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Biomedical subjects

M Akizuki

Publications and source records attributed to M Akizuki.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Study on combined of auranofin, salazosulfapyridine and methotrexate in rheumatoid arthritis].

Patients with rheumatoid arthritis who did not respond sufficiently to auranofin therapy were divided into three groups to be continued on auranofin monotherapy (1), to be on combination therapy of auranofin and salazosulfapyridine (2) and to be given methotrexate concomitantly with auranofin (3), and clinical responses were compared in a prospective manner. Patients on combination therapy either with salazosulfapyridine or with methotrexate demonstrated higher improvement than those on continued auranofin monotherapy. No unknown side effects associated with monotherapy of any of the three compounds were seen in any of the three groups. The study suggests usefulness of combination therapy either with methotrexate or with salazosulfapyridine for patients who failed to respond sufficiently to auranofin.

Adult↗
PubMed1994

[Methylprednisolone pulse therapy for SLE patients with CNS disorder].

A clinical trial was conducted in 22 SLE patients with central nervous system (CNS) disorder in which the efficacy of pulse methylprednisolone suleptanate at the dose of 400 mg or 800 mg (as methylprednisolone) was assessed. The symptoms of CNS disorder disappeared within 40 days after pulse therapy in all of the 16 patients with organic brain syndrome (OBS). No improvement in the symptoms took place in any but one of the five patients who had cerebrovascular disorder. One SLE patient with depression showed improvement 55 days after pulse therapy. In the patients with OBS who had not received pulse therapy until 28 days or more after onset of CNS disorder, the symptoms disappeared in 20 days or more in both 400 mg and 800 mg dose groups. On the other hand, five of the six patients given the dose of 800 mg within 10 days of occurrence of the disease experienced a complete relief of the symptoms in 10 days after pulse therapy. However, at least 13 days were required for complete relief in all the four patients of the 400 mg group. The adverse reactions reported consisted of hyperlipemia, diabetes mellitus, and infections such as thrush or herpes zoster. The above results suggest that methylprednisolone pulse therapy is useful in the treatment of CNS disorder associated with SLE, particularly in patients with OBS who are given the dose of 800 mg early after onset of the disease.

Adolescent↗
PubMed1994

[Double blind trial of pulse methylprednisolone versus conventional oral prednisolone in lupus nephritis].

A double blinded clinical trial was conducted in which the efficacy and safety of pulse methylprednisolone (400 mg/day) was compared with oral prednisolone (50 mg/day), a control drug for a period of 3 months. One-hundred and two (102) patients were enrolled in the study, of which 91 patients were determined as eligible for analysis of efficacy. Patients on pulse methylprednisolone had more favorable response to therapy with regard to laboratory value changes from baseline such as CH50 and anti-DNA antibody titers. In terms of anti-DNA antibodies, a significant difference was detected at one week after treatment. With regard to time course changes in laboratory values, CH50 at one and two weeks after treatment showed a significantly higher elevation in the pulse methylprednisolone group than in the control group. There was no significant difference noted in incidence of adverse reactions between both treatment groups. No serious adverse reaction was encountered in the pulse methylprednisolone group. The physician's assessment of final global improvement significantly favored the pulse methylprednisolone-treated group. The above results suggest that the pulse therapy with methylprednisolone leads to more rapid onset of drug effect than the conventional oral prednisolone in the treatment of lupus nephritis.

Administration, Oral↗
PubMed1994

[Two cases of rheumatoid arthritis presenting autoimmune hepatic diseases].

We report on two cases of rheumatoid arthritis (RA) presenting autoimmune hepatic diseases. The first patient, who had been diagnosed as RA at the age of 63, was hospitalized in order to undergo surgery for total left knee replacement at the age of 69. She acquired acute serum hepatitis as a result of blood transfusion she received during the operation. Five years later, she visited our clinic suffering from polyarthritis. She was found to have hyper-alkaline phosphatase (ALP) and hyper rGTP, but no AMA. The second patient, a 60-year-old female whose onset of RA was at the age of 45, complained of general fatigue, and was admitted to the hospital because of persistent liver dysfunction. When corticosteroid was administered to these patients, ALP and rGTP levels in the first case, and AST and ALT levels in the second case were reduced to values in the normal range. ANA in the first case continued to register negative, but ANA in the second case became positive after the patient developed acute hepatitis. Both patients were found to have anti-p25 triplet liver/kidney microsome antibody. We discuss the clinical significance of this antibody.

Aged↗
PubMed1994

[A case of polyarthritis developed on the non-paralytic side in a hemiplegic patient].

A 37-year old house wife who developed polyarthritis localized to contralateral to hemiplegic side was reported. The patient had been on the physical therapy program for right hemiplegia which occurred at the age of 33. The polyarthritis are chronic and showed significant responses to salazosulfapyridine. Her serum contained rheumatoid factor (RF) of high titer and hand X-ray showed characteristic erosive changes in PIP and MCP joints. Presence of morning stiffness, positive RF, bone erosion, isotope accumulation, HLA-DR4 and responses to DMARD are all consistent with a diagnosis of rheumatoid arthritis. Review of the literature revealed that fifteen patients had been reported in whom occurrence of neurological disorders and rheumatic conditions were described. In most of these patients including the present case, the rheumatic symptoms did not occur or subsided in the hemiplegic side of neurological disorders. Possible mechanisms of inactivation on rheumatic inflammation were discussed.

Adult↗
PubMed1994

Genetic and immunological differences between Japanese patients with diffuse scleroderma and limited scleroderma.

OBJECTIVE: To study the association between HLA-DR and scleroderma (SSc), subsets of SSc, and autoantibodies in SSc. METHODS: HLA-DR antigens were determined in 45 Japanese patients with SSc. The association between HLA-DR and SSc, subsets of SSc, and autoantibodies was analyzed in 22 patients with SSc excluding mixed connective tissue disease (MCTD)/overlap syndrome (OL). RESULTS: When the 20 patients with MCTD and 3 patients with OL were excluded from the original patient group, a significant increase of HLA-DR2 was observed (59 vs 29% of controls, p < 0.01). The frequency of DR2 increased to 69% in patients with diffuse SSc (p < 0.01). DR1, which was not found in diffuse SSc, was found in 2 of 9 patients with limited SSc. The frequency of DR2 was significantly higher in patients with antitopoisomerase I (10/12, 83%, p < 0.05). In contrast, DR1 was found only in 2 patients with anticentromere antibodies (ACA), and all 5 patients with ACA had no HLA-DR2 (p < 0.01). CONCLUSION: Our results suggest that different HLA-DR markers may be associated with the production of distinct autoantibodies in diffuse SSc and limited SSc.

Antibodies↗
PubMed1993

A case of Sjögren's syndrome complicating immune-mediated aplastic anaemia.

A 78-year-old Japanese woman with Sjögren's syndrome complicating immune-mediated aplastic anaemia is described. A diagnosis of aplastic anaemia was made from severe pancytopenia with hypoplastic marrow. Laboratory studies suggested an association of bone marrow suppressive T-lymphocytes with the pathogenesis of aplastic anaemia. Following the administration of mepithiostan and prednisolone, pancytopenia improved gradually. Two years after the onset of aplastic anaemia, Raynaud's phenomenon developed and examinations revealed the existence of keratoconjunctivitis sicca and anti-SSA/Ro and anti-SSB/La antibodies.

Aged↗
PubMed1993

Chronic destructive monoarthritis of the wrist in patients with anti-SSA/Ro antibodies: report of two cases.

Among 340 patients with rheumatic diseases, two cases of chronic destructive monoarthritis of the wrist with anti-SSA/Ro antibodies and rheumatoid factor, were observed for over three years. It is not clear whether these cases represent a specific subset of rheumatoid arthritis (RA) or whether they may progress to diffuse symmetrical destructive polyarthritis typical of RA. Long-term follow-up studies including analysis of autoantibodies will be needed to clarify the characteristics and course of chronic monoarthritis.

Antibodies, Antinuclear↗
PubMed1993

Difference in HLA-linked genetic background between mixed connective tissue disease and systemic lupus erythematosus.

We have typed 64 Japanese patients with mixed connective tissue disease (MCTD) and 53 Japanese patients with systemic lupus erythematosus (SLE) for HLA-DRB1, DRB3, DRB4, DRB5, DQA1, DQB1, and DPB1 genes by the HLA-DNA typing method using the PCR-SSOP technique. Frequencies of HLA-DRB1*0401, DRB1*0901, DRB4*0101, and DQA1*03 were increased and those of HLA-DRB1*0405 and DQB1*0401 were decreased in the patients with MCTD, while the frequencies of HLA-DRB1*1501, DRB5*0101, and DQB1*0602 were increased in the patients with SLE. The typing results suggest that susceptibility to MCTD is strongly associated with the HLA-DRB1*0401-DRB4*0101-DQA1*03-DQB1*0301 haplotype, and that to SLE is associated with the HLA-DRB1*1501-DRB5*0101-DQA1*0102-DQB1*0602 haplotype. The observation that the MCTD-associated HLA alleles are distinct from the SLE-associated ones may support the clinical entity of MCTD different from SLE.

Alleles↗
PubMed1993

Rheumatoid arthritis in a patient with pseudoxanthoma elasticum.

Pseudoxanthoma elasticum (PXE) is a rare, inherited disorder of the connective tissue. Possible association of autoimmune thyroiditis and PXE has been suggested, but reports of other autoimmune diseases complicating PXE are rare. We report a case of rheumatoid arthritis (RA) in a patient with PXE. Since the frequency of PXE is likely to be underdiagnosed, further studies to elucidate the true incidence and significance of the association of RA and PXE will be needed.

Adult↗
PubMed1993

Pulmonary pseudolymphoma presented with a mass lesion in a patient with primary Sjögren's syndrome: beneficial effect of intermittent intravenous cyclophosphamide.

A 61-year-old woman with primary Sjögren's syndrome (SS) presented with fever, dry cough, dyspnea on exertion, and a mass lesion with reticular shadowing at both bases on her chest X-ray. Pulmonary pseudolymphoma was diagnosed by transbronchial lung biopsy which revealed infiltration of T cell-like slightly atypical lymphoid cells. After three infusions of cyclophosphamide (750 mg every 4 weeks) combined with prednisolone, the pulmonary mass lesion was diminished and her symptoms improved. Evaluation of the 12 reported cases of pulmonary pseudolymphoma with SS that presented with mass lesions showed an increase in IgM level, frequent pulmonary fibrosis, precedence of SS, and better prognosis with immunosuppressants in those patients.

Biopsy↗
PubMed1993

[Development of Stevens-Johnson syndrome following sulindac administration in a patient with mixed connective tissue disease].

Nineteen-year-old woman with mixed connective tissue disease developed Stevens-Johnson syndrome following treatment of arthritis using sulindac. Involvements of infectious and malignant diseases have been ruled out and sulindac has strongly been suspected as a causative agent for Stevens-Johnson syndrome. Ten out of 13 cases with Stevens-Johnson syndrome associated with non-steroidal anti-inflammatory drugs, sulindac has been administrated. Four cases also presented with severe liver disease. Patients who developed Stevens-Johnson syndrome following sulindac administration did not have apparent common clinical or laboratory findings which might be implicated for development of this severe side effects. Among the various non-steroidal anti-inflammatory drugs, safety of sulindac has widely been appreciated. However, occurrence of severe adverse events as reported here indicated that sulindac should be administrated as carefully as other non-steroidal anti-inflammatory drugs.

Adult↗
PubMed1993

[Occurrence of bronchiolitis obliterans organizing pneumonia (BOOP) in a flare-up stage of systemic lupus erythematosus (SLE)].

A 33-year old housewife who developed BOOP in a flare-up stage of SLE was reported. She had been treated for Hashimoto's thyroidtis since the age of 18. When the patient was 21 years old, she noticed polyarthritis and subcutaneous nodules. She had a high titer of rheumatoid factor and a diagnosis of rheumatoid arthritis was made. At the age of 23, ulnar drift was noted despite the lack of subjective and objective signs of active articular inflammation. At the age of 25, she developed dry eyes and dry mouth, and at the age of 27, photosensitivity was experienced. At the age of 28, she was first admitted to our department and diagnosis of Sjögren's syndrome and SLE was made. Since then, she had been treated by corticosteroid and remained in a stable condition. In January 1991, she developed facial erythema, dry cough and edema of the lower extremities. Laboratory findings included profuse proteinuria, hypoalbuminemia, hyperlipidemia, elevated anti-DNA titer, depressed serum complements. Chest X-ray films showed a presence of patchy non-segmental infiltrates in both lung fields. TBLB specimen showed the characteristic findings of BOOP described by Epler at al. She had marked ulnar deviation at the MCP joints bilaterally and X-ray findings were consistent with Jaccoud's arthropathy. The pulmonary lesions and nephrotic syndrome responded to the combined therapy of prednisolone and immunosupressants. An occurrence of BOOP associated with flare of SLE indicates that immunological mechanisms might be involved for development of BOOP. Indeed, review of the literature shows that substantial numbers of patients with BOOP had clinical and serological overlapping findings with autoimmune diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

[Development of multiple subcutaneous nodules in a patient with rheumatoid arthritis during methotrexate therapy].

A 59-year-old woman with a 14 years' history of seropositive nodular rheumatoid arthritis (RA) who developed multiple subcutaneous nodules during methotrexate therapy was reported. Weekly pulse methotrexate therapy (5-7.5 mg) was initiated in June, 1990 for exacerbation of RA. By January 1991 (total dose of methotrexate: ca 240-310 mg), marked clinical and laboratory improvements were observed. However, subcutaneous which were present prior to methotrexate administration, increased in number and size. The excised nodules showed typical histological features of rheumatoid nodules. The subcutaneous were also characterized by their presence in atypical locations such as the extensor surfaces of finger joints and toes. Recent reports which describe development of subcutaneous nodules and vasculitic lesions in RA patients following methotrexate therapy indicate different pathogenetic mechanisms might be involved in articular disease and nodular lesions.

Arthritis, Rheumatoid↗
PubMed1992

Characterization of autoantibodies that recognize U4/U6 small ribonucleoprotein particles in serum from a patient with primary Sjögren's syndrome.

We identified autoantibodies that recognize the U4/U6 snRNPs in a serum from a 63-year-old Japanese patient (TT) with primary Sjögren's syndrome. This patient's serum immunoprecipitated U4 and U6 sn-RNAs exclusively from 32P-labeled HeLa cell extracts and a newly identified 120-kDa protein along with the Sm core proteins (B'/B, D, E, F, and G) from [35S] methionine-labeled HeLa cell extracts. Immunoblotting demonstrated that only the 120-kDa protein was recognized by this unique serum. In glycerol density gradient centrifugation, the 120-kDa protein reactive with TT serum cosedimented with U4 and U6 snRNAs, suggesting that the 120-kDa protein is a unique component of the U4/U6 snRNP particle. In the same study, the U4/U6 snRNP precipitated by TT serum sedimented only in the lower density, whereas anti-Sm antibodies precipitated U4/U6 snRNAs in a broad range of the gradient. This result suggests the presence of at least two molecular forms of the U4/U6 snRNP particles; larger particles, probably the U4/U5/U6 snRNP complex, and free particles. Thus, the U4/U6 snRNP recognized by TT serum includes the U4 and U6 snRNAs, with Sm core proteins, and the novel 120-kDa protein, and appears to be a free particle not associated with larger complexes.

Autoantibodies↗
PubMed1992

Autoantibodies to small nuclear and cytoplasmic ribonucleoproteins in Japanese patients with inflammatory muscle disease.

OBJECTIVE: To elucidate the profile and clinical significance of autoantibodies to small nuclear and small cytoplasmic ribonucleoproteins in Japanese patients with polymyositis and dermatomyositis (PM/DM). METHODS: Radioimmunoprecipitation assays were performed with sera from 91 patients with various inflammatory muscle diseases and from 254 control patients with other rheumatic diseases. Patients with PM/DM were categorized according to autoantibody specificities, and clinical comparisons were made. RESULTS: Antibodies to aminoacyl transfer RNA (tRNA) synthetases and the signal recognition particle (SRP) were found to be specific for PM/DM: PM/DM patients with antibodies to 3 aminoacyl-tRNA synthetases (histidyl, threonyl, and glycyl) appeared to form a distinct clinical subset, associated with chronic interstitial lung disease, polyarthritis, and myositis, while 3 patients with antibodies that bound the SRP had severe myositis that was resistant to corticosteroid therapy. In general, the frequency and clinical correlations of anti-aminoacyl-tRNA synthetase antibodies in Japanese patients were similar to those in North American populations. In contrast, among this Japanese cohort, the occurrence of anti-PM/Scl appeared to be reduced in frequency, whereas anti-Ku and anti-U2 RNP antibodies were accentuated in patients with overlap syndromes. CONCLUSION: We conclude that racial groups differ somewhat in their characteristic autoimmune responses to individual autoantigens. These differences could reflect variation in immunogenetic background or different etiologic mechanisms which might occur at different geographic locations.

Asian People↗