Sagamihara National Hospital Research Articles

Basophil Activation Marker CD203c Is Useful in the Diagnosis of Hen’s Egg and Cow’s Milk Allergies in Children

Background: The diagnosis of food allergy (FA) is usually based on oral food challenge tests (OFC). However, OFCs occasionally induce severe adverse reactions. CD203c expression on basophils is emerging as a potential diagnostic index. We evaluated whether CD203c expression on basophils would be a useful marker of OFC-associated symptoms in hen’s egg and cow’s milk allergies in children. Methods: Seventy-one patients who had been diagnosed with FA based on OFCs or a convincing history of FA symptoms in the Department of Pediatrics, Sagamihara National Hospital, were recruited. CD203c expression was assessed after stimulation with antigens (egg white, ovomucoid, milk or casein) using allergenicity kits. The CD203c stimulation index (SI = the allergen-induced CD203c expression level divided by the baseline expression level) and the threshold of CD203c expression (the minimum concentration of antigen to induce CD203c SI ≧2) were analyzed in association with tolerance acquisition. Results: For the CD203c SI, the areas under the receiver-operating characteristic curve were 0.72 for egg white, 0.82 for ovomucoid, 0.84 for milk and 0.67 for casein. The positive predictive value for the threshold of CD203c expression was 94.7% for egg white, 100% for ovomucoid, 85.7% for milk and 75.0% for casein. Conclusions: Assessment of food antigen-induced CD203c expression on basophils is useful to determine if children will outgrow FA as well as in decision making regarding whether or not to perform OFCs.

Henoch-Schönlein purpura in a patient with rheumatoid arthritis receiving etanercept

Auteur(s) : Akihiko Asahina1, Noboru Ohshima1, Hisanori Nakayama2, Akira Shirai1, Takuo Juji3, Toshihiro Matsui2 1Department of Dermatology 2Department of Rheumatology 3Department of Orthopedics, Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa 252-0392, Japan We report the case of a 61-year-old woman with a 28-year history of severe rheumatoid arthritis (RA), who developed Henoch-Schonlein purpura (HSP) while receiving etanercept. Since her RA [...]

Neutrophil CD64 as a marker of infection in patients treated with tocilizumab

Tocilizumab, a humanized antihuman interleukin-6 receptor antibody, has proven therapeutically effective for rheumatoid arthritis (RA) [1], systemic-onset juvenile idiopathic arthritis [2], Crohn’s disease [3] and Castleman’s disease [4]. However, infection is a major adverse effect of tocilizumab treatment. Inhibition by tocilizumab of interleukin-6 signaling in response to infection may also prevent fever induction and the elevation of acutephase reactants such as CRP. We previously reported that quantification of CD64 (FccR I) expressed on peripheral neutrophils is a useful marker for infection in patients with RA [5]. Neutrophil CD64 expression can be upregulated by complications due to vasculitis or interstitial pneumonia, but it is not affected by the disease activity of RA. Upregulation of CD64 on neutrophils can be observed in infections caused by any kind of pathogen, such as bacteria, viruses, fungi, and mycobacteria [5]. Based on this background information, we monitored neutrophil CD64 in an RA patient undergoing treatment with tocilizumab for 4 years who had repeatedly suffered from different infections but had little fever or elevated CRP (Fig. 1). A 53-year-old female patient with RA received tocilizumab (8 mg/kg, every 4 weeks) starting July 2003 in a clinical trial. She responded with a decrease in her clinical disease activity index (CDAI; from 148 in July to 93 in September to 35 in December of 2003), and her CRP remained less than 0.02 mg/dl. In January 2004, she had gastroenteritis with fever (38.4 C) and increased CRP (4.16 mg/dl). In February 2004, she complained of mild sore throat and slight fever (37.2 C). We suspected the common cold, but influenza A antigen in a pharyngeal swab tested positive by immunological detection. Although CRP was not elevated (0.05 mg/dl), neutrophil CD64 was increased to 5500 molecules/cell (normal range \2000 [5]). Thereafter, she suffered bronchitis and upper respiratory tract infection without fever or increased CRP, but again with upregulated CD64 (approximately 2800 molecules/cell). Afterwards, despite repeatedly suffering different infections (upper respiratory tract infection, bronchitis, gastroenteritis), she remained afebrile without CRP elevation except for the periods when the tocilizumab treatment was interrupted between clinical trials (CDAI flared up to 133) and for sinusitis surgery. Both of these occasions were accompanied by transient RA flares. CD64 levels remained at 400–1000 molecules/cell during periods without infection, but each infectious episode led to [50% elevation from the baseline, although it did not necessarily exceed the normal upper limit. In this RA patient, tocilizumab masked fever and elevation of CRP in all infectious episodes except the first gastroenteritis. When treating patients with this agent, we must keep in mind its possible masking of the signs of infection, which could lead to a delay in diagnosis. Monitoring neutrophil CD64 may facilitate the early detection of infection by using the definition of ‘‘CD64 T. Matsui (&) A. Komiya K. Shimada H. Nakayama S. Tohma Department of Rheumatology, Sagamihara National Hospital, National Hospital Organization, 18-1 Sakuradai, Sagamihara, Kanagawa 228-8522, Japan e-mail: t-matsui@sagamihara-hosp.gr.jp

Yasuichi nagano (1906-1998)

Journal of Interferon & Cytokine ResearchVol. 20, No. 11 ObituaryYasuichi Nagano (1906–1998)Dr. Jiro ImanishiDr. Jiro ImanishiSearch for more papers by this authorPublished Online:7 Jul 2004https://doi.org/10.1089/10799900050198354AboutSectionsPDF/EPUB ToolsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail "Yasuichi Nagano (1906–1998)." , 20(11), p. 925FiguresReferencesRelatedDetailsCited ByCelebrating the 50th Anniversary of the Discovery of Interferon Philip I. Marcus31 January 2007 | Journal of Interferon & Cytokine Research, Vol. 27, No. 2 Volume 20Issue 11Nov 2000 To cite this article:Dr. Jiro Imanishi.Yasuichi Nagano (1906–1998).Journal of Interferon & Cytokine Research.Nov 2000.925-925.http://doi.org/10.1089/10799900050198354Published in Volume: 20 Issue 11: July 7, 2004PDF download

アデノウイルス感染症に関する研究

The status of adenovirus infections in this country was studied by analysis of patients with acute respiratory infections and other diseases by the complement fixation test. The antigen employed was prepared from HeLa cell culture infected with Type 3 adenovirus. The patients studied were those at the Sagamihara National Hospital, Kanagawa. The incidence of the antibody was studied on 571 patients without respiratory infections in September and October, 1957. The positive rate increased with age and reached a plateau at the age of 17-20 years with some decrease in higher age groups. No significant difference in incidence was observed between male and female. The longer the period in hospital was, the higher the incidence was. In the test on 108 cases of primary atypical pneumonia and 180 cases of upper respiratory infections from April, 1957, to December, 1958, the incidence of the patients with titers of 1:8 or higher was 40.7 and 47.8per cent, respectively, much higher than the control group of patients with other diseases whose incidence was 21.5per cent. In those two groups of patients no difference in incidence distribution by age or sex was observed. Patients with a definite increase and/or decrease in titer (four-fold or greater) were found in 13.6per cent of 81 cases with primary atypical pneumonia and in 21.6per cent of 88 cases with upper respiratory infections. Among patients in which appropriate serum specimens were available in the first and the 3rd-6th week of disease, the detection rate was 25.0per cent of 12 cases and 31.4per cent of 35 cases, respectively. The clinical picture and the appearance and persistence of the antibody was analysed with those serologically diagnosed cases. The cases were found throughout the year, although some difference was noticed between 1957 and 1958.

Statistical Observation of Malignant Tumorat Surgical Department of Sagamihara National Hospital

Statistical Observation of Malignant Tumorat Surgical Department of Sagamihara National Hospital