Efficacy of passive immunotherapy in experimental postsplenectomy sepsis due to Haemophilus influenzae type B

Camel, James E.; Kim, Kwang Sik; Tchejeyan, Gregory H.; Mahour, G. Hossein

doi:10.1016/0022-3468(93)90427-m

Cited by 11 publications

(3 citation statements)

References 27 publications

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“…Blood cultures are positive in ∼95% of cases of OPSI [1,3], and antibiotics can be modified once the cultures are available. As well as intravenous antibiotics, we advise intravenous immunoglobulin 0.4 g/kg daily for 3 days: although there are no studies to show it is beneficial, there is good theoretical evidence for its use [17,18] and it is a practice endorsed by others [19].…”

Section: Treatment Of Opsimentioning

confidence: 99%

Prevention and management of infections in patients without a spleen

Davidson

Wall

2001

Clinical Microbiology and Infection

249

149

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Patients who lack a functioning spleen become vulnerable to sepsis caused by bacteria and, occasionally, protozoa. The risk is higher in children and in those who have had immunosuppressive treatment, and the risk remains lifelong. Overwhelming post-splenectomy infection (OPSI) occurs at an estimated incidence of 0.23-0.42% per year, with a lifetime risk of 5%. Episodes of OPSI are emergencies, requiring immediate parental antibiotics and intensive care; intravenous immunoglobulins may be useful. OPSI carries a mortality of 38-69%. Streptococcus pneumoniae is the commonest infecting organism, accounting for 50-90% of isolates from blood cultures in reported series; it is particularly common in children with sickle cell disease. Less commonly, the infecting organisms are other bacteria, Babesia or Ehrlichia. OPSI may be, to some extent, preventable by several interventions. These are surgical conservation of the spleen; immunization against S. pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis; prophylactic antibiotics; stand-by antibiotics; patient information sheets; and a medical alert bracelet. Asplenic patients living in malaria-endemic areas require optimal prophylaxis. The initial step in prevention of OPSI is the creation of an asplenia register, as many patients are not covered by these simple measures.

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Section: Treatment Of Opsimentioning

confidence: 99%

Prevention and management of infections in patients without a spleen

Davidson

Wall

2001

Clinical Microbiology and Infection

249

149

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“…El uso de inmunoglobulina endovenosa (0,4 g/kg día por tres días) es discutido. Aunque no se cuenta a la fecha de estudios que demuestren su beneficio, existe una buena base teórica que apoya su empleo 16,17 .…”

Section: Síndrome De Infección Devastadora Post Esplenectomía-opsiunclassified

Asplenia congénita y purpura fulminans neumocóccico en paciente pediátrico: Reporte de caso con necropsia y revisión del tema

et al. 2009

Rev. chil. infectol.

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Introduccióna asplenia congénita es infrecuente, su incidencia exacta se desconoce, ya que es común-mente sub-diagnosticada [1][2][3] . Estudios en neonatos con malformación cardíaca describen la asociación con asplenia hasta en 3% 4 . El diagnóstico de asplenia congénita es difícil y requiere un alto índi-ce de sospecha ya que su reconocimiento precoz puede cambiar la morbi-mortalidad asociada esta condición.La presencia de una función esplénica reducida se ve reflejada en una disminución del aclaramiento de antígenos, tanto extracelulares como intracelulares, en una disminución de la respuesta a nuevos antígenos (lipopolisacáridos), en la alteración de la fagocitosis bacteriana y una disminución de los niveles de properdina y tuftsina 5 . Asplenia congénita y purpura fulminans neumocóccico en paciente pediátrico. Reporte de caso con necropsia y revisión del tema Katalina Bertrán S., Alejandro Donoso F., Pablo Cruces R., Franco Díaz R. y Daniela Arriagada S.Congenital asplenia and pneumococcal purpura fulminans in a pediatric patient.Case report with pathological findings and review Absent or defective splenic function is associated with a high risk of fulminant bacterial infections, especially due to encapsulated bacteria. Not knowing this condition may delay medical treatment. Streptococcus pneumoniae is the leading cause of sepsis in these patients. Asplenic patients are at high risk for septic shock and eventually purpura fulminans, a life-threatening condition. We report the case of a 3 years old girl, with mitral stenosis and recurrent pneumonia that was admitted due to fever but in the next few hours presented hypotension, purpura and livedo reticularis. Laboratory test showed leucopenia (3.400/mm 3 ), bandemia (43% of immature forms), thrombocytopenia, hypoprothombinemia and severe lactic acidosis (ph: 7.0 and lactic acid 11 mmol/l). The patient developed septic shock and multiorganic failure. Mechanical ventilation, volume resuscitation, vasoactive drugs and antibiotic therapy was initiated. Ultrasound was performed on the second day, demostrating asplenia. Peripheral blood smear showed Howell-Jolly bodies. Patient had a positive blood culture for penicillin-resistant Streptococcus pneumoniae (serotype 19F). Patient died of intracerebral hemorrhage after 8 days of admission. Necropsy confirmed asplenia and bilateral suprarenal haemorrhage. Absence of spleen can lead to life threatening infections, it is important to recognize it because vaccination and antibiotic prophylaxis can provide life-saving protection. This case provides a reminder to pursue asplenia as a potential underlying mechanism for invasive bacterial infection in children.Key words: Asplenia, Streptococcus pneumoniae, pneumococcal sepsis, purpura fulminans, HowellJolly bodies.Palabras clave: Asplenia, Streptococcus pneumoniae, sepsis neumocóccica, purpura fulminans, corpús-culos de Howell-Jolly. LPurpura fulminans (PF) es una patología poco frecuente, de extrema gravedad y alta mortalidad. Se caracteriza fundamentalmente por la repenti...

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“…Tuftsin acquires its activity after excision from the protein carrier via the successive action of two enzymes: splenic tuftsin endocarboxypeptidase, which cuts the C terminus of tuftsin, and the phagocytic enzyme leucokinase, which cuts its N terminus [124][125][126][127].…”

Section: Introductionmentioning

confidence: 99%

A New Generation of Drugs: Synthetic Peptides Based on Natural Regulatory Peptides

Kolomin¹,

Шадрина²,

Slominsky³

et al. 2013

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Natural regulatory peptides are biologically active compounds that are produced by various cells and provide a link among the main regulatory systems of the body. The field of research into the biologic activity of endogenous regulatory peptides is extremely vast. These peptides affect the cardiovascular, immune, reproductive, endocrine, digestive, and other systems, alter energy metabolism, and are especially effective in the regulation of the central nervous system. Despite of the wide range of preventive and therapeutic effects of natural regulatory peptides and proteins, their application in clinical practice is difficult. This is primarily because of their extreme instability, as they are rapidly degraded by proteases of the gastrointestinal tract, blood, cerebrospinal fluid, and other biologic media. Compounds with higher stability (i.e., a considerably longer half-life compared with that of natural molecules) and the ability to provide a directional effect on the various body systems were obtained from modifications of endogenous regulatory peptides. Synthetic analogs of regulatory peptides, as a rule, contain only natural amino acids in their composition, and their biodegradation does not lead to the formation of toxic products; thus, they have fewer side effects. This review focuses on the consideration of two synthetic regulatory peptides, Semax and Selank, which were the bases for the creation of new drugs that are used effectively in the treatment of various diseases of the nervous system. The synthetic analog of an adrenocorticotropic hormone 4-10 fragment (ACTH 4-10) Semax is a powerful neuroprotective agent that is particularly effective as a therapy for stroke. Selank was synthesized on the basis of the natural immunomodulator tuftsin. Selank is a powerful anxiolytic that is used as a therapy for generalized anxiety disorder and neurasthenia without sedative and muscle-relaxant effects. This review presents the results of research aimed at studying the influence of these peptides on the transcriptome of brain cells. The problems of drugs developed based on the clinical activities of Semax and Selank are discussed separately.

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Efficacy of passive immunotherapy in experimental postsplenectomy sepsis due to Haemophilus influenzae type B

Cited by 11 publications

References 27 publications

Prevention and management of infections in patients without a spleen

Prevention and management of infections in patients without a spleen

Asplenia congénita y purpura fulminans neumocóccico en paciente pediátrico: Reporte de caso con necropsia y revisión del tema

A New Generation of Drugs: Synthetic Peptides Based on Natural Regulatory Peptides

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