A 71-year-old previously healthy woman developed unexplained thrush, onychomycosis, Pneumocystis carinii pneumonia, and a T-cell defect consistent with the acquired immunodeficiency syndrome. Her only apparent risk factor was infrequent, monogamous sexual contact with her husband, a 74-year-old hemophiliac who had received factor VIII concentrate and subsequently died due to P. carinii pneumonia. She first developed probable signs of the syndrome (recurrent thrush and onychomycosis) 1 year before her husband became ill. These findings suggest that the syndrome can be transmitted heterosexually by an asymptomatic person, and that the female sexual partners of hemophiliacs treated with factor VIII concentrate may be at risk of acquiring the syndrome; frequent sexual contact or several sexual partners are not necessary for transmission to occur; and the syndrome can occur in elderly people if exposed to risk factors. This case further supports the theory that the syndrome in hemophiliacs is due to an infectious agent that can be transmitted heterosexually as well as parenterally.
Leukocyte kinetics were studied in two individuals with marked eosinophilia. Blood leukocytes, labeled in vitro with Na251CrO4, disappeared from the circulation at different rates in the two subjects during the first eight hours after infusion. In one, label disappeared exponentially with a T/2 of 4.5-5.0 hours; in the other, the level of radioactivity remained constant. In both, however, a significant rise in radioactivity appeared during the second 24 hours, suggesting recirculation of the eosinophils. Blood leukocyte DNA-32P labeling was similar in both subjects and closely resembled neutrophil DNA-32P labeling observed in normal individuals. Hydrocortisone infusion produced an exponential decrease in circulating eosinophils in one subject and, for reasons unknown, a linear decrease in the other; the drug exhibited no effect on eosinophils in vitro.
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