A child with atopic features, raised serum IgE, and recurrent infection treated with levamisole.

Abstract

SUMMARY. A 6-year-old girl had a long history of severe eczema, asthma, recurrent otitis media, and staphylococcal infections with disseminated chronic skin abscesses. Immunological studies showed a neutrophil chemotaxis defect, hyperimmunoglobulinaemia E, IgE antibodies against cows' milk proteins, absence of IgM, and absence of staphylococcal haemolysins. Neutrophil phagocytic and bactericidal functions and complement system were normal. In the course of treatment with levamisole (2 5 mg/kg, 3 times a week for one year) a striking clinical improvement occurred: the skin lesions and the staphylococcal abscesses gradually cleared and the girl gained weight. There was also a partial correction of the immune deficiency.

Effect of Levamisole on Chemotaxis of Granulocytes from Uremic Patients

“…These data are analogous to the effect of levamisole observed in other disease states with defective chemotax is [9][10][11][12][13][14],…”

“…The intrinsic locomotive capacity of uremic granulocytes, on the other hand, was found to be normal [4] or decreased [5,6]. Defective chemotaxis per se may be the cause for in creased susceptibility to infections [7], Levamisole, an 'immunomodulator', has been shown to improve many immune functions in various immune deficiency states [8], It was also found to improve im paired chemotaxis in a number of diseases [9][10][11][12][13][14], It was therefore of interest to investigate the effect of levamisole on chemotaxis of granulocytes from chronically uremic patients.…”

Untitled

“…Previous treatment of HIE patients with a variety of agents and immune modulators, including levamisole, cimetidine, transfer factor and ascorbic acid, isotretinoin , cromoglycate and repeated plasma pheresis, failed to induce long term clinical remissions in these patients [9][10][11][12][13][14][15]48]. Although interferon-γ was shown in vitro to regulate the IgE production by PBMC form HIE patients, it had no significant clinical effect in treating these patients [41].…”

“…Treatment of HIE patients is frustrating and remains largely unsuccessful. Several treatment modalities have been tried with limited and often temporary success [9][10][11][12][13][14][15]. Because HIE patients have excessive production of IgE and IL-4, clinical improvement may be achieved by down regulation of IgE and IL-4.…”

Untitled

“…Treatment of HIE patients is frustrating and remains largely unsuccessful. Several treatment modalities have been tried with limited and often temporary success [9][10][11][12][13][14][15]. Because HIE patients have excessive production of IgE and IL-4, clinical improvement may be achieved by down regulation of IgE and IL-4.…”