Biomedical subjects
P Small
Publications and source records attributed to P Small.
Chronic urticaria and angioedema.
Of 231 patients evaluated for chronic urticaria and angioedema (CUA), 192 were diagnosed as having an idiopathic condition. The roles of serum IgE, complement (CH50), and immune complexes (IC) were investigated in 112 patients with idiopathic CUA. Immediate skin tests were not helpful, but total IgE was elevated in 13%, equally divided between dermographic (D) and non-dermographic (ND) patients. Depressed haemolytic complement (CH50) was noted in 10% of CUA, all of whom were D. Serum IC were elevated in 38% equally divided between D and ND patients. There was no relationship between depressed CH50 and elevated IC. Skin biopsies, evaluated by both light and immunofluorescent techniques, were negative for all specimens tested. The pathophysiology of idiopathic CUA is multifactorial, with a variety of immunological mechanisms involving serum IgE, CH50, and IC. . The relationship between depressed CH50 and dermographism was noted but unexplained by serum or tissue studies.
Prophylactic antihistamines in the management of radiographic contrast reactions.
Two hundred and twenty consecutive patients, referred for intravenous pyelography, were assessed for adverse reactions. The effect of prophylactic antihistamines was evaluated. Patients were divided randomly into control, saline or chlorpheniramine treated groups. Changes in serum total haemolytic complement (CH50) and immune complexes (IC) at times 0, 1, 5, 10 and 20 min after injection of radiocontrast material were assayed. Forty-two of the 220 patients suffered reactions, classified clinically into allergic and non-allergic types. There was no difference in the incidence of allergic reactions between control and saline groups. However, significantly less (P less than 0.05) allergic reactions were noted in the antihistamine pre-treatment group. Depressed CH50 occurred in forty-three, of eighty-eight patients tested and persisted for at least 20 min in twenty-two. There was no correlation between CH50 depressions and clinical symptoms. The IC remained unchanged throughout. In conclusion, prophylactic antihistamines may diminish the incidence of allergic reactions. Complement activation occurs in a large number of patients, unrelated to symptomatology, and does not appear to be the only factor responsible for adverse reactions.
Clinical data systems: meeting organizational needs.
Explore the source record for details and available documents.
Nasal polyposis--a multidisciplinary study.
Thirty-seven adults with nasal polyps were assessed in a multidisciplinary fashion. It was found that 43% of patients were allergic and 57% had asthma. Performing a polypectomy did not alter lower airway flow rates. Eosinophilia was prominent in nasal secretions of both atopics and nonatopics. Histological characteristics could not distinguish the "allergic" from the "inflammatory" polyp. Immunofluorescent studies indicated an abundance of polyp IgE leading to speculation of an IgE mediated process in polyp formation.
Clinical significance of screening for antibody to ribonucleoprotein.
Of more than 1500 sera screened for antinuclear antibody 13 were positive for antiribonucleoprotein (RNP). Nine patients had either systemic lupus erythematosus or mixed connective tissue disease. Four other had no significant medical problems. The detection of anti-RNP antibody does not have diagnostic specificity and may not indicate active collagen disease.
Beclomethasone dipropionate in the management of rhinitis--a review.
Beclomethasone dipropionate has been demonstrated to be effective in the treatment of seasonal and perennial rhinitis. Comparative studies with other medications are lacking. Adverse reactions are frequent but minor. No alterations of the hypothalamic-pituitary-adrenal axis, nasal mucosal histology or bacterial and fungal flora have been recognized.
Chronic urticaria dnd vasculitis.
Of 231 patients with chronic urticaria, eight presented with arthritis. All had elevated sedimentation rates, five had depressed complement (CH50) and two elevated serum immune complexes (IC). Skin biopsies were abnormal in only four patients, unrelated to abnormalities of CH50 or IC. No single diagnostic test was consistently abnormal.
Beclomethasone dipropionate nasal aerosol in adult patients with ragweed seasonal rhinitis.
Explore the source record for details and available documents.
An immunological evaluation of pleural effusions in systemic lupus erythematosus.
Of 59 patients with pleural effusions, four had systemic lupus erythematosus. Assessments of pleural antinuclear antibody, rheumatoid factor, anti-DNA antibody and hemolytic complement after corrections for pleural protein and corresponding serum values were of no diagnostic significance. Pleural analyses did not contribute diagnostic information beyond that defined by serum markers.
Hyperthyroidism and polycythemia vera with chronic urticaria and angioedema.
Of 154 patients with chronic urticaria, six manifested concomitant hyperthyroidism and four polycythemia vera. Investigations of serum IgE, immune complex quantitation, complement and skin biopsies failed to elucidate a causal relationship. Polycythemia vera and hyperthyroidism should be considered as possible associations in the evaluation of chronic urticaria.
Immunotherapy with glutaraldehyde treated tyrosine adsorbed grass pollen in the treatment of allergic rhinitis.
Explore the source record for details and available documents.
Multifactorial etiology of nasal polyps.
Forty patients with nasal polyps were assessed. Elevated serum total IgE levels in nine patients did not correlate with skin testing. Increased serum immune complexes were detected in 11 patients but did not correlate with depressed complement (five patients). Multiple immunological mechanisms may be involved in nasal polyp formation.
Relapsing polychondritis. A feature of systemic lupus erythematosus.
In summary, we have presented two well documented cases of SLE with relapsing polychondritis. The chondritis was not a presenting feature and had no obvious prognostic significance. Neither patient has developed any further manifestations of relapsing polychondritis. A local immune complex etiology may be suggested by the laboratory findings. Treatment with corticosteroids was associated with the resolution of inflammation within a few days. Relapsing polychondritis should be recognized as an uncommon feature of SLE.
Persistent adenoid presenting as a nasopharyngeal mass.
A diagnosis of hypertrophied adenoid tissue was confirmed in 12 adults each investigated for a nasopharyngeal mass. The patients ranged in age from 17 to 64 and initially presented with either nasal obstruction or serous otitis media. Four patients had evidence of allergic disease. The development of the lymphoid tissue of Waldeyer's ring is reviewed. Although the adenoid is thought to regress in adolescence, it appears that it can remain hypertrophied and become symptomatic in adulthood. A thorough clinical investigation culminating in biopsy is essential to exclude more ominous pathology.
Central nervous system involvement in SLE. Diagnostic profile and clinical features.
The clinical course and diagnostic profile of 13 patients with central nervous system involvement and systemic lupus erythematosus (CNS-SLE) are presented. The diagnostic yield for each procedure was measured as the precent abnormal: CSF total protein was 38%; increased CSF IgG 69%; decreased CSF hemolytic C4 10%; increased CSF anti-DNA 64%; electroencephalogram 80%; flow brain scan 50%; and static brain scan 0%. No single procedure was consistently abnormal, but the battery of tests provided a useful and specific CNS-SLE diagnostic profile.
Disseminated histoplasmosis and necrotizing vasculitis.
A 74-year-old man with congestive heart failure was found to have Histoplasma capsulatum in a lesion of the right nasal septum. His initial treatment with amphotericin B was inadequate because of severe intolerance to the drug. Three months after initial presentation H. capsulatum was detected in his blood and bone marrow. Slightly elevated purpuric lesions on the arms, lower legs and trunk showed the typical features of necrotizing vasculitis. Cutaneous anergy was reversed after treatment with transfer factor. Skin involvement in disseminated histoplasmosis is unusual and there are no previous reports of vasculitis associated with this infection.
Studies of the sheep red blood cell receptor using anti-lymphocyte antibodies.
Explore the source record for details and available documents.