T-CELL ACTIVATION AND PROLIFERATION IN A CASE OF RECURRENT MENSTRUAL TOXIC SHOCK SYNDROME

A case of menses-related toxic shock syndrome with a relapse within 9 days is presented. Cervical smear of the patient yielded growth of a S taphylococcus aureus strain which produced toxic shock syndrome toxin- 1 (TSST-1). Serum antibody against TSST-1 were absent in the first sam ple which was obtained in the acute phase and did not increase signifi cantly within 5 weeks. We studied the proliferative response of the pa tient's T cells during and after the acute phase of disease to evaluat e whether they have been rendered unresponsive to TSST-1. We could nor detect any reduction in the T cell proliferation at any time. Periphe ral T cells of the patient were analysed flow-cytometrically at two di fferent rimes to determine the expression of the T cell activity marke rs CD25 and HLA-DR. The expression of HLA-BR was increased during the acute phase and had declined significantly at the time of the second a nalysis; the CD25 expression remained constant.