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Biomedical subjects

W Lowenstein

Publications and source records attributed to W Lowenstein.

At least 37 records · Page 2Linked to original sources
PubMed1993

Clinical manifestations of allergy and their relation to HIV infection.

In this retrospective study 141 HIV positive subjects were included. Allergy was studied by a specific questionnaire and the Phadia Top Test, an in vitro screening test for specific IgE. Both were related to the patients' history, clinical symptoms and the treatment used. Allergy was studied in reference to HIV negative controls and in relation to the clinical and biological subgroups of HIV patients. The statistical analysis (x 2 test) demonstrated a relationship between allergy and HIV infection and the clinical stage of AIDS-IKEL among patients with CD4 > 300 microliters, which may suggest that allergy contributes to the functional deficiency of these cells. We also demonstrated a high frequency of hypersensitivity reactions (75%) in HIV asymptomatic patients with CD4 < 300 microliters, which indicates that allergy could contribute to the early destruction of these cells. The allergic patients declared to be hypersensitive before contamination. Both mechanisms, functional deficiency and destruction of CD4 T-lymphocytes could be the result of the mediators, cytokines and enzymes released from the mast cells during IgE allergic reaction. Thus this study demonstrated that allergy could be a predisposing factor for the contamination and a polyvalent co-factor for the clinical and biologic evolution of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Hepatobiliary manifestations in AIDS in adults. Place of cholecystectomy].

In AIDS patients an acalculous cholecystitis may be responsible for abdominal pain subsiding after cholecystectomy. But the indications for cholecystectomy are not clear: cholecystitis is usually associated with diffuse cholangitis and this might cause the symptoms. Since 1985, 8 AIDS patients have undergone cholecystectomy for acute cholecystitis. Ultrasonography revealed a 5 to 12 mm thickening of the gallbladder wall in all of them and gallbladder stones in two; four patients had cholangitis. The decision to operate was based on persistent pain associated with fever, poor general condition and muscular rigidity at palpation. Four patients had septic shock at the time of surgery; one died in the immediate postoperative period. In all other patients pain and septic syndrome subsided. Two patients died of AIDS complications 20 days after surgery; the remaining five died of AIDS 6, 9, 10, 12 and 14 months respectively after surgery; in two of them cholestasis had reappeared due to cholangitis. To summarize, in the 8 AIDS patients studied cholecystectomy was performed for clinical deterioration. Gallbladder pathology was responsible for the abdominal pain and the febrile general condition which was relieved by cholecystectomy.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Allergic angiitis with granulomatosis: Churg-Strauss syndrome. Retrospective study of 16 cases].

Sixteen patients with Churg-Strauss syndrome (CSS), a disorder characterized by hypereosinophilia and systemic vasculities which complicate preexisting asthma, were analyzed. The mean duration of asthma before CSS was 8 years; peripheral blood eosinophilia was always greater than 1,900/microliters and exceeded 5,000/microliters in 14 cases. The clinical manifestations were the following: 16 in generally poor condition with fever; 12 peripheral neuropathies; 11 cutaneous lesions; 9 pericardial or myocardial involvement; 9 digestive disorders; 9 muscular or articular diseases; 5 renal involvement, all associated with the vasculitis; 7 upper respiratory tract disorders. Chest radiographs showed pleuropulmonary or cardiac anomalies in 11 patients. The diagnosis was confirmed histologically in 11 cases, however, no clinical, biological or evolutive differences were observed between these patients and those with negative biopsies (5). Follow-up for 6.35 +/- 5.55 years was characterized by relapses always preceded by increased eosinophilia. Fourteen patients were successfully treated with corticosteroids, associated with cyclophosphamide in 7 of them. Five-year survival was 87%. Four deaths occurred, all CSS-associated, two because of a poorly adapted therapeutic regimen. The need for rapid and effective treatment must be stressed. The diagnosis can be made based on clinical manifestations alone before histological confirmation can be obtained.

Adolescent↗
PubMed1991

Free erythrocyte protoporphyrin assay in the diagnosis of iron deficiency in the anemic aged subject. A prospective study of 103 anemic patients.

We determined the relative value of the free erythrocyte protoporphyrin (FEP) assay compared to those of total iron-binding capacity (TIBC) and serum ferritin in the diagnosis of iron deficiency in a population of elderly anemic subjects. One hundred and three patients, 65 to 98 years old (mean +/- SD: 81.5 +/- 8.8), with hemoglobin levels of less than 110 milligrams (mean +/- SD: 97 +/- 12, range 53-109) were included in the study. In the patients with iron-deficiency anemia due solely to chronic bleeding, mean values for the three parameters were highly different from those in patients without chronic bleeding. In the patients with anemia due to an association of chronic bleeding and chronic inflammation, the mean FEP value was very significantly different (p less than 0.001) from that in the patients with chronic inflammation but without bleeding, whereas this was not the case for TIBC or serum ferritin. The sensitivity of FEP in the diagnosis of iron deficiency due to chronic bleeding in this population of anemic subjects was 60% (specificity 90%), compared to 13% (specificity 96%) for TIBC and 20% (specificity 100%) for serum ferritin. The FEP assay thus emerges as being highly suitable for the diagnosis of iron-deficiency anemia in the elderly subject, particularly when bone marrow is not examined.

Aged↗