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R J Enzenauer

Publications and source records attributed to R J Enzenauer.

At least 19 recordsLinked to original sources
PubMed1999

Can immunization precipitate connective tissue disease? Report of five cases of systemic lupus erythematosus and review of the literature.

OBJECTIVES: To report a series of five patients who developed systemic lupus erythematosus (SLE) after immunization and review the literature on vaccine-associated connective tissue diseases and the theoretical mechanisms that could explain such an association. METHODS: Uncontrolled retrospective analysis of cases identified sporadically over 7 years at three centers. RESULTS: In our series of 5 patients, symptoms of SLE developed within 2 to 3 weeks after secondary immunization. All patients met American College of Rheumatology (ACR) criteria for the diagnosis of SLE. In most patients, symptoms have been persistent. CONCLUSION: Although a coincidental association between vaccination and the onset of SLE cannot be excluded, the temporal relationship with the development of symptoms makes it immunologically plausible that vaccination triggered systemic autoimmunity in these rare cases. We propose that epidemiological studies be performed to examine this potential association in more detail to quantitate the risk and identify possible genetic risk factors.

Adult↗
PubMed1999

Watermelon stomach.

Explore the source record for details and available documents.

Endoscopy, Digestive System↗
PubMed1998

Antigen-specific antibody responses in lupus patients following immunization.

OBJECTIVE: To determine the safety and efficacy of 3 clinically relevant vaccines in patients with systemic lupus erythematosus (SLE). METHODS: We studied 73 consecutive SLE patients immunized with pneumococcal, tetanus toxoid (TT), and Haemophilus influenzae type B (HIB) vaccines. Patients were evaluated preimmunization and 12 weeks postimmunization for disease activity and immunization side effects. RESULTS: Eighty-four percent of the SLE patients developed a 4-fold titer increase in response to at least 1 vaccine, with 51% developing a 2-fold titer increase with all 3 vaccines. The majority of SLE patients developed protective levels of antibody to TT (90%) and HIB (88%). Although protective antibody levels could not be determined for pneumococcus, almost half of the patients (47%) developed a 4-fold antibody response. There was a trend toward a lower antibody response in patients with active disease treated with immunosuppressive therapy. Overall lupus disease activity was unaffected by immunization. CONCLUSION: Immunization is safe in SLE patients, with the overwhelming majority developing protective antibody levels. Therefore, SLE patients should receive immunizations according to the recommendations of the Centers for Disease Control and Prevention and the Immunization Practices Advisory Committee.

Adolescent↗
PubMed1996

Hypomagnesemia in postoperative spine fusion patients.

STUDY DESIGN: This was a retrospective review of 49 consecutive patient charts and a prospective study of 44 consecutive patients who underwent spinal fusion. OBJECTIVE: To determine the incidence and clinical significance of hypomagnesemia after spinal fusion. SUMMARY OF BACKGROUND DATA: Hypomagnesemia may be seen in 61% of patients in postoperative intensive care and may be associated with increased mortality. However, symptomatic hypomagnesemia is rare. METHODS: A retrospective review of the charts of 49 consecutive patients who underwent spine fusion was completed to determine postoperative magnesium levels. Twenty-seven patients with postoperative hypomagnesemia received routine magnesium replacement regardless of symptoms. Forty-four patients who underwent spine fusion were studied prospectively for postoperative hypomagnesemia. Prospectively studied observational patients who developed hypomagnesemia were treated only when clinical signs or symptoms of magnesium deficiency occurred. RESULTS: Postoperative hypomagnesemia occurred in 28 of 49 retrospectively studied patients who underwent spine fusion (57%) and 38 of 44 prospectively studied patients who underwent spine fusion (86%). Symptoms associated with hypomagnesemia developed in three of 44 prospectively studied and two of 49 retrospectively studied patients who underwent spine fusion (7% and 4%, respectively). The combined incidence for symptomatic hypomagnesemia was five of 93 patients. (5.4%). The majority of patients from the prospective study with postoperative hypomagnesemia were asymptomatic, and their magnesium levels returned to normal within 4 days, with or without treatment. CONCLUSIONS: This study confirmed a high incidence of hypomagnesemia in patients who underwent spine fusion, although only 5.4% developed clinical signs or symptoms of magnesium deficiency. The cause of hypomagnesemia remains speculative.

Adolescent↗
PubMed1996

Cervical spine injury in a boxer: should mandatory screening be instituted?

Cervical spine fracture is a rare, yet potentially catastrophic complication associated with boxing. Neurologic deficits, ocular injuries, or other traumatic musculoskeletal injuries have been commonly reported. Symptoms of cervical spine injury may be minimal or absent. Cervical spine fracture may be undiagnosed and unreported in boxers with presumed soft-tissue injury to the head and neck. We describe a young athlete who sustained a transient spinal cord injury while boxing, which required a cervical spine fusion and postoperative immobilization in a halo vest. This athlete also had an os odontoideum, which placed him at significant risk for such an injury. Pre- and postparticipation screening of the cervical spine should be considered in all boxers.

Adult↗
PubMed1995

Cogan's syndrome mimicking acute Lyme arthritis.

A pediatric case of Cogan's syndrome mimicking acute Lyme arthritis is described. A 12-year-old black boy was admitted to the pediatric service for presumed right knee septic arthritis. Symptoms included acute pain and swelling with decreased range-of-motion. Although the patient's right knee symptoms and positive Lyme serology were consistent with a diagnosis of Lyme arthritis, the presence of sensorineural hearing loss and interstitial keratitis with inflammatory arthritis suggested a diagnosis of Cogan's syndrome. Subsequent Western blot analysis was negative for Borrelia burgdorferi antigens. The patient had dramatic clinical improvement of musculoskeletal and ophthalmologic complaints shortly after receiving high-dose corticosteroids, although residual sensorineural hearing loss persisted.

Child↗