ABSTRACT
We report the first experience in Thailand with the use of OKT3 (monoclonal anti T lymphocyte antibody) in rescuing an acute rejection unresponsive to methylprednisolone pulses in 3 cadaveric renal transplant patients. The treatment regimen was 10 daily 5 mg intravenous injections of OKT3. In the first and second patients OKT3 was started on days 26 and 18 of the rejection episode. In the third one OKT3 was given when he became anuric secondary to severe acute rejection. Within 24 hours of the therapy, urine flow increased. A brisk diuresis and a decline in serum creatinine started within 4 days. The kidney function returned to normal within the 10-day course of therapy. Side effects were fever, conjunctivitis, stuffiness of nose and herpes infection.
Subject(s)
Antibodies, Monoclonal/therapeutic use , Graft Rejection/drug effects , Kidney Transplantation , Acute Disease , Adult , Antibodies, Monoclonal/adverse effects , Humans , Infections/complications , Male , Middle Aged , Thailand , Transplantation, HomologousABSTRACT
Immunogenicity of four plasma-derived hepatitis B vaccines (Merck, Sharp and Dohme, Pasteur, Dutch CLB and Korean Cheil-Sugar) was compared in Thai young adults. After primoimmunization, only the Merck and Pasteur vaccines could achieve greater than 90% seroconversion (i.e. anti-HBs greater than or equal to 10 mIU ml-1) whereas both the CLB and Korean vaccines needed a fourth dose to achieve this level of seroconversion. The anti-HBs titres of both heat-inactivated vaccines (CLB and Korean) were also significantly lower than those of the other two vaccines. We propose that the HBsAg content in both heat-inactivated vaccines should be increased and a booster (fourth) dose should be given in order to enhance their immunogenicities.
Subject(s)
Viral Hepatitis Vaccines/immunology , Adult , Drug Administration Schedule , Female , Hepatitis B Antibodies/biosynthesis , Hepatitis B Vaccines , Humans , Male , Thailand , Viral Hepatitis Vaccines/administration & dosage , Viral Hepatitis Vaccines/adverse effectsABSTRACT
Acquired immune deficiency syndrome (AIDS) has been rarely reported as occurring primarily in Asia. We report here on first three cases of AIDS diagnosed at Chulalongkorn Hospital Medical School. One case was an American who had been in Thailand for two years; the other two were Thai. The American and one of the Thai patients were male homosexuals but they had no connection with one another. The latter Thai male homosexual had sexual contact with a German man who showed no evidence of the disease. The other Thai patients was the mistress of the male Thai patient, which underlies the importance of heterosexual transmission of the disease. The two male patients had opportunistic infections whereas the female patient had only generalised lymphadenopathy (Pre-AIDS). Delayed type hypersensitivity response, T-cell subsets enumeration and the in vitro T-cell mitogen response served as diagnostic tools when combined with the clinical history. The diagnosis was made even before the results of tests to determine the presence of antibodies to HTLV-III were known. The presence of anti-HTLV-III simply confirmed our diagnosis.
Subject(s)
Acquired Immunodeficiency Syndrome/diagnosis , Acquired Immunodeficiency Syndrome/immunology , Acquired Immunodeficiency Syndrome/transmission , Adult , Antibodies, Viral/analysis , Deltaretrovirus/immunology , Female , Humans , In Vitro Techniques , Lymphocyte Activation , Male , T-Lymphocytes/classification , T-Lymphocytes/immunology , ThailandSubject(s)
Heroin Dependence/immunology , Adolescent , Adult , Aged , Antigen-Antibody Complex/analysis , Autoantibodies/analysis , Complement System Proteins/analysis , Cryoglobulins/analysis , Female , Hepatitis B Surface Antigens/analysis , Heroin/administration & dosage , Heroin Dependence/complications , Humans , Immunoglobulins/analysis , Male , Middle AgedABSTRACT
Various autoantibodies were sequentially studied in 183 consecutive Thai adults infected with Plasmodium falciparum. On the first day of admission, 31.1% of the patients had positive fluorescent anti-nuclear antibodies (FANA) and 16.9% had positive smooth muscle antibodies (SMA). The incidences of positive FANA and SMA rose progressively with times when the patients returned for the 2 and 4 week follow-ups after discharge, although most of their malaria was cured. The majority of the positive FANA and SMA titres lay between 1:20 and 1:160. The positivity of the FANA and SMA did not correlate with the complications of malaria, nor the initial serum IgG or IgA levels. However, they significantly correlated with the initial hyper-IgM. More interestingly, almost all of the positive FANA were of the speckled type of nuclear staining. The antigen specificity of the speckled FANA were found not to be the double stranded DNA or the extractable nuclear antigens. The polyclonal B cell activation in active malarial infection was postulated.
