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C Belizna

Publications and source records attributed to C Belizna.

10 recordsLinked to original sources

Antiendothelial cell antibodies in vasculitis and connective tissue disease.

Antiendothelial cell antibodies (AECA) are a heterogeneous family of antibodies reacting with endothelial cell antigens. These antibodies are found in various diseases and recognise several antigen determinants. Different pathophysiological effects have been observed in in vitro experiments, which include direct or indirect cytotoxicity and endothelial cell apoptosis. Furthermore, some AECA activate endothelial cells, resulting in increased leucocyte adhesiveness, activation of coagulation and vascular thrombosis. In animal models, it has been shown that AECA could promote vascular damage. Neither the endothelial cell antigens nor their precise role in the pathogenecity of different diseases in which AECA are found is well characterised. Nowadays, it is not known whether AECA are an epiphenomenon accompanying vascular injury or whether they are pathogenic. It is controversial whether fluctuations in AECA titres are associated with disease activity during follow-up studies. This review summarises the present knowledge about AECA, AECA antigens and their potential role in the pathogenecity of vasculitis and connective tissue diseases.

Animals↗

[Spontaneous splenic hematoma: trauma injury or drug reaction or both?].

INTRODUCTION: Spontaneous splenic hematomas are uncommon and frequently associated with infectious, hematologic, or neoplastic diseases. Presentation is typically acute but progressive forms have been described. CASE: We report the case of a 45-year-old man consulting for abdominal pain that was found to be due to a spontaneous splenic hematoma. No recent injuries, infections, or hematologic, neoplastic or gastrointestinal diseases were found, but the patient had had a minor injury 9 months earlier and had been treated with selective serotonin reuptake inhibitors (venlafaxine) for the past year. This history suggested that the drug might play a role. DISCUSSION: Although the likely cause of this splenic hematoma appears to be a minor injury 9 months before the onset of pain, we cannot rule out the possibility that selective serotonin reuptake inhibitor treatment was a predisposing factor.

Abdominal Pain↗

[Tuberculosis peritonitis: an always present disease. About 4 new cases].

INTRODUCTION: Tuberculous peritonitis, a major problem in developing country, occurs preferentially in immigrant population and in patients with acquired immune deficiency syndrome (AIDS). Although rare in France, it did not disappear and epidemiological, clinical and therapeutic approach deserve to be reminded. EXEGESIS: We reported 4 patients (immigrants in two cases), occurred in caucasian and African persons (one with AIDS). Disease was characterized by fever, abdominal pain, anorexia, weight loss and ascites. Biological and radiological were unconclusive. Cell count analysis from ascitic fluid show a lymphocytic predominance with negative direct smear for Ziehl-Neelsen strain. Tuberculous peritonitis was established with combined visual and histological diagnosic laparoscopic examination. CONCLUSION: These observations have the interest to underline that tuberculous peritonitis must be evoked in case of lymphocytic ascitis. We believe an aggressive diagnostic approach, particulary with peritoneal biopsy, is warranted for the diagnosis of tuberculous peritonitis. Validity of PCR amplification is ascitic fluid still needs to be established.

Adult↗

[Venous tromboembolic treatment in patients with cancer].

PURPOSE: Venous tromboembolic treatment in patients with cancer can be a clinical dilemma. Comorbid conditions, significant risk of recurrence of bleeding associated with warfarin, difficult venous access, are some of the factors that often complicate anticoagulants therapy in patients with cancer. EXEGESIS: Low molecular weight heparin has replaced unfractionated heparin as the first line treatment in the majority of patients with venous thromboembolism and cancer, in hospital or safely at home. Recent trial demonstrated that long-term low molecular weight heparin administrated over a 6-month period reduced the rate of recurrence venous thromboembolism with non increase in bleeding compared with oral anticoagulant therapy. Placement of an inferior vena caval filter should be reserved for patients with active or very high risk of bleeding, but oncologist should consider these sobering results in such patients. Whether anticoagulants might also improve cancer survival rates independent of their effect on thromboembolism deserves further investigation. PERSPECTIVE: In future, new antithrombotic agents such as oral direct thrombin or long-acting synthetic factor Xa inhibitor may be useful in these patients.

Humans↗

Specificity, pathogenecity, and clinical value of antiendothelial cell antibodies.

OBJECTIVE: To characterize the putative target antigens for antiendothelial cell antibodies (AECA), the possible pathophysiological role of AECA, and the clinical value of these antibodies as markers of disease activity. METHODS: A structured literature search was done using Medline in combination with a manual search. Two physicians reviewed all articles of special interest. RESULTS: AECA are a heterogenous group of antibodies directed against a variety of antigen determinants on endothelial cells (EC). The EC antigens can be constitutively expressed, constitutively expressed and modulated by cytokines, or cryptic. In addition, antigen determinants for AECA may also be molecules that adhere to EC ("planted" antigens). However, many AECA antigens are currently not well characterized. AECA are detected in a wide variety of inflammatory disorders. Although probably of limited value in disease diagnosis, the detection of these antibodies may be valuable in following disease activity. In several diseases such as systemic lupus erythematosus and systemic vasculitis, high AECA titers are found during active disease whereas lower titers or disappearence of AECA have been reported during remission. The correlation between changes in AECA titers and disease activity suggests an important role for AECA in processes in which vessel wall damage occurs, although it does not exclude the possibility that AECA are an epiphenomenon of vascular injury. Several recent in vitro studies support a role of AECA in the pathophysiology of these inflammatory disorders. AECA may play a role in the pathophysiology by inducing activation of EC resulting in upregulation in the expression of endothelial adhesion molecules and/or secretion of chemoattractants and cytokines. An alternative mechanism by which AECA could be a trigger in the pathogenesis of some diseases is complement dependent cytotoxicity (CDC) and/or antibody dependent cellular cytotoxicity (ADCC). In experimental animal models, antibodies to antigenic determinants expressed on EC were capable of inducing vascular injury. CONCLUSION: AECA represent a heterogenous group of antibodies directed against a variety of antigenic determinants on EC. They are present in a variety of inflammatory disorders. The detection of these antibodies may be valuable in following disease activity. Further characterization of putative antigens is needed to better understand their pathophysiological role.

Animals↗