Biomedical subjects
Publications and source records attributed to R Jarisch.
The "asthma programme", the product of teamwork between the 1st Department of Dermatology and the 2nd Department of Medicine is presented. It contains all examinations necessary for the diagnosis of bronchial asthma: case history, skin test, IgE, RAST, lung function test, inhalative provocation test. The value of each is discussed. Finally, the results of hyposensitation treatment are presented.
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A case of hereditary incomplete, combined immunodeficiency is reported. The patient, a 20-week-old boy, suffered from severe, generalized tuberculosis after BCG-vaccination. A conspicuous discrepancy was found between the normal number of lymphocytes in the peripheral blood and the severe morphological changes in the organs of the lymphoreticular system (deficient development of thymic structures; absence of lymphocytes in the thymus and the thymus-dependent areas of the periphery as well as in the bursa-dependent structures). A partial primary defect of the stem cells and a secondary insufficiency of the functions with incomplete differentiation due to an insufficiency of the primary lymphatic organs are discussed as possible causative factors. The inability to develop epitheloid cells in connection with the tuberculous infection is interpreted in part as a sequence of a T-cell insufficiency.
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In this report clinical and immunologic data of a female diabetic patient with immediate-type allergy against insulin preparations of different species, including pancreatic human insulin, biosynthetic human insulin and semisynthetic human insulin are described. The determination of insulin-specific antibodies showed relatively high IgE-antibody titers in contrast to low IgG-antibody concentrations, which is in accordance with the assumption that the ratio of IgE- to IgG-insulin antibodies is important in the outcome of clinically manifest allergic reactions. Negative results for cutaneous delayed-type insulin hypersensitivity and for stimulation of lymphocyte blastogenesis exclude type IV immunopathogenic reaction in this insulin-allergic patient. Preliminary data suggest that inherited individual factors--such as DR2, DR3 positivity in this diabetic individual--might predispose diabetic patients to insulin allergy.
Sneezing, flush, headache, diarrhea, skin itch, and shortness of breath are symptoms occurring in patients intolerant to wine after drinking one glass of red wine. The role of histamine in wine intolerance was evaluated by a red wine provocation test in 28 patients with a history of wine intolerance and in 10 controls with good tolerance of wine. Patients were challenged with 125 ml red wine (equivalent to 50 micrograms histamine); blood samples were drawn before and after 15 and 30 minutes. Plasma histamine was assessed by a radioimmunoassay. Lung function tests were performed before and after the wine test. Twenty-two of twenty-eight patients had symptoms showing significantly higher plasma histamine levels 30 minutes after wine challenge (p < .01) compared with asymptomatic controls. Basal histamine levels of patients were higher (p < .05) than in controls. A slight asthmatic attack as well as a 30% decrease of FEF 25 was seen in 2/22 patients. Terfenadine premedication significantly eliminated symptoms in 10/12 patients (p < .05) in a subsequent wine test. Histamine assessment was done in 52 wines (red, white, and champagne) and in 17 beers by radioimmunoassay. Histamine levels ranged from 3-120 micrograms/l in white wines; 15-670 micrograms/l in champagnes; 60-3800 micrograms/l in red wines; and 21-305 micrograms/l in beers. Histamine is causing wine intolerance. Patients intolerant to wine seem to have diminished histamine degradation probably based on a deficiency of diamine oxidase.