Background: Recently some studies have suggested that human platelets may play an important role in allergic inflammation through the high affinity IgE receptor (FcΕRI), the low affinity IgE receptor (FcΕRII/CD23) and the low affinity IgG receptor (FcγRIIA/CD32) expressed on the cell surface. We reported that human platelets via the FcΕRI induced the release of the chemical mediator serotonin and the chemokine RANTES (regulated upon activation, normal T expressed and presumably secreted), but the biological implication of human platelets in type I allergy has not yet been understood clearly. Methods: We compared the levels of RANTES release from platelets obtained from allergic patients and healthy individuals, stimulated with monoclonal antibody (Ab) to human FcΕRI α-chain, or human myeloma IgE and anti-human IgE Ab. Results: We confirmed that the level of RANTES release from platelets of allergic patients stimulated with human IgE and anti-human IgE was significantly higher than that of healthy individuals. Conclusions: We demonstrated that the surface expression levels of FcΕRI on the platelets from allergic patients and healthy individuals were not significantly different, but that the platelets of allergic patients were more activated by the IgE-FcΕRI pathway than those of healthy individuals. Taken together, these results suggest a novel and important role for human platelets in perpetuating allergic inflammation through the IgE and FcΕRI.
Background and Purpose-Kawasaki disease is a febrile disease of children notable for systemic vasculitis. There have been many previous reports of various complications, including disorders of the central nervous system. We evaluated cerebral perfusion during the acute stage in patients with Kawasaki disease. Methods-Single-photon emission-computed tomography (SPECT) with 99m Tc-hexamethylpropyleneamine oxime was performed in 21 children with acute stage Kawasaki disease. Follow-up SPECT and MRI were performed about 1 month after the first SPECT in patients who exhibited abnormal SPECT findings during the acute stage. Results-In 6 of 21 children SPECT imaging demonstrated localized cerebral hypoperfusion without abnormal neurological findings or clinical symptoms, and the follow-up SPECT and MRI approximately 1 month after the first SPECT revealed no abnormalities. Conclusions-Some patients with Kawasaki disease have transient localized cerebral hypoperfusion at the acute stage.
ABSTRACT. Objective. Kawasaki disease (KD) is one of the common causes of cervical lymphadenopathy during early childhood. The purpose of this study was to compare the ultrasonographic feature of cervical lymph nodes in patients with KD, bacterial lymphadenitis, and infectious mononucleosis.Design. We studied 22 patients with KD, 8 with presumed bacterial lymphadenitis, and 5 with Epstein-Barr virus infectious mononucleosis. We examined the cervical nodes by ultrasonography using a 7.5-MHz or 10-MHz transducer of a B-mode sector scanner in all patients with a chief complaint of fever and a visible cervical mass during a fixed time interval (July 1995-March 2000).Results. In KD patients, transverse ultrasonograms demonstrated multiple hypoechoic-enlarged nodes forming one palpable mass, which resembled a cluster of grapes. The ultrasonographic appearance of these nodes was similar in patients with acute Epstein-Barr virus infection, but differed from the pattern in presumed bacterial lymphadenitis. Five KD patients had had fever and cervical lymphadenopathy for several days before other manifestations of KD were noted. In these patients, it was possible to differentiate by ultrasonography between KD and presumed bacterial lymphadenitis at an early stage.Conclusion. K awasaki disease (KD) is an acute febrile illness of unknown cause that occurs primarily in infants and young children. 1 Between 20% and 25% of untreated patients develop coronary artery lesions (CAL), which can lead to myocardial infarction or even death. 2 Early diagnosis and treatment with intravenous gammaglobulin (IVGG) can reduce the risk of cardiac complications of KD. 3 Because there are no specific diagnostic tests for KD, the diagnosis is established by the presence of 5 of 6 criteria in the absence of some other explanation for the illness. 1 The Japanese diagnostic criteria include the following: 1) fever persisting for 5 days or longer; 2) nonexudative conjunctival injections; 3) oral mucosal changes; 4) changes of the peripheral extremities; 5) rash, primarily truncal; and 6) cervical lymphadenopathy (at least 15 mm in diameter). Cervical lymphadenopathy is the least common diagnostic criterion and is present in approximately 50% to 75% of KD patients. In contrast, the other 5 criteria are present in greater than 90% of patients with KD. 4 Nevertheless, we have experienced patients who had only fever and cervical lymphadenopathy at the initial examination. 5 The clinical presentation in KD patients may initially resemble that of other infectious diseases, including bacterial and viral infections. It is important to recognize KD at an early stage so that appropriate therapy can be initiated. For this reason, we investigated cervical lymphadenopathy by ultrasonography as a means of differentiating between KD and other infectious diseases, such as presumed bacterial lymphadenitis and acute Epstein-Barr virus (EBV) infection presenting as infectious mononucleosis (IM). MATERIALS AND METHODS PatientsEligible patients were those who presented...
Using a colour pulsed Doppler flow mapping system, we examined the intracranial arteries of 40 healthy infants. The anterior cerebral, basilar, intracranial internal carotid and middle cerebral arteries were visualized clearly enough to evaluate flow velocity at the success rates of 100%, 87.5%, 65% and 82.4%, respectively. In the anterior cerebral, intracranial internal carotid and middle cerebral arteries, the maximum blood flow velocity slightly decreased to a minimum at around 4-6 h after birth, and then gradually increased. The minimum blood flow velocity pattern was similar. The maximum blood flow velocity in the basilar artery decreased from 0-3 h, rapidly increased from 4-6 h, and remained at a steady level thereafter. A possible mechanism for the chronological changes in the intracranial blood flow velocity is discussed.
Outbreaks of hMPV, rather than, RSV infection may have a greater impact on the development of hypoxic respiratory illness in asthmatic children.
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