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Biomedical subjects

N B Allen

Publications and source records attributed to N B Allen.

At least 55 records · Page 3Linked to original sources
PubMed1991

Discrimination of antineutrophil antibodies from antinuclear antibodies using immunofluorescence on neutrophils and HL60 cells.

Sera of 209 patients with rheumatic disease demonstrated 3 patterns of immunofluorescence (IF) on ethanol fixed neutrophils (PMN) and a promyelocytic cell line (HL60): (1) cytoplasmic on PMN, negative on HL60 cells, (2) nuclear or perinuclear on PMN, negative on HL60 and (3) nuclear or perinuclear on both PMN and HL60 cells. Pattern 1 was observed in sera of patients with Wegener's granulomatosis, but also in several patients with other rheumatic diseases. Pattern 2 was observed in sera of patients with systemic vasculitis or rheumatoid arthritis (RA). Antimyeloperoxidase activity was detected in sera from patients with systemic vasculitis that produced Pattern 2, but rarely in sera of patients with RA that produced the same IF pattern. Pattern 3 was observed in sera that contained antinuclear antibodies as detected by IF on HEp-2 cells.

Antibodies↗
PubMed1990

Expression of autoantibodies to recombinant (U1) RNP-associated 70K antigen in systemic lupus erythematosus.

To determine the specificity of antibodies to the (U1) ribonucleoprotein antigen in systemic lupus erythematosus (SLE), patient sera were tested for binding to a recombinant human 70K antigen. By solid-phase immunoassay, we detected anti-70K reactivity in sera from 31 of 96 patients with systemic lupus erythematosus (SLE), demonstrating that anti-70K antibodies may occur in patients with SLE as well as other clinical diagnoses. In sequential sera from 2 of these patients, we found that anti-70K binding varied dramatically over the course of disease. The changes in anti-70K antibody levels did not correlate with clinical events nor evolving antibody reactivity with the Sm-specific antigens.

Autoantibodies↗
PubMed1988

Methotrexate-associated hepatotoxicity: retrospective analysis of 210 patients with rheumatoid arthritis.

PURPOSE: Beginning in the 1980s, methotrexate has been used successfully to treat rheumatoid arthritis. The magnitude and severity of short- and long-term methotrexate toxicity, however, have not been adequately investigated. Our study was performed to determine the prevalence of hepatotoxicity in patients with rheumatoid arthritis receiving long-term methotrexate therapy. PATIENTS AND METHODS: We conducted a retrospective, computer-assisted review of all Duke University Medical Center patients undergoing liver biopsy for methotrexate monitoring from January 1979 to January 1988. A total of 538 biopsies were performed in 399 patients, 259 of whom had inflammatory arthritis (210 with rheumatoid arthritis, 47 with psoriatic arthritis, and two with seronegative spondyloarthropathy). RESULTS: No evidence of cirrhosis was defined in the cohort with rheumatoid arthritis; however, six patients with rheumatoid arthritis had histologic changes of fibrotic liver disease (prevalence of 2.9 percent in the group with rheumatoid arthritis) while taking methotrexate. Five of the six patients were obese and three had glucose intolerance or overt diabetes mellitus, and one person admitted to alcohol usage. Only one patient with fibrotic liver disease had elevated liver function test results, and no person showed a declining serum albumin level at the time of biopsy. Sixty-one patients with rheumatoid arthritis underwent multiple samplings (44 with two, 13 with three, and four with four biopsies). Fourteen of these patients showed progressive hepatic disease, whereas four patients improved. CONCLUSION: Although the prevalence of methotrexate hepatotoxicity in this large cohort of patients with rheumatoid arthritis was low, a small but definite risk of hepatic fibrosis, not predictable by laboratory screening, still exists.

Aged↗
PubMed1988

Ureaplasma urealyticum septic arthritis in hypogammaglobulinemia.

We describe a hypogammaglobulinemic man with erosive oligoarticular septic arthritis due to Ureaplasma urealyticum. His clinical course was complicated by a subcutaneous abscess. Multiple synovial cultures were negative until finally cultures specific for mycoplasmas were performed. Serologic diagnosis cannot be relied upon in hypogammaglobulinemic patients because they do not mount a perceptible antibody response. This underscores the importance of a high clinical suspicion of mycoplasmas as etiologic agents of septic arthritis in this population and early communication with the microbiology laboratory so that appropriate cultures for mycoplasmas can be performed and joint destruction minimized.

Adult↗
PubMed1987

Survival in systemic lupus erythematosus. A multivariate analysis of demographic factors.

We analyzed survival rate and important clinical outcomes in 411 patients with systemic lupus erythematosus who were seen at our center between 1969 and 1984. All eligible subjects met 4 of the revised American Rheumatism Association criteria for systemic lupus erythematosus and all were seen within 2 years of diagnosis. Mean followup was 75.6 months. Multivariate analysis suggested significant independent effects of race (P = 0.0139) and socioeconomic status (P = 0.0326) on survival. No evidence of diminished lupus-related mortality with age was documented. Previously reported findings of improved survival rate with age may have been confounded by differences in race distribution between the younger- and older-onset groups.

Adult↗
PubMed1987

Defective release of tissue plasminogen activator in systemic and cutaneous vasculitis.

The fibrinolytic system in a group of 23 patients with vasculitis and 10 patients with the cutaneous vasculitis atrophie blanche were studied. These patients were found to have markedly suppressed release of vascular tissue plasminogen activator (t-PA) stores whether the disease was active or in remission. The control group had releasable t-PA levels of 0.70 +/- 0.10 IU/ml of plasma. Levels of releasable t-PA in the patient population were 0.09 +/- 0.03 IU/ml for those with active vasculitis (p less than 0.0001 compared with the control group by the Student t test), 0.23 +/- 0.12 IU/ml for those with inactive vasculitis (p less than 0.001), and 0.03 +/- 0.01 IU/ml for those with atrophie blanche (p less than 0.0001). It is concluded that there is a generalized defect in plasminogen activator in a variety of vasculitides. Such a defect may contribute to the pathogenesis of lesions as well as the thromboembolic disease that may be observed in these patients.

Adult↗
PubMed1987

Wegener's granulomatosis involving the breast. Report of three cases and review of the literature.

Three cases of necrotizing granulomatous vasculitis of the Wegener's type involving the breast are described. In each, the presumed diagnosis was localized or metastatic carcinoma. The breast lesion and other manifestations of Wegener's granulomatosis developed concomitantly in one patient, and the breast lesion appeared several months before classic pulmonary symptoms in another. In the third patient, not only were her upper and lower airway symptoms explained only in retrospect, but even the significance of the breast biopsy findings was clarified only after other aspects of Wegener's granulomatosis developed. All patients ultimately demonstrated a good response to corticosteroids and cyclophosphamide therapy. Wegener's granulomatosis is a rare lesion affecting the breast but should nonetheless be considered in the evaluation of any breast mass.

Adult↗
PubMed1987

Pyomyositis and polyarticular septic arthritis from Hemophilus influenzae in a nonimmunocompromised adult.

We describe a healthy woman in whom pyomyositis of the left buttock, polyarticular septic arthritis, and meningitis due to Hemophilus influenzae type B developed after pneumonia. Systemic antibiotic therapy and local drainage provided a good result. This is the first case of pyomyositis and the 30th case of septic arthritis from Hemophilus influenzae described in an adult.

Arthritis, Infectious↗
PubMed1986

Acute gout presenting in the manubriosternal joint.

A 54-year-old black man developed acute pain and swelling of the manubriosternal joint. Acute gouty arthritis was diagnosed by arthrocentesis and polarizing microscopy. The histology of the manubriosternal joint and its involvement in other arthritides are briefly discussed.

Arthritis↗
PubMed1986

Multiple unusual manifestations of Wegener's granulomatosis: breast mass, microangiopathic hemolytic anemia, consumptive coagulopathy, and low erythrocyte sedimentation rate.

We describe a patient who presented with multiple unusual manifestations of Wegener's granulomatosis, including a breast mass, microangiopathic hemolytic anemia, and consumptive coagulopathy. Erythrocyte sedimentation rate (Westergren), usually elevated in the course of this disease, persistently remained low in this patient. We found that C-reactive protein levels were, in this case, a more sensitive gauge of disease activity.

Anemia, Hemolytic↗
PubMed1986

Diagnostic and therapeutic approach to the patient with vasculitis.

This article presents an approach to the diagnosis and therapy of patients with vasculitis. Effective treatment of patients with vasculitis requires a systemic approach to diagnosis and classification of disease, evaluation of the extent of organ system involvement, and an exclusion of underlying treatable diseases.

Adrenal Cortex Hormones↗
PubMed1986

Polymyalgia rheumatica and temporal arteritis.

Polymyalgia rheumatica and temporal arteritis are a clinical syndrome and clinicopathologic entity, respectively. Polymyalgia rheumatica occurs more commonly than temporal arteritis, with approximately half of all patients with temporal arteritis having the polymyalgia rheumatica syndrome. Both conditions are found in the population over 50 years of age and are associated with an elevated ESR. The etiology of both is unclear, although genetic, and potentially, environmental factors may play significant roles. Both conditions respond to corticosteroid therapy, but patients with temporal arteritis require significantly higher doses to control symptoms and to prevent blindness.

Adrenal Cortex Hormones↗