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Biomedical subjects

J Bretza

Publications and source records attributed to J Bretza.

9 recordsLinked to original sources
PubMed1983

Association of IgE antibodies to sodium aurothiomalate and adverse reactions to chrysotherapy for rheumatoid arthritis.

The relationship between adverse reactions to chrysotherapy and specific IgE antibodies to sodium aurothiomalate (auIgE) was studied in 67 patients with rheumatoid arthritis (62) or psoriatic arthritis (5). Thirty patients (45 percent) had such antibodies versus none of the 27 control patients. Of the 34 patients in whom reactions to chrysotherapy developed, 23 (68 percent) had auIgE versus 7 (21 percent) without reactions (p less than 0.001). Mucocutaneous lesions were significantly associated with auIgE (p less than 0.001). All five patients with thrombocytopenia, but only one of five with the nephrotic syndrome, had auIgE. The patients with IgE response had higher total serum IgE levels (p less than 0.005), were more likely to be atopic (four to one), and had more recently received chrysotherapy (mean 2.8 +/- 1.95 years versus 7.0 +/- 5.75 years, p less than 0.001) than those without response, but did not differ by either the gold product or the total dose used. Chrysotherapy is associated with the production of specific IgE antibodies to a gold salt, and some mucocutaneous and hematologic reactions may be immunologically mediated.

Adult↗
PubMed1981

Diagnostic errors in polymyalgia rheumatica and temporal arteritis.

Incomplete clinical response or persistence of a rapid ESR despite corticosteroid treatment of polymyalgia rheumatica or temporal arteritis should always arouse suspicion and prompt a search for other diagnoses. Lumbar spinal stenosis and Pancoast's tumor are two unusual entities that can complicate or compete for the diagnosis of polymyalgia rheumatica and temporal arteritis.

Diagnostic Errors↗
PubMed1980

Duration of streptokinase-streptodornase (SK/SD) protency for delayed hypersensitivity skin testing.

During of potency for SK/SD solutions used as recall antigens in delayed hypersensitivity skin testing had not been determine. In a study of 50 normal subjects over a one-year period it was found that antigenicity diminished with time. At four months, however, there was no evidence of impaired potency at any of the dilutions tested. Authors suggest that reconstitution of SK/SD be made every three months when kept at room temperature and that increasing strengths be applied beginning at 4/1 units.

Adolescent↗
PubMed1979

Scleroderma simulating vinyl chloride disease.

Progressive systemic sclerosis, especially prior to distinctive internal organ involvement can be difficult to distinguish from vinyl chloride disease. A 50-year-old male developed classic scleroderma while working with polyvinyl chloride. Early in his disease he displayed a number of features common to both disorders, including acroosteolysis, sclerodactyly, polygammopathy and circulating immune complexes. Characteristic visceral involvement was the cardinal feature which distringuished his disease from the pseudoscleroderma of vinyl chloride disease.

Diagnosis, Differential↗
PubMed1978

Mycobacterium intracellulare presenting as a sarcoid-like illness.

A combined infection with Mycobacterium intracellulare and histoplasmosis in a patient with end-stage sarcoidosis is reviewed. A healthy skepticism should be applied to all but the most classic cases of sarcoidosis. Prolonged follow-up with repeated attempts to demonstrate a specific causative agent will decrease the possibility of overlooking treatable infections. An initial work-up of a patient with sarcoidosis includes fungal immunologic tests, which if positive can lead to further investigation and the correct diagnosis. Steroids should be reserved for clear indications in sarcoidosis. Any exacerbation of an underlying bronchopulmonary disease should compel a search for an infectious cause. This patient responded to amphotericin and three antituberculous drugs but nevertheless had significant sequelae of her illness.

Female↗