Japanese Journal of Clinical Immunology
Online ISSN : 1349-7413
Print ISSN : 0911-4300
ISSN-L : 0911-4300
Volume 15, Issue 2
Displaying 1-14 of 14 articles from this issue
  • [in Japanese]
    1992 Volume 15 Issue 2 Pages 115-126
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
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  • Hideki Onodera, Yoshihiro Kasamatsu, Shuhei Takemura, Risa Nakahara, N ...
    1992 Volume 15 Issue 2 Pages 127-134
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Immunoglobulin (IG) therapy was received 7 times to 3 patients with diffuse panbronchiolitis (DPB), and its immunomodulating effects to peripheral blood cells were investigated. IG therapy decreased the erythrocytes counts and the expression of complement receptors on the peripheral monocytes and granulocytes transiently. Etiology of a transient decrease of erythrocytes wasn't clarified but it was suggested that IG therapy induced the erythrocytes' accumulation to reticuloendothelial system for the clearance of immune complex. IG therapy decreased expression of CR 1, CR 2 and CR 3 on monocytes and CR l on granulocytes but didn't alter deposition of C 3 on those cells, so that accerelated interiorization or capping, and impaired regulation of complement receptors expressing on those cells might be evoked by IG therapy. By contraries, increase of these complement receptors' expression were observed immediately after IG administration in some cases. Those altered expression of complement receptors suspected to contribute to the enhancement of phagocytotic activity and contribute to the accerelated release of some chemical mediators.
    In vitro experiment on normal human volunteers, both intact globulin and F (ab')2globulin increased expression of CR l on monocytes and granulocytes, and also increased expression of HLA•DR on monocytes. Only intact globulin increased expression of IL-2 receptors on monocytes, and decreased expression of HLA•DR on lymphocytes. These results suggested the role of IG therapy would be enhancement of opsonizing effect, and on the other hand might be immunomodulation with cellular immune reaction in patients with DPB.
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  • Isao Itoh, Koichi Amano, Jun Koide, Tsutomu Takeuchi, Takami Matsuyama ...
    1992 Volume 15 Issue 2 Pages 135-141
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Renal disorders were noted in 25 out of 276 patients with rheumatoid arthritis (RA). The renal disorders were clinically divided into two groups; one was characterized by persistent proteinuria (_??_ 0.5 g/day) and the other by hematuria. Frequency of proteinuria was 32.0% and hematuria 76.0%. Accordingly hematuria was considered to be the common renal disorder in RA patients.
    Although it has been reported that secondary amyloidosis in RA patients tends to develop in long-standing RA with more active disease, matched controlled study failed to confirm such conclusion.
    Discontinuation or change of NSAIDs and/or DMARDs in half of RA patients with hematuria cleared their urinary findings, suggesting that drugs were causative agents for hematuria.
    Life table analysis disclosed that RA patients with renal disorders had poor prognosis.
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  • Kozo Onami, Yoshihide Umetsu, Yutaka Kikuta, Tomoe Nishimaki, Reiji Ka ...
    1992 Volume 15 Issue 2 Pages 142-147
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    This study was undertaken to clarify the significance of anticentromere antibody (ACA) in various diseases. Among these patients, Raynaud's phenomenon, arthritis, subcutaneous calcinosis, esophageal dysmotility, telangiectasia, Sjögren's syndrome, sclerodactyly and swollen hands were found in 15, 13, 11, 6, 4, 3 and 1 of 18 ACA positive patients respectively. In the 18 sera with ACA, rheumatoid factor (RF), anti-M 2 antibody (A-M 2), anti-mito-chondrial antibody (AMA), anti-microsome antibody (AMiA), anti-platelet antibody (APL), anti-smooth muscle antibody (ASMA) and anti-DNA antibody (A-DNA) were found in 6, 5, 4, 3, 3, 2 and 1 sera respectively. ACA was found to distribute not only in patients with collagen diseases but also in patients with primaly biliary cirrhosis (PBC). Eight ACA positive patients were also examined for HLA antigens. HLA-B 51 (5) and/or DRw 8 were highly detected. In two patients with PBC and CREST (Calcinosis, Raynaud's phenomenon, Esophageal dysmotility, Sclerodactyly, Telangiectasia) syndrome, HLA-DR 9 antigen was detected.
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  • Masayuki Yasuda, Kazuhisa Tomooka, Shiro Nonaka, Yasuo Suenaga, Masash ...
    1992 Volume 15 Issue 2 Pages 148-153
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    From the beginning of 1981 to the end of 1990, 125 patients with connective tissue diseases have continuously received more than 20mg/day of prednisolone. The correlations between the increase in the ocular pressure and ocular symptoms due to corticosteroid administration were studied. We found 15 episodes of visual disturbance from 12 patients of our own and 2 patients transferred to our clinic, including 13 episodes in 12 patients with systemic lupus erythematosus. The clinical symptom most specific to glaucoma was blurred vision that was complained as “I feel as if I were in mist”. Disturbance in visual acuity was the next, but this symptom was not specific for glaucoma although observed frequently. Ocular pain and nausea were observed after prolonged increase in the ocular pressure, suggesting that these signs should be thought as more serious ocular symptoms. Increase in the ocular pressure appeared within 2 months after the initiation of the corticosteroid administration in 11 episodes and in the other 4 were observed later than 100 days when the patients were in remission. Response to acetazolamide (Diamox) or ophthalmic preparations was fair in 10 episodes, but 5 patients needed decompression operation. We conclude that the increase in the ocular pressure due to corticosteroid is not specific for SLE, and the serious eye damage can be avoided by careful monitoring of the ocular pressure and education of the patients with connective tissue diseases receiving corticosteroid about the risk of ocular damage.
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  • Naoto Horigome
    1992 Volume 15 Issue 2 Pages 154-161
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    WBC count, percentage of lymphocyte to WBC, lymphocyte count and lymphocyte subsets were analysed in splenic arterial and venous blood of gastric cancer patients, and the role of the spleen on their immunological responses was investigated. For this study, 67 patients with gastric cancer, from stage I to IV, were used, and lymphocyte subsets were analysed by a flow cytometry using various monoclonal antibodies.
    There were statistical differences in WBC count, lymphocyte count and lymphocyte subsets of CD 8+ CD 11+, CD 57- CD 16+ and CD 57+ CD 16- cells between stage IV and I. There were, however, no differences of these measurements between splenic artery and splenic vein in all stages. Splenic vein/splenic artery (SV/SA) ratio of each subset was compared among four stages. CD 8+ CD 11+ cells were superior and CD 8+ CD 11- cells and CD 57- CD 16+ cells were inferior in splenic venous blood to splenic arterial blood of stage IV patients.
    These data suggest that the splenic circulation results in an increase of suppressor T cells and decrease of cytotoxic T cells and a part of NK cells in stage IV patients. Therefore, the patients with stage IV gastric cancer were characterised by negative immunological responces expressed by splenic circulation.
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  • Yoshiro Tanizaki, Hikaru Kitani, Morihiro Okazaki, Takashi Mifune, Fum ...
    1992 Volume 15 Issue 2 Pages 162-167
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    The release of histamine induced by C. albicans was significantly higher in asthmatics aged 21-30 yr, 41-50 yr and 61+ years old compared with the age-matched groups of healthy subjects. The level of C. albicans specific IgG was significantly higher in asthmatics aged 41-50 years old compared with age-matched group of healthy subjects. No significant difference was found among any age groups of healthy and asthmatic subjects. The increased level of C. albicans specific IgG seemed not to be of significance in the pathogenesis of asthma.
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  • Tohru Nakabayashi, Akira Sagawa, Yoshiharu Amasaki, Satoshi Jodo, Tats ...
    1992 Volume 15 Issue 2 Pages 168-176
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Primary Sjögren's syndrome, like other autoimmune diseases, is a multisystemic disorder.
    Trigeminal sensory neuropathy (TSN) has been recognized as a rare neurological complication of primary Sjögren's syndrome and the pathogenesis remains obscure. Previous reports have identified an association between primary Sjögren's syndrome and TSN in other countries but this relationship has been rarely reported in Japan.
    We reported that six cases of 185 patients with primary Sjögren's syndrome complicated with TSN: one case with multiple cranial neuropathies including TSN, three cases with isolated TSN in the absence of other neurologic diseases, two cases with TSN as a part of peripheral neuropathy. In all cases TSN was considered to be peripherally involved.
    All six cases were female, age range 34 to 58 years at onset of TSN. Neurological central nervous involvements and systemic vasculitis were not found in any cases. TSN preceded the diagnosis of primary Sjögren's syndrome in three cases, and in these cases TSN presented as an initial manifestation of primary Sjögren's syndrome.
    Anti-RNP antibody was positive in four cases. Three cases out of four developed Raynaud's phenomenon. The interval between TSN and Raynaud's phenomenon in these cases was within two months. In one case with isolated TSN, thermography of the face was performed, and it showed that the temperature was low in the area of the involved trigeminal nerves.
    These observations suggest that Raynaud's phenomenon and/or anti-RNP antibody may play a role in the pathogenesis of TSN in primary Sjögren's syndrome.
    Our experience with six cases and review of the literature indicate that in patients with TSN, especially isolated TSN with Raynaud's phenomenon, the diagnosis of primary Sjögren's syndrome should be considered, even if sicca symptoms are absent, and that appropriate evaluation must be carried out.
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  • Yuka Uno, Takashi Mizuguchi, Katuyuki Nakao, Masaaki Kosaka
    1992 Volume 15 Issue 2 Pages 177-183
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Two patients with “immunodeficiency with thymoma” associated with leukocytopenia were reported. Case 1 of a 55-year-old man and case 2 of a 62-year-old man were admitted to our hospital for examinating the cause of recurrent infections. They were diagnosed as immunodeficiency with thymoma because of the presence of thymoma and hypogammaglobulinemia. In addition, case 1 had neutropenia and case 2 lymphocytopenia. The immunophenotyping of the lymphocytes in the peripheral blood revealed that case 1 had an increase of CD 8+, CD 11 b-, CD 57+ and DR- cells, and case 2 had an increase of CD 8+, CD 11 b+, CD 57+ and DR+ cells, resulting in a decrease of CD 4+/CD 8+ ratio and B cell counts. On colony forming unit (CFU) assay of the bone marrow mononuclear cells, the formations of CFU-G and CFU-GM in case 1 and those of CFU-G, CFU-GM and CFU-E in case 2 were markedly suppressed. However, the removal of T cells resulted in an increase to subnormal level of the formations of CFU-G and CFU-GM in case 1, and CFU-G and CFU-E in case 2. These results suggest that leukocytopenia found in both patients was possibly due to bone marrow suppression by abnormal proportion of T cells.
    In addition, abnormal proportion of T cells caused by unknown factors may induce thymoma, hypogammaglobulinemia and aberrant hematopoiesis in some patients with “immunodeficiency with thymoma”.
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  • Satoshi Jodo, Akira Sagawa, Yoshiharu Amasaki, Nobutaka Ogura, Tatsuya ...
    1992 Volume 15 Issue 2 Pages 184-189
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A case of systemic lupus erythematosus (SLE) complicated with meningitis due to Enterococcus faecium is reported.
    An 18-year-old female diagnosed as SLE had been treated with corticosteroid since 1988. On January 11, 1990, she was admitted to a hospital because of high fever and mental disturbance. Though she was treated with several courses of broad spectrum antibiotics and high dose of prednisolone (60 mg/day), her fever persisted and headache and neck rigidity developed. The examination of her cerebro-spinal fluid (CSF) showed pleocytosis.
    She was transfered to our hospital on February 13 and the laboratory examination on admission revealed high titer of anti-nuclear antibody and anti-DNA antibody. She was diagnosed as SLE with CNS involvement and treated with steroid pulse therapy. But the pleocytosis of her CSF and her clinical symptoms did not improve. On the 8 th hospital day, Enterococcus faecium (E. faecium) was detected from the culture specimen of her CSF and in addition to steroid, antibiotics sensitive against E. faecium were administrated intravenously and intrathecally. After this combination therapy, the pleocytosis of her CSF and clinical symptoms improved gradually.
    Meningitis due to E. faecium is very rare and occurs in patients receiving broad spectrum antibiotics for a long time or in patients in immunosuppressive state. In this case, it is considered that the cause of meningitis might be the disturbance of blood-brain barrier by CNS-lupus and immunosuppressive state due to steroid.
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  • Minoru Takata, Kiyoshi Takahashi, Ryou Souda, Yasuo Nanba, Kazuo Oguru ...
    1992 Volume 15 Issue 2 Pages 190-195
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    We experienced a case of dyskeratosis congenita with typical triad which consists of generalized reticular pigmentation, leukoplakia of the tongue and deformed nails. His immunological status seemed to be somewhat depressed, because he developed frequent upper and lower respiratory infections including tuberculosis. Laboratory studies revealed pancytopenia that was also typical for the syndrome. Delayed-type skin reactions to various antigens were diminished. In addition, serum IgE was highly elevated, and serum immunoglobulins (IgG, IgA, IgM) were also increased polyclonally. Flow cytometric analysis showed decreased number of T cells and strong CD 23 expression on B cells.
    His elevated serum IgE can be explained by the presence of atopic predisposition. However, several immunodeficiency syndromes are known to develop elevated IgE value and dyskeratosis congenita is recently considered to be one of immunodeficiency syndromes. Some cases of this disorder may develop high serum IgE level and this can be due to deficient immune regulation. Measurement of serum IgE seemed to be useful in elucidating pathophysiolgy of this syndrome.
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  • Tamotsu Mukai, Fusayuki Omori, Takashi Matsunaga, Ryuichi Iwakiri, Yuj ...
    1992 Volume 15 Issue 2 Pages 196-200
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    In this report we described a case of scleroderma associated with rheumatic fever. A 40-year-old male was admitted to our hospital because of polyarthralgia, cubital nodules with redness and pain of the elbows, and sclerodactyly. The diagnosis of rheumatic fever was confirmed by clinical features and high titer of ASK. After daily administration of 1.2 million unit of benzathine penicillin G was started, polyarthralgia and acute inflammatory reaction were improved but screlodactyly continued. Scleroderma was diagnosed because the histological findings in skin biopsy revealed a striking increase of compact collagen fibers in the deeper reticular dermis. D-penicillamine of 100mg per day was then started, and sclerodactyly was gradually improved. There have been no reports of scleroderma with rheumatic fever. This case was thought to be interesting in order to consider the pathogenesis of scleroderma, because both scleroderma and rheumatic fever are considered to be based on immunological disorder.
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  • Mikiya Fujieda, Fumihiko Hamada, Ichiro Nomura, Hideo Morita, Hiroshi ...
    1992 Volume 15 Issue 2 Pages 201-207
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A 9 years old girl, in whom both motor and mental activities were found to be deteriorated since the patient was 7 years old, was diagnosed as subacute sclerosing panencephalitis (SSPE). Clinical signs and symptoms were consisted with regression, myoclonic movement of extremities, periodic synchronous dischange (SSPE complex) in EEG. Antimeasles antibody was detected with high titers in both serum and CSF. She has been treated with combination of anticonvulsants, inosiplex, intrathecal injection of recombinant interleukin-2 (rIL-2) and intravenous injection of high dose glycyrrhizin. She showed a sign of recovring in speaking ability and relieved from frequent myoclonus. Several immunological abnormalities including reversed CD 4/CD 8 ratio, negative delayed type hypersensitivity skin test, low natural killer cell activity and poor ability of IFN-γ production were noticed. Those abnormalities have been recovered to normal lebels following clinical improvement after the treatment.
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  • Shigeo Katabami, Toshiro Sugiyama, Yasuhiro Takai, Mitsuo Suga, Kohzoh ...
    1992 Volume 15 Issue 2 Pages 208-214
    Published: April 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    We report a case of autoimmune hepatitis associated with idiopathic thrombocytopenic purpura (ITP) developing severe polyclonal hypergammaglobulinemia. A 69-year-old woman was admitted to the Sapporo Medical College Hospital, complaining of general malaise and heaviness in the head. On admission, she was found to have severe polyclonal hypergammaglobulinemia (γ-glovbulin 6.0g/dl, IgG 5, 582mg/dl, IgA 740mg/dl, IgM 1, 938mg/dl). Various autoantibodies including anti-single stranded DNA antibodies, antismooth muscle antibodies and anti-sulfatide antibodies were positive with high titer. Biopsy specimens obtained from the liver revealed those of chronic active hepatitis, showing periportal necrosis with lymphocytic and plasma cell infiltrates.
    In addition, the decreased platelet counts (30, 000/mm3) and the elevation of titer of platelet associated IgG (PA-IgG; 234.9ng/107 cells) were found. Bone marrow examination showed normocellularity with slightly elevated number of megakaryocytes (125/mm3).
    According to these findings, the patient was diagnosed as autoimmune hepatitis associated with ITP. We started treatment by prednisolone (30mg/day), which resulted in dramatic reduction of hypergammaglobulinemia and recovery of thrombocytopenia.
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