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Biomedical subjects

C L Leen

Publications and source records attributed to C L Leen.

At least 55 records · Page 3Linked to original sources
PubMed1988

Tolerance of Scottish National Blood Transfusion Service intravenous immunoglobulin in patients with primary hypogammaglobulinaemia: report of 1235 infusions.

A total of 1235 immunoglobulin infusions were carried out as replacement therapy in 37 patients suffering from primary hypogammaglobulinaemia from 1983 to 1987, using Scottish National Blood Transfusion Service (SNBTS) IV IgG, manufactured by cold ethanol fractionation of plasma, ultrafiltration and mild pepsin proteolysis at pH4. Ten patients experienced adverse reactions during 34 infusions (2.8% of all infusions) and all but five were mild; 21 (62%) of the adverse reactions were encountered in the patients' first five infusions. A maximum immunoglobulin infusion rate of 5 mg/kg/min was tolerated without adverse reaction.

Adolescent↗
PubMed1987

Double-blind comparative trial of standard (commercial) and antibody-affinity-purified tetanus toxoid vaccines.

Tetanus toxoid purified by antibody-affinity chromatography, was compared with conventionally purified material in a double-blind trial in 205 healthy blood donors. There was neither any difference in immunogenicity as assessed by enzyme-linked immunoassay nor in side-reactions between the two vaccines. This study confirms that side-reactions to tetanus toxoid are not eliminated by purifying it.

Adolescent↗
PubMed1986

Salmonellosis in patients with primary hypogammaglobulinaemia.

Three of 20 patients with primary hypogammaglobulinaemia developed Salmonella gastroenteritis. Two of them who also had low concentrations of serum IgG and pernicious anaemia were clinically septicaemic. Patients with primary hypogammaglobulinaemia have previously been thought not to be more susceptible to Salmonella infection but a combination of low gastric acidity and impaired humoral immunity may predispose them to such infection.

Adult↗
PubMed1986

Selection of plasma donors suitable for tetanus boosting.

As a result of a comparative trial examining the immunogenicity and clinical reactivity of two tetanus vaccines, 33 donors with high antibody levels were plasmapheresed over 6 months for the collection of tetanus hyperimmune plasma. Serial antibody assay results and the frequency of adverse reactions were analysed to define the donors most suitable for an immune plasma programme. A high proportion of boosted donors were withdrawn from plasmapheresis because of poor persistence of antibody levels. Donors most suitable for boosting appear to be males under 25 years old with a tetanus antibody level of around 8 IU/ml prior to boosting.

Adolescent↗
PubMed1986

Increase of serum immunoglobulin level into the normal range in primary hypogammaglobulinaemia by dosage individualization of intravenous immunoglobulin.

The effect of varying the dose or the frequency or of both dose and frequency of immunoglobulin administration was evaluated in 17 patients with primary hypogammaglobulinaemia treated with Scottish National Blood Transfusion Service intravenous immunoglobulin (SNBTS IV IgG), an intravenous immunoglobulin preparation manufactured by the pH 4/mild pepsin method. Individualised dosage of SNBTS IV IgG resulted in trough serum IgG levels of greater than 4.0 g/l in 13 of the 17 patients studied. 6 of the 17 patients had trough serum IgG levels in the normal range (5.0 g/l). In 2 patients, more frequent infusions were required to achieve normal trough serum IgG levels because of their clinical conditions. In 1 of these 2 patients, the frequency could be reduced to three weekly when the gastrointestinal loss of IgG was reduced. There was a low incidence of adverse reactions (6.4%) which occurred mainly during the initial infusions. Most patients benefited from an increased serum IgG level, but the frequency of diarrhoea was unaffected. One patient with severe bronchiectasis continued to suffer from respiratory infections despite normal serum IgG levels.

Adolescent↗
PubMed1986

Serum ALT levels in patients with primary hypogammaglobulinaemia receiving replacement therapy with intravenous immunoglobulin or fresh frozen plasma.

The intravenous immunoglobulin (IV. IgG) preparation used in this study is manufactured by the Scottish National Blood Transfusion Service (SNBTS) by the pH 4/mild pepsin method. Recent reports suggest that non-A, non-B hepatitis may be transmitted by certain intravenous immunoglobulin preparations. Serum ALT levels were therefore measured prospectively in 16 patients with primary hypogammaglobulinaemia who received an intravenous immunoglobulin replacement therapy (SNBTS IV IgG) over a period ranging from 6 to 25 months. Retrospective analysis of serum ALT levels was also carried out in 8 patients with primary hypogammaglobulinaemia who received fresh frozen plasma (FFP) for periods ranging from 8 months to 13 years. There was no evidence of non-A, non-B hepatitis transmission by either SNBTS IV IgG or by FFP in all the patients studied.

Adolescent↗
PubMed1985

Immune hepatitis B plasma procurement.

The requirement for hepatitis B immunoglobulin for passive immunisation persists despite the availability of a safe hepatitis B vaccine, and there is therefore a need for immune plasma for immunoglobulin production. We have screened a large number of blood donors to identify potentially suitable hepatitis B immune plasma donors. The logistics of this have been examined, and the programme was found to be inefficient and labour-consuming. A suitably designed programme of active immunisation with hepatitis B vaccine should provide a more effective means of obtaining plasma.

Blood Donors↗
PubMed1985

Sarcoidosis and primary hypogammaglobulinaemia: a report of two cases and a review of the literature.

We are aware of only four previous cases of Kveim positive sarcoidosis reported in hypogammaglobulinaemic patients and we describe two further patients. Patients with hypogammaglobulinaemia and a sarcoid-like syndrome or sarcoidosis have been reviewed. Similarities between sarcoidosis and a subgroup of late onset primary hypogammaglobulinaemia have been highlighted. It is suggested that sarcoidosis in this patient population is probably commoner than was previously thought, but the association between the two conditions remains unclear.

Adult↗
PubMedDate not supplied

Haemophilus parainfluenzae: an unusual case of psoas abscess.

A case of Haemophilus parainfluenzae psoas abscess in a previously healthy 36-year-old man is reported here. The absence of any bowel pathology indicates that abscess formation occurred secondary to haematogenous spread of the organism.

Adult↗
PubMedDate not supplied

Cytomegalovirus disease in AIDS: the Edinburgh experience.

Retrospective analysis of medical records of 557 HIV positive patients (including 113 with AIDS) revealed 17 patients with an antemortem clinical diagnosis of cytomegalovirus (CMV) disease. This group comprised 7 injection drug users (2 male and 5 female) and 10 homosexual men. Males were significantly older than females, and homosexual men were significantly older than drug users at the time of diagnosis of CMV. All 17 patients had evidence of retinitis, and 6 also had evidence of extraocular disease. CMV retinitis was the AIDS defining diagnosis in two patients, and the attack rate of CMV in all AIDS patients progressively increased with time, with a 3-year CMV-free survival of 57%. Fifteen patients with CMV disease had evidence of previous CMV infection (CMV IgG positive), with 7 also having a positive CMV IgM and 10 a positive viral culture. The mean CD4+ lymphocyte count at diagnosis of CMV was 17 cells/mm3, compared with 68 cells/mm3 at diagnosis of AIDS. Therapy was unsatisfactory, often being complicated by marrow suppression. Relapse occurred in 11 patients after initial improvement but despite this only 3 patients died with severe visual impairment. The mean survival after a diagnosis of CMV was 10.5 months. This study confirms that disease caused by CMV is usually a late manifestation of AIDS, and the increasing prevalence among patients with AIDS implies that, the longer the survival, the greater the risk of disease. Frequent fundoscopy in HIV positive patients is of paramount importance particularly in patients who have a CD4+ lymphocyte count of less than 100 cells/mm3.

AIDS-Related Opportunistic Infections↗