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Biomedical subjects

K Andrassy

Publications and source records attributed to K Andrassy.

At least 91 records · Page 5Linked to original sources
PubMed1992

[Antineutrophil cytoplasmic antibodies in chronic inflammatory bowel diseases].

Serum samples from 83 patients (42 women, 41 men, mean age 41 [19-85] years) with chronic inflammatory bowel diseases (ulcerative colitis: n = 41, Crohn's disease: n = 42) of differing degrees of activity were tested for antineutrophil cytoplasmic antibodies (ANCA) by immunofluorescence microscopy and various ELISA techniques. Seven patients with ulcerative colitis and one with Crohn's disease were suffering from associated primary sclerosing cholangitis. ANCA were detected in 18 sera, 13 from patients with ulcerative colitis (31.7%) and five from patients with Crohn's disease (11.9%). Six of the eight patients with primary sclerosing cholangitis were ANCA-positive. Nine sera showed a cytoplasmic (c-ANCA-) pattern and 9 others showed a partially atypical perinuclear (p-ANCA-) pattern. Among the ANCA-positive sera, ELISA techniques showed that two had antibodies against serine proteinase 3, two against lactoferrin, two against elastase and one against myeloperoxidase. There was no correlation between the anatomical pattern or activity of the disease and the presence of ANCA. The antineutrophil cytoplasm antibodies demonstrable in chronic inflammatory bowel disease appear to be directed against so far unknown antigens. They are particularly frequent in patients with associated primary sclerosing cholangitis.

Adult↗
PubMed1992

Dose dependent suppression of mineralocorticoid metabolism by different heparin fractions.

One neglected side effect of heparin therapy is the inhibition of adrenal aldosterone production leading to occasionally life-threatening hyperkalaemia. This is only reported with (therapeutic) high doses (greater than or equal to 20.000 IU). The complex interplay of mineralocorticoid metabolites was studied in 29 subjects with unfractionated (UFH) and low molecular weight heparin (LMWH). Both heparins altered mineralocorticoid metabolism in a dose dependent manner. Whereas no effect was observed with UFH 2 x 5000 IU sc/day or LMWH 2500 a FXa U sc/day, higher doses significantly suppressed aldosterone and 18-hydroxycorticosterone production in plasma and urine. Three out of seven patients receiving UFH 3 x 7500 IU sc/day developed hyperkalaemia. This study shows the threshold dosage of UFH leading to suppression of mineralocorticoid metabolism in man and provides information that LMWH as well as UFH can suppress mineralocorticoid production. With respect to therapeutic implications it is important that LMWH at 2500 a FXa U sc/d had no effect on mineralocorticoid metabolism in contrast to UFH at a dosage currently used for prevention of thromboembolism (3 x 5000 IU sc/d).

Adult↗
PubMed1992

Safety profile of cefodizime.

The results of animal toxicology studies with cefodizime (CDZ) showed no reason for concern with respect to drug safety. Renal tolerance of CDZ proved to be better than that observed with other cephalosporins; furthermore, CDZ had no adverse effects on spermatogenesis, fertility or embryonic development. A total of 6,299 patients were treated with CDZ in clinical trials worldwide, while 1,225 patients received cefuroxime, cefotaxime, cefmenoxime or cefizoxime in comparative studies. The incidence of mortality in the repeated dose trials was 1.6% (CDZ) and 1.75% (comparators); the incidence of adverse drug reactions (ADRs) was 3.06% and 3.64%, respectively. ADRs were mostly of gastrointestinal or allergic nature. In no case was a causative relationship established between CDZ and the death of a patient. Any influence of CDZ on platelet count and function, plasma coagulation and vitamin K metabolism has been excluded. Cefodizime has a favorable risk/benefit ratio.

Animals↗
PubMed1992

Antineutrophil-cytoplasmic antibodies and antiglomerular basement membrane antibodies in Goodpasture's syndrome and in Wegener's granulomatosis.

Antiglomerular basement membrane (anti-GBM) diseases-including Goodpasture's (GP) syndrome-and Wegener's granulomatosis (WG) are systemic diseases, which may be diagnosed by means of circulating autoantibodies. Possible overlap syndromes may exist; however, they remain imperfectly defined. We analyzed sera from 31 patients with WG and from 23 patients with anti-GBM disease. All underwent biopsy. Anti-cytoplasmic antibodies (ANCA) were demonstrated by indirect immunofluorescence (IIF); a perinuclear (P-ANCA) or diffuse-cytoplasmic (C-ANCA) staining was discerned. In addition, myeloperoxidase (MPO) antibodies (P-ANCA) and protein 3 (SP3) antibodies (C-ANCA) were analyzed by specific ELISA systems. Anti-GBM antibodies (anti-NC1 antibodies) were detected by ELISA and immunoblotting; the globular domain NC1 of collagen IV was employed as antigen. All 31 WG patients, as defined by clinical and histological criteria, showed ANCA by IIF. Twenty-nine of 31 showed a C-ANCA pattern; all were also positive for SP3 antibodies by ELISA. Three of 31 WG patients were P-ANCA positive by IIF and also had anti-MPO antibodies by ELISA. In one of these patients, SP3 antibodies were additionally found by IIF and by ELISA (double positive). No patient with WG had anti-NC1 antibodies. All 23 serum samples from patients with GP syndrome (N = 19) or anti-GBM glomerulonephritis (N = 4) had anti-NC1 antibodies. In seven of these patients, low titers of anti-MPO antibodies were detected by ELISA; however, the IIF for ANCA was negative. None of these seven patients had extraglomerular vasculities. In addition, the clinical prognosis of these patients was similar to that of those patients who lacked these antibodies.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Rapidly progressive glomerulonephritis and Wegener's granulomatosis.

Wegener's granulomatosis is estimated at 1/100.000/year. Histological proof of the characteristic granuloma is only demonstrated in 1/3 of patients suspected of having WG. The ANCA test is essential in making the diagnosis. Wegener's granulomatosis can affect any organ system. That the beginning of the disease is restricted to one organ (limited WG) is postulated to be true in at least 1/3 of all patients. One peculiar organ manifestation of WG is the pulmonary-renal syndrome. Renal involvement in WG is common and can reach from pauci-immune mild mesangial to crescentic lesions, depending on the severity of the disease. Predictors of renal outcome are glomerular obsolescence and degree of tubulo-interstitial lesions.

Antibodies, Antineutrophil Cytoplasmic↗
PubMed1992

Severe hemorrhagic complications from infection with nephropathia epidemica strain of Hantavirus.

In the following we describe a case of severe hemorrhagic fever with renal syndrome (HFRS) caused by Puumala infection. The diagnosis was made by immunofluorescence technique and by solid phase enzyme immunoassay using recombinant nucleocapsid antigen of a Puumala serotype strain. Such a clinical course with severe bleeding complications is considered untypical for Puumala induced HFRS.

Aged↗
PubMed1992

De novo glomerulonephritis in patients during remission from Wegener's granulomatosis.

In a cohort of 20 consecutive patients with Wegener's granulomatosis and biopsy-proven pauci-immune crescentic glomerulonephritis three patients were in remission, but developed again a nephritic sediment without signs of systemic disease or positive ANCA titers. The second renal biopsy showed de novo mesangial IgA deposits 6, 17 and 28 months following admission for systemic disease and institution of immunosuppressive treatment. All patients were male, HLA-DR-2 positive and exhibited repeated upper respiratory tract infections. A fourth patient was admitted in end-stage renal failure with high titers of C-ANCA of the IgG isotype and proteinase 3 ab without clinical evidence of systemic manifestations of WG. Renal biopsy showed chronic sclerosing GN with marked IgA deposits. De novo development of IgA-GN is observed in a remarkable proportion of patients with WG and must be distinguished from exacerbation of the systemic disease.

Aged↗
PubMed1991

[Renal incompatibility with antibacterial drugs: diagnosis and preventive measures].

Renal intolerance as a consequence of antibacterial therapy shows up in different ways. It is important to frequently control urine, serum creatinine and urea. Pre-existing renal disease and illnesses which need intensive care treatment and therapy with potentially nephrotoxic drugs require a careful application of antibiotics with nephrotoxic properties, e.g. aminoglycosides. Therefore drug monitoring is mandatory. The administration of NSAIDS should be avoided, because they impair the glomerular filtration rate. In addition, the excessive use of diuretics should be prevented. It is recommended that modern beta-lactam antibiotics with their wide antibacterial spectrum and their good renal compatibility should be preferred for therapy of bacterial infections under the conditions mentioned above.

Anti-Infective Agents↗
PubMed1991

Pharmacokinetics and hemostasis following administration of a new, injectable oxacephem (6315-S, flomoxef) in volunteers and in patients with renal insufficiency.

Flomoxef is a new oxacephem of broad antibacterial activity. The compound is mainly excreted through the kidneys. Two dose finding studies in patients with various degrees of renal insufficiency revealed that the dosage of flomoxef has to be reduced exactly according to the renal function. Although the N-methylthiotetrazole group has been replaced by a hydroxyethyl group, an inhibitory effect of flomoxef on vitamin K metabolism persisted. This effect was, however, less pronounced than with latamoxef. Only patients with low vitamin K stores are endangered. For those in whom low vitamin K stores are suspected repeated controls of prothrombin time are advised during the treatment. In contrast to latamoxef the platelet system was not affected by flomoxef. With the exception of loose stools in some patients no other clinical side effects during treatment were observed.

Adult↗
PubMed1991

Rapidly progressive glomerulonephritis: analysis of prevalence and clinical course.

Over a period of 68 months we observed 33 patients with biopsy-confirmed severe crescentic glomerulonephritis (GN) and another 5 patients who fulfilled the clinical criteria of rapidly progressive glomerulonephritis (RPGN; no biopsy confirmation) in a region comprising approximately 930,000 inhabitants. Additional 7 patients with Wegener's granulomatosis (WG)/microscopic polyarteritis (MP) from the same region were not seen by nephrologists. The calculated annual incidence of crescentic GN/RPGN is 0.7/100,000. Of the 38 patients 13 had classical WG, 7 MP, 3 systemic lupus erythematosus, 5 Schönlein-Henoch purpura, 3 Goodpasture's syndrome, 2 IgA glomerulonephritis. Of note is the high prevalence of WG/MP and the relative frequency of Schönlein-Henoch purpura. At the last follow-up, 3 patients were dead (8%), 7 patients were on dialysis (18%), 7 patients had elevated serum creatinine (18%) and 21 patients had normal serum creatinine (55%). We conclude that: (i) RPGN is more frequent than reported; (ii) WG and MP account for more than 50% of cases of RPGN; (iii) renal functional prognosis is good in WG/MP, but less favorable in RPGN of other causes; (iv) severe hypertension is not a feature of RPGN; (v) WG/MP, and not Goodpasture's syndrome, is the most common cause of pulmonary hemorrhage in association with RPGN; (vi) death from infection or malignoma is uncommon (not observed in this series); (vii) de novo IgA GN may occur in patients in remission from WG (2 observations).

Adult↗