Shinya Tada

The role of interleukin-8 in interstitial pneumonia.

Objective:  A variety of inflammatory cells accumulate in the lungs of patients with interstitial lung disease. The potential for IL‐8 to be released from these cells into the lungs of patients with idiopathic interstitial pneumonia (IIP), interstitial pneumonia with collagen vascular disease (IP‐CVD), sarcoidosis (SAR) and hypersensitivity pneumonitis (HP) was investigated.

Bronchiolitis obliterans organizing pneumonia (BOOP) in a case of smouldering adult T‐cell leukaemia

Although various respiratory diseases have been reported in human T lymphotropic virus type‐1 (HTLV‐1) carriers or patients with adult T‐cell leukaemia (ATL), there appears to be no report of the development of bronchiolitis obliterans organizing pneumonia (BOOP) in ATL or HTLV‐1‐related disorders. We describe a 51‐year‐old male with smouldering ATL who developed BOOP during a long‐term follow up. Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) were performed in the right lower lobe B 6 with infiltrative shadows. As a result of flow cytometric analysis of peripheral lymphocytes and BAL lymphocytes, histological examination of the biopsied lung specimen, and the clinical course, we excluded the pulmonary infiltration of ATL cells and bacterial infection. Thus, he was diagnosed as having BOOP and successfully treated with corticosteroid therapy. This is probably the first report of BOOP developing in ATL. Bronchiolitis obliterans organizing pneumonia should be considered in the differential diagnosis of pulmonary complications in HTLV‐1 carriers or ATL patients since BOOP can be successfully treated by corticosteroids.

Non-African Burkitt's lymphoma in a young woman.

Non‐African Burkitts lymphoma is presented in a 29‐year‐old, unmarried woman, who developed tumors in both breasts and ovaries, ascites and pleural effusion. Assessment of B cells in the tumor cells, derived from ascites, pleural effusion and tumor tissue is 90%, surface IgM being consisted of 86%, in an average. Histologically, the tumor tissue demonstrates prominent, so‐called starry‐sky effect, and cytologically, tumor cells are poorly‐differentiated lymphocytoid ceUs in their features.

THE CONTINUOUS TREATMENT OF GENERALIZED MYASTHENIA GRAVIS WITH SMALL DOSES OF PREDNISOLONE WITH OR WITHOUT IMMUNOSUPPRESSANTS

重症筋無力症(以下MG)の病因として自己免疫説が注目されてきたにもかかわらず,本症に対しては副腎皮質ホルモンは一般に無効とされていた.最近になつて本剤の大量療法が難治全身型の本症に有効であることが見直されたが,なおその適応には種々の限界がある.わたくし達は胸腺摘出術(以下Thx)施行後の全身型MG8症例およびThx未施行の全身型MG8症例に対してprednisolone 5～10mg/dの少量持続療法を試みた.その結果, Thx施行後あるいは未施行のいずれの群でも60～75%の寛解あるいは著明改善例を認めることができ,効果発現時期は2～3カ月,寛解もしくは著明改善に到達するに要した期間は3～5カ月であつた.本療法開始後の臨床経過では一部の症例に1～2カ月以内に比較的不安定な時期がみられたが,これは抗cholinesterase剤(以下抗ChE剤)に対する神経筋接合部の反応性が増したためcholinergicに傾いたためであり,抗ChE剤を徐々に減量していくことによつて症状は好転し,この時期をすぎた3～5カ月頃には微量の抗ChE剤で安定した効果が得られるようになつた.本療法は少量であるところから従来の大量療法に較べ副作用はほとんどなく,一部の難治例に限られることなく軽症全身型MGにも応用できる点で適応の広い治療法であることが判明した.胸腺組織および末梢リンパ球にも検討を加え,本療法は胸腺(胚中心)ならびにリンパ球に働き,これらの異常を是正するとともに運動神経終板に結合する自己抗体の産生と機能を阻害すると考えられた.