TABLE 2.
Immunological workup
| Case | Resultsa |
||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mitogen-stimulated cytokine profileb |
IgG (819-1,725) | IgA (70-386) | IgM (55-307) | B cells (160-708) | CD3 (716-2,011) | CD4 (415-1,418) | CD8 (292-1,258) | NK cells (158-1,156) | ANA (highest) | ||
| IFN-γ | IL-12 | ||||||||||
| 1 | Unstimulated, 0 (N); PHA induced, 2,480 (N); ConA induced, 10,440 (N) | Unstimulated, 15 (N); PHA induced, 95 (L); SAC induced, 100 (N) | 1,930 | 382 | 351 | 123 | 1,189 | 534 | 626 | 287 | 1:80 |
| 2 | Unstimulated, 0 (N); PHA induced, 4,440 (H); ConA induced, 13,950 (H) | Unstimulated, 0 (N); PHA induced, 75 (L); SAC induced, 35 (L) | 4,950 | 243 | 86 | 81 | 822 | 3,997 | 363 | 769 | NA |
| 3 | NA | NA | 2,060 | 61 | 67 | 62 | 1,349 | 671 | 712 | 415 | 1:160 |
| 4 | NA | NA | 2,480 | 252 | 150 | 45 | 933 | 506 | 347 | 495 | Neg |
| 5 | NA | NA | 1,110 | 228 | 113 | 263 | 1,048 | 444 | 627 | 140 | Neg |
| 6 | Unstimulated, 0 (N); PHA induced, 12,240 (H); ConA induced, 26,280 (H) | Unstimulated, 0 (N); PHA induced, 280 (N); SAC induced, 160 (N) | 1,660 | 330 | 170 | 70 | 2,530 | 1,170 | 1,340 | 40 | 1:80 |
| 7 | NA | NA | 4,440 | 440 | 98 | NA | NA | NA | NA | NA | 1:80 |
| 8 | NA | NA | 5,480 | 294 | 113 | NA | NA | NA | NA | NA | Neg |
ANA, anti-nuclear antibody; CD, cluster of differentiation; ConA, concanavalin A; H, high; L, low; N, normal; NA, not available; Neg, negative; NK, natural killer; PHA, phytohemagglutinin; SAC, Staphylococcus aureus Cowan-I. Abnormal results are in italics.
IFN-γ- and IL-12-producing cells were measured by enzyme-linked immunospot (ELISPOT) assays. Patients' peripheral blood mononuclear cells were unstimulated or stimulated with PHA, ConA, and SAC in plates with nitrocellulose membranes coated with anti-cytokine capture antibody. Cells with intracellular IL-12 or IFN-γ were detected by a biotinylated anti-cytokine detection antibody, streptavidin-alkaline phosphatase, and 5-bromo-4-chloro-3-indolyl phosphate/nitroblue tetrazolium chloride. The ELISPOTs were counted, and the numbers of cytokine-secreting cells per 106 peripheral blood mononuclear cells were calculated.