1/8. CD4 T-lymphocyte-induced Epstein-Barr virus reactivation in a patient with severe hypersensitivity to mosquito bites and Epstein-Barr virus-infected NK cell lymphocytosis.BACKGROUND: Natural killer (NK) cell lymphocytosis associated with Epstein-Barr virus (EBV) infection often shows severe hypersensitivity to mosquito bites (HMB) characterized by intense local skin reactions and systemic symptoms such as high fever, lymphadenopathy, and hepatosplenomegaly. However, the induction mechanism of HMB is still unclear. OBSERVATIONS: We investigated a typical case of HMB with EBV-positive NK cell lymphocytosis. CD4 T cells dominantly infiltrated the site of the mosquito bite, while EBV-positive cells were few in comparison. CD4 T cells, but not CD8 T cells or NK cells, responded to the mosquito salivary gland extracts. Interestingly, coculturing of the NK cells and CD4 T cells activated by mosquito extracts induced expression of EBV lytic-cycle proteins in the NK cells. Furthermore, the expression of BZLF1, a viral lytic-cycle transactivator, was detectable at the skin lesion induced by scratch patch testing with mosquito extract. The EBV dna copy number levels in the plasma were elevated in systemic HMB symptoms compared with the normal condition. CONCLUSIONS: CD4 T cells are important for the primary skin reaction to mosquito bites and might play a key role in reactivation of latent EBV infection in NK cells. This viral reactivation contributed to the pathogenesis of the infectious mononucleosis-like systemic symptoms of HMB in our present case.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/8. Epstein-Barr virus-associated extranodal NK/T-cell lymphoma following mosquito bites in an elderly patient without prior hypersensitivity.We describe a 73-year-old woman who developed fever and inflammation with ulceration at the site of mosquito bites in the lower thigh. Soon she developed disseminated skin lesions characterized by redness, induration, and local heat. Some lesions showed necrosis and ulceration, including those located in the nasal cavity. She had no history of hypersensitivity to mosquito bites, and the serum IgE concentration was within the reference range. A skin biopsy specimen from the lower thigh adjoining the mosquito bites was diagnosed pathologically as showing extranodal NK/T cell lymphoma, nasal type. Southern analysis of the biopsy specimen showed an oligoclonal band representing Epstein-Barr virus (EBV) dna. bone marrow examination revealed infiltration by lymphoma cells and marked hemophagocytosis. The patient underwent three cycles of chemotherapy with carboplatin, etoposide, ifosfamide, and dexamethasone (DeVIC), but died of lymphoma progression during treatment. We speculate that, rather than an allergic reaction, this late-life occurrence of hypersensitivity to mosquito bites might represent lymphoproliferative disease induced by a direct action of mosquito salivary gland secretions on EBV- infected NK cells.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/8. Bullous allergic hypersensitivity to bed bug bites mediated by IgE against salivary nitrophorin.In Central europe, bites from the common bed bug (Cimex lectularius) are nowadays rather uncommon. Nevertheless, infestations are sometimes observed in old framehouses and by immigration due to international travel and migration. The clinical picture of bug bites substantially varies between individuals, depending upon previous exposure and the degree of an immune response. The host immune response and potential protein antigens present in the saliva of C. lectularius or specific antibodies have not been characterized thus far. We describe a patient with bullous bite reactions after sequential contact with C. lectularius over a period of 1 year. In skin tests, we observed immediate reactions to the salivary gland solution of C. lectularius, which were followed by a pronounced partially blistering late-phase response. Immunoblot analysis of the patient's serum with salivary gland extracts and recombinant C. lectularius saliva proteins revealed specific IgE antibodies against the 32 kDa C. lectularius nitrophorin, but not to 37 kDa C. lectularius apyrase. Our data demonstrate that bullous cimicosis may be the late-phase response of an allergic IgE-mediated hypersensitivity to C. lectularius nitrophorin.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
4/8. Chronic pruritic eruption in patients with acquired immunodeficiency syndrome associated with increased antibody titers to mosquito salivary gland antigens.Five of seven patients with acquired immunodeficiency syndrome (AIDS) who had pruritus and a chronic, nonspecific-appearing skin eruption had increased antibody titers to antigens in the salivary glands of aedes taeniorhynchus, a salt marsh mosquito common to South florida. We hypothesize that the pruritus and skin lesions in patients with AIDS represent a form of chronic "recall" reaction. Increased antibody titers to mosquito salivary gland antigens may be a consequence of nonspecific B cell activation, a feature of AIDS.- - - - - - - - - - ranking = 6keywords = gland (Clic here for more details about this article) |
5/8. tularemia in otolaryngologic practice. An analysis of 127 cases.Ulceroglandular, glandular, and oropharyngeal forms of tularemia may occur in otolaryngologic patients, frequently causing diagnostic difficulties. A retrospective analysis of 127 patients with serologically proved tularemia in the head and neck region is presented with special reference to diagnostic difficulties. Short case reports of six patients are included. Difficulties seemed to appear especially in the diagnosis of glandular tularemia. Oropharyngeal tularemia is easily confused with infectious mononucleosis. A high degree of suspicion of tularemia is recommended in endemic areas.- - - - - - - - - - ranking = 3keywords = gland (Clic here for more details about this article) |
6/8. immunoglobulins specific to mosquito salivary gland proteins in the sera of persons with common or hypersensitive reactions to mosquito bites.Using the immunoblot technique, we analyzed the quality and quantity of IgG, IgG4, and IgE specific to mosquito salivary gland (hereafter abbreviate as SG) components of aedes albopictus in the sera of volunteers with common reactions and of 3 patients with severe reactions. In the volunteers with delayed reactions only or with both delayed and immediate reactions, IgG against SG components of A. albopictus formed several faint or moderately stained bands. Those with immediate reactions showed several intense bands and many other weak bands. In volunteers, who had been bitten by aedes sp. frequently but had no skin reaction, and in severe cases, many intense IgG bands were observed. IgG4 bound to SG components were found in the sera of the common reaction group at the levels of 24 and 48 kD, but, in one severe case, no bands were observed, although the total IgG was very high. IgE levels specific to SG components were much higher in severe cases than in the volunteers. These results indicate that high titers of specific IgG and IgE and lack of IgG4 for particular components of SG may lead to severe allergic reactions in severe cases. immunoblotting analysis of the antibodies also verified the possibility of developing in vitro tests to identify causative species of the mosquito for severe cases.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
7/8. A quantitative study of specific immunoglobulins to mosquito salivary gland antigen in hypersensitive and common types of mosquito bite reaction.This study was designed with two purposes: first, to elucidate immunologic mechanisms in different cutaneous reactions, particularly in hypersensitivity to mosquito bites, and, second, to develop a more reliable and safer method of identifying the causative species of mosquito in severe cases. The amounts of IgG, IgG4 and IgE specific to the mosquito salivary gland extract of aedes albopictus were determined in the sera of 116 volunteers with normal reactions, either immediate or delayed, and 4 patients with severe systemic symptoms caused by mosquito bites. Titers of IgG and IgE in the severe cases were considerably higher than in volunteers with normal reactions, but there were no differences in IgG4 titers between the two groups. These results indicate that high titers of IgG and IgE may be involved in development of systemic symptoms in severe cases and verify the possibility of in vitro tests to identify causative species of the mosquito.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
8/8. Coexistent anaphylaxis to diptera and hymenoptera.BACKGROUND: anaphylaxis to the bite of diptera and specifically the bite of the Tabanidae family (horsefly) have been sparsely documented. The coexistent hypersensitivity to both the order diptera and hymenoptera has not been documented. methods: We present a patient who experienced anaphylaxis to both insect species. Venom skin testing and RAST revealed sensitivity to several members of the hymenoptera order. Prick, intradermal and RAST with whole body extracts of Tabanidae species is also documented in this patient. Twenty patients who are sensitive to hymenoptera and have been bitten by horseflies but have had no reaction to the horsefly bite were used as controls. RESULTS: An anaphylactic reaction to horsefly bite has been documented in a 56-year-old white male. This patient also demonstrated evidence of anaphylactic reaction to hymenoptera envenomation. In controls consisting of 20 patients with hymenoptera sensitivity, there was no clinical history of reaction to horsefly bite despite the presence of positive prick and/or positive intradermal tests and/or positive RAST to mixed Tabanidae species extract. CONCLUSIONS: Skin testing to horsefly by prick and/or intradermal testing using whole body insect extract is not useful in making a diagnosis of Tabanidae hypersensitivity. RAST using Tabanidae species as antigen is similarly useless in making a diagnosis of Tabanidae hypersensitivity. In vivo and in vitro diagnosis of horsefly hypersensitivity may be achieved when the salivary gland antigen of the horsefly becomes available.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |