On the Nonautoimmune Aspects of Endocardial Fibroelastosis: Continued Inquiry into the Significance of Delayed Sensitivity to Mumps Virus

Abstract

Using both the capillary precipitin and the agar gel immunoprecipitin methods, we were unable to identify cross-reacting antigenic determinants between human heart and chicken tissues. These observations do not support the premise that the positive cutaneous delayed hypersensitivity to mumps antigen in some children with primary endocardial fibroelastosis might represent nothing more than nonspecific avian sensitivity. Furthermore, there was no support for the notion that endocardial fibroelastosis represents an immunopathogenic phenomenon of shared antigenic relationships between mumps virus and human heart like that suggested for the group A beta-hemolytic streptococcus and myocardial and valvular tissue in acute rheumatic fever.4-6 We continue to believe that the positive mumps skin test in certain children with primary endocardial fibroelastosis may represent the immunologic marker of previous intrauterine antigenic exposure to briefly replicating mumps virus.