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L Mosconi

Publications and source records attributed to L Mosconi.

54 records · Page 3Linked to original sources
PubMed1981

Plasma exchange as a therapy for Guillain-Barré syndrome with immune complexes.

Small volume plasma exchange (PE) was evaluated in 6 patients with acute Guillain-Barré syndrome (GBS) and in 1 with its chronic relapsing type. Patients were treated during the onset or progression of their neurologic involvement and no other combined therapy was provided. 6 of our patients had clear benefit following the first session. Two procedures on alternate days were carried out in 4 patients while a third procedure was performed in 3 due to insufficient exchange or to equivocal improvement. After PE, patients showed moderate to marked improvement in motor strength, in their ventilatory function and in their sensory symptoms, which improved definitely but more slowly than motility. Each patient showed, prior to therapy, high levels of immune complexes; their level was clearly reduced by PE and clinical results correlated with this removal. No relapse was observed during 5-15 months of appropriate follow-up.

Adult↗
PubMed1981

Patients with high titers of circulating immune complexes are most likely to benefit from plasmapheresis treatment.

Intermittent flow centrifugation system was utilized in the management of 17 patients with IC diseases. 14 out of 14 patients that had high levels of ICs prior to plasmapheresis showed both clinical and immunochemical evidence of improvement with plasmapheresis. 3 patients had no evidence of circulating ICs prior to plasmapheresis: in these cases no apparent result was achieved after the apheretic therapy. Although the striking correlation between IC removal and clinical result is not a formal proof of responsibility of CIC in the pathogenesis of the disease, it is suggested that quantitative determination of CICs (utilizing several different recognition units) may be a useful parameter in the decision to apply plasmapheresis in the therapy of selected autoimmune diseases.

Adolescent↗
PubMed1981

Plasmapheresis in the treatment of four cases of Guillain-Barré syndrome (acute form).

Four patients with GBs were treated by PE. In all cases the treatment was successful in that it halted the progression of the disease, induced regression of the signs of bulbar impairment, ventilatory failure and cranial nerve paralysis and improved motility. In all instances the response was quicker for the nerves affected last. Our results confirm that PE is probably the only pathogenetic therapy that can be offered to GBs patients, especially since it can halt the progression of the disease and dramatically shorten its course. It is noteworthy that clinical benefit correlates strongly with removal of large quantities of circulating immune complexes.

Acute Disease↗
PubMed1980

Plasma exchange for a hemolytic crisis due to autoimmune hemolytic anemia of the IgG warm type.

A patient with a hyperacute hemolytic crisis due to AIHA of the IgG type was treated by combined plasmapheresis and exchange transfusion. A discontinuous flow centrifuge was used. Immediately after the exchange the hemoglobin level rose from 2.6 to 9.8 g/dl. The D. A. T. became weakly positive and the hemolytic crisis subsided. During the days following the exchange the autoantibodies responsible for the hemolytic crisis, switched from IgG1 and IgG3 to IgG2 and IgG4. The clinical and laboratory picture stabilized thereafter.

Adult↗
PubMed1980

Plasma exchange in management of a patient with diffuse necrotizing cutaneous vasculitis.

It has been sufficiently established that the so-called small vessel vasculitis results from hypersensitivity reactions to various endogenous or exogenous antigens, and that, in most cases, the pathogenic mechanism is the deposition of immune complexes in the blood vessel wall. Among the therapeutic protocol that have been applied recently, plasma exchange (PE) received little attention, that only a few cases have been treated accordingly until now. Here, we present a patient with diffuse cutaneous necrotizing vasculitis, in whom PE proved to be of irreplaceable benefit in halting the progression of the disease. When PE was discontinued, the disease relapsed in spite of therapy with steroids and heparin. A second series of PE again controlled the disease activity. The authors point out the PE was of unique value pending the effects to treatment with cyclophosphamide, which remains the essential therapeutic agent.

Acute Disease↗
PubMed1980

Successful treatment by plasma exchange in Guillain-Barré syndrome with immune complexes.

A 18-year-old woman in the 7th month of pregnancy had a mild enteritis followed within 8 days by a typical Guillain-Barré syndrome with respiratory failure requiring ventilatory support and bulbar palsy. After induction of delivery and discouraging results with steroid therapy, she was treated by plasma exchange. After 2 sessions on alternate days, a recovery of motility was observed and respiratory failure was abolished. It is pointed out that the most significant improvement was recorded immediately after the plasma exchanges, and that this correlated with the removal of immune complexes.

Adolescent↗
PubMed1979

An evaluation of N-ethyl-maleimide-induced lipid peroxidation in platelet concentrates stored at 4 or 22 degrees C.

A method for the quality control of platelet viability, based on N-ethyl-maleimide (NEM)-induced lipid peroxidation, is reported. Duplicate platelet concentrates from individual donors were stored at 22 and 4 degrees C, respectively. At time 0 and at 24-hour intervals, pH, O2 and CO2 tensions, ADP-induced aggregation, glass adhesivity, hypotonic shock response (HSR) and NEM-induced lipid peroxidation were measured. A highly significant correlation between NEM-induced lipid peroxidation and HSR was established, which suggests that the former method can be used for the in vitro prediction of posttransfusion survival of preserved platelets.

Blood Platelets↗
PubMedDate not supplied

Plasma-exchange in neurological diseases.

This paper summarizes experience with plasma-exchange therapy for neurological diseases at the Saronno hospital. Most treatments were performed by discontinuous flow centrifugation, but membrane plasma separation and cascade filtration were also employed. Eighty-five patients with demyelinating diseases of the peripheral nervous system (Guillain-Barré syndrome, immune complex polyneuropathies, paraneoplastic polyneuropathies), demyelinating diseases of the central nervous system (multiple sclerosis, subacute sclerosing panencephalitis), dermatopolymyositis and myasthenia gravis have been treated so far. Particular attention is paid to the combination of plasmapheresis with lymphocytapheresis and immunosuppressive drugs. This therapeutic approach appears to bring about dramatic and sustained improvement in most patients with neurological diseases, thus altering their natural course.

Acute Disease↗
PubMedDate not supplied

Evaluation of a new filter for membrane plasma separation (Preliminary observations).

A new plasma filter for membrane plasma separation was used in 10 patients with the following diagnoses: relapsing Guillain-Barré syndrome (one patient), multiple sclerosis (one patient), myasthenia gravis (two patients), cryoglobulinemia (two patients), rheumatoid arthritis (one patient) and psoriasis (three patients). In all patients but one the plasma flow was from 975 to 1,370 ml/h; extremely high levels of cryoglobulins were the cause of filter plugging during a single procedure. The composition of the effluent plasma was not significantly different from the patients' plasma as regards protein electrophoresis and the levels of immune complexes, immunoglobulins and complement. No platelet activation or blood clotting within the processed blood was observed during 20 procedures. No elevation of lysozyme levels or changes in the osmotic fragility of the red blood cells were found, confirming the excellent biocompatibility of these new filters. The clinical results were consistent with the volumes of plasma exchanged and the clinical diagnoses.

Blood↗
PubMedDate not supplied

Anti-GOR antibodies, HCV, liver disease and cryoglobulinemia.

OBJECTIVE: We investigated the presence of anti-GOR antibodies in patients with essential mixed cryoglobulinemia, since both autoimmune pathogenetic processes and a high prevalence of HCV infection are present in this syndrome. METHODS: We compared these cases to patients with HCV-related chronic active hepatitis or alcoholism, and to ex-blood donors. A total of 60 patients with biopsy-proven chronic liver disease were studied. RESULTS: HCV related markers, cryoglobulins, anti-GOR antibodies and ANA were detected in all of the groups. CONCLUSION: Our data would appear to indicate that anti-GOR are related to the presence of HCV chronic hepatitis and not to cryoglobulinemia or chronic liver damage.

Cryoglobulinemia↗