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Biomedical subjects

M H Lessof

Publications and source records attributed to M H Lessof.

At least 91 records · Page 5Linked to original sources
PubMed1979

Systemic lupus with nephritis: a long-term study.

Seventy-one patients with systemic lupus erythematosus and clinical evidence of nephritis were seen during a 15-year period, and followed for a mean of seven years. Survival was calculated to be 76 per cent at five years and 57 per cent at ten years from onset of clinical nephritis; and 80, 65, 55 and 55 per cent five, ten, fifteen and twenty years from onset of clinical lupus. Renal biopsies showed mild or focal lesions in 30 per cent of patients, membranous lesions in 14 per cent and diffuse proliferative lesions in 55 per cent. However, there was no difference in the long-term outcome of the different histological groups. Nineteen patients (27 per cent) died during follow up, eleven from renal failure, six from sepsis and two from cerebral lupus. Death in renal failure is now usually a late event in lupus, even in patients with clinical evidence of severe nephritis. The prognosis of even severe lupus nephritis is now better than formerly reported. Reducing the dose of corticosteroid drugs, by the use of cytotoxic drugs such as azathioprine may have diminished the mortality from cardiovascular complications. Side effects of treatment, however, remain an important cause of death and morbidity.

Adolescent↗
PubMed1978

Prostaglandin-synthesis inhibitors in prophylaxis of food intolerance.

Prophylactic doses of aspirin, indomethacin, or ibuprofen prevented symptoms of food intolerance in five out of six patients who on several occasions had had acute gastrointestinal symptoms after the ingestion of specific foodstuffs. Blood and stool prostaglandin E2 and F2alpha concentrations during unprotected challenge were consistent with the idea that these symptoms were mediated through prostaglandin release. Prostaglandin-synthetase inhibitors may benefit some patients with specific food intolerance who are unable or unwilling to avoid the offending food.

Acute Disease↗
PubMed1978

Relapsing polychondritis with crescentic glomerulonephritis.

Relapsing polychondritis is rare and its cause is unknown. The tissues affected are those with a high glycosaminoglycan content, such as cartilage, the aorta, the sclera and cornea, and parts of the ear. Symptoms can usually be controlled with oral steroids, but when there is coexistent progressive crescentic glomerulonephritis quadruple chemotherapy may be used. Three cases of the clinical syndrome of relapsing polychondritis were studied in which rapidly progressive cresentic glomerulonephritis developed. In two the patients appeared to respond to aggressive treatment with immunosuppressive agents and anticoagulants. The multisystemic nature of the disease, the renal lesions, and the response to treatment all suggested that the condition might be related to periarteritis nodosa.

Adult↗
PubMed1978

Effects of passive antibody in bee venom anaphylaxis.

Twelve patients allergic to honeybees were challenged by injections of bee venom; five responded systemically to the venom, with symptoms ranging from angioedema to respiratory distress. These patients were given intramuscular or intravenous infusions of gamma-globulin obtained from the plasma of hyperimmune beekeepers who had high levels of antibody to an allergen (phospholipase A) in the venom. Post-infusion, all five patients tolerated 1.5 to 5 times the venom dose that previously elicited adverse reactions. The quantity of passive IgG antibody infused did not impair the patient's own immune response to venom. These results represent the best available evidence for a direct role for IgG blocking antibodies in clinical protection against anaphylaxis occurring as a result of parenteral antigenic challenge as may be observed in penicillin and insect hypersensitivity.

Adolescent↗
PubMed1977

Protection against anaphylaxis in hymenoptera-sensitive patients by passive immunization.

Passive administration of specific immunoglobulin led to a transient rise in antiphospholipase IgG. An observed rise of 2 microgram/ml (twofold in three cases) was associated with a very diminished response to bee venom. This did not prevent the patient's own IgG response to challenge, which was at least as good as that of non-infused patients. The infusion of IgG cannot be proposed at present as a routine mode of therapy in insect allergy. However, we present the results of our study as the best evidence to date that blocking antibody is protective.

Anaphylaxis↗
PubMed1976

Psotcardiotomy syndrome: pathogenesis and management.

It now appears probable that this syndrome and postinfarction syndrome result from an exaggerated immune response to cardiac damage. Both are self-limited, except following coronary artery bypass surgery, in which the incidence of graft occlusion may be high. Early recognition is vital so that treatment, with corticosteroids and aspirin, can prevent morbidity, anxiety, and inappropriate therapy.

Adrenal Cortex Hormones↗
PubMed1976

Disease activity in the nephritis of systemic lupus erythematosus in relation to serum complement concentrations. DNA-binding capacity and precipitating anti-DNA antibody.

Serum C4 and C3 concentration and binding of double-stranded-DNA (ds-DNA) were measured in sera from ninety-nine patients with systemic lupus erythematosus and clinical evidence of nephritis. C3 and C4 concentrations correlated poorly with ds-DNA binding. In sera from fifty-three patients, precipitating antibody was sought using the counterimmunoelectrophoretic technique. Precipitating antibody was detected on at least one occasion in 44% of the patients, and these sera with precipitating antibody showed higher binding of ds-DNA and lower C4 concentrations than those without precipitating antibody. In thirty-two patients, serial assessments of the activity of the renal disease were made using decline or improvement in glomerular filtration rate, degree of proteinuria, oedema and hypertension as indices of "activity". All patients were receiving immunosuppressive drugs. Active nephritis was rarely found in patients showing, at that time, a normal serum C4 or normal ds-DNA binding; but a raised ds-DNA binding or lowered serum C4 were found in both active and inactive nephritis. There was no correlation of activity with serum concentrations of C3, or the presence or absence of precipitating antibody. We conclude that measurements of serum-complement concentrations and binding of ds-DNA are of most use in the diagnosis of systemic lupus erythematosus, and that in patients with nephritis and taking immunosuppressive drugs, these tests are of limited use in guiding treatment.

Antibodies, Antinuclear↗
PubMed1976

The Crithidia luciliae kinetoplast immunofluorescence test in systemic lupus erythematosus.

An immunofluorescence test for antibodies to native DNA, using the kinetoplast of Crithidia luciliae as substrate, has been assessed in comparison with the Farr precipitation technique, on a total of 395 sera from sixty-three patients with systemic lupus erythematosus, 185 other hospital patients and sixty healthy controls. The immunofluorescence test appears to have great specificity as a diagnostic test for SLE, though lacking the sensitivity of the Farr technique. Like the latter, it is altered by immunosuppressive treatment, and in patients with SLE nephritis on immunosuppression it does not show good correlation with activity of renal disease. Its specificity and simplicity nevertheless make it a valuable clinical test.

Antibodies, Antinuclear↗
PubMed1975

Antibodies against spermatozoa in infertile women with poorly invading spermatozoa on postcoital tests.

Sixty-four women with poorly invading spermatozoa on postcoital tests (PCT's) were investigated for serum spermatozoal antibodies by the immunofluorescent technique. Control groups tested were women with explained infertility but normal PCT's, normal pregnant women, and normal previously pregnant women. A positive immunofluorescent test was obtained in 19 of 64 women with abnormal PCT's compared with 26 of 51 patients with explained infertility, including 11 of 13 who had well-identified gynecological disorders, 12 of 61 pregnant women, and one of 59 previously pregnant normal women. High titers (larger than or equal to 1/200) were found in a few patients in all groups except normal nonpregnant women. In no patient was evidence of complement fixation found. The immunofluorescent test, as carried out here, is therefore of little value in discriminating a group of patients in whom immunologic abnormalities are the primary cause of the infertility.

Adolescent↗
PubMed1975

Immunologic studies of male infertility.

Infertile men with azo- or oligospermia of unknown cause were investigated for evidence of testicular autoimmunity. Testicular germinal cell antibodies were found in 14% of the patients, compared with 5% of normal men, and 21% had spermatozoal antibodies, compared with 5% of the normal subjects. One-third had positive macrophage inhibitory factor tests, compared with 5% of normal subjects. However, of autoantibodies against thyroid, stomach, and nuclear material, only the prevalence of thyroid cytoplasmic antibodies was significantly greater than in normal subjects; serum IgG, IgM, and IgA levels were normal in all cases tested. Furthermore, there was no excess of lymphoid tissue on biopsy and no evidence of antibody deposition in the testicular tissue. The evidence for autoimmunity is less impressive than that for leprous orchitis, which has been proposed as a model for testicular organ-specific autoimmunity. Nevertheless, it is possible that certain germinal cell or spermatozoal antibodies may be directed against factors necessary for orderly spermatogenesis. If so, they may play a role in some cases of maturation arrest and shedding defects.

Adult↗
PubMed1975

Carcinoembryonic antigen in rheumatic diseases.

In an earlier study, the mean plasma carcinoembryonic antigen (CEA) level of patients with seropositive rheumatoid arthritis (RA) was found to be significantly higher than that of normal, control subjects. Levels of CEA in patients with seronegative RA and ankylosing spondylitis, however, did not differ from normal. In this study it was shown that the mean CEA level of 16 patients with Sjögren's syndrome was also significantly higher than normal (P equals 0.001), whereas in a group of 23 children with Still's disease the mean level fell within the normal adult range. Despite the apparent association between rheumatoid factor and raised plasma CEA, no correlation was found between titre of rheumatoid factor and CEA levels. Gel filtration studies indicated that the CEA in rheumatoid arthritis was of a similar molecular weight to that found in cancer of the colon and that there was minimal contribution by the known cross-reacting antigen CCEA2. The mean CEA level in rheumatoid synovial fluids was found to be significantly higher than in osteoarthrotic fluids. A preliminary study has also shown that CEA can be extracted from rheumatoid synovial membranes but was not detected in a normal synovium, further indicating that the source of this antigen in RA may be the inflamed synovium.

Arthritis, Juvenile↗