title: Throat infection, neck and chest pain and cardiac response: a persistent infection-related clinical syndrome.
abstract: Dizziness, chest discomfort, chest depression and dyspnea are a group of symptoms that are common complaints in clinical practice. Patients with these symptoms are usually informed that while neurosis consequent to coronary heart disease is excluded nonetheless they remain unhealthy with no rational explanation or treatment. 165 cases of these symptoms and 85 control subjects were reviewed and underwent further medical history inquiry, routine EKG test and cardiac ultrasound examination. Thirty-five patients received coronary artery angiography to exclude coronary heart disease. Serum myocardial autoantibodies against beta(1)-adrenoceptor, alpha-myosin heavy chain, M(2)-muscarinic receptor and adenine-nucleotide translocator were tested, and inflammatory cytokines and high sensitivity C-reaction protein were measured and lymphocyte subclass was assayed by flow cytometry. All patients had a complex of four symptoms or tetralogy: (1) persistent throat or upper respiratory tract infection, (2) neck pain, (3) chest pain and (4) chest depression or dyspnea, some of them with anxiety. Anti-myocardial autoantibodies (AMCAs) were present in all patients vs. 8% in controls. TNF-alpha, IL-1 and IL-6 were significantly higher in patients than in controls (P<0.01). CD3(+) and CD4-CD8(+) lymphocytes were significantly higher and CD56(+) lymphocytes lower in patients than those in controls (P<0.01). The ratio of serum pathogen antibodies positive against Coxsackie virus-B, cytomegalovirus, Mycoplasma pneumoniae and Chlamydia pneumoniae were all markedly higher in patients. These data led to identification of a persistent respiratory infection-related clinical syndrome, including persistent throat infection, neck spinal lesion, rib cartilage inflammation, symptoms of cardiac depression and dyspnea with or without anxiety.
authors.affiliation: The Institute of Hypertension and Cardiovascular Division, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. doczhoucq@yahoo.com.cn
authors.forename: Changqing
authors.initials: C
authors.lastname: Zhou
authors.forename: Xiangning
authors.initials: X
authors.lastname: Fu
authors.forename: Jiangtao
authors.initials: J
authors.lastname: Yan
authors.forename: Qiao
authors.initials: Q
authors.lastname: Fan
authors.forename: Zhuoya
authors.initials: Z
authors.lastname: Li
authors.forename: Katherine
authors.initials: K
authors.lastname: Cianflone
authors.forename: Daowen
authors.initials: D
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000150:complications / Q000175:diagnosis*; D003327:Coronary Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004244:Dizziness / Q000150:complications / Q000175:diagnosis; D004417:Dyspnea / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000150:complications / Q000175:diagnosis*; D010612:Pharyngitis / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D011446:Prospective Studies; D013577:Syndrome; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis; D055815:Young Adult