Immunoregulatory T cell abnormalities in mucocutaneous lymph node syndrome

We recently demonstrated that during the acute phase of mucocutaneous lymph node syndrome (MCLS)3 there was a significant reduction in circulating T8+ suppressor/cytotoxic T cells and an increased number of Ia/Dr-bearing T4+ T cells, which suggests the presence of circulating activated helper T cells (1). Furthermore, the vast majority of patients with acute MCLS had a significantly elevated number of circulating B cells spontaneously secreting IgG and IgM. In the present study, the possible role of the immunoregulatory T cell abnormalities in the polyclonal B cell activation was investigated by assaying the ability of T cells and T cell factors from patients with acute MCLS to induce immunoglobulin production by normal B lymphocytes. We also examined the capacity of normal T cells to suppress immunoglobulin production by activated B cells from patients with acute MCLS.     

Experimental candida-induced arteritis in mice. Relation to arteritis in the mucocutaneous lymph node syndrome.

An extract of Candida albicans isolated from a patient with typical mucocutaneous lymph node syndrome (MCLS) can produce coronary arteritis in a mouse when injected intraperitoneally. An unusual feature of this arteritis is that it is granulomatous, shows no fibrinoid change and is confined to the coronary arteries. These characteristics are quite similar to those found in patients with MCLS.     

Mucocutaneous lymph node syndrome in Canada.

Two Edmonton children recently had a disease seemingly new to North America but a common problem in young children in Japan in the last few years. Named "mucocutaneous lymph node syndrome", it is an acute febrile condition with massive focal cervical lymphadenopathy, conjunctivitis and indurative edema of the hands and feet progressing to desquamation. It may have an infectious basis and therefore may become common in Canada.     

Asteroid bodies in a lymph node aspirate. A case report

BACKGROUND: Sarcoidosis, a multisystem disease with tbe potential to occur at any site, has varied clinical manifestations. Cutaneous lesions, seen in one-third of patients, may precede systemic manifestations. Identification of asteroid bodies in aspirated material may aid early diagnosis in the appropriate clinical setting. CASE: A 37-year-old woman had multiple asymptomatic, buff-colored, sucutaneous nodules, 0.5-1.0 cm in diameter, on the scalp, face, dorsum of the wrist and back of the elbows for 2 months. On examination, firm, nontender right inguinal and epitrochlear lymphadenopathy, 2 x 1 cm each, was detected. The epitrochlear lymph node aspirate showed noncaseating epithelioid granulomas, multinucleate giant cells and asteroid bodies. Subsequent biopsy of 1 of the subcutaneous nodules corroborated the aspiration cytology findings. Following the diagnosis of sarcoidosis, other investigations were done. Erythrocyte sedimentation rate was 66 mm at the end of 1 hour, Mantoux test was negative, and chest radiograph showed bilateral reticulonodular shadows. Angiotensin-converting enzyme level was significantly elevated. CONCLUSION: This case draws attention to 1 of the rare cytologic findings of sarcoidosis. Differentiation from other granulomatous lesions, especially when special stains are negative, is difficult. In our case, a lymph node aspirate showing asteroid bodies in a background of granulomatous inflammation supported the diagnosis.     

Yellow-nail syndrome: report of three cases.

The yellow nail syndrome, a combination of yellow discolouration of and dystrophic changes in the nails, pleural effusions and lymphedema, is thought to be relatively rare; to date 44 cases have been reported. Of a further three patients with this syndrome, one had all three features, one had the yellow nails alone and the other had pleural effusions and lymphedema without classic nail changes. Each had recurrent lower respiratory tract infections; and of all 47, chronic pulmonary infections occurred in approximately one quarter and were frequently associated with chronic sinus infections. The underlying abnormality is presumed to be a congenital defect of the lymphatics, but so far this has not been demonstrated to be the cause of the nail changes, the pathogenesis of which remains obscure.