Osamu Itakura

Tropism of human herpesvirus 8 for peripheral blood lymphocytes in patients with Castleman's disease

Multicentric Castlemans disease (MCD), also called multicentric angiofollicular lymphoid hyperplasia, is a systemic lymphoproliferative disorder causing fever, lymphadenopathy and splenomegaly. Recently, Kaposis sarcoma‐associated herpesvirus/human herpesvirus 8 (KSHV/HHV‐8) DNA sequences have been detected in cases of MCD. We examined HHV‐8 DNA sequences in the peripheral blood mononuclear cells (PBMCs) of two HIV‐negative patients with MCD and in PBMCs and the lymph node of a HIV‐negative patient with localized Castlemans disease (LCD) by the polymerase chain reaction. The novel sequences were detected in all DNA samples. Furthermore, the sequences were detected in only the CD19+ B‐lymphocyte fraction of the patient with LCD as previously reported. However, the sequences were detected in CD19+ B‐lymphocyte and CD2+ T‐lymphocyte fractions of two patients with MCD. These results suggest that HHV‐8 has tropisms for both B lymphocytes and T lymphocytes in Castlemans disease.

Analysis of mycoplasmal pleural effusion by the polymerase chain reaction

Ten pediatric patients with mycoplasmal pleuritis were tested for the presence of Mycoplasma pneumoniae in pleural fluid by the polymerase chain reaction (PCR). Three of the four PCR positive cases left a persistent consolidation. The remaining one was an infant who required mechanical ventilation. PCR may be useful in predicting delayed resolution of roent- genographic abnormality.

Measles virus-specific immunoglobulin G subclass response in serum and cerebrospinal fluid

BACKGROUND While many previous studies have focused on the impairment in the cellular immunity during measles virus infection, to date, a limited amount of data is available concerning the virus-specific IgG subclass response during measles virus infection. OBJECTIVE The purpose of this study is to analyze the measles virus infection on the basis of virus-specific IgG subclass (G 1 and G 3). STUDY DESIGN Frozen-stored, serum and/or cerebospinal fluid samples from three groups of patients were tested retrospectively; Group 1 comprised 14 patients with measles primary infection, group 2, ten patients with reinfection/vaccine failure, and group 3, seven patients with subacute sclerosing panencephalitis. The method used was a modified ELISA method utilizing the Enzygnost IgG detection kit with mouse-monoclonal antibodies (clone HP6091 for IgG 1 and clone HP6050 for IgG 3). Avidity testing for each subclass IgG was also performed for selected samples by means of an 8 M urea-denaturation method. RESULTS In group 1, the IgG 3 could be detected in serum within 7 days from the onset of rash more frequently than IgG 1. In the cases of group 2, both subclasses were detected in very acute phase serum samples. In these cases, the IgG 1-specific avidity was always higher than that of IgG 3. In group 3, the subclass IgGs detected in the cerebrospinal fluid had a lower avidity than those in the serum. CONCLUSIONS Our results suggested that in measles virus infection, like other viral infections, the IgG 3 response normally occurs before the IgG 1 response, and plays a major role in the acute phase immunity during the primary infection, while the IgG 1 plays a major role in the maintenance of immunity. Continuously produced IgG 1 and IgG 3 in the central nervous system in cases of subacute sclerosing panencephalitis may be derived from cell populations different from those in the blood.

Unusual Presentation of Measles Giant Cell Pneumonia in a Patient with Acquired Immunodeficiency Syndrome

The typical clinical presentation of measles in a normal immunocompetent host includes cough, coryza, conjunctivitis, Kopliks spots, and rash. However, in an immunocompromised host, measles may have an atypical clinical presentation and may be commonly associated with severe pneumonia or encephalitis. We report a fatal case of measles pneumonia without any clinical features that suggest measles in a patient with acquired immunodeficiency syndrome.

Age-dependent expression of abdominal symptoms in patients with Yersinia enterocolitica infection.

Abstract Background: The aim of the present study was to determine the relationship between the expression of abdominal symptoms and the age of patients with Yersinia enterocolitica infections.

Measles encephalomyelitis in a patient with a history of vaccination

Secondary vaccine failure (SVF) of measles is generally believed to run a milder course of illness than an ordinary course of infection. Severe complications such as central nervous system involvement have rarely been reported. A 12 year old girl, who had received a live attenuated measles vaccine 10 years earlier, developed an encephalomyelitis in the absence of symptoms indicative of ordinary measles such as Koplik spots. Anti‐measles hemagglutination inhibition (HI) titer and measles IgM and IgG anitbody titers were measured in a commercial laboratory. Measles virus genomic sequence was detected by polymerase chain reaction. Both serum and cerebrospinal fluid (CSF) samples obtained at acute phase already showed extremely high titers of HI (x 8192 in serum and x 1024 in CSF, respectively) and IgG antibody along with the presence of IgM antibody. Polymerase chain reaction detected the measles virus genomic sequence in the acute phase CSF. The patients definite history of measles vaccination, high titers of HI and IgG antibodies observed at the very early stage of illness and the clinical course indicated that this patient had an encephalomyelitis due to SVF of measles. It is suggested that measles virus can be a pathogen of encephalitis without symptoms indicative of ordinary measles in individuals who received live attenuated measles vaccines.