Thyroid function in systemic sclerosis.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to G Tirri.
Explore the source record for details and available documents.
One hundred and two patients suffering from systemic lupus erythematosus were observed over 5-140 months. IgG and IgM anticardiolipin antibodies (aCL) were searched for by ELISA in 448 serum samples, and were found in 88 (86.3%) patients on at least one occasion. Changes of aCL levels and isotypes were recorded in most patients. In patients with medium (20-80 U. GPL and/or MPL) and high (> 80 U. GPL and/or MPL) aCL levels associations with thrombosis, neurological manifestations, cerebrovascular disease, prolonged aPTT, and thrombocytopenia were found. A highly significant statistical association was found between IgG aCL and the occurrence of active disease (p < 0.0001).
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Recently the availability of human immunoglobulin for intravenous use (IVIg) has been helpful in the treatment of some conditions characterized by autoimmune disorders and anecdotal reports have been suggested a favourable role in the therapy of SLE. We report our experience on 4 SLE patients in whom IVIg was administered. Our data suggest that IVIg may be considered an alternative regimen to treat selected patients affected by SLE.
The case is reported of a patient with monoclonal gammopathy of undetermined significance (M.G.U.S.) in whom suddenly an acute polyarthritis appeared. Upon differential diagnosis, this arthropathy was attributed to the precipitation of paraprotein-containing complexes within the synovial fluid leading to an inflammatory articular reaction. Treatment with low doses of methylprednisolone lead to complete remission of this arthritis.
We evaluated basophil releasability in 16 female patients with scleroderma (systemic sclerosis) and in 16 normal age- and sex-matched donors. Basophils from patients with scleroderma released significantly more histamine "spontaneously" than did those from normal donors (12.9 +/- 2.1% versus 4.5 +/- 0.7%; P less than 0.0005). Basophil reactivity (maximal percentage histamine release) to anti-IgE was higher in patients with scleroderma than in controls (57.0 +/- 7.5% versus 35.4 +/- 7.8%; P less than 0.05). Basophil sensitivity (the concentration of anti-IgE that causes 40% of maximal percentage histamine release) to anti-IgE in scleroderma patients was similar to that found in controls (4.6 +/- 2.8 x 10(-2) micrograms/ml versus 2.3 +/- 1.0 x 10(-1) micrograms/ml; P not significant). Scleroderma patients also showed enhanced releasability compared with that of the controls when challenged in vitro with interleukin-3 (8.3 +/- 1.7% versus 3.2 +/- 0.6%; P less than 0.01). Releasability induced by the formyl-containing tripeptide, f-met peptide, was significantly higher in the scleroderma patients than in the controls at the 2 lower concentrations used. No differences in basophil reactivity and sensitivity to f-met peptide and calcium ionophore A23187 were found between patients and normal donors. These results show that spontaneous basophil releasability and releasability in response to IgE cross-linking and activation of interleukin-3 receptors are increased in patients with scleroderma.
Transcutaneous oxygen pressure (TcPO2) and skin blood flow (as evaluated by laser doppler) (LD) were investigated in 24 systemic sclerosis (SSc) patients in sclerotic skin (dorsal aspect of the hand) and non-sclerotic skin (interscapular region) and in 24 controls matched for sex and age for the same sites. The two parameters were evaluated at 44 degrees C (temperature of the two sensors) in 13 patients and 13 controls, and at 36-37 degrees C in the remaining 11. At 44 degrees C, TcPO2 was lower in SSc patients than in controls for both sclerotic and non-sclerotic skin. At 37 degrees C there was no significant difference. At 44 degrees C, LD values were decreased in patients with respect to controls for both sclerotic and and non-sclerotic skin. In contrast, at 37 degrees C the values were increased in patients only for the sclerotic skin. It can be hypothesized that the increased LD values at physiological temperature are at least in part balancing a decreased tissue oxygen tension, then a normal TcPO2 is ensured. On the other hand, the decreased LD values at 44 degrees C, when TcPO2 is also decreased, indicates that there is an inability of SSc vessels to significantly increase their flow under the stimulus of a maximal hyperaemia-inducing temperature.
Ninety systemic sclerosis (SSc) patients, all females, none of them suffering from either renal failure or intestinal malabsorption, and 90 sex and age matched controls were investigated for bone mineral content (BMC) by dual photon-absorptiometry (Am 241, I 125) (Osteoden P, NIM) evaluated at two sites of the nondominant radius. BMC as well as bone density (BD) were found to be significantly lower in the patients than in the controls. No alteration of calcium metabolism was detected in the patients, neither were we able to find any relationship between osteopenia and the extent of the involvement of the skin or of any internal organ. We observed, however, that the percentage of the patients in menopause was significantly greater than that of the controls (p less than .001). Furthermore, menopause had occurred in the patients significantly earlier than in the controls (p less than .001). Therefore, earlier menopause can play a role in the induction of osteopenia in systemic sclerosis. Further prospective studies are needed to check the hormonal status of SSc patients.
Sixteen patients suffering from rheumatoid arthritis (RA) (n = 8), systemic lupus erythematosus (SLE) (n = 5), and systemic sclerosis (SSc) (n = 3), and 10 healthy subjects matched for age, sex, and body mass index, were submitted to an intravenous (IV) glucose tolerance test (GTT) (0.33 g/kg of body weight in 3 minutes) and to a euglycemic hyperinsulinemic glucose clamp to study insulin response and action. In the euglycemic clamp, along with the two insulin infusion rates (0.5 mU/kg.min from 0 to 120 minutes and 1 mU/kg.min from 121 to 240 minutes), a primed (20 microCi) continuous (0.2 microCi/min) infusion of 3H-glucose allowed determination of glucose kinetics. Our data show that patients versus controls have (1) a significant increase in basal plasma insulin levels (87.2 +/- 14.8 v 41.3 +/- 6.0 pmol/L, P less than .05); (2) similar glucose-induced acute insulin response; and (3) a lower glucose disappearance rate (Rd), glucose metabolic clearance rate (gMCR), and glucose infusion rate (GIR) when the lowest insulin infusion rate was delivered. These differences disappeared when the insulin infusion rate was doubled. Furthermore, basal plasma insulin levels and glucose disappearance rate significantly correlated with the main inflammatory indices of each disease studied. We conclude that in our patients impaired glucose handling is mainly due to peripheral insulin resistance.
Antinuclear antibodies (ANA), as detected by indirect immunofluorescence on HEp-2 cells, have been investigated in five spouses and 41 first-degree relatives of nine probands with polymyositis-dermatomyositis (PM-DM) and in 41 sex- and age-matched controls. ANA were detected in 12 out of the 41 first-degree relatives and in two controls (chi 2 = 6.97; P less than 0.01). HLA typing was done in four out of the nine families; in two of them only, ANA segregated with a haplotype. ANA positivity was not correlated either to sex or to age or to household contact. Our results show that ANA occur in a significant percentage of first-degree relatives of patients with PM-DM. The finding seems to be genetically conditioned.
Ventricular diastolic filling was investigated in a series of 51 consecutive patients with systemic sclerosis by means of Doppler echocardiography. Peak flow velocity in early (peak E) and late (peak A) diastole, E/A ratio, slope of the early diastolic flow velocity and isovolumic relaxation period were calculated. Nine out of the 51 patients showed abnormalities of ventricular filling dynamics in the absence of left ventricular systolic dysfunction at rest and after provocation. The abnormal diastolic filling pattern in these patients was detected in spite of the absence of systemic hypertension, left ventricular hypertrophy or other clinically evident myocardial disease. These diastolic abnormalities might represent an isolated evidence of the underlying myocardial fibrosis not yet clinically apparent.
Explore the source record for details and available documents.
We report a case of a rare association between acne conglobata and ankylosing spondylarthritis B27 negative which occurred in a young man. The pathogenetic relationship of the association is not certain, although some researches suggest that the onset of ankylosing spondylarthritis can result from cutaneous disease. Despite the long evolution of ankylosing spondylitis, it is not severe. Thus, the presence of B35 CREG antigens confirm that locus B antigens different from B27 could be associated with a more favourable prognosis of the disease.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.