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P Martinez-Osuna

Publications and source records attributed to P Martinez-Osuna.

12 recordsLinked to original sources
PubMed1994

Eosinophilic hepatitis: a new feature of the clinical spectrum of the eosinophilia-myalgia syndrome.

The eosinophilia-myalgia syndrome associated with L-tryptophan-containing products is highlighted by eosinophilia, incapacitating myalgias, and diverse multisystemic manifestations. In addition to involvement of the skin, skeletal muscle, and peripheral nerves, visceral damage has been quite prominent, particularly affecting the lungs, the heart, and the liver. Hepatic involvement has been manifested by altered liver tests but is clinically silent. We report the unique case of a woman with this syndrome who developed abdominal pain, a clinical picture of hepatitis and chronically abnormal liver tests. Histologic examination of the liver disclosed eosinophilic hepatitis with piecemeal necrosis. The occurrence of clinically overt hepatic involvement has not been reported previously. Potential mechanisms of liver damage in eosinophilia-myalgia syndromes are discussed.

Adult↗
PubMed1994

Clinical findings in symptomatic women with silicone breast implants.

We report the clinical findings in a series of women with silicone breast implants (SBI) and rheumatic disease. These findings represent the first 50 patients seen at the University of South Florida Medical Clinic between March 1977 and January 1991. The average age was 44 years with a range of 30 to 66 years. The most common clinical findings included chronic fatigue, muscle pain, joint pain, joint swelling, and lymphadenopathy. Seventeen women with an average Steinbrocker functional class of 1.8 decided not to remove the implants. An average of 14 months later, follow-up showed no change in their condition. Thirty-three women, with an average functional class of 2.5 underwent implant removal. Twelve of the 33 had documented implant rupture. During an average follow-up of 22 months after implant removal, 24 women improved clinically, 8 did not change, and 1 worsened. We believe this series supports a relationship between silicone breast implants and rheumatic disease signs and symptoms. Although this report is not a definitive epidemiological study, findings suggest that physicians should inform women about the possible benefit of implant removal.

Adult↗
PubMed1993

Refractory nephrotic syndrome in lupus nephritis: favorable response to indomethacin therapy.

The effects of indomethacin on urinary protein excretion, levels of serum albumin and renal function were studied prospectively in six patients with systemic lupus erythematosus (SLE) and refractory nephrotic syndrome due to lupus nephritis. Two had membranoproliferative glomerulonephritis, two had diffuse proliferative glomerulonephritis, and one each had mesangioproliferative and membranous glomerulonephritis. All experienced a considerable reduction in urinary protein excretion and an increase in serum albumin. Indomethacin was discontinued in two patients because of side effects, and proteinuria recurred to pretreatment levels. The decrease of proteinuria continued during long-term treatment in three patients. Indomethacin did not cause a permanent decline in renal function. Our results suggest that therapy with indomethacin may be beneficial for the treatment of refractory nephrotic syndrome in selected SLE patients. However, because of potential side effects the administration of indomethacin should be monitored closely.

Adult↗
PubMed1992

Hyperprolactinemia in systemic lupus erythematosus: association with disease activity.

This study was designed to determine the prevalence and clinical significance of hyperprolactinemia in systemic lupus erythematosus (SLE) and other rheumatic diseases. Basal levels of prolactin were determined in 130 nonselected sera from patients with rheumatic diseases including 45 with SLE, 31 with rheumatoid arthritis, 23 with osteoarthritis, 18 with fibromyalgia, and 13 with polymyalgia rheumatica. Serum samples of 28 healthy subjects were used as normal controls. Serum prolactin was measured by radioimmunoassay. ANA, anti-DNA, RNP, Sm, Ro, La, and anticardiolipin antibodies were determined by standard techniques. Elevated serum levels of prolactin (PRL greater than 20 ng/ml) were found in a subset of SLE patients. In addition, a direct correlation with clinical disease and serological (ANA) activity was also found. These findings suggest a potential role for this immunoregulatory hormone in SLE pathogenesis.

Adult↗
PubMed1992

There is an association between human immunodeficiency virus infection and spondyloarthropathies.

The presence of inflammatory musculoskeletal manifestations during the course of human immunodeficiency virus (HIV) infection is well established. A wide spectrum of rheumatic disorders have been reported since the first reports of Reiter's syndrome with HIV infection. Other reported associations include forms of arthropathies, psoriatic arthritis, Sjögren's syndrome, polymyositis-dermatomyositis, vasculitis, and septic arthritis.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Is silicone associated with connective tissue disease?

Connective tissue diseases have been described in patients who have had silicone augmentation mammoplasty. Several possible mechanisms of pathogenesis are postulated. Although otherwise indistinguishable from other connective tissue disease, these patients may experience improvement or remission following implant removal. Current data suggest that the risk of disease after silicone breast augmentation is less than one percent. A large well-designed epidemiologic study will be needed to confirm this association.

Adult↗
PubMed1991

Characteristics and pathogenesis of myositis in human immunodeficiency virus infection--distinction from azidothymidine-induced myopathy.

Inflammatory muscle involvement during the course of human immunodeficiency virus (HIV) infection is described and guidelines are suggested for its differentiation from the myopathy associated with azidothymidine (AZT) therapy. Six patients infected with HIV presented with proximal muscle weakness, biochemical and electromyographic abnormalities consistent with myositis. One patient had a skin rash characteristic of dermatomyositis. Muscle biopsy findings demonstrated the presence of an inflammatory cell infiltrate and HIV-p24 antigen. All patients developed their clinical picture prior to AZT therapy and responded to steroids with or without coadministration of AZT.

Adult↗
PubMedDate not supplied

Does serum rheumatoid factor have an influence on the clinical picture of ankylosing spondylitis?

OBJECTIVE: To describe the influence of serum rheumatoid factor (RF) on the clinical and radiological picture of definite ankylosing spondylitis (AS). METHODS: In a retrospective chart review of 281 AS patients typed for RF, the clinical picture of RF positive patients (Group 1) was compared with RF negative patients (Group 2); mode of onset, disease duration, and treatment were recorded. All patients were examined to determine their clinical status; the blood cell count. HLA-B27, serum IgG, IgM, IgA, and erythrocyte sedimentation rate (ESR) were determined, and radiological studies of the entire spine, pelvis and affected peripheral joints were carried out. In patients from Group 1 the HLA-DR was also determined. RESULTS: Fifteen of 281 patients (8 men, 7 women) with AS were RF+ (1:64 to 1:1024) (5.3%) and 11 were HLA-B27+. Seven patients in Group 1 had spine involvement and chronic arthritis of the knees. Four out of these 7 were tested for DR, and none was positive; in 6, AS and rheumatoid arthritis (RA) coexisted, 2 were DR1 and 2 were DR4 (test not carried out in 2). In two others we found spinal involvement only, and one of them had both DR1 and DR4. The onset of AS was similar in both groups. Group 1 was characterized by a chronic disease of moderate intensity with chronic arthritis of the metacarpophalangeal and proximal interphalangeal joints (p = 0.0008 and p = 0.04, respectively), no valvulopathy (p = 0.04) and fewer uveitis sequelae (p = 0.007) than Group 2. The ESR (p = 0.01), IgG (p = 0.008) and IgM (p = 0.0001) were higher in Group 1 than in Group 2. CONCLUSIONS: The presence of RF in AS is associated with a chronic disease of moderate intensity with chronic peripheral arthritis and fewer extra-articular manifestations. The presence of RF, not always associated with HLA-DR, seems to affect the course of AS and does not necessarily indicate an association with RA.

Adult↗