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Biomedical subjects

K Steinsson

Publications and source records attributed to K Steinsson.

46 records · Page 3Linked to original sources
PubMed1993

Relation of antiphospholipid antibody and placental bed inflammatory vascular changes to the outcome of pregnancy in successive pregnancies of 2 women with systemic lupus erythematosus.

Histological changes in biopsies from the placental and placental bed in 2 successive pregnancies of 2 women with systemic lupus erythematosus and antiphospholipid antibodies were studied. In one of the first 2 pregnancies vasculitis was found in the spiral arteries of the placental bed biopsy, while the other showed perivascular inflammatory infiltration and deciduitis. This was associated with poor pregnancy outcome and elevated antiphospholipid antibodies (aPL). In the subsequent 2 pregnancies prednisolone treatment was tailored to suppress the aPL titer with markedly decreased inflammatory changes and no evidence of vasculitis in the spiral arteries of the placental bed was found. This was associated with a normal pregnancy outcome. A causal relationship between aPL and inflammatory vascular changes in the placental bed as well as a beneficial effect of the corticosteroid treatment in those two women in suggested.

Adult↗
PubMed1990

Increased amounts of C4-containing immune complexes and inefficient activation of C3 and the terminal complement pathway in a patient with homozygous C2 deficiency and systemic lupus erythematosus.

Plasma and serum samples from a patient with homozygous C2 deficiency and severe systemic lupus erythematosus who responded with full clinical remission after plasma infusions were examined for immune complexes (IC), C3 activation products, and the terminal complement complex (TCC). Plasma contained large amounts of C4-containing IC but no C3-containing IC or complement activation products. Classical pathway activation in vitro did not lead to C3 activation or TCC formation as seen in normal serum, but a very efficient binding of C1q and C4 was found. No disturbances in alternative pathway activation were observed. The results indicate an impaired formation of C3-containing IC and an inefficient clearance of C4-containing IC, supporting the idea of a causal relationship between the dysfunctional classical pathway, pathophysiology, and clinical manifestations in this patient.

Antigen-Antibody Complex↗
PubMed1990

Cyclosporin A in psoriatic arthritis: an open study.

Eight patients with psoriatic arthritis entered an open study to determine the efficacy of oral cyclosporin A for their treatment. The starting dose was 3.5 mg/kg daily. Findings after the first six months are reported. One patient withdrew from the study after five months because of tremors, general malaise, and lack of improvement. Seven patients continued through the study, and marked improvement was found after two months in all clinical indices. The skin lesions improved in a parallel fashion. The cyclosporin A dose had to be reduced temporarily by 25% in three patients because of an increase in serum creatinine of more than 50%. A rise in diastolic blood pressure in three patients responded to treatment. The study suggests that cyclosporin A effectively treats arthritic manifestations of psoriasis as well as psoriatic skin lesions.

Adult↗
PubMed1990

Systemic lupus erythematosus in Iceland 1975 through 1984. A nationwide epidemiological study in an unselected population.

In a nationwide study the 1982 revised ARA criteria were applied for the classification of systemic lupus erythematosus (SLE). This unselected group of patients included all cases diagnosed and managed in hospitals, as well as outside hospitals in Iceland over the 10-year period from 1975 to 1984. Seventy-six new cases were found, with an incidence of 5.9 and 0.8/100,000 for females and males at risk, respectively. The mean age at diagnosis was 46.6 years. Twenty-five percent of the patients would have been missed had the study included hospital patients only. A clinical pattern different from previous studies was found as illustrated by a low incidence of kidney disease; nephritis was found in 20% of patients. Comparison with a former study on SLE in Iceland shows an actual increase in incidence over a period of 10 years. The 5 year survival was 84% and the 10 year survival 78%.

Adolescent↗
PubMed1989

Methotrexate treatment of rheumatoid arthritis: effects on radiological progression.

Radiological progression was evaluated in 15 patients with rheumatoid arthritis (RA) treated with methotrexate (MTX). Prior to MTX treatment, all the patients had failed on other slow-acting agents and all showed radiological deterioration. For each patient, three sets of radiographs of hands and wrists were evaluated: prior to MTX treatment while on other slow-acting agents, at the beginning of MTX treatment, and at the most recent evaluation on MTX. Two experienced radiologists evaluated the radiographs independently. The rate of radiological progression was calculated by dividing the change in radiological score by the number of months between sets of radiographs. The mean time from film set one to two (period one) was 29.4 months and from set two to three (period two) 32.5 months. The mean rate of radiological progression for period one was 0.576 and for period two, 0.381. Eight patients showed decline in radiological progression during MTX treatment.

Aged↗
PubMed1989

Successful plasma infusion treatment of a patient with C2 deficiency and systemic lupus erythematosus: clinical experience over forty-five months.

We describe a patient with C2 deficiency and severe systemic lupus erythematosus (SLE) that did not respond to conventional therapy. Over a period of 45 months, she was given 22 cycles of plasma therapy. For 6-8 weeks after each plasma infusion, there was a full clinical remission of the SLE, and a brief restoration of hemolytic complement activity. However, there were more prolonged increases in the activities of the complement components that are believed to be more directly involved in the clearance of immune complexes. Because of the theoretical risk that the infused complement might enhance inflammatory tissue damage, there has been some reluctance to try plasma replacement therapy in SLE patients with complement deficiency. We have not observed any adverse effects with the long-term use of this treatment, and our experience indicates that this therapeutic approach can be beneficial.

Adult↗
PubMed1983

Selective complete Clq deficiency associated with systemic lupus erythematosus.

We report a case of systemic lupus erythematosus (SLE) and recurrent infections associated with isolated Clq deficiency. A 17-year-old girl from Saudi Arabia was hospitalized with seizures, fever, arthralgia, hair loss, oral ulceration and skin rash. Clinical and laboratory findings fulfilled the ARA preliminary criteria for the classification of SLE. Nonlesional skin contained immunoglobulins and C3 at the dermal-epidermal junction. She did not have antibodies to DNA or low C3 or C4. Total serum hemolytic complement activity was absent due to a total selective absence of Clq. There was no circulating inhibitor of Clq activity. The published experience of isolated selective complete Clq deficiency associated with clinical disease is reviewed.

Adolescent↗
PubMedDate not supplied

Genetic aspects of rheumatic diseases.

In this review on the genetic aspects of rheumatic diseases, the approach was taken (i) to discuss, in general, important principles in the identification of susceptibility genes and (ii) to focus on five autoimmune rheumatic diseases that have the characteristics of complex diseases and in which important advances have been made in the identification of the genetic component. A decade ago, most reviews on the genetics of rheumatic diseases focused almost exclusively on a discussion of the human leukocyte antigen (HLA) but in this fast-moving field it is now apparent that genes outside the HLA also contribute to susceptibility. Current hypotheses concerning the pathogenesis of autoimmunity have led to the inclusion of hundreds of genes as potential candidates. Almost any molecule involved in immune recognition, cell interaction, intracellular signalling, cytokine pathways or programmed cell death can be reasonably proposed. The identification of the genes involved in complex diseases will contribute to an understanding of disease mechanisms and disease biology. The disease pathways by which the genes exert their effects or functions could lead to the discovery of new therapeutic targets that may be modulated. An increased understanding of the interactions between genes and environment might also be attained.

Autoimmunity↗
PubMedDate not supplied

Low dose methotrexate in rheumatoid arthritis.

A systematic analysis of the efficacy of methotrexate (MTX) in severe rheumatoid arthritis (RA) was carried out. Twenty-one patients with severe classical RA resistant to conventional therapy were treated with 7.5 to 25 mg of oral or intramuscular MTX for 3-114 weeks (mean of 38 weeks). Eleven patients (52.4%) showed definite clinical improvement and a fall in sedimentation rate; some improvement was seen in 5 other patients (23.8%). Two patients were unresponsive. Three patients discontinued MTX, 1 because of acute hepatitis and the other 2 because of noncompliance and fear of toxicity. Abnormal liver function tests reversible with modification of therapy occurred frequently. Other side effects were minor. The results of this uncontrolled study indicate that MTX may be an effective drug for the treatment of severe RA. Double blind trials and longterm followup are needed prior to its widespread use in RA.

Adult↗