Search PubMed⌕ Search

Biomedical subjects

R Kasukawa

Publications and source records attributed to R Kasukawa.

At least 163 records · Page 9Linked to original sources

Carbamazepine-induced systemic lupus erythematosus-like disease.

A 14-year-old female developed systemic lupus erythematosus (SLE)-like symptoms, rash, fever, leukopenia and positive anti-nuclear antibody (ANA) two weeks after administration of carbamazepine (CBZ; Tegretol) used against benign Rolandic epilepsy. Clinical symptoms and leukopenia normalized after discontinuation of CBZ and administration of prednisolone at 40 mg. The cases of CBZ-induced SLE reported in the literature were reviewed.

Adolescent↗

Anti-centromere antibody and CREST syndrome in patients with primary biliary cirrhosis.

Anti-centromere antibodies (ACA) in 41 sera from patients with primary biliary cirrhosis (PBC) were analyzed by an immunoblotting method and the correlation between the presence of ACA and the clinical features in these PBC patients was studied. In 10 of 16 ACA-positive PBC patients, one or more clinical features of CREST syndrome (PBC-CREST) were found. Statistical differences were observed in age at disease onset, serum levels of IgM and total bilirubin and titer of anti-M2 antibody, between PBC-CREST patients and the PBC patients without CREST symptoms (PBC-non CREST). By immunoblotting analysis, three major epitopes of ACA were identified at 18 kD, 80 kD and 140 kD polypeptides. The 18 kD polypeptides were detected in all 16 ACA-positive PBC patients. From these results, it is suggested that ACA-positive PBC-CREST patients can be separated from ACA-negative PBC-CREST and PBC-non CREST patients.

Adult↗

Cyclosporin for inflammatory pseudotumour.

Dramatic efficacy of cyclosporin was observed in a patient with inflammatory pseudotumour in the liver. The 30-year-old male patient had suffered several attacks of high fever, polyarthralgia and lymph node swelling since 1981. In February 1989, abdominal CT showed multiple space-occupying lesions in his liver, and histopathology of the biopsied liver showed infiltration of plasma cells and lymphocytes with proliferation of collagen fiber, which was comparable to an inflammatory pseudotumour. In May 1990, a treatment regimen of cyclosporin A along with prednisolone was begun because he had been diabetic since March 1990. Within a few days of treatment, the high fever and polyarthralgia subsided, and leucocytosis of 32,000/mm3 and the increased CRP of 17.7 mg/dl were normalised within one month. A reduction of the size of the space-occupying lesions in the liver was observed on abdominal CT taken one month after cyclosporin treatment.

Adult↗

[A case of late-onset SLE complicated with EDTA-dependent pseudothrombocytopenia].

A 57-year-old man was admitted to our clinic with complaints of proximal myalgia in extremities. He was diagnosed as late-onset SLE based on the findings of pleuritis, pericarditis, arthritis and antibodies to DNA and cardiolipin. Aggregation of the platelets and the decreased counts of platelets were observed when EDTA was used as anticoagulant for the blood tests. However, the platelet aggregation was not noted with normal counts of platelets when Heparin-Theophylline was used as anticoagulant. From this observation, EDTA-dependent pseudothrombocytopenia was diagnosed and IgM class of EDTA-dependent anti-platelet antibody was detected by means of flow cytometry. Administration of prednisolone at 40mg/day reduced the symptoms and EDTA-dependent pseudothrombocytopenia, and EDTA-dependent anti-platelet antibody disappeared. His clinical course suggested that EDTA-dependent pseudothrombocytopenia was closely associated with the disease activity of SLE.

Autoantibodies↗

Preliminary criteria for classification of adult Still's disease.

We have attempted to design classification criteria for adult Still's disease by analyzing the data obtained through a multicenter survey of 90 Japanese patients with this disease and of 267 control patients. The proposed criteria consisted of fever, arthralgia, typical rash, and leukocytosis as major, and sore throat, lymphadenopathy and/or splenomegaly, liver dysfunction, and the absence of rheumatoid factor and antinuclear antibody as minor criteria. Requiring 5 or more criteria including 2 or more major criteria yielded 96.2% sensitivity and 92.1% specificity. However, an exclusion process will be needed for an accurate classification, since this disease is relatively rare.

Adolescent↗

An investigation on rheumatoid factor of different immunoglobulin classes in hepatitis B virus carriers.

Rheumatoid factor (RF) is known to be present very frequently in HB virus carriers. When RF was assayed in 140 asymptomatic carriers by agglutination method, 20.0% were found to be positive, whereas 2.7% in the controls (p less than 0.01). ELISA for detection of RF isotypes showed RF in carriers to be almost IgMRF only. IgMRF showed a tendency to react more readily to human IgG rather than to rabbit IgG. The incidence of IgMRF positivity was higher among anti-HBe antibody-positive carriers than among anti-HBe antibody negative ones, but the difference between the two populations was not significant. However, the incidence of IgMRF positivity in the group showing hepatic dysfunctions was found to be significantly higher than in the group with normal hepatic functions.

Agglutination Tests↗

Prediction of the recurrence of esophageal varices based on portal vein pressure and oxygen tension in portal and peripheral blood.

In 27 variceal patients completely treated by ethanolamine oleate and polidocanol and followed for more than one year, the recurrence of varices was studied by measuring portal vein pressure and oxygen tension in the portal vein and peripheral arteries and veins before and after EIS. Frequent recurrence was observed in patients with increased PVP after EIS and lower or inverse PVO2-VO2 tension after EIS. The recurrence of varices after EIS may thus possibly be predicted based on portal vein pressure and PVO2-VO2 tension differences.

Esophageal and Gastric Varices↗

[A case of pustulotic arthro-osteitis with secondary amyloidosis].

A 63-year-old man with a history of Pustulosis Palmaris et Plantaris since 1960 was suffered from lumbago and anterior chest pain in 1973. Chest X-ray film showed inter-sterno-costo-clavicular ossification. Spondylodiscitis, Syndesmophyte of lumbal spine, Sacro-iliitis were seen by abdominal X-ray film. He was admitted to near hospital with generalized edema and urinary protein (10-20 g/day) in April 1986. Laboratory studies showed hypoproteinemia, positive C-reactive protein, high serum amyloid A protein(240 ng/100 microliters) and negative HL-A B27. He was diagnosed Pustulotic arthro-osteitis and Secondary Amyloidosis by renal biopsy and rectal biopsy in 1987. He was treated with high-dose oral prednisolone(60 mg/day)and dimethyl sulfoxide. After treatment, Edema and Nephrose improved. Increasement of renal function was not observed.

Amyloidosis↗

Pulmonary hypertension in connective tissue disease. Clinical analysis of sixty patients in multi-institutional study.

Clinical features and prognosis of sixty patients with connective tissue disease accompanied by pulmonary hypertension (PH) (26 MCTD, 20 SLE, and 14 PSS) reported retrospectively by multi-institutions were compared. Though the obtained data were incomplete and lacking in uniformity, no significant difference in the clinical features among the three diseases were observed except high incidence of pulmonary fibrosis and low % VC in PSS and PH patients. Statistically significant difference, however, was observed between live and dead patients of three diseases gathered in post sternal pain, pulmonary diastolic murmur, right ventricular hypertrophy on ECG and mean pressure of pulmonary artery. Higher incidence of anti-nRNP antibody was observed in SLE with PH and PSS with PH patients than with the general population. A quicker occurrence of PH and shorter survival time were observed in MCTD patients with PH than in SLE and PSS patients with PH.

Adult↗

The destructive effects of sclerosant ethanolamine oleate on mammalian vessel endothelium.

Ethanolamine oleate (EO) used widely in sclerotherapy against esophageal varices was studied for its pharmacological effect on blood coagulation and vascular damage in animals. Blood coagulation was completely inhibited by EO at a concentration of 0.31%. EO destroyed the endothelial cells of the vessel of dog and rat within one minute after injection into the vessels. An accumulation of fibrin and platelets on the surface of the damaged vessel was observed electron microscopically. Mural thrombus was formed in a few hours and the thrombus occluded the blood stream in the vein. From these animal experiment, intravasal injection of EO was considered to cause the disappearance of varices by the following two processes: collapse of varices because of occlusion of the blood stream and shrinking of the obstructed thrombus through organization.

Adult↗

[Two cases of allergic granulomatosis and angiitis (AGA); Churg-Strauss syndrome].

AGA is an angiitis syndrome that has some characteristic features, for example preceding asthma and polyneuritis. And histological findings are granulomatous angiitis or extravascular granuloma. We report two typical cases of AGA. Case 1; 51-year-old woman had been suffering from asthmatic dyspnea for one year and developed in 1987 multiple neuritis in her extremities. Eosinophilia and high level of IgE were noted. Pathologic diagnosis of the biopsied right calf muscle specimen was granulomatous angiitis. Case 2; 40-year-old woman had been suffering from asthmatic dyspnea for two years. She complained of severe cough and myalgia in 1986 and her chest X-ray showed homogeneous shadows in right upper and left lower fields. And her blood showed eosinophilia and high level of IgE. The histology of the biopsied subcutaneous nodules of hands showed extravascular granuloma. These two cases had specific features of AGA. About symptoms of angiitis, case 1 showed multiple neuritis and case 2 had subcutaneous nodules of hands. About laboratory data, case 1 showed WBC count of 9400/mm3 with 85% eosinophils and high level of IgE at 1400 IU/ml, case 2 had WBC count of 13200/mm3 with 22% eosinophils and IgE at 846 IU/ml. The vary of eosinophil count and IgE level were related to the degree and course of illness. These symptoms and laboratory data, except neuritis, improved by an administration of prednisolone. In early stage of AGA, prednisolone is effective, so the criteria of AGA and usage of corticosteroids must be considered.

Adult↗

Adult Still's disease: a multicenter survey of Japanese patients.

A comprehensive survey of Japanese patients with adult Still's disease was made by questionnaire which was sent to major institutions with rheumatology units in Japan. Of 146 cases from 32 institutions, 90 were judged to be definitely diagnosed as adult Still's disease. The major clinical features in these 90 patients consisted of high fever, polyarthralgia, rash, increased erythrocyte sedimentation rate, negative autoantibodies, leukocytosis, liver dysfunction, and hyperferritinemia. The incidence of several features showed significant differences between these cases and previous nonJapanese cases.

Adolescent↗

[Eosinophilia in primary biliary cirrhosis].

The numbers and the percent of eosinophils in peripheral blood of thirty patients with primary biliary cirrhosis were serially measured and were compared with their clinical data. eosinophils of 22 patients at non icteric stage (total bilirubin less than 2.0 mg/dl) were significantly higher (P less than 0.05) than those of 8 patients at icteric stage (total bilirubin more than 2.0 mg/dl). Seven patients (23.3%) showed eosinophilia with value of 6% or more and in which four patients (13.3%) showed eosinophilia more than 8%. These eosinophilia was found in non icteric patients alone but not in icteric. In two patients who have shown eosinophilia at their non icteric stage, numbers of their eosinophils decreased gradually following the increment of their total bilirubin levels. These results would indicate that eosinophils in the peripheral bloods of PBC patients could reflect some clinical conditions at their non icteric stage.

Adult↗