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Biomedical subjects

R B Stricker

Publications and source records attributed to R B Stricker.

103 records · Page 6Linked to original sources
PubMed1984

Aplastic anemia complicating systemic lupus erythematosus: response to androgens in two patients.

We describe two female patients with systemic lupus erythematosus (SLE) who developed severe aplastic anemia. Although each patient had received multiple medications including diphenylhydantoin, the relationship to these drugs to the development of marrow aplasia was unclear. After administration of an oral androgen (oxymethalone) and corticosteroids, there was complete hematologic recovery. Both patients relapsed when oxymethalone was withdrawn, and both recovered when androgen therapy was reinstituted, with or without high-dose prednisone. In both patients, there was complete reversal of pancytopenia despite the presence of initially severe marrow aplasia (less than 10% cellularity). However, in both cases, prolonged androgen therapy (2 months) was required before hematologic improvement occurred. Androgens are known to stimulate hematopoiesis in man, and they appear to influence immune function in a mouse model of SLE. Thus androgens may be particularly useful in the treatment of SLE-associated aplastic anemia.

Adult↗
PubMed1984

Failure of two-dimensional echocardiography to detect aspergillus endocarditis.

Two-dimensional echocardiography has been shown to be a reliable diagnostic procedure in patients with valvular lesions due to fungal endocarditis. We describe a patient with four-chamber Aspergillus endocarditis localized to the nonvalvular endocardium. In this case, two-dimensional echocardiography failed to demonstrate cardiac abnormalities despite the presence of extensive endomyocardial disease at autopsy. The case emphasizes the diagnostic limitations of two-dimensional echocardiography in the absence of valvular vegetations.

Adult↗
PubMed1983

Acute lymphoblastic leukemia with monosomy 7 in a Hiroshima survivor 37 years after the bomb.

Acute lymphoblastic leukemia (ALL) developed in a 53-year-old survivor of the Hiroshima bomb blast. Chromosomal analysis disclosed a single abnormality, deletion of chromosome 7. This deletion has been reported in patients with radiation exposure, but it is uncommon in adults with ALL. The karyotypic abnormality suggests that our patient's leukemia may be related to prior radiation exposure despite a 37-year hiatus. The findings raise further questions about the persistent risk of leukemia among atomic bomb survivors.

Aneuploidy↗
PubMed1983

Chemotherapy in advanced Kaposi's sarcoma. Implications for current cases in homosexual men.

Kaposi's sarcoma has recently appeared in an aggressive form in young, previously healthy, homosexual men. The disease in these patients corresponds most closely to disseminated Kaposi's sarcoma common in areas of Africa. This and the underlying acquired immune deficiency in the current patients in the United States affect the choice of appropriate therapy. Because Kaposi's sarcoma in these patients is rapidly progressive, it often requires aggressive systemic therapy, but this can be difficult given the patients' susceptibility to opportunistic infections. Reports from Africa suggest that Kaposi's sarcoma is very responsive to several chemotherapeutic agents, but these data must be interpreted cautiously because of problems in study design and differences between cases in Africa and the United States. This report reviews the clinical classification of Kaposi's sarcoma and the reported results of chemotherapy in patients with advanced disease. Implications of this experience in the treatment of recent cases in the United States are discussed.

Acquired Immunodeficiency Syndrome↗
PubMed1983

Hematologic and immunologic abnormalities in anorexia nervosa.

Anorexia nervosa has been associated with various hematologic and immunologic abnormalities, including characteristic bone marrow changes, red cell acanthocytosis, leukopenia, complement deficiencies, and defective bactericidal activity of granulocytes. Dietary and psychogenic factors may play a role in these abnormalities, which are readily reversible after resolution of the underlying anorectic state. Although clinical data are conflicting, anorectic patients may have an increased susceptibility to infection.

Acanthocytes↗
PubMedDate not supplied

A simplified method for quantitation of human immunodeficiency virus type 1 (HIV1) RNA in plasma: clinical correlates.

Human immunodeficiency virus type 1 (HIV1) RNA was quantitated in the plasma of HIV1-seropositive patients using a simplified guanidinium-based extraction technique, reverse transcriptase (RT) and the polymerase chain reaction (PCR). Plasma samples were obtained from 15 HIV1-seronegative individuals and 38 HIV1-seropositive patients. Following the extraction of RNA from plasma using "RNAzol", HIV1 RNA was reverse-transcribed using random hexamers, amplified by PCR and then detected by solution oligonucleotide hybridization. Of the 15 HIV1-seronegative individuals, 14 were negative for HIV1 RNA by RT-PCR. One high-risk patient who was HTLV-I-seropositive but HIV1-seronegative was found to be positive for HIV1 RNA by RT-PCR. All 38 HIV1-seropositive patients were positive for HIV1 RNA by this technique. The HIV1 RNA levels in plasma varied from 800 to 500,000 copies/ml. Patients with advanced clinical disease tended to have HIV1 RNA levels above 25,000 copies/ml. In patients studied serially, an increase in plasma HIV1 RNA correlated with a progressive decline in CD4+ T cells and a deteriorating clinical course. The simplified quantitative RT-PCR assay for HIV1 RNA provides a useful tool for the evaluation and management of HIV disease.

Disease Progression↗
PubMedDate not supplied

Decrease in viral load associated with topical dinitrochlorobenzene therapy in HIV disease.

Quantitative measurement of human immunodeficiency virus (HIV) RNA is being used to assess the efficacy of various treatment modalities in HIV disease. Topical dinitrochlorobenzene (DNCB) therapy has been associated with improved clinical and immunologic parameters in HIV-infected patients. We have now examined the effect of topical DNCB treatment on plasma HIV RNA levels in a small prospective study. Eight HIV-infected subjects had T-cell counts and plasma viral load measured prior to initiation of DNCB therapy and 3-4 months after starting treatment. Six patients who refused DNCB therapy served as simultaneous controls. The mean CD4 and CD8 T-cell counts did not change significantly in either group over the study period. In contrast, plasma HIV RNA levels decreased one-half to greater than one log in each DNCB-treated subject, and the decrease in viral copies was statistically significant (p = 0.006). In the control group, plasma HIV RNA levels increased significantly over the course of the study (p = 0.037). We conclude that topical DNCB therapy has the ability to lower viral load in HIV-infected patients. The long-term effect on viral burden of this inexpensive, readily available therapeutic modality merits further investigation.

Administration, Topical↗
PubMedDate not supplied

Weight gain associated with protease inhibitor therapy in HIV-infected patients.

Weight loss and wasting are significant complications of HIV disease. HIV protease inhibitor therapy promotes clinical, immunologic and virologic improvement in HIV-infected patients. In this study, we sought to determine the specific effect of HIV protease inhibitors on patient weight. Ten consecutive HIV patients were treated with protease inhibitor-containing regimens over six months. CD4 T-cell counts, plasma viral load levels and bariatric changes were monitored during the study. Patients experienced a mean weight gain of 19 Pounds (P = 0.006). There was a significant increase in mean CD4 T-cell count (P = 0.008) and a significant decrease in mean viral load level (P = 0.004). The increase in CD4 T cells did not correlate with weight gain, whereas the decrease in viral load did show a significant correlation with the weight increase (P = 0.003). The mechanism of protease inhibitor-induced weight gain is discussed. The medications may also be useful for wasting diseases unrelated to HIV.

Anti-HIV Agents↗
PubMedDate not supplied

An AIDS-related cytotoxic autoantibody reacts with a specific antigen on stimulated CD4+ T cells.

Patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related conditions are known to have abnormalities of T cell subpopulations, including a decreased helper/inducer (bearing the CD4 antigen) to suppressor/cytotoxic (bearing the CD8 antigen) T cell ratio and decreased absolute numbers of T cells with the CD4+ phenotype. Infection of T cells with a retrovirus, termed human immunodeficiency virus (HIV), is thought to be important in these abnormalities. HIV infection alone does not adequately explain the CD4+ T-cell abnormalities seen in AIDS, however, and the nature of T-cell destruction in this disease remains poorly characterized. Here we describe an AIDS-related serum autoantibody that reacts with an antigen of relative molecular mass 18,000 (Mr 18K) restricted to lectin-stimulated or HIV-infected CD4+ T cells. The antibody also suppresses proliferation of CD4+ T cells in vitro and induces cytotoxicity of these cells in the presence of complement. Its role in the development of AIDS merits attention.

AIDS-Related Complex↗