Serum beta 2-microglobulin and C reactive protein concentrations in viral infections

Alteration of beta-2-microglobulin level in malignant lymphoproliferative diseases after a high dose of alpha-2-recombinant interferon

A group of 10 patients with malignant lymphoproliferative diseases resistant to any standard therapeutical modalities were treated with a high dose of alpha-2-recombinant interferon (alpha-2-rIF). Alpha-2-rIF was administered at a total dose of 120 x 10(6) IU in a continuous infusion during 48 h. Two cycles of alpha-2-rIF immunotherapy were employed with an interval of 1 month in between each. Serum and urinary beta-2-microglobulin (B2M) were examined prior to alpha-2-rIF application and on days 2, 4, 6 afterwards. Alpha-2-rIF treatment induced an increase in serum B2M as noted on day 2 followed by a decline to below the normal range. The initial increased value was significantly higher as compared to either the pretreatment value or the normal physiological range. The reduced B2M serum level was protracted and lasted until the second cycle of treatment. Similar but not so great changes in B2M serum values were noted during the second application of alpha-2-rIF. The changes of B2M level in the urine, although less convincing, mimic those observed in the serum. The present results confirmed the biological activity of alpha-2-rIF in malignant lymphoproliferative diseases.

Serial study of C-reactive protein during fungal esophagitis and enterocolitis

C-reactive protein (CRP) responses were followed in weekly serum samples in the course of eight episodes of esophagitis (37 sera) and ten episodes of enterocolitis (45 sera) caused by Candida albicans in an equal number of patients with hematologic malignancies under antibacterial medication. During fungal esophagitis CRP was elevated, with peak values ranging from 73 to 380 mg/l (mean +/- SD: 170 +/- 104 mg/l). The same was true for fungal enterocolitis, with the peak values ranging from 54 to 225 mg/l (mean +/- SD: 146 +/- 56 mg/l). In both these conditions, antimycotic treatment was followed by clinical improvement, reduced or eliminated fungal growth and falling levels of CRP, occasionally down to the normal value (less than 6 mg/l). Thus, follow-up of CRP level is useful as an aid in the diagnosis of gastrointestinal candidosis and in evaluating its treatment.

Routine full blood counts as indicators of acute viral infections

Over a period of three weeks about 9000 full blood counts were analysed on the Technicon H6000 automated haematology machine. From these, 62 patients were identified who had abnormally high numbers of large unstained white cells; these patients were followed up for evidence of viral infection. Seventeen were either lost to follow up or in chronic renal failure; of the remaining 45 patients, 40 had viral infections, 26 of which were due to Epstein-Barr virus. In the presence of a raised number of large unstained white cells, an IgM test for Epstein-Barr virus is recommended, followed by routine serology when necessary.