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PubMed1987

[Pulmonary tuberculosis and primary infection in children. Retrospective study of 53 children].

A 4-year retrospective study of 53 children aged from 4 1/2 months to 16 years showed the persistent frequency of tuberculosis in a general paediatrics department: one out of 250 children of the same age admitted during the same period presented with tuberculosis. Acute febrile pulmonary manifestations (13%) were much less frequent than primary infections (87%) which were symptomatic in only one out of 2 cases. But, whether the primary infection was patent or latent, mediastinal lymphadenopathy was present in one out of 5 cases. In children, a 15 mm or more intradermal reaction to 10 units of tuberculin is strongly suggestive of tuberculosis, especially when previous intradermal tests were negative. Radiography of the chest and gastric fluid aspiration indicated the degree of infection. In spite of its low yield (10% positive microscopic examinations and 20% positive cultures), gastric aspiration had the merit of confirming the diagnosis of tuberculosis in 4 out of 35 children with apparently normal X-ray films. A firm therapeutic approach could be derived from these three examinations.

Adolescent↗
PubMed1986

Toluene diisocyanate-induced asthma without airway hyperresponsiveness.

Six workers with occupational asthma due to toluene diisocyanate (TDI) were studied. For each worker a detailed clinical and occupational history was taken, and lung function measurement and skin intradermal tests for common allergens were carried out. Methacholine inhalation challenge was performed before TDI inhalation, and 8 h after TDI inhalation. Methacholine challenge was within normal limits when performed before TDI inhalation, but went into the asthmatic range after TDI inhalation. These cases provide evidence that asthma can be induced by toluene diisocyanate in the absence of airway hyperresponsiveness. They further demonstrate that an isolated negative methacholine inhalation test cannot be used to exclude sensitization to TDI. Screening and follow-up studies on workers exposed on TDI require serial measurements of airway responsiveness and of variable air-flow obstruction.

Adolescent↗
PubMed1986

Sensitivity to avian sensitin of tuberculin reactors in Belgium.

It was proposed that a study should be made on the specificity of the reactions of 1068 subjects reacting "weakly to moderately" to an intradermal test with 2 units of PPD RT23; 43% were classified as "positives" (greater than or equal to 10 mm) and Palmer type IV indurations or merely erythema were seen in 81%. Three months later, the same people were retested, this time with 2 units of PPD RT23 and, simultaneously, with 0.1 mcg of avian sensitin: 23% of all reactors (13% of all "positives", but none with a Palmer type I of II induration) had completely lost their sensitivity to RT23. Of the 1068 original reactors, 87% reacted to avian sensitin and 69% did so with a reaction greater than or equal to to human RT23. According to the results of this double test, and depending on the strictness of the comparative criterion, 69% to 84% of the original reactors (65% to 78% of the "positives") would be classified as non-specifically infected. There was a high degree of agreement between an induration greater than or equal to 10 mm to PPD RT23 in the second test and classification as specific infection, based on a comparative criterion.

Adolescent↗
PubMed1987

Effect of infectious stunting syndrome on the immunocompetence of broilers.

Immune responses and liveweights of broilers affected with the stunting syndrome (group C) were compared with those of unaffected birds from the same premises (group B) and normal control broilers of the same genetic origin (group A). Measurements of cell-mediated immunity were made using the phytohaemagglutinin (PHA) intradermal test and those of humoral immunity by antibody response to sheep red blood cells. Weekly observations were made of birds aged from two to eight weeks. Throughout the investigation the weekly mean weight of affected birds was very significantly lighter (P less than 0.001) than that of unaffected and control birds. From the second to the sixth week, wing web PHA reactions in group C were very significantly less than those in groups B or A (P less than 0.001), and during the seventh and eighth week wattle PHA reactions were significantly less in group C than those in group B (P less than 0.02). No significant differences were detected between the three groups in humoral immunity; the complete, IgG and IgM, antibody levels being closely similar. The significance and possible practical applications of these findings are discussed.

Animals↗
PubMed1987

Ability of the phenolic glycolipid-I antigen of M. leprae to elicit a positive Mitsuda response in the armadillo (Dasypus novemcinctus).

Three lepromin-positive armadillos and three lepromin-negative armadillos were tested intradermally with 100 micrograms of phenolic glycolipid-I (PGL-I) in 0.1 ml of normal saline. Positive delayed-hypersensitivity granulomas at 21 days in the lepromin-positive animals and negative responses in the lepromin-negative animals were obtained. These observations suggest that purified PGL-I is capable of eliciting cell-mediated immune or delayed-hypersensitivity responses in animals sensitized to Mycobacterium leprae.

Animals↗
PubMed1987

Delayed-type allergy against various insulin preparations including human semisynthetic insulin.

The authors present a patient with delayed-type allergy against insulin preparations of different species including highly purified monocomponent insulin and human semisynthetic insulin. Positive results for cutaneous delayed-type hypersensitivity and for lymphocyte blastogenesis suggested a type IV immunopathogenic reaction. Intradermal tests performed with various components of insulin preparations revealed delayed-type allergy to insulins of different species (bovine, porcine and human) but not to any of the other components.

Drug Hypersensitivity↗
PubMed1987

[Advances and perspectives in American cutaneous leishmaniasis].

The advances and perspectives in American (mucocutaneous) leishmaniasis are presented under the following topics: 1. Epidemiology in Latin America, particularly in Brazil. 2. Parameters for taxonomic identification of species and subspecies of the genus leishmania, which belong to L. mexicana and L. braziliensis complexes: biologic behaviour in hamster, in culture, in animal reservoir, clinical aspects, vectors, electronic microscopy, electrophoretic mobility of isoenzymes, radiorespirometry, DNA characterization, monoclonal antibodies, other immunological aspects and genetics. 3. Diagnosis by intradermal test, indirect immunofluorescence, ELISA, culture and animal inoculation. 4. Therapeutics and prevention by vaccination.

Animals↗
PubMed1987

[Delayed cutaneous response to different antigens in household contacts of leprosy patients and controls].

The delayed type hypersensitivity (DTH) response to PPD, candidin and histoplasmin, and Mitsuda reaction (MR) in household contacts (HC) of multibacillary (HCM) and paucibacillary (HCP) leprosy patients, and non exposed controls was studied. Intradermal tests with 0.1 ml. of each antigen were performed and read after 48 hours. Late nodular reaction to ML (MR) was evaluated at the 21st day post-challenge. As we had formerly demonstrated, MR was depressed in HCM. Interestingly, this reaction was also depressed in HCP to a lesser magnitude. HCM had a lower DTH response to histoplasmin in relation to PPD and candidin when persons were simultaneously challenged with the three antigens. According to these results we conclude that: a), HCM have a depression in late lepromin reaction; b), in HCP the depression in MR is of a lower magnitude. We hypothesize that in healthy contacts of bacilliferous patients an active mechanism of immunosuppression to mycobacterial antigens may be produced. Alterations in the skin response to histoplasmin is discussed.

Female↗
PubMed1986

[Sterile eosinophilic pustulosis].

Sterile eosinophilic pustulosis (SEP) first described by Ofuji et al. in 1970 as "eosinophilic pustular folliculitis," is obviously a new entity. The majority of patients are Japanese. So far only four European cases have been reported. However, we have recently observed a 46-year-old Greek male (the fifth case in Europe) with the typical clinical features of SEP: repeated eruptions of aggregated pruritic (follicular) papulopustules (1-2 mm in diameter). The eruptions developed in slightly elevated erythematous patches localized on the extremities, face, and trunk. Histologic examination revealed intraepidermal pustules containing eosinophils and moderate dermal infiltrates with mononuclear cells and eosinophils around follicles, sebaceous glands, and vessels. In addition to the characteristic clinical and histological features, our patient showed all the typical laboratory findings previously described: negative bacterial cultures from the pustules, blood eosinophilia, increased total IgE, negative reactions to intradermal tests of recall agents. Furthermore, the rate of suppressor/cytotoxic T-cells (OKT 8-cells) in peripheral blood was significantly diminished, and mitogenic stimulation of lymphocytes in vitro was negative (decreased LTT). These laboratory data resemble the immunopathological findings in atopic diseases. On the other hand, seborrheic skin with sterile eosinophilic pustules predominantly occurring in skin areas rich in sebaceous glands seems to be another remarkable sign of SEP. The question of whether the co-incidence of atopylike immunological constellation and seborrheic skin observed in SEP has pathogenetic importance, however remains open. Apart from corticosteroids and sulfones, a favorable therapeutic effect may be obtained by inhibitors of cyclooxygenase. In our case indomethacin caused a quick and lasting therapeutical benefit.

Antibodies, Monoclonal↗
PubMed1978

[An endemic area of sporotrichosis in Guatemala].

An endemic area of sporotrichosis is described in the Lake of Ayarza District, South Guatemala, where 53 patients have been observed within 3 years. In 45.3% of the cases, the infection appeared after handling fish. The disease was more frequently observed in man (83%) and in patients less than 30 years of age. The most frequent clinical type was the ascending lymphocutaneous sporotrichosis of the limbs. Some cases of ulcerative or verrucous lesions were seen. Almost all the patients cured rapidly either by potassium iodide (46 patients) or spontaneously, or after application of local heat (4 patients). Intradermal tests were performed in healthy population in the endemic area and, for comparison, in Guatemala City. Whole yeast cell antigens of Sporothrix schenckii and Ceratocystis stenoceras were used in these tests. Skin tests to both antigens were more frequently positive in the endemic area; the highest frequency was obtained with the antigen of C. stenoceras. A serological study was performed in 26 patients. The fluorescent antibody staining technique was more sensitive than yeast cell and latex particles agglutinations. C. stenoceras was isolated from bark of some trees, especially Eucalyptus, in the environment, but not S. schenckii.

Agglutination↗
PubMed1987

Tolerability of a new vitamin K1 preparation for parenteral administration to adults: one case of anaphylactoid reaction.

The efficacy and tolerability of a conventional vitamin K1 preparation containing polyoxyethylated castor oil as solubilizer were compared with those of a new compound containing mixed micelles as solubilizer in 30 patients. A statistically significant increase in the thrombotest was detected after treatment in both groups. No hematological or chemical toxicity was observed during the observation period. One patient had an anaphylactoid reaction after intravenous injection of the mixed micelles preparation. Intradermal testing yielded positive results. The authors conclude that intravenous administration of vitamin K preparations should be reserved for acute emergencies.

Adult↗
PubMed1987

Long-term IgG4 determinations in hymenoptera-sensitive treated patients.

Honey bee and vespid venom immunotherapy have been practiced for the past 10 years. Several studies have evaluated the short-term effects of this therapy. The current study evaluated the long-term effects using venom-specific IgG4 determinations. Forty-six patients ranging in age from 3 to 67 years were followed for periods up to 6 1/2 years. All patients included in the study demonstrated Hymenoptera sensitivity on intradermal testing using 0.2 mL of venom extract at concentrations of 0.01 microgram/mL, 0.1 microgram/mL, or 1 microgram/mL. IgE-specific venom antibody levels were tested and found to be elevated. During the first year following institution of venom immunotherapy, 46/46 patients demonstrated an increase in venom-specific IgG4. After the first year of treatment, values reached a plateau. The IgG4 venom-specific antibodies remained relatively constant over the second and third years of the study. Thirty of the 46 patients were followed for more than 3 years. All of the 30, treated greater than 3 years with continuous immunotherapy, demonstrated a gradual decline in IgG4 levels. Despite very low or negligible levels of venom-specific IgG4 antibodies, six patients accidentally stung were still clinically protected. This study suggests that long-term immunity is not mediated in the same manner as that of short-term protection.

Adolescent↗
PubMed1985

Normocalcemic tetany and candidiasis.

We have observed a high frequency of chronic Candida albicans infection and of allergic sensitization to candida among patients with normocalcemic latent tetany (LT). Among 50 LT patients, 34% suffered from recurrent or chronic candida infection by history, 24% showed evidence of active infection and 48% demonstrated type I hypersensitivity to C. albicans extract on intradermal testing. Treatment with oral antifungal drugs and allergy desensitization to Candida produced complete relief of symptoms in 44% of the patients, with remission occurring for symptoms of depression, irritable bowel syndrome, fatigue, premenstrual tension, headache, anxiety and back pain. The complex relationship between candidiasis and Mg deficit is discussed. Patients with LT, refractory symptoms and a history of prolonged antibiotic exposure or recurrent candida infection should be considered for oral antifungal therapy and candida desensitization.

Adolescent↗
PubMed1985

[Anaphylactoid shock following Alloferin].

Reports of allergic complications related to Alloferin are very infrequent. We report a case of anaphylactoid reaction to this drug. The diagnosis was confirmed by intradermal testing.

Alcuronium↗
PubMed1985

[Current aspects of endemic mucocutaneous leishmaniasis in Brazil].

Mucocutaneous leishmaniasis has a large incidence in Brazil. Biochemical, immunological and biological studies have characterized three disease agents: Leishmania mexicana amazonensis, Leishmania brasiliensis guyanensis and Leishmania brasiliensis brasiliensis; these have distinct geographical distributions. The last one is the most common and is the most difficult to treat. Destructive mucosal lesions can occur days, months or years after the cutaneous lesions. The Montenegro intradermal test, biopsy, smears of the border of ulcers and indirect immunofluorescence are the auxiliary diagnostic methods currently in use. The only effective drugs for the treatment of this disease are pentavalent antimonials and amphotericin B. After clinical cure, relapses can occur, and there are rare cases with mucosal lesions that are resistant to all forms of treatment.

Biopsy↗
PubMed1971

Titration of diphtheria and tetanus antitoxins in sera of low titre.

Available methods for titrating diphtheria and tetanus antitoxin at low concentrations in human or animal blood are surveyed, with special attention to the amount of serum required for the test.In vivo methods, especially the rabbit or guinea-pig intradermal test for diphtheria and the mouse test for tetanus, are precise and reliable. If, however, serum levels as low as about 0.001 IU/ml have to be determined, rather large amounts of serum are required: moreover, the tests are rather time-consuming and expensive.Tissue culture methods are available only for diphtheria antitoxin titration. The titres found coincide very well with those from animal tests. The titrations are less time-consuming and more economical. These methods seem to be very promising for the replacement of animal tests. Of the real in vitro methods, the haemagglutination procedure has been investigated most thoroughly and used most frequently. Low titres can be measured using small amounts of serum, but the titres thus obtained may differ considerably from those obtained in animal tests, at least for individual sera. For mass screening, the method is very suitable.A number of other methods are briefly discussed, but they are either less suitable or have not yet been sufficiently investigated.

Animals↗
PubMedDate not supplied

[Clinical and statistical study on the allergy of type 1 to mycetes (author's transl)].

From 1963 to 1977 the authors have examined 5700 patients; 11.5% of those positive to intradermal test were sensitive to Mold spores. 78 individuals showed allergic sensitivity exclusively to Mold spores; 89% were affected by bronchial asthma. Symptom onset was observed more frequently in subjects 30 to 50 years old. The authors intend to stress the important role played by the allergy to Mold spores in determining type 1 immunologic reactions.

Adult↗
PubMedDate not supplied

[Alcyonidium gelatinosum (L.) (Bryozoa) and cutaneous hypersensitivity reactions. Preliminary results of an experimental study].

The appearance of acute eczematous dermatitis in fishermen from the estuary of the Seine, about which the responsibility of Alcyonidium gelatinosum (L.) is still under discussion, led us to estimate the ability of this Bryozoa to induce cutaneous responses of delayed hypersensitivity. Intradermal tests carried out in guinea-pigs after subcutaneous, respiratory or percutaneous sensitization, gave evidence of a clear allergenic ability of this alcyonelline. The deposit of the biological product on normal skin during four consecutive days is enough to induce strong responses of delayed hypersensitivity. This experimental study needs further investigations in which the possible existence of anaphylactic reactions should be confirmed.

Animals↗