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Immunosuppressive Conditions (immunosuppressive + condition)

Distribution by Scientific Domains

Medical Sciences	83%

Selected Abstracts

Visceral leishmaniasis: a threat to immunocompromised patients in non-endemic areas?

CLINICAL MICROBIOLOGY AND INFECTION, Issue 8 2007
M. Weisser
Abstract Visceral leishmaniasis is rare in western Europe, but may be life-threatening in immunocompromised patients. It is therefore important to understand the incidence of the disease in a non-endemic area and its relationship with immunosuppressive conditions. Between 1990 and 2005, 12 patients were diagnosed with leishmaniasis at Basel University Hospital, Switzerland. Eleven presented with visceral symptoms and ten had an underlying immunosuppressive condition. Since increasing numbers of immunosuppressed patients have a history of travel to endemic countries, an association of visceral leishmaniasis with cellular immunosuppression (other than that associated with human immunodeficiency virus) might become more frequent in non-endemic areas. [source]

Fulminant hepatitis after allogenic bone marrow transplantation caused by reactivation of hepatitis B virus with gene mutations in the core promotor region

EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 3 2006
Kiyoshi Kitano
Abstract:, Under immunosuppressive conditions after hematopoietic stem cell transplantation (HSCT), even if hepatitis B virus (HBV) antigen is negative but hepatitis B surface antibody (HBsAb) or hepatitis B core antibody (HBcAb) is presented, HBV reactivates and sometimes causes fulminant hepatitis. However, it remains unclear which patients will develop fulminant hepatitis, or whether fulminant hepatitis is caused by host-related factors or by virus-related factors. A 30-yr-old man with a history of aplastic anemia since 3 yr of age underwent allogenic BMT, when HBsAb and HBcAb were positive but HBs antigen (HBsAg) was negative. The donor was negative for HBsAg, HBsAb and HBcAb. After transplantation, the patient was complicated by acute graft-vs.-host disease (GVHD), cytomegalovirus infection, intestinal thrombotic microangiopathy and aspergillus colitis. Chronic GVHD was well controlled by FK506 and prednisolone. Twenty months after transplantation, the patient was admitted with general fatigue and liver dysfunction and was found to be positive for HBsAg and HBeAg. His serum HBV-DNA level was >8.8 log of the genome equivalent (LGE)/mL. Therefore, he was diagnosed as having hepatitis B caused by HBV reactivation and 100 mg/d lamivudine treatment was started. However, jaundice and hepatic failure deteriorated and became fatal. On analysis of the HBV-DNA, two adjacent gene mutations in the core promoter region (T1762/A1764) were detected. Increased replication of the mutated HBV might have caused HBV reactivation which progressed to fulminant hepatitis. [source]

Lymphoproliferative disorders in autoimmune diseases in Japan: Analysis of clinicopathological features and Epstein-Barr virus infection

INTERNATIONAL JOURNAL OF CANCER, Issue 3 2004
Yoshihiko Hoshida
Abstract Lymphoproliferative disorders (LPD) occasionally develop in individuals with immune deficiencies such as immunosuppressive conditions and autoimmune diseases (AID). In our study, the clinicopathologic features and virus status were analyzed in 53 cases with LPD developing in rheumatoid arthritis (RA) and other AID. AID in only 4 of 53 patients had been treated with some sort of immunosuppressive therapy, including methotrexate. Median age at the diagnosis of LPD in AID was 60 years old with marked female predominance (M/F = 0.4). The median interval between the onset of AID and LPD development was 45 months, and longer in RA patients than in other AID (p < 0.01). The primary site of lymphoma was nodal in 21 cases and extra-nodal in 24, with clinical Stage I in 17, II in 5, III in 13, and IV in 13. Immunohistochemistry showed that 39 cases were B cell type, 10 were T cell type and 4 were Hodgkin lymphoma (HL). Then majority of B cell cases were diffuse large B cell lymphomas, and 2 were diffuse polymorphic type. EBER-1 in situ hybridization for Epstein-Barr virus (EBV) showed positive signals in tumor cells in 16 of 53 (30.2%) cases. The EBV-positive rate in T cell LPD (70%) was much higher than that in B cell LPD (12.8%) (p < 0.01). All 4 cases of HL were EBV-positive. Immunohistochemistry showed a latency II pattern of EBV infection (LMP-1+ and EBNA-2,). Five-year overall survival rate was 33%. Multivariate analysis showed that only type of AID was an independent factor for survival of patients, i.e., LPD in RA showed the most favorable prognosis. In conclusion, LPD in AID generally shared common features with sporadic LPD except for a much higher EBV-positive rate in T cell LPD. © 2003 Wiley-Liss, Inc. [source]

Epidemiology of varicella-zoster virus in England and Wales

JOURNAL OF MEDICAL VIROLOGY, Issue S1 2003
M. Brisson
Abstract Many countries are studying currently the possibility of mass vaccination against varicella. The objective of this study was to provide a complete picture of the pre-vaccine epidemiology of the Varicella-Zoster Virus in England and Wales to aid in the design of immunisation programs. Population-based data including general practitioner sentinel surveillance, hospitalisation data, and death certificates from England and Wales were analysed. The average incidence rates for varicella and zoster between 1991 and 2000 were 1,291 and 373 per 100,000 years, respectively. Overall hospitalisation rates were equal for varicella and zoster (4.5 vs. 4.4 hospitalisation per 100,000 population) with 5 and 8%, respectively, having underlying immunosuppressive conditions. The age-specific proportion of cases hospitalised and length of stay were similar between the two diseases. However, the overall burden of disease is considerably higher for zoster. The number of inpatient days and case-fatality due to zoster are roughly 4 to 6 times greater than for varicella (11 vs. 3 days and 25 vs. 4 deaths per 100,000 case). These results provide base-line estimates should mass varicella vaccination be introduced in England and Wales. J. Med. Virol. 70:S9,S14, 2003. © 2003 Wiley-Liss, Inc. [source]

Natural Killer Cells and the Immune Response in Solid Organ Transplantation

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 6 2010
W. Van Der Touw
Natural killer (NK) cells have been characterized classically for their cytotoxicity against pathogen infected or stressed cells as well as for their role in monitoring the expression of self MHC I. However, the participation of NK cells in solid organ transplantation (SOT) is poorly defined due to conflicting clinical and animal model data. Preclinical models have shown that NK cells exacerbate T-cell allogeneic responses during rejection, but can also promote tolerance induction under immunosuppressive conditions. Further, while protocols such as costimulatory blockade effectively induce tolerance by blocking T-cell activation and promoting Treg generation, how such regimens regulate other innate and adaptive immune cells, including NK cells, is incomplete. This review examines NK cells and the regulation of their effector functions in SOT. [source]