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Title: 遅延型皮膚反応の低下を伴ったつつがむし病の一症例
Other Titles: A Case Infected with Rickettsia tsutsugamushi Accompanied by Transient Depression of Delayed-Type Hypersensitivity
Authors: 鈴木, 寛 / 氷武, 毅 / 隆杉, 正和 / 吉田, 俊昭 / 松本, 慶蔵
Authors (alternative): Suzuki, Hiroshi / Nagatake, Tsuyoshi / Takasugi, Masakazu / Yoshida, Toshiaki / Matsumoto, Keizo
Issue Date: 30-Jun-1986
Publisher: 長崎大学熱帯医学研究所 / Institute of Tropical Medicine, Nagasaki University
Citation: 熱帯医学 Tropical medicine 28(2). p115-122, 1986
Abstract: つつがむし病の一症例において,その増悪期間中に遅延型皮膚反応の低下が一過性に検出された.この現象は麻疹,インフルエンザ,ムンブス,風疹,重症結核,全身性真菌症,伝染性単核球症,水痘ではすでに観察されているが,つつがむし病においては未だ報告されていない.我々の症例の遅延型皮膚反応は,発症13日で陰転化し,40日目で正常に復した.遅延型皮膚反応低下中の免疫学的分析では,末梢血中リンパ球のうち,OKT3およびOKT4が減少し,OKIalが増加していたが,PHA, ConAおよびPWMに対するリンパ球増殖反応は正常で,さらに血清中の免疫グロブリン(IgG,IgM,IgA)産生量にも抑制は認められなかった.これらの成績より,遅延型皮膚反応のメカニズムを説明することは困難であるが,つつがむし病増悪期間中に細胞性免疫が低下し,ひいては細胞性免疫に関与する感染症発現の可能性が示唆された. / Transient depression of intradermal skin test to purified phytohemagglutinin (PHA) and purified protein derivative (PPD) was observed in a case infected with Rickettsia tsutsugamushi (R. tsutsugamushi). This transient depression has already been observed in some of infectious diseases as well as in viral vaccine in human, but not in R. tsutsugamushi infection. In this case of R. tsutsugamushi infection the intradermal skin test became normal after 40 days of proper therapy for this infection. In immunological analysis of lymphocytes in peripheral blood OKT3 and OKT4 decreased and OKIal increased, while lymphocyte proliferation test using PHA, concanavalin A (ConA) and pokeweed mitogen (PWM) was almost normal and suppression of immunoglobulins in serum was not detected. Although the microorganism of R. tsutsugamushi were not isolated, the diagnosis was done from the clinical symptoms and laboratory data. However, the mechanism of this transient depression of delayed-type hypersensitivity (DTH) is not yet well known.
URI: http://hdl.handle.net/10069/4443
ISSN: 03855643
Type: Departmental Bulletin Paper
Appears in Collections:Volume 28, No. 2

Citable URI : http://hdl.handle.net/10069/4443

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