No abstract

Peripheral blood lymphocytes from 20 patients with systemic lupus erythematosus (SLE) and 21 normal donors were incubated with pokeweed mitogen in order to assess in vitro terminal-differentiation of B lymphocytes into cells synthesizing intracytoplasmic immunoglobulin (Ig). Although the percentage (mean k SEM) of B lymphocytes bearing surface Ig in the initial cell suspensions was not statistically different in SLE than in normal subjects (15 f 2.2% versus 16 f 1.9%, respectively), the frequency of cells containing intracytoplasmic Ig per lo3 mononuclear cells was significantly lower in mitogen-stimulated cultures derived from the patients than from the normal controls (10 f 2.3 versus 56 f 13.0 for IgM, P < 0.01; 21 f 3.6 versus 63 f 10.4 for IgG, P < 0.01; 13 f 3.1 versus 24 f 3.8 for IgA, P < 0.05 respectively).Coculturing active SLE lymphocytes with cells from nor- Submitted for publication April 28, 1977; accepted May 19. 1977. ma1 subjects resulted in a significant (P < 0.05) increase in the frequency of cells containing intracytoplasmic IgG when stimulated with pokeweed mitogen. Moreover, culturing SLE lymphocytes in cell-free media derived from activated normal lymphocytes also resulted in a significant increase in the frequency of IgG-containing cells. These results suggest that B-lymphocyte differentiation in vitro is depressed in SLE and may, at least partially, be reversed by products derived from normal lymphocytes.

The concentration of the conjugated bile acid, cholylglycine, in serum is a sensitive and specific indicator of hepatic function. We describe a convenient, specific, and precise radioimmunoassay for cholylglycine, in which 125I-labeled cholylglycyltyrosine is used as tracer. In addition, a blocking agent in the buffer system eliminates binding of bile acids to serum albumin. Therefore no extraction is required. We found no interference by (a) abnormal concentrations of albumin or gamma-globulin, (b) lipemic sera, (c) hemolyzed sera, (d) anticoagulants, or (e) various commonly used drugs. The reference interval for fasting subjects is estimated to be 0.0 to 0.6 mg/L. Our clinical studies show that serum cholylglycine concentrations are usually abnormal in most hepatobiliary diseases, such as viral hepatitis, alcoholic liver disease, cirrhosis, and pediatric liver diseases.

A case of encephalopathy complicating cat-scratch disease has been described. Neurologic signs manifested by convulstions and stupor appeared ten days after epitrochlear lymphadenopathy. The clinical course gradually improved over the next few days and recovery was complete. The spinal fluid was normal. The skin test with CSD antigen was positive. In all cases of encephalopathy developing within six weeks following the appearance of unexplained lymphadenopathy, the diagnosis of cat-scratch disease should be entertained. The importance of the cat-scratch disease antigen in diagnosis is emphasized.