title: A case of toxic shock-like syndrome presenting with serious hypoproteinaemia because of a protein-losing gastroenteropathy.
abstract: A 37-year-old man was admitted to our hospital because of toxic shock-like syndrome (TSLS) induced by Streptococcus pyogenes. After the pathogenic bacteria had been eradicated, serious diarrhoea appeared and a protein-losing gastroenteropathy developed. An immunohistochemical study of the biopsy specimens of both small and large intestines revealed the infiltration of T-lymphocytes, predominantly CD8+ cells, into the lamina propria of affected mucosa, villus atrophy and crypt hyperplasia. Considering these histological findings, some immunological mechanism which lead the activation of cytotoxic T-lymphocytes may play an important role in the pathogenesis of this rare intestinal manifestation of TSLS.
authors.affiliation: Department of Internal Medicine, Shiga University of Medical Science, Ohtsu, Shiga, Japan. kazut@belle.shiga-med.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Tasaki
authors.forename: M
authors.initials: M
authors.lastname: Sasaki
authors.forename: M
authors.initials: M
authors.lastname: Bamba
authors.forename: Y
authors.initials: Y
authors.lastname: Shintani
authors.forename: A
authors.initials: A
authors.lastname: Andoh
authors.forename: T
authors.initials: T
authors.lastname: Tsujikawa
authors.forename: S
authors.initials: S
authors.lastname: Koyama
authors.forename: Y
authors.initials: Y
authors.lastname: Fujiyama
authors.forename: T
authors.initials: T
authors.lastname: Bamba
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003106:Colon / Q000473:pathology; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000382:microbiology* / Q000473:pathology; D004386:Duodenum / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007019:Hypoproteinemia / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology; D007150:Immunohistochemistry; D008297:Male; D012772:Shock, Septic / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D013297:Streptococcus pyogenes
chemical_list: D000900:Anti-Bacterial Agents