Multisystem adverse reaction to lamotrigine.
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Biomedical subjects
Publications and source records attributed to E W Barnes.
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The transformation of peripheral blood lymphocytes in response to PHA was studied in 37 newly presenting patients who were subsequently proven to have carcinoma of the lung. When compared with healthy age- and sex-matched normal controls, no differences were noted in the thymidine uptake of the unstimulated lymphocytes in culture or in the response to any of the three dose levels of PHA used. Neither the extent of the spread of the carcinoma nor the type of its histology showed any correlation with the PHA response, but the PHA response was significantly depressed within 14 days of death in 7 patients. No evidence for serum inhibitory factors was found.
Two female volunteers, of menstrual age, with severe idiopathic hirsutism were treated for eight cycles and fifteen cycles respectively with cyproterone acetate 50 mg twice daily on days 5-14 of the cycle. In all but one cycle, ethinyl oestradiol in a dose of 50 mug daily from day 5 to 21 was given in addition. Cyproterone acetate when given alone abolished the mid-cycle LH surge. Combined therapy with cyproterone acetate and ethinyl oestradiol produced a significant improvement in both patients' hirsutism and was accompanied by a marked reduction in the urinary excretion of LH, FSH and androgens and by a fall in plasma testosterone. However, the clinical benefit derived from this drug was due principally to its action as a peripheral antiandrogen.
Human granulosa cells growing in culture were used to study the effects of sera from twenty-three patients with idiopathic Addison's disease. There were two women with primary amenorrhoea, thirteen with premature ovarian failure following a normal menarche, and one man with testicular atrophy in this group. The sera from all twenty-three patients contained antibodies which reacted with fresh sections of human corpus luteum using an in vitro immunoflorescence test. Serum fron nine of the twenty-three patients contained antibodies which were cytotoxic to human granulosa cells in tissue culture; the cytotoxic effect was complement dependent, and related to the immunofluorescent staining properties of the serum and dilution of antibody present. No cytotoxic effect was observed when granulosa cells were cultured in serum from the remaining fourteen Addisonian patients, or from normally menstruating women, post-menopausal women or in serum containing organ-specific antibodies to other endocrine tissues. The cytotoxic effect was paralleled by a fall in progesterone production by the granulosa cells. The production of progesterone by cells cultured in any of the non-cytotoxic sera was significantly greater than that produced by cells in the presence of cytotoxic antibody.
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Organ-specific antibodies were looked for in 26 patients with lichen sclerosus. Ten of the 25 female patients (40%) had organ-specific antibodies to thyroid cytoplasm and 11 (44%) had organ-specific antibodies to gastric parietal cells. Both values were significantly greater than those obtained in age-matched controls. None of the sera from patients with lichen sclerosus contained antibodies to steroid-producing tissues. No organ-specific antibodies were found in the one male patient.The findings suggest that lichen sclerosus may be related to an autoimmune process.
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Anti-complementary activity was detected in the sera of 23 (59%) out of 39 patients with Hashimoto thyroiditis; in 10 (29%) out of 34 patients with primary hypothyroidism; in six (17%) out of 36 patients with thyrotoxicosis; and in only six (8%) out of 78 control subjects. Fractionation of Hashimoto sera by Sephadex G-200 chromatography showed that the anti-complementary activity was founding fractions of larger molecular size than monomeric IgG, being localized predominantly in the ascending limb of the second elution peak, suggesting that it was in the form of small immune complexes.
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