促進現象の発現機序に関する研究-5-サルコイドーシス患児におけるツ反応反復 (同一局所反復施行によるツベリクリン反応の促進に関する研究-19,20-)

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概要

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• In the skin area in which a tuberculin test was previously given (the used site), the reaction pattern is altered. Namely, the early reaction is elicited and the course of the delayed reaction is accelerated. In the preceeding studies it was proved that the alteration of the reaction pattern at the previously used site is the result of the local sensitization which is caused by the injection of tuberculin protein into a tuberculin sensitive person.<BR>In the case of sarcoidosis, the systemic tuberculin sensitivity is d epressed. A possible explanation of this phenomenon is the depressed production of the sort of antibodies which participate in the delayed reactions and are contained in circulating lymphocytes.<BR>This study was made to investigate the local tuberculin sensitivity at the used site among sarcoidosis patients, whose systemic tuberculin sensitivity was depressed.<BR>Nine sarcoidosis patients, aged 7 years and 8 months to 14 y ears and 9 months, who were all tuberculin positive before the onset of the disease (Table 1), were injected with 5 TU Old Tuberculin in two sites, namely, the upper one third of the left forearm where tuberculin had been previously injected (the used site) and the lower one third of the upper arm where tuberculin had never been injected (the new site). Reactions were observed 4, (8, 12), 24 and 48 hours after the injection (Table 2, Figure 1).<BR>In two out of nine patients, the delayed re a ction at the new site was positive (erythema with diameter over 10 mm). In the other seven patients the delayed reaction at the new site was negative (erythema with diameter under 4 mm) or doubtful (erythema with diameter 5-9mm). In one of them, neither the delayed reaction at the new site, nor the early reaction at the used site was observed. In the remaining six cases, definite early reaction was elicited at the used site. In three of them the reaction attenuated markedly after 24 hours and showed only small erythema with diameter under 6 mm. These reactions might be considered as early reaction without accompanying delayed reaction. In the other three patients the reaction continued for 24 hours, declined thereafter, and after 48 hours only a very pale erythema or pigmentation remained.<BR>From these results it is likely that the antibody which elicits the local early reaction may differ from that which participate in the systemic delayed reaction and which is contained in circulating cells.

• 一般社団法人 日本結核病学会の論文

著者

• 戸所 正雄

  群馬大学医学部小児科学教室

• 松島 正視

  群馬大学医学部小児科学教室

• 寺尾 宏一郎

  群馬中央総合病院小児科

• 木村 利定

  群馬県立東毛病院

• 宮下 晴夫

  利根中央病院

• 寺尾 宏一郎

  群馬中央総合病院

• 松島 正視

  群馬大学医学部小児科

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