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M R Caudle

Publications and source records attributed to M R Caudle.

48 records · Page 3Linked to original sources

Clinical significance of naturally occurring anti-zona pellucida antibodies in infertile women.

Although implicated in the etiology of unexplained infertility, a primary role for antibodies to zona pellucida antigens remains uncertain. We therefore prospectively studied 21 infertility patients found to have significant anti-zona pellucida antibody titers (1:4 to 1:16). When treated for endometriosis or other concurrent fertility problems, 7 of the 21 (33%) delivered viable infants. Two other patients conceived without treatment. Decreases in anti-zona antibody titers were found in most but not all women with successful outcomes. In a given individual, anti-zona antibodies may coexist with other fertility disorders. Therefore, these antibodies should not preclude treatment of concurrent fertility disorders.

Autoantibodies↗

Thrombocytopenia in preeclampsia: associated abnormalities and management principles.

Severe thrombocytopenia, abnormal liver function, and renal dysfunction may occur as manifestations of preeclampsia. Failure to recognize that this cluster of abnormalities represents a form of preeclampsia may result in erroneous initial diagnoses. Management of 13 such patients has shown a direct correlation between the degree of thrombocytopenia and the measures of liver dysfunction. Platelet counts and liver functions improved prior to delivery in five patients treated with corticosteroids. Management should be directed toward investigation and correction of deranged physiology and appropriate monitoring of maternal-feto-placental status. Early delivery is indicated in patients with progressive thrombocytopenia and in those with evidence of fetal maturity or distress. Provided that the disease process remains stable, consideration should be given in cases of fetal immaturity, to the use of betamethasone therapy. The occurrence of severe thrombocytopenia in 20% of neonates should be a consideration in selecting the mode of delivery.

Adult↗

Circulating immune complexes in pregnancy, preeclampsia, and autoimmune diseases: evaluation of Raji cell enzyme-linked immunosorbent assay and polyethylene glycol precipitation methods.

Sera from 86 individuals were tested for circulating immune complexes by the polyethylene glycol precipitation method and a Raji cell enzyme immunoassay (Raji-ELISA). These included normal nonpregnant control subjects, nonpregnant patients with autoimmune diseases, healthy women in the second and third trimesters of pregnancy, patients with preeclampsia, and women with pregnancies complicated by preexisting autoimmune diseases. Diseases such as systemic lupus erythematosus and rheumatoid arthritis were associated with increased levels of immune complexes in both pregnant and nonpregnant individuals. Circulating immune complexes were not observed in normal pregnancies or in preeclampsia. Although pregnancy itself is not an immune complex-associated state, the presence of immune complexes in autoimmune diseases may explain some of the complications observed during pregnancy in these patients.

Antigen-Antibody Complex↗

Detection of circulating immune complexes with a Raji cell enzyme immunoassay.

The Raji cell assay for circulating immune complexes (CIC) is frequently the method of choice when the detection of large, complement fixing complexes is desired. We have developed an enzyme-linked immunosorbent assay modification (Raji-ELISA) of the Raji cell technique which is easy to perform, uses commercially available reagents and is more convenient than the conventional Raji cell radioimmune assay (Raji-RIA). Fourteen samples were tested by both assays and a good correlation was observed (P = 0.05). Sera from patients with suspected immune complex associated diseases were tested in the Raji-ELISA. Unsensitized Raji cells gave a value of 1.25 micrograms of immune complex associated IgG/ml. Using 2 standard deviations as a cutoff to determine positivity, 2 of 32 healthy controls (6.2%) had elevated levels of circulating immune complexes. In our study population, 9 of 23 cancer patients (39.1%), 10 of 13 patients with autoimmune diseases (76.9%), 3 of 17 patients with positive rheumatoid factor titers (17.6%), 1 of 23 pregnant patients (4.3%), 1 of 5 preeclamptic patients (20%) and 9 of 30 other patients with suspected immune complex associated diseases (30%) had elevated levels of CIC.

Animals↗

Histocompatibility in couples with recurrent spontaneous abortion and normal fertility.

Histocompatibility between husband and wife at the HLA locus has been suggested as a determinant of recurrent spontaneous abortion. We measured the incidence of HLA antigen sharing within 12 couples with histories of unexplained recurrent abortion and in a fertile control population of 77 couples. In the recurrent abortion group, 6 of 12 (50%) of the couples shared no HLA antigens, whereas only 3 of 12 (25%) shared one antigen, 1 of 12 (8.3%) shared two antigens, and 2 of 12 (17%) shared three antigens. In the fertile group, 27 of 77 (35.1%) shared no antigens, 33 of 77 (42.8%) shared one antigen, 14 of 77 (18.2%) shared two antigens, 2 of 77 (2.6%) shared three antigens, and 1 of 77 (1.3%) shared four antigens. In 50 of these control couples who were available for complete reproductive histories, there were no significant correlations between the incidence of antigen sharing and the numbers of offspring, the incidence of spontaneous abortion, or infertility problems. Six of the women in the recurrent abortion group became pregnant during the study. Three of these (50%) delivered live infants independent of the degree of antigen sharing and without the benefit of immunologic treatment. Therefore, the degree of HLA antigen sharing did not define a population with increased pregnancy wastage or predict subsequent pregnancy outcome.

Abortion, Habitual↗

Effect of betamethasone on fetal macrophage function: depression of adherence of immunoglobulin-coated red blood cells.

In this study, betamethasone was found to significantly inhibit the binding of immunoglobulin-coated O Rh-positive red cells to fetal macrophages. At a dose of 0.15 mg%, betamethasone depressed immune rosette formation to 44% of controls (p less than 0.01); and a dose of 0.60 mg% resulted in an average depression to 22%. This in vitro effect may reflect important alterations in in vivo immune function in infants delivered from mothers who have received antenatal corticosteroids.

Betamethasone↗