RESUMEN
This case concerns a newborn with many small transparent vesicles on the forehead, trunk and face. Miliaria crystallina was diagnosed based on the typical presentation. Miliaria crystalline is a transient obstruction of sweat glands resulting in non-inflammatory vesicles. The treatment is simple: cool down.
Asunto(s)
Vesícula , Miliaria , Recién Nacido , Humanos , Vesícula/diagnóstico , Vesícula/etiología , Miliaria/diagnóstico , Miliaria/terapiaRESUMEN
Human herpesvirus (HHV) 6 causes substantial morbidity and mortality in the immunocompromised host and has no approved therapy. Adoptive transfer of virus specific T cells has proven safe and apparently effective as prophylaxis and treatment of other virus infections in immunocompromised patients; however, extension to subjects with HHV6 has been hindered by the paucity of information on targets of cellular immunity. We now characterize the cellular immune response from 20 donors against 5 major HHV6B antigens predicted to be immunogenic and define a hierarchy of immunodominance of antigens based on the frequency of responding donors and the magnitude of the T-cell response. We identified specific epitopes within these antigens and expanded the HHV6 reactive T cells using a GMP-compliant protocol. The expanded population comprised both CD4(+) and CD8(+) T cells that were able to produce multiple effector cytokines and kill both peptide-loaded and HHV6B wild-type virus-infected target cells. Thus, we conclude that adoptive T-cell immunotherapy for HHV6 is a practical objective and that the peptide and epitope tools we describe will allow such cells to be prepared, administered, and monitored in human subjects.
Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/inmunología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Herpesvirus Humano 6/inmunología , Inmunoterapia Adoptiva , Infecciones por Roseolovirus/terapia , Trasplante Homólogo/efectos adversos , Activación Viral , Antígenos Virales/inmunología , Células Cultivadas/inmunología , Técnicas de Cocultivo , Citomegalovirus/inmunología , Citotoxicidad Inmunológica , Factores de Transcripción Forkhead/análisis , Herpesvirus Humano 6/aislamiento & purificación , Herpesvirus Humano 6/fisiología , Humanos , Huésped Inmunocomprometido , Epítopos Inmunodominantes/inmunología , Activación de Linfocitos , Monocitos/inmunología , Infecciones por Roseolovirus/prevención & control , Especificidad del Receptor de Antígeno de Linfocitos T , Activación Viral/inmunologíaRESUMEN
Persistent Mullerian duct syndrome (PMDS) is a rare syndrome and sometimes the cause of a common problem in paediatric and surgical practice, namely undescended testes. PMDS is a recessive disease in which there is a defect in anti-Mullerian hormone secretion or receptor activity resulting in persistence of Mullerian structures such as a uterus or fallopian tubes with otherwise normal virilisation. Here the authors present a case of a 1½-year-old boy who was referred to their hospital because of unilateral cryptorchidism. During laparoscopic surgery, two gonads were present joined together by a uterus-like structure. Additional investigations showed a normal male karyotype and biopsies of the gonads revealed infantile testis parenchyma making the diagnosis PMDS likely.