Devictor D, Fischer A, Mamas S, de Saint Basile G, Durandy A, Buriot D, Griscelli C
Arch Fr Pediatr. 1982 Mar;39(3):135-40.
We report 8 cases of familial lymphohistiocytosis collected in 6 families. Several data argue for an hyperactivation of the reticuloendothelial system (RES). An abnormal visualization of all organs was observed in a scintigraphic study after 99technetium labelled red blood cells injection. Blood monocytes contained very low peroxidase activity as detected by cytoenzymology and secreted large quantities of prostaglandin E2 (PGE2). Adherent cells isolated from blood exercised a strong suppressor effect on the proliferation of normal lymphocytes induced by phytohemaglutinin. This effect was reduced by indomethacin and therefore appears PGE2-dependent. One patient's serum exerced an inhibitory activity on antigen-induced proliferation of normal lymphocytes and on mixed leucocyte reaction. In contrast, cellular and humoral functions were not deeply impaired. The hyperactivation of the RES remains unexplained and not related to a graft versus host reaction, which could be excluded in 3 of our patients. Therapeutic attempts were not efficient, all patients dying despite steroid, vincaleucoblastin and indomethacin therapy.
我们报告了在6个家庭中收集到的8例家族性淋巴细胞组织细胞增生症病例。多项数据支持网状内皮系统(RES)的过度激活。在注射99锝标记的红细胞后进行的闪烁扫描研究中,观察到所有器官的显像异常。通过细胞酶学检测发现,血液单核细胞中的过氧化物酶活性非常低,并分泌大量前列腺素E2(PGE2)。从血液中分离出的贴壁细胞对植物血凝素诱导的正常淋巴细胞增殖具有强烈的抑制作用。吲哚美辛可降低这种作用,因此该作用似乎依赖于PGE2。一名患者的血清对正常淋巴细胞的抗原诱导增殖和混合淋巴细胞反应具有抑制活性。相比之下,细胞和体液功能并未受到严重损害。RES的过度激活原因不明,且与移植物抗宿主反应无关,在我们的3例患者中可以排除该反应。治疗尝试均未取得成效,尽管使用了类固醇、长春新碱和吲哚美辛治疗,所有患者均死亡。