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Adult severe combined immunodeficiency and sarcoid-like granulomas with hypersplenism.

A patient presented with lymphopenia, anergy, hypogammaglobulinemia and hypersplenism. Histologic examination of the spleen and lymph node revealed noncaseating sarcoid-like granulomas. Despite a significant rise in circulating lymphocytes after splenectomy there was in vivo and in vitro evidence of B- and T-lymphocyte dysfunction. A histologic picture mimicking sarcoidosis may occur in patients with immune deficiency. The granulomatous proliferation may represent an altered host response to antigen.

Adult↗

Depression of cellular-mediated immunity in systemic lupus erythematosus. relation to disease activity.

Cellular-mediated immunity was examined in 6 consecutive patients with active SLE, 6 patients with low active SLE 6 patients with DLE, 8 patients with other collagen diseases, and 9 healthy controls. The following parameters were measured: delayed hypersensitivity, in vitro lymphocyte blast transformation, and MIF production after stimulation with five common antigens, DNA, and two nonspecific mitogens (PHA, PWM). The 6 active SLE patients were anergic and had a markedly depressed response in vitro to the specific antigens and PWM (P less than 0.001). When CMI was retested in 5 patients as early as 5 days after the start of prednisone (60 mc/day), the results were significantly improved in 4 who also improved clinically, and they remained unchanged in a fifth patieht who failed to improve. There was a less marked impairment of CMI among the low active SLE group, whereas the DLE and OCD patients did not differ significantly from the control subjects. DNA did not cause significant stimulation of blast transformation in any of the study groups.

Adult↗

Aspirin and delayed type hypersensitivity.

The effects of aspirin on delayed hypersensitivity were assessed in 40 healthy subjects who were randomly assigned to two equal groups. In a double-blind format, the individuals in one group were placed on 4 gm aspirin daily for 5 days, and individuals in the other group were given placebo. Lymphocyte proliferation was measured before and 72 hours after the initiation of drug, by using three mitogens and four antigens. The percentages of T and B lymphocytes were likewise measured before and during therapy. The subjects were skin tested with the same four antigens 72 hours after the initiation of drug, and the skin tests were read 48 hours later. No significant differences between the two groups were detected when skin tests, lymphocyte proliferation, and percentage of T lymphocytes were compared.

Adult↗

Restoration of immunocompetency by lymphocyte transfusion.

A female patient with metastatic osteosarcoma was given a lymphocyte transfusion from her brother, cured of the same histologic type of tumor ten years earlier. Prior to the transfusion the patient was anergic. Following lymphocyte transfer cutaneous reactivity to DNCB was restored. Skin reactivity to mumps and varidase antigens was specifically transferred. Whole lymphocyte transfer is a feasible method for restoring immune competence in the anergic cancer patient.

Adolescent↗