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

I新生儿TSS样外展性疾病的全貌根据对我们问卷的答复，到2002年为止，在日本85.4%的主要新生儿护理单位中观察到符合NTED临床标准的新生儿。2002年，在38个单位观察到122例NTED病例。从NICU的NTED患者中分离的68株MRSA中有五十六株保留TSST-1/SEC基因。66株MRSA均为PFGE A亚型，其中SCCmec型为II型。日本NICU中的单克隆病毒的流行性传播应引起大多数NTED。我们发现了两例来自美国和法国的NTED病例，并报道了法国的病例，这是欧洲第一例NTED病例。II.川崎病的T细胞分析我们研究了12例川崎病患者外周血T细胞TCR V β 2，3，12和CD 45 RO的表达。虽然没有患者显示TCR V β 2 + T细胞扩增，但其中2例显示TCR V β 2 + T细胞缺失。其中1例还显示抗TSST-1抗体滴度升高。因此，我们可以得出结论，小部分川崎病与TSST-1有关，并且川崎病患者中TCR V β 2 + T细胞不如NTED患者扩增。

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.