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Biomedical subjects

C Amberger

Publications and source records attributed to C Amberger.

7 recordsLinked to original sources

Autologous stem cell transplantation of treatment-resistant systemic vasculitis--a single center experience and review of the literature.

AIMS: Autologous peripheral blood stem cell transplantation (autoPBSCT) is increasingly and successfully applied to patients with treatment-resistant autoimmune diseases, mainly multiple sclerosis and systemic sclerosis, but also juvenile idiopathic arthritis and systemic lupus erythematosus. We intended to analyze the effects of autoPBSCT in patients with treatment-resistant systemic vasculitis by analyzing the outcome of 4 patients from our own hospital, and comparing them to cases reported in the literature. METHODS: 4 patients with treatment-resistant vasculitis (Wegener granulomatosis, Churg Strauss syndrome, Takayasu arteritis and relapsing polychondritis) received an autologous PBSCT. Stem cell mobilization was performed with cyclophosphamide (CY) and G-CSF, stem cells were purged by positively selecting CD34+ stem cells over a CliniMacs device, and the conditioning was performed with high dose CY and anti-thymocyte globulin (ATG). RESULTS: AutoPBSCT was well tolerated in all 4 patients. The patient with WG achieved complete remission although cANCA persisted, the other patients are in good partial remissions and respond to maintenance treatments which had been ineffective before PBSCT (CSA, azathioprin). Glucocorticosteroids (GC) could be reduced to a maximum of 10 mg in all patients. Shortly after the procedure, reactivation of viruses from the herpes family occurred in 3 of the patients and had to be treated. In the data base, 25 patients transplanted for severe systemic vasculitis are registered, in the literature, 6 additional vasculitis patients remitting after autoPBSCT are reported. CONCLUSIONS: Autologous PBSCT is feasible and effective in severe, treatment-resistant forms of systemic vasculitis. Data are sparse, further prospective studies are needed. These should also aim at evaluating more optimal regimens for conditioning and purging during PBSCT, as in most of the vasculitis patients reported until now, mostly good partial remissions, but less complete remissions were achieved.

Adult↗

[ECG abnormalities in Airedale terriers].

Because of bradyarrhythmic complications under anesthesia in two Airedale Terriers, we performed a prospective search of ECG-abnormalities in healthy dogs of that breed. Resting ECG's were screened for routine abnormalities. None of the 42 dogs investigated so far had a completely normal ECG. Among the common abnormalities were: deviation of the mean electrical axis (MEA) in 32 dogs, low voltage QRS-complexes in 22 dogs, and AV-blocks 1st degree in 14 dogs. None of the recorded abnormalities with the exception of AV-blocks, were considered predictors of anesthetic complications. Because of the high frequency of recorded abnormalities, we are continuing this prospective study.

Anesthesia↗

[Relapsing rhabdomyolysis in a greyhound. Description of a case].

A 3-year-old female Greyhound presents difficulties of locomotion in the hind limbs after one round of the field since the beginning of the racing season. After making a diagnosis of relapsing rhabdomyolysis without secondary renal involvement, several blood samples were taken before and after the effort in order to determine the most adequate moment for clinical evaluation of a rise in serum enzymes. The possibility of making an early diagnosis and a attempt for prevention are discussed. Blood values in a population of racing Greyhounds are compared with data of the literature.

Animals↗

[Aortic valvular dysplasia in a dog].

A case of aortic valve dysplasia in a 6 year old male cocker spaniel is described. The dog was presented to the veterinarian because of strong dyspnea and frequent coughing. Clinical examination, EKG, radiographs and angiocardiography all pointed towards a tentative diagnosis of aortic insufficiency. Four months after the first appointment the dog was presented again with congestive heart failure, neural symptoms and strong abdominal pain. Electrocardiography and concentrations of LDH and CK were typical of myocardial infarction. Autopsy revealed a narrowing of the aortic valves in combination with a subaortic stenosis and several infarctions localized in the left ventricle as well as a recent infarction in the left kidney.

Animals↗

Takayasu's arteritis secondary to myelodysplasia as a predictor of poor outcome: two case reports.

We present two patients with myelodysplasia in association with Takayasu's arteritis (TA). In both patients intensive immunosuppressive treatment could not control the vascular inflammation. Subsequently both patients developed myelodysplasia, rapidly progressing to secondary acute myelogenous leukaemia. One patient had a peripheral blood stem cell transplant from a compatible sibling donor, but died of refractory leukaemia 5 months later. The other patient died of fungal sepsis. These are the first two patients reported to have TA associated with myelodysplasia/secondary leukaemia.

Adult↗