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Biomedical subjects

P Auer-Grumbach

Publications and source records attributed to P Auer-Grumbach.

18 recordsLinked to original sources
PubMed1999

Anti-cardiolipin antibodies in patients with inflammatory bowel disease.

Elevated levels of anti-cardiolipin antibodies are associated with an increased risk for venous and arterial thrombosis. In patients with inflammatory bowel disease thrombosis is a well known complication. We determined the prevalence of elevated anti-cardiolipin antibodies in 136 patients with inflammatory bowel disease compared with 136 healthy controls and analyzed thromboembolic complications in patients with increased anti-cardiolipin antibody levels. Anti-cardiolipin antibody titers were significantly elevated in patients with Crohn's disease (5.7 units/ml) and ulcerative colitis (5.3 units/ml) compared to the control group (2.5 units/ml). We found no correlation between disease activity and anti-cardiolipin antibody levels. Seven patients had deep venous thrombosis in their history, in three of them this was complicated by pulmonary embolism. In only two of the seven patients with deep venous thrombosis were anti-cardiolipin antibody levels increased. In conclusion, anti-cardiolipin antibody titers were significantly increased in patients with inflammatory bowel disease. Elevated anti-cardiolipin antibody levels appear to play no role in the pathogenesis of thromboembolic events in patients with inflammatory bowel disease.

Adult↗
PubMed1997

Detection of antichlamydial antibodies in tears: a diagnostic aid?

OBJECTIVES: The antibody response in sera and tears of 167 patients with suspected chlamydial conjunctivitis was compared with the antibody response in sera and tears of 45 patients with symptoms of urogenital chlamydial infection to discover whether and which type of antichlamydial antibody detected in tears may be of diagnostic help in chlamydial conjunctivitis. METHODS: Diagnosis was based on chlamydial antigen detection from the conjunctiva and urogenital tract, done by a direct immunofluorescence assay, McCoy cell culture, and polymerase chain reaction. Additionally, antichlamydial immunoglobulin A (IgA) and immunoglobulin G (IgG) were determined in sera and tears of all patients by an immunoperoxidase assay. RESULTS: Two hundred twelve patients were examined--167 with conjunctivitis, 45 with symptoms of urogenital chlamydial infection. Cell culture, direct immunofluorescence assay, and polymerase chain reaction brought identical results. Conjunctival specimens taken from 33 (20%) of the patients with conjunctivitis were Chlamydia antigen positive; specimens taken from 134 (80%) were negative. Antichlamydial antibodies were found in tears of 29 (88%) of the patients with conjunctivitis whose specimens were Chlamydia antigen positive. Fifty-four (40%) of the patients with conjunctivitis whose specimens were Chlamydia antigen negative had antichlamydial antibodies in their tears. Twenty-five patients with urethritis (56%) were Chlamydia antigen positive in urethral swabs; 20 (44%) were negative. Antichlamydial antibodies were found in the tears of eight (32%) of the Chlamydia antigen-positive and two (10%) of the Chlamydia antigen-negative patients with urethritis. In contrast to patients with conjunctivitis, findings for patients with urethritis always were negative for antichlamydial IgG in the tears. CONCLUSION: Antichlamydial antibodies in tears were seen significantly more often in patients with conjunctivitis than in those with urethritis (P < or = 0.05). Antichlamydial IgG was found only in tears of patients with conjunctivitis. Therefore, the authors conclude that the detection of antichlamydial IgG in the tears might be helpful for diagnosis in patients with suspected chlamydial conjunctivitis who have antigen-negative conjunctival swabs.

Adolescent↗
PubMed1997

Markers in cutaneous lupus erythematosus indicating systemic involvement. A multicenter study on 296 patients.

Lupus erythematosus (LE) is an autoimmune disorder, involving the skin and/or other internal organs. As cutaneous variants, chronic discoid LE (CDLE) and subacute cutaneous LE (SCLE) usually have a better prognosis, however, involvement of internal organs with transition into systemic disease may occur. The aim of this study was to assess the significance of some clinical and laboratory criteria that could serve as markers for early recognition of systemic involvement in cutaneous LE. Three hundred and seventy-nine patients with LE, seen in five cooperating Departments of Dermatology during the years 1989-1994, were documented by electronic data processing according to a common protocol. Two hundred and forty-five of these patients had cutaneous LE (CDLE or SCLE), and 51 had systemic LE (SLE) and were included in this study. Forty-nine patients with either CDLE/SCLE or SLE were not evaluated because of incomplete documentation; also, 34 patients suffered from other LE subsets and were likewise excluded from the evaluation. Multivariate statistical analysis was used to assess the value of seven selected variables for distinguishing between the CDLE/SCLE and SLE groups: ESR, titers of antinuclear antibodies, anti-dsDNA-antibodies, photosensitivity, presence of arthralgias, recurrent headaches and signs of nephropathy. Univariate and multivariate analysis of the obtained data showed that signs of nephropathy (proteinuria, hematuria) was the variable with the highest statistical relevance for distinguishing between patients with cutaneous (CDLE/SCLE) and with systemic LE (SLE) in all statistical models tested, followed by the presence of arthralgias and of high ANA titers (> or =1:320). In contrast, low ANA titers as well as anti-dsDNA antibodies showed little or no statistical relevance as a criterion for distinction. It seems, therefore, that cutaneous LE patients showing signs of nephropathy, presence of arthralgias and elevated ANA titers (> or =1:320) should be carefully monitored, because they may be at risk of developing systemic LE involvement.

Adolescent↗
PubMed1997

[Prevalence and risk factors in the population of Graz (Austrian Stroke Prevention Study)].

The Austrian Stroke Prevention Study recruited 1960 randomly selected subjects aged 50 to 75 years during a 3-year period of enrollment. The response rate of the study was 32.4%. A telephone interview with 200 randomly selected non-responders yielded no differences to responders regarding the frequency of major vascular risk factors known to the subjects. Besides demographics, the study assessed arterial hypertension, diabetes mellitus, cardiac disease, smoking, a complete lipid status including the apolipoprotein-E genotype, serum fibrinogen and anticardiolipin antibodies as well as various natural antioxidants such as vitamins A, C, E and beta-carotene. Arterial hypertension, diabetes mellitus, cardiac disease and hypercholesterolemia > 200 mg/dl were strikingly common and occurred in 38%, 7.6%, 32% and 76%, respectively. Suboptimal plasma concentrations of vitamin A, E, and beta-carotene were noted in 77.2%, 56.1% and in 53.2% of study participants. The rate of treatment of major risk factors known to the subjects prior to study entry were 60.3% and 70% for arterial hypertension and diabetes mellitus, but only 37.1% and 6.3% for cardiac disease and hypercholesterolemia > 250 mg/dl. Diet was commonly used to treat diabetes but was almost neglected in the treatment of other vascular risk factors. These data provide an orientation on the prevalence of risk factors and the use of primary preventive measures for stroke treatment in our community.

Adult↗
PubMed1996

Evaluation of two nonculture antigen tests and three serotests for detection of anti-chlamydial antibodies in the diagnosis of ocular chlamydial infections.

BACKGROUND: Diagnosis of chlamydial conjuctivitis is difficult in chronic diseases because chlamydial elementary bodies are mostly undetectable in conjunctival scrapings by cell culture. We therefore compared two nonculture antigen tests and three different serotests for anti-chlamydial antibodies with McCoy cell culture, the "gold standard" of chlamydial diagnosis. Conjunctival scrapings and serum samples of 93 patients attending the outpatient eye clinic in Graz because of chronic follicular conjunctivitis were tested. METHODS: A total of 558 conjunctival scrapings and 93 serum samples were investigated. Chlamydial antigen detection was done by McCoy cell culture, polymerase chain reaction (PCR; Amplicor, Roche), and direct immunofluorescence assay (DFA; Microtrak, Syva). Antichlamydial IgA and IgG antibodies in the sera were detected by an immunoperoxidase assay (IPAzyme, Savyon) and two different enzyme-linked immunosorbent assays (SeroELISA, Savyon and rELISA, medac). RESULTS: Cell culture and PCR yielded identical results. The positivity rate for chlamydial conjunctivitis was 8.6% (8 of 93 patients). PCR proved most sensitive and most specific. IPAzyme was 75% sensitive for IgA and 100% for IgG; SeroELISA and rELISA were less sensitive. IPAzyme was 81% specific for IgA and 47.3% for IgG. SeroELISA and rELISA were less specific for IgA, but more specific for IgG. Post-test likelihood of disease was greatest in IPAzyme. CONCLUSIONS: PCR proved to be a good alternative to cell culture; DFA is useful for quick diagnosis. Genus-specific serotests cannot compete with chlamydial antigen detection. They differ in sensitivity and specificity because of the antigen type they present. They are still of only supportive value in cases where chlamydial antigen detection is not possible. Recently introduced species-specific antibody tests should be of greater value.

Adolescent↗
PubMed1995

[Cutaneous calciphylaxis in chronic renal failure].

A case of a 53-year-old chronically uraemic female patient who suddenly developed widespread cutaneous necrosis on both thighs is presented. On the basis of the typical histopathological features a diagnosis of calciphylaxis was made and supported by elevated serum parathyroid hormone levels. Calciphylaxis is a rare and serious disease, mostly seen in uraemic patients subjected to chronic haemodialysis. Typical features are calcifying panniculitis and thrombosis of small to medium-sized blood vessels followed by necrosis of the skin. The poor prognosis is due to systemic calcifications of visceral organs. When acute cutaneous necrosis of the skin is encountered in patients with chronic uraemia calciphylaxis should always be considered as a possible cause in the differential diagnosis. Determination of the serum parathyroid hormone level is recommended.

Biopsy↗
PubMed1995

Pustulosis acuta generalisata is a post-streptococcal disease and is distinct from acute generalized exanthematous pustulosis.

Generalized pustular eruptions with fever present a diagnostic and therapeutic problem. Based on a case of pustulosis acuta generalisata and a review of the literature, this entity can be regarded as an exclusively post-streptococcal disorder with an elevated antistreptolysin titre. It has a distinct clinical presentation of isolated pustules on normal skin, predominantly in an acral location. We propose criteria for the clear separation of this disease from acute generalized exanthematous pustulosis and from pustular psoriasis.

Acute Disease↗
PubMed1995

Anticardiolipin antibodies in normal subjects. Neuropsychological correlates and MRI findings.

BACKGROUND AND PURPOSE: Our aim was to assess the association of elevated anticardiolipin antibody (aCL) titers with silent brain damage and cognitive functioning in middle-aged and elderly normal subjects. METHODS: We determined the IgM and IgG aCL titers from 233 randomly selected clinically normal participants of a population-based stroke prevention study (age range, 44 to 82 years). aCL titers were categorized into negative (0 to 10 U/L), low positive (10 to 20 U/L), and moderately high positive (> 20 U/L). All participants underwent 1.5-T MRI and demanding neuropsychological testing. Semiautomated measurements of the total white matter hyperintensity area and the size of ventricles and cortical sulci were conducted. RESULTS: There were 180 subjects (77.3%) with negative, 35 (15.0%) with low positive, and 18 (7.7%) with moderately high positive aCL titers. The frequency and extent of focal and diffuse brain abnormalities were not related to the aCL status of those examined. However, subjects with positive aCL results performed worse than those with negative findings on almost all tests administered, and this effect was mainly IgG titer related. When an ANCOVA test and partial correlations to correct for slight group differences in age and for the presence of major vascular risk factors were used, values of P < .05 were noted on tests assessing mnemonic and visuopractical abilities. CONCLUSION: Increased aCL titers in normal elderly persons may be associated with subtle neuropsychological dysfunction, but they do not appear to cause any morphological changes as demonstrated by MRI.

Adult↗
PubMed1994

[Pacemaker erythema with telangiectasis ].

Pacemaker erythema is a rare, irreversible side effect of cardiac pacemakers, clinically characterized by epifocal teleangiectatic erythema. Histology reveals teleangiectatic vessels in the superficial dermis and a slight perivascular infiltrate. We report on three patients presenting with pacemaker erythema following either pacemaker or defibrillator implantation. The pathogenesis of this histopathologically uncharacteristic lesion is unknown. In contrast to peri- or postoperative pacemaker infections, physical irritation can be considered a possible triggering mechanism. Allergic reactions to the implanted material have been ruled out by negative patch test results.

Aged↗
PubMed1994

Anticardiolipin antibodies in rheumatoid arthritis: their relation to rheumatoid nodules and cutaneous vascular manifestations.

One hundred and seventy-three consecutive patients with rheumatoid arthritis were examined for the presence of anticardiolipin antibodies (ACA), and for the clinical relevance and the relation of these antibodies to skin manifestations. Abnormally elevated IgG- and/or IgM-ACA levels were detected by an enzyme-linked immunosorbent assay in the sera of 55 (32%) patients. There was no statistical evidence of an association between ACA and a history of thrombosis in these patients. However, ACA were statistically significantly linked to the presence of rheumatoid nodules, which were found in 36 (21%) patients. In three patients, ACA were associated with vascular manifestations, including livedo reticularis, thrombophlebitis, and leucocytoclastic vasculitis. Our findings suggest that, although a subset of ACA may be linked to cutaneous vascular conditions, the major fraction of ACA in rheumatoid arthritis may have a different specificity than in other diseases, in which ACA are often linked to thrombotic events.

Adult↗
PubMed1994

Uncomplicated pregnancy and birth of a healthy child by a woman with systemic lupus erythematosus and anti-U1RNP, anti-PCNA/cyclin, anti-dsDNA and anti-phospholipid autoantibodies.

We report the course of a pregnancy of a 21-year-old primipara and primigravida with systemic lupus erythematosus (SLE) and anti-U1RNP, anti-PCNA/cyclin, anti-dsDNA and anti-phospholipid autoantibodies. The pregnancy was normal and a healthy child was born at term. The risks associated with the HLA phenotype of the mother and with these autoantibodies were previously unknown. We present a model for risk assessment in patients with rare laboratory features of SLE.

Adult↗
PubMed1993

Autoantibodies to nuclear mitotic apparatus in a patient with vitiligo and autoimmune thyroiditis.

Circulating autoantibodies against the nuclear mitotic apparatus (NuMA) protein have been detected in sera of patients with a variety of connective tissue diseases. A close relation of anti-NuMA antibodies to define subsets of these diseases could not be established. This is the first description of a patient with vitiligo, autoimmune thyroiditis and a high titer of antibodies against NuMA on Hep-2 cells. The possibility of a beginning of multiple autoimmune syndrome cannot be excluded.

Adult↗
PubMed1992

Increased IgM-anticardiolipin antibodies in patients with restenosis after percutaneous transluminal coronary angioplasty.

Increased anticardiolipin antibodies (acL) are often associated with arterial thrombosis in patients with autoimmune diseases. A mural thrombus at the site of percutaneous transluminal coronary angioplasty (PTCA) has been suggested as the initial cause for restenosis after primarily successful PTCA. In this study, IgM- and IgG-acL were determined in 65 men with coronary artery disease treated by PTCA; patients with infectious and autoimmune diseases were excluded from the study. Follow-up coronary angiography was performed 12 months after PTCA; restenosis was defined as greater than or equal to 50% reduction in diameter of the coronary vessel. The series comprised 2 groups: 34 patients (mean age 56 +/- 8 years) with (group A) and 31 (mean age 55 +/- 9 years) without (group B) restenosis. Medical history and laboratory findings were comparable in both groups. In patients with restenosis, IgM-acL were more often increased (9 of 34) than were those in patients without restenosis (2 of 31; p less than 0.05); IgG-acL values did not differ in both groups. Furthermore, there was no correlation between any vascular risk factors or laboratory findings, or both, with both IgM- and IgG-acL levels. Thus, IgM-acL appear to be independent indicators for an increased risk for restenosis after PTCA. Our observations suggest that an autoimmune mechanism may have a role in restenosis.

Adult↗
PubMedDate not supplied

Rapid detection of Chlamydia trachomatis in conjunctival, pharyngeal, and urethral specimens with a new polymerase chain reaction assay.

GOAL OF THIS STUDY: The Amplicor polymerase chain reaction (PCR) assay for the detection of Chlamydia trachomatis (Roche Molecular Systems, Branchburg, NJ) was evaluated on conjunctival, pharyngeal, and urethral swabs. STUDY DESIGN: A total of 515 conjunctival, pharyngeal, and urethral swabs. The reference system was culture with McCoy cells in shell vials with fluorescent immunostaining. One swab was used for both cell culture and the molecular assay. Initial storage took place in 2-SP medium. After transfer to Amplicor specimen transport medium the molecular assay was done using the Amplicor Chlamydia trachomatis amplification and detection kits. RESULTS: The total positive rate was 6.6%. Specificity of culture was 100%. The evaluated molecular assay gave a specificity of 99.8%. Sensitivities of PCR and culture were 100% and 85.3%, respectively. CONCLUSIONS: Because of the high sensitivity, specificity, and ease of use, the molecular assay was found to be a good alternative to culture for detection of C. trachomatis in conjunctival, pharyngeal, and urethral specimens.

Adolescent↗