SUCCESSFUL TRIMETHOPRIM SULFAMETHOXAZOLE THERAPY IN A PATIENT WITH HYPERIMMUNOGLOBULIN-E SYNDROME

A male patient with hyperimmunoglobulin E syndrome is described. Recur rent lymphadenitis and cutaneous staphylococcal abscesses were resista nt to various antibiotics, and chemotaxis and hydrogen peroxide produc tion of polymorphonuclear leukocytes were impaired. Following trimetho prim-sulfamethoxazole therapy, he was free from the above infections, and impaired polymorphonuclear leukocyte functions recovered and serum IgE decreased to approximately one-fifth of its initial level. Subseq uent irregular medications, however, resulted in impairment of polymor phonuclear leukocyte functions and an increased serum IgE concentratio n, which recovered after regular resumption of trimethoprim-sulfametho xazole treatment. From these results, the beneficial effects of trimet hoprim-sulfomethoxazole in hyperimmunoglobulin E syndrome are clinical ly apparent, but in vitro studies failed to demonstrate the positive e ffect of trimethoprim-sulfamethoxazole on polymorphonuclear leukocytes and their mechanism still remains to be elucidated.