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Biomedical subjects

M Valbonesi

Publications and source records attributed to M Valbonesi.

At least 127 records · Page 7Linked to original sources
PubMed1982

Management of immune-mediated and paraproteinemic diseases by membrane plasma separation and cascade filtration.

Membrane plasma separation was utilized in the management of 19 patients with autoimmune, immune complex or paraproteinemic diseases. In these patients 34 procedures were carried out employing a new filter composed of polyvinyl alcohol hollow fibers with a nominal pore size of 0.4 micrometer. Cascade filtration was performed in 23 procedures using a second filter built up with ethylenevinylalcohol copolymer hollow fibers with a nominal pore size of 0.1-0.2 micrometer. Both filters employed showed a very good biocompatibility, and no untoward effect was observed. Using the differential sieving effect of cascade filtration it was possible to eliminate circulating immune complexes and immunoglobulin M without the loss of necessary plasma components.

Antigen-Antibody Complex↗
PubMed1981

Defective function of granulocytes in patients with cancer.

Mobilization of granulocytes into a serum-filled chamber, histochemical nitroblue tetrazolium (NBT) reduction tests, and phagocytosis were performed in 11 patients with solid tumors treated with surgical excision and chemotherapy and in 22 untreated or surgically treated patients. The results revealed a decreased mobilization (p less than 0.001) and an impaired capability of neutrophils to reduce NBT after stimulation (p less than 0.05) in both groups of patients. The decrease in the values in the stimulated reduction of NBT was more pronounced in untreated patients than in treated ones. At the same time the phagocytic activity of neutrophils on Candida albicans, which was decreased (p less than 0.01) in untreated patients, was normal in those who had been treated with chemotherapy. There were no distinctive correlations between circulating immune complexes and granulocyte function. We propose that this newly demonstrated defect in neutrophil mobilization and low median C. albicans-stimulated NBT reduction contributes more in the evolution of the tumor than in the pathogenesis of infections and that chemotherapy seems to restore a better granulocyte function.

Adult↗
PubMed1981

[Apropos of a case of idiopathic cryoagglutininemia with cryoglobulinemia and bone marrow lymphoplasmacytoid infiltration].

A case of idiopathic cryoagglutininaemia, with cryoglobulinaemia and lymphoplasmacytoid infiltration of the bone marrow is reported. The case is not held to be an independent clinical entity but an aspect of immunoproliferative disease, similar to Waldenstrom's disease. An association of steroids in high doses and cyclophosphamide led to a definite improvement in the clinical and haematological picture and this has continued for the past 4 years with little or no treatment.

Anemia, Hemolytic, Autoimmune↗
PubMed1981

Plasma exchange in the management of patients with multiple sclerosis: preliminary observations.

Since humoral factors have been implicated in the pathogenesis of multiple sclerosis (MS) and previous attempts at therapeutic intervention have not met with uniform success, plasma exchange (PE) was recently proposed for the management of this disease. We are currently investigating the possible effectiveness of PE in the treatment of MS, and to date 6 patients have been entered into the study. At least 4 of our patients who did not respond to conventional therapy have shown unequivocal, moderate to marked improvement following the first session of PE. At the time of treatment, these patients had an acute exacerbation of their disease. We found no correlation between clinical improvement and the serum immune complex levels, suggesting that other poorly known mechanisms were operative. Based on our preliminary results, we feel that PE may be efficacious in treating exacerbations of MS. More evidence is needed on the effects of PE in the chronic stage of the disease.

Adult↗
PubMed1981

Plasma exchange as a therapy for Guillain-Barré syndrome with immune complexes.

Small volume plasma exchange (PE) was evaluated in 6 patients with acute Guillain-Barré syndrome (GBS) and in 1 with its chronic relapsing type. Patients were treated during the onset or progression of their neurologic involvement and no other combined therapy was provided. 6 of our patients had clear benefit following the first session. Two procedures on alternate days were carried out in 4 patients while a third procedure was performed in 3 due to insufficient exchange or to equivocal improvement. After PE, patients showed moderate to marked improvement in motor strength, in their ventilatory function and in their sensory symptoms, which improved definitely but more slowly than motility. Each patient showed, prior to therapy, high levels of immune complexes; their level was clearly reduced by PE and clinical results correlated with this removal. No relapse was observed during 5-15 months of appropriate follow-up.

Adult↗
PubMed1981

Patients with high titers of circulating immune complexes are most likely to benefit from plasmapheresis treatment.

Intermittent flow centrifugation system was utilized in the management of 17 patients with IC diseases. 14 out of 14 patients that had high levels of ICs prior to plasmapheresis showed both clinical and immunochemical evidence of improvement with plasmapheresis. 3 patients had no evidence of circulating ICs prior to plasmapheresis: in these cases no apparent result was achieved after the apheretic therapy. Although the striking correlation between IC removal and clinical result is not a formal proof of responsibility of CIC in the pathogenesis of the disease, it is suggested that quantitative determination of CICs (utilizing several different recognition units) may be a useful parameter in the decision to apply plasmapheresis in the therapy of selected autoimmune diseases.

Adolescent↗
PubMed1981

Plasmapheresis in the treatment of four cases of Guillain-Barré syndrome (acute form).

Four patients with GBs were treated by PE. In all cases the treatment was successful in that it halted the progression of the disease, induced regression of the signs of bulbar impairment, ventilatory failure and cranial nerve paralysis and improved motility. In all instances the response was quicker for the nerves affected last. Our results confirm that PE is probably the only pathogenetic therapy that can be offered to GBs patients, especially since it can halt the progression of the disease and dramatically shorten its course. It is noteworthy that clinical benefit correlates strongly with removal of large quantities of circulating immune complexes.

Acute Disease↗
PubMed1980

Plasma exchange for a hemolytic crisis due to autoimmune hemolytic anemia of the IgG warm type.

A patient with a hyperacute hemolytic crisis due to AIHA of the IgG type was treated by combined plasmapheresis and exchange transfusion. A discontinuous flow centrifuge was used. Immediately after the exchange the hemoglobin level rose from 2.6 to 9.8 g/dl. The D. A. T. became weakly positive and the hemolytic crisis subsided. During the days following the exchange the autoantibodies responsible for the hemolytic crisis, switched from IgG1 and IgG3 to IgG2 and IgG4. The clinical and laboratory picture stabilized thereafter.

Adult↗
PubMed1980

Plasma exchange in management of a patient with diffuse necrotizing cutaneous vasculitis.

It has been sufficiently established that the so-called small vessel vasculitis results from hypersensitivity reactions to various endogenous or exogenous antigens, and that, in most cases, the pathogenic mechanism is the deposition of immune complexes in the blood vessel wall. Among the therapeutic protocol that have been applied recently, plasma exchange (PE) received little attention, that only a few cases have been treated accordingly until now. Here, we present a patient with diffuse cutaneous necrotizing vasculitis, in whom PE proved to be of irreplaceable benefit in halting the progression of the disease. When PE was discontinued, the disease relapsed in spite of therapy with steroids and heparin. A second series of PE again controlled the disease activity. The authors point out the PE was of unique value pending the effects to treatment with cyclophosphamide, which remains the essential therapeutic agent.

Acute Disease↗
PubMed1980

Successful treatment by plasma exchange in Guillain-Barré syndrome with immune complexes.

A 18-year-old woman in the 7th month of pregnancy had a mild enteritis followed within 8 days by a typical Guillain-Barré syndrome with respiratory failure requiring ventilatory support and bulbar palsy. After induction of delivery and discouraging results with steroid therapy, she was treated by plasma exchange. After 2 sessions on alternate days, a recovery of motility was observed and respiratory failure was abolished. It is pointed out that the most significant improvement was recorded immediately after the plasma exchanges, and that this correlated with the removal of immune complexes.

Adolescent↗
PubMed1979

An evaluation of N-ethyl-maleimide-induced lipid peroxidation in platelet concentrates stored at 4 or 22 degrees C.

A method for the quality control of platelet viability, based on N-ethyl-maleimide (NEM)-induced lipid peroxidation, is reported. Duplicate platelet concentrates from individual donors were stored at 22 and 4 degrees C, respectively. At time 0 and at 24-hour intervals, pH, O2 and CO2 tensions, ADP-induced aggregation, glass adhesivity, hypotonic shock response (HSR) and NEM-induced lipid peroxidation were measured. A highly significant correlation between NEM-induced lipid peroxidation and HSR was established, which suggests that the former method can be used for the in vitro prediction of posttransfusion survival of preserved platelets.

Blood Platelets↗
PubMed1979

Chronic autoimmune neutropenia due to anti-NA1 antibody.

A 12-month-old child neutropenic since the age of 8 months, was referred to our institute for a sepsis from Candida albicans. On exploring the cause of neutropenia, an anti-NA1 antibody could be detected in the patient's serum. This antibody seemed to be responsible for the neutropenia because the child's PMN type was NA1+. The reactivity of the autoantibody with the patient's own granulocytes was confirmed by direct and indirect immunofluorescence studies performed on blood and marrow cells. A reduced number of T lymphocytes with poor PHA responsivity has been interpreted as the possible cause of the autoimmune disease. Steroid therapy did not cure the neutropenia but the child's general condition improved.

Agranulocytosis↗