 6 exists, but the real risk of a first infection during pregnancy is very low, because only 7-8% are susceptible in this group.

Adolescent↗

[The blood picture in exanthema subitum (Zahorsky)/ critical 3-day fever-exanthema in young children].

Exanthema subitum was described in 1910 by John Zahorsky/USA; in 1986 and 1988 the human herpesvirus 6 (HHV 6) was discovered as the causative agent of the disease and serologic tests were established for diagnostics (specific IgM and IgG antibodies). Up to this time the diagnosis was based on the typical clinical course: the prodromal febrile stage (3 days) followed by the onset of a (more or less characteristic) rash closely connected with the normalisation of the body temperature. Usually a typical white blood cell count was described for diagnostics on the first day of exanthema: leukocytopenia with eosino- and granulocytopenia associated with consequent lymphocytosis. We analysed the hematologic data for children with a serologically documented HHV6 infection including exanthema (group 1: n = 9), without exanthema (group 2: n = 11) or with a serologically unexplained febrile rash (group 3: n = 13). In children with exanthematous HHV6 infection (exanthema subitum) granulocytopenia and a decreased thrombocyte count (mean values) is the rule. But the total white blood cell count and the mean values for eosinophils did not differ between the groups studied.

Agranulocytosis↗

[Blood picture findings in children with Parvovirus B19 infections (fifth disease/erythema infectiosum)].

The human parvovirus B19 provokes erythema infectiosum ("e.i."); moreover there is a wide range of diseases due to parvovirus B19 without exanthema/rash. The erythropoietic blast cells of the bone marrow seems to be the main target cells for this virus. Therefore in cases of prenatal infection the consequences are extremely similar to fetal erythroblastosis ("non-immunological" fetal hydrops). In postnatal life the parvovirus B19 infection causes hyporegenerative phases of the erythropoiesis with anaemia after 3-4 weeks. We studied the white blood cell count (WBC), erythrocytes and thrombocytes in children suffering from (serologically well documented) parvovirus B19 infection with exanthem/"e.i." (group 1; n = 23), without exanthem (group 2; n = 46) and with unknown febrile exanthematous rashes (group 3; n = 76). We did not find any characteristic data in the WBC for a diagnosis of parvovirus B19 infection. However we have for the first time documented a significant thrombocytopenia in "e.i." (group 1) not found in group 2. The thrombocytopenia appears earlier than the anaemia, because the lifespan of thrombocytes is considerably shorter than that of erythrocytes. These data suggest that parvovirus B19 attacks not only "erythropoietic" blast cells but also immature bone marrow cells, which are later responsible for the thrombocytopoiesis.

Adolescent↗

[Obstructive respiratory tract diseases in children and Parvovirus B19 infections].

Acute respiratory diseases (ARD) due to parvovirus B 19 infection can be observed relative frequently in children. In 21 children (infants, toddlers and school children) we have seen acute or prolonged obstructive bronchitis/bronchiolitis (15 infants), acute subglottic laryngitis (3 toddlers) and acute asthmatic attacks (3 children of school age) in connection with parvovirus B 19 infection. Other respiratory viruses (adeno-, influenza, parainfluenza and RS-virus) could be excluded as agents causing the ARD. We suggest that parvovirus B 19 can provoke ARD with obstructive ventilatory disturbances of the upper or lower airways in children with a specific endogenous predisposition (small or unstable bronchial walls, or bronchial or tracheal mucosal hyperreactivity).

Airway Obstruction↗

Serum prolactin concentration and hypothalamic-pituitary hormone release in CF-children.

Some experimental data from animals suggest that prolactin (PROL) is involved in sweat production and modulates the chloride concentration of sweat. We determined the serum PROL level by RIA in 38 CF-patients (age: 3-24 years) and 48 patients with bronchial asthma (age: 2-18 years) and found no concentration differences between the two groups each taken as a whole; the TSH level was increased in CF (p less than 0.05). Separate analysis showed a significantly higher PROL level in CF-females and in CF-children (male and female) under 12 years old (p less than 0.05). To assess the hypothalamic-pituitary system we performed the metoclopramide test (by Cerucal) on 30 children suffering from CF (n = 10), bronchial asthma (n = 10) or pyelonephritis (n = 10) for PROL, LH, FSH, TSH and HGH. The hormone release was normal for all kinds checked in all groups of patients. Hence it follows that the neurohormonal system of prolactin is normal in CF-patients and the increased serum PROL and TSH concentrations in CF should be seen as a regulatory phenomenon but not as a mechanism associated with the basic defect of the CF-disease.

Adolescent↗

The eosinophilic granulocyte count in the respiratory secretions of children with chronic nonspecific respiratory diseases.

We performed cytologic evaluations of 6116 nasal and/or bronchial smears from 4510 patients (average age: 7.6 years; 3 months--17 years) suffering from different kinds of chronic nonspecific respiratory diseases (CNSRD); in 137 children (average age: 4.8 years) undergoing bronchologic examinations under general anesthesia we compared the findings with those for bronchoalveolar lavage (BAL). Nasal smears of 77 healthy children at a day care center (control group) were analysed four times per year for "significant secretory eosinophilia" (SEE; i.e. more than 13% eosinophils). We found: 1. Healthy children do not have such "SSE" in contrast to children with CNSRD who show different frequencies of "SSE" depending on the age of the child and the specific kind (diagnosis) of CNSRD. 2. 4.6% of infants (first year of life) were found to have SSE with a statistically significant correlation to increase in the following 10 years up to 50% of all children (p less than 0.001). 3. We found SSE in 4.41% of cases with relapsing bronchitis, in 7.14% (8.3% resp.) with chronic bronchitis, in 6.49% (9.2% resp.) with relapsing or chronic obstructive bronchitis and in 46.05% (55.3% resp.) with bronchial asthma (p less than 0.001). 4. The intensity of obstructive symptoms (nose: rhinitis; bronchus: dyspnoea) did not correlate with the number of eosinophils in the secretions. 5. Only the smear cytograms (nose/bronchus) enabled us to detect "SSE" whereas BAL cytograms were too insensitive (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Human-mouse interspecies collagen I heterotrimer is functional during embryonic development of Mov13 mutant mouse embryos.

To investigate whether the human pro alpha 1(I) collagen chain could form an in vivo functional interspecies heterotrimer with the mouse pro alpha 2(I) collagen chain, we introduced the human COL1A1 gene into Mov13 mice which have a functional deletion of the endogenous COL1A1 gene. Transgenic mouse strains (HucI and HucII) carrying the human COL1A1 gene were first generated by microinjecting the COL1A1 gene into wild-type mouse embryos. Genetic evidence indicated that the transgene in the HucI strain was closely linked to the endogenous mouse COL1A1 gene and was X linked in the HucII transgenic strain. Northern (RNA) blot and S1 protection analyses showed that the transgene was expressed in the appropriate tissue-specific manner and as efficiently as the endogenous COL1A1 gene. HucII mice were crossed with Mov13 mice to transfer the human transgene into the mutant strain. Whereas homozygous Mov13 embryos die between days 13 and 14 of gestation, the presence of the transgene permitted apparently normal development of the mutant embryos to birth. This indicated that the mouse-human interspecies collagen I heterotrimer was functional in the animal. The rescue was, however, only partial, as all homozygotes died within 36 h after delivery, with signs of internal bleeding. This could have been due to a functional defect in the interspecies hybrid collagen. Extensive analysis failed to reveal any biochemical or morphological abnormalities of the collagen I molecules in Mov13-HucII embryos. This may indicate that there was a subtle functional defect of the interspecies hybrid protein which was not revealed by our analysis or that another gene has been mutated by the retroviral insertion in the Mov13 mutant strain.

Animals↗