Ami Vonsover

Kaposi's sarcoma in immunosuppression. Possibly the result of a dual viral infection.

Kaposis sarcoma of the gingiva and skin developed in an HIV‐negative renal transplant patient while he was receiving cyclosporine therapy. The Kaposis sarcoma developed shortly after the patient had an acute infection with cytomegalovirus (CMV). Electron microscopy of the tumors established cell line showed two types of virus‐like particles. CMV DNA was identifiable in the cell line whereas infectious CMV could be isolated only after repeated passages (only after 3 months of culture). The other virus could not be identified, but did not appear to be either HIV or papilloma virus. The patients tumor regressed after the discontinuation of cyclosporine therapy and the recovery from the acute CMV infection.

Antibodies to epstein-barr virus in patients with Hodgkin's disease and leukemia

Sera from 67 Hodgkins disease patients, 71 leukemia patients, and 186 healthy subjects were tested for antibodies to Epstein‐Barr (EB) viral antigens by immunofluorescence methods. In both disease categories, in particular Hodgkins disease patients, levels of antibodies to the viral capsid antigen (EBV‐VCA) and MGT were higher than in the healthy controls. Significantly higher titers were found in Jewish patients of Asian‐African origin, as compared to Jews of European origin, with Arab patients as intermediates. The effect of ethnic origin was independant of age and histopathologic type. Sex had no effect on titer. Inconsistent differences in titer were found between age groups in the various ethnic‐histopathologic type groups. Some of the leukemia patients had no detectable antibodies to EBV, while all Hodgkins disease patients showed previous contact with EB virus. Antibodies to the early antigen (EBV‐EA) were found in 27% of Hodgkins and 37% of leukemia patients, and in none of the healthy controls tested.

Rearrangement of the immunoglobulin heavy chain gene in juvenile chronic myeloid leukaemia

Summary. Five patients with clinical and laboratory features typical for juvenile chronic myeloid leukaemia (JCML) are presented. Rearrangement of the j joining region of the immunoglobulin heavy chain (Jh) was demonstrated in three children out of five analysed. As no Vh to Dhjh nor kappa light chain rearrangements were demonstrated, it is reasonable to speculate that the transforming event of the stem cell happened at the stage when Dh to Jh rearrangement took place. As the monocytic lineage is prominent in JCML, it is suggested that the transforming event happens in a unique stem cell with intermediate differentiation towards the myelomonocytic as well as the B‐lymphatic lineage. This stem cell, which is present at a certain stage of embryogen‐esis, disappears later. Such an early‘hybrid’cell is sometimes involved in leukaemias of early infancy, and may be the transformed cell in some cases of infantile leukaemia.

Immediate immunosuppression caused by acute HIV-1 infection: a fulminant multisystemic disease 2 days post infection.

SummaryA healthy 19-year-old woman had vaginal intercourse on a single occasion with an HIV-1 positive male from Gambia. Two days later she developed an acute HIV infection presenting as a fulminant multisystem disease that lasted for 35 hospital days and included: immediate immunosuppression with extreme CD4+ lymphocytopenia and combined with CD8+ lymphocytosis, neutropenia and hypogammaglobulinemia; intermittent spiking fever; pneumonitis; hepatitis; changing skin rashes; peripheral neuropathy with myopathy, and panencephalitis. P24 antigen was detected by Western blot on day 23 and seroconversion was detected by ELISA on day 25. Cultured lymphocytes from peripheral blood and cerebrospinal fluid grew HIV-1.ZusammenfassungEine gesunde 19-jährige Frau hatte einmaligen vaginalen Geschlechtsverkehr mit einem HIV-1-positiven Mann aus Gambia. Nach 2 Tagen entwickelte sich eine fulminante Multi-System-Erkrankung, die während des 35tägigen Krankenhausaufenthaltes bestehen blieb: sofortiges Auftreten einer Immunsuppression mit extremer CD4+-Lymphopenie, kombiniert mit CD8+-Lymphozytose, Neutropenie und Hypogammaglobulinämie, intermittierenden Fieberschüben, Pneumonitis, Hepatitis, wechselnden Exanthemen, peripherer Neuropathie und Myopathie sowie Panencephalitis. Der Western Blot für p24-Antigen war am Tag 23 positiv, die Serokonversion wurde am Tag 25 mit einem ELISA nachgewiesen. In Lymphozytenkulturen aus dem peripheren Blut und Liquor konnte HIV-1 angezüchtet werden.A healthy 19-year-old woman had vaginal intercourse on a single occasion with an HIV-1 positive male from Gambia. Two days later she developed an acute HIV infection presenting as a fulminant multisystem disease that lasted for 35 hospital days and included: immediate immunosuppression with extreme CD4+ lymphocytopenia and combined with CD8+ lymphocytosis, neutropenia and hypogammaglobulinemia; intermittent spiking fever; pneumonitis; hepatitis; changing skin rashes; peripheral neuropathy with myopathy, and panencephalitis. P24 antigen was detected by Western blot on day 23 and seroconversion was detected by ELISA on day 25. Cultured lymphocytes from peripheral blood and cerebrospinal fluid grew HIV-1. Eine gesunde 19-jährige Frau hatte einmaligen vaginalen Geschlechtsverkehr mit einem HIV-1-positiven Mann aus Gambia. Nach 2 Tagen entwickelte sich eine fulminante Multi-System-Erkrankung, die während des 35tägigen Krankenhausaufenthaltes bestehen blieb: sofortiges Auftreten einer Immunsuppression mit extremer CD4+-Lymphopenie, kombiniert mit CD8+-Lymphozytose, Neutropenie und Hypogammaglobulinämie, intermittierenden Fieberschüben, Pneumonitis, Hepatitis, wechselnden Exanthemen, peripherer Neuropathie und Myopathie sowie Panencephalitis. Der Western Blot für p24-Antigen war am Tag 23 positiv, die Serokonversion wurde am Tag 25 mit einem ELISA nachgewiesen. In Lymphozytenkulturen aus dem peripheren Blut und Liquor konnte HIV-1 angezüchtet werden.

Blastogenic response of lymphocytes derived from patients with hematopoietic malignancies to antigens of a type C retrovirus isolated from a Burkitt's lymphoma cell line

Cellular immune response to antigens associated with a type C retrovirus derived from Burkitts lymphoma (BL) lymphoblastoid cells was studied in patients with hematopoietic malignancies, noncancer patients and healthy controls. Response was determined by lymphocyte blastogenesis assay measuring [3H]-thymidine incorporation, thereby enabling the calculation of stimulation indices (SI). Positive response (SI greater than 2.0) was demonstrated in patients with multiple myeloma (MM), chronic lymphocytic leukemia (CLL), chronic myelocytic leukemia (CML) and BL. No response was demonstrated in the non-cancer and healthy controls. Specific blastogenic response was obtained towards antigen extracted from three different cell lines infected with the tested type C retrovirus. No response was evident towards purified whole or purified disrupted virions or antigen extracted from murine myeloma MOPC-315 cells secreting a murine type C retrovirus or an antigen extracted from Mason-Pfizer monkey virus-infected NC-37 cells. The correlation between human hematopoietic malignancies and the in vitro lymphocyte blastogenic response to the BL-derived type C retrovirus was statistically highly significant.