PubMed Health⌕ Search

Biomedical subjects

C R Strakosch

Publications and source records attributed to C R Strakosch.

12 recordsLinked to original sources
PubMed1991

Optic disc oedema and diabetes mellitus: a case report with review.

Optic disc oedema is a neurological complication of diabetes mellitus. Typically, the patient is a young diabetic with minimal symptomatology but severe bilateral optic disc oedema discovered on routine eye examination. It is a relatively benign condition which on occasion can result in a residual visual deficit, but requires no specific intervention and represents a subgroup of anterior ischaemic optic neuropathy (AION). We present a patient with insulin dependent diabetes and asymptomatic bilateral optic disc oedema, with a brief review of the syndrome and its pathogenesis.

Adult↗
PubMed1986

Thyroiditis.

In this review, the major types of immune mediated thyroiditis are described and the etiology explained in the light of current theories of autoimmunity. Hashimoto's thyroiditis is a common autoimmune disease. The onset is gradual with patients presenting with symptoms of hypothyroidism, nonspecific symptoms of the autoimmune process itself, or symptoms relating to a goitre. The disease is usually relentless and, except in young patients, permanent replacement with thyroxine is eventually required. Silent thyroiditis is another autoimmune disease of more acute onset. The initial, thyrotoxic, phase lasting several weeks is due to release of thyroid hormone from damaged follicles, and radionuclidic scans show absent uptake. There often follows a hypothyroid phase with final recovery in most patients. Post partum thyroiditis is due to silent thyroiditis, or, less commonly, Hashimoto's thyroiditis, occurring three to six months after delivery. Subacute thyroiditis often follows a viral infection and is not thought to be an autoimmune disease. It presents with severe thyroid pain and tenderness with marked non-specific symptoms such as myalgia and fatigue. The initial, thyrotoxic, phase is also due to release of thyroid hormone, and radionuclidic scans show absent uptake. A hypothyroid phase often follows and recovery is complete. Hashimoto's thyroiditis appears to be due to a congenitally present, antigen specific, T suppressor lymphocyte defect. It is proposed that in silent thyroiditis there is a less severe Ts defect and a correspondingly greater decompensating factor. In post partum thyroiditis, this factor appears to be a general decline in T suppressor lymphocyte function after delivery. Subacute thyroiditis is not an autoimmune disease. The thyroid appears to be an "innocent bystander" in an immune mediated antiviral attack.

Adolescent↗
PubMed1979

Thyroid binding antibodies and other immunological abnormalities in patients with Graves' ophthalmopathy: effect of treatment with cyclophosphamide.

Patients with Graves' ophthalmopathy were studied for a possible role of thyroid binding antibodies (TBAb) as measured by a radioreceptor assay, and for in vitro evidence of immunoreactivity to orbital antigens. The effect of cyclophosphamide (CY) treatment on the immunological parameters and the clinical course of the eye disease was also studied. The mean TBAb index for all patients with eye disease was significantly less than that for the normal and for patients with Graves hyperthyroidism who lacked eye disease. The mean TBAb index for patients with ophthalmopathy and past or present hyperthyroidism was significantly less than for those patients with eye disease but no associated hyperthyroidism ('euthyroid Graves' disease'). TBAb levels did not correlate with the severity of duration of the eye disease and did not change during treatment with CY. Significant titres of serum antibodies against human eye muscle extract or subcellular fractions, or macrophage inhibitory factor (MIF) production in response to human orbital tissue extract were not detected in patients with eye disease. The congestive changes improved in all patients treated with CY, although the degree of proptosis and eye muscle involvement improved in only 3 of 24 and 11 of 20 patients respectively with these abnormalities. TBAb are unlikely to play a role in the pathogenesis of Graves' ophthalmopathy and the hyperthyroidism and eye disease should be considered separate autoimmune disorders. The apparently anomalous finding of a higher mean TBAb index in patients with eye disease and hyperthyroidism than in those with hyperthyroidiam alone may reflect a more severe defect of suppressor T cell function in the former group. Because evidence for specific immunoreactivity against orbital antigens was not found in this study other approaches to defining the underlying immunological mechanisms will have to be sought.

Adult↗
PubMed1978

Early diagnosis of Addison's disease; pigmentation as sole symptom.

A diagnosis of primary adrenocortical insufficiency was made in a shapely, suntanned girl whose sole complaint was increasing pigmentation. Plasma cortisol was low in spite of markedly elevated levels of ACTH. Plasma cortisol, urinary 17-oxogenic steroids and urinary aldosterone did not respond to three days of ACTH stimulation. Addison's disease can be diagnosed and treated before development of anorexia, weight loss, weakness and other classical symptoms.

Addison Disease↗
PubMed1978

Multi-system immunologically mediated disease: T lymphocyte deficiency and thyroid immunologic disease--a report of four cases.

Four cases are described of multi-system immunologically-mediated disease (systemic lupus erythematosus (two cases), polymyositis, and sarcoidosis) in association with thyroid autoimmunity. In all patients there was evidence of T lymphocyte deficiency, namely poor response of peripheral blood lymphocytes (PBL) to T cell mitogens (four cases) and failure or decreased ability to become sensitized to dinitrochlorobenzene (three cases), although two patients were ill and two were being treated with steroids. There was also evidence of B lymphocyte deficiency since PBL of no patient responded normally to pokeweed mitogen, a B and T lymphocyte mitogen. In two patients there was evidence of cell-mediated immunity to human thyroid antigens. Although thyroid stimulating antibody was not detected in the one patient with Graves' disease tested, significant titres of thyroid antibodies were detected in all cases. Possible relationships between T lymphocyte deficiency, organ-specific autoimmune disease and immunologically-mediated multi-system disorders are discussed.

Adult↗
PubMed1978

Thyroid stimulating antibodies in patients with subacute thyroiditis.

A radioreceptor assay was used to measure thyroid stimulating antibodies (TSAb) during the acute and recovery phases in 7 patients with subacute thyroiditis. High levels of TSAb were detected in 4 patients during the acute phase. In two other patients, tests were borderline positive. In the latter two patients tests were negative by two weeks, whilst in the 4 patients with strongly positive tests initially, levels persisted for several weeks, falling to within the normal range by 3 months in the two patients in whom repeated tests were carried out. TSAb probably do not play a role in the transient hyperthyroidism commonly seen in this disorder, since the detection of TSAb did not correlate with clinical or biochemical evidence of hyperthyroidism. Thus, in this disorder, TSAb are apparently able to bind to thyroid membranes in vitro, but not stimulate the gland in vivo. On the other hand TSAb could possibly play a role in the recovery phase. The possible role of suppressor cells in the development of the transient immune abnormalities which are associated with temporary thyroid damage is discussed.

Adult↗
PubMed1978

Thyroid-stimulating antibodies in patients with autoimmune disorders.

A radioreceptor assay was used to measure thyroid-stimulating antibody (TSAb) in 1) patients with Graves' disease with untreated hyperthyroidism, selected for absence of clinically significant eye disease; 2) patients with Graves' ophthalmopathy, with and without previously treated hyperthyroidism; 3) patients with other thyroid disorders; 4) patients with other autoimmune disorders; and 5) normal subjects. TSAb was detected in 14 of 15 (93%) patients with Graves' hyperthyroidism and in 10 of 16 (63%) patients with Graves' ophthalmopathy. Of the patients with Graves' ophthalmopathy, TSAb was detected in 9 of 10 patients who had once been hyperthyroid and in only 1 of 6 patients who had never been hyperthyroid (euthyroid Graves' disease). TSAb was detected in 1 patient with idiopathic Addison's disease (autoimmune adrenalitis) and in 1 patient with juvenile diabetes mellitus (both of whom were euthyroid), and borderline levels were found in 1 patient with Sjögren's syndrome and 1 patient with methyldopa-induced antired blood cell antibodies. TSAb was not detected in normal subjects or patients with other thyroid disorders. The conclusions are: 1) the test is very useful in the diagnosis of Graves' disease; 2) Graves' eye disease may be a frequently associated but separate disorder; and 3) because TSAb may be present in some euthyroid patients with other autoimmune disorders, TSAb production may occur primarily because of a disorder in the immune system.

Adolescent↗
PubMed1976

Hypokalaemia occurring during insulin-induced hypoglycaemia.

Insulin-induced hypoglycaemia was used to test pituitary function in six patients with suspected pituitary deficiency. In each, a fall in serum potassium concentration of from 0-63 to 1-48 mEq/litre (mean fall 1-10 mEq/litre +/- 0-30 SEM) was observed during the two hour period following administration of 1-15 units of insulin per kilogram body weight. In several patients the resulting hypokalaemia was at a level which has been associated with cardiac complications.

Adolescent↗
PubMedDate not supplied

In vitro production of thyroid-binding antibodies by peripheral blood lymphocytes from patients with Graves' disease: nonspecific responses associated with culture supernatant proteins.

Peripheral blood lymphocytes from patients with Graves' disease were cultured for 7 days with mitogens (phytohemagglutinin, Concanavalin A, protein A), or specific antigen (thyroid membranes), in an attempt to produce thyroid-binding antibodies (TBAb) in vitro. TBAb was measured in culture supernatants using a sensitive radioreceptor assay. Mean TBAb indices of mitogen or antigen-stimulated cultures did not differ significantly from those of unstimulated cultures for either patients or normal subjects. Although TBAb indices of less than 0.70, which are generally considered positive for serum TBAb, were demonstrated in a small proportion of individual tests of supernatants from patients with Graves' disease, low indices were also found in tests from normal subjects. One cause of such nonspecific responses was found to be culture infection. The factor associated with positive responses in infected cultures was unlikely to be an immunoglobulin since TBAb-like activity was not detected in globulins isolated by DEAE + -Sephadex chromatography, which isolates only IgG and IgA, and the activity was not neutralized by anti-IgG serum. The possible ways of improving the culture system for in vitro TBAb production and the significance of nonspecific responses in the radioreceptor assay are discussed.

Adult↗