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J Teichmann

Publications and source records attributed to J Teichmann.

At least 19 recordsLinked to original sources
PubMed2001

Relationship between disease activity and serum levels of vitamin D metabolites and parathyroid hormone in ankylosing spondylitis.

Vertebral fractures due to osteoporosis are a common but frequently unrecognized complication of ankylosing spondylitis (AS) and various factors may contribute to the development of osteoporosis in AS. It is known that inflammatory activity in rheumatic disease (i.e., proinflammatory cytokines) itself plays a possible role in the pathophysiology of bone loss. 1,25-Dihydroxyvitamin D3 (1,25(OH)2D3) seems to be another possible candidate for mediatory function in regulating both the inflammatory process and bone turnover. The aim of this study was to evaluate the relation between disease activity, bone turnover and calciotropic hormones. In 70 patients with established AS and an age- and sex-matched control group, the relation between disease activity (erythrocyte sedimentation rate, C-reactive protein, Bath Ankylosing Spondylitis Disease Activity Index), and serum levels of vitamin D metabolites, parathyroid hormone (PTH), bone alkaline phosphatase (bAP) and urinary pyridinium cross-links were determined. Serum levels of 1,25(OH)2D3 (p<0.01) and PTH (p<0.01) were negatively correlated with disease activity, the excretion of urinary pyridinium crosslinks showed a positive correlation with disease activity (p<0.01), and 1,25(OH)2D3 and PTH were positively correlated with bAP (p<0.01). These results indicate that high disease activity in AS is associated with an alteration in vitamin D metabolism and increased bone resorption. Furthermore, the decreased levels of 1,25(OH)2D3 may contribute to a negative calcium balance and inhibition of bone formation. Our results suggest further research is necessary to determine whether low levels of 1,25(OH)2D3 as an endogenous immune modulator suppressing activated T cells and cell proliferation may accelerate the inflammation process in AS.

Adolescent↗
PubMed2000

Correlation between plasma TNF-alpha, IGF-1, biochemical markers of bone metabolism, markers of inflammation/disease activity, and clinical manifestations in ankylosing spondylitis.

In patients with established ankylosing spondylitis (AS) and a healthy control group, plasma levels of IGF-1 and TNF-alpha as well as possible connections with biochemical markers of the bone metabolism, humoral inflammatory activity (ESR, CRP), clinical manifestations, and an established clinical activity score (Bath Ankylosing Spondylitis Activity Index = BASDAI) were examined. In AS-patients (men and women) significantly increased TNF-alpha levels were found. Moreover, patients with enthesopathy showed a significantly more frequent increase of CRP and TNF-alpha levels besides an increased urinary pyridinium cross-link excretion. In addition, a significant positive correlation between TNF-alpha, CRP, BASDAI, and urinary pyridinium cross-link excretion was proved, besides a significant negative correlation of IGF-I to urinary pyridinium cross-links and TNF-alpha levels. Summing up, it may be said that TNF-alpha seems to be a reliable surrogate marker in enthesitis. This was proved so far for IgA and endothelium stimulating angiogenic factor only. Besides, the present results argue against a stimulation of osteogenesis. The catabolic situation under high TNF-alpha and low IGF-1 levels may play an important role in the pathogenesis of osteoporosis in AS.

Adult↗
PubMed2000

Ultrasonography of the glenohumeral joints--a helpful instrument in differentiation in elderly onset rheumatoid arthritis and polymyalgia rheumatica.

In a prospective study, the glenohumeral joints of 51 patients (aged 60 or above) were examined, using ultrasonography. Twenty-two patients were suffering from characteristic polymyalgia rheumatica (PMR) symptoms. In contrast, 29 other patients initially had similar complaints, but were diagnosed as having elderly onset rheumatoid arthritis (EORA, rheumatoid factor negative) upon development of typical symptoms. Ultrasound examination revealed glenohumeral joint inflammation in 40.9% (9/22) of the patients with PMR and 65.5% (19/29) of the patients with EORA. A discrete symmetrical biceps tendon sheath effusion was found in only three patients and unilateral in six patients with PMR. In contrast, 12 patients with EORA presented a massive effusion of the biceps tendon sheath, in some cases combined with a bilateral subdeltoid bursitis, and an intraarticular (i.a.) effusion/synovitis. To summarize our results: an i.a. effusion/synovitis, subdeltoid bursitis and biceps tendon sheath effusion were more frequent in patients with EORA, with a predominate symmetry and signs for massive inflammation. The typical ultrasonographic result in patients with PMR was a unilateral inflammation of the glenohumeral joint with predominate discrete biceps tendon sheath effusion and, in comparison with the EORA group, with signs of a low grade inflammation. We conclude that the results of our prospective study might be helpful in the differentiation of PMR and a rheumatoid factor negative subgroup of EORA at the first time of manifestation where clinical overlaps can be observed. However, ultrasonography of the glenohumeral joints might be a good and helpful instrument of differentiation in both diseases.

Age of Onset↗
PubMed2000

Serum amyloid A--an indicator of inflammation in ankylosing spondylitis.

Biological markers of inflammation are useful for the diagnosis and monitoring of inflammatory rheumatic diseases. The present study tested, whether serum amyloid A (SAA) could be used as a marker of inflammatory disease activity in ankylosing spondylitis (AS). In 72 patients with AS, the two valuable surrogate markers of disease activity, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), and an established clinical activity score (Bath Ankylosing Spondylitis Disease Activity Index, BASDAI) were correlated to the serum levels of SAA. It was found that SAA correlates well with ESR, CRP, and BASDAI. Because of its strong correlation, SAA seems to be an additional very useful disease activity marker. When used in diagnosis, and especially in monitoring of inflammation, further studies are required. Another interesting point of view is the described role of plasma SAA as a precursor of Amyloid A (AA) protein in secondary amyloidosis, a known complication in AS. In all probability, high circulating SAA levels are a predisposing indicator of disease activity.

Adult↗
PubMed2000

Changes in calciotropic hormones and biochemical markers of bone metabolism in patients with human immunodeficiency virus infection.

Data on the bone metabolism of human immunodeficiency virus (HIV)-infected patients are still extremely rare. To investigate the influence of HIV infection on the calciotropic hormones and markers of bone metabolism, we therefore performed a cross-sectional study on 100 patients (65 males and 35 females) with proven HIV infection. The following criteria were used for exclusion from the study: age less than 20/more than 50 years, confinement to bed, wasting symptoms, treatment with agents containing ketoconazole, renal or hepatic insufficiency, clinical or echographic signs of liver cirrhosis, endocrine diseases, or treatment with medications known to influence bone metabolism. Bone mineral content (BMC) was determined by single-photon absorptiometry on the left forearm. Reduced BMC was found among the male and female HIV-infected patients. Additional long-term use of heroin resulted in a severe loss of mineralization in the respective females. The markers of bone metabolism were determined in urine and serum samples. Significantly lower osteocalcin concentrations were found, indicating a reduced bone formation rate whose severity showed a significant correlation with the progressive loss of CD4 helper cells and was independent of low vitamin D3 levels (1,25-dihydroxycholecalciferol) and alterations of protein metabolism. Increased urinary excretion of cross-links as an expression of enhanced bone resorption was likewise significantly correlated with the loss of CD4 helper cells and independent of the vitamin D concentration and protein metabolism. It is therefore concluded that the changes in bone metabolism are mainly due to mechanisms of the impaired immune defense of HIV-infected patients.

Adult↗
PubMed2000

Pineal influence on annual nuclear volume changes in ventromedial hypothalamic nucleus (VMH) neurons of the male Wistar rat.

The ventromedial hypothalamic nucleus (VMH) regulates various autonomic, endocrine, and behavioral activities. These activities show annual changes, and the pineal gland is involved in their adjustment to environmental cues. Therefore, this study investigated whether the VMH belongs to the effector structures of the pineal gland. To abolish the rhythmic melatonin release, male Wistar rats were subjected to pinealectomy (PX) or ganglionectomy (sympathetic denervation of the pineal gland, GX) regularly at the beginning of any of the four seasons. Brains from animals of PX-, GX-, and sham-operated control groups were prepared 3 months later for measurement of the nuclear volume, which changes according to the general gene activity. At each of the four seasons, 2000 nuclei of VMH neurons stemming from 18 animals per group were measured to obtain both seasonal daily mean values and annual mean values, respectively, as well as to calculate annual curves of the nuclear volume using empirical regression and locally adjusted polynomial approximation. The major findings are the following. First, inactivation of the pineal function influences the nuclear activity of VMH neurons, (2) PX and GX mainly depress the nuclear activity, indicating that the pineal influence on the VMH may predominantly be a stimulatory one. Third, size and direction of the changes caused by PX and GX vary in a seasonally dependent manner. Fourth, the annual rhythm of the nuclear activity of the VMH is modified by PX and GX. To explain how the pineal effects on the VMH may be mediated, a possible inhibitory influence of the suprachiasmatic nucleus (SCN), which has been activated in the same animals following both PX and GX, is discussed. In conclusion, the results confirm that the nuclear activity of VMH neurons underlies pineal influences. This also indicates an involvement of the pineal gland in many VMH-regulated functions.

Animals↗
PubMed2000

Bone mineral density and biochemical markers of bone metabolism in late onset rheumatoid arthritis and polymyalgia rheumatica--a prospective study on the influence of glucocorticoid therapy.

In the present prospective study, bone metabolism was examined in 51 patients at the time of diagnosis and 6-7 months later: 29 patients had definitive diagnosis of late onset rheumatoid arthritis (LORA) and 22 patients had polymyalgia rheumatica (PMR). At the time of diagnosis, the patients had not received any medication; during the 6-7 months of follow-up they were treated with corticosteroids and nonsteroidal-antirheumatic drugs (NSAIDs). Serum levels of osteocalcin, alkaline phosphatase and ostase, as markers for bone formation, were tested. Bone density was examined by dual x-ray absorption (DEXA) of the lumbar spine and the left ward triangle. At the time of diagnosis, no signs of bone alterations were seen. After 6-7 months, abnormal values of the serum parameters and bone mineral density were found in 16/51 patients (31%): 10/29 patients with LORA and 6/22 with PMR. Thus, our findings suggest that an alteration of bone metabolism could be observed in a minority of patients during the first few months of glucocorticoid medication, but in the majority of patients an osteoprotective effect seems to be worth discussing. The results suggest from a prophylactic and therapeutic point of view that an additional disease-modifying antirheumatic medication should be considered in the early stages of therapy to reduce the osteoporotic risk of a longterm corticoid therapy.

Aged↗
PubMed1999

Thyroid disorders in female patients with ankylosing spondylitis.

The association between rheumatological and thyroid disorders has long been known, the most common being the association of rheumatoid arthritis and autoimmune thyroiditis. Little is known as to possible thyroid involvement in ankylosing spondylitis (AS). In 22 female patients with AS and 22 healthy age-matched control subjects parameters of thyroid gland function, rheumatic activity, as well as a subtle drug anamnesis of the rheumatic medication, and an ultrasonographic examination of the thyroid gland were determined. Thyroid function was tested by intravenous injection of 400 microg thyrotropin-releasing hormone (TRH). In parallel basal levels of reverse-T3 (rT3), calcium and anti-thyroid antibodies were estimated. In the AS-group an enlarged thyroid volume was seen in 10 cases, basal FT4, FT3 and TT3 were significantly lower, TSH and TT4 were found to be in the normal range and rT3 was significantly increased. The prevalence of anti-thyroid antibodies was significantly higher in the AS-group. The AS-patients responded as well as the controls with thyroid hormone secretion to TRH, within an observation period of 2 hours. No differences were observed in TSH response. Free serum calcium showed in both groups no significant difference. To summarize our results, female patients with AS showed a

Adult↗
PubMed1999

Ankylosing spondylitis and genitourinary infection.

One hundred and thirty-four male and 32 female patients with ankylosing spondylitis and 33 women with pure ileitis terminalis Crohn were examined. The study protocol included a medical-rheumatological examination and thorough investigation for genitourinary infection. Urethroadnexitis was found in 37/134 male patients (2 patients suffered from balanitis, 17 patients from urethritis, 18 patients from prostatitis, and 2 patients from epididymitis), 15/32 female patients (11 of them had urethritis and in 4 cases urethritis associated with vaginitis) and 5/33 women with ileitis terminalis (every case with urethritis). The microorganism isolated most frequently from patients with genitourinary infection was Chlamydia trachomatis. The majority of patients with genitourinary infection were HLA-B27 positive. Nevertheless, the following conclusions can be reached: (1) evidence of Chlamydia trachomatis infection is frequent in male and female patients with ankylosing spondylitis, (2) patients with genitourinary infection tend to have HLA-B27, and (3) furthermore, presence of genitourinary infection was not significantly associated with chronic illness.

Adult↗
PubMed1999

Bone metabolism and bone mineral density of systemic lupus erythematosus at the time of diagnosis.

Recent studies have shown that systemic lupus erythematosus (SLE) is associated with a loss of trabecular bone. However, these changes have not been not described in patients with SLE at the time of diagnosis. To investigate the markers of bone metabolism 20 female patients with a recently manifested clinical picture of SLE were selected. All patients included in this study met the ARA criteria (for classification) of SLE. For comparison, 35 female patients with SLE, which had previously manifested itself and which had been treated with glucocorticoids, were included in a second group. A control group (III) consisting of 20 healthy individuals of the same age was formed to compare the results obtained. Test parameters comprised both serum levels of osteocalcin (OC) as the marker for bone formation and crosslinks excretion (CE) in urine as a specific marker for bone resorption. The bone density (BMD) was examined by dual energy X-ray absorption (DEXA) of the vertebral column (L2-L4), femoral neck, Ward's triangle and trochanter. The patients under study received either no medication or nonsteroidal antirheumatic drugs. The BMD of the vertebral column was significantly lower than expected in SLE-afflicted subjects of group II when compared with the age-matched normal female controls. The reduction of BMD in female patients with SLE was related to the significantly increased excretion of urinary pyridinoline, to hypoparathyroidism, and to the decrease in serum OC. Bone loss in women with fresh manifestation of SLE (I) increases to a degree similar to that of patients in group II. Lowered BMD predicts an increased risk for bone fractures. Therefore, female premenopausal SLE patients should be monitored for osteoporosis.

Absorptiometry, Photon↗
PubMed1998

Evaluation of serum and urinary estrogen levels in male patients with HIV-infection.

Several endocrine functions are described which are altered in patients with human immunodeficiency virus infection. However, there is limited information available on estrogens and their function in these patients. The aim of this study was to relate the stage of the disease with urinary and serum estrogens and the influence of heroin consumption on gonadal steroids. Forty human immunodeficiency virus infected outpatients without AIDS or the clinical picture of AIDS were involved in this cross-sectional study. The subjects were divided in two groups: heroin addicts and non heroin addicts. Blood samples were taken and 24 h urines collected. Serum follicle stimulating hormone, luteinizing hormone, prolactin, estrone, estradiol, testosterone and urinary total estrogens were measured by commercially available radioimmunoassays. Prolactin levels were not affected in the patients. However, compared with controls, follicle stimulating hormone and luteinizing hormone were significantly higher for both groups tested. In contrast, the elevated serum estrone levels were significantly lower expressed in the patients with heroin abuse compared to those of the other group. Urinary estrogens in human immunodeficiency virus infected patients of both groups were found to be higher than those compared to healthy controls. Since these drugs are known to enhance estrogen levels, we conclude that other factors are modulating estrogen formation and degradation in these patients.

Adult↗
PubMed1998

Whipple's disease - current status of diagnostics and therapy.

Whipple's disease is a multisystemic infectious disease whose pathogen, a gram-unstable actinomycete, has been characterized in the meantime by molecular-biological techniques (polymerase chain reaction). This infectious disease which was firstly described in 1907 by G.H. Whipple as intestinal lipodystrophy appears rarely and sporadically and can affect nearly every organ, in the course of which the small intestine is also concerned in the majority of patients. The symptoms and signs are polymorphous and depend on organic involvement and stage. This leads to significant difficulties concerning differential diagnosis and to a delay in diagnosis. Misjudging the syndromes provokes invalidism and death whereas correct therapy leads to a cure in most of the cases.

Biopsy↗
PubMed1998

Ankylosing spondylitis and infections of the female urogenital tract.

Thirty-two female patients with confirmed ankylosing spondylitis (AS) and 33 women of similar age with pure ileitis terminalis Crohn were examined for genitourinary infection. Urethral syndrome was found in 15 out of 32 patients with AS: 11 of them had urethritis and 4 urethritis associated with vaginitis. Five women of the control group suffered from urethritis. In all cases with genitourinary infection, Chlamydia trachomatis was isolated. By comparing the AS-patients (urogenital infection group and the non-infected group) with regard to other present clinical parameters, it was found, as expected, that the erythrocyte sedimentation rate in the 1st hour was significantly higher in the infected group. In addition, the infected patients had a significantly higher incidence of enthesopathy, involvement of the spinal column, and higher C-reactive protein values (CRP > or = 5 mg/l). A family history of AS was equally present. Other clinical parameters, such as inflammatory involvement of the joints and HLA-B27 correlation, did not differ significantly between infected and non-infected patients.

Adult↗
PubMed1998

Elderly onset rheumatoid arthritis and polymyalgia rheumatica: ultrasonographic study of the glenohumeral joints.

The glenohumeral joints of 32 patients (aged 60 or above) were examined using ultrasonography. Thirteen patients were suffering from characteristic polymyalgia rheumatica (PMR) symptoms. In contrast 19 other patients initially had similar complaints, but were diagnosed as having elderly onset rheumatoid arthritis (EORA) upon development of typical symptoms. Ultrasound examination revealed glenohumeral joint inflammation in 61% (8 out of 13) of the patients with PMR and 63.2% (12 out of 19) of the patients with EORA. These findings suggest that a subgroup of patients with PMR and EORA suffers from shoulder joint inflammation and this synovitis/bursitis/intraarticular effusion might play an important role in the understanding of their symptoms. We conclude that overlapping forms of PMR and a predominate rheumatoid factor negative subgroup of EORA might exist and should be further characterized.

Aged↗
PubMed1997

Elevated serum-calcium and parathormone-levels in HIV afflicted female heroin addicts.

Alterations of calcium and bone metabolisms have been observed in numerous studies of small groups of male HIV-infected patients. However, our knowledge regarding the manifestation of AIDS-associated hypoparathyroidism in female subjects is limited. In order to investigate the influence of heroin on the calciotropic hormones we performed a cross-sectional study on 45 female patients with proven HIV infection. The following criteria were used for exclusion from the study: age less than 20/ more than 50 years; confinement to bed; wasting symptoms; treatment with agents containing ketoconazole, renal or hepatic insufficiency; clinical or echographic signs of liver cirrhosis; endocrine diseases, or treatment with drugs known to influence calcium metabolism. A reduced parathormone (PTH) level was found among the female HIV-infected patients. Additional long-term use of heroin resulted in a significant increase of PTH compared to sex- and age matched controls and a second group of non-HIV-afflicted heroin dependent females. Significantly lowered serum magnesium concentrations were found in all three groups. Both serum calcium and urinary excretion of calcium were elevated in the group of HIV-infected heroin addicts and were independent from low vitamin D3 levels (1,25-dihydroxycholecalciferol) and alterations of protein metabolism. Therefore, it is concluded that the changes of PTH secretion are mainly due to mechanisms both of the impaired immune defense of HIV-infected females and the additional effect of opiates.

Adult↗
PubMed1997

Rapid spinal trabecular bone loss in female patients with ileitis terminalis Crohn and additional sacroiliac joint inflammation.

Patients with Crohn's disease are well known to have local and generalized osteopenia of varying degrees. The aim of this study was to investigate whether the additional involvement of the sacroiliac joint as an extraintestinal manifestation has an influence on bone turnover in female patients with Crohn's disease. Osteocalcin and other parameters of bone metabolism were measured in 79 female patients with Crohn's disease. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DEXA). Z scores were obtained by comparison with age- and sex-matched normal values. As regards the sacroiliac involvement (n = 26; group 1), we found a significantly lower BMD in the lumbar spine (L4) and in Ward's triangle of the femoral neck compared to controls (P < 0.05) and those patients (n = 53; group 2) with pure ileitis terminalis Crohn. Furthermore, the duration of the disease process in patients with Crohn's disease and extraintestinal involvement was markedly shorter than that of patients in group 2 (P < 0.05). In conclusion, osteoporosis in female patients with sacroiliac involvement manifested itself in a more severe way.

Adult↗