Experimental Coxsackie virus B4 valvulitis in cynomolgus monkeys

Clinicopathological study of coxsackie B viral myocarditis

Autopsy cases of myocarditis caused by Coxsackie viruses in two infants, aged 5 years and 10 months and 12 years, and two adults, aged 24 years and 45 years, were presented. Of the four cases, three revealed a rise in serum neutralization titer to Cox B,4 virus and one to both Cox B2 and Cox B4 viruses. Compared with the adult cases, the 2 infant cases showed less inflammatory response with relatively prominent hypertrophy in the heart. Both of the adult cases revealed intensive inflammatory reaction. Extensive inflammatory cell infiltration remained in one of the adult cases though the case survived about 4 years after manifestation of the infection, suggesting possible involvement of immunological factors.

Postmyocardial infarction (Dressler's) syndrome: report of a case with immunological and viral studies

A case of PMIX with immunologic and viral studies obtained prior, during, and after a typical exacerbation are reported. Immunologic studies indicated the presence of humoral antiheart autoantibodies, and an increase in the number and proportion of lymphocytes containing surface IgG immunoglobulin during acute activity. Viral studies were negative. Previously reported immunologic and viral data, as well as etiology and pathogenesis of PMIS are discussed.

The coronary arteries in active viral cardiomyopathies

These studies reveal that in mice, Coxsackie B₄ and EMC viruses produce not only myocardial disease but extensive disease of the myocardial capillaries, coronary arteries, aorta and mesenteric arteries and veins and other arteries and veins. These lesions impair luminal calibre and, in turn, lead to myocardial ischaemia. This ischaemia contributes further to the myocardial damage. It is postulated that viruses initiate arteriosclerosis in man. A 19-year-old man who died of Coxsackie B₄ viral cardiomyopathy had changes in the aorta noted on light and electron microscopy which are compatible with atherosclerosis. The relationship of these aortic changes to the viral infection can only be opened to speculation. Nevertheless, all of these studies establish a new concept of the possible initiating cause of arteriosclerosis, a common and extremely important disease of man.

Differences in antibody response to streptococcal antigens in children with rheumatic and non-rheumatic mitral valve disease

The usefulness of streptococcal antibody tests — anti-streptolysin O (ASO), anti-desoxyribonuclease B (anti-DNAse B), and anti-group A carbohydrate (A-antibody) — in differentiating rheumatic from non-rheumatic mitral disease was explored. Sera from 154 children with mitral disease were studied. Fifteen of 17 patients with chronic mitral insufficiency (MI) following acute rheumatic fever manifested persistence of elevated A-antibody levels following the decline of ASO and anti-DNAse B titers to normal 18-36 months after their acute illness. This antibody pattern was not observed among sera from 35 patients with congenital mitral valve deformities. Serologic study of 71 children with mitral disease of obscure etiology identified three groups: subgroup A includes those 12 who demonstrated the antibody pattern associated with rheumatic MI, while subgroup B is comprised of 39 children with normal A-antibody levels. Twenty patients (subgroup C) manifested evidence of recent streptococcal infection. These data suggest that the use of the A-antibody test in conjunction with other streptococcal antibody tests is of potential value in differentiating rheumatic from non-rheumatic mitral disease.