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Biomedical subjects

S Fikrig

Publications and source records attributed to S Fikrig.

At least 37 records · Page 2Linked to original sources
PubMed1990

Acyclovir-resistant varicella zoster virus infection after chronic oral acyclovir therapy in patients with the acquired immunodeficiency syndrome (AIDS).

Four patients with human immunodeficiency virus (HIV) infection who received chronic oral acyclovir therapy for suppression of recurrent varicella zoster or herpes simplex virus infection developed persistent disseminated hyperkeratotic papules that failed to heal with intravenous or high-dose oral acyclovir therapy. Varicella zoster virus, resistant to acyclovir in vitro, was isolated from skin lesions of all four patients. Three patients were adults in whom the acquired immunodeficiency syndrome (AIDS) had been diagnosed 12 to 20 months before isolation of acyclovir-resistant varicella zoster virus. The fourth patient was a perinatally HIV-infected child who developed primary varicella infection at age 7 years when profoundly immunosuppressed (absolute CD4+ lymphocyte count less than 50 cells/microL). Mean antiviral susceptibilities (ED50 values) of the four clinical isolates compared with the ED50 values of the reference strain Oka were 85 compared with 3.3 mumol/L for acyclovir, 1.4 compared with 0.8 mumol/L for vidarabine, and 123 compared with 117 mumol/L for foscarnet. When assayed by [125I]-dC plaque autoradiography, 90% to 100% of the viral isolate populations had altered or no measurable thymidine kinase function. Acyclovir-resistant varicella zoster virus infection may complicate long-term oral acyclovir administration in patients with AIDS and may be associated with the appearance of atypical hyperkeratotic papules.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Lack of evidence for craniofacial dysmorphism in perinatal human immunodeficiency virus infection.

Thirty children perinatally exposed to human immunodeficiency virus (HIV) infection and 30 healthy control subjects matched for age, sex, and race were evaluated for growth, head size, craniofacial dysmorphism, dermatoglyphics, and other physical features. Thirteen patients met the criteria for group IV (constitutional, neurologic, and secondary infectious diseases), 14 for group III (persistent generalized lymphadenopathy or hepatosplenomegaly), and three for group II (asymptomatic infection) of the classification of HIV infection established by the Centers for Disease Control, Atlanta. Postnatal growth failure and microcephaly, observed in a significant proportion of patients (46.7% and 30%, respectively), could be attributed to chronic illnesses and to progressive central nervous system lesions in HIV-infected patients. There were however, no significant differences between patients and controls with regard to the incidence of craniofacial features and dermatoglyphics, and the incidence of other anomalies was not different from that expected in the population. The patients born to drug-using mothers were not different from those born to non-drug-using mothers in relation to the studied criteria. We could not confirm the presence of characteristic craniofacial dysmorphism in children exposed to perinatal HIV infection.

Abnormalities, Multiple↗
PubMed1987

Polyclonal polymorphic B-cell lymphoproliferative disorder with prominent pulmonary involvement in children with acquired immune deficiency syndrome.

Four cases of pediatric Acquired Immune Deficiency Syndrome (AIDS) with lymphoproliferative disorder are described and other lymphoid lesions in previously reported cases of pediatric AIDS are reviewed. The lymphoproliferative disorder was characterized by polyclonal, polymorphic B-cell content without evidence of cellular atypia, necrosis or prominent mitotic activity but with predominantly extranodal systemic and prominent pulmonary involvement. Since the lesion has overlapping features it is considered to be intermediate between benign and malignant lymphoproliferations and designated as polyclonal, polymorphic B-cell lymphoproliferative disorder (PBLD) of pediatric AIDS. The PBLD is part of a spectrum of lymphoid lesions in pediatric AIDS consisting of follicular lymphoid hyperplasia of nodal and extranodal sites, pulmonary lymphoid hyperplasia/lymphoid interstitial pneumonitis complex (PLH/LIP complex) in cases previously reported by the authors, and also malignant lymphoma reported by others. It is possible that Epstein-Barr virus (EBV) by itself or in synergism with human T-lymphotropic virus-type III (HTLV-III) is related to pathogenesis of PBLD in children with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Children with AIDS--is pathologic diagnosis possible based on chest radiographs?

In a review of the clinical, radiographic and pathologic data of 36 patients with AIDS we found 29 with pulmonary infections (Cytomegalic virus, Pneumocystis carinii, etc.) and 7 who had varying types of lymphocytic infiltration and interstitial changes on chest radiographs but did not have opportunistic infection. Pathologic diagnosis included lymphocytic interstitial pneumonitis, bronchus associated lymphoid tissue, chronic interstitial pneumonitis, desquamative interstitial pneumonitis and immunoblastic sarcoma. The chest X-rays were not predictive in making a specific diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS-related complex.

Thirty-four children have been cared for at SUNY-Health Science Center at Brooklyn with diagnoses of either acquired immunodeficiency syndrome (AIDS) or AIDS-related complex. Reported here are descriptions of pregnancies resulting in these children. Few of the mothers (four of 32) were symptomatic; however, low birth weight (11 of 34), preterm birth (11 of 34), and premature rupture of membranes (ten of 32) were common. Of 33 patients whose mode of delivery was known, cesarean section was used in ten cases, including one elective repeat. Among mothers who had children before their affected offspring, the average birth weight of the older children significantly exceeded that of the affected (3241 +/- 508 versus 2712 +/- 722 g, P less than .05). The affected child's age at onset of symptoms did not correlate with birth weight, mode of delivery, or status of membranes at the onset of labor.

AIDS-Related Complex↗
PubMed1987

Pregnancies resulting in infants with acquired immunodeficiency syndrome or AIDS-related complex: follow-up of mothers, children, and subsequently born siblings.

Although several hundred cases of acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) in infants have been reported, there is little information available concerning the follow-up of mothers and these children or subsequently born children. Thirty-four children with perinatally acquired AIDS and ARC (19 AIDS; 15 ARC) have been followed at the Downstate Medical Center. Although no mother had AIDS or ARC during her pregnancy, after an average follow-up (+/- SD) of 27.8 +/- 21.6 months, five had AIDS and ten had ARC. For 22 of the mothers, T4/T8 ratios were obtained; 15 of these were less than 1, and five were between 1 and 1.5. Among 11 subsequently born siblings for whom HTLV-III antibody status was known, four were positive; of these, two had ARC and one had AIDS. We conclude that the diagnosis of AIDS or ARC in a child indicates a risk for the development of illness in the mother and subsequently born siblings.

AIDS-Related Complex↗
PubMed1986

Spectrum of human T-cell lymphotropic virus type III infection in children. Recognition of symptomatic, asymptomatic, and seronegative patients.

This study was done to gain insight into the clinical spectrum and immunologic disturbances resulting from infection with the human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) in children. Serum antibody to p41 antigen of HTLV-III and/or direct evidence of HTLV-III in lymphocytes was considered indicative of HTLV-III/LAV infection. In 36 children with HTLV-III/LAV infection, a wide clinical spectrum was noted, ranging from asymptomatic (seven children) to symptomatic, the latter including 14 children with the acquired immunodeficiency syndrome. Microcephaly was noted in five symptomatic infants. Immunologic dysfunction was noted in all symptomatic and in two asymptomatic children. Panhypogammaglobulinemia was noted in one child. Two asymptomatic children who were HTLV-III antibody negative had virologic evidence of HTLV-III infection. All of 20 mothers who were studied were HTLV-III antibody positive and had immunologic abnormalities but only nine were symptomatic, indicating that apparently healthy women may transmit HTLV-III/LAV infection to their offspring.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Low circulating thymulin-like activity in children with AIDS and AIDS-related complex.

Thymic secretory function was assessed by determining levels of circulating thymulin-like activity in plasma of 21 pediatric patients infected with the HTLV-III/LAV retrovirus. All the patients had serum antibodies against p41 antigens of HTLV-III on Western blot analyses. In accordance with the latest definition established by the Centers for Disease Control, 14 patients had the acquired immunodeficiency syndrome (AIDS) and the remaining 7 were classified as having AIDS-related complex. Their ages ranged from 1 to 7 years, with 10 being less than 1 year of age. Circulating thymulin activity, normally highest in healthy children under 15 years of age, was undetectable in 11 patients and below normal range for age in the remaining. OKT4/OKT8 ratios of T-cell subsets in peripheral blood were below normal in the majority of patients. Our findings suggest that thymic epithelial injury may be an early event in HTLV-III/LAV-related disease and may precede the development of clinical and/or immunologic aberrations.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Pediatric acquired immunodeficiency syndrome: demonstration of B lymphocyte defects in vitro.

Acquired immunodeficiency syndrome (AIDS) in childhood is characterized by recurrent bacterial infections, a feature common in antibody deficiency disorders. The present study was aimed at investigating B lymphocyte function in 15 children aged 6 months to 6 years with AIDS or AIDS-related complex (ARC). Spontaneous secretion of immunoglobulins by freshly isolated peripheral blood B cells and the generation of immunoglobulin and antibody-secreting cells in lymphocyte cultures after polyclonal and antigenic stimulation were quantified in hemolytic plaque assays. Despite excessive spontaneous immunoglobulin secretion, responses elicited by B cells after in vitro stimulation were depressed in these children. Responses to T-dependent as well as to T-independent stimuli were affected. Studies of immunoregulatory T cells and intrinsic B cell function suggested that deficient precursor B cells and abnormal immunoregulation contributed to the defects in B cell differentiation. These findings indicate that B lymphocyte dysfunction is an integral feature of HTLV III infection in children who clinically present as either AIDS or AIDS-related complex.

Acquired Immunodeficiency Syndrome↗
PubMed1985

The effect of Chlamydia trachomatis on luminol-dependent chemiluminescence of human polymorphonuclear leukocytes: requirements for opsonization.

The factors involved in the in vitro interaction of two strains of Chlamydia trachomatis with polymorphonuclear leukocytes were studied by employing the technique of luminol-dependent chemiluminescence. Unopsonized, partially purified elementary bodies of chlamydia failed to induce a significant chemiluminescence response when compared with serum-activated zymosan (less than 90%). Opsonization of the chlamydia with human sera greatly enhanced the chemiluminescence response. This enhancement was independent of the presence or absence of antibody specific for chlamydia or of complement. Primate serum had 77% of the activity of human serum; nonprimate sera (sheep, cow, horse, and rabbit) demonstrated substantially less activity. The magnitude of the chemiluminescence response observed with opsonized chlamydia was also dependent on the chlamydia-to-polymorphonuclear leukocyte ratio, with the greatest effect seen at 10:1. Chlamydia opsonized with human sera containing less than 100 mg of IgG/dl did not stimulate chemiluminescence more than did unopsonized chlamydia. These results suggest that human IgG may interact with C. trachomatis independent of specific antibody-binding sites.

Animals↗
PubMed1984

Persistence of protective pneumococcal antibody following vaccination in patients with the nephrotic syndrome.

We have determined the level of persisting pneumococcal antibody in a group of nephrotic children vaccinated by us 5 years ago. Of the 19 vaccinated children, 2 have died and 1 has moved away. Sera from the remaining 16 patients were examined by radioimmunoassay to determine the antibody response to 11 of the 14 types contained in the polyvalent pneumococcal vaccine. The lowest protective level of geometric mean titre (GMT) of antibody in our laboratory is 300 ng antibody nitrogen per millilitre. 56% (9/16) of the patients showed adequate GMT 5 years after vaccination. All 9 patients had minimal change nephrotic syndrome. 44% (7/16) of the children had a GMT less than 300 ng antibody nitrogen per millilitre. 3 of these patients had focal sclerosis, 3 had membranoproliferative glomerulonephritis, and 1 patient had IgM nephropathy. Of these 7 patients, 1 with the lowest GMT (23 ng antibody nitrogen per millilitre) developed pneumococcal peritonitis. During this same period, in 20 other unvaccinated nephrotic patients followed continuously from 1976 to 1981, 7 cases of pneumococcal peritonitis occurred (p less than 0.05). Additionally, 1 unvaccinated child died of pneumococcal sepsis. Our study indicates that patients with minimal change nephrotic syndrome continue to maintain adequate amounts of antibody, but those with disease other than minimal change nephrotic syndrome are unable to maintain an adequate level of antibody.

Adolescent↗
PubMed1983

Lupus nephritis in black and Hispanic children.

We studied the long-term outcome of lupus nephritis in 23 black and Hispanic children. The follow-up period ranged from two to 16.5 years, with a mean follow-up of 5.4 years. The mean age at onset was 10.1 years, which is younger than that described in recent series of children with lupus nephritis. All patients had renal involvement, including four normotensive patients with normal renal function and normal urinary sediment. When children whose disease started before the age of 10 years were compared with patients older at onset, there were no significant differences regarding the type of lesion or duration of therapy, but a higher incidence of renal death (.02 less than P less than .05) was noted in younger children. Overall, 25% of our patients have died of renal causes, and another 25% have been undergoing dialysis, receiving transplants, or in chronic renal failure. The mortality in our series was higher than that reported in other series of children with lupus nephritis in recent years. Age and race may be acting synergistically to produce the higher mortality and morbidity.

Age Factors↗
PubMed1983

Reversal of neutropenia with intravenous gammaglobulin in autoimmune neutropenia of infancy.

Intravenous gammaglobulin (IVIgG) was used to treat autoimmune neutropenia of infancy in two males with repeated infections. The neutrophil count increased significantly in both patients with the initial IVIgG therapy; 1 patient went into remission. The neutrophil count in the other remained above baseline for 3 wk, and a subsequent booster infusion also caused the neutrophil count to increase. The patients have remained clinically well since their treatment began. Serial studies of antineutrophil antibody and serum lysozyme, performed to elucidate the mechanism of action, suggested decreased neutrophil destruction, perhaps by Fc receptor blockade, as well as decreased synthesis of antineutrophil antibody. Neutrophil function was not impaired after the neutrophil count increased. Many patients with immune neutropenia have a benign course, but those who have significant infections could be treated, acutely or prophylactically, with intravenous gammaglobulin.

Agranulocytosis↗
PubMed1983

Autologous mixed lymphocyte reaction in man. VI. Deficiency of autologous mixed lymphocyte reaction in type I (insulin-dependent) diabetes mellitus.

Autologous mixed lymphocyte reaction (AMLR) was examined in the peripheral blood from 20 patients with type I (insulin-dependent) diabetes mellitus. Six of 20 patients demonstrated deficient AMLR when compared to the range for simultaneously studied age and sex matched healthy controls. The kinetics of AMLR with regard to duration of the peak proliferative response was similar to controls, the peak response being on day 6. In allogeneic MLR. T cells from patients responded normally. However, non-T cells from patients were poor stimulators against responder T cells from healthy controls. This study demonstrates a deficiency of AMLR in a subset of patients with type I diabetes that further supports an abnormal immune regulation and might be an important mechanism in the pathogenesis and autoimmune manifestations of type I diabetes.

Adolescent↗