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Biomedical subjects

L Moriconi

Publications and source records attributed to L Moriconi.

At least 37 records · Page 2Linked to original sources
PubMed1990

Unusual reaction to chlorambucil: a case report.

In this brief report we describe a case of cutaneous reaction during treatment of chronic lymphatic leukemia (CLL) with chlorambucil. The patient developed a confluent maculopapular erythema and large flaccid bullae of trunk, legs, feet and mucous membranes, with fever up to 38 degrees C. Toxic epidermal necrolisis (TEN) was supposed and the diagnosis was confirmed by a skin patch test followed by cutaneous biopsy. TEN by chlorambucil is a rare syndrome that may be considered in presence of cutaneous reaction to this drug.

Chlorambucil↗
PubMed1988

Protection of renal function and of nutritional status in uremic rats by means of a low-protein, low-phosphorus supplemented diet.

A low-protein, low-phosphorus diet supplemented with essential amino acids and keto analogues was given to 12 rats, starting from the 90th day after subtotal nephrectomy. The purpose was to assess its effect on the residual renal function and on the nutritional status in rats with already established severe renal failure. Ten control rats in the same conditions, following a standard diet supplying normal amounts of protein and phosphorus were also studied. The supplemented diet exerted a well-evident protection of residual renal function and structure: lower rate of decline of creatinine clearance, lower mortality, significant decrease of proteinuria and almost total absence of histological signs of activity. The nutritional status was also well protected by the dietary therapy: increase of body weight, normal values of total serum protein, and low-constant values of urea appearance. In the control rats body weight decreased, total serum protein was lower than normal and the values of urea appearance were increasing simultaneously with a decreasing food intake and body weight.

Animals↗
PubMed1986

Treatment of the renal involvement in mixed cryoglobulinemia with prolonged plasma exchange.

Nine patients with mixed cryoglobulinemia and severe membranoproliferative glomerulonephritis were treated with plasma exchange alone or in combination with medium to low amounts of corticosteroids, but never with cytotoxic drugs. In 5 patients renal function and/or proteinuria improved after plasma exchange, and no clinical relapse usually occurred when the procedures were reduced or discontinued. These procedures seemed of particular effect in the presence of histologically active and not irreversible lesions and rapid deterioration of renal function. While cryocrit almost invariably decreased, circulating immune complex or complement levels were unpredictably affected by plasma exchange. Cryocrit, but not immune complex or complement levels, was the serological parameter which most often closely correlated with signs of renal involvement (i.e., proteinuria and/or serum creatinine). Thus, plasma exchange might be a safe and useful tool in the treatment of an often drug-resistant and rapidly progressive renal involvement occurring in patients with mixed cryoglobulinemia.

Adult↗
PubMed1985

Hypotensive effect of plasma exchange in immune complex nephritis.

The effect of plasma exchange (PE) on blood pressure (BP) in 20 hypertensive patients (9 with mixed cryoglobulinemia, 7 with systemic lupus erythematosus, and 4 with idiopathic glomerulonephritis) was evaluated retrospectively. In each PE 1.5-2.5 L of plasma was replaced with an equal volume of 4% albumin polysaline solution. The frequency of PE was three times per week for the first 2 weeks and twice per week subsequently. Sixteen patients were on hypotensive treatment at the onset of PE. Their systolic/diastolic BP was 171 +/- 4.7/102 +/- 3.0 mm Hg (mean +/- 1 SEM). After 4 weeks, BP decreased to 141 +/- 2.8/89 +/- 2.3 mm Hg (p less than 0.001), although in 10 patients antihypertensive drug therapy had been reduced or discontinued. The most marked decrease of BP occurred after the first week (152 +/- 5.3/92 +/- 2.9 mm Hg), and this decrement correlated remarkably well with pressure levels before PE despite the great heterogeneity of the individual patients (for diastolic BP, r = 0.87, p less than 0.001; for systolic BP, r = 0.60, p less than 0.01). A mild decrease of serum creatinine was observed during PE, but its time course was different from that of BP, and did not correlate with this parameter.

Adolescent↗
PubMed1985

Acute effect of plasma exchange on arterial blood pressure and plasma renin activity.

Blood pressure (BP) decreases significantly in patients with immune complex nephritis and hypertension in the course of therapeutic plasma exchange (TPE). To investigate possible underlying mechanisms of this effect, the variations of supine and upright BP and plasma renin activity (PRA) acutely induced by PE (performed by isovolumetric replacement of plasma with 4% albumin in saline solution) were analyzed in six patients. On the average, both supine and upright BP decreased after TPE; however, statistical significance was obtained only for upright systolic BP. Supine and upright PRA did not change significantly, although a clearly blunted response to posture was observed in three patients. The changes of BP induced by TPE were apparently not due to a functional depression of the renin-angiotensin system, since the more marked decrements in BP were observed in the patients with lower basal PRA.

Adolescent↗
PubMed1985

Immune complex behaviour during prolonged plasma exchange in essential mixed cryoglobulinemia and systemic lupus erythematosus.

A number of immunological parameters were measured in 9 patients with essential mixed cryoglobulinemia and 12 patients with systemic lupus erythematosus undergoing plasma exchange alone or without cytotoxic drugs. Only cryocrit significantly decreased in the majority of patients with essential mixed cryoglobulinemia. In contrast, immune complex levels, measured in two different ways, did not change on the whole, although variable and unpredictable changes were often present in individual patients. Thus, these data do not support the view that the mechanism(s) of action of plasma exchange in these diseases is only due to the quantitative removal of circulating immune complexes, and qualitative changes in the immune complex moiety may also occur.

Adolescent↗
PubMed1983

Plasma exchange in the treatment of lupus nephritis.

Seven women with severe Systemic Lupus Erythematosus Nephritis were treated with Plasma Exchange, without any additional therapy with cytotoxic agents. All patients had failed to respond to high doses of corticosteroids and, in 3 cases, to 6-methylprednisolone pulses. In 4 patients the indication for plasma exchange treatment was a rapid deterioration of renal function, and in the others a need to better control symptoms without using toxic corticosteroid dosages. The total number of plasma exchange sessions ranged from 14 to 57 depending on the patient. After PE treatment, serum creatinine values significantly decreased in all 4 patients with rapidly developing, nephritis while in the others it remained unchanged. No major side effects were recorded and no relapse of renal disease occurred whenever Plasma Exchange treatment was gradually tapered or discontinued. These data suggest that prolonged Plasma Exchange treatment without the concomitant administration of cytotoxic agents may be effective in the treatment of steroid resistant severe lupus nephritis.

Adult↗
PubMed1983

Prolonged plasma exchange in the treatment of renal involvement in essential mixed cryoglobulinemia.

Four men and 2 women with Essential Mixed Cryoglobulinemia and a membrano-proliferative glomerulonephritis were treated with prolonged Plasma Exchange without the addition of cytotoxic agents. All patients had Nephrotic Syndrome and Renal Insufficiency. Three of them presented a rapid deterioration of renal function just prior to Plasma Exchange treatment. Total number of procedures varied for each patients from 24 to 105. Serum creatinine decreased significantly in those patients with rapid deterioration of renal function, while it was not modified in the 3 with stable chronic renal failure. In no instance major side effects were recorded, and relapses of the disease did not occur, after gradually tapering of Plasma Exchange sessions. These data suggest that Plasma Exchange alone, if early instituted, may be an effective and safe treatment of Essential Mixed Cryoglobulinemia Glomerulonephritis.

Complement System Proteins↗
PubMed1980

Serum levels of PTH, Mg, Ca, inorganic phosphate and alkaline phosphatases in uraemic patients on differentiated Mg dialysis.

The serum levels of PTH, Mg, Ca, inorganic phosphate (Pi) and alkaline phosphatases (AlkPase) were determined in 22 uraemic patients on chronic haemodialysis with different Mg levels in th dialysate, in an attempt to clarify the pathogenesis of uraemic osteodystrophy. Baseline levels of all the considered parameters were obtained over a four month period whilst on standard Mg concentration in the dialysis solution (1.5 mEq/L). Patients were then divided into three groups: 10 patients were dialysed for six months with 0.5mEq/L of Mg, seven patients with 1.5mEq/L and five patients with 2.5mEq/L in the dialysate. At the end of the six months with differentiated Mg dialysis, the three groups had significantly different Mg serum levels, whereas no significant changes were observed in the PTH and Ca serum levels. All the patients on high-Mg dialysis showed a significant reduction of the Pi serum levels, whereas a significant increase of AlkPase was observed in the low-Mg dialysis group. The overall results obtained in the present study indicate a possible beneficial effect of low-Mg dialysis on the progression of uraemic osteodystrophy of patients on maintenance haemodialysis.

Alkaline Phosphatase↗
PubMedDate not supplied

Plasma-exchange in mixed cryoglobulinemia. Effects on renal, liver and neurologic involvement.

Prolonged plasma-exchange without addition of cytotoxic agents was employed in 16 patients with mixed cryoglobulinemia and kidney, liver or neurologic involvement. Patients with rapidly progressive renal failure or active and reversible lesions generally improved after plasma-exchange, as well as those with a recently occurring sensory-motor peripheral neuropathy. In 4 out of 6 patients with mixed cryoglobulinemia and chronic active hepatitis, plasma-exchange was followed by either normalization or significant reduction of liver enzymes and bromosulfophthalein retention. In all cases responding to plasma-exchange the beneficial effects were evident after the first 2-3 weeks of treatment, while symptoms did not generally recur when the procedures were either slowly tapered or discontinued. Although the pathogenetic mechanism(s) of action of plasma-exchange remains largely unknown, preliminary data indicate that these procedures induce quantitative as well as qualitative changes in the immune system.

Adrenal Cortex Hormones↗