Successful trimethoprim-sulfamethoxazole therapy in a patient with hyperimmunoglobulin E syndrome.
A male patient with hyperimmunoglobulin E syndrome is described. Recurrent lymphadenitis and cutaneous staphylococcal abscesses were resistant to various antibiotics, and chemotaxis and hydrogen peroxide production of polymorphonuclear leukocytes were impaired. Following trimethoprim-sulfamethoxazole therapy, he was free from the above infections, and impaired polymorphonuclear leukocyte functions recovered and serum IgE decreased to approximately one-fifth of its initial level. Subsequent irregular medications, however, resulted in impairment of polymorphonuclear leukocyte functions and an increased serum IgE concentration, which recovered after regular resumption of trimethoprim-sulfamethoxazole treatment. From these results, the beneficial effects of trimethoprim-sulfamethoxazole in hyperimmunoglobulin E syndrome are clinically apparent, but in vitro studies failed to demonstrate the positive effect of trimethoprim-sulfamethoxazole on polymorphonuclear leukocytes and their mechanism still remains to be elucidated.
Department of Pediatrics, Kansai Medical University, Osaka, Japan.
K
K
Hattori
M
M
Hasui
K
K
Masuda
M
M
Masuda
H
H
Ogino
Y
Y
Kobayashi
D000293:Adolescent; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000187:drug effects; D007589:Job Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D009504:Neutrophils / Q000187:drug effects; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology / Q000627:therapeutic use*
D007073:Immunoglobulin E; D015662:Trimethoprim, Sulfamethoxazole Drug Combination