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Biomedical subjects

J D MacFarlane

Publications and source records attributed to J D MacFarlane.

7 recordsLinked to original sources

Extracapillary glomerulonephritis in a patient with juvenile chronic arthritis.

A patient with juvenile chronic arthritis (JCA) in remission developed the nephrotic syndrome 17 years after the onset of the disease. A renal biopsy showed diffuse extracapillary proliferative glomerulonephritis without immune complex deposits. The patient was treated with glucocortico-steroids and cyclophosphamide. Extracapillary glomerulonephritis without immune complex deposits appears to be a rare complication of JCA.

Adult↗

Joint effusions after kidney transplantation.

Thirty-seven consecutive renal transplant recipients were studied prospectively for joint disease. Six developed arthralgias while corticosteroid doses were being lowered. Eleven patients (30%) developed knee effusions at a mean interval of 10 days following transplantation. Synovial fluids were colorless or very pale yellow, with few leukocytes (mean, 28/mm3). These benign transudative effusions did not correlate with immunologic abnormalities, transplant rejection, crystal deposition, or avascular necrosis and may have been due to high dose oral corticosteroid therapy.

Adolescent↗

Cost of management of patients with haemophilia.

The cost of managing 114 adult haemophiliacs in the west of Scotland was assessed for the period 1 March 1971 to 28 February 1974. Altogether 23 of them (20%) accounted for 80% of the resources used. The cost of hospital treatment of these patients during the period was compared with the predicted cost of home treatment, given the availability of freeze-dried factor VIII concentrate in sufficient amounts. We calculate that adequate on-demand home treatment would cost only 16% more than the present treatment, which is substantially less efficient.

Adult↗

Subcutaneous fat biopsy in the diagnosis of amyloidosis secondary to chronic arthritis.

Subcutaneous fat biopsy was investigated for its sensitivity in giving a diagnosis in 44 consecutive patients with rheumatoid arthritis or ankylosing spondylitis suspected of systemic amyloidosis. In 26 of these patients amyloidosis could be demonstrated by fat or rectal biopsy or biopsies from organs suspected of amyloid deposition. Fourteen of the 26 (54%) fat biopsy specimens of the patients with amyloidosis were positive after staining with Congo red and 22 (85%) of the rectal biopsy specimens were positive. All 12 kidney biopsy specimens and 4 biopsy specimens from other organs of these 26 patients were positive for amyloidosis. In 2 patients with a negative rectal biopsy specimen, fat biopsy would have obviated the need for a more invasive biopsy. All patients experienced fat biopsy as less demanding compared to other biopsy procedures. These results imply that in patients with chronic arthritis subcutaneous fat biopsy is a useful screening procedure. In this patient group fat biopsy is less sensitive for the diagnosis of amyloidosis compared to rectal biopsy.

Adipose Tissue↗