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Biomedical subjects

G Liedén

Publications and source records attributed to G Liedén.

At least 19 recordsLinked to original sources
PubMed1990

Plasma exchange in endocrine ophthalmopathy.

We studied the effects of intensive plasma exchange on endocrine ophthalmopathy in 12 patients with Graves' disease and one with Hashimoto's thyroiditis. All patients were euthyroid at the time of plasma exchange. All but five had concomitant treatment with azathioprine. Each patient had a treatment period consisting of six plasma exchanges performed in 2-3 weeks; two patients were treated in two periods. Each time a mean of 2.4 liters plasma was exchanged. There was a prompt reduction in the concentration of circulating immune complexes and/or thyrotropin receptor antibodies following plasma exchange. Six of the 13 patients improved their proptosis; their median duration of eye symptoms before treatment was less than 8 months. In patients suffering from eye symptoms for more than 1 year improvement was rare. Overall the Hertel values were 24.1 +/- 4.4 (SD) before and 22.8 +/- 3.4 after plasma exchange for the left eyes (P = 0.07) and 23.8 +/- 4.0 before and 23.0 +/- 3.8 after for the right eyes (P = 0.09). Nine patients altogether improved their ophthalmopathy index and periorbital oedema. In patients with disabling endocrine ophthalmopathy plasma exchange may sometimes be of value to induce a relief of the ophthalmopathy; when it is used it should be instituted before fibrotic changes occur. We suggest that concomitant immunosuppressive drugs should be given to prevent rebound phenomenon induced by plasma exchange. To establish the role of plasma exchange in the treatment of endocrine ophthalmopathy controlled studies should be performed.

Adult↗
PubMed1990

Presence of IgA and IgG antigliadin antibodies in healthy adults as measured by micro-ELISA. Effect of various cutoff levels on specificity and sensitivity when diagnosing coeliac disease.

In this study a micro-ELISA (ELISA = enzyme-linked immunosorbent assay) was established and used to evaluate IgA and IgG antigliadin antibodies in 1,866 healthy adults. There was a covariation between the level of IgA antigliadin antibodies and the total serum IgA concentration, probably due to an increased IgA response in some healthy subjects. We could not find any correlation between the presence of IgG and IgA antibodies in the healthy population using the 97.5th percentile as a cutoff value. The specificity of various cutoff levels was compared with the sensitivity of the test in a population of 40 patients with coeliac disease. IgA antigliadin antibodies had a high specificity (95%) at a cutoff value giving a high sensitivity (80%). This was not possible with IgG antigliadin antibodies which had a low sensitivity (40%) when the cutoff value was selected to give a high specificity. Due to the low prevalence of coeliac disease, a decrease in the specificity of the test will have a pronounced effect on the positive predictive value. The results indicate that only IgA antigliadin antibodies are useful markers when screening subjects with few typical symptoms for biopsy when diagnosing coeliac disease, whereas IgG antibodies are of low value because of their low specificity.

Adolescent↗
PubMed1987

Cryoprecipitate infusion fails to improve organ function in septic shock.

Plasma fibronectin may be of critical importance for the septic patient through its proposed function as the major opsonin for macrophage clearance of circulating, noncellular debris. As a rule, critically ill, septic patients are depleted of fibronectin. In earlier uncontrolled studies, infusion of fibronectin-rich cryoprecipitate had resulted in improved renal and pulmonary functions and changes in peripheral hemodynamics. In this controlled study, 32 septic ICU patients (mean initial fibronectin level = 60% of normal) received cryoprecipitate or control infusions. Although the fibronectin level was significantly elevated to the normal range in the cryoprecipitate group, no effects were seen in hemodynamics, oxygen metabolism, or lung and kidney functions. Our results indicate that this form of fibronectin therapy does not influence the impaired organ function in septic shock.

Adult↗
PubMed1986

Plasma exchange and leukapheresis in psoriasis--no effect?

Nine patients with severe or therapy-resistant psoriasis were treated by plasma exchanges or leukapheresis; one received both treatments in succession. None of the patients showed convincing signs of improvement. We therefore conclude that there is little evidence for the existence of a "psoriasis factor", the removal of which, it has been suggested, would explain the beneficial effects of dialysis. Nor is there anything to indicate that the removal of large numbers of leukocytes would bring about healing.

Adult↗
PubMed1986

Long-term remission of pure red cell aplasia after plasma exchange and lymphocytapheresis.

A 57-year-old man with idiopathic pure red cell aplasia went into remission after plasma exchange. He relapsed after 5 months and then failed to respond to treatment with intensive plasma exchange and immunosuppressive agents. Because of a high proportion of T-suppressor cells in the peripheral blood he was treated with lymphocytapheresis in addition to the previous treatment. The patient achieved a long-term haematological remission which has now persisted for more than 3 yr.

Cyclophosphamide↗
PubMed1984

Tumour regression after extracorporeal affinity chromatography of blood plasma across agarose beads containing staphylococcal protein A.

The therapeutic effect of absorbing plasma from tumour patients with immobilized staphylococcal protein A was tested. Plasma prepared by centrifugation was passed over protein A-Sepharose and then reinfused into the patient. Five patients were thus treated. One with malignant melanoma and one with renal adenocarcinoma showed measurable regression of metastatic lesions. In another with malignant melanoma a subcutaneous metastasis showed histopathological changes compatible with a therapeutic effect. In two patients, one with malignant melanoma and one with renal adenocarcinoma, no signs of regression were found. No severe adverse effects of the treatment were observed.

Adenocarcinoma↗
PubMed1984

Changes in circulating immune complexes in tumour patient serum after in vitro or ex vivo affinity chromatography of blood plasma or whole blood over immunoglobulin-binding staphylococcal protein A-Sepharose.

Circulating immune complexes (CIC) were determined in tumour patient sera using three methods. One is based on PEG-precipitation, one on C1q-reactivity, and one on protein A-reactivity. About 25-30% of the sera were positive in at least one of the tests. Incubation of serum with protein A-Sepharose in vitro removed PEG-precipitable CIC from most sera, whereas C1q-reactive CICs had a much lower affinity to protein A. The protein A-reactive complexes showed considerable variation in their binding to protein A-Sepharose, and in some sera the amount of these CICs was actually increased. Similar changes in protein A-reactive CIC were also found during ex vivo treatment of tumour patients with immune adsorption. It is proposed that the binding of immune complexes to protein A can result in remodelling of protein A itself. Results from ultracentrifugation and fractionated PEG-precipitation support this hypothesis.

Antigen-Antibody Complex↗
PubMed1983

Plasmapheresis in the initial treatment of insulin-dependent diabetes mellitus in children.

Several factors indicate that autoimmune mechanisms may play a part in the aetiology of insulin-dependent diabetes mellitus. At the onset of the disease in 10 children (aged 11-16 years) plasmapheresis was performed four times over one to two weeks. Seventeen age-matched children with the same clinical features served as controls. The C-peptide concentrations at onset were the same in the two groups, but after one month the children treated with plasmapheresis had significantly higher values. This difference became even more pronounced after three, nine, and 18 months, both during fasting and at the maximum response to a standardised meal. The study group also had a significantly more stable metabolism, longer partial remission, and no higher insulin requirement. Of the 10 treated children islet-cell cytoplasmic antibodies were present in seven before plasmapheresis and in nine during treatment. The antibodies remained detectable in five and six out of nine patients at one and six months respectively after plasmapheresis. Although the mechanisms are obscure, plasmapheresis performed at the onset of insulin-dependent diabetes mellitus may help to preserve beta-cell function.

Adolescent↗
PubMed1983

Plasma fibronectin deficiency during chemotherapy of acute myeloid leukaemia.

Plasma fibronectin was determined using a laser nephelometric method in 10 patients with acute myeloid leukaemia undergoing chemotherapy. There was a continuous fall during the first 3 weeks to about 50% of the normal level. The decrease of fibronectin may contribute to the lowered resistance against infection characteristic of these patients.

Adult↗
PubMed1981

Thyroid function after thermal trauma.

The thyroid function was analyzed for 4-6 weeks in a prospective study of 12 thermally injured patients. The burn size range was 15-90%. Serum concentrations of 3,5,3'-triidothyronine (T3) was suppressed and 3,3',5'-triidothyronine (rT3) was increased. The ratio T3/rT3 was subnormal on the third day after the trauma and normalized after 3 weeks. Thyroxine and the free T4-index were within the normal range. The free T3-index were within the normal range. The TSH concentration was initially low but slowly increasing during the period of study. The concentration of the thyroxine-binding globulin (TBG) varied within the normal range. The T3 resin uptake test varied inversely with the TBG concentration. The concentration of thyroxine-binding prealbumin (TBPA) was subnormal. A control experiment excluded possible interference on the hormone concentrations of administered donor blood and plasma. It is concluded that the thyroid hormones are not responsible for the posttraumatic hypermetabolism in burn injury. The present findings further indicate a depletion of metabolically active thyroid hormones at the cellular level after burn injury.

Adult↗
PubMed1977

Dose-related levodopa-induced haemolytic anaemia.

A 71-year-old white man developed direct antiglobulin positive haemolytic anaemia after 16 months of levodopa therapy for Parkinson's disease. Immunoglobulin G autoantibodies directed against Rh antigens were found in the patient's serum and on his erythrocytes. Reduction of levodopa dosage to one sixth with the aid of a peripheral decarboxylase inhibitor (benserazide) largely eliminated autoimmune haemolysis while maintaining adequate control of neurologic symptoms.

Aged↗