Sixty-one patients with a variety of different illnesses were studied with respect to skin test anergy and the presence of serum chemotactic inhibitors. In initial testing, 55% of the patient tests demonstrated negative skin test responses to all six test antigens. Sera from 65% of these anergic patients were capable of suppressing the migration of normal polymorphonuclear leukocytes toward chemotactic factors. Statistical analysis of the association of anergy and chemotactic inhibitory sera resulted in a P value of <0.0005. Chemotactic inhibitory sera were also capable of suppressing monocyte chemotaxis. No association of chemotactic inhibitory activity and lymphocytotoxic antibody or suppressors of mitogen-induced lymphocyte blast transformation were noted. In addition, T-cell populations in some anergic patients were studied by the erythrocyte-binding technique. Erythrocyte-binding lymphocytes in anergic patients were significantly suppressed when compared to normal controls, but not when compared to skin test-positive patients. The data presented here indicate a close parallel between skin test anergy and the presence of serum chemotactic inhibitory activity. The exact relationship is yet undefined but may indicate the involvement of chemotactic inhibitors as immunological regulators in the host during a variety of systemic illnesses.

Summary: An unusual case of neck cancer with associated C-6 dermatome neuralgia causing vasodepressor syncope episodes is discussed. Pacemaker therapy proved not to be required. When evaluating syncope with brddycardia, it is important to search for underlying causes and to ascertain whether or not pacemaker therapy is indicated.