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M Karmochkine

Publications and source records attributed to M Karmochkine.

At least 19 recordsLinked to original sources
PubMed1995

[Antiphospholipid antibodies: cause of thrombosis or an epiphenomenon?].

Antiphospholipid antibodies (aPL) present in systemic lupus erythematosus and the primary antiphospholipid syndrome are a well-known risk factor for thrombosis. Most of them require the presence of a cofactor, beta 2-glycoprotein I for anticardiolipin antibodies, prothrombin for lupus anticoagulant. These aPL are of the "immune" type. APL are also found in various non-immunological conditions, in which repeated endothelial or membranous damages appear to be frequent, but thromboses are rare. Most of these aPL are cofactor-independent, except those induced by chlorpromazine, and might belong to "natural" antibodies.

Animals↗
PubMed1995

[Apoptosis].

Explore the source record for details and available documents.

Apoptosis↗
PubMed1994

[Antiphospholipid syndrome. 20 cases].

OBJECTIVES: We analyzed the clinical and biological characteristics as well as the clinical course and outcome observed in 20 patients with antiphospholipid antibodies and clinical signs including thrombosis or repeated spontaneous abortion to better identify the recently described antiphospholipid syndrome. METHODS: We retrospectively studied all patients observed in our unit from 1981 to 1992 who fulfilled the following inclusion criteria: a) at least one episode of arterial or venous thrombosis and/or repeated spontaneous abortions, b) positive for antiphospholipid antibodies. RESULTS: Twenty patients were included, 3 with systemic lupus erythematosus (according to the American Rheumatism Association criteria). Arterial or venous thrombosis occurred in 9 and 16 respectively, including exceptional cases of cerebral phlebitis and thrombosis of dermal capillaries. High blood pressure was recorded in 8. Only 1 or 2 types of antiphospholipid antibodies were found in most patients. Anticardiolipin, a circulating anticoagulant and a false-positive Bordet-Wassermann reaction were found together in only 3 out of 16. In addition, the antibody level varied independently from the thrombotic events. There was no case with a clinical course from primary antiphospholipid syndrome to systemic erythromatosus lupus. The effect to treatment on occurrence of new thrombotic events was studied. Three patients suffered one or more haemorrhagic events during antivitamin K treatment. CONCLUSION: It is difficult to establish a differentiation between primary antiphospholipid syndrome, systemic lupus erythematosus and lupus-like syndromes, and precise methods of identifying antiphospholipid antibodies should be further developed.

4-Hydroxycoumarins↗
PubMed1994

[Antiphospholipid syndrome and the pneumologist].

The antiphospholipid syndrome (APS) is usually defined by the association of a clinical manifestation (venous or arterial thrombosis or miscarriage) with the presence of antiphospholipid antibodies (lupus anticoagulant and/or anticardiolipin antibodies). It frequently occurs in the course of systemic lupus erythematosus but is also encountered as a "primary" disease. APS is responsible for diverse respiratory manifestations. Pulmonary embolism is common. The site of the causal venous thrombosis is frequently unusual. Pulmonary hypertension may be a consequence of repeated embolism or may belong to the primary idiopathic variety. Pulmonary manifestations may also result from left-sided heart failure due to mitral or aortic valve abnormalities, myocardial infarction or a specific myocardiopathy. APS is probably involved in the occurrence of some cases of adult respiratory distress syndrome. Long term secondary prevention of recurrent thrombosis is a central point in the management of APS.

Adult↗
PubMed1994

Long-term plasma exchange. Analysis of indications, outcome and side effects.

In order to determine the characteristics and the course of diseases treated with long-term plasmapheresis (e.g., more than 25 plasma exchanges), we retrospectively studied 850 patients who underwent plasmapheresis. Long-term plasma exchange was prescribed to 38 patients who failed to respond to conventional therapy; cryoglobulinemias, peripheral neuropathies and monoclonal gammopathies were their most frequent underlying diseases. Improvement was noted in 65.8% cases. Only minor side effects were observed and the risk/benefit ratio for such therapy was excellent.

Adult↗
PubMed1993

Antiphosphatidylethanolamine antibodies in systemic lupus erythematosus.

Antiphosphatidylethanolamine antibodies (aPEA) were investigated in a population of 78 systemic lupus erythematosus (SLE) patients, by means of an enzyme-linked immunosorbent assay method. These antibodies are specifically directed against phosphatidylethanolamine, one of the zwitterionic phospholipids present in cell membranes. Antiphosphatidylethanolamine antibodies were found in 13 patients (16.6%). They were generally associated with lupus anticoagulant (two patients), antiphospholipid antibodies directed against anionic phospholipids (six patients), or both (four patients). In only one case, aPEA were the sole detectable antiphospholipid antibodies. Thrombosis, recurrent fetal loss, valvular disease or neurological involvement was present in most (11 of 13) of the patients with aPEA. It seems valuable to carry on further searches for these antibodies in SLE, since patients with aPEA are at higher risk of thrombosis and/or recurrent fetal losses than are patients with antiphospholipid antibodies (anticardiolipin, anti-anionic phospholipid and/or lupus anticoagulant) other than aPEA. Moreover, since aPEA can be the sole detectable antiphospholipid antibodies, they should be investigated in SLE with thrombosis when neither lupus anticoagulant nor anticardiolipin antibodies can be demonstrated.

Adolescent↗
PubMed1993

Plasma reactivity to hexagonal II phase phosphatidylethanolamine is more frequently associated with lupus anticoagulant than with antiphosphatidylethanolamine antibodies.

In membranes, phosphatidylethanolamine (PE) is usually in a lamellar phase, but it can also adopt a hexagonal II phase (HexII PE), which has been demonstrated to be immunogenic in mice and has recently been used in a new clotting assay to detect lupus anticoagulant (LA). A population of 58 patients susceptible of having LA or antiphospholipid antibodies (aPLA), was screened for reactivity to HexII PE using the new clotting assay and for the presence of anti-PE antibodies (aPEA) using ELISA. The patients could be classified as follows: 26 systemic lupus erythematosus, 14 primary antiphospholipid syndromes and 18 miscellaneous non autoimmune disorders. HexII PE reactivity was detected in 22 patients. It was significantly more often associated with LA-positivity (20/29) than with LA-negativity (2/29), (p < 0.0001). However, 9 patients with LA had negative HexII PE assays. Anti-PE antibodies were detected by ELISA in only 12% of the cases. No correlation was observed between the distribution of aPEA and that of HexII PE reactivity. Interestingly, 2 LA- and aPLA-negative patients exhibited HexII PE reactivity. The absence of identity between the distribution of HexII PE reactivity and that of either LA or aPEA indicates that this new assay has its own specificity. It might detect antibodies to the immunogenic hexagonal PE and may therefore have a broader scope than that proposed initially. Although in the studied populations, no significant relationship could be found between HexII PE positivity and clinical complications (thrombosis and/or recurrent fetal losses), it might be associated with other complications of the antiphospholipid syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Recovery from staphylococcal septicaemia in neutropenic patients without removal of the previously inserted central venous catheter.

OBJECTIVES: An open clinical study was conducted in the haematological department of an intensive care unit to investigate cure of staphylococcal septicaemia in neutropenic central venous catheter carriers without removal of the line. METHODS: Thirteen neutropenic patients with a central venous catheter were investigated. These patients were under treatment for haematological malignancies and had at least 2 blood cultures positive for Staphylococcus aureus or coagulase-negative staphylococcus. Antibiotherapy including vancomycin was given through the catheter. Each case was re-evaluated on day 3 of treatment. The catheter was removed if blood cultures remained positive or if clinical signs of bloodstream infection persisted or worsened. RESULTS: Clinical recovery was obtained in ten patients and bacterial eradication in twelve. Three patients died from septic shock: two deaths were not related to staphylococcal septicaemia; one death was due to a staphylococcal septic shock which occurred within a few hours of admission, despite of prompt removal of the central venous catheter. CONCLUSIONS: With appropriate antibiotherapy, leaving the central venous catheter in place would appear possible in cases of staphylococcal septicaemia. Response to treatment, however, must be carefully monitored.

Adult↗