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Biomedical subjects

A L Parke

Publications and source records attributed to A L Parke.

30 records · Page 2Linked to original sources
PubMed1991

The prevalence of antiphospholipid antibodies in women with recurrent spontaneous abortion, women with successful pregnancies, and women who have never been pregnant.

Antibodies to negatively charged phospholipids are associated with a predisposition to both arterial and venous thrombosis, recurrent fetal wastage, and thrombocytopenia. These associations have been reported in patients who do not fulfill criteria for connective tissue diseases. In this study, we determined the prevalence of antiphospholipid antibodies in 81 women who had had recurrent spontaneous abortion (3 or more fetal losses), in 88 women whose pregnancies were successful, and in 64 women who had never been pregnant. Antiphospholipid antibodies were found in 16% of women with recurrent spontaneous abortion, and at a statistically greater prevalence than in women who had successful pregnancies (7%) as well as those who had never been pregnant (3%). A false-positive VDRL and IgG anticardiolipin antibodies were more specific for fetal wastage than was either the lupus anticoagulant or IgM anticardiolipin antibodies.

Abortion, Habitual↗
PubMed1991

Isotretinoin for refractory lupus erythematosus.

We describe six patients with cutaneous manifestations of lupus erythematosus who were treated with isotretinoin, 1 mg/kg/day. In each case the cutaneous lesions had proved resistant to systemic corticosteroids and antimalarial therapy. Treatment with isotretinoin resulted in rapid clinical improvement in all cases. Recurrences were similarly rapid when the drug was discontinued. Side effects were minimal and easily controlled by adjustments in dose or by the use of lubricants.

Adult↗
PubMed1991

Gastrointestinal disorders and rheumatic diseases.

Pathologic changes in the gastrointestinal tract may be associated with clinical complaints in multiple organs. In some instances, the association between gastrointestinal pathology and extraintestinal disease is so strong that treatment of gastrointestinal disease cures the patient of the extraintestinal complaints. The references in Table 1 show that maintenance of the structural and immunologic barriers of the gastrointestinal tract are vital in determining the general health of the patient, and that the associations between the gut, arthritis, dermatitis, and autoimmune disease are much stronger than may appear at first glance.

Autoimmune Diseases↗
PubMed1990

L-tryptophan associated eosinophilia-myalgia syndrome.

Environmental chemicals are increasingly incriminated in the pathogenesis of several disease states. The eosinophilia-myalgia syndrome is a recently described entity attributed to the ingestion of the normal dietary amino acid L-tryptophan. We describe a patient who fulfills criteria for the eosinophilia-myalgia syndrome and who was ingesting supplemental L-tryptophan. Exhaustive investigations failed to reveal other causes for her eosinophilia or her myalgic/neuropathic complaints, and she improved dramatically when she discontinued the L-tryptophan supplements. The mechanisms whereby this chemical may induce this syndrome are discussed.

Aged↗
PubMed1989

Antiphospholipid antibody syndromes.

There is no doubt that in some individuals the presence of antibodies to negatively charged phospholipids currently measured as the lupus anticoagulant, a biologically false positive VDRL, and anticardiolipin antibodies is associated with certain clinical features, in particular, a predisposition to both arterial and venous thrombosis and, in women, to fetal wastage. This syndrome may be seen in patients with readily identifiable connective tissue disease, in patients with an ill-defined disease, and in clinically healthy individuals who only manifest signs of this syndrome when they are pregnant or when taking oral contraceptives. This last group have given rise to the term "subclinical" autoimmune disease, but it remains to be seen whether these women stay healthy or go on to develop overt clinical autoimmune disease states. Current recommendations for treating pregnant patients with these antibodies are based on uncontrolled studies, and there is a need for well controlled age-matched, parity-matched studies to be done. Similarly, the discrepant reports addressing the significance of these antibodies and their laboratory associations emphasize the need for standardization of the tests used to measure these antibodies with international standards for the cardiolipin assay an absolute must. These problems are being addressed. This exciting field of research that has extended the world of autoimmunity far beyond the limits of rheumatology, has given rheumatologists, hematologists and obstetricians a new challenge: to find the link between antibodies, blood clots, and babies.

Abortion, Habitual↗
PubMed1988

Antimalarial drugs, systemic lupus erythematosus and pregnancy.

Antimalarial drugs containing the 4-amino quinoline radical are used to help control disease activity in discoid lupus erythematosus and systemic lupus erythematosus (SLE). Many patients with these complaints are young women, some of whom will become pregnant. The use of these substituted 4-amino quinoline compounds in pregnancy is controversial. We studied the full obstetric histories of 8 women with SLE who had taken either chloroquine phosphate or hydroxychloroquine sulphate (Plaquenil) throughout the entire length of at least 1 pregnancy. These 8 women had 14 pregnancies while receiving antimalarial drugs. Fetal wastage was high in these patients, regardless of antimalarial therapy, and was almost 100% in patients who were clinically active. Six normal full term spontaneous deliveries resulted from these pregnancies with clinically healthy normal babies born despite exposure to antimalarial therapy throughout the pregnancies.

Abortion, Spontaneous↗
PubMed1984

A double-blind study comparing sodium aurothiomalate and auranofin in patients with rheumatoid arthritis previously stabilized on sodium aurothiomalate.

Auranofin, an orally active gold preparation, was compared with sodium aurothiomalate in a double-blind trial in patients with rheumatoid arthritis fulfilling the ARA criteria, who had been stabilized on sodium aurothiomalate for at least six months. Twenty-four patients have so far been entered in the trial, of whom fourteen have been randomly allocated to receive auranofin and ten to receive sodium aurothiomalate. After initial stabilization, patients receive either auranofin 6 mg daily and placebo injection, or sodium aurothiomalate 50 mg monthly and placebo tablets. Five patients have completed one year on auranofin. The remaining nine patients were withdrawn because of loss of efficacy (two), side-effects, (five), loss of efficacy and side-effects (one) and default (one). Four patients have completed one year's treatment with sodium aurothiomalate. Of the remaining six patients, two were withdrawn because of side-effects, three because of poor disease control and one because of side-effects and poor disease control. Diarrhoea occurred in eight patients receiving auranofin. Rashes occurred in both groups but otherwise there were no serious side-effects. The efficacy of both drugs appeared similar, there being no significant differences in morning stiffness, fatiguability, visual analogue pain score, grip strength and articular index. There were also no significant differences in laboratory parameters of efficacy. Auranofin appears to control disease activity in rheumatoid arthritis but diarrhoea is a frequent side-effect.

Adolescent↗
PubMed1983

Sex hormones in male patients with systemic lupus erythematosus: a comparison with other disease groups.

There is substantial evidence for alteration of oestrogen metabolism in both males and females with systemic lupus erythematosus (SLE). Low testosterone levels have been described in men with SLE, and it has been suggested that this may be a further predisposing factor to the development of the disease. Serum testosterone, oestradiol, FSH and LH levels were measured on two or more occasions in nine male patients with SLE. Similar estimations were performed on four other groups for comparison: ten male patients with rheumatoid arthritis, six male patients on long-term steroid therapy, eleven male patients with renal failure on long-term haemodialysis and eleven healthy male volunteers. Mean testosterone levels were significantly reduced in all disease groups and there was no significant difference between patients with SLE and those with other chronic disorders. Oestradiol levels were normal in all groups, but there was a trend to elevated mean levels of FSH and LH (p 0.05 for the haemodialysis group). Our results confirm that testosterone levels are low in males with SLE, but suggest that this is an effect of chronic disease, and therefore unlikely to be a pre-existing risk factor for the development of SLE in men.

Arthritis, Rheumatoid↗
PubMed1981

Rheumatoid arthritis and food: a case study.

Clinical and laboratory studies in a patient whose rheumatoid arthritis appeared to be exacerbated by dairy produce showed that challenge with milk and cheese resulted in a produced increase in synovitis and changes in immune complexes, IgE antibodies, and heat-damaged red cell clearance rates. Exclusion of dairy products from the diet produced a considerable improvement in her previously aggressive disease.

Adult↗