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Biomedical subjects

H Amital

Publications and source records attributed to H Amital.

At least 55 records · Page 3Linked to original sources
PubMed1995

Pseudotumor cerebri in systemic lupus erythematosus.

OBJECTIVE: To assess the association between pseudotumor cerebri (PC) and systemic lupus erythematosus (SLE), and to seek a pathogenic mechanism that may elucidate the appearance of PC in patients with SLE. DATA SOURCE: Original English articles having the terms SLE, PC, or benign intracranial hypertension in their titles were identified by Medline search. In addition we report three new patients with this association. STUDY SYNTHESIS: Thirteen articles were found and 21 patients were analyzed. DATA EXTRACTION: Of the reported 21 patients, 18 were previously reported and 3 new patients with coexisting PC and SLE are described. The clinical characteristics of the patients is presented. Patients with PC and SLE generally had a more severe course of SLE; renal involvement occurred in 79%, massive proteinuria in 47%, and hematologic abnormalities were detected in a third. A hypercoagulable state manifest by either recurrent thromboembolic events or a high anti-cardiolipin antibody titer was detected in 58% of the patients described. CONCLUSIONS: The association of PC and SLE is probably not coincidental. The high prevalence of serologic or clinical evidence of a hypercoagulable state suggests that microscopical thromboembolic events play a role in the genesis of PC.

Adolescent↗
PubMed1995

Autoimmune aspects of primary pulmonary hypertension.

Although primary pulmonary hypertension (PPH) is considered to be an idiopathic condition, it has been postulated that autoimmunity may play a role in the pathogenesis of the disease. This argument has been based on frequent coexisting clinical and serological rheumatic findings. Moreover, approximately in a third of the patients with PPH, and antinuclear factor can be detected. Pulmonary hypertension may appear as a secondary complication to various autoimmune conditions. In light of these findings we examined sera derived from 40 patients diagnosed as having PPH for the presence of 18 different autoantibodies by the ELISA and immunofluorescent techniques. Of the 40 patients, 62.4% had circulating autoantibodies and 47.5% presented with multiantibody responses. Autoantibodies most commonly observed were antinuclear (42.5%), anti-ssDNA (25%) and antithyroglobulin (30%) antibodies. These results may imply that in a subgroup of patients with PPH the disease may be ascribed to an immune dysregulation or alternatively that autoantibodies accompany the disease progression as an epiphenomenon.

Antibodies, Antinuclear↗
PubMed1994

[Thromboembolic events in heparin-induced thrombocytopenia].

Thrombocytopenia following heparin treatment appears in 5% of patients so treated. In 20% of such patients paradoxical thromboembolic phenomena may be associated with the thrombocytopenia. This process is most probably mediated via an antibody reaction against a heparin-platelet complex. We present a 70-year-old woman with recurrent episodes of lower extremity thrombophlebitis associated with thrombocytopenia following treatment with heparin for pulmonary embolism.

Aged↗
PubMed1994

Anti-idiotypes and their application under autoimmune, neoplastic, and infectious conditions.

Idiotypes and anti-idiotypes are becoming widely used in various experimental applications in multiple fields of research. Administration of anti-idiotypes has been attempted in order to manipulate immune reactions affecting autoimmune, neoplastic, and infectious processes. Immunization with anti-idiotypes and idiotypes may change the autoantibody expression in autoimmune diseases. In certain experimental models administration of anti-idiotypes and idiotypes may even propagate the induction of autoimmune-like disorders. Internal image bearing anti-idiotypes may provide an effective tool in the combat of neoplastic and infectious diseases. Such anti-idiotypes may resemble the structure of neoplastic cell antigen or mimic the composition of a contagious viral antigen. This review will deal in detail with the various aspects of idiotype and anti-idiotype immunomanipulation.

AIDS Vaccines↗
PubMed1993

Autoimmunity and schizophrenia: an epiphenomenon or an etiology?

During the last 20 years considerable data have accumulated indicating that schizophrenia may have an autoimmune immunology. Patients with schizophrenia may have autoantibodies; in addition, cellular changes may occur that are compatible with autoimmunity, e.g., an increased number of CD5+ cells. If, indeed, schizophrenia does have an autoimmune pathogenesis, we should consider an alternative therapy based on immune system-manipulating drugs in addition to antipsychotic compounds.

Autoantibodies↗
PubMed1992

Analysis of autoantibodies among patients with primary and secondary uveitis: high incidence in patients with sarcoidosis.

The sera of 122 patients with uveitis were examined for the presence of various antinuclear autoantibodies. Overall 21.3% of the patients had antibodies to ribonucleoprotein (RNP) and 18% to Ro (SSA). When subdividing the patients according to primary uveitis versus secondary uveitis, the autoantibodies were detected more frequently in the second group [anti-RNP 13.3 vs. 31.4%, anti-Ro (SSA) 11.8 vs. 27.7%, anti-Sm 10.3 vs. 24% and poly (G) 2.9 vs. 14.8%, respectively]. No differences could be asserted in autoantibody frequencies according to disease location within the uvea. Among uveitis patients afflicted with sarcoidosis a particular high incidence of autoantibodies was detected in comparison with all other subgroups of patients with uveitis. Although the presence of autoantibodies among patients with uveitis appears not to have a major diagnostic value, their assessment may aid to a better understanding of disease pathogenesis.

Antibodies, Antinuclear↗
PubMedDate not supplied

New therapeutic avenues in autoimmunity.

During the last decade, much progress has been made in the understanding of processes that lead to autoimmunity. Cellular interactions mediated through cytokines and adhesion molecules were found to play a major role in the genesis of autoimmune conditions. During this period, we learned to recruit monoclonal antibodies to manipulate these delicate processes and to divert their outcome to a path we control better. Our comprehension of IVIG (intravenous immunoglobulin therapy) has broadened, and new indications for the implementation of this promising therapy have been pursued. In this review, we shed light on new therapeutic modalities that have been published since our previous report and discuss new data concerning the old modalities.

Autoimmune Diseases↗
PubMedDate not supplied

Valvular deposition of antiphospholipid antibodies in the antiphospholipid syndrome: a clue to the origin of the disease.

In this report we present an unusual case of a 45-year-old female patient with systemic lupus erythematosus (SLE) who was hospitalized for mitral valve replacement. In her childhood she presented with mitral stenosis and chorea on which grounds a preliminary diagnosis of rheumatic fever was established. After a quiescent period lasting two decades her disease erupted with mitral stenosis, thromboembolic phenomena, and nephritis. Due to severe malfunctioning of her mitral valve, the patient eventually underwent mitral valve replacement. The antibodies involved in the pathogenesis of our patient's valvular disease were studied by immunohistochemical analysis, applying rabbit polyclonal anti-human IgG and IgM anti-human C3c and anti-idiotypes to a mouse monoclonal naturally occurring polyspecific human monoclonal anti-cardiolipin antibody termed S2.9, and to the 16/6 Id which defines a common Id on anti-DNA antibodies in patients with SLE. Immunoperoxidase staining using an anti-idiotype mAb to anti-cardiolipin antibodies demonstrated the deposition of these anti-bodies in the subendothelial layer of the valve. We believe that anti-phospholipid syndrome (APS) with SLE was the initial and primary disease in this patient. These findings clearly indicate that APS must be considered in the differential diagnosis of rheumatic fever, particularly in young female patients who present with mitral stenosis and chorea.

Adolescent↗
PubMedDate not supplied

Use of intravenous immunoglobulin in livedo vasculitis.

We describe a 36-year-old woman with livedo vasculitis (atrophie blanche) lasting for 15 years. After the failure of numerous therapeutic modalities the patient was treated with intravenous immunoglobulin. Significant resolution of the cutaneous lesions was seen with a concomitant alleviation of pain. To the best of our knowledge this is the first patient with livedo vasculitis described in the medical literature ever to be treated with IVIG and to achieve a successful outcome.

Adult↗
PubMedDate not supplied

Isotretinoin-induced adult onset Still's disease.

We describe a 21-year old man who was diagnosed as having adult onset Still's disease (AOSD) in association with isotretinoin treatment for acne conglobata. The patient was febrile, with a macular salmon pink rash, arthritis, hepatosplenomegaly, and axial lymphadenopathy. Laboratory results showed leukocytosis, mild liver dysfunction and negative rheumatoid factor and antinuclear antibodies. Isotretinoin, an orally active derivative of vitamin A, has been associated with various rheumatologic conditions such as arthralgia, myalgia, vasculitis and arthritis. The etiology of rheumatic disorders associated with retinoids is still obscure; however, it is presumed that immunomodulation by several mechanisms (such as an alteration of the cytokine balance) is probably ascribable to this interesting association.

Adult↗
PubMedDate not supplied

Alveolar hemorrhage in cryoglobulinemia--an indicator of poor prognosis.

OBJECTIVE: Alveolar vasculitis is an unusual event in the course of cryoglobulinemia (CG). The inflammatory process involving the alveolar capillary walls may result in severe alveolar hemorrhage and consequently lead to a grave outcome. The objective of this study was to evaluate the occurrence of this unusual finding in CG. METHODS: We reviewed the records of all patients with CG who developed acute alveolitis, registered their associated clinical and laboratory parameters and evaluated the possible impact these parameters may have on their prognosis. In addition we scanned the Medline for similar cases. RESULTS: Of the 125 patients with CG who were hospitalized in our medical center during the last 23 years, 4 (3.2%) developed alveolar hemorrhage. All patients exhibited extreme fatigue, fever with clinical and radiological evidence of alveolitis. Of the 4 new cases, 1 had type II CG and 3 had type III CG. Of our 4 patients, 3 developed concomitant acute renal failure necessitating hemodialysis. A literature survey resulted in 6 additional cases. All 10 patients experienced acute respiratory insufficiency and eight had at least one episode of hemoptysis. In the other 2 patients the bronchoalveolar lavage (BAL) fluid contained hemosiderin laden macrophages. Five of the 10 patients had concomitant hepatitis C virus (HCV) infection; 2 patients were seen prior to modern identification of the HCV; however, liver abnormalities were not described. Of the 10 patients 5 patients had type II CG and 5 others had type III. Of the 7 patients in whom outcome was available, 6 died from their illness. Acute renal failure or exacerbation of antecedent glomerular disease occurred in 8 patients. CONCLUSIONS: Alveolitis is a rare manifestation of CG, presenting as an overwhelming systemic illness and portends a poor prognosis with a high mortality rate.

Adult↗