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Biomedical subjects

M F Kahn

Publications and source records attributed to M F Kahn.

At least 217 records · Page 12Linked to original sources
PubMed1987

Antiphospholipid antibodies: a disease marker in 25 patients with antinuclear antibody negative systemic lupus erythematosus (SLE). Comparison with a group of 91 patients with antinuclear antibody positive SLE.

Twenty-five antinuclear antibody (ANA) negative patients with systemic lupus erythematosus (SLE) or lupus-like disease were compared to 91 ANA positive patients with SLE for clinical and biological symptoms. Cutaneous symptoms were infrequent in ANA negative patients (p less than 0.03). Thrombocytopenia (p less than 0.001), venous or arterial thrombosis (p less than 0.02) as well as cerebral infarction (p less than 0.001) were more frequent. Three types of antiphospholipid antibodies were determined by different methods; the VDRL, the lupus anticoagulant and an ELISA for IgG anticardiolipin antibody (aCL). The frequency of a positive VDRL test was significantly higher in the ANA negative group (p less than 0.05). Correlation studies suggest that the 3 methods are not redundant and detect overlapping but not identical antibodies. Of the 3 antiphospholipid antibody assays, only the IgG aCL test was significantly associated with thrombosis in the ANA negative group (p less than 0.02).

Adolescent↗
PubMed1987

Anti-mitochondrial type 5 antibodies and anti-cardiolipin antibodies in systemic lupus erythematosus and auto-immune diseases.

Twenty sera from patients with systemic lupus erythematosus (SLE) and high titre of IgG anti-cardiolipin antibodies (ACA) were studied in order to evaluate the prevalence of anti-mitochondrial type 5 antibodies (AMA 5). None of these sera were found to be AMA 5 positive but five of 18 were positive for VDRL. Twenty sera from patients with AMA 5 were studied in order to evaluate the prevalence of ACA: only six of 20 were positive for ACA. In contrast to this finding, 15 of the 20 sera positive for AMA 5 were also positive for VDRL (P less than 0.001). The six sera positive for ACA and AMA 5 were absorbed with cardiolipin micelles. This absorption eliminated the ACA activity but not the AMA 5 activity. Despite the clinical similarities between the two groups of patients with AMA 5 or ACA, these data suggest that patients with AMA 5 and patients with ACA belong to two different subsets of SLE or SLE-like syndromes and that AMA 5 antigen is different from cardiolipin.

Autoantibodies↗
PubMed1987

[Acrosclerosis, Gougerot-Sjögren syndrome, myxedema and anti-centromere antibodies. 3 cases of this association].

The authors report three identical cases of the association of acrosclerosis with telangiectasis without calcinosis, Sjögren-Gougerot syndrome, myxoedema with antithyroid antibodies and anti-centromere antibodies. The association of these conditions one with another has already been published, but, to the authors' best knowledge, this is the first report of all of them grouped together in the same patients. With reference to the literature, the authors discuss the problems of individualization of the CRST syndrome and its varieties and the clinical significance of the presence of anti-centromere antibodies.

Aged↗
PubMed1987

[Antiphospholipid antibodies in a series of 25 cases of lupus without antinuclear antibodies. Comparison with a series of 91 lupus patients with antinuclear antibodies].

Twenty-five patients with at least 3 of 1982 ARA criteria of SLE but without the ANA, were compared with 91 patients with 4 or more of the ARA criteria of lupus with positive ANA. The ANA-negative group was characterised by the low incidence of skin involvement, serous effusions and alopecia, and a relatively high incidence of thrombocytopaenia and venous and arterial thrombosis. Three types of antiphospholipid antibodies were looked for: the VDRL, antiprothrombinase and anticardiolipin antibodies by an immuno-enzymatic method. The VDRL was the only antibody which was significantly commoner in the ANA-negative group. Statistical studies showed that the three methods of demonstrating antiphospholipid antibodies detected crossed but not identical specificities. In the ANA-positive group only the antiprothrombinase was associated with a high incidence of venous thrombosis and stroke. In the ANA-negative group, only the anticardiolipin antibodies were associated with a high incidence of arterial or venous thrombosis. Two subgroups may be identified in the group of ANA-negative lupus patients: firstly, those with high anticardiolipin antibody titres with a high incidence of thrombotic and haematological complications, and, secondly, patients with low anticardiolipin antibody levels with a high incidence of cutaneous involvement, serous effusions and Raynaud's phenomenon.

Adolescent↗
PubMed1987

[Papular mucinosis. Associated dermatologic and dysimmune aspects].

Papular mucinosis (PM) is an overload disease mostly made of proteoglycans, essentially cutaneous and accompanied with a monoclonal gammapathy. In addition to the cutaneous lesions, vascular and neurological manifestations may be responsible for severe complications. The gammapathy, most often benign, does not seem always correlated with the skin involvement. We report the case of a patient with mucinosis associated with a rheumatoid polyarthritis, then with a systemic necrotizing angiitis. A review of the literature has enabled us to notice the frequency with which PM is accompanied with dysimmune diseases, especially lupus.

Adolescent↗
PubMed1987

[Double valve replacement in a 30-year-old man with acute systemic lupus erythematosus].

A 30 year old man presenting with a 10 year history of delayed pressure urticaria had a secondary lupus-induced double mitral and aortic regurgitation which necessitated double valve replacement within 2 years. The anatomical appearances of the valvular lesions were very unusual and suggest a new anatomo-clinical form of the classical Libman-Sacks endocarditis. In addition to infective endocarditis, systemic lupus erythematosus may also lead to valvular lesions necessitating valve replacement. The association of S.L.E. and delayed urticaria is rare, and also merits publication.

Acute Disease↗
PubMed1987

[Sclerodermatomyositis. Apropos of 13 cases].

13 cases of sclero (dermato)myositis are reported with cutaneous signs specific of dermatomyositis in 6 cases. Scleroderma was rather benign, without any visceral involvement. In contrast, myositis was much more severe that usually encountered in systemic sclerosis, threatening the vital prognosis and requiring aggressive therapeutic measures to be controlled. In 6 cases, the axial musculature was involved. Occurrence of each component was not simultaneous. No case was paraneoplastic. Antinuclear antibodies were present in all cases. Antibodies against soluble nuclear antigens, specifically found by others in sclerodermatomyositis, were absent. The very peculiar clinical spectrum of this syndrome associated with immunologic abnormalities, elsewhere described, confirm the individualization of sclerodermatomyositis.

Adult↗
PubMed1986

[Idiopathic diffuse polyalgia syndrome].

The term "idiopathic diffuse polyalgia syndrome" is suggested to designate an entity well known to neurologists, rheumatologists and all physicians interested in pain. In this syndrome pain is diffuse but often predominates in a given region. Physical examination shows excessive tenderness in well-defined areas. Radiological and laboratory examinations are negative. Psychological factors are not always obvious. Several arguments are in favour of dysfunction of the pain control mechanisms. The effectiveness of the various treatments prescribed is related to the quality of the doctor-patient relation.

Humans↗
PubMed1986

Lumbar posterior marginal intra-osseous cartilaginous node.

This report concerns 12 patients, eight young adults and four adolescents, presenting with lumbar or sciatic pain. This was associated with an unusual defect of the inferior and posterior edges of the vertebral bodies of L4 or L5, together with a small bony ridge protruding into the spinal canal. We found 11 similar cases in the literature, all involving adolescents except for one young adult. It has been considered to be the result of a fracture of the posterior ring apophysis in association with a herniated disc. In our cases, in the absence of any known previous trauma, the radiological features and surgical results and the similarity and frequent association with typical lesions of Scheuermann disease, all suggest a posterior marginal cartilaginous node. The inferior lumbar location and frequent association with herniated disc and sciatic nerve root compression in young patients are discussed.

Adolescent↗
PubMed1986

Anti-C3b-receptor (CR1) antibodies in patients with systemic lupus erythematosus.

Using an enzyme-linked immunoadsorbent assay, IgG in the plasma and purified IgG from 2 patients with systemic lupus erythematosus (SLE) were found to strongly react with purified C3b receptor (CR1) insolubilized on microtiter plates. The amount of IgG that bound to CR1 in 201 plasma samples from 179 other patients with SLE did not significantly differ from that which bound in 72 control samples from normal individuals. Purified IgG from the patients with anti-CR1 reactivity did not inhibit CR1 function in vitro. The number of CR1 antigenic sites expressed on erythrocytes from both patients was much lower than that observed in a normal population and in the lowest range of the decreased numbers found in patients with SLE. The occurrence of anti-CR1 antibodies in patients with SLE could provide an acquired mechanism for decreased expression of CR1 through antigenic modulation of the receptor on precursor cells and/or alter the function of cells of the immune system bearing C3b receptors.

Animals↗
PubMed1986

[Aortic insufficiency in certain so-called systemic diseases].

The authors present a retrospective study of all the patient followed up for systemic disease in the rheumatology Department of Bichat hospital between 1975 and 1984 in whom aortic regurgitation developed. Only rare or previously undescribed associations were retained: two MacDuffie syndromes, one adult form of Still's disease, one Takayashu's disease, one association of rheumatoid arthritis and Takayashu's disease, one rheumatoid arthritis, one Cogan's syndrome and two cases of disseminated lupus erythematosis. The authors use these cases and a review of the literature to discuss the possible physiopathological mechanisms of the aortic regurgitation. This study confirms the value of regular clinical cardiovascular examination with echocardiography in cases with progressive symptoms. The evolution of the vascular disease seems to be more or less parallel to that of the systemic disease and in a significant number of cases it becomes sufficiently severe to become the main clinical problem. In our series, there was one sudden death, one death due to cardiogenic pulmonary oedema and three patients required aortic valve replacement.

Adult↗
PubMed1986

[Comparative profile of antinuclear antibodies in Gougerot-Sjögren syndrome with and without diffuse interstitial pulmonary fibrosis].

Eleven patients with an isolated Gougerot-Sjögren syndrome and a diffuse interstitial fibrosis were compared with twenty patients with an isolated Gougerot-Sjögen without pulmonary involvement. Patients with pulmonary fibrosis are younger and the evolution of their dry syndrome is shorter (p less than 0.05) than in patients without fibrosis. The frequency of extra-articular clinical manifestations (except for the lung) is identical in both groups. Antinuclear antibodies are present in 100 p. cent of patients with pulmonary fibrosis. Specific antibodies of soluble nuclear antigens are detected in 64 p. cent of them. This frequency is 55 p. cent in the group without pulmonary fibrosis. The specificities of these antibodies are anti-U1-RNP (3 cases), anti-SS-B (La) (3 cases), anti-SS-A (Ro) (2 cases), non identified (1 case). There was no serum containing antibodies Jo1 or anti-Sm. This immunological profile is identical to the profile found in isolated Gougerot-Sjögren syndromes without pulmonary fibrosis. The search for specific antibodies of soluble nuclear antigens permits to differentiate pulmonary fibrosis secondary to an isolated Gougerot-Sjögren syndrome, from primary diffuse interstitial fibrosis and fibrosis associated to a polymyositis.

Adult↗