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Biomedical subjects

D Gouet

Publications and source records attributed to D Gouet.

At least 19 recordsLinked to original sources
PubMed1989

Nephrotic syndrome associated with chronic lymphocytic leukemia: an immunological and pathological study.

Three patients with B chronic lymphocytic leukemia and the nephrotic syndrome had atypical membranous glomerulonephritis or lobular membranoproliferative glomerulonephritis with subepithelial and subendothelial deposits containing IgG1 kappa, IgG1 lambda or IgM and IgG by immunofluorescence, respectively. A monoclonal cryoglobulin was intermittently found in the serum in one case. In two patients, kidney deposits were made of organized microtubular structures. Intracytoplasmic immunoglobulin inclusions in the two patients' lymphocytes showed a very similar electron microscopic pattern. The immunologic phenotype of leukemic lymphocytes was analogous in the three cases (with expression of CD2) and suggestive of a late maturation step. A complete remission of the nephrotic syndrome was observed after therapy with chlorambucil (and prednisone). These observations suggest a direct role of monoclonal immunoglobulins in kidney disease.

Aged↗
PubMed1988

Isotypic distribution of anti-double-stranded DNA antibodies: a diagnostic evaluation by enzyme-linked immunosorbent assay.

Anti-native DNA antibodies were studied using an immunoglobulin class-specific enzyme-linked immunosorbent assay (ELISA) in 450 sera, virtually all of which were antinuclear antibody positive. ELISA was positive in about 85% of systemic lupus erythematosus (SLE) sera, usually at high titer and for two or three isotypes. Virtually all sera with antibodies of the three main classes were collected from SLE patients. Very high titers were unique to SLE. In contrast, low-titer antibodies of a single, mostly IgM, class were found in certain patients without evidence of autoimmune disease or with non-SLE autoimmune diseases. The isotypy and titer of the antibodies hence appear to be critical parameters for a correct interpretation of results. Under these conditions, ELISA seems to be usable as single screening test for the demonstration of anti-DNA antibodies.

Autoantibodies↗
PubMed1986

[Prognosis of treated temporal arteritis. Retrospective study of 87 cases].

Eighty-seven patients (mean age 73 years) with histologically proven Horton's disease were followed up in 5 different specialized hospital units from 1970 to 1984. Except for one patient treated exclusively with antimalarials, all were under corticosteroids. The mean initial dose of prednisone or equivalent was 0.7 mg/kg/day and the mean maintenance dose, 10 mg/day. Steroids could be discontinued in 21 cases after 36 months on average; the other patients could not be weaned, even though 4 of them had been on steroids for more than 10 years. Side-effects were noted in 43 cases. Twenty-four patients died, mostly of cardiovascular diseases. Survival rates were 89 +/- 6.35% at 1 year, 60.2 +/- 8.7% at 5 years and 48 +/- 11.3% at 10 years. In the long run, mortality in our series proved to be exactly the same as in the general population. Nineteen patients had ocular manifestations of giant cell arteritis always from the onset, except for a fall in visual acuity; 26 relapses were observed in 18 patients, either during reduction of steroid dosage (21 cases) or after withdrawal (5 cases). In 2 cases histology showed typical lesions of giant cell arteritis after 41 and 50 months respectively under corticosteroid therapy.

Aged↗
PubMed1986

[Prognosis of generalized scleroderma. A retrospective study of 78 cases].

From 1960 to 1984, 78 new patients with progressive systemic sclerosis were followed up: 60 women and 18 men whose ages ranged from 20 to 83 years, with a mean age of 58 years. Twenty nine are known to be dead and 3 were lost of follow-up. Forty six have been followed up to the present time for a mean period of 5 years. The cumulative survival rates were 88 +/- 7 p. 100 at one year, 62,5 +/- 11,5 p. 100 at five years and 50,5 +/- 15 p. 100 at ten years. These figures are significantly different from those found in a matched group from the French general population. Nine features at the time of diagnosis which might influence prognosis were studied. Seven factors apparently have not affected prognosis: sex, age, time elapsed between initial symptom and definitive diagnosis, location of scleroderma, blood pressure, erythrocyte sedimentation rate and creatinine clearance. On the other hand, survival declined significantly faster in the 28 patients with anemia than in the 50 patients without anemia (P less than 0,001). Similarly, the 47 patients with radiological pulmonary involvement or pulmonary function abnormalities were at significantly higher risk for death than the 31 patients without interstitial pulmonary fibrosis. Anemia and pulmonary involvement are predictors of mortality and important prognostic tools in the management of the different drugs that have been recommended for the treatment of patients with systemic sclerosis.

Adult↗
PubMed1986

[Effects of the artificial pancreas on peripheral nerve function in the diabetic].

Twenty-one diabetic subjects were studied; all manifested fasting hyperglycemia and elevated Hb A1C. Motor conduction velocity of the median, ulnar and peroneal nerves; F wave of the peroneal nerve; sensory conduction velocity and sensory potential amplitude of the median and ulnar nerves and H reflex were determinated immediately before and after two days of strict glucose control with an artificial endocrine pancreas. A significant and acute improvement of some electrophysiological parameters led us to presume that repair of structural lesions would be unlikely. Only a metabolic disturbance, due to hyperglycemia, can be rapidly corrected.

Adolescent↗
PubMed1986

Atenolol induced systemic lupus erythematosus syndrome.

We report the first case of an illness resembling idiopathic lupus erythematosus, with fever, pleuropericarditis, antinuclear antibodies and antidenaturated DNA antibodies after 18 months of treatment with atenolol for hypertension. After withdrawal of atenolol our patient's clinical symptoms disappeared and laboratory test results returned to normal, which strongly suggests the role of atenolol in inducing the syndrome, therefore atenolol should be added to the list of beta blocking agents capable of inducing a lupus-like syndrome.

Atenolol↗
PubMed1986

Serum immunoglobulin G subclass dysbalances in the lymphadenopathy syndrome and acquired immune deficiency syndrome.

Serum IgG subclass levels were measured by an indirect competitive immunoenzymatic assay with monoclonal antibodies in 61 adult patients of different geographic origins affected either with the lymphoadenopathy syndrome (LAS, 46 cases) or with the acquired immune deficiency syndrome (AIDS, 15 cases). In spite of considerable variations from patient to patient, IgG-1 and IgG-3 levels were higher than in normal Caucasians, with IgG-1 levels much more elevated in LAS than in AIDS patients. In Caucasians with AIDS or LAS, IgG-4 levels were low. IgG-2 levels tended to be low and correlated negatively with IgG-1 levels. IgG subclass imbalances were especially striking in patients with lymphoid interstitial pneumonitis. The results suggest that the IgG increase predominantly affects the less T-dependent subclasses. The low levels of the more T-dependent isotypes do not appear to play a clear role in the occurrence of pyogenic infections in certain patients.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Detection of anti-double stranded DNA antibodies of IgG, IgA and IgM classes by ELISA. Comparison with the Farr test and indirect immunofluorescence].

Anti-double stranded DNA antibodies were measured by an immunoglobulin class-specific immunoenzymatic assay (ELISA), in 450 sera from 265 patients as well as by indirect immunofluorescence using Crithidia luciliae as a substrate and, for 124 sera, by the Farr test. ELISA proved specific and reproducible and it yielded results that were well correlated with the Farr assay, with a slightly higher sensitivity of ELISA. Correlation with immunofluorescence was not as good because of the lower sensitivity of the latter method. ELISA enables the levels and isotypes of anti-DNA antibodies to be determined. Both appear to be critical parameters for a clinical interpretation of results, especially with respect to the diagnosis of systemic lupus erythematosus.

Antibodies, Antinuclear↗
PubMedDate not supplied

[Atypical echocardiographic aspects of cardiac amylosis].

Echographic abnormalities of cardiac amylosis are now well known and quite useful to the diagnosis. Forms that are morphologically atypical are rare. From three observations (2 hypertrophic, asymmetrical and obstructive forms, and 1 hypertrophic and dilated form) and a review from the literature, we study the nosological, diagnostic and therapeutic problems presented by these atypical echographic of cardiac amylosis.

Aged↗