Unusual immunologic alterations in sarcoidosis during repeated Kveim testing |
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| Authors: | T Putkonen E J Jokinen K K Mustakallio |
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| Affiliation: | 1. Department of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China;2. Key Laboratory of Liver and Kidney Diseases, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China;3. TCM institute of kidney disease, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China;4. Shanghai Key Laboratory of Traditional Chinese Clinical Medicine,Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China;1. Department of Ophthalmology, Second Xiangya Hospital of Central South University, Changsha, Hunan Province, People''s Republic of China;2. Institution of Ophthalmic Center, Second Xiangya Hospital of Central South University, Changsha, Hunan Province, People''s Republic of China;1. Pôle de psychiatrie et d’addictologie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours cedex 9, France;2. Département de psychologie, EA 2114 « psychologie des âges de la vie », université François-Rabelais de Tours, 3, rue des Tanneurs, 37041 Tours, France;3. Service de médecine légale, hôpital Trousseau, CHRU de Tours, 37044 Tours cedex 9, France;4. UMR Inserm U930 ERL, université François-Rabelais de Tours, parc de Grandmont, 37200 Tours, France |
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| Abstract: | A thirty-eight year old woman, suffering from lymphonodal sarcoidosis, displayed exceptionally strong, rapid skin responses to several Kveim antigens, including an autologous antigen. During the initial Kveim tests the number of plasma cells in her lymph nodes increased, and marked hypergammaglobulinemia ensued. At the same time her blood showed a profound monocytosis and reactivity in flocculation tests for syphilis and in the latex flocculation test for rheumatoid factor.On the day following the second test with the most potent Kveim antigen, her blood displayed marked eosinophilia and strong complement-fixing activity against this antigen. During prednisone treatment the eosinophil count dropped abruptly, while flocculation reactions for syphilis disappeared more gradually, simultaneously with normalization of the level of gamma globulins and regression of Kveim papules and lymph nodes to a nonpalpable state. The serum, however, retained its complement-fixing activity against the repeatedly tested Kveim antigens for a longer time.The interrelations of these unusual immunologic alterations and their connection with repeated Kveim testing are discussed. |
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