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Biomedical subjects

J Abbosh

Publications and source records attributed to J Abbosh.

8 recordsLinked to original sources
PubMed1999

Angiotensin converting enzyme inhibitor-induced angioedema more prevalent in transplant patients.

BACKGROUND: Angioedema in association with angiotensin converting enzyme inhibitor (ACEI) use is rare, but serious. Which patients are predisposed to the reaction and whether it involves an immune mechanism remain unclear. OBJECTIVES: To determine the frequency of ACEI angioedema in immunosuppressed cardiac and renal transplant patients. METHODS: This was a retrospective chart review of all adult cardiac (n = 156) and renal (n = 341) transplant patients followed at our hospital (years 1985 to 1995). RESULTS: Of 105 cardiac and 91 renal transplant patients on a combination of immunosuppressive and ACEI therapy, 5 (4.8%) cardiac and 1 (1%) renal patients developed angioedema. This prevalence of ACEI angioedema among cardiac and renal transplant patients is 24 times and 5 times higher, respectively, than that observed in the general population (0.1% to 0.2%). Reactions often appeared after prolonged ACEI use (average 19 months; range 3 days to 6.3 years). African-Americans were significantly more likely to experience ACEI-associated angioedema (P = .034), especially among the cardiac patients where 4 of 5 reactors were African-American. CONCLUSIONS: For unclear reasons, ACEI-induced angioedema (often late-onset) is more prevalent among immunosuppressed cardiac and renal transplant patients. Additionally, African-Americans are over-represented among those developing the reaction.

Adult↗
PubMed1976

Toleracne to equine IgG after immunosuppression in patients with multiple sclerosis.

Fourteen patients with multiple sclerosis were given two tolerizing doses of equinine gammaglobulin followed by equine antilymphocyte globulin. Twelve were sufficiently tolerant to have no clinical symptoms of hypersensitivity, no skin reactivity and normal plasma clearance rates. Some tolerance was lost in the following months revealed by immediate wheal and flare skin reactions. No correlation between success in tolerance induction and beneficial effects on the disease process could be established in the short term follow-up period of this pilot study.

Animals↗
PubMed1976

The effect of intensive immunosuppression on the in vitro activity of lymphocytes from multiple sclerosis patients.

During a small clinical trial of intensive immunosuppression in multipel sclerosis (MS, 14 patients) the changes of in vitro lymphocyte responses to mitogens were followed. A variable depression of the normal responses to phytohaemagglutinin (PHA), Concanavalin A (Con A) and pokeweed mitogen (PWM) was seen in the patinets during the inital week of treatment with prednisone (150 mg/day tapered to 20 mg/day by day 7), and azathiprine (3 mg/kg daily). They were further depressed during antilymphocyte globulin therapy (ALG 500 mg/day on weekdays, weeks 2-5 of treatment). These responses returned rapidly to the lower normal range after the three weeks of ALG despite the continued prednisone and azathipprine therapy. A complex effect of immunosuppression on lymphocyte subpopulations was suggested by three findings. Firstly, in contrast with the reduction in response to plant mitogens no lowering of the response to allogeneic lymphoid cell line cells (LCL) was seen during the first week of treatment. Secondly, some patinets, particularly those expressing the HLA-7 antigen, had a low pre-treatment response to LCL which showed an improvement during treatment and which was maintained through the first week of ALG treatment. Thirdly, single inviduals sometimes showed different degrees of suppression of different responses during and after ALG treatment. Occasionally, responses showed some recovery even during the ALG treatment, suggesting that higher ALG doses were required in these patients. The results suggest that the action of immunosuppressive drugs on lymphocyte activity differs between individuals due to the heterogeneity of the lymphocyte subpopulations present.

Antilymphocyte Serum↗
PubMed1975

Plasma heparin levels after low dose subcutaneous heparin in patients undergoing hip replacement.

Plasma heparin levels were measured at 2 and 8 h after 5000 iu of heparin subcutaneously in 43 patients awaiting total hip replacement. At 2 h, 37 patients had plasma levels between 0.05 and 0.15 iu/ml, three patients had more than 0.2 iu/ml, and three had only trace levels. At 8 h, most patients had less than 0.1 iu/ml, and six patients had no detectable plasma heparin. There were no correlations between plasma heparin levels and age, sex, body weight or use of analgesics. Patients with high 2 h plasma heparin levels may bleed at operation, whereas those with very low plasma heparin concentrations may be at risk of post-operative venous thrombosis; it may therefore sometimes be necessary to monitor plasma heparin levels in order to determine the optimal regime in individual cases.

Adult↗
PubMed1975

Intensive immunosuppression in patients with disseminated sclerosis. III. Lymphocyte response in vitro.

Lymphocytes from fifteen multiple sclerosis patients gave responses to phytohaemagglutinin (PHA), conconavalin A (con A) and pokeweed mitogen (PWM) which were in the normal range. However, the responses of lymphocytes to stimulation by an allogeneic lymphoid cell line (LCL) were significantly lower in HLA-7-positive than in HLA-7-negative patients (a distinction not found in control groups). Depression of con A, PHA and PWM responses were observed during intensive immunosuppression. Responses to LCL were unaltered or increased during initial azathioprine and prednisone treatment. The depression of this response following antilymphocyte globulin (ALG) treatment was delayed in the HLA-7-positive patients. One week after the end of ALG treatment, most PHA, con A and PWM responses had returned to low normal values. Reduction of azathioprine and prednisone treatment at the end of 1 year resulted in a sharp rise in PHA and con A responses in some patients. Relapses in patients were frequently associated with low responses to LCL cells.

Antilymphocyte Serum↗
PubMed1975

Intensive immunosuppression in patients with disseminated sclerosis. II. Tolerance to equine IgG and effect on immunoglobulin and complement levels.

Fourteen patients with multiple sclerosis were given two tolerizing doses of equine gamma-globulin before treatment with anti-lymphocyte globulin. Twelve patients had no clinical symptoms of hypersensitivity and most of them had no detectable antibody to the equine globulin until several months later. Even then, antibody could only be shown by immediate type skin reactions but not by any in vitro assay. We conclude that a state of partial tolerance was established in these patients for the period of treatment but that later they may develop traces of hypersensitivity.

Animals↗