Antineutrophil cytoplasmic antibodies in systemic lupus erythematosus in childhood.

OBJECTIVE: Antineutrophil cytoplasmic antibodies (ANCA) have been found in up to 25% of adults with systemic lupus erythematosus (SLE) and in 69% of affected children. We investigated ANCA and antibodies to myeloperoxidase (MPO) in 50 children with SLE. METHODS: ANCA in serum were measured by indirect immunofluorescence and antibodies to MPO by ELISA. RESULTS: ANCA were found in 8 (7 perinuclear ANCA, 1 cytoplasmic ANCA) of the 50 sera tested (16%). All the 8 ANCA positive patients were also positive for anti-MPO antibodies. No association with vasculitis or specific organ involvement was observed. CONCLUSION: Our results in children are roughly similar to those reported for adults.

Gastric perforation with Candida tropicalis invasion in a previously healthy girl.

Fungal cells were observed infiltrating the submucosal margins of an acutely perforated gastric ulceration in an apparently immunocompetent 3-year-old girl. Perforation had occurred 24 h after hospital admission because of pain and vomiting. Colonies of Candida tropicalis were grown from peritoneal fluid and blood cultures. After surgical repair and a 30-day treatment with amphotericin B at a daily dose of 1 mg kg-1 body weight, the child was discharged in good health. No further infections have occurred in the 3 years since treatment.

[Juvenile dermatomyositis: clinical, immunologic, and therapeutic characteristics]. / Dermatomiositis juvenil: características clínicas, inmunológicas y terapéuticas.

Although dermatomyositis is a rare disease in infancy, it involves several systems and tissues throughout the body causing death or serious disabilities at the musculoesquelethal level. The increased incidence of vasculitis and other characteristics in children make their clinical presentation different from the adult, which could modify the diagnostic criteria, course disease and treatment of the child. We analyze the clinical experience at Hospital Infantil de Mexico Federico Gomez with 21 children studied during a period of ten years. All patients fulfilled the Bohan and Peters diagnostic criteria and 91% of them responded to treatment. At the present time 52% are in remission without treatment, 37.7% improved with treatment, 4.5% with little response to treatment and 4.7% have died because of infections.

[Selective IgA deficiency and malabsorption. Review of the literature apropos of a case]. / Deficiencia selectiva de IgA y malabsorción. Revisión de la literatura a propósito de un caso.

One of the most common primary immunodeficiencies is the selective deficiency of IgA, which is present in very variable clinical conditions. This situation had conducted to different criteria with respect to the clinical meaning in a particular patient. The association of immunodeficiency of IgA and intestinal malabsorption is reported as statistically significant in the international literature. Nevertheless, the precise pathogenic connection between them is unknown. The relationship between bowel and immune system is reviewed here, and illustrated with the clinical case of a six-year old girl who presented with malabsorption and selective deficiency of IgA.

[Enterobacterial antigen in human peripheral blood lymphocytes]. / Un antígeno de enterobacterias en los linfocitos de sangre periférica humana.

The following study has as prior history the research reports which have shown the existence of an antigenic tissue deposit in gram-negative enterobacteria. The antigens of the enterobacteria have also been found in the lymphocytic membranes and cytoplasm. Since intestinal lymphoid tissue cells can recirculate by means of the thoracic duct to the peripheral venous system, it was proposed that the circulating lymphocytes in healthy people could also contain small amounts of a common enterobacterial antigen. The study was carried out in 15 human venous blood samples, of which the lymphocytic population was separated to later be used in the preparation of 15 alcohol soluble extracts. This material was used for inhibiting the immuno-hemolysis assay in three occasions in order to show the presence of antigens shared by different enterobacterias, using as reference a fraction separated from the LPS of Escherichia coli 08. The results showed that the human lymphocytes also had antigenic determinants common to gram-negative bacteria.

[The association of HLA and disease]. / Asociación entre HLA y enfermedad.

The classification and genetic codification of human histocompatibility antigens (HLA), as well as the participation of these membrane structures in the stimulation mechanism of immune system and functional cell clones formation derived from T and B lymphocytes are reviewed in this work. In addition we present an up-date about the numerous association between HLA molecules expression and different human diseases described. The main mechanisms that have been proposed to explain the reasons for that associations are also presented; however we clarify that none of these can be consider as a proof of HLA participation in the etiopathogeny of those diseases. The HLA determination may help the physician to evaluate the risk of disease presentation and some of its complications as well as the prevention through the genetic advice.