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PubMed1983

[Retrospective study of the effects of D-penicillamine and pyrithioxin in the treatment of rheumatoid arthritis].

The authors made a comparative study of the effectiveness and tolerance of D-penicillamine (DP) and pyrithioxine (Pyr) and investigated possible prognostic factors for the tolerance and effectiveness of these two treatments. This retrospective study concerned 150 patients with rheumatoid arthritis (RA). 86 patients were treated with DP and 64 were treated with Pyr. The percentage effectiveness, evaluated in terms of morning stiffness and the articular index as well as the need for steroidal and non-steroidal anti-inflammatory agents, attained 67.4 p. cent with DP and 51.6 p. cent with Pyr. Suspension of treatment because of ineffectiveness, was more frequent with Pyr. The changes in the following laboratory parameters were also compared: ESR, rheumatoid serology, ANF, C3 and C4 complement levels, IgG, IgA and IgM levels. The treatment was stopped definitively because of intolerance in 37.2 p. cent of cases with DP and in 29.7 p. cent of cases with Pyr. Serious renal and haematological complications are essentially, but not exclusively, due to DP.

Arthritis, Rheumatoid↗
PubMed1982

Modulation of classical C3 convertase of complement by tear lactoferrin.

Lactoferrin isolated fom normal human tears was shown to inhibit the complement-mediated lysis of antibody-coated red cells. The anti-complementary effect of lactoferrin on serum complement could be reversed by adding Fe3+ but not by Mg++ or Ca++. Lactoferrin did not inhibit the formation of EAC14 but markedly blocked the assembly of the EAC142 enzyme. Once the C3 convertase was formed lactoferrin did not affect the function of the enzyme and only had a minor effect on the intrinsic decay of C2 from the convertase. Inhibition of the C3 convertase formation was not seen by preincubating EAC14 intermediates with lactoferrin, but only occurred when lactoferrin and C2 were incubated together with EAC14 cells. Our findings suggest that lactoferrin may play an anti-inflammatory role by modulating activation of the complement system.

Calcium Chloride↗
PubMed1982

[Berger's disease. Study of eleven cases (author's transl)].

Among 39 patients with recurrent hematuria, 11 accomplished criteria of Berger's disease. The frequent association between recurrent hematuria and upper respiratory tract infections as well as constant elevation of serum IgA are emphasized. Their finding as well as the deposition of IgA on the mesangium and C'3 without C1q and C'4 suggest an alternative activation of the complement system which could explain the role of the IgA in the pathogenesis of Berger's disease. The disease can begin as acute glomerulonephritis and occasionally as a nephrotic syndrome, and its' prognosis is generally good in most instances.

Child↗
PubMed1982

Useful laboratory measurements in the management of systemic lupus erythematosus.

Thirty-five patients with systemic lupus erythematosus (SLE) have been monitored clinically and serologically for up to three and a half years. The data collected was analysed by computer using the Statistical Package for the Social Sciences Program. The patients were categorized into severely active, moderately active and inactive disease groups and associations between clinical state and laboratory tests were sought. No single test was found to distinguish, reliably, the clinical groups but levels of circulating immune complexes (by polyethylene glycol precipitation), platelet count and ESR were shown to distinguish inactive from active disease (p less than 0.05). Severely active disease was distinguished from the less active forms by circulating immune complex levels (Clq solid phase assay) double-stranded DNA binding, lymphocyte count, and CH50 estimations (p less than 0.05). Tests were found to differ considerably in their ability to reflect disease activity when patients were separated into sub-groups according to the major clinical features (eg. arthralgia, renal disease and vasculitic rash). However, those patients with cerebral manifestations and thrombocytopenia proved to be the most difficult to assess. Discriminant function analysis showed that a maximum of 44 per cent of cases could be correctly classified into their clinical grades when combinations of four out of five laboratory tests were used. These results emphasise the continuing need for better tests to monitor the course of SLE.

Adolescent↗