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Biomedical subjects

B Devulder

Publications and source records attributed to B Devulder.

At least 145 records · Page 8Linked to original sources
PubMed1989

T lymphocyte activation in systemic lupus erythematosus analysed by proliferative response to nucleoplasmic proteins on nitrocellulose immunoblots.

Polyclonal B cell activity in systemic lupus erythematosus (SLE) may be under T cell control. The use of nitrocellulose immunoblots for the analysis of recognition by peripheral blood lymphocytes of nucleoplasmic proteins in SLE patients led to the characterization of significant proliferative responses to 68K (U1 RNP); SS-B; B-B' and D (Sm) antigen in 15 of 20 patients. Variations of proliferative response were parallel to disease activity over a follow-up period of greater than or equal to 6 months, conferring some prognostic value to the assay of lymphocyte response to nucleoplasmic antigens. The pattern of reactivity differs from the corresponding serum antibody profile, and purified T cell suspensions (greater than 95% pure) were shown to proliferate in response to soluble nucleoplasmic antigens, indicating that T and B cell repertoires against nucleoplasmic proteins may differ. This suggests that activated helper T cells contribute to the fine modulation of B cell reactivity to subcellular particles to determine the particular antibody profile of the patients.

Adolescent↗
PubMed1988

[Clinical value of the determination of urinary antitrypsin activity].

Urinary trypsin inhibitory capacity is mainly due to the excretion of a glycoprotein which is immunologically related to the inter alpha-trypsin inhibitor and may be a proteolytic degradation product of that substance. It was tested in 133 subjects divided into 7 groups: 24 healthy controls (group A), 21 patients with bacterial infection (group B), 37 with bacterial infection under antibiotic therapy (group C), 25 with connective tissue disease (group D), 8 with infected connective tissue disease (group E), 14 with cancer (group F) and 4 with infected cancer (group G). Urinary trypsin inhibitory capacity level was very low in controls (3.32 +/- 0.8 U/g urinary creatinine), but it was dramatically increased when infection was present (149.67 +/- 23.6 U/g urinary creatinine). This test appeared to be more effective than serum C-protein measurement simultaneous carried out in the same patients. Urinary trypsin inhibitory capacity is not related to the degree of proteinuria in the urine sample, but it is increased in patients with chronic renal failure excluded from this study. Thus, its measurement is a sensitive, easy and useful test for detecting and monitoring infections. The return to its physiological value is a very good argument in favour of therapeutic effectiveness.

Bacterial Infections↗
PubMed1987

Subclinical lung inflammation in primary Sjögren's syndrome. Relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease.

To directly evaluate whether a subclinical alveolar inflammation is associated with primary Sjögren's syndrome (SS), we evaluated the distribution of cells obtained by bronchoalveolar lavage (BAL) from the lower respiratory tract in 29 patients who had primary SS, but who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. There was no difference in total cell counts of specimens from patients versus those of controls. An abnormal differential cell count was noted in 16 patients (55%). Two patterns of alveolitis were observed: a pure lymphocyte alveolitis (greater than 18% lymphocytes, present in 11 patients) and a neutrophil alveolitis (greater than 4% neutrophils, present in 5 patients). There was associated lymphocytosis in 4 of the patients with neutrophil alveolitis. All patients had normal results on pulmonary function tests. Patients with abnormal BAL findings showed clinical and biologic indexes of more severe disease than did those with normal BAL results, as demonstrated by greater extraglandular extension of the disease, higher mean values of serum gamma globulins and serum beta2-microglobulin, and higher prevalence of rheumatoid factor and of antinuclear antibody. Thus, our data demonstrate that BAL permitted the detection of subclinical inflammatory alveolitis in 55% of our patients with primary SS. A long-term followup is required to determine whether these patients will develop obvious pulmonary involvement.

Adult↗
PubMed1986

Subclinical pulmonary involvement in collagen-vascular diseases assessed by bronchoalveolar lavage. Relationship between alveolitis and subsequent changes in lung function.

Collagen-vascular disorders (CVD) are commonly associated with chronic interstitial lung disease. Clinicopathologic observations suggest that inflammatory process of the lower respiratory tract may appear prior to fibrosis. Subclinical pulmonary involvement, as assessed by bronchoalveolar lavage (BAL) was evaluated in 61 patients with various CVD but free of clinical pulmonary symptoms and with normal chest roentgenograms. Eight of 61 had abnormal pulmonary function tests (PFT) at entry to the study. Total BAL cell yield from nonsmokers was greater in patients with abnormal than in those with normal PFT (p less than 0.05). Abnormal differential count of BAL cells was noted in 29 of 61 patients (48%). Lymphocyte alveolitis (lymphocytes greater than or equal to 18%) was a characteristic finding in patients with primary Sjögren's syndrome (11 of 25) or Sjögren's syndrome associated with another CVD (4 of 8). Neutrophil alveolitis (neutrophils greater than 4%) with or without increased percentage of lymphocytes occurred in patients with CVD classically associated with pulmonary fibrosis: progressive systemic sclerosis (6 of 10), rheumatoid arthritis (1 of 4), dermatopolymyositis (2 of 3), and mixed connective tissue disease (3 of 8). An increased percentage of eosinophils was detected in 1 patient with progressive systemic sclerosis. Bronchoalveolar lavage abnormalities were more frequently detected in patients with active and severe extrapulmonary disease. On follow-up PFT 12 months later, 11 patients with normal BAL and 10 patients with lymphocyte alveolitis had not deteriorated. In marked contrast, the presence of neutrophils in BAL was associated with a progressive deterioration of PFT in 6 of 7 untreated patients, whereas 4 corticosteroid-treated patients with neutrophil alveolitis had not deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Dermatopolymyositis and pulmonary fibrosis associated with Gougerot-Sjogren syndrome. Study of 3 cases].

3 new cases of dermatomyositis associated with diffuse interstitial pulmonary fibrosis and, more exceptionally, with Sjögren's syndrome are reported. The pulmonary fibrosis observed in patients with dermatomyositis differs from that found in other connective tissue diseases in that it follows a more acute course and may respond to corticosteroids. Thus, in 2 of these patients treated with corticosteroids (combined in 1 case with cyclophosphamide) the high percentage of lymphocytes and polymorphonuclears in the broncho-alveolar lavage fluid, which reflects alveolitis activity, was reduced and the pulmonary fibrosis was cured in one patient and stabilized in the other.

Cyclophosphamide↗
PubMed1985

[Renal insufficiency caused by chronic granulomatous interstitial nephritis in Löfgren's syndrome].

The authors report the case of a woman with Löfgren's syndrome who developed renal failure associated with abnormalities of acidification and concentration of the urine. In the absence of a phosphate-calcium metabolic disturbance, these signs were attributed to a granulomatous interstitial nephropathy demonstrated on renal biopsy. These abnormalities regressed completely with steroid therapy. Secondary renal failure due to an isolated granulomatous interstitial nephropathy is exceptionally rare in sarcoidosis and has never been previously reported in Löfgren's syndrome.

Acute Kidney Injury↗
PubMed1985

[Chorea and systemic lupus erythematosus with circulating anticoagulant. 3 cases].

Circulating anticoagulant was detected during the course of choreic manifestations in three young women with systemic lupus erythematosus, associated in two cases with false syphilitic serology due to the presence of antiphospholipid antibodies. The high prevalence of the presence of these antibodies in lupic chorea was confirmed by reports of 41 cases in the literature. These findings could suggest a possible pathogenic role for these antibodies in choreic manifestations by either a thrombotic or auto-immune encephalitis mechanism.

Adolescent↗
PubMed1984

[Arterial Doppler in Horton's disease. A prospective study of 24 cases].

The authors studied the role of Doppler ultrasonography in the diagnosis of Horton's disease, the assessment of the ophthalmic risk and the management of therapy. The study involved 24 patients and 20 control patients (mean age: 68 years) without inflammatory arteritis. A score (0 to 3) was established according to the degree of abnormality of blood flow. 12 patients were regularly followed up over a 2 year period. 83 p. 100 of the temporal arteries examined were pathological, 50 p. 100 of which had severe stenoses (scores 2 and 3). The facial, occipital and ophthalmic arteries were commonly involved (79 p. 100 of arteries examined), as was the central artery of the retina (92 p. 100, with 53 p. 100 of scores 2 and 3), although only 15 patients had minor (11 patients) or major (4 patients) ocular symptoms. However, a close correlation was observed between the presence of ocular symptoms and the severity of the stenoses observed on the central artery of the retina. The low incidence of signs of stenosis in the control group explains the excellent specificity of the Doppler examination (95 p. 100). Improvement with steroid therapy took at least 3 months and correlated well with the clinical and biological response. Blood flow changes reverted to normal in 4 patients after 1 year's treatment; 3 patients had relapses which were always associated with aggravation of the Doppler signs of stenosis. This study shows that Doppler ultrasonography is a valuable diagnostic tool, helps establish a prognosis and manage therapy in Horton's disease.

Aged↗
PubMed1984

[Systemic manifestations of angiitis with asthma and hypereosinophilia. Study of 10 cases].

We report 10 cases of systemic manifestations of angiitis with asthma and hypereosinophilia, some of which had the pathologic features of an allergic granulomatous angiitis of Churg and Strauss. We compare these 10 cases with 109 observations previously reported in the literature from which they differ by a high incidence of digestive tract involvement and by a near constant increase of total plasma immunoglobulin E concentration during the evolutive phases of vasculitis. Broncho-alveolar lavage had been performed in 3 patients, showing pulmonary hypereosinophilia. We discuss the clinical, biological and pathogenic features which differentiate this syndrome, particularly from periarteritis nodosa.

Adult↗