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Biomedical subjects

E Palazzo

Publications and source records attributed to E Palazzo.

At least 73 records · Page 4Linked to original sources

The actual survival rate in systemic lupus erythematosus: study of a 1976 cohort.

The purpose of this study was to establish the actual survival rate of a cohort of 51 patients with systemic lupus erythematosus (SLE) all of whom were followed during 12 years from 1976 to 1988 and to evaluate the prognostic significance of the severe complications of the disease. Forty-eight were females. The mean age was 28.5 at onset, 36.2 at diagnosis and 42 at entry; 80% had four or more 1982 ARA criteria at diagnosis and 96% in 1988. Survival rates were: 96% at two years, 86.3% at five years and 74.5% at twelve years. The main cause of death was infection (62%); SLE was directly responsible in only one case. Manifestations considered as severe occurred in almost two-thirds of the cases without any concordance in the time sufficient to recognize different severe forms of the disease.

Adolescent↗

[Detection of anti-Ro(SS-A) by using immunoimprint. Comparison with double diffusion in agar. Apropos of a series of 63 primary Gougerot-Sjögren syndromes].

Among soluble anti-nuclear antigen auto-antibodies, anti-Ro(SS-A) were, for unknown reasons, difficult to detect by immunoimprint (II). The aim of this study was the development of a method of preparation of Ro(SS-A) antigen enabling greater sensitivity in the detection by II of the corresponding antibodies, then application of this method in a series of 63 cases of primary Sjögren's syndrome in order to study the clinical significance of anti-Ro(SS-A) antibodies. Ro(SS-A) antigen was prepared from human spleen and partially purified on DE-52 resin. The protein extract prepared reacted in II with reference anti-Ro(SS-A) and anti-La(SS-B) antibodies. The series of 63 cases of primary Sjögren's syndrome (57 F, 6M) included 50 of extraglandular primary Sjögren's syndrome and 13 of isolated glandular primary Sjögren's syndrome. Twenty two cases of primary Sjögren's syndrome had anti-Ro(SS-A) (35%). Twenty patients had anti-Ro(SS-A) by II (32%) and 17 by double diffusion in agar (27%) (p = NS). Among 7 discordant sera, 2 were not detected by II. The incidence of anti-Ro did not differ statistically between the extraglandular (40%) and glandular (15%) primary Sjögren's syndrome groups. Patients were divided into two groups according to whether they did (n = 22) or did not (n = 41) produce anti-Ro(SS-A).(ABSTRACT TRUNCATED AT 250 WORDS)

Antibodies, Antinuclear↗

Sternoclavicular pustulotic osteitis (SAPHO). 20-year interval between skin and bone lesions.

In 2 cases of palmoplantar pustulosis, a 20-year interval was observed between the skin lesion and the bone involvement. In one case, the bone lesion came first. In the other a skin lesion was seen for 3 weeks without subsequent relapse. The 2 cases underline the multifaceted presentation of the condition for which we have coined the name synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome.

Adult↗

[Orthopedic surgery in rheumatoid polyarthritis].

The authors have determined the timing and details of the recourse to surgery in a cohort of 288 non-selected cases of rheumatoid arthritis. This was necessary in one third of the patients after a mean follow-up period of 10 years. The same was true for patients followed up as out-patients as for those hospitalized during the active progress of the disease. Fifteen percent of the patient in the cohort received total replacement of a large joint by a prosthesis. Orthopedic surgery makes a major contribution towards improving the functional prognosis in rheumatoid arthritis.

Arthritis, Rheumatoid↗

Retroperitoneal fibrosis after surgery for aortic aneurysm in a patient with periarteritis nodosa: successful treatment with corticosteroids.

A 54-year-old man with hepatitis B virus-related periarteritis nodosa developed retroperitoneal fibrosis with bilateral hydronephrosis 2.5 months after placement of an aortobifemoral prosthesis for abdominal aortic aneurysm. Retroperitoneal fibrosis disappeared after treatment with corticosteroids. This observation is interesting in the light of the hypothesis that retroperitoneal fibrosis is caused by vasculitis.

Aorta, Abdominal↗

Anti-Scl-70 antibodies detected by immunoblotting in progressive systemic sclerosis: specificity and clinical correlations.

One hundred and forty five serum samples from patients with a connective tissue disease and 30 serum samples from healthy blood donors were analysed by immunoblotting. The presence of anti-Scl-70, which seems to discriminate between progressive systemic sclerosis (PSS) and the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) syndrome, was found in 31/64 (48%) patients with PSS, in 6/55 (11%) patients with systemic lupus erythematosus, in 2/26 (8%) patients with mixed connective tissue disease, and in none of 30 healthy blood donors. These data resulted in a specificity of 93% for this antibody in systemic sclerosis. For patients with PSS the duration of disease was significantly shorter in those with anti-Scl-70 antibodies than in those without, whereas the presence of anti-Scl-70 did not correlate with severity of disease. An 82% prevalence of anticentromere antibodies in patients with the CREST variant compared with a 4% prevalence in patients with PSS or with overlap syndrome confirms the high diagnostic value of this autoantibody for the CREST variant of PSS.

Aged↗

[Antinuclear and anticytoplasmic antibodies in 24 cases of dermatomyositis. Value of western blotting].

Antinuclear and anticytoplasmic antibodies were detected, using 4 methods, in 96% of the sera (23/24) from 24 dermato- or polymyositis patients, who were followed in the Rheumatology Department. Immunofluorescent (IF) labeling of Hep-2 cell smears was more sensitive than IF staining of liver sections (72 vs 67%), and the patterns observed were in agreement 20/24 times. Gelose precipitation is even less sensitive (29%), but enables a characterization of the antigens recognized: 3 anti-RNP, 3 anti-J01, 1 anti-PMScl, 1 anti-SSB and 1 anti-Ro; the latter two specificities were associated with a sicca syndrome. Western-blotting was the most informative method because it was highly sensitive (79%) and identified the principle antigen-antibody systems: anti-U1-RNP (33%) and anti-Scl70 (33%), both associated with myositis with an overlap syndrome (p less than 0.02); anti-J01 (25%) associated with various forms of myositis; and, more rarely, anti-SSB and anti-Ro (both 4%) when a sicca syndrome was present. Finally, non-identified specificities were observed in 37% of the cases.

Adolescent↗

Combination chemotherapy of malignant histiocytosis.

Three patients with malignant histiocytosis treated with combination chemotherapy are reported. Induction treatment included bleomycin, adriamycin, cyclophosphamide, vincristine and prednisone (BACOP). Complete response was obtained in one patient who is alive and well 32 months after diagnosis. A partial response was obtained in the second patient, who is alive and well 35 months after diagnosis. The third patient died with drug-induced agranulocytosis and sepsis.

Adolescent↗

Valvular heart disease in patients with hypocomplementemic urticarial vasculitis syndrome associated with Jaccoud's arthropathy.

BACKGROUND: Since 1973, more than 75 patients with hypocomplementemic urticarial vasculitis syndrome (HUVS) were reported, but valvular heart disease does not seem to have been noted in these patients. Since 1993, however, five patients with HUVS accompanied by Jaccoud's arthropathy (JA) were found to have serious valvular heart disease. METHODS: To characterize the cardiac valvulopathy of the third patient with HUVS/JA to have undergone valve replacement, this study included the use of routine and special tissue stains, as well as immunohistochemical staining. We compared gross and histologic findings of this patient's valve to those of two other patients with this complex syndrome who underwent valve replacement. Pathologic findings of these latter two patients were described in separate earlier reports. RESULTS: Histologic examination of the resected valves in all three patients showed an acute necrotizing endocarditis and fibrin deposition on the surface of valve leaflets. Beneath the surfaces of the leaflets, there was evidence of chronic inflammation, consisting of lymphocytes and histiocytes. A fibrocalcific degenerative change was also present in all three valves. Positive staining for IgG, IgA, IgM, and light-chain determinant-bearing proteins was detected primarily at the valve surface in special studies of the aortic valve of the patient described in the current report. CONCLUSION: Patients with HUVS and associated JA should be evaluated for the presence of valvular heart disease. The latter is probably a nonrheumatic, inflammatory, and degenerative process, mediated by immune complex, as well as cellular immune mechanisms.

Antigen-Antibody Complex↗

Predictive factors of response to splenectomy in adult chronic idiopathic thrombocytopenic purpura.

A total of 26 surgical patients with chronic idiopathic thrombocytopenic purpura (ITP) were reviewed and results of splenectomy were statistically related to age and sex, length of and response to pre-operative corticosteroid therapy, pre-operative platelet count and time interval between diagnosis and surgery. Median age was 37 years (range, 17-81 years) and the male:female ratio was 1.16. Pre-operative platelet count ranged from 2-70 x 10(9)/l. The length of pre-surgical corticosteroid therapy (prednisone 1-2 mg/kg/day) varied from 2 weeks to 3 years. Steroid therapy was unsuccessful in 15 patients and only achieved temporary remission in the remaining 11 cases. The time interval between diagnosis and splenectomy ranged from 4-60 months. There were 21 responders (80.4%) and 5 non-responders (19.6%) to splenectomy. Using the chi-square test, differences in age, length and response to pre-operative steroid therapy and diagnosis-to-splenectomy interval did not achieve statistical significance when responder and non-responder groups to splenectomy were compared. Conversely, a significant difference was found comparing male to female groups, since 92.9% of males and only 66.7% of females were successfully treated by surgery (P approximately 0.01). In addition, patients with a pre-operative platelet count less than 30 x 10(9)/l responded at an higher rate (100% versus 70.6%; P approximately 0.05) to splenectomy.

Adolescent↗

[Post-traumatic psoriatic rheumatism. Clinical and medico-legal aspects].

The possibility that injury may play a role in the development of some forms of chronic inflammatory rheumatic disease has been a subject of debate for many years. Such a role is accepted for some cases of rheumatoid arthritis, remains controversial for spondylarthropathies, and is poorly understood in psoriatic arthritis. Three cases of post-traumatic psoriatic arthritis are reported herein. The difficulty of establishing the causative role of the injury (despite precise criteria) is underlined, the pathophysiologic mechanism is discussed (deep Koebner phenomenon?), and possible legal consequences are reviewed.

Adult↗