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Biomedical subjects

E Neville

Publications and source records attributed to E Neville.

At least 55 records · Page 3Linked to original sources
PubMed1980

Biochemical findings in sarcoidosis.

The majority of patients with sarcoidosis in this large series have had a number of biochemical investigations performed. Abnormal calcium metabolism was demonstrated in 40% of the patients but permanent renal damage due to nephrocalcinosis as a result of persistent derangement of calcium metabolism was rare. Raised immunoglobulin levels were seen. Half the white and two-thirds of the West Indian patients had elevated IgG levels. Abnormal immunoglobulin levels carried no obvious diagnostic or prognostic significance. Raised alkaline phosphatase levels reflected space-occupying hepatic granulomas and occurred in 23% of patients. Serum angiotensin converting enzyme (SACE) was elevated in half the patients. The highest SACE activity was found in patients with severe parenchymal lung infiltration due to sarcoidosis, and the lowest levels in those with inactive disease or after successful management with steroid drugs. SACE levels were not significantly elevated in four other granulomatous conditions: Crohn's disease, primary biliary cirrhosis, Hodgkin's disease, and active tuberculosis.

Adult↗
PubMed1977

HLA antigens in sarcoidosis.

The HLA antigens were identified in sixty-five patients with sarcoidosis, comprising forty-five with uveitis, twelve with erythema nodosum and eight with arthritis. In the group with arthritis, B8 was present in seven of eight (P = 0-0016) and the haplotype 1,8 in five of eight (P = 0-0053). A1 was present in 44% with uveitis (P = 0-04). There was no other significant disturbance of antigen frequencies in uveitis or in erythema nodosum, but it was noteworthy that B27 was present in only two patients with uveitis.

Arthritis↗
PubMed1977

Sarcoidosis of bone.

Sarcoidosis of bone has been observed in 29 patients for up to 43 years. It was present in the hands and/or feet in 26 patients, in the nasal bone in three and once each in the hard palate and temporal bones. There were three types of bone lesion: (a) lytic in 25 patients; rounded cortical or medullary lesions ranging in size from 1 mm to 1 cm in diameter, which on healing left a residual punched-out 'cyst'; (b) permeative in nine patients; these showed progressive cortical 'tunnelling' with remodelling of trabecular and cortical architecture; (c) destructive in three patients: rapidly progressive with pathological fractures and secondary joint surface involvement. Soft tissue swelling preceded the radiological abnormality for up to four yearts in 10 patients, accompanied it twice, followed it once and was absent on 16 (55 percent) occasions. Bone involvement was usually an incidental finding when sarcoidosis presented elsewhere. Other features included intrathoracic sarcoid (86 per cent), lupus pernio (48 per cent), skin plaques (41 per cent), ocular inflammation (48 per cent), nasal mucosal disease (24 per cent), lymphadenopathy (24 per cent), hepatomegaly (13 per cent), splenomegaly (10 per cent), and parotid enlargement (10 per cent). Pulmonary infiltration with or without lymphadenopathy was observed in three fifths and hilar adenopathy alone in one third of patients. Abnormalities in chest radiographs of patients with bone sarcoid resolved in only 20 per cent. Hypercalciuria was noted in one and hypercalcaemia in the other two patients with bone distruction.

Adult↗
PubMed1976

Sarcoidosis of the upper respiratory tract and its relation to lupus pernio.

The authors present a personally studied series of 32 patients with sarcoidosis affecting the upper respiratory tract and nose. Twenty-five of these patients had lupus pernio (LP), which in 8 instances was accompanied by sarcoidosis of the upper respiratory tract (SURT). The 7 other patients had SURT (mucosal disease) without LP. There was a female to male ratio of 7:1. SURT presented mainly in the third decade, whereas LP presented mainly in the fourth and fifth. Despite this, SURT was as much a chronic manifestation of sarcoidosis as LP. Five of 11 patients (45%) presenting with SURT progressed to LP within 2 yr. Overall 26 patients (81%) had intrathoracic sarcoidosis, 19 patients (59%) had skin lesions other than LP, 10 patients (31%) had bone sarcoidosis, 7 patients (22%) had ocular lesions, and 6 patients (19%) had peripheral lymphadenopathy. The Kveim-Siltzbach skin-test was positive in 12 of 12 patients with SURT, making it a useful aid in the differential diagnosis of sarcoid granulomas in the nose. Two patients had nasal perforations, both of which followed a submucous resection.

Adolescent↗
PubMed1976

Bone sarcoidosis.

Sarcoidosis of the bone has been observed in 24 patients for up to 43 yr. It was always present in hands and/or feet and also elsewhere in 4 other patients. Soft-tissue swelling preceded the radiological abnormality for up to 4 yr in 9 patients accompanied it once, followed it once, and was absent in 13 (55%). Bone involvement was usually an incidental finding when sarcoidosis presented elsewhere, including lupus pernio (50%) and other chronic skin lesions (41%), lungs (75%), eyes (51%), lymph nodes (21%), liver (17%), spleen (13%), parotids (13%), facial palsy in 2 patients and erythema nodosum in 1. Pulmonary infiltration, with or without lymphadenopathy, was evident in three-fifths of the patients and hilar adenopathy alone in one-fifth. Sarcoid tissue was observed in the bone, but not in the surrounding soft-tissue swelling of 2 amputated fingers. There were 3 types of bone lesions: a) Lytic in 20 patients; minute 1-mm cortical defects or larger, usually rounded defects that on healing become corticated leading to punched-out "cysts". b) Permeative in 8 patients; these showed progressive cortical tunnelling with remodelling of trabecular and cortical architecture. c) Destructive in 3 patients, with secondary joint-surface involvement and in one a periosteal reaction.

Adult↗
PubMed1976

Sarcoidosis of the upper respiratory tract and its association with lupus pernio.

In a series of 34 patients with sarcoidosis affecting the upper respiratory tract and nose, 26 had lupus pernio (LP) and 17 had sarcoidosis of the upper respiratory tract (SURT). In nine patients these features coexisted. A patient presenting with SURT carried a 50% risk of developing LP although one feature could be present without the other. Both were disorders of women of the child-bearing years of life. SURT, like LP, was an indicator of chronic fibrotic sarcoidosis, developing insidiously and progressing indolently over the years. It was complicated by ulceration, septal perforation, and LP. Three patients had nasal septal perforations, in two instances following submucous resection. This operation is contraindicated in patients with active sarcoidosis, particularly when granulomas are found on nasal biopsy. The Kveim-Siltzbach skin test was positive in all patients with SURT, making it invaluable in the differential diagnosis of granuloma of the nasal cavity.

Adolescent↗
PubMed1976

Ocular sarcoidosis.

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Adrenal Cortex Hormones↗
PubMed1975

Immunology of sarcoidosis.

The cardinal immunologic changes in sarcoidosis consist of depression of delayed-type hypersensitivity, hyperreactive circulating antibody responses and the Kveim-Siltzbach skin test phenomenon. Depression of delayed-type hypersensitivity is demonstrated by skin tests using tuberculin, mumps, pertussis, trichophytin, oidiomycin, dinitrochlorobenzene and Californian keyhole limpet hemocyanin. The cultured lymphocytes from patients with depression of delayed-type hypersensitivity react poorly to phytohemagglutinin, and there is a close correlation between anergy of lymphocytes in culture and by cutaneous anergy. In vivo cutaneous anergy mirrors in vitro cellular hyporeactivity. Other technics used to expose immunologic defects in peripheral lymphocytes of patients with sarcoidosis include tests of T and B cell function, rosetie formation and migration inhibition. Whereas there is cutaneous anergy and impaired cellular immunity in patients with sarcoidosis, the reverse holds for circulating factors. There are increased circulating immunoglobulin levels, increased circulating antibody levels to Epstein-Barr, herpes simplex, rubella, measles and parainfluenza viruses, increase antibody response to mismatched blood and occasional false-positive Wassermann reactions, but there is no increase in circulating autoan tibodies. There is no evidence that patients with sarcoidosis belong predominantly to any particular histocompatibility locus. Worldwide figures for the Kveim-Siltzbach skin test are presented. They provide evidence of its specificity in various international series. The causes of nonspecific reactions are discussed.

Antibodies, Viral↗