[Treatment of extrinsic bronchial asthma with transfer factor]. / Tratamiento del asma bronquial extrínseca con factor de trasferencia.

A group of 90 external asthmatics with cellular immunodeficiency or not was studied and treated during 10 months with transfer factor or double blind placebo. Total immunoglobulin serum studies (A, G, M and E), spontaneous rosette and intradermal tests, were made a month before the treatment's beginning and a month after the ending of the treatment. The patients were clinically evaluated every day in accordance to the intensity and the frequency of their crisis and with the immunological point of view of the tests made. There was not significant differences between the study groups treated with the transfer factor or not. Adverse reactions were not noticed.

Chronic urticaria: humoral and clinical diagnosis of its morphological variables.

Thirty adult patients with a diagnosis of chronic urticaria were attended as outpatients at the Allergology Service, Clinical Surgical Hospital "Hnos. Ameijeiras". An accurate clinical history was made, humoral parameters such as erythrosedimentation, total eosinophil count, serum levels of immunoglobulins and complement fractions were measured, and a skin biopsy was done. Most of the patients with urticarial vasculitis showed almost permanent papulous reactions with fever and arthralgias. Duodenal smear was positive for Giardia lamblia in a high percentage of patients with urticarial vasculitis. Paraffin-embedded skin biopsy was very useful for measuring morphological variables, and it is recommended that this technique be used in recent reactions (< 24 h evolution).

[Melkersson Rosenthal syndrome. Presentation of a case]. / Síndrome de Melkersson Rosenthal. Presentación de un caso.

This a case report of a 24 year old black woman who referred to her physician recurrent episodes of inferior lip enlargement for a period of two years. Remission periods were incomplete, unrelated to any apparent cause and plicate tongue. No improvement was seen with medication, including the use of steroids. Complementary exams were negative except the biopsy which reported granulomatous cheilitis. We conclude that the Melkersson Rosenthal Syndrome must be considered when confronted with a patient who suffers from lip enlargement and pleated tongue, with or without neurological alterations as for example, facial paralysis.

Atopic dermatitis: serum immunoglobulins and T-lymphocyte subpopulations.

A group of patients with atopic dermatitis who attended the Allergy Outpatient Service of the Hermanos Ameijeiras Clinical Surgical Hospital from May, 1987 to May, 1988 were studied. The patients were assigned to 2 groups; the first one composed of 38 patients and the second one composed of 12 non-allergic, supposedly healthy subjects. Different tests were carried out for the quantification of total serum immunoglobulins (A, G, M, E) by means of the radial immunodiffusion method and the ELISA ultramicromethod. They were also submitted to quantification of lymphocyte subpopulations by means of the indirect immunofluorescence test with monoclonal antibodies, using Cuban antiserum prepared at the National Institute of Oncology and Radiobiology. In our study IgG and IgA values were within normal limits in patients, contrary to the statistically significant increase in IgM and IgE values. The relative values of total T-lymphocytes (anti-T3) and of the suppressor lymphocyte subpopulations decreased.

Atopic dermatitis. Findings of skin biopsies.

Twenty-eight adult patients with a clinical diagnosis of atopic dermatitis (according to the criteria of Hanifin and Lobitz) were studied at the Allergy Outpatient Service, the Dermatology Service and the Pathological Anatomy Service of the Hermanos Ameijeiras Clinical Surgical Hospital, from January to September 1986. The patients were submitted to a quantification of total serum IgE by means of the ELISA enzymatic ultramicromethod, developed at the Radioimmunoassay National Center, and skin biopsies were carried out by means of the paraffin and direct immunofluorescence methods. The most frequent histopathological findings were acanthosis, espongiosis, parakeratosis and exocitosis, as a chronic inflammatory infiltrate, mainly composed of lymphocytes, mast cells and eosinophils. In the skin direct immunofluorescence method we found depots of IgE in all the patients, having no relation in intensity to total serum IgE values.

[Determination of serum immunoglobulins in asthmatic patients]. / Determinación de inmunoglobulinas séricas en pacientes asmáticos.

One hundred eighty one asthmatic patients were evaluated at the Allergy Consultation in Hermanos Ameijeiras Clinical Surgical Hospital. A case history was made for each of the patients, where the family background and personal history of allergy was collected; possible precipitating factors (such as inhalable, food, infectious, irritant, as well as climate factors) and physical and respiratory examinations. Serum immunoglobulin tests (by means of the ultramicroanalitic system (SUMA) and the rest of Igs: IgA, IgG, IgM by means of Mancini's simple radial immunodifusion method were made. Total eosinophil count was made to all of the patients in the study as well as serial studies of the faces. An increase in the IgE and IgM figures was found in asthmatic patients related to individual controls, and in relation to the normal figures for the adult population in our country. IgA and IgG determinations were normal both in the asthmatic and control groups, related to the standard figures.

Some aspects of the allergy to cow's milk. Morphological alterations of the jejunal mucosa.

Forty-four patients were studied at the Allergology and Pediatric Outpatient Services of the "Centro Habana" Pediatric Hospital. Allergy to cow's milk was demonstrated in these children by means of a detailed medical history, suppression diet and reexposition, lactose tolerance test, intradermal skin tests with casein extracts and the remaining proteins of cow's milk; finally, a careful study of the jejunal mucosas by means of biopsy was carried out, according to Townley and Barnes' method with a Crosby capsule. The skin reactivity was evident in children with allergy to cow's milk with tested extracts, mainly casein; in the control group this result was scarce or nil. Likewise, it was verified that there are morphological changes in the jejunal mucosa of children with allergy to cow's milk; these changes consist of partial atrophy of the villi, increase in the cell-infiltrate of the lamina propria and patchy areas. Our results are compared with the studies carried out by other authors and were statistically assessed.

Immunology of atopic dermatitis.

Thirty-two adult patients with atopic dermatitis were studied at the Allergology Service of the "Hnos. Ameijeiras" Clinical Surgical Hospital. The diagnosis was established following the criteria of Hanifin and Lobitz. A detailed medical history was written for the patients; the study of some immunological parameters, such as the serum immunoglobulin quantification, delayed skin tests with a battery of antigens, and the spontaneous rosette-test, was also carried out. Almost all the patients showed serum IgE values above 150 UI, by means of the ELISA test modified by C.E.N.I.C. The mean values of the spontaneous rosette-test were low; this was more noticeable during the exacerbation period of the lesions. Candida sp, Mantoux and Streptokinase-Streptodornase antigens showed negative results in a high proportion of patients with atopic dermatitis, in relation with the control group. In atopic dermatitis, there are humoral disorders of immunity; this was demonstrated in our group by increased values of IgE and cellular disorders due to skin anergy, and to a low percentage of rosette forming cells; this does not allow to state that these phenomena have an active participation in the etiopathogenesis of this entity.