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Biomedical subjects

J M Gumpel

Publications and source records attributed to J M Gumpel.

At least 37 records · Page 2Linked to original sources
PubMed1988

Near fatal eosinophilic gastroenteritis responding to oral sodium chromoglycate.

Eosinophilic gastroenteritis (EG) is an uncommon disorder, characterised by cramping abdominal pain, diarrhoea and vomiting and histologically by eosinophilic infiltration of bowel wall. We present a patient who developed EG during the course of a systemic, necrotising vasculitis, who became critically ill after failure of treatment with corticosteroids and cytotoxic drugs and responded only to oral sodium chromoglycate.

Cromolyn Sodium↗
PubMed1988

Diaphragm disease: pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs.

Operative small bowel resection specimens received over a period of 16 years were reviewed to assess whether any intestinal disease could be directly attributed to the use of non-steroidal anti-inflammatory drugs (NSAID). Seven cases of intestinal disease associated with the use of NSAID were identified, all of which occurred in the final six years of the survey, which may reflect the increasing use of these compounds. A spectrum of patterns was found from multiple pathognomonic ileal mucosal diaphragms to broad strictures similar to those seen as a complication of enteric potassium. It seems likely that the formation of diaphragm lesions requires an additional factor, but what is not known as yet is whether the effects of NSAID are local or systemic.

Adult↗
PubMed1985

Stimulation of bone marrow erythropoiesis by T lymphocytes of anaemic patients with rheumatoid arthritis.

An inappropriate response of the bone marrow is implicated in the aetiology of the anaemia of chronic disease complicating rheumatoid arthritis. T lymphocyte subsets have been shown to inhibit early erythroid development in vitro in association with some cases of bone marrow failure, and an expanded peripheral blood pool of these cells is reported in rheumatoid arthritis. We have studied the role of peripheral blood T lymphocytes in erythroid bone marrow culture from seven normal volunteers and nine anaemic patients with rheumatoid arthritis and found comparable stimulation of growth in both groups.

Adult↗
PubMed1985

Bone turnover in early rheumatoid arthritis. 1. Biochemical and kinetic indexes.

Biochemical, hormonal, and kinetic indexes of bone turnover were measured in 17 ambulant female patients with rheumatoid arthritis (RA) of recent onset (mean disease duration 14.2 months) and 19 controls. Mean serum osteocalcin concentration and 85Sr accretion rates were reduced and mean urinary hydroxyproline-creatinine ratios were increased in RA, but these differences were not significant compared with control values. Mean total body potassium (TBK), an index of skeletal muscle mass, was significantly reduced in RA, and the ratio of observed to predicted TBK correlated with indexes of bone formation. No abnormality of skeletal metabolism could be shown in early RA, but reduced rates of bone formation associated with diminished muscle mass may influence the development of osteopenia later in the disease.

Adult↗
PubMed1985

Bone turnover in early rheumatoid arthritis. 2. Longitudinal bone density studies.

Serial measurements of bone mineral in 17 ambulant female patients with rheumatoid arthritis (RA) of recent onset and 19 age matched female controls were made in the radius by computed tomography and in the vertebrae by dual photon absorptiometry. Loss of trabecular bone from the distal radius was more rapid in RA (p = 0.0014), but there was no difference in the rate of loss of bone mineral from the radial midshaft or lumbar spine compared with the controls. This study is consistent with the hypothesis that the predominant form of bone loss early in the disease is the vicinity of affected joints.

Arthritis, Rheumatoid↗
PubMed1985

Calcium absorption in rheumatoid arthritis.

Calcium absorption, assessed by a double isotope method, was found to be impaired in postmenopausal women with rheumatoid arthritis of recent onset (mean 14.2 months) compared with controls. Circulating levels of 1,25-dihydroxyvitamin D (calcitriol) were higher than in controls, suggesting a primary malabsorption of calcium in these patients. The reduction in calcium absorption correlated with several measures of disease activity, suggesting that the disease process was responsible for the intestinal defect, but an effect from non-steroidal anti-inflammatory agents cannot be excluded. A primary reduction in calcium absorption may increase the risk of osteoporosis in women with rheumatoid arthritis.

Adult↗
PubMed1984

Intestinal permeability and inflammation in rheumatoid arthritis: effects of non-steroidal anti-inflammatory drugs.

The suggestion that the intestinal mucosa may be abnormally permeable and a site of absorption of antigens in rheumatoid arthritis was tested by the use of a 51Cr-EDTA (edetic acid) absorption test. 24 patients with rheumatoid arthritis excreted significantly more 51Cr-EDTA than did 34 controls. Intestinal permeability was normal in untreated patients but almost invariably abnormal in patients treated with non-steroidal anti-inflammatory drugs. Studies in patients with osteoarthritis showed that the permeability abnormalities were due to an effect of NSAIDs on both the proximal and the distal intestine and that the effect was systemically mediated. Indium-111-labelled leucocyte scans showed ileocaecal inflammation in 6 of 9 patients on or recently on NSAIDs. Although increased intestinal permeability does not seem to be important in the pathogenesis of rheumatoid arthritis, the administration of NSAIDs may lead to loss of intestinal integrity, thus facilitating antigenic absorption and perhaps contributing to persistence of the disease.

Anti-Inflammatory Agents↗
PubMed1984

The mechanism of the anaemia in rheumatoid arthritis: effects of bone marrow adherent cells and of serum on in-vitro erythropoiesis.

Clonal assays for erythroid progenitors (BFU-e and CFU-e) were used to study 20 patients with rheumatoid arthritis, 15 of whom had anaemia of chronic disease and five of whom were haematologically normal. The numbers of bone marrow BFU-e and CFU-e in the anaemic patients did not differ significantly from those in normal controls. Macrophages were removed from the bone marrow by a combination of adherence and buoyant density centrifugation over a sucrose gradient and the resulting fractions were cultured alone or together with autologous adherent cells in BFU-e assays. Co-culture with adherent cells significantly increased colony growth in both the controls and in seven of eight anaemic patients studied. Serum from 14 anaemic patients and from five non-anaemic patients was added to cultures of bone marrow or to control peripheral blood 'null' cells. Anaemic serum uniformly either inhibited or failed to stimulate BFU-e growth under these conditions. Serum from non-anaemic patients and from 10 healthy controls stimulated BFU-e growth from 'null' cells to an equal degree.

Adult↗
PubMed1984

Gold nephropathy due to auranofin obscured by tolmetin pseudoproteinuria.

A 63-year-old woman with seropositive rheumatoid arthritis was successfully treated with auranofin for 12 months. Heavy proteinuria then developed and the drug was stopped. However, the proteinuria apparently became worse. This was later recognised to be a spurious effect due to the introduction of tolmetin. Renal biopsy showed a type I membranous glomerulonephropathy.

Anti-Inflammatory Agents↗
PubMed1984

The CREST syndrome--successful reduction of pulmonary hypertension by captopril.

A patient with severe pulmonary hypertension due to pulmonary arteriolar obliteration complicating a long standing CREST variant of systemic sclerosis showed improvement in cardiac output and exercise tolerance during treatment with captopril, which was discontinued because of persistent systemic hypotension. It is suggested that captopril would have a useful and possible prophylactic effect early in pulmonary hypertension in systemic sclerosis.

Captopril↗
PubMed1983

Systemic lupus erythematosus and abdominal pain.

Abdominal pain is a common symptom in systemic lupus erythematosus. We report two patients with recurrent severe attacks of abdominal pain, often necessitating hospital admission, which were not diagnosed until laparotomy. In one an active arteritis of the mesenteric arteries was seen, with infarction of the jejunum and ileum, and in the second infarction of the ileum with haemorrhage and conglutination of red cells, but no true arteritis.

Abdomen↗