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Biomedical subjects

M A Ogryzlo

Publications and source records attributed to M A Ogryzlo.

At least 19 recordsLinked to original sources

Acute leukemia in rheumatoid arthritis treated with cytotoxic agents.

Acute leukemia is described in two patients treated with cytotoxic agents for a destructive, seropositive rheumatoid arthritis. Both patients had received longterm azathioprine therapy. In addition, one patient had been treated with cyclophosphamide, the other with melphalan. Chromosomal abnormalities were noted in both patients. Studies in one patient included colony forming units, ferrokinetics, electron microscopy of bone marrow, and autopsy examination. All reports of acute leukemia associated with cytostatic drugs in the literature to date are reviewed and the possible mechanisms discussed. It is suggested that patients with rheumatoid arthritis treated with azathioprine and alkylating agents may have an increased risk of developing a therapy-related acute leukemia.

Acute Disease↗

Nail lesions in systemic lupus erythematosus.

Unusual nail changes have been observed in 42 of 165 patients with systemic lupus erythematosus (SLE) followed at the Wellesley Hospital, Toronto, Canada, over the past seven years. These changes had almost the same frequency as mucous membrane ulcerations seen in 31% of the patients. Nail changes were associated with active disease in 39 of the 42 patients. Patients with nail changes had a significantly higher incidence of Raynaud's phenomenon and mucous membrane ulcerations than patients without these changes. There was no increased incidence of other skin manifestations or of systemic vasculitis in these patients. Thus, nail changes may be an additional helpful criterion in the diagnosis of SLE.

Female↗

Azathioprine in early rheumatoid arthritis. Comparison with gold and chloroquine.

This study compares the effect of azathioprine with those of gold and chloroquine in early (Class II) rheumatoid arthritis (RA). Thirty-three similar patients with classic or definite RA of less than 5 years duration were randomly entered, 11 into each drug group. Assessment of standard clinical and laboratory measures at 12 and 24 weeks showed significant improvement in all three groups. In general, all three drugs were effective antirheumatic agents with low toxicity. However, because of serious potential toxicity, azathioprine could not be recommended over gold and chloroquine in early RA therapy.

Adult↗

Systemic lupus erythematosus. A review of 110 cases with reference to nephritis, the nervous system, infections, aseptic necrosis and prognosis.

Observations made on 110 patients with SLE over a four and a half year period have been reviewed. The patients were seen at intervals of two months when, both clinical and serological findings were recorded, according to a set protocol. The results have been presented with particular reference to nephritis, neurological manifestations, infections, aseptic necrosis, mortality and predicted survival. Such studies have led to the identification of various prognosis factors in SLE, and assisted in providing better directed therapy. The results indicate a milder from of SLE in the patients of this series when compared with previously published studies, and is more representative of the wide spectrum of disease severity seen in the general population.

Adolescent↗

The bimodal mortality pattern of systemic lupus erythematosus.

The changing pattern of mortality in systemic lupus erythematosus (SLE) led to an examination of the deaths in a long-term systematic analysis of 81 patients followed for five years at the University of Toronto Rheumatic Disease Unit. During the follow-up 11 patients died; six patients died within the first year after diagnosis (group I) and five patients died an average of 8.6 years (from 2.5 to 19.5 years) after diagnosis (group II). In those who died early, the SLE was active clinically and serologically, and nephritis was present in four. Their mean prednisone dose was 53.3 mg/day. In four patients a major septic episode contributed to their death. In those who died late in the course of the disease, only one patient had active lupus and none had active lupus nephritis. Their mean prednisone dose was 10.1 mg/day taken for a mean of 7.2 years. In none was sepsis a contributing factor to their death. All five of these patients had had a recent myocardial infarction at the time of death; in four, ti was the primary cause of death. Mortality in SLE follows a bimodal pattern. Patients who die early in the course of their disease, die with active lupus, receive large doses of steroids and have a remarkable incidence of infection. In those who die late in the course of the disease, death is associated with inactive lupus, long duration of steroid therapy and a striking incidence of myocardial infarction due to atherosclerotic heart disease.

Adult↗

Polymyositis in a patient with multiple neoplasms.

A 64 year old woman with a past history of panhysterectomy and oophorectomy for carcinoma of the body of the uterus (1950) and partial colectomy for carcinoma of the colon (1971), presented in 1972 with severe weakness of the proximal girdle muscles and histological evidence of polymyositis. A detailed search disclosed no tumor and she was treated with prednisone. Two years later, investigations for iron deficiency anemia revealed two polyps in the colon. Pathological examination of the resected colon disclosed two separate foci of adenocarcinoma and a number of adenomatous polyps. Three months later, further investigations for melena led to the discovery of a gastric carcinoma. Due to the extent of the tumor, she was subjected to gastrectomy. splenectomy, and excision of the tail of the pancreas, but died of postoperative complications. At autopsy, no residual cancer was detected, but a meningioma was found. The association of polymyositis with malignant tumors has been recognized for a long time, but only two previously reported patients have had more than one cancer. Although a causal relationship is difficult to establish, continued vigilance for neoplasms is advocated during the follow-up period.

Colonic Neoplasms↗

Acute leukemia in rheumatoid arthritis treated with cytotoxic agents.

Acute leukemia is described in two patients treated with cytotoxic agents for a destructive, seropositive rheumatoid arthritis. Both patients had received longterm azathioprine therapy. In addition, one patient had been treated with cyclophosphamide, the other with melphalan. Chromosomal abnormalities were noted in both patients. Studies in one patient included colony forming units, ferrokinetics, electron microscopy of bone marrow, and autopsy examination. All reports of acute leukemia associated with cytostatic drugs in the literature to date are reviewed and the possible mechanisms discussed. It is suggested that patients with rheumatoid arthritis treated with azathioprine and alkylating agents may have an increased risk of developing a therapy-related acute leukemia.

Acute Disease↗

Heterogeneity of IgM/IgG cryocomplexes: immunological-clinical correlation.

A detailed study has been made of the mixed cryoglobulins (MCs) occurring in four patients with different disease states. These included (1) macroglobulinemia of Waldenström with an IgM(K)/IgG cryocomplex containing Clq, free DNA, rheumatoid factor, anti-ssDNA and VDRL activity; (2) Peetom-Meltzer syndrome with an IgM(K)/IgG cryocomplex containing free DNA, Clq, Cls, fibrinogen, alpha2-macroglobulin and beta-lipoprotein; (3) rheumatoid arthritis with an IgM(K)/IgG cryocomplex containing rheumatoid factor, free DNA and anti-ssDNA activity; and (4) angioimmunoblastic lymphadenopathy with an IgM(K)/IgG cryocomplex containing rheumatoid factor, free DNA and anti-I cold agglutinin activity. All of these patients exhibited multisystem involvement with evidence of vascular injury. A review of the MCs found in various clinical states, reveals that whereas in systemic lupus erythematosus MCs almost invariably possess antinuclear factor activity and contain DNA as well as some components of complement, in Peetom-Meltzer syndrome MCs do not have these characteristics, but invariably have strong rheumatoid factor activity, usually absent in MCs from systemic lupus erythematosus. MCs in lymphoproliferative disorders have strong rheumatoid factor activity but not ANF activity. In infectious diseases, MCs usually exhibit strong rheumatoid factor, VDRL and cold agglutinin activity, and co-precipitate with alpha2-macroglobulin. While there is some overlap in the characteristics of MCs from various clinical diseases, the above mentioned differences are probably of some biological importance and require further investigation.

Aged↗