Læknablaðið : fylgirit - 01.05.1978, Qupperneq 139

Læknablaðið : fylgirit - 01.05.1978, Qupperneq 139
TABLE I PREVALENCE OF ANTIBODIES REACTING WITH CAUDATE AND SUBTHALAMIC NUCLEI IN COMPATATIVE GROUPS OF NORMALS AND PATIENTS STUDIED I Group Studied I. Normal Controls No positive (%) No studied children 0/24, (0) adults 1/31+ (3.2) Streptococcal Patients. A) rheumatic carditis 7/50 (14.0) rheumatic chorea 14/30 (46.6) B) post-streptococcal 1/19 + (5.2) glomerulonephritis - C) streptococcal pharyngitis 0/8 (0) Non- -streptococcal Disease A) Connective Tissue Disease systemic lupus erythematosus 2/27 + (7.4) adult rheumatoid arthritis 0/10 (0) juvenile rheumatoid arthritis 2/28+ (7.1) B) Neurological Disease multiple sclerosis 0/21 (0) Strokes, Parkinson's disease, amytrophic lateral sclerosis, peripheral neuropathy 0/15 (0) C) Miscellaneous Diseases (pneumonia, Hodkin's disease, cirrhosis, myo- cardial infarctions) l/20+ (5.0) + mean titer of all positive reactions in miscellaneous control tested was 1 or present in undiluted serum only. immunoglobulin classes revealed that in all instances the antibodies involved were of the IgG class. IgG was also separated from selected, positive sera by ion exchange chromatography and thereafter digested with pepsin. The re- sulting F (ab')2 fragments of IgG, that is the antibody reactive site of the molecule, showed staining with subthalamic and caudate nuclei to the same extent as the corresponding whole serum, confirming that the reactions were true antibody binding and not, for example, non-immunologic binding of the Fc part of the IgG molecule to the tissue. Figure 1, shows an example of the neuronal staining of the caudate nucleus using a positive serum from a patient with chorea. The cyto- plasmic staining, is confirmed by the yellow, autofluorescent granules which represent lipofuchsin known to be located in the cytoplasm of neuronal cells. To exclude the possibility that the staining was due to antinuclear antibodies, the sera were also tested on liver sections, how- ever, allt the rheumatic fever sera, from patients with chorea as well as with carditis, were nega- tive. Table n shows the relative intensity of the staining in different central nervous tissues. The 137
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