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Biomedical subjects

H Mobacken

Publications and source records attributed to H Mobacken.

At least 55 records · Page 3Linked to original sources
PubMed1985

Serum antibodies to gliadin and small-intestinal morphology in dermatitis herpetiformis. A controlled clinical study of the effect of treatment with a gluten-free diet.

Serum gliadin antibodies of the IgA and IgG classes were determined by the diffusion-in-gel enzyme-linked immunosorbent assay in 41 patients with dermatitis herpetiformis before treatment with a gluten-free diet. Increased gliadin antibody levels were found more frequently in patients with subtotal villous atrophy (9 out of 17 patients, or 53%; p less than 0.05) than in patients with partial villous atrophy (2 out of 13 patients, or 15%) or normal villous appearance (2 out of 10 patients, or 20%). The gliadin antibody levels were negatively correlated with the urinary xylose excretion (r = -0.40, p less than 0.02 for the IgA class and r = -0.64, p less than 0.001 for the IgG class). Intestinal morphology improved and mean gliadin antibody levels of the IgA and IgG classes decreased during treatment with a gluten-free diet for 16-36 months (mean, 20 months) (p less than 0.005, n = 26), whereas no significant changes of the gliadin antibody levels or the small-intestinal morphology were observed in the other 15 patients, who continued on a non-restricted diet for 17-35 months (mean, 20 months). Thus, gliadin antibody levels in sera from patients with dermatitis herpetiformis seem to be correlated with the severity of the intestinal disease. However, all patients with villous atrophy are not detected by determination of serum gliadin antibodies.

Adolescent↗
PubMed1985

Influence of gluten-free diet on the gastric condition in dermatitis herpetiformis.

Achlorhydric atrophic gastritis occurs in approximately 25% of patients with dermatitis herpetiformis (DH). The effect of gluten withdrawal on the gastric condition was studied in 35 patients, with a control group of 20 patients continuing their habitual diet. Gastrointestinal examinations were performed initially and repeated after about 1 3/4 years. Adherence to the diet was confirmed by dietary interviews, improvement of malabsorption test results and intestinal villous structure, and decreased dapsone requirement. Neither the non-restricted diet nor the gluten-free diet had any effect on gastric morphology, the ability to secrete gastric acid, serum gastrin levels, or the frequency or titres of circulating parietal cell antibodies. The findings indicate that gluten is not responsible for the perpetuation of the gastric affection in DH, in contrast to the enteropathy.

Adolescent↗
PubMed1985

Gastric morphology and function in dermatitis herpetiformis and in coeliac disease.

Gastric acid secretory capacity was evaluated in 116 patients with dermatitis herpetiformis by means of the pentagastrin test. Endoscopic gastric mucosal biopsy specimens were obtained from both the body and the antrum in 90 of them. Forty-eight patients (41%) had a maximal acid output less than 10 mmol/h, and 30 of them (26%) were achlorhydric. The frequency of achlorhydria increased with age, and 27 out of 58 patients (47%) more than 50 years old were achlorhydric. Antrum-sparing chronic atrophic gastritis was present in 92% of the achlorhydric patients, and hypergastrinaemia and serum parietal cell antibodies were found in most of them. The prevalence of chronic gastritis of the body and of the antrum increased with age. There was no correlation between atrophic gastritis or achlorhydria and small-intestinal villous atrophy, the results of the D-xylose test, and blood folate and serum zinc determinations. The transferrin saturation index was lower in patients with achlorhydria. The frequency of achlorhydria was significantly higher in patients with dermatitis herpetiformis than in 69 patients with coeliac disease.

Adolescent↗
PubMed1985

Changes in food consumption and its nutritional quality when on a gluten-free diet for dermatitis herpetiformis.

Dietary intakes of energy and nutrients were calculated from diet history interviews in 30 patients with dermatitis herpetiformis, before and after 18 months on a gluten-free diet. In spite of great changes in the intake of different foods, the mean intake of dietary fibre did not decrease. There was only a small decrease in the intake of iron in women, while the intake in men did not change. Patients with a previous high intake of gluten had indirect evidence of malabsorption.

Adult↗
PubMed1984

Oral lichen planus: hypersensitivity to dental restoration material.

67 patients with oral lichen planus of the atrophic-erosive or reticular plaque type were examined. Dental amalgam in contact with mucosal lesions was present in 64 patients, and gold fillings in 33. Patch testing with a standard procedure was performed with components of dental fillings. 11 patients (16%) reacted to at least one of the mercury compounds compared to 8% in a reference group. Most positive reactions were caused by elemental mercury and ammoniated mercury. No patient reacted to gold or copper. Readings at days 10-14 did not increase the number of responders. 13 patients were patch tested with palladium; all were negative. It is not clear whether in the mercury-positive patients allergy to dental amalgam is a causative or aggravating factor, or merely on epiphenomenon.

Adult↗
PubMed1984

Conventional malabsorption tests: do they detect the adult patient with villous atrophy?

A total number of 134 patients with subtotal or partial villous atrophy, of whom 49 had dermatitis herpetiformis, were investigated with blood folate assay and xylose and lactose absorption tests. Faecal fat excretion was determined in 71 patients without dermatitis herpetiformis (coeliac group). A comparison was made between three patient groups, the patients with dermatitis herpetiformis and the coeliac patients studied in 1970-74 and 1975-79, respectively. From clinical and biochemical analyses of these patients we conclude that although a combination of the four malabsorption tests used here still detect a majority of coeliac patients, small intestinal biopsy may reveal villous atrophy also in patients without any laboratory evidence for malabsorption by these commonly used tests. In dermatitis herpetiformis, however, the sensitivity of the tests used was low; these malabsorption tests therefore have little diagnostic value in this category of patients.

Adult↗
PubMed1984

Incidence of liver disease in chronic lichen planus of the mouth.

Fifty-four patients with oral lichen planus were screened for chronic inflammatory liver disease utilizing standard biochemical parameters of liver function, serum levels of immunoglobulins G, A and M and circulating autoantibodies against mitochondriae, smooth muscle and cell nuclei. One patient had primary biliary cirrhosis, and another had cryptogenic cirrhosis. This study did not confirm previous observations of a frequent association of oral lichen planus and primary biliary cirrhosis or chronic active hepatitis.

Adult↗
PubMed1984

Incidence and prevalence of dermatitis herpetiformis in western Sweden.

The annual incidence of IgA-positive dermatitis herpetiformis (DH) during the years 1976-1981 in Gothenburg, Sweden, a city with approximately 430000 inhabitants, was estimated prospectively. The mean annual incidence was 1.1 per 10(5) inhabitants. The prevalence of DH as at 31 December, 1981 was 22.9 per 10(5) inhabitants or 19.6 if patients in long-standing spontaneous remission were excluded. These figures probably represent the minimum overall prevalence rate.

Adult↗
PubMed1984

Influence of the amount of dietary gluten on gastrointestinal morphology and function in dermatitis herpetiformis.

The individual daily intake of gluten was calculated in 45 patients with dermatitis herpetiformis (DH) on the basis of a depth interview about food habits. Gastric and small intestinal morphology and function were studied concurrently. Mean daily gluten intake was estimated to be 15 g, a figure which corresponds well to the average gluten intake in Sweden. There was a significant correlation between the degree of morphological mucosal changes of the small intestine and the quantity of gluten ingested. All patients with jejunal villous atrophy consumed more than 10 g gluten daily and all but one patient with normal jejunal villous structure had a gluten intake of less than 10 g/d. The findings suggest a dose-dependent effect of gluten on the intestinal mucosa. Conversely, the daily gluten intake was not correlated to gastric morphology, gastric acid secretion, serum gastrin levels or serum parietal cell antibodies. Patients with reduced ability to secrete gastric acid did not differ from the remaining patients in this respect. Whereas the coeliac-like enteropathy in DH seems to be caused by ingested gluten, the frequently occurring achlorhydric atrophic gastritis must be assumed to be of different immunopathogenesis.

Achlorhydria↗
PubMed1983

Failure to detect immune complexes in the secondary stage of pityriasis rosea.

Thirty-three patients with pityriasis rosea were studied with regard to the possible presence of circulating and cutaneously deposited immune complexes. The levels of circulating immune complexes, determined by a solid-phase C1q-binding assay, were not different from those of healthy control individuals. The levels were similar in samples obtained during the initial and during the remission stages of the disease. Cutaneous deposits of immunoglobulin and/or complement were found in only 5 of 33 patients. This study does not support of concept that circulating immune complexes are important for the development of the secondary skin lesions in pityriasis rosea.

Adolescent↗
PubMed1983

Biochemical and clinical studies in a case of contact urticaria to potato.

Contact urticaria to potato was confirmed by skin testing in a 26-year-old male with atopic dermatitis, birch-pollen rhinoconjunctivitis and a history of immediate finger itching upon handling raw potato. The potato peel was non-reactive. The urticarial reactivity to potato could be transferred by the patient's serum in a Prausnitz-Küstner test, indicating an immunological etiology. Electrophoretic and chromatographic examination of extracts from homogenized potatoes (unexposed to synthetic fertilizers and insecticides) revealed allergenic activity in a heat-labile macromolecular fraction with a mass of 20-30 kdalton migrating towards the anode during agarose gel electrophoresis at pH 8.6 with a mobility similar to that of human alpha 1-antitrypsin. The technique used for preliminary fractionation of the allergenic activity in a potato extract, similar to crossed immunoelectrophoresis, appears to be a simple and widely applicable technique for the characterization of proteins with this biological activity. A partially purified fraction with allergenic activity, seemingly more stable than the activity in crude homogenates, was obtained by gel filtration and preparative agarose gel electrophoresis. When an antihistamine was also injected, the urticarial reaction to the protein fraction was less pronounced. Pretreatment of the skin with compound 48/80, a histamine releaser, blocked the reaction. Histamine thus seems to be the major vasoactive substance mediating the contact urticarial response to potato antigen in this patient.

Adult↗
PubMed1983

Severe oral lichen planus: remission and maintenance with vitamin A analogues.

Twenty-five patients with chronic oral lichen planus, usually of the atrophic-erosive type, were treated for 2 months with Etretinate 0.6 mg/kg b.w./day, followed for 4 months by Etretinate 0.3 mg/kg/day, or 0.1% Tretinoin in an adhesive base. Complete resolution or improvement was seen in 85% of the lesions after first treatment. The number of patients with oral soreness and pain was significantly reduced (p less than 0.001). During the second treatment, the improvement was maintained or even increased in about 70% of the patients, irrespective of the mode of treatment. Treatment was discontinued in one patient owing to moderately increased serum transaminase levels. The number of drug-related drop-outs was significantly lower than in a previous study utilizing an etretinate dose of about 1 mg/kg/day (p less than 0.05). Other adverse effects were minor and tolerable. Retinoids offer an effective mode of therapy for severe oral lichen planus.

Adult↗
PubMed1983

Linear IgA dermatosis: a study of ten adult patients.

Ten adult patients with homogeneous-linear deposition of IgA along the basement membrane zone have been studied. The direct immunofluorescence IgA pattern was stable, and there was no deposition of IgG or IgM. The clinical presentations were heterogeneous and resembled dermatitis herpetiformis (DH) (3 cases) or bullous pemphigoid (5 cases). Two patients had widespread gyrate blistering lesions of acute onset. Pruritus was constantly present. The course of the disease was chronic except for one patient who had a spontaneous remission after 5 years. The histology was indistinguishable from "classical" DH with granular IgA in dermal papillae. The patients studied in the present investigation did not show the high incidence of atrophic intestinal villi found in "classical" DH. Five of 9 cases carried the haplotype HLA-A1, B8, DR3. In spite of a close similarity between linear IgA dermatosis and DH, differences exist which indicate discrepancies in etiopathogenesis.

Adult↗