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Biomedical subjects

P Michielsen

Publications and source records attributed to P Michielsen.

At least 91 records · Page 5Linked to original sources
PubMed1985

Protein-losing enteropathy in systemic lupus erythematosus.

A 33-year-old woman presented a recurrent steroid-sensitive protein-losing enteropathy as the major manifestation of systemic lupus erythematosus. An increased capillary permeability for proteins is considered to be the most likely explanation.

Adult↗
PubMed1985

[Acute renal insufficiency: 1st manifestation of familial sarcoidosis].

We report an unusual case of sarcoidosis remarkable for: 1) The presentation as acute irreversible renal failure with interstitial granulomas and ischemic glomerular lesions. This leads to a discussion of the possibility of perivascular granulomas or the existence of a vasculitis. 2) The unusual localisation of other lesions in the stomach and cutaneous tissues with a necrotising epidermal vasculitis, unusual in sarcoidosis. 3) The existence, in the patient's mother, of nasal mucosal sarcoidosis and also a carrier of the B8 and DR3 antigens.

Acute Kidney Injury↗
PubMed1984

Cardiac involvement in juvenile ceroid lipofuscinosis of the Spielmeyer-Vogt-Sjögren type: prospective noninvasive findings in two siblings.

The results of prospective noninvasive cardiologic investigations, including echocardiography and Holter monitoring are described in 2 siblings with juvenile ceroid lipofuscinosis of the Spielmeyer-Vogt-Sjögren type. In the elder patient, echocardiography revealed ventricular hypertrophy with slowed ventricular relaxation. Holter monitoring showed not only bradycardia but also slow and fast ectopic atrial rhythms, sinus arrests and complex ventricular ectopic activity including ventricular tachycardia. In the younger patient the findings were less severe. These functional disturbances due to cardiac involvement, never reported before in this disease, are discussed.

Adult↗
PubMed1984

Comparison of the immunosuppressive effect of fractionated total lymphoid irradiation (TLI) vs conventional immunosuppression (CI) in renal cadaveric allotransplantation.

Beginning in November 1981, eight patients with end stage diabetic nephropathy underwent renal cadaveric transplantation after TLI. Transplantation was done between 2 to 11 days after the end of a fractionated TLI to a total dose of 20 to 30 Gy. During the same observation period, 60 nondiabetic patients with end stage renal disease of different origin also received a cadaveric kidney graft, with a conventional regimen of immunosuppression that consists of anti-lymphocyte-globulin, tapering high doses of prednisone, and azathioprine. In the TLI-treated group only a low maintenance dose of prednisone (15 mg) was given. Immunologic monitoring was performed after transplantation at regular intervals and was compared in both groups. Phytohemagglutinin (PHA)-, concanavalin A (con A)-, and pokeweed mitogen (PWM)-induced blastogenesis, as well as the mixed lymphocyte reaction (MLR) and the cell-mediated lympholysis (CML) decreased progressively during the first months after conventional immunosuppression to 50% of the pretransplantation level, and remained there for the first year after transplantation. These tests were much more impaired after TLI (less than 15% of pre TLI value) and again no recovery occurred during the first year. Natural killer (NK) cell activity progressively decreased from a mean value of 53% lysis before transplantation to 15% lysis at the end of the first year after transplantation in the conventionally treated patients. In TLI-treated patients, however, the NK activity, which declined during irradiation from 46% specific lysis to 12%, recovered rapidly after TLI to reach levels of 35 to 40% of specific lysis from the second month on after TLI. In both groups of patients the ratio of helper-inducer (TH) to suppressor-cytotoxic (TS) lymphocytes, as determined with monoclonal antibodies, progressively declined during the first 2 mo after transplantation to a low value of about 1.2. In TLI-treated patients however, this fall progressed further, so that very low levels (less than 0.6) were noticed from the third month on after TLI. The decline of the TH:TS ratio after TLI is due to an absolute increase in the number of suppressor cells. This is in contrast with the conventionally treated patients, where the low ratio is mainly provoked by a more important decrease of the helper cell population. These changes in the balance between TH and TS subpopulations are more frequently associated with positive functional suppressor cell assays in the TLI-treated patients.(ABSTRACT TRUNCATED AT 400 WORDS)

Cadaver↗
PubMed1984

Prognostic factors in a transplantation center with good results.

In a homogeneous group of 299 first cadaver kidney allograft recipients transplanted within one single center between 1973 and 1983, we analyzed the influence of several factors on graft survival. All recipients received at least one blood transfusion before transplantation. Criteria of donor-recipient selection as well as immunosuppressive treatment policy have never changed significantly within the studied period. In contrast to matching for HLA-A and B antigens, DR-matching has a significant influence on early graft survival. Kidneys with zero DR-mismatches have a one year graft survival of 96.2% versus 75.6% for kidneys with 2 DR-mismatches (P less than 0.05). The presence or absence of DRW6 in the recipient as well as in the donor has no effect on graft survival. A preservation time less than 12 hours is accompanied by a decreased early graft survival. The long-term survival of kidneys from donors older than 30 years is significantly reduced. At 5 years graft survival of kidneys from donors younger than 30 years is 75% versus 53% for kidneys from donors older than 30 years.

Blood Grouping and Crossmatching↗
PubMed1984

Sclerosing peritonitis with mural bowel fibrosis in a patient on long-term CAPD.

A 66 year old white woman developed an incomplete small-bowel obstruction after 3 years of CAPD with lactate containing solutions. There were six episodes of peritonitis. The bowel obstruction was not due to a "sclerosing obstructive" (encapsulating) peritonitis but to a diffuse sclerosis of the serosal membranes extending into the muscle layers of the small and large bowels ("mural fibrosis"). This picture may be just one other expression of a spectrum of structural changes resulting from long-term chronic irritation of the abdominal cavity.

Female↗
PubMed1983

Importance of HLA-DR matching in polytransfused cadaveric kidney transplant recipients. A prospective one-center study.

Since August 1978 prospective HLA-DR typing has been performed in 157 donor-recipient pairs. All recipients received pretransplant blood transfusions. This study shows that HLA-DR matching can significantly improve the survival of cadaveric kidney allografts, even in polytransfused recipients. Patients receiving kidneys with no HLA-DR incompatibilities have a one-year graft survival of 97%, versus 86% for recipients with 1 HLA-DR incompatibility and 73% for recipients with 2 HLA-DR incompatibilities. The cumulative dose of corticosteroids during the first year after transplantation is significantly lower in patients with no DR-incompatibilities. HLA-A and B matching have no additional effect on graft survival.

Adult↗