Background: Fever and severe myalgia in a tropical country like India bring to mind leptospirosis, rickettsioses, dengue, and other viral fevers. Enteric fever is widely prevalent in Asia, but myositis has not been previously described in Salmonella paratyphi A bacteremia. Materials and Methods: Retrospectively, we recruited patients with enteric fever admitted to our treating unit over a 6-month period. Demography, historical, clinical, and laboratory data were obtained. Data of culture-positive S. paratyphi A patients were analyzed and were compared with those patients with culture-negative enteric fever. Results: Forty-three cases were found in total with 19 of S. paratyphi A bacteremia. Elevations in creatine kinase (CK) ranged from one-and-half to six times normal. Forty-seven percent had thrombocytopenia and alanine transaminase elevations, while aspartate transaminase elevations were seen in 17 patients, which corresponded to those with elevated CK levels. Conclusions: Myositis associated with S. typhi and S. paratyphi is very rare and is more often due to non-typhoidal Salmonellae. Elevated creatine kinase was seen in most of our patients with S. paratyphi A bacteremia. Such myositis has not been described previously and hence, myalgia with fever in a tropical country could be a harbinger of paratyphoid fever.
In order to determine the role of growth Ilor~none (GII) on imnrunological functions, several kinds of lympl~ocyte subsets and killer cell activities including natural killer (NK), interkrone-augrnentcd NK, and ly~nphokine activated killer (LAK) celles were studied in 12 children and 12 adulu with GH deficiency. The results were compared wit11 age-n~atched nonnal conuols. Adult patients had been previously treated wit11 hGti in childhood. In child patients, NK and LAK activities were signilicnnlly low before hGH therapy, but they increased to nom~al levels alter one year ofhGH Ihcnpy. tlowever, a significant low percentage of Leu 7. cells WAS ob\ervcd both belbre and after hGH therapy in 1 I children. In adult patiettts, NK activilics were nor~i~al, but interferon-augmented NK acl~vitics and LAK activities were low. However, LAK activities increased after one ~nonlh of hGH therapy. These results suggest that in children GH deficiency may cause the defective killer cell activities, and that hGH therapy may recover tllc function of hiller cells, though the number of killer cells remained at a low Icvel. In adult patients, shon term hGH therapy resulted in nonn~li~alion ol' LAK activities but did not resulted in normalization of other cellular irntnut~ological abnormalities. Therefore, GH is thought to be indispensable to develop and maintain some killer cell activities. 195IGFs AND IGF BINDING PROTEINS IN HUMAN CORD SERA: FSLATIONSHIP TO INTRAUTEINE GROWTH K.Fuiieda, N.Shinohara,J.Nakae and T.Tajima Department of Pediatrics, Hokkaido University School of Medicine,Sapporo JapanThe IGF autocrine/paracrine system is klieved to play a niajor role in the regulation of human fetal growth. We have examined the ontogeny of IGF1,IGF-11.1GFDP-l.2,3 concentrations in fetal developmenl tllroughout gestation using cord sera from 97 normal newborns between 26 and 42 weeks. We also compared these variables with lhose from 18 SFD and 9 LFD newborns. IGF-I and IGF-11 were measured by RIA and ELlSA after acid-ethanol extraction. IGFDP-1.2.3 were measured by ELlSA newly deveoloped. In relation to gestational age and birth weight, IGF-I and IGFUP-3 had positive correlation and IGFDP-I had negative correlation. IGF-11 and IGFBP-2 did not show any correlation. In cord sera from SFD newborns the decreased IGF-I and IGFDP-3 levels and the increased IGFDP-I levels were observed. In contrast, in LFD cord sera these variables were not significantly different from those of normals. These results imply that these IGF-related peplides play significant role in human fetal growth by positive and negative regulatory mechanism. In contrast IGF-I1 and IGFBP-2 do not play a role in fetal growth during late stage of fetal development. 196GROWTll OF PUBERTAL SHORT NORMAL CllILDREN TREATED 3 YEARS WITH GROWTH HORMONE ALONE OR ASSOCIATED WITH LIIRII AGONIST J . C . Job and F.Land1er. Hopital St Vlncent, P a r i s , and Kabl Pharmacia, France.30 adolescents s t a r t i n g puberty with a short helght and slaw growth without detected cause verc treated 3 ...
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