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R H Kauffmann

Publications and source records attributed to R H Kauffmann.

42 records · Page 3Linked to original sources
PubMed1980

Circulating and tissue-bound immune complexes in allergic vasculitis: relationship between immunoglobulin class and clinical features.

Sixty-two patients with allergic vasculitis and histological evidence of leukocytoclastic vasculitis were examined to determine whether clinical features, such as course and degree of systemic involvement, could be related to the class of the immunoglobulins in immune complexes (IC) in both the circulation and the vessel wall. Circulating IC were detected with the 125I-C1q-binding assay (C1q-BA), an anti-IgA inhibition binding assay (a-IgA-Inh BA) and the conglutinin-binding assay (Con-BA). Stabilized heat-aggregated IgG, IgA and IgM were used to determine the immunoglobulin class specificity of these assays. With the C1q-BA only aggregated IgG were detected, with the a-IgA-Inh Ba only aggregates containing IgA. With the Con-BA IgG, IgA or IgM in reactive aggregates were identified with class-specific antibodies. For patients with acute cutaneous vasculitis all assays were negative. The a-IgA-Inh BA was frequently positive in sera of patients with chronic cutaneous and acute systemic vasculitis; in the latter group conglutinin-binding IC of the IgG, IgA and IgM class were also detected. Levels in the C1q-BA were high for patients with chronic systemic vasculitis. Comparison of the results of the IC assays with the immunofluorescence studies of the cutaneous vessel walls of the same patients showed agreement between the results of the C1q-BA and deposition of IgG and the results of the a-IgA-Inh BA and IgA deposition. The class of immunoglobulin in conglutinin-binding IC did not correspond as well with the immunoglobulins in vessel walls. This study shows that certain clinical features of allergic vasculitis are related to the composition of the IC in the circulation and in the vessel wall.

Adolescent↗
PubMed1979

Aggregated human immunoglobulin G stabilized by albumin: a standard for immune complex detection.

Stabilized preparations of heat-aggregated human immunoglobulin G (A-IgG) of restricted size were made by separating A-IgG by sucrose density gradient ultracentrifugation in the presence of bovine serum albumin (BSA). Periodic recentrifugation of stored fractions of the radiolabelled A-IgG indicated that the initial sedimentation characteristics were preserved. Pooled fractions of A-IgG stored for up to 16 months had the same functional activity as freshly prepared A-IgG of corresponding size when assessed by activation of the first component of complement and consumption of C4 and CH50 in normal human serum. It was also found that the reactivity of A-IgG in the C1q binding assay (C1Q-BA) and the conglutinin binding assay (Con-BA) was not altered by long-term storage of these A-IgG. Testing different batches of [125I]C1q and conglutinin with the same batch of stabilized A-IgG showed variations due to the instability of both [125I]C1q and conglutinin. The influence of these variations on the quantification of the levels of immune complexes in sera was reduced by using stable A-IgG as a reference. The assays were compared to determine the effect of the size of the aggregate. The C1Q-BA detected preferentially A-IgG of large size, while size had no influence in the Con-BA. These results suggest that the stability of A-IgG in BSA is such that this preparation may be used as a reliable standard for immune complex assays.

Animals↗
PubMed1978

Acquired antithrombin III deficiency and thrombosis in the nephrotic syndrome.

Antithrombin III levels were studied in relation to the occurrence of thromboembolism in 48 patients with various degrees of proteinuria. Nine of these patients had clinical signs of thrombosis, including four with renal vein thrombosis. In eight of these nine patients, antithrombin III concentrations were below 70 per cent. There was a significant negative correlation between the antithrombin III concentration and the urinary protein excreation (P less than 0.001). Antithrombin III was found in the urine of 32 of 42 patients. There was a significant correlation between the renal clearance and the degree of antithrombin III serum deficiency (P less that 0.001). The clearance and serum level of albumin closely paralleled these changes. We conclude that thrombosis in patients with severe proteinuria is associated with a deficiency of antithrombin III due to urinary excretion of this protein.

Adolescent↗
PubMed1976

Unilateral renal vein thrombosis and nephrotic syndrome. Report of a case with protein selectivity and antithrombin III clearance studies.

A case of the nephrotic syndrome with unilateral renal vein thrombosis is reported. The patient, an 18 year old man, presented with a six month history of edema and the recent development of a left-sided varicocele. An enlarged left kidney and a thrombus in the left renal vein were demonstrated roentgenographically. A biopsy specimen of the right kidney was interpreted as membranous glomerulonephritis. Selective renal function studies showed nearly identical creatinine excretion, and similar total protein excretion and protein selectivity from each kidney. Thus, the thrombus in the left renal vein did not influence glomerular filtration rate or quantitative or qualitative protein excretion. A high urinary output and a decreased serum level of antithrombin III were measured. These findings suggest a mechanism to explain the increased thrombotic tendency seen in this and other patients with the nephrotic syndrome.

Adolescent↗
PubMedDate not supplied

A randomized trial of geriatric liaison intervention in elderly medical inpatients.

OBJECTIVE: The aim of this study was to examine the effect of psychogeriatric intervention in a group of elderly medical inpatients over 75 years of age. In addition to usual care, intervention consisted of multidisciplinary joint treatment by a psychogeriatric team. The main purpose of intervention was to obtain the optimal level of physical functioning. METHOD: In a prospective randomized trial the effect of the intervention (N = 140) compared with usual care (N = 97) was estimated for physical functioning, length of stay, and nursing home placement within 12 months of discharge. RESULTS: Substantially more patients assigned to the intervention group improved in their physical functioning, and fewer became worse. The mean length of stay was 5 days shorter for the intervention group. There were more readmissions to hospital in the usual care group (29.9%) compared with the intervention group (17.4%). Of the patients assigned to the intervention treatment, 18% were admitted to a nursing home. In the usual care group this was 27%. The effects of intervention remained statistically significant for all the outcome variables after controlling for possible confounding baseline characteristics. CONCLUSIONS: The intervention we studied had clinically relevant effects on important outcome variables. Psychiatric co-morbidity was an important risk factor for the outcome of the patients in our study. By combining elements from a psychiatric and geriatric consultation service with elements from a unit-driven service, we were able to improve health care for the elderly in our hospital in a feasible and cost-effective way.

Activities of Daily Living↗