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C Dostál

Publications and source records attributed to C Dostál.

At least 19 recordsLinked to original sources
PubMed2006

[Antiphospholipid syndrome--the description of two cases].

Antiphospholipid syndrome (APS) often occurs in young people, it is defined by the presence of venous or arterial thromboses, repeated miscarriages, thrombocytopenias and increased levels of antiphospholipid antibodies. Clinical symptoms are different, there is often experienced the phlebothrombosis of lower limbs, miscarriages or neurological symptoms characterized by transient ischemic attacks (TIA). If APS is associated with other system disease, most often with systemic lupus erythematosus (SLE), it is called secondary APS. We present two cases of secondary APS in the work. In first case we describe synchronous occurrence of SLE with secondary APS, which was clinically manifested by phlebothrombosis of veins of crus. At another elder patient there was stated the diagnosis of non-differentiated disease of bonding agent with secondary APS with cardial, pneumonic and neurological clinical symptoms.

Adult↗
PubMed2003

[Characteristics of foci of increased MR signals in the brain of patients with systemic lupus erythematosus and cerebral involvement].

The frequency and size of MR hypersignal foci in the white and grey matter in T2 weighted images were evaluated in 50 patients with the definite diagnosis of systemic lupus erythematosus (SLE) with neuropsychiatric symptomatology (neuropsychiatric lupus--NPSLE) and in 50 healthy persons in this study. The lesions were divided according to the size to lesions smaller than 3 mm, lesions of 3-6 mm size and ones greater than 6 mm. Their total and relative number in the brain, the number in cerebral supra- and infratentorial regions and in all cerebral lobes was evaluated. Further their occurrence in the brain in the mediolateral and craniocaudal direction of MR investigation was determined. The study showed that the focal pathology manifests itself in NPSLE patients in 100% of cases with pronounced white matter predominance; the supratentorial occurrence of lesions and their subcortical localization significantly prevailed. As the lesions size is concerned in all patients, the lesions up to 3 mm significantly prevailed, lesions of 3-6 mm size were solitary and lesions greater than 6 mm were present up to 10% of cases. The significant predominance of all size lesions number in frontal and parietal lobes was observed in both groups of investigated persons. The statistically significant difference (p < 0.01) between both followed groups (SLE patients and controls) was found as in absolute and relative numbers of supratentorial lesions up to 3 mm, as in the total brain and in single cerebral lobes. The significant difference was recorded in the same parameters in 3-6 mm lesions and in ones greater than 6 mm. Lesions greater than 6 mm were never observed in controls. This specification of cerebral MR finding in NPSLE patients significantly supports the clinical diagnosis of NPSLE, even though it is not specific.

Adolescent↗
PubMed2002

Effects of stress on serum prolactin levels in patients with systemic lupus erythematosus.

The results of a study of effects of stress on serum prolactin (PRL) levels in patients with SLE reveal statistically significant differences in serum PRL level readings in samples taken over a short period of time, thus corroborating the need to take into account PRL stress induction during sample withdrawals and to interpret the values obtained, especially where moderate idiopathic hyperprolactinemia was detected. To eliminate any external stress factors, it is advisable to take PRL samples repeatedly and in perfectly resting patients.

Adult↗
PubMed1999

[EEG findings in patients with systemic lupus erythematosus].

We have examined electroencephalography (EEG) and Mini-Mental State Examination (MMSE) in 38 patients with verified diagnosis of systemic lupus erythematosus (SLE). In the clinical neurological finding there were epileptic attacks in 9 patients, 10 patients suffered from stroke, 15 patients from lupus headache, 4 patients from psychosis, in 15 patients cranial neuropathy was present, in one person extrapyramidal syndrome. EEG findings were in 12 patients normal (32%), in 26 patients abnormal (66%). In 3 cases there were focal abnormalities (8%), in 19 cases episodic ones (48%), four times abnormalities were diffuse (10%). Diffuse abnormalities correlated in EEG findings with case history of GM attacks.

Adult↗
PubMed1998

[Soluble cytokinin receptors in renal vasculitis and lupus nephritis].

BACKGROUND: Activation of various cytokines, e.g. TNF alpha, IL-1 and/or IL-6 may play important role in the pathogenesis of renal vasculitis and lupus nephritis (LN). Systemic effects of these cytokines may be modulated by their circulating soluble receptors. Plasma levels of cytokine receptors may thus be also markers of the activation of these cytokines. METHODS AND RESULTS: Plasma levels of TNF alpha, its soluble receptor p75 (sTNF-RII), IL-6 and soluble IL-6 receptor (sIL-6R) were measured using ELISA in 17 pts with ANCA-positive renal vasculitis (12 active-ANCA-A, 7 in remission ANCA-R), 9 pts with active lupus nephritis (LN) and 5 healthy subjects. Pts with LN had in comparison with controls increased plasma levels of TNF alpha, sTNF-RII, IL-6 and sIL-6R. Pts with ANCA-A had also in comparison with controls increased plasma levels of TNF alpha, sTNF-RII and sIL-6R, but plasma levels of IL-6 were not significantly increased dut to great standard deviation. Pts with ANCA-R had in comparison with controls increased plasma levels of sTNF-RII, but plasma levels of TNF alpha were in ANCA-R significantly lower than in ANCA-A. While the ratio TNF alpha/sTNF-RII was significantly lower in all groups of pts than in controls, the ratio IL-6R/sIL-6R was in comparison with controls significantly increased only in LN. CONCLUSIONS: While increased plasma levels of TNF alpha may be nonspecific marker of the activity of ANCA-positive renal vasculitis and LN, plasma levels of sTNF-RII are increased also in pts with ANCA-positive renal vasculitis in remission. Increased plasma levels of sTNF-RII may interfere with systemic effects of TNF alpha, but may also prolong the lifetime of its active form. Plasma levels of sIL-6R are increased both in ANCA-A and in LN, but their increase is, however, much less pronounced than that of sTNF-RII and cannot effectively block systemic effects of IL-6.

Adult↗
PubMed1998

Cytokines and adhesion molecules in renal vasculitis and lupus nephritis.

BACKGROUND: Plasma levels of some pro-inflammatory cytokines and soluble adhesion molecules have been suggested to be useful parameters to assess the activity of antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis and lupus nephritis. We hypothesized that the renal activity of these diseases is better reflected by the urinary excretion and fractional excretion of these molecules. METHODS: Plasma levels and urinary excretion of tumour necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, IL-8, and the soluble cell adhesion molecules sICAM-1 and sVCAM-1 were measured by enzyme-linked immunosorbent assay (ELISA) in 14 patients with ANCA-positive renal vasculitis (eight active, ANCA-A; six in remission, ANCA-R), six patients with active lupus nephritis (LN), 15 patients with IgA nephropathy (IgAN) and nine healthy subjects. Fractional excretion of selected cytokines and adhesion molecules was also calculated. RESULTS: Patients with ANCA-A had increased urinary excretion and fractional excretion of TNF-alpha (9.27 +/- 3.19% vs 0.58 +/- 0.02%, P < 0.01), IL-6 (120.79 +/- 65.83% vs 1.89 +/- 0.34%, P < 0.01) and increased fractional excretion of IL-8 (23.34 +/- 6.38% vs 2.56 +/- 1.07%, P < 0.01) and sVCAM-1 (0.81 +/- 0.33% vs 0.03 +/- 0.02%, P < 0.01) compared with controls. Urinary excretion of TNF-alpha and IL-6 and fractional excretion of TNFalpha, IL-6 and IL-8 were higher in ANCA-A than in ANCA-R. Patients with LN had increased plasma TNF-alpha (20.52 +/- 2.01 pg/ml vs 12.33 +/- 0.23 pg/ml, P < 0.05) and sVCAM-1 (1537.88 +/- 276.36 ng/ml vs 692.26 +/- 44.42 ng/ml, P < 0.05) and increased urinary excretion of TNF-alpha (2.81 +/- 0.51 microg/mol creat vs 0.98 +/- 0.05 microg/mol creat, P < 0.01), IL-8 (35.78 +/- 14.03 microg/mol creat vs 12.46 +/- 5.19 microg/mol creat, P < 0.05) and sVCAM-1 (48.98 +/- 20.20 microg/mol creat vs 2.92 +/- 1.35 microg/mol creat, P < 0.01) compared with controls. Patients with IgAN had, in comparison with controls only increased plasma TNF-alpha (18.10 +/- 0.57 pg/ml vs 12.33 +/- 0.23 pg/ml, P < 0.05). CONCLUSIONS: Urinary excretion and fractional excretion, but not plasma levels, of selected pro-inflammatory cytokines (TNF-alpha, IL-6 and IL-8) were increased in patients with active ANCA-positive renal vasculitis, but not in ANCA positive vasculitis in remission. These parameters may be useful to monitor the activity of this disease.

Adult↗
PubMed1998

Effect of 1 year cyclosporine A treatment on the activity and renal involvement of systemic lupus erythematosus: a pilot study.

Our objective was to determine the effect of 1 year low-dose cyclosporine A (CSA) treatment on disease activity and renal involvement in systemic lupus erythematosus (SLE). Patients included in the pilot study had an active form of the disease as defined by the SLE Disease Activity Index (SLEDAI). Main organ involvement was represented by lupus nephritis classified in repeated renal biopsies. Eleven patients with SLE were enrolled in the study. In eight of them, previous therapy with cyclophosphamide or azathioprine had to be interrupted due to serious adverse reaction or low efficacy. Nine patients experienced clinical nephrotic syndrome, and two the nephritic syndrome. After 12 months of CSA treatment, the mean SLEDAI score had decreased significantly from 26.18 to 4.00 (P < 0.01). Similarly, the titre of antinuclear and anti-dsDNA antibodies had dropped significantly (P < 0.01). Proteinuria decreased rapidly from 9.10 to 1.70 g/24 h (P < 0.001). According to the WHO classification of renal biopsies, three patients had their class altered from IV to III in response to CSA treatment and five patients had changed the status from the high severity grade to the mild. The adverse reactions included hypertension (45%), gingival hyperplasia (18%) and hirsutism (9%). No significant increase in serum creatinine or any CSA related toxic changes were found in renal biopsies. The favourable response observed in patients with active SLE and with major renal involvement strongly suggests that low-dose CSA is a potent drug as much for the reduction of the disease activity as for lupus nephropathy treatment.

Adult↗
PubMed1997

[Cytokines and adhesion molecules in renal vasculitis and lupus nephritis].

BACKGROUND: Plasma levels and urinary excretion of proinflammatory cytokines and soluble adhesion molecules may be useful parameters of the activity of ANCA-positive renal vasculitis and lupus nephritis. METHODS AND RESULTS: Plasma levels and urinary excretion of TNF alpha, IL-6, IL-8, ICAM-1 and VCAM-1 were measured by ELISA in 14 patients (pts) with ANCA-positive renal vasculitis (8 active-ANCA-A, 6 in remission ANCA-R), 6 pts with active lupus nephritis (L.N), 15 pts with IgA nephropathy (IgAN) 10 pts with autosomal dominant polycystic kidney disease and 9 healthy subjects (Co). Fractional excretion (FE) of selected cytokines and adhesion molecules was also calculated. Pts with LN had in comparison with controls increased plasma levels of ICAM-1, VCAM-1, IL-6, IL-8 and TNF alpha, increased urinary excretion of VCAM-1, IL-8 and TNF alpha and increased fractional excretion of VCAM-1 and IL-8. Patients with ANCA-A had in comparison with controls increased plasma concentrations of ICAM-1 and VCAM-1, increased urinary excretion of VCAM-1, IL-6 and TNF alpha and increased fractional excretion of VCAM-1, IL-6, IL-8 and TNF alpha. Patients with ANCA-R had in comparison with controls higher plasma levels of ICAM-1, VCAM-1, IL-6 and TNF alpha, increased urinary excretion of VCAM-1 and TNF alpha and increased fractional excretion of VCAM-1, IL-6 and TNF alpha. CONCLUSIONS: Patients with ANCA-positive renal vasculitis had in contradistinction to pts with active LN increased fractional excretion of IL-6 and TNF alpha. Both cytokines are probably produced in renal vasculitis locally in the kidney. Increased plasma levels of soluble adhesion molecules and increased plasma levels and fractional excretion of proinflammatory cytokines in patients with ANCA-positive renal vasculitis in clinical remission may explain the strong propensity of these patients to develop relapses of the diseases on withdrawal of immunosuppressive treatment.

Adult↗
PubMed1997

[Clinical spectrum of the antiphospholipid syndrome].

Antiphospholipid syndrome (APS) is characterized by multiple arterial and venous thromboses, repeated spontaneous abortions and thrombocytopenia, together with the presence of antiphospholipid antibodies in serum. We present three patients, two men and a woman, at the age of 43, 24 and 23 years respectively. The younger man and the woman had secondary APS and systemic lupus erythematosus, the older man had primary APS. The symptoms and course of the disease were different. The older man lives 17 years after the onset of first symptoms with multiple neurologic disorders, the younger man is symptomless. The woman died several months after the acute onset of the disease.

Adult↗
PubMed1996

[Practical results of monitoring pregnancy in women with systemic lupus erythematosus].

BACKGROUND: The authors dealt with the urgent problem under what conditions it is possible to achieve in a woman with systemic lupus erythematosus (SLE) or another collagenosis, or secondary antiphospholipid syndrome (APS) a favourable outcome of pregnancy and the delivery of a healthy infant. METHODS AND RESULTS: The investigation comprised 23 women incl. 20 with SLE, two with the mixed form of a diffuse connective tissue disease (MCTD) and one with Sjögren's syndrome of the primary type. From the total number of 20 pregnancies six were consulted in advance with a doctor (group I-s-called planned pregnancies) and all terminated by a successful delivery. Of 11 pregnancies which were not consulted with a doctor in advance (group II-so-called unplanned pregnancies) 9 were terminated in term, however, only 5 with a successful delivery (55.5%), two women are still pregnant. Exacerbation of the basic disease during pregnancy was recorded only once and did not lead to discontinuation of the pregnancy. CONCLUSIONS: The authors provide evidence that desired pregnancy of informed women suffering from SLE or another collagenosis when assisted by a specialized medical team can lead to a successful delivery of an infant.

Adult↗
PubMed1994

[The antiphospholipid syndrome].

The author summarized contemporary findings on anti-phospholipid autoantibodies, their different types and probable site of action. This autoimmune phenomenon produces some typical clinical symptoms which made it necessary to describe them as the so-called anti-phospholipid syndrome. If concurrently some autoimmune disease is present, in particular lupus erythematosus , this syndrome is considered "secondary". If this is not the case, it is assumed that the "primary form" is involved. The author suggests diagnostic criteria and in large groups of patients suffering from SLE the true prevalence of different symptoms of this syndrome is tested with participation of anti-phospholipid antibodies.

Antiphospholipid Syndrome↗
PubMed1992

[Systemic lupus erythematosus and pregnancy. Present status].

The authors summarize contemporary views on the relationship between pregnancy and systemic lupus erythematosus (SLE) in women of reproductive age. It is known that pregnancy influences in a marked way the basic disease and conversely the disease has an impact on the course of pregnancy. Risks ensuing from these in errelations for women--mothers with SLE and the foetus are exacerbation (flare-up) of the basic disease, loss of the foetus and damage of the foetus by so-called "lupus neonatorum" with skin symptoms and complete cardiac A-V block. The contemporary state of knowledge makes it possible under certain conditions to achieve by therapeutic interventions the development and delivery of a healthy foetus. Among these views it is most important for conception to occur in these patients with SLE during a period without signs of active SLE. To ensure a successful course of pregnancy in women with SLE is the task of a team of appropriate specialists.

Female↗
PubMed1990

[Rheumatology today and yesterday. Modern advances and future trends].

The author mentions some recent advances from the sphere of clinical medicine and associated theoretical disciplines which may closely influence the future development of rheumatology. In addition to technical advances as regards visualization of tissue structures such as magnetic resonance and the development of artificial prostheses of damaged joints, molecular biology and genetics are the greatest advance as regards knowledge of the aetiopathogenesis of disease in particular those which have an immunopathological background.

Humans↗
PubMed1990

[Antibodies against deoxyribonucleoproteins in circulating immune complexes in the blood of patients with autoimmune diseases].

In 40 patients with various autoimmune diseases antibodies against desoxyribonucleoprotein (DNP) were assessed by enzyme immunoanalysis (ELISA) in serum and after dissociation of the isolated precipitate of circulating immune complexes (CIC) in the presence of polyethylene glycol. The results indicate that antibodies against DNP are not specific for systemic lupus erythematosus (SLE) and can be detected in serum and in particular in CIC in various autoimmune conditions. In SLE they may be important for evaluation of the activity of the disease, in particular if estimated concurrently in serum and in CIC.

Antigen-Antibody Complex↗