Japanese Journal of Clinical Immunology
Online ISSN : 1349-7413
Print ISSN : 0911-4300
ISSN-L : 0911-4300
Volume 15, Issue 3
Displaying 1-15 of 15 articles from this issue
  • [in Japanese], [in Japanese]
    1992 Volume 15 Issue 3 Pages 215-223
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
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  • Masao Shingu, Ichiko Ezaki, Masahiro Yamamoto, Shirou Nonaka, Teturou ...
    1992 Volume 15 Issue 3 Pages 224-231
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Mononuclear cells (MNC) from bone marrow bloods of patients with rheumatoid arthritis (RA) and osteoarthritis (OA) patients were obtained at total knee or hip replacement of the joints and determined for their capacity to produce immunoglobulins, IgG rheumatoid factor (IgGRF) and IgMRF in vitro. Bone marrow bloods were obtained from tibia or femur adjacent to the affected joints, and from iliac bone which was supposed to be intact control bone marrow. Immunoglobulins and RF were measured by ELISA. IgGRF and IgMRF produced by bone marrow MNC were significantly higher in RA than in OA. There were no significant differences of RF production between bone marrow adjacent to the affected joints and intact iliac bone marrow. IgGRF/IgG and IgMRF/IgM ratios were significantly greater in RA than in OA. IgMRF produced by RA bone marrow MNC correlated with serum RF levels of the corresponding patients, but not with serum CRP levels or clinical activity index.
    These results suggest that bone marrow MNC of RA patients produce high levels of RF and are responsible for elevated serum RF in RA patients.
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  • Takashi Seki, Kosuke Joh, Masakatsu Kubo
    1992 Volume 15 Issue 3 Pages 232-238
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    We studied neopterin levels in cerebrospinal fluid (CSF) from 40 control patients without disorders of central nervous system, 13 patients with bacterial meningitis and 18 patients with aseptic meningitis. Neopterin levels in CSF was measured by radioimmunoassay. The CNS neopterin levels of both the patients with bacterial meningitis and the patients with aseptic meningitis were significantly higher (P<0.01) in CSF in comparison with controls. Furthermore, the CSF neopterin levels of the patients with bacterial meningitis was significantly higher (P<0.01) than that of the patients with aseptic meningitis. There was no difference between CD 14 positive cell numbers in CSF of bacterial meningitis and aseptic meningitis. But the CSF CD 14 positive cells in CSF from patients with bacterial meningitis produced significantly more neopterin in comparison with those from patients with aseptic meningitis. It is concluded that the CD 14 positive cells in CSF were more activated in bacterial meningitis than in aseptic meningitis.
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  • in connection with respiratory candida infection
    Tsunesuke Tomoda, Takashi Kageyama
    1992 Volume 15 Issue 3 Pages 239-245
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Respiratory candida infection is one of the opportunistic infections in patients given antileukemic drugs. In this study, candida antigen and antibody in the serum and the number of candida in the sputum and feces were determined for the diagnosis of respiratory candida infection in patients with leukemia.
    Patients with candida antigen (+) or antibody (+) were significantly (p<0.01) more numerous than in the control group (leukemia patients before treatment), but there was no correlation between candida antigen or antibody levels and candida respiratory infection. However, the incidence of respiratory candida infection was significantly (p<0.05) higher in patients with candida antigen (+) and antibody (-) than in those with antigen (-) and antibody (-). It was low in patients with candida antigen (+) and antibody (+). Increased numbers of candida in not only sputum but also feces were found (p<0.01) in those with respiratory candida infection even if the serum contained no candida antigen.
    Thus, the diagnosis and prophylaxis of respiratory candida infection in patients given antileukemic drugs can be confirmed by a combination of various laboratory examinations.
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  • Tetsuo Ozawa, Tomoko Honma, Masatoshi Kikuchi, Takehiro Sato, Masaaki ...
    1992 Volume 15 Issue 3 Pages 246-253
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    In 42 systemic lupus erythematosus (SLE) patients, the plasma levels of circulating immune complexes (CIC) and four kinds of complement derived product (Bb, C 4 d, iC 3 b and C 5 b-9) were examined to evaluate their usefulness in monitoring disease activity of SLE.
    CIC levels were measured by two different enzyme linked immunosorbent assays (ELISA), (1) anti-C 3 d antibody method (C 3 dCIC) and (2) solid phase C 1 q binding method (C 1 qCIC). The levels of complement derived products were also measured by ELISA using monoclonal antibodies to each product. At the initiation of this study, 5 patients were considered to be active according to our criteria.
    The following results were obtained: (1) The incidence of elevated plasma levels of C 3 dCIC, C 1 qCIC, Bb, C 4 d, iC 3 b and C 5 b-9 was 21.4%, 45.2%, 16.7%, 38.1%, 85.7% and 64.2%, respectively. C 3 dCIC was positive in all 5 patients with active disease, and C 1 qCIC was positive in 4 of these 5 patients. (2) The plasma levels of C 3 dCIC, Bb and C 5 b-9 had statistically significant correlation with anti DNA antibody titers, and had inverse correlation with values of CH 50 and serum concentrations of both C 3 and C 4. However, there was no significant correlation between the C 1 qCIC levels and any of these conventional parameters of lupus activity. (3) The mean plasma levels of C 3 dCIC, Bb and C 5 b-9 were significantly higher in active group than those in inactive group. (4) In one longitudinally followed patient, elevation of C 3 dCIC occurred correlated with flares of SLE. The levels of C 5 b-9 also varied in accordance with lupus activity, however, they continued to remain rather high after the disease activity was controlled. In conclusion, measurement of plasma levels of C 3 dCIC and C 5 b-9 is considered to be useful for evaluating disease activity of patients with SLE.
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  • Akira Ueda, Hiroshi Tsukamoto, Kohei Nagasawa, Yasuo Yamauchi, Yoshifu ...
    1992 Volume 15 Issue 3 Pages 254-260
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Circulating complement breakdown products, C 4 d, iC 3 b and Bb, in plasma from patients with various rheumatic diseases were determined by ELISA kits using monoclonal antibodies. Plasma C 4 d, iC 3 b and Bb, especially Bb, were elevated in systemic lupus erythematosus (SLE) with hypocomplementemia, and also in rheumatoid arthritis (RA), aortitis syndrome and Behcet's disease with hypercomplementemia. Among plasma levels of C 4 d, iC 3 b and Bb, there was no significant correlation in SLE, mixed connective tissue disease, polymyositis, progressive systemic sclerosis or RA. In aortitis syndrome and Behcet's disease, there was a positive correlation between C 4 d and iC 3 b. In SLE, C 4 d showed significant correlations with circulating immune complex (CIC) (r=0.633, P<0.001) and with CH 50 (r=-0.346, P<0.01). iC 3 b and Bb showed no significant correlation with CIC or CH 50. These data suggested that both pathways of the complement system were activated in patients with SLE and other rheumatic diseases, CIC activated the classical pathway resulting in plasma C 4 d elevation, and other factor activated the alternative pathway resulting in plasma Bb elevation.
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  • Yuji Akiyama, Teruhiko Suzuki, Toshiro Katagiri, Toshiko Ishibashi, Fu ...
    1992 Volume 15 Issue 3 Pages 261-268
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Mononuclear cells were isolated from human peripheral blood and separated into dendritic cells (DC), macrophages (Mφ) and T cells. The role of allogeneic DC and Mφ in concanavalin A (Con A)-induced T cell responses were investigated.
    In the case of Con A-stimulated T cells, only faint proliferative responses were observed. But the responses were significantly enhanced by the addition of allogeneic DC or Mφ (P<0.01 or 0.05). In particular, the addition of allogeneic DC showed a stronger proliferative response.
    Con A responses were dose-dependently reduced by HLA-DR monoclonal antibodies. Therefore, it is considered that HLA-DR antigens on DC played an important role in Con A stimulated T cell responses mediated by allogeneic DC in humans.
    Allogeneic DC- and Mφ-mediated Con A responses were compared with the autologous systems, and the former proliferative responses were equal to, or greater than the latter. Thus, it is considered that the accessory function of allogeneic DC and Mφ is equal to, or greater than that of the autologous systems.
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  • Shin'ichiro Yasunaga, Takehito Mayumi, Kohei Nagasawa, Yoshifumi Tada, ...
    1992 Volume 15 Issue 3 Pages 269-275
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A 49-year old woman who had been diagnosed as systemic lupus erythematosus (SLE) at the age of 28 years (in 1968) began to complain of bilateral intermittent claudication in 1986. Translumbar abdominal aortography performed in 1989 demonstrated an occulusion of the abdominal aorta just below the renal arteries. Since the symptom gradually deteriorated despite of the warfarin therapy, thromboendoarterectomy and aorto-rt. femoral and lt. iliac bypass formation with synthetic Y graft was performed in 1990, which resulted in relief from the symptom. She was found to have lupus anticoagulant (LAC) and anti-cardiolipin antibodies (ACA) which were considered to be associated with the development of thrombosis in the abdominal aorta. This was an unusual case in that LAC and ACA were involved in the formation of thrombus in a large vessel.
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  • Katsuya Wada, Ryozoh Ohtsuki, Teruaki Akaogi, Zensho Tanaka, Masami Sa ...
    1992 Volume 15 Issue 3 Pages 276-284
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A 63-year-old man, who had sustained progressing polyarthropathy mimicing rheumatoid arthritis for the past 20 years, suffered from pathological fractures of the left and, 6 months later, of the right femoral neck. Histological examination revealed massive deposits of amyloid in the femoral necks and periarticular tissue. On bone X-ray films, osteolytic lesions were found in the left humeral head and in the left tibia. Atypical plasma cells moderately increased in number on bone marrow smears. One year after the initial fracture, the patient died of respiratory failure. At autopsy, massive deposits of amyloid were demonstrated in alveolar septa and blood vessels throughout the lungs. The type of the amyloid was AL. No pathologocal changes indicating multiple myeloma were noted in the bone marrow. The final diagnosis was primary amyloidosis associated with amyloid arthropathy and diffuse pulmonary amyloidosis. The latter seems to have led to adult respiratory distress syndrome as the major cause of death.
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  • Kinya Hamada, Motoki Ohno, Mitsuhiro Higashikawa, Hiroyuki Hamasaki, H ...
    1992 Volume 15 Issue 3 Pages 285-289
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A 33-year-old woman who was diagnosed as having Evans' syndrome 5 years before admission was transferred to our hospital because of dysarthria. On admission, MRI of the brain revealed multiple infarction. Laboratory examination showed anemia with positive Coombs test, thrombocytopenia with platelet associated IgG, elongation of APTT, biological false positive for syphilis, positive test for anti-microsome or thyroglobulin hemagglutination test, and anti-cardiolipin antibody. These findings suggest that she had antiphospholipid antibody syndrome, Evans' syndrome, and chronic thyroiditis. Anti-cardiolipin antibody might be crossreactive with platelets, red cells, and thyroid tissue.
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  • Mutsuto Tateishi, Tetsuo Kubota, Hitoshi Kohsaka, Masaharu Okuda, Nobu ...
    1992 Volume 15 Issue 3 Pages 290-296
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    In this report, we described a case of atypical Crohn's disease associated with Sjögren's syndrome (SjS) who suffered from reccurent pleuritis of unknown origin. A 59 year-old woman started to have episodes of acute polyarthritis from 1970. She suffered from left pleuritis of unknown origin in 1978. In 1987, she had hematemesis and anal bleedings, and then was diagnosed as atypical Crohn's disease lacking colonic lesion, because of oral, esophageal and anal ulcers with a pathological finding of non-caseous granulomatous lesions in the anal ulcer. In March, 1988, she was admitted to our hospital with exertional dyspnea. On admission, multiple oral ulcers, polyarthritis and right pleuritis were found. Laboratory data revealed elevated ESR, hypergammaglobulinemia, positive fluorescent antinuclear antibodies and weakly positive anti-ds-DNA antibody. SjS was diagnosed with the existence of keratoconjunctivitis sicca, positive lip biopsy and positive sialography. After treatment with 3 g/day of salicylazosulfapyridine, pleural effusion and polyarthritis rapidly disappeared and oral lesions became improved.
    Crohn's disease is rarely asscciated with SjS. We discussed here possible relationship between these diseases.
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  • Satomi Ohsako, Naoyuki Kamatani, Sadao Kashiwazaki, Hirahito Endo, Hir ...
    1992 Volume 15 Issue 3 Pages 297-304
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A case of dermatomyositis with digital gangrene and skin eruption which was improved by oral administration of vitamin A was reported. A 39-year-old woman with complaint of palmer and facial erythema later developed a decrease in muscle strength. The symptoms resisted to oral steroid therapy, but the muscle strength was almost normalised by the subsequent administration of cyclophosphamide and azathioprine. Because of the worsening of digital microcirculation which appeared later in the course of the disease, a gangrenous lesion appeared on the tip of the left fifth finger which was judged as being the consequence of vasculitis by muscle biopsy and angiography. By the treatment with vitamin A, however, the lesion dropped spontaneously, and both the skin eruption and circulatory disorder improved dramatically. Thus, we, hereby, reported a rare adult case of dermatomyositis with evident vasculitis and skin rash to which vitamin A was effective. The present case is considered valuable for the better understanding of the pathophysiology of dermatomyositis.
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  • Shin Fujisawa, Akira Shirai, Toshihisa Igarashi, Michio Matsuzaki, Kei ...
    1992 Volume 15 Issue 3 Pages 305-309
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    Many cases of the myelodysplastic syndrome (MDS) were reported after the presentation of the criteria for MDS in 1982, but, as far as we know, there were only four MDS case reports complicated with rheumatoid arthritis (RA).
    We report a 75-year-old woman who had troubled with the disease of classical RA for 20 years, and suddenly vomited blood without other symptoms. The examination of bone marrow showed refractory anemia without the abnormal findings of gastrointestinal system and virus titer.
    The relationship between the immunological abnormality of RA and the pathogenesis of MDS was discussed.
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  • Takahiro Suzuki, Takao Koike, Kenji Ichikawa, Takao Sugiyama, Katsuhik ...
    1992 Volume 15 Issue 3 Pages 310-316
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    We investigated the relation between the presence of anti-cardiolipin antibodies (aCL) and the incidence of acute myocardial infarction (AMI) in 176 patients with systemic lupus erythematosus (SLE). Five out of 59 aCL positive cases have history of AMI, while only 1 case had AMI in 116 aCL negative cases (p<0.05). In AMI cases the levels of serum aCL were moderately elevated, but lupus anticoagulant were negative in the 3 cases examined. There was no relation among the history of AMI, disease activity of SLE and the presence of other autoantibodies such as anti-RNP, anti-Sm, and anti-SS-A, antibodies. In most cases, the risk factors of coronary heart disease and the influence of corticosteroids on AMI were neglegeble.
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  • Mikio Kataoka, Sachie Katagi, Shigee Hosoya, Ken Osada, Shinya Tada, K ...
    1992 Volume 15 Issue 3 Pages 317-325
    Published: June 30, 1992
    Released on J-STAGE: January 22, 2009
    JOURNAL FREE ACCESS
    A 28-year-old woman admitted at the Okayama University Hospital demonstrated pulmonary infiltrates, splenomegaly and pancytopenia. She received anti-tuberculous therapy for 5 months; however, the pulmonary X-ray shadows did not improve. At that time a transbronchial lung biopsy (TBLB) and bronchoalveolar lavage (BAL) were performed. TBLB showed organizing pneumonia, and lymphocytosis and decreased CD 4/CD 8 ratio was seen in the BAL fluid. Treatment with a corticosteroid was effective on the pulmonary shadows and pancytopenia. Fifteen months later, the patient was re-admitted because of high fever and hepatosplenomegaly. A hemogram revealed anemia and leukopenia, and blood chemistry studies showed liver dysfunction and coagulation abnormalities. She also had tender subcutaneous nodules. A skin showed inflammatory cell infiltration into the fat lobules, and she was diagnosed cytophagic histiocytic panniculitis (CHP). Increasing the dose of prednisolone did not influence her clinical course. We initiated treatment with ciclosporin A at a daily dosage of 300 mg, and dramatic improvement of her clinical symptoms occurred.
    These results suggest that T lymphocytes as well as macrophages play an important role in CHP, because ciclosporin A acts primarily on T lymphocytes and the BAL fluid revealed T lymphocytosis.
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