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Clinical hypersensitivity to cigarette smoke
28
Abstracts
The Journal of ALLERGY APRIL 1971
or low levels of all the immunoglobulins, and the failure to develop delayed allergy and cell-mediated immune reactions. These patients cannot reject skin homografts or graft versus host reactions initiated by allogeneic lymphocytes. There is an absence of germinal centers, tonsils, adenoids, and Peyer's patches. The thymus is dysplastic, hypoplastic, or vestigial. A 6-month-old dehydrated female infant was hospitalized with a history of recurrent diarrhea, intolerance to milk and hypoallergenic formulas since birth, and a history of recurrent respiratory infections for one month prior to admission. Laboratory findings were typical of SAG. Infection with Candida albicans and Pneumocystis oarinii ensued, and she subsequently died following the occurrence of a ruptured viscus. Autopsy findings revealed a minute thymus with hypoplastic lobules and an absence of lymphoid cells and Hassall's corpuscles. There was no gross or microscopic evidence of lymphoid tissue in the body. Bodies characteristic of P. carina were detected in the lung. This is the ninth reported case of SAG in the United States. Treatment has been attempted with thymic transplants, bone marrow transplants, and fetal liver cell transplants, but thus far have been unsuccessful. One patient with SAG who received a transplant of fetal thymus and bone marrow has been reported to have been successfully treated. Infants presenting with a history of failure to thrive or malabsorption syndromes should be investigated for the possibility of the presence of immune disease. N. W.
Cardiac arrhythmia in a child due to chloral hydrate ingestion. Nordenberg, A., Delisle, G., and Izukawa, T . : Pediatrics 47: 134, 1971. Chloral hydrate does not significantly change respiration, blood pressure, or heart rate when the recommended hypnotic dose is given. Higher doses may reduce the blood pressure, depress the contractility of the myocardium, and shorten the refractory period. A 2-year- and 4-month-old boy vomited and became drowsy 15 minutes after ingesting 1,500 mg. of chloral hydrate (recommended dose for patients this age: 150 to 600 mg). The electrocardiogram revealed the presence of multiple multifocal premature ventricular beats. Normal sinus rhythm returned 1% hours after the ingestion of chloral hydrate. This is apparently the first reported case of the administration of chloral hydrate causing serious cardiac arrhythmia in a ohUd. It appears that chloral hydrate may cause myocardial toxicity when 2 to 3 times the maximal therapeutic dose is given. A^. W.
Miscellaneous allergies Clinical hypersensitivity to cigarette smoke. Savel, H . : Arch. Environ. Health 2: 146, 1970. The lymphocyte transformation technique was used in an effort to determine whether clinical sensitivity to cigarette smoke could be demonstrated. Peripheral blood was obtained from 100 subjects and prepared as blood lymphocyte cultures. Cigarette smoke was added in a measured quantity to each of the lymphocyte preparations. Duplicate cultures were incubated without smoke and with phytohemagglutinin to ensure lymphocyte competence. Eight subjects showed hypersensitivity as evidenced by increased incorporation of tritiated thymidine. All eight subjects had impressive allergic histories and experienced a proper respiratory discomfort after even brief exposure to cigarette smoke. The authors concluded that among the many adverse effects of cigarette smoke on the respiratory tract there should be included those caused by a hypersensitivity mechanism. J. B.
Abstracts
The Journal of ALLERGY APRIL 1971
or low levels of all the immunoglobulins, and the failure to develop delayed allergy and cell-mediated immune reactions. These patients cannot reject skin homografts or graft versus host reactions initiated by allogeneic lymphocytes. There is an absence of germinal centers, tonsils, adenoids, and Peyer's patches. The thymus is dysplastic, hypoplastic, or vestigial. A 6-month-old dehydrated female infant was hospitalized with a history of recurrent diarrhea, intolerance to milk and hypoallergenic formulas since birth, and a history of recurrent respiratory infections for one month prior to admission. Laboratory findings were typical of SAG. Infection with Candida albicans and Pneumocystis oarinii ensued, and she subsequently died following the occurrence of a ruptured viscus. Autopsy findings revealed a minute thymus with hypoplastic lobules and an absence of lymphoid cells and Hassall's corpuscles. There was no gross or microscopic evidence of lymphoid tissue in the body. Bodies characteristic of P. carina were detected in the lung. This is the ninth reported case of SAG in the United States. Treatment has been attempted with thymic transplants, bone marrow transplants, and fetal liver cell transplants, but thus far have been unsuccessful. One patient with SAG who received a transplant of fetal thymus and bone marrow has been reported to have been successfully treated. Infants presenting with a history of failure to thrive or malabsorption syndromes should be investigated for the possibility of the presence of immune disease. N. W.
Cardiac arrhythmia in a child due to chloral hydrate ingestion. Nordenberg, A., Delisle, G., and Izukawa, T . : Pediatrics 47: 134, 1971. Chloral hydrate does not significantly change respiration, blood pressure, or heart rate when the recommended hypnotic dose is given. Higher doses may reduce the blood pressure, depress the contractility of the myocardium, and shorten the refractory period. A 2-year- and 4-month-old boy vomited and became drowsy 15 minutes after ingesting 1,500 mg. of chloral hydrate (recommended dose for patients this age: 150 to 600 mg). The electrocardiogram revealed the presence of multiple multifocal premature ventricular beats. Normal sinus rhythm returned 1% hours after the ingestion of chloral hydrate. This is apparently the first reported case of the administration of chloral hydrate causing serious cardiac arrhythmia in a ohUd. It appears that chloral hydrate may cause myocardial toxicity when 2 to 3 times the maximal therapeutic dose is given. A^. W.
Miscellaneous allergies Clinical hypersensitivity to cigarette smoke. Savel, H . : Arch. Environ. Health 2: 146, 1970. The lymphocyte transformation technique was used in an effort to determine whether clinical sensitivity to cigarette smoke could be demonstrated. Peripheral blood was obtained from 100 subjects and prepared as blood lymphocyte cultures. Cigarette smoke was added in a measured quantity to each of the lymphocyte preparations. Duplicate cultures were incubated without smoke and with phytohemagglutinin to ensure lymphocyte competence. Eight subjects showed hypersensitivity as evidenced by increased incorporation of tritiated thymidine. All eight subjects had impressive allergic histories and experienced a proper respiratory discomfort after even brief exposure to cigarette smoke. The authors concluded that among the many adverse effects of cigarette smoke on the respiratory tract there should be included those caused by a hypersensitivity mechanism. J. B.