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Immune Reconstitution in Keratoconjunctivitis and Superficial Candidiasis: Title and subTitle BreakThe Role of Immunocompetent Lymphocyte Transfusion and Transfer Factor FREE

Vernon G. Wong, MD; Charles H. Kirkpatrick, MD
[+] Author Affiliations

Submitted for publication Sept 19, 1973.

Read before the American Ophthalmological Society, Hot Springs, Va, May 29, 1973.

Reprint requests to Georgetown University Medical Center, 3800 Reservoir Rd NW, Washington, DC 20007 (Dr. Wong).


Arch Ophthalmol. 1974;92(4):335-339. doi:10.1001/archopht.1974.01010010345018
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A 17-year-old white male subject with phlyctenular keratitis, superficial candidiasis, and hypoparathyroidism was found to be anergic in delayed hypersensitivity. Reconstitution of the cell-mediated immune response to Candida albicans by means of allogeneic lymphocyte transfusion and by means of transfer factor, and amphotericin B promptly resulted in the clinical remission of the phlyctenulosis and chronic candidiasis.

REFERENCES

Sutphin A, Albright F, McCune PJ:  Five cases (three in siblings) of idiopathic hypoparathyroidism associated with moniliasis . J Clin Endocrinol 3:625, 1943;.
Walsh FB, Murray RG:  Ocular manifestations of disturbances of calcium metabolism . Am J Ophthalmol 36:1657, 1953;.
Bronsky D, et al:  Idiopathic hypoparathyroidism and pseudohypoparathyroidism: Case reports and review of the literature . Medicine 37:317, 1958;.
Gass JDM:  The syndrome of keratoconjunctivitis, superficial moniliasis, idiopathic hypoparathyroidism and Addison's disease . Am J Ophthalmol 54:660, 1962;.
Sjoberg KH:  Moniliasis—an internal disease? Acta Med Scand 179:157, 1966;.
Louria DB, et al:  The susceptibility to moniliasis in children with endocrine hypofunction . Trans Assoc Am Physicians 80:236, 1967;.
Blizzard RM, Gibbs JH: Candidiasis:  Studies pertaining to its association with endocrinopathies and pernicious anemia . Pediatrics 42:231, 1968;.
Hermans PF, Ulrich JA, Markowitz H:  Chronic mucocutaneous candidiasis as a surface expression of deep seated abnormalities . Am J Med 47:503, 1969;.
Chilgren RA, et al:  The cellular immune defect in chronic mucocutaneous moniliasis . Lancet 2:1286, 1969;.
Kirkpatrick CH, Chandler JW Jr, Schimke RN:  Chronic mucocutaneous moniliasis with impaired delayed hypersensitivity . Clin Exp Immunol 6:375, 1970;.
Newberry NW, et al:  Immunology of the mycoses: I. Depressed lymphocyte transformation in chronic histoplasmosis . J Immunol 100:436, 1968;.
Thor DE, et al:  Cell migration inhibition factor released by antigen from human peripheral lymphocytes . Nature 219:755, 1968;.
Rocklin RE, Meyers OL, David JR:  An in vitro assay for cellular hypersensitivity in man . J Immunol 104:95, 1970;.
Bach FH, Voynow NK:  One-way stimulation in mixed leukocyte cultures . Science 153:545, 1966;.
Mickerberg ID, Root RK, Wolff SM:  Leukocyte function in hypogammaglobulinemia . J Clin Invest 49:1528, 1970;.
Rebuck JW, Crowley JH:  A method of studying leukocyte functions in vivo . Ann NY Acad Sci 59:757, 1955;.
Mittal KK, et al:  Serotyping for transplantation: XVIII. Refinement of microdroplet lymphocyte cytotoxicity test . Transplantation 6:913, 1968;.
Buckner D, et al:  Leukapheresis by continuous flow centrifugation (CFC) in patients with myelogenous leukemia (CML) . Blood 33:353, 1969;.
Lawrence HS:  Transfer factor , in Dixon FJ Jr, Kunkel HG (eds): Advances in Immunology . New York, Academic Press, 1969;, vol 2, p 195.
Hutter RVP, Collins HS:  The occurrence of opportunistic fungal infections in a cancer hospital . Lab Invest 11:1035, 1962;.
Rifkind D, et al:  Systemic fungal infections complicating renal transplantation and immunosuppressive therapy . Am J Med 43:28, 1967;.
Chilgren RA, et al:  Chronic mucocutaneous candidiasis, deficiency of delayed hypersensitivity and selective local antibody defect . Lancet 2:688, 1967;.
Valdimarsson H, et al:  Lymphocyte abnormality in chronic mucocutaneous candidiasis . Lancet 1:1259, 1970;.
Rocklin RE, et al:  Transfer of cellular hypersensitivity in chronic mucocutaneous candidiasis monitored in vivo and in vitro . Cell Immunol 1:290, 1970;.
Buckley RA, et al:  Defective cellular immunity associated with chronic mucocutaneous moniliasis and recurrent staphylococcal botryomycosis: Immunological reconstitution by allogenic bone marrow . Clin Exp Med 131:235, 1968;.
Schulkind ML, et al:  Transfer factor in the treatment of a case of chronic mucocutaneous candidiasis . Cell Immunol 3:606, 1972;.
Levin AS, et al:  Wiskott-Alrich syndrome, a genetically determined cellular immunologic deficiency: Clinical and laboratory responses to therapy with transfer factor . Proc Nat Acad Sci 67:821, 1970;.
Bullock WE, Fields J, Brandriss M:  Transfer factor therapy in lepromatous leprosy . J Clin Invest 50:16, 1971;.
Kirkpatrick CH, Rich RR, Smith TK:  Effect of "transfer factor" on lymphocyte function in anergic patients . J Clin Invest 51:2, 948, 1972;.
Goldberg LS, et al:  Studies of lymphocyte and monocyte function in chronic mucocutaneous candidiasis . Clin Exp Immunol 8:37, 1971;.
Zoschke DC, Bach FH:  Lymphocyte reactivity in vitro: VIII. Specificity of allogenic cell recognition in mixed leukocyte cultures , in Schwarz MR (ed): Proceedings of the Sixth Leukocyte Culture Conference . New York, Academic Press, 1972;, p 639.
Rocklin RE, Ratcliffe HE:  Antigen-induced production of migration inhibition factor (MIF) by non-dividing human lymphocytes . Fed Proc 31:753, 1972;.
Bloom B:  In vitro approaches to the mechanism of cell-mediated immune reactions . Adv Immunol 13:102, 1971;.
Duke-Elders: System of Ophthalmology . vol 3, (part 1) , 1965;, p 461.
Podos SM, et al:  Ophthalmic manifestations of the Wiskott-Aldrich syndrome . Arch Ophthalmol 82:322, 1969;.
Smolin G, Okumoto M:  Antilymphocyte serum potentiation of Candida keratitis . Am J Ophthalmol 66:804, 1968;.

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Sutphin A, Albright F, McCune PJ:  Five cases (three in siblings) of idiopathic hypoparathyroidism associated with moniliasis . J Clin Endocrinol 3:625, 1943;.
Walsh FB, Murray RG:  Ocular manifestations of disturbances of calcium metabolism . Am J Ophthalmol 36:1657, 1953;.
Bronsky D, et al:  Idiopathic hypoparathyroidism and pseudohypoparathyroidism: Case reports and review of the literature . Medicine 37:317, 1958;.
Gass JDM:  The syndrome of keratoconjunctivitis, superficial moniliasis, idiopathic hypoparathyroidism and Addison's disease . Am J Ophthalmol 54:660, 1962;.
Sjoberg KH:  Moniliasis—an internal disease? Acta Med Scand 179:157, 1966;.
Louria DB, et al:  The susceptibility to moniliasis in children with endocrine hypofunction . Trans Assoc Am Physicians 80:236, 1967;.
Blizzard RM, Gibbs JH: Candidiasis:  Studies pertaining to its association with endocrinopathies and pernicious anemia . Pediatrics 42:231, 1968;.
Hermans PF, Ulrich JA, Markowitz H:  Chronic mucocutaneous candidiasis as a surface expression of deep seated abnormalities . Am J Med 47:503, 1969;.
Chilgren RA, et al:  The cellular immune defect in chronic mucocutaneous moniliasis . Lancet 2:1286, 1969;.
Kirkpatrick CH, Chandler JW Jr, Schimke RN:  Chronic mucocutaneous moniliasis with impaired delayed hypersensitivity . Clin Exp Immunol 6:375, 1970;.
Newberry NW, et al:  Immunology of the mycoses: I. Depressed lymphocyte transformation in chronic histoplasmosis . J Immunol 100:436, 1968;.
Thor DE, et al:  Cell migration inhibition factor released by antigen from human peripheral lymphocytes . Nature 219:755, 1968;.
Rocklin RE, Meyers OL, David JR:  An in vitro assay for cellular hypersensitivity in man . J Immunol 104:95, 1970;.
Bach FH, Voynow NK:  One-way stimulation in mixed leukocyte cultures . Science 153:545, 1966;.
Mickerberg ID, Root RK, Wolff SM:  Leukocyte function in hypogammaglobulinemia . J Clin Invest 49:1528, 1970;.
Rebuck JW, Crowley JH:  A method of studying leukocyte functions in vivo . Ann NY Acad Sci 59:757, 1955;.
Mittal KK, et al:  Serotyping for transplantation: XVIII. Refinement of microdroplet lymphocyte cytotoxicity test . Transplantation 6:913, 1968;.
Buckner D, et al:  Leukapheresis by continuous flow centrifugation (CFC) in patients with myelogenous leukemia (CML) . Blood 33:353, 1969;.
Lawrence HS:  Transfer factor , in Dixon FJ Jr, Kunkel HG (eds): Advances in Immunology . New York, Academic Press, 1969;, vol 2, p 195.
Hutter RVP, Collins HS:  The occurrence of opportunistic fungal infections in a cancer hospital . Lab Invest 11:1035, 1962;.
Rifkind D, et al:  Systemic fungal infections complicating renal transplantation and immunosuppressive therapy . Am J Med 43:28, 1967;.
Chilgren RA, et al:  Chronic mucocutaneous candidiasis, deficiency of delayed hypersensitivity and selective local antibody defect . Lancet 2:688, 1967;.
Valdimarsson H, et al:  Lymphocyte abnormality in chronic mucocutaneous candidiasis . Lancet 1:1259, 1970;.
Rocklin RE, et al:  Transfer of cellular hypersensitivity in chronic mucocutaneous candidiasis monitored in vivo and in vitro . Cell Immunol 1:290, 1970;.
Buckley RA, et al:  Defective cellular immunity associated with chronic mucocutaneous moniliasis and recurrent staphylococcal botryomycosis: Immunological reconstitution by allogenic bone marrow . Clin Exp Med 131:235, 1968;.
Schulkind ML, et al:  Transfer factor in the treatment of a case of chronic mucocutaneous candidiasis . Cell Immunol 3:606, 1972;.
Levin AS, et al:  Wiskott-Alrich syndrome, a genetically determined cellular immunologic deficiency: Clinical and laboratory responses to therapy with transfer factor . Proc Nat Acad Sci 67:821, 1970;.
Bullock WE, Fields J, Brandriss M:  Transfer factor therapy in lepromatous leprosy . J Clin Invest 50:16, 1971;.
Kirkpatrick CH, Rich RR, Smith TK:  Effect of "transfer factor" on lymphocyte function in anergic patients . J Clin Invest 51:2, 948, 1972;.
Goldberg LS, et al:  Studies of lymphocyte and monocyte function in chronic mucocutaneous candidiasis . Clin Exp Immunol 8:37, 1971;.
Zoschke DC, Bach FH:  Lymphocyte reactivity in vitro: VIII. Specificity of allogenic cell recognition in mixed leukocyte cultures , in Schwarz MR (ed): Proceedings of the Sixth Leukocyte Culture Conference . New York, Academic Press, 1972;, p 639.
Rocklin RE, Ratcliffe HE:  Antigen-induced production of migration inhibition factor (MIF) by non-dividing human lymphocytes . Fed Proc 31:753, 1972;.
Bloom B:  In vitro approaches to the mechanism of cell-mediated immune reactions . Adv Immunol 13:102, 1971;.
Duke-Elders: System of Ophthalmology . vol 3, (part 1) , 1965;, p 461.
Podos SM, et al:  Ophthalmic manifestations of the Wiskott-Aldrich syndrome . Arch Ophthalmol 82:322, 1969;.
Smolin G, Okumoto M:  Antilymphocyte serum potentiation of Candida keratitis . Am J Ophthalmol 66:804, 1968;.

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