Serum anti-Yersinia antibody in Chinese patients with Kawasaki disease.

BACKGROUND: Many infectious agents have been implicated as an etiology to develop Kawasaki disease (KD). In Taiwan, studies on the relationship between Yersinia and KD have not been reported. METHODS: We measured sera for anti-Yersinia antibodies by using enzyme immunoassay (EIA) in 31 patients with KD and 60 healthy children (HC). Yersinia strains included Y. pseudotuberculosis I, II, III, IV, V, VI and Y. enterocolitica O3, O8 and O9. RESULTS: Data of 31 patients with KD showed that for the IgG antibody, serum anti-Y. pseudotuberculosis II, III, Y. O8 and O9 antibody were significantly higher when compared to the HC. Except for Y. pseudotuberculosis IV, all other Yersinia strains of either IgA or IgM antibodies increased significantly in patients with KD vs. the HC. If we compared the number of patients who had significant elevation of OD and those of HC, we found IgA anti-Yersinia antibodies (PST I, PST II, O3, O8, O9), IgM (PST VI, O8) and IgG (PST II, O8, O9) were significantly elevated in KD patients than in HC. A significant relationship was present between KD with myocarditis and increased anti-Yersinia antibody titer. CONCLUSIONS: The findings in this study suggest that preceding Yersinia infection may play a role in the pathogenesis of KD. Further study of the relationship between KD with myocarditis and increased anti-Yersinia antibody is needed.

Interstitial lung disease and xerostomia as initial manifestations in a patient with human immunodeficiency virus infection.

A 56-year-old human immunodeficiency virus (HIV)-infected man presented with progressive interstitial lung disease (ILD) and lymphocyte infiltration of the salivary glands which mimicked autoimmune disease. Pneumonia, which was very likely caused by Pneumocystis carinii, developed after 3 courses of monthly methylprednisolone pulse therapy for ILD. Both enzyme immunoassay and Western blot analysis confirmed the HIV infection. After antibiotic treatment, the pneumonia gradually resolved. Autoimmune manifestations such as ILD and xerostomia may be initial presentations of HIV infection. Immunosuppressive drugs must be used cautiously in these patients. Screening for HIV is mandatory in the differential diagnosis of patients with ILD or xerostomia.

Adequate nourishment through total parenteral nutrition treatment may augment immune function in patients with colon cancer.

BACKGROUND: Our objective was to evaluate immune function after total parenteral nutrition (TPN) treatment in colorectal cancer patients. METHODS: Data were collected from 11 patients with colorectal cancer who received total parenteral nutrition. Healthy medical staff volunteers were used as controls. Delay hypersensitivity skin test with eight agents tested was used before total parenteral nutrition (TPN) treatment. Phytohemagglutinin (PHA)-stimulated lymphocyte proliferation and mononuclear cytokine production (IL-1 beta, IL-2, IFN gamma), serum ICAM-1 and IL-6, and lymphocyte subpopulation including CD4, CD8, and CD4/CD8 ratio were measured before and after TPN treatment. RESULTS: Each patient had at least four of seven positive skin tests. After TPN treatment, lymphocyte proliferation increased remarkably (27,450 +/- 16,800 vs. 41,738 +/- 28,484, p=0.0168) and showed no significant difference to control group (p=0.0269). Levels of IL-1beta, IL-2, and IFN gamma after LPS-stimulation showed no significant difference before and after TPN treatment. Serum ICAM-1 showed a significant difference (388 +/- 158 vs. 481 +/- 210, p=0.0023) before and after TPN treatment. IL-6 was significantly different between patient and control groups but not different between patients before and after TPN treatment. CONCLUSIONS: This study showed a significant increase of mitogen-stimulated lymphocyte proliferation and intercellular adhesion molecular 1 (ICAM-1) level after TPN supply. Adequate nutrition through TPN may augment immune function.