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It is well established that cluster headache shows impaired functions at their neuroimmunomodulatory system level. Defect in receptor expression for 5-HT, IL-1 and IL-2 have been found in these patients. Sumatriptan, a molecule with agonistic activity for 5-HT1D receptor, truncates cluster headache attacks in 74% of patients. Flow cytometric analysis of monocytes expressing 5-HT receptor in cluster headache patients showed different trends clearly correlated with the clinical response to sumatriptan. Our findings strongly support the concept that cluster headache patients who are non responders to sumatriptan could present a block in their 5-HT receptor possibly due to specific autoantibodies for this receptor site.

The authors examined 46 patients with autoimmune thrombocytopenic Purpura and 17 patients with autoimmune neutropenia, with the direct and indirect immunofluorescence method. They intended to verify the sensibility of such methods and to determine the class of immunoglobulins. In the PTA the direct PSIFT was positive in 26 of the 46 examined patients, while the indirect in 15 cases. In the GPA the direct GIFT was positive in 9 of the 17 patients and the indirect in 6 cases. By using FITC-labelled monospecific anti-immunoglobulin reagents, in the PTA we have found IgG in the 57.7% of the patients, IgM in the 11.5% and IgG + IgM in 30.8%; in the GPA we have found IgG in the 66% of the cases, IgM in 11% and IgG + IgM in 23%. These methods have shown a good reliability and sensibility, but also delicacy.