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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    European journal of pediatrics 150 (1991), S. 665-668 
    ISSN: 1432-1076
    Keywords: Vitamin D resistant rickets ; Extramedullary haematopoiesis ; Intravenous calcium ; Neutrophil chemotaxis ; Lipid A antibodies
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We present a new patient with vitamin D dependent rickets type II. A 20-month-old Arabian boy whose parents are first cousins showed florid rickets, myelofibrosis and recurrent septicaemia. In addition to absent specific binding for 1,25-dihydroxyvitamin D3 (1,25(OH)2D3). 25-Hydroxyvitamin D3-24-hydroxylase activity could not be induced in cultured fibroblasts. The patient did not respond to 99 μg 1,25(OH)2D3 per day, but skeletal and haematological abnormalities improved with daily infusion of 100 mg/kg calcium, as serum parathyroid hormone levels fell to normal values. At the age of 7 years, he died from pneumonia. The improvement of haematological abnormalities with calcium infusions but not with 1.25(OH)2D3 suggests a pathogenetic relationship of myelofibrosis and hyperparathyroidism. Having antilipid A IgM antibody titres up to 1∶10.000 after Gram negative septicaemias, the patient never produced corresponding IgG antibodies. His neutrophil chemotaxis was persistently reduced to 57%±3% of age-matched controls (P〈0.028). The patient showed two pathological immune functions considered to contribute to the well-known susceptibility to infection in rickets.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Fifteen patients aged between three and 27 years were examined clinically and immunologically. Common to all patients were severe recurring cutaneous and pulmonary staphylococcal infections, chronic eczema, eosinophilia and an extremely elevated serum IgE level. Eight of the patients had in addition facial dysplasia characterised by coarse features, prognathism and poorly formed external ears. Marked osteoporosis, particularly of the vertebral bodies, was observed in eight patients. A constant defect of granulocyte chemotaxis was found in only three patients; fluctuating or constantly normal chemotaxis occurred in six patients. Polyclonal hypergammaglobulinemia was detected in 14 patients, elevated IgD in two patients, a partial T-cell defect in two patients and a history of lack of antibody response in one patient. Therapeutic trials with immunoglobulins, transfer factor, levamisole and anti-H2 receptor-antihistamines did not produce lasting or satisfactory clinical or immunological results in the pathogenetically unidentified disease.
    Notes: Zusammenfassung Fünfzehn Patienten im Alter von drei bis 27 Jahren wurden klinisch und infektionsimmunologisch untersucht. Allen gemeinsam waren schwere rezidivierende, kutane und pulmonale Staphylokokken-infektionen, ein chronisches Ekzem, Bluteosinophilie und eine extreme Erhöhung des Serum-IgE-Spiegels. Acht der Patienten wiesen zudem eine faziale Dysmorphie auf, die durch grobe Gesichtszüge, Prognathie und schlecht modellierte Ohrmuscheln charakterisiert ist. Eine deutliche Osteoporose, vor allem der Wirbelkörper, wurde bei acht Patienten beobachtet. Ein konstanter Granulozyten-Chemotaxis-Defekt fand sich nur in drei Fällen, variable oder konstant normale Chemotaxis-Befunde traten in sechs Fällen auf. Eine polyklonale Hypergammaglobulinämie (14 Patienten), erhöhtes IgD (zehn Patienten) wurden nachgewiesen, ebenso ein partieller T-Zell-Defekt (zwei Patienten) und eine fehlende anamnestische Antikörperantwort bei einem Patienten. Therapieversuche mit Immunglobulinen, Transfer-Faktor, Levamisol und anti-H2-Rezeptor-Antihistaminika blieben bei der pathogenetisch ungeklärten Erkrankung ohne anhaltende oder befriedigende klinische und immunologische Ergebnisse.
    Type of Medium: Electronic Resource
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