Pathopysiological aspects of Neonatal TSS-like exanthematous disease and Kawasaki disease

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I Whole picture of Neonatal TSS-like exanthematous diseaseAccording to replies to our questionnaires, neonates fulfilling the clinical criteria of NTED have been observed in 85.4% of major neonatal care units in Japan until 2002. One hundred twenty-two NTED cases were observed in 38 units in 2002. Five severe NTED cases, four DIC and one NEC, were included in those patients.Fifty-six among 68 MRSA strains isolated from NTED patients in major NICUs retained TSST-1/SEC genes. Those sixty-six MRSA isolates can be classified in PFGE subtype A, and of which SCCmec type was II. The pandemic dissemination of the single clone in NICUs in Japan should cause the majority of NTED. We identified two NTED cases from USA and France, and reported the case in France as the first NTED case in Europe.II.T cell analysis in Kawasaki diseaseWe investigated the expression of TCR Vbeta2,3,12 and CD45RO in peripheral T cells from 12 patients with Kawasaki disease. Although there were no patients who showed the expansion of TCR Vbeta2+ T cells, two cases showed the deletion of TCR Vbeta2+ T cells among them. One of the two cases showed also the increase of anti-TSST-1 antibody titer. Therefore, we can conclude that small portion of Kawasaki disease is related to TSST-1, and that TCR Vbeta2+ T cells are not so expanded in the patients with Kawasaki disease as those with NTED.