Biomedical subjects
Publications and source records attributed to G Krook.
The urine of an albino woman contained small quantities of 5-S-cysteinyldopa; 6-hydroxy-5-methoxyindole-2-carboxylic acid, a melanin precursor metabolite, was lacking. The 5-S-cysteinyldopa excretion observed may reflect non-specific oxidation of dopa. Two other albino patients showed normal values for the excretion of 5-S-cysteinyldopa and of 6-hydroxy-5-methoxyindole-2-carboxylic acid.
Antinuclear antibodies with a nucleolar staining pattern appeared in a psoriasis patient during PUVA therapy. No antinuclear antibodies were found after the termination of PUVA but they reappeared one year later together with symptoms consistent with a connective tissue disease. The course was fatal and the clinical and the laboratory investigations suggested a scleroderma-like syndrome.
A review of published trials with beta-carotene and/or canthaxanthin treatment of erythropoietic protoporphyria is presented. Increased tolerance to sunlight is reported in about 85% of the cases in uncontrolled studies. In the only controlled trial on record no difference was found between beta-carotene and placebo. Correlations between the results of carotenoid treatment and phototests have been reported in some studies, but denied in others. During treatment the protoporphyrin levels in erythrocytes were significantly increased in one study, but decreased or unaffected in others. A possible mechanism of photoprotection by beta-carotene is briefly presented. To date no serious side effects or hypervitaminosis-A induced by beta-carotene have been reported.
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During PUVA therapy 7 patients out of 34 with severe psoriasis developed circulating antinuclear antibodies (ANA) (21%). Before treatment only 3 patients of 50 (6%) considered for PUVA had detectable ANA. The ANA titres were usually low. Antibodies against native DNA as studied with the Crithidia luciliae test, were not found, and blood and urinary screening for collagenosis was negative. All 7 patients responded well to the PUVA treatment. The significance of these findings remains to be determined.
A case of liver injury caused by 8-methoxypsoralen given orally during PUVA therapy is presented. The reaction, manifested by elevated serum alanine-aminotransferase and serum aspartate-aminotransferase, was provoked on three consecutive occasions, on the last one with 8-MOP only. The liver injury seems to be of the hepatocellular and nonpredictable type.
Four patients with occupational contact dermatitis to Lactuca sativa had cross-sensitivity to Cichorium endivia. One of the patients also had contact urticaria to Lactuca and Cichorium, and another reacted positively to scratch tests with these plants as a sign of immediate allergy. In two cases such immediate allergy was considered the cause of a vesicular, intense itching eruption within a few minutes of contact with fresh leaves of Lactuca on previously eczematous skin. The severe chronic dermatitis of the hands of these patients is ascribed to combined delayed and immediate allergy.
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