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Biomedical subjects

A N Gorsuch

Publications and source records attributed to A N Gorsuch.

17 recordsLinked to original sources
PubMed1985

Reversible coma in Wernicke's encephalopathy.

A case of coma due to Wernicke's encephalopathy complicated by respiratory failure is described. Ventilation and thiamine administration lead to recovery, although Korsakoff's psychosis and ataxia persisted. A review of similar cases of coma emphasizes the absence of diagnostic features, but that if structural disease is excluded the presence of pupillary and ocular signs may support a diagnosis of Wernicke's encephalopathy. The response to thiamine may be diagnostic as in 8 of these patients who received it, but the long-term morbidity remains high.

Acute Disease↗
PubMed1983

Evidence for an association between rheumatoid arthritis and autoimmune endocrine disease.

Evidence is presented for the first time of a significantly increased prevalence of type 1 (insulin-dependent) diabetes in the close relatives of patients with rheumatoid arthritis. Thirty-nine (13%) of 295 patients with classical or definite rheumatoid arthritis had a first or second degree relative with type 1 diabetes and 38 (13%) had a close relative with autoimmune thyroid disease. These findings could be compatible with a possible common genetically determined mechanism of susceptibility to both diseases.

Adult↗
PubMed1982

Can future type I diabetes be predicted? A study in families of affected children.

This article examines the risk of type I (insulin-dependent) diabetes in siblings of affected children, in relation to HLA genotypes. The 288 available siblings of 160 diabetic probands were grouped according to the number of HLA haplotypes in common with their probands. HLA-identical siblings (both haplotypes in common) have an approximately 100 times greater risk of developing the disease than that in the general population, and this risk is significantly higher than that in haplo-identical siblings (one haplotype in common) P = 0.008). Thus, in Northern European populations, some 30% of HLA-identical siblings are expected to be diabetic by the age of 30 yr. The risk in nonidentical siblings (neither haplotype in common) is not significantly increased. These findings carry implications for genetic counseling and research.

Adolescent↗
PubMed1981

Increased killer cell activity in insulin dependent (type 1) diabetes mellitus.

Antibody dependent cell mediated cytotoxicity in relation to the levels of circulating killer cells was investigated in 16 newly diagnosed classical insulin dependent (Type 1) diabetics, 11 islet cell antibody positive non diabetic children with at least one HLA haplotype in common with their diabetic sibling, and in 15 normal controls. Antibody dependent cell mediated cytotoxicity was evaluated using, as target, 51Cr labelled human 0+ erythrocytes sensitised with an anti-CD antiserum. Killer cells were measured by the low affinity E-rosetting cell technique. Increased killer cell levels (greater than normal mean + 2SD) were accompanied by a significant enhancement in antibody dependent cell mediated cytotoxicity both in newly diagnosed diabetics (p less than 0.05) and in unaffected siblings (p less than 0.01). These preliminary results indicate that raised antibody dependent cell mediated cytotoxicity is a feature of insulin dependent diabetes at diagnosis and suggest that active B cell damage might be occurring some time before the onset of clinical symptoms.

Adolescent↗
PubMed1980

Complement-fixing islet-cell antibodies in type-I diabetes: possible monitors of active beta-cell damage.

Evidence is presented for the existence of a separate species of islet-cell antibodies which fix complement. Investigations in type I diabetics, non-diabetic polyendocrine patients, and unaffected first-degree relatives of type I diabetic probands show that the complement-fixing islet-cell antibodies are more closely related to the onset of clinical disease than the conventional islet-cell antibody, and they tend to disappear more rapidly. The complement-fixing antibodies may reflect damage of pancreatic beta cells more selectively and may be preferable to the conventional antibody as a serological marker for studying the natural history of type I diabetes.

Adolescent↗
PubMed1980

Evidence that type I diabetes and thyrogastric autoimmunity have different genetic determinants.

The prevalences of autoimmune endocrine disease and relevant organ-specific autoantibodies were determined in 141 patients with type I (insulin-dependent) diabetes and their families. All available members of the families were genotyped for HLA. Islet-cell antibody was found in 10 (4%) out of 248 unaffected siblings, all of whom were genetically potential cases of diabetes. One developed classical symptoms six months later. In contrast, thyroid and gastric parietal-cell antibodies occurred independent of the HLA-linked susceptibility to diabetes. These results suggest that different genes control the production of these autoantibodies and the susceptibility to type I diabetes.

Adolescent↗
PubMed1980

Type 1 diabetes and the HLA-D locus.

HLA-D specificities have been investigated in 58 classical Type 1 diabetics and 43 healthy subjects. Both groups were selected according to the HLA-B locus antigens which are known to have a significant positive or negative association with the disease. The results indicate that (1) the primary association of the disease is with HLA-DW3, (2) the increased frequency of DW4 in diabetics with rare exception is co-existent with the presence of DW3, (3) the low frequency of DW2 is secondary to the increase in DW3 and/or DW4, and is not consistent with a primary 'protective' role. It is suggested that these data support the hypothesis of interaction between HLA-linked genes operating by separate mechanisms to confer the susceptibility to young onset Type 1 diabetes (Type 1 A).

Adolescent↗
PubMed1979

A new look at HLA genetics with particular reference to type-1 diabetes.

HLA genotypes were ascertained in 150 families with a diabetic child from the same geographical area. There was preferential zygotic assortment of the paternal HLA A1-B8 haplotype (63--65% compared with the expected 50%) in 69 diabetic families and 33 control families (pooled from elsewhere) who were informative for this haplotype. In diabetic families, the offspring also had an increased incidence of the maternal HLA A2-B15-Cw3 haplotype. Irrespective of which parent contributed the HLA A1-B8 haplotype, there was a significantly increased incidence of male children (63%) who inherited this particular haplotype. This probably explains the known excess of male diabetic children.

Adolescent↗
PubMedDate not supplied

Evidence for a long prediabetic period in type I (insulin-dependent) diabetes mellitus.

In a prospective investigation of the prediabetic period before onset of type 1 (insulin-dependent) diabetes, HLA genotypes were determined in 582 healthy parents and siblings of 160 affected children. Islet cell antibody was sought by both the conventional (ICA-IgG) and the complement fixation (CF-ICA) techniques during regular prospective observation over a mean period of 2.0 years. 4 siblings and 2 parents became diabetic; the interval before detection of any biochemical abnormality exceeded a year in 4 of these (range 3-30 months), and in all cases ICA-IgG was positive from the outset, CF-ICA being positive in 5. These observations suggest that the initiation of pathogenesis may precede the abrupt clinical onset of diabetes by several years, even in children. This has important implications, both for research and for possible future prophylaxis.

Adolescent↗