A Case of Central Nervous System Myelomatosis with Complex Chromosome Aberrations / 대한진단검사의학회지

Involvement of the central nervous system is very uncommon in multiple myeloma, observed in approximately 1% of the multiple myeloma patients. We report a case of central nervous system myelomatosis with complex chromosome aberrations in a 62-yr-old female patient, who had previously been diagnosed as multiple myeloma. Fluorescent in situ hybridization revealed 13q deletion, p53 gene deletion and IGH/FGFR3 rearrangement and chromosomal study showed complex chromosome aberrations. After four cycles of chemotherapy, the patient was admitted to the hematology department with severe headache. Plasma cells were found in the cerebrospinal fluid (CSF), and CSF immunoelectrophoresis revealed abnormal precipitin arcs against anti-IgG and anti-lambda antisera. She was given systemic chemotherapy and eight courses of intrathecal chemotherapy, which cleared plasma cells in the CSF. Two months later, she was given autologous stem cell transplantation. Three months after stem cell transplantation, central nervous system myelomatosis progressed to plasma cell leukemia and two months later,the patient expired.

Aspergilloma formation in cavitary sarcoidosis / Formação de uma aspergilloma em sarcoidose com cavitação

Pulmonary cavitation is rather uncommon in patients with sarcoidosis, and aspergilloma is even more uncommon in such cases. Here, we present the case of a 63-year-old female patient with cavitary lung disease who had been under treatment for TB for 9 months. A diagnosis of pulmonary sarcoidosis was established based on the fiberoptic bronchoscopy finding of noncaseating granuloma. Treatment with corticosteroids led to a dramatic improvement in symptoms. While under treatment for sarcoidosis, the patient developed an aspergilloma. She presented immediate skin test reactivity to Aspergillus fumigatus, as well as positivity for A. fumigatus serum precipitins. This is the first reported case of aspergilloma formation in a patient with cavitary sarcoidosis in India.

A cavitação pulmonar é rara em pacientes com sarcoidose, e o aspergiloma é ainda mais raro nestes casos. Apresentamos o caso de uma paciente de 63 anos com doença pulmonar cavitária em tratamento para a TB por 9 meses. Estabeleceu-se o diagnóstico de sarcoidose pulmonar com base nos achados de granuloma não-caseoso na fibrobroncoscopia. Houve grande melhora dos sintomas com o tratamento com corticosteroides. A paciente desenvolveu um aspergiloma durante o tratamento para a sarcoidose. Houve reação imediata ao teste cutâneo para Aspergillus fumigatus, assim como resultado positivo para precipitinas de A. fumigatus no soro. Este é o primeiro caso relatado de formação de aspergiloma em um paciente com sarcoidose com cavitação na Índia.

Partial characterization of serum immunoglobulins of Oreochromis mossambicus.

Serum immunoglobulins of O. mossambicus were purified using chromatography methods--CM affinity gel blue chromatography followed by two step purification involving a combination of ion-exchange and gel filtration chromatography. Studies revealed that O. mossambicus produces only one class of high molecular weight macroglobulin as determined by molecular sieving by Sepharose CL 6-B. Immunoelectrophoresis of purified O. mossambicus serum against rabbit anti O. mossambicus serum gave only a single precipitin line. Further analysis of the immunoglobulin by SDS-PAGE showed that the IgM macroglobulin weighs about 900,000 Da, composed of mu-like heavy chain weighing about 90 kDa each and light chains weighing about 30 kDa each.

Imunidade humoral em pacientes com fibrose cística / Humoral immunity of patients with cystic fibrosis

Pacientes com FC frequentemente såo acometidos por infecçöes pulmonares, principalmente por P. aeruginosa tanto da variedade nåo mucóide como mucóide. Esta última, quando se instala, é acompanhada geralmente de deterioraçåo progressiva da funçåo pulmonar. Detectam-se nestes pacientes, anticorpos para o microorganismo e diversos produtos por ele produzidos. A imnunoeletroferese cruzada tem sido tradicionalmente utilizada para pesquisa de precipitinas para P. aeruginosa. Esta surgem pouco após o início do episódio infeccioso e guardam correlaçåo com a cronicidade do processo, quando se mostram mais numerosoas. Em pacientes infectados por P. auruginosa mucóide, o número de precipitinas costuma ser maior que nos infectados pela variedade nåo-mucóide. As precipitinas habitualmente nåo surgem nos pacientes apenas colonizados, servindo assim para distinguir casos de colonizaçåo dos de infecçåo, e indicando a oportunidade do emprego de antibioticoterapia nestes pacientes. O número de precipitinas se reduz após controle do processo infeccioso. Outras técnicas vêm sendo desenvolvidas com sucesso, para a pesquisa de anticorpos para P. aureginosa, visando a obtençåo de maior sensibilidade e especificidade, abrindo caminho para novas possibilidades de investigaçåo

Serum precipitins in pulmonary aspergillosis: preliminary results.

Definitive diagnosis of pulmonary aspergillosis is difficult to establish. Thus, confirmative evidence of active fungal aggression is imperative. In this study, an immunodiffusion test was carried out on 36 cases of pulmonary aspergillosis and two groups of subjects comprising 133 patients with non-fungal diseases and 134 healthy volunteers as controls. The test was positive in 92.3% of the patients with mycetoma, in 50% of the patients with allergic bronchopulmonary aspergillosis, and in 25% of the patients with invasive aspergillosis. Results were negative in all subjects in the two control groups. The findings indicate the efficacy of the test under study for supporting the diagnosis of pulmonary aspergillosis.

The threat of reintroduction of natural transmission of Chagas' disease in Bambuí, Minas Gerais state, Brazil, due to Panstrongylus megistus

In the Epidemiological Surveillance Program in the county of Bambuí, Minas Gerais, between August 1986 and December 1988, 154 Panstrongylus megistus were captured by the local population in both peridomicile and intradomicile environments. Fifteen (9.8%) of the P. megistus harboured Trypanosoma cruzi. Preciptin tests showed that the most frequent triatomine blood meal sources were birds, but other sources were dogs, men and cats. The isoenzyme characterization of 13 T. cruzi strains showed that six belonged to zymodeme Z1, corresponding to the wild parasites, and seven belonged to zymodeme Z2, corresponding to parasites isolated from chronic chagasic patients (domestic cycle). As P. megistus were found to be naturally infected by parasites from both cycles, they are cleary able to transmit T. cruzi from the wild cycle to the domestic cycle. Furthermore the capacity of P. megistus in colonizing houses was observed in one residence, vacant for several years, in wich 153 triatomines were captured. The data show the possibility of P. megistus reintroducing transmission of Chaga's disease in the county if Epidemiological Surveillance is interrupted

Precipitating antibodies to non-treated dengue type 2 viral antigens in sera of Thai hemorrhagic fever patients by crossed immunoelectrophoresis.

Crossed immunoelectrophoresis of dengue type 2 virus revealed at least two precipitating antigens which shared some antigenic determinants. Glycoprotein components of both antigens were detected by binding to concanavalin A. Sera from dengue hemorrhagic fever patients showed precipitating antibodies to both antigens which could be quantitated according to the precipitate patterns formed in the intermediate gel of crossed immunoelectrophoresis. All secondary dengue hemorrhagic fever patients demonstrated an increase in precipitin titers in convalescence sera. Most patients with mild illness contained precipitating antibodies in acute phase sera whereas severe cases did not. Convalescent sera from severe cases showed only low titers. These precipitating antibodies may be associated with protection since they were produced early only in those with mild form of illness.

immunodiffusion test in rift valley fever 1 Standardization of procedure and detection of precipitin antibodies in experimentally infected laboratory animals

An account is given on the possible integration of the gel diffusion test in the serodiagnosis of the Rift Valley Fever. The effect of different variables [saline or buffer, pH of agar medium, different antigen preparations, temperature, dilution of reagents] was studied. A single precipitation line was easily detectable after 24 - 48 hours incubation at room temperature or at 37°C. The specifity of the reaction is discussed in detail and confirmed through the virus isolation from a previously infected sheep herd, whose convalescent sera gave positive reactions when tested with the gel diffusion test