Robert H. Page

Autoimmune hemolytic anemia: Natural history and viral-immunologic interactions in childhood

Long-term studies of autoimmune hemolytic anemia (AIHA) in twenty-eight unselected children showed three main patterns: I, low age, acute onset, early full recovery, normal immunoglobulins; II, wide age range, acute onset, chronic course, occasional purpura, eventual recovery, abnormal immunoglobulins; III, indeterminate onset, frequency of growth failure, purpura, neutropenia, massive lymphadenopathy, various illnesses and complications, high mortality, indefinite duration, immunoglobulins abnormal, mostly IgA deficiencies. Chromosomal abnormalities were common in all groups. Primary or recurrent cytomegalovirus infections were a common finding and apparently implicated directly in hemolysis and autoimmunity, susceptibility depending on lack of acquired immunity in group I and gradations of immunodeficiency in groups II and III. Other occult viruses may be involved. Autoantibodies correlated poorly with hemolysis and appeared to indicate variable secondary response to virus-related antigens, depending on host immunologic capacity, rather than intrinsic disturbances of erythrocyte immune homeostasis. The observations support the hypothesis that the basic disturbance in AIHA is an immunologic handicap predisposing to occult viral infections which in some as yet undetermined manner cause hemolysis and may induce autoantibody formation.

Clinical, Bacteriological, and Serological Observations of two Human Volunteers Following Ingestion of Escherichia coli:

Summary 1. Two healthy, adult white, male volunteers ingested, respectively, 4 and 8 million organisms of E. colt serotype 0127: B8. 2. Symptoms of mild to moderate gastroenteritis appeared in both subjects 7 to 17 hours after ingestion of the organisms and persisted for 32 to 46 hours. 3. By daily rectal swab cultures, E. colt 0127:B8 organisms were recovered within 24 hours after ingestion and were found during 5 days in one and 12 days in the second volunteer. 4. Hemagglutinins were detected 3 days and bacterial agglutinins 5 days following ingestion. Antibody titers in both subjects rose rapidly, reaching peaks by the eighth to ninth day. Hemagglutination titers were consistently higher than bacterial agglutination titers. 5. Challenge ingestion of 8,000.000 organisms by one volunteer was followed by bacterial and serological response without appearance of clinical symptoms.

Comparative behavior of 16 ECHO virus types in fibroblast-like and epithelial-like human cell strains.

Summary The susceptibility ranges of a fibroblast-like and 6 epithelial-like human cell strains to 16 ECHO virus types have been described. All of these ECHO viruses except type 10 multiplied in the fibroblast-like cell strain (Detroit-196 Fb-L). In contrast, an epithelial-like strain (Detroit-196 Ep-L) evolving from the Fb-L strain, as well as 5 additional Ep-L cell strains, either were refractory or had narrow susceptibility ranges. The significance of differences in morphology with respect to virus susceptibility was discussed.