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Biomedical subjects

J Ordi

Publications and source records attributed to J Ordi.

At least 109 records · Page 6Linked to original sources

High grade atrioventricular heart block in 2 adults with systemic lupus erythematosus.

We describe 2 patients with systemic lupus erythematosus (SLE) and high grade atrioventricular (AV) block. In one patient anti-Ro antibodies were positive. This antibody has been associated with congenital complete heart block in children of mothers with SLE; however, its role in adult high grade AV block is not clear. We reviewed the 8 published cases of adults with SLE and high grade AV block. The possible mechanisms that could be implicated in the pathology of high grade AV block are discussed.

Adult↗

Platelet activation, endothelial cell dysfunction in the absence of anticardiolipin antibodies in systemic sclerosis.

The presence of anticardiolipin antibodies (aCL), von Willebrand factor activity and platelet function was studied in 35 patients with systemic sclerosis (SSc) scleroderma and 22 healthy controls. aCL positivity was observed in no patient with SSc or controls, whereas beta-thromboglobulin and platelet factor 4 levels were significantly higher in patients with SSc (p less than 0.001 and p less than 0.002, respectively). Furthermore, plasma from patients with SSc had a greater degree of aggregation to adenosine diphosphate 1 microM (p less than 0.05) but not to collagen or arachidonic acid. The plasma of patients with scleroderma also had increased von Willebrand factor activity compared with controls (p less than 0.001). We conclude that aCL appears not to play a central role in the pathogenesis of vascular and hemostatic alterations in SSc.

Adult↗

[T lymphoblastic leukemia with leukemoid reaction or the extramedullary blast crisis of Philadelphia chromosome-negative chronic myeloid leukemia? Comments apropos 2 cases].

Reactive leukocytosis has been reported in patients with non-Hodgkin's lymphoma of different histologic types. On the other hand, the blastic crisis of chronic myelocytic leukemia (CML) can sometimes be localized outside the bone marrow and simulate lymphoma, particularly when the blasts are of lymphoid lineage and the blastic crisis is the presenting feature of the disease. We report two patients in whom the differential diagnosis between lymphoblastic lymphoma with reactive leukocytosis and blastic crisis of CML outside the bone marrow was raised. They were two males aged 32 and 22 years, respectively, with lymphadenopathy (and one with splenomegaly), who were initially diagnosed of T lymphoblastic lymphoma. In both cases, leukocytosis was detected with myelemia and dysgranulopoiesis in the onset in one of them and when lymphadenopathy reappeared after remission in the other one. In addition, one patient had marked eosinophilia. In the bone marrow there was marked granulopoietic hyperplasia, with a reduction of fatty cells, and the granulocyte alkaline phosphatase index was reduced. However, the cytogenetic study did not disclose the existence of Philadelphia (Ph) chromosome, and bcr/abl molecular rearrangement was also not observed in the molecular study of both cases. We discuss the basic aspects of differential diagnosis between T lymphoblastic lymphoma with leukemoid reaction and T lymphoid lymphadenopathic blastic crisis of Ph-negative, bcr/abl-negative CML.

Adult↗

[Autoimmune hemolytic anemia and CREST syndrome].

There are few studies addressing the frequency and etiology of anemia in progressive systemic sclerosis. Anemia is present in about 25% of these patients. Among the implicated causes are ferropenia, generally associated with gastrointestinal hemorrhage, and renal failure. In a considerable number of patients, the specific etiology of anemia remained unknown. We report a 59-year-old female with autoimmune hemolytic anemia and incomplete CREST syndrome. We emphasize the rarity of autoimmune hemolysis as a cause of anemia in systemic sclerosis, and we discuss its significance as indirectly supporting the possible autoimmune pathogenesis of that condition.

Anemia, Hemolytic, Autoimmune↗

[Primary antiphospholipid syndrome: study of 27 patients].

The clinical and biological features of a series of 27 patients with the recently described primary antiphospholipid syndrome are reported. Most of them belonged to a cohort of 90 patients who were carriers of lupus anticoagulant, which had been detected in the systematic evaluation of prolonged activated partial thromboplastin times in our hospital. Since the diagnosis they underwent a prospective protocol of follow up, with a peak follow up period of 9 years. The mean age of the 27 patients was 40.8 years and there were virtually no differences between sexes. Venous thrombosis was the most common clinical finding (16 episodes in 14 of the 27 patients). The most prevalent laboratory findings were lupus anticoagulant and IgG anticardiolipin antibodies.

Abortion, Spontaneous↗

[Amebic liver abscess: presentation of 4 cases].

We report four patients with amebic liver abscess diagnosed in our hospital between January 1985 and January 1990. Mean patient age was 40 years. All patients had previously travelled to an endemic area. Fever, weight loss, right-upper-quadrant pain and hepatomegaly were the most frequent clinical manifestation. Two patients had a history of diarrhea. Diagnosis was made by epidemiology, clinical manifestation, ultrasonic scanning and computerized tomography and serologic test. Two patients received metronidazole exclusively and two patients required percutaneous catheter drainage under ultrasound guidance.

Adult↗

[Multi-infarct dementia associated with antiphospholipid antibodies. Presentation of 2 cases].

Two patients with positive antiphospholipid antibody and early multi-infarction dementia as a presenting feature of their illness are reported. One was included in the so called primary antiphospholipid antibody syndrome, while the second one met the criteria for systemic lupus erythematosus. We point out to the presence of aortic regurgitation in one of the patients and its possible relation with these antibodies. Although the precise mechanism of thrombosis is incompletely known, the recognition of this type of dementia is of paramount importance as it is a potentially treatable condition.

Adult↗

Fetal loss treatment in patients with antiphospholipid antibodies.

A group of seven young women with antiphospholipid antibodies, histories of recurrent fetal loss, and no live births is reported. Two patients had systemic lupus erythematosus, and the other five fulfilled criteria for the primary antiphospholipid syndrome. A false Venereal Disease Research Laboratory (VDRL) test was present in four of the patients, three had a previous episode of arterial or venous thrombosis, or both, and two had thrombocytopenia. Prednisone and acetylsalicylic acid were given, and monthly controls of lupus anticoagulant activity were carried out. The dose of acetylsalicylic acid was fixed while the dose of steroids was adjusted according to the degree of lupus anticoagulant activity. A fetal survival was obtained in 7/9 (78%) of the pregnancies. Three of the newborn infants had transitory lupus anticoagulant activity. A search for antiphospholipid antibodies should be carried out in patients with otherwise unexplained fetal losses, falsely positive VDRL tests, thrombosis, or thrombocytopenia as the treatment of such patients with prednisone and acetylsalicylic acid is highly effective.

Abortion, Habitual↗