Zimmerli W, Schaffner A, Scheidegger C, Scherz R, Späth P J
Department of Internal Medicine, University Hospital, Basel, Switzerland.
J Infect. 1991 Jan;22(1):59-69. doi: 10.1016/0163-4453(91)91010-u.
Host defence mechanisms were analysed in a patient with three episodes of fulminant pneumococcaemia and one episode of bacteraemic epiglottitis with Haemophilus influenzae type b. The first episode took place 11 years after splenectomy for blunt abdominal trauma. Investigations revealed several host defence mechanisms to be impaired. In addition to the patient's asplenia, an inherited C2-deficiency was noted. Assessment of IgG subclasses repeatedly revealed markedly low IgG4 concentrations. These were not due to an increased turnover of IgG4, as could be shown following infusion of intravenous IgG. In addition, IgG2 concentrations were low in the patient who lacked G2M(23). Opsonic mediating antibodies against type 23-F pneumococci were in the range of those of non-immune volunteers 6 months after vaccination with a 23-valent pneumococcal vaccine. These antibodies did not increase after a septic episode with 23-F capsular-type pneumococci. Neutrophil function was apparently normal.
对一名患有三次暴发性肺炎球菌血症和一次b型流感嗜血杆菌菌血症性会厌炎的患者的宿主防御机制进行了分析。首次发作发生在因钝性腹部创伤行脾切除术后11年。调查发现几种宿主防御机制受损。除了患者无脾外，还发现了遗传性C2缺乏。对IgG亚类的评估反复显示IgG4浓度明显降低。这并非由于IgG4周转率增加，静脉注射IgG后即可证明这一点。此外，缺乏G2M(23)的患者IgG2浓度较低。针对23 - F型肺炎球菌的调理介导抗体水平与接种23价肺炎球菌疫苗6个月后的非免疫志愿者相当。在发生23 - F荚膜型肺炎球菌败血症后，这些抗体并未增加。中性粒细胞功能显然正常。
