Unusual presentation of Bruton's agammaglobulinemia--Pseudomonas sepsis.

A case of Pseudomonas sepsis and meningitis is described in a family in which the first child died in the first year of life after a fulminant Pseudomonas sepsis. In our patient, the second son, treatment was begun immediately after admission with clinical and bacteriological signs of Pseudomonas sepsis and continued for a 4-week period. Subsequent cessation of the treatment resulted in a relapse, with meningeal involvement. After specific therapy was added for his immunologic incompetence, as well as subsequent antibiotic treatment, the patient was cured of his prolonged illness.

Nonspecific suppressor cell activity and lymphocyte response to beta-lactoglobulin in cow's milk protein hypersensitivity.

beta-Lactoglobulin (BLG) is clinically the most frequent allergen in cow's milk protein hypersensitivity (CMPH). We therefore assessed its in vitro blastogenic effect on lymphocytes of patients suffering from CMPH. Twenty-two patients aged from 1 to 20 months were investigated. beta-Lactoglobulin produced a significantly (p less than 0.00003) higher blastogenic response in lymphocytes of patients with CMPH (mean stimulation index 7.7 +/- 0.7 SEM) than in 26 age-matched controls (2.7 +/- 0.4). This response was age related, being most marked in infants up to 5 months of age. Lymphocyte proliferation following stimulation with BLG can be a useful in vitro test in the diagnosis of CMPH. Because of this augmented lymphocyte response, we considered the possibility of a related defect in immune suppression. Nonspecific concanavalin A-induced suppressor cell activity was assessed in the above patient and control populations. Concanavalin A-induced suppressor cell activity was significantly (p less than 0.05) reduced in patients with CMPH. This too was most marked in the first few months of life. We suggest that the development of CMPH may be due to delayed maturation of a suppressor cell population.