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Biomedical subjects

I Griffiths

Publications and source records attributed to I Griffiths.

27 records · Page 2Linked to original sources
PubMed1992

Association of DR3 with susceptibility to and severity of primary Sjögren's syndrome in a family study.

A study of HLA and primary Sjögren's syndrome (1 degree SS) was performed in 40 index cases and 180 relatives all of whom were Caucasian. The association of DR3 and 1 degree SS was confirmed. In probands, DR3 associated with extraglandular manifestations of 1 degree SS and homozygosity for DR3 associated with younger onset of disease. Familial clustering of 1 degree SS was evident. Definite or probable 1 degree SS (Fox criteria) occurred with a prevalence of 4.4% in the relatives, exclusively in older female first degree relatives and was associated with DR3. The relative risk was greatest in those who expressed anti-nuclear factor, rheumatoid factor or Ro and DR3. We identified a group of young females expressing some criteria for 1 degree SS and the same immunogenetic markers. They may be at risk of full expression of 1 degree SS as they become older. Milder forms of 1 degree SS were common in older relatives but not DR3 associated. 1 degree SS in males was rare and mild irrespective of immunogenetic status. Symptoms of 1 degree SS in relatives were mild or absent. Such individuals will only be identified through a family study or a community survey.

Adolescent↗
PubMed1991

Prognostic significance of paraproteinaemia in rheumatoid arthritis.

The incidence of lymphoma and myeloma is increased in rheumatoid arthritis (RA), though the reasons for this are incompletely understood. The predictive value of monoclonal gammopathy in RA for the later development of lymphoproliferative malignancy was assessed. A serum paraprotein was discovered in 23 patients (14 female) with a median age of 58 years and a median duration of RA of six years. The paraprotein was quantified and further investigations, including a bone marrow examination and skeletal survey, were undertaken to study the possible development of a lymphoproliferative disorder. Secondary Sjögren's syndrome was noted in 12 patients. The paraprotein was monoclonal in 21 patients and was classed as IgG (12 cases), IgA (six cases), or IgM (three cases). Biclonal paraproteins were seen in two patients. Free light chains were found in the urine of eight patients. Bone marrow abnormalities were found in 13 subjects. The bone marrow was abnormal in four of six patients with an IgA paraprotein, in two of three with an IgM paraprotein but in only five of 12 patients with an IgG paraprotein. Patients were followed up for a median of four years, and five patients with an abnormal bone marrow developed myeloma, of whom three had an IgA lambda paraprotein. Two other patients developed non-Hodgkin's lymphoma. Extra-articular bone erosions were seen in four patients, three of whom developed myeloma, but the presence of urinary free light chains was not specific for the development of malignancy. Paraproteinaemia in RA indicates monoclonal B cell proliferation and carries a high risk of malignant transformation.

Adult↗
PubMed1991

Lung function in primary Sjögren's syndrome: a cross sectional and longitudinal study.

Clinical and radiological assessment of 100 patients (97 female) with primary Sjögren's syndrome was performed within six months of diagnosis in conjunction with spirometry and measurement of transfer factor for carbon monoxide (TLCO). This was repeated in an unselected subgroup of 30 patients after a mean interval of four years. On initial assessment, 43 patients had symptoms of lung disease and 10 had related physical signs; the chest radiograph was abnormal in five. There was a significant reduction (more than 2 standardised residuals) in forced expiratory volume in one second (FEV1), vital capacity (VC), and TLCO in 14, 12, and 10 patients, 24 patients overall having a significant reduction in one or more of these measures. There was a strong relation between reduction in lung function and both pulmonary symptoms and a lip biopsy specimen positive for Sjögren's syndrome. Lung function at the initial assessment in the 30 patients who were restudied was almost identical to that of the group as a whole. Seventeen now had symptoms and nine had related physical signs. The chest radiograph was abnormal in four patients. More patients had a significant reduction in FEV1, VC, and TLCO. Lung disease is sometimes an early feature of primary Sjögren's syndrome and may progress over a relatively short period.

Adolescent↗
PubMed1987

Lymphadenopathy in rheumatic patients.

Lymph node biopsy specimens from 22 patients with chronic inflammatory joint disease have been studied. The histology has been reviewed and immunoperoxidase staining carried out for the major immunoglobulin heavy and light chains, macrophage markers, and MT1, MB1 surface markers. Although two of these patients had been initially diagnosed and treated for malignant lymphoma, the clinical course has not substantiated the diagnosis, and on review malignancy could not be identified in any of the biopsy specimens. Careful attention to specific histological features, together with adequate clinical information, is therefore essential if the true nature of the lymph node enlargement is to be recognised. Clinical review of the 22 patients suggested that lymphadenopathy may, in some cases, be an early feature of inflammatory polyarthritis, and this was supported by the observation that 20% of patients with otherwise unexplained reactive lymphadenopathy developed an inflammatory polyarthropathy within one year of biopsy.

Adult↗
PubMed1978

Post meningococcal acute glomerular nephritis.

A case of meningococcal meningitis is described in which 10 days later there developed the histological lesions of acute exsudative proliferative glomerular nephritis without proteinuria, hematuria, hypertension or salt and water retention. The relationship between structural and functional changes in the kidney in glomerular nephritis is discussed in the light of these findings.

Acute Disease↗