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Biomedical subjects

E Ben-Chetrit

Publications and source records attributed to E Ben-Chetrit.

At least 91 records · Page 5Linked to original sources

A 52-kD protein is a novel component of the SS-A/Ro antigenic particle.

Anti-SS-A/Ro autoantibodies are found in the sera of patients with Sjogren's syndrome (SS) and SLE. In the course of analyzing 61 SS patients for their autoantibody profiles, we found that 42 were positive for anti-SS-A by double diffusion in agarose and demonstrated precipitin lines identical to that produced by a prototype anti-SS-A serum. Further analysis of these SS-A antibody-positive sera by Western blotting of cell extracts revealed that 21 sera reacted with two proteins of 60 and 52 kD, 13 sera reacted with 52-kD protein, two detected only 60 kD, while six were nonreactive. Affinity-purified anti-60-kD and anti-52-kD antibodies reacted exclusively with their corresponding antigens. Partial proteolysis of these proteins did not reveal common degradation fragments. Thus the 52- and 60-kD proteins were found to be antigenically and apparently structurally distinct from each other. They were also distinct from 48-kD SS-B/La protein. In immunoprecipitation using labeled cell extracts, affinity-purified anti-52-kD antibodies brought down the 52-kD protein as well as the 60-kD band. In [32P]orthophosphate-labeled HeLa cell extract both antibodies precipitated the same spectrum of small RNAs (hYl-5). In indirect immunofluorescence, anti-52-kD and anti-60-kD antibodies immunolocalized in similar subcellular structures and showed similar punctate nuclear staining patterns. Western blot analysis revealed that both proteins were present in lymphocytic as well as epithelial human cell lines tested. The data above define a new antigen of 52 kD which is another component of the SS-A particle and is associated in complex formation with the previously reported 60-kD protein.

Autoantibodies↗

Specific inhibition of the DNA-anti-DNA immune reaction by low molecular weight anionic compounds.

The structural features of the interaction between DNA and lupus anti-DNA antibodies were investigated by competition experiments with low molecular weight synthetic compounds. It was found that two correctly spaced chemical components, a substituted aromatic ring system and a negatively charged acidic residue, were required for the binding of most anti-DNA autoantibodies to their respective antigens. These chemical elements are combined in the structure of several anionic dyes, including some certified food colours. The dyes were found to interfere efficiently and specifically with the lupus DNA-anti-DNA immune reaction. Therefore, this family of compounds may serve as a basis for the development of a new approach to drug therapy in SLE.

Anions↗

Insulinoma complicating pregnancy: case report and review of the literature.

A 24-year-old woman, gravida 1, para 0, experienced recurrent attacks of headaches and bizarre behavior from the sixth week of gestation onward. Three days before confinement, she lapsed into coma and was delivered of a normal child. Plasma glucose, insulin, and C-peptide levels were diagnostic of insulinoma. Subsequently, after she spontaneously regained consciousness, a pancreatic tumor was removed at laparotomy with complete resolution of symptoms. The problems of diagnosing insulinoma during pregnancy are discussed.

Adenoma, Islet Cell↗

Total lymphoid irradiation in refractory systemic lupus erythematosus.

In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis. The second patient developed massive bronchopneumonia, necrotic cutaneous lesions, and progressive nephritis and died 2 weeks after completion of radiotherapy. These observations, although limited to two patients, indicate that total lymphoid irradiation in patients with severe systemic lupus erythematosus should be regarded as strictly experimental.

Adult↗

IgA nephropathy and acute reversible renal failure.

Macroscopic hematuria, severe oliguria for 9 days, and azotemia requiring a period of hemodialysis treatment developed in a young woman. Renal biopsy during the acute episode showed IgA nephropathy with blockage of tubules by red cell casts and tubular epithelial cell damage. Renal function recovered spontaneously. The severity of the renal failure was unique, and this syndrome should be added to the other known causes of acute reversible renal failure.

Acute Kidney Injury↗

Exacerbation of psoriasis by ibuprofen.

We describe a patient whose cutaneous manifestations of psoriatic arthritis were exacerbated while she was treated with ibuprofen. Discontinuation of the medication resulted in immediate improvement of the skin lesions. Reappearance of the joint symptoms prompted the patient to take ibuprofen again, after which she experienced a flare of new psoriatic plaques.

Adult↗

Yellow nail syndrome: case report and review of the literature.

A patient with yellow nail syndrome is described. The presenting features were right pleural effusion resistant to therapy, leg edema and slow-growing yellow nails. T-lymphopenia in the peripheral blood and T cell predominance in the pleural fluid were demonstrated. In addition, the capillaries in the conjunctival and nail beds showed increased vasomotion and decreased diameter. It is suggested that the disease is not confined to the lymphatic system, but also involves the capillaries.

Anti-Bacterial Agents↗

Short course of synacthen therapy as an adjunct in the management of rheumatoid arthritis.

The effect of synthetic adrenocorticotrophic hormone (Synacthen), in conjunction with hydroxychloroquine, aurothioglucose, or penicillamine, was evaluated retrospectively in 21 patients with rheumatoid arthritis (RA). One mg of depo Synacthen was administered at increasing intervals of 4 to 14 days for a total period of 3 to 7 months. Fourteen patients with RA on either hydroxychloroquine or aurothioglucose and not on Synacthen, served as controls. Patients in the Synacthen group were, on the whole, sicker, as indicated by a lower functional capacity, higher mean erythrocyte sedimentation rate, and systemic and articular indices. Physicians' estimate of the patients condition after 1 - 2 months of therapy showed no improvement or deterioration in 10 out of 13 cases in the control group. Likewise, the erythrocyte sedimentation rate decreased significantly more and seronegativity was achieved in more of the Synacthen-treated cases. Six to 8 months after the beginning of therapy (1 to 4 months after cessation of Synacthen) clinical improvement was comparable in both groups, although seroconversion was more common in patients who had received Synacthen (7 out of 10 as compared to 1 out of 7 respectively). It is suggested that Synacthen may be used safely in the early phase of selected RA patients, until the effect of second-line drugs is achieved.

Adrenocorticotropic Hormone↗

Amiodarone-associated hypothyroidism--a possible cause of digoxin intoxication.

The problem of a possible interaction between amiodarone and digoxin is still unsettled. We have recently treated two patients with digoxin intoxication who had received amiodarone for eight and 36 months respectively. Both developed extreme bradycardia requiring temporary pacemakers. The presence of hypothyroidism was confirmed in both cases by laboratory data. Judging by present knowledge concerning the interaction between amiodarone, thyroid function, and digoxin, it is suggested that digoxin intoxication was not the result of its direct interaction with amiodarone. The possibility that amiodarone-induced hypothyroidism precipitated digoxin intoxication seems to be more plausible. Prevention of digitalis toxicity in amiodarone-treated patients would therefore require monitoring of thyroid function every three to six months. Frequent monitoring of digitalis blood levels is also indicated in patients with amiodarone associated hypothyroidism. Early detection of hypothyroidism and digitalis intoxication is necessary in view of the severity of the course of the disease.

Aged↗

Predominant T cells in pleural effusion of a patient with B-cell CLL.

Pleural effusion is a relatively rare complication of chronic lymphatic leukemia (CLL). It can be the result of primary pleural involvement, central lymphatic blockage, infection or changes induced by previous irradiation or chemotherapy. When the effusion is caused by leukemic pleural infiltration, the lymphocytes are identical to those in the peripheral blood. We have recently treated a splenectomized patient with B-cell CLL who developed pleural effusion with predominant T cells. It is suggested that this might be due to a redistribution of the T cells in the recirculating lymphocytic pool in a patient who had undergone splenectomy in the past. The possible source of these cells in the pleural effusion is discussed.

B-Lymphocytes↗

HLA antigens in Reiter's syndrome in Israeli patients.

Major histocompatibility antigens (HLA loci A, B and C) were determined in 28 Israeli patients with Reiter's syndrome. The HLA-B27 antigen was found in only 8 (29%). Seven of the 20 B27 negative patients (35%) demonstrated crossreactive group antigens (CREG) B7, or Bw 22. HLA-B40 or Bw42 were not found. Only 3 of the 13 (22%) patients with the classical triad were B27 or Bw22 positive. In contrast, 12 of 15 patients with incomplete RS carried the B7 CREG antigens. These data suggest that in the Israeli population Reiter's syndrome is infrequently associated with HLA-B27 and that the B7 CREG antigens may be additional markers for this form of reactive arthritis.

Adult↗

Syncope: a retrospective study of 101 hospitalized patients.

A retrospective study was conducted of 101 hospitalized patients who had one or more episodes of syncope. The etiology of syncope was established with relative ease in 61% of these patients. History and physical examination revealed the cause in 34%, resting ECG in 11% and 24-h ECG monitoring in 16%. Additional tests (electroencephalograms, Doppler studies of the cervical arteries, computerized tomography of the brain, ultrasonography of the heart and cardiac catheterization) either were noncontributory or did not contribute to confirmed diagnoses already established by other means. Cardiac causes were responsible for the syncope in 34% and noncardiac causes in 27%. Comparison between diagnosed and undiagnosed patients revealed no significant differences with respect to age, number of syncopal episodes or presence of hypertension or diabetes. There were, however, significantly more women, and a lower frequency of ischemic heart disease and other associated diseases in the undiagnosed group. It is concluded that all patients with syncope should undergo ambulatory ECG and 24-h ECG monitoring, and that hospitalization should be reserved for patients whose clinical condition requires admission or when further investigation is necessary.

Adult↗

Disseminated intravascular coagulation in two patients with histiocytic medullary reticulosis.

Two young adults with characteristic features of histiocytic medullary reticulosis (HMR) are described. Of particular interest was the development of striking clinical and laboratory features of disseminated intravascular coagulation (DIC), in the absence of sepsis in both cases. Both patients had a marked and fatal bleeding tendency. The association between neoplasia and DIC is well established, but, to the best of our knowledge, DIC presenting a major feature of HMR has not yet been described. The possible pathogenesis of DIC in HMR is discussed.

Adult↗