Immunologic reconstitution, autoimmunity, and T-cell immune deficiencies.
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Biomedical subjects
Publications and source records attributed to M B Lowenstein.
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Immunofluorescent microscopy was performed on the clinically normal skin of 3 patients with infective endocarditis, 3 patients with bacteremia, and 6 normal subjects. Perivascular deposition of immunoglobulin and complement was demonstrated in two of the three patients with infective endocarditis and in none of the bacteremic or control subjects.
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The clinical history, deposition of IgG, IgM, IgA, C3, C4 and properdin at the dermal-epidermal junction (DEJ) of clinically normal skin, serum ANA, DNA-binding, C3, C4, Factor B, and properdin were compared in 27 systemic lupus erythematosus (SLE) probands, 21 first-degree household contact relatives (FDHCR), 19 first-degree nonhousehold contact relatives (FDNHCR), 15 spouses, 26 controls, and 16 chronic discoid lungs lupus erythematosus patients. Female consanguineous relatives of SLE patients had a higher incidence of rheumatic symptoms than male relatives (P less than 0.01). Female FDHCR and male spouses had a higher incidence of protein deposition at the DEJ than sex-matched controls (P = 0.026 and 0.0028). The incidence of protein deposition at the DEJ in FDNHCR did not differ from sex-matched controls. ANA titers of the consanguineous relatives were significantly higher than those of the spouses or sex-matched controls irrespective of household contact with their proband. The observation of protein deposition at the DEJ in normal appearing skin of FDHCR and spouses suggests the importance of environmental factors, whereas the elevations of ANA titers in consanguineous relatives suggests the importance of genetic factors in the pathogenesis of SLE.
In 182 patients with systemic lupus erythematosus (SLE), oral mucosal ulceration occurred in 47 patients (26%), was usually painless (82%), and most often involved the hard palate (89%). Oral ulceration was associated with an increase in overall clinical activity, although this was not accompanied by significant changes in the levels or titers of C3, anti-DNA antibodies, and anti-nuclear antibodies. Necrotizing vasculitis was not observed. Microscopic changes were similar to the skin lesions of SLE and immunoglobulin and complement were found in both the basement membrane and blood vessel walls.