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Biomedical subjects

S Barandun

Publications and source records attributed to S Barandun.

At least 37 records · Page 2Linked to original sources
PubMed1984

Varicella and herpes zoster in immunosuppressed children: preliminary results of treatment with intravenous immunoglobulin.

Seven immunosuppressed children with varicella and two with herpes zoster were treated with large intravenous doses of polyvalent, intact immunoglobulin (IgG i.v.). In all patients the treatment was effective for controlling fever and skin lesions and for preventing progression and complications, even if this therapy was started late and/or if the patient was severely lymphopenic . More IgG was needed to control disseminated than less advanced varicella. No untoward effects of IgG therapy were observed. The preliminary results suggest that in future trials i.v. IgG should be used for comparison with antiviral agents.

Adolescent↗
PubMed1984

Correlation of natural killer cell function with Leu 7 reactivity in patients with humoral immunodeficiency.

We studied the surface markers Leu 7, Leu 1, Leu 2a and Leu 3a on lymphocytes of 54 healthy blood donors and 19 patients with humoral immunodeficiencies and compared the relative numbers of positive cells with the natural killer cell (NK) activity. In controls, and in 12 out of 19 patients (group A) the percentage of the Leu 7+ cells was positively correlated with NK activity. Seven of 19 patients had increased relative numbers of Leu 7+ cells and low NK activity (group B). In controls and group A patients about 40% of the Leu 7+ cells simultaneously expressed the cell markers Leu 1 and Leu 2a. In group B patients approximately 70% of the Leu 7+ cells carried T cell antigens. Furthermore, a distinct suppressor T cell predominance was noticed and the large granular lymphocytes of these patients showed morphological abnormalities.

Adolescent↗
PubMed1983

[High-dose immunoglobulin infusions in idiopathic thrombopenic purpura].

In childhood approximately 90% of all idiopathic thrombocytopenic purpuras (ITP) are acute while in adults the majority is chronic (6 months duration). 0,5 - 1% of the children with ITP die. Conventional treatment comprises corticosteroids and, for chronic ITP, splenectomy and/or cytostatic immunosuppression. Inspired by the disappearance, during substitution, of concomitant ITP in 2 agammaglobulinemic boys, 13 children with ITP (3 chronic, 4 intermittent, 6 acute) were treated with high-dose intravenous immunoglobulin SRK. All responded favorably but one boy with chronic ITP became resistant after 11 months of infusions. F(ab')2 fragments are inactive. High doses of immunoglobulin could block Fc receptors of macrophages. They could also facilitate the formation and elimination of immune complexes and, indirectly, prevent the accumulation of platelet-associated immunoglobulin.

Blood Platelets↗
PubMed1983

Intravenous use of gammaglobulin in the treatment of chronic immune thrombocytopenic purpura as a means to defer splenectomy.

Intravenous gammaglobulin was used to treat 12 children with chronic immune thrombocytopenic purpura in order to avoid splenectomy. The average rise in platelet count with initial treatment was 226,000/microliters. Currently, one patient is in remission, four patients maintain platelet counts greater than 40,000/microliters without treatment, four patients maintain platelet counts greater than 40,000/microliters with single maintenance infusions of IV IgG at four- or 10-week intervals; three patients did not respond to treatment. In nine of 12 patients, splenectomy was avoided or at least postponed. In responding patients, we were able to discontinue immunosuppressive medication. Platelet count rises with initial IV IgG therapy were correlated with both platelet antibody levels and with a better long-term outcome. Toxicity was minimal.

Adolescent↗
PubMed1983

Reversal of neutropenia with intravenous gammaglobulin in autoimmune neutropenia of infancy.

Intravenous gammaglobulin (IVIgG) was used to treat autoimmune neutropenia of infancy in two males with repeated infections. The neutrophil count increased significantly in both patients with the initial IVIgG therapy; 1 patient went into remission. The neutrophil count in the other remained above baseline for 3 wk, and a subsequent booster infusion also caused the neutrophil count to increase. The patients have remained clinically well since their treatment began. Serial studies of antineutrophil antibody and serum lysozyme, performed to elucidate the mechanism of action, suggested decreased neutrophil destruction, perhaps by Fc receptor blockade, as well as decreased synthesis of antineutrophil antibody. Neutrophil function was not impaired after the neutrophil count increased. Many patients with immune neutropenia have a benign course, but those who have significant infections could be treated, acutely or prophylactically, with intravenous gammaglobulin.

Agranulocytosis↗
PubMed1983

Intravenous gammaglobulin treatment of chronic idiopathic thrombocytopenic purpura.

High-dose intravenous gammaglobulin (IVIgG) was given to 12 children and adults with chronic idiopathic thrombocytopenic purpura (ITP) to avoid splenectomy or because they either failed to respond to or required maintenance with high doses of steroids and/or immunosuppressives. The average platelet count increase to initial therapy was 239,500/microliters (range 23,000-790,000). A concomitant IgG Fc receptor blockade, measured by IgG-sensitized 51Cr-labeled autologous erythrocytes, was seen in 11 of 11 patients tested, both splenectomized and not splenectomized, lasting 3-4 wk. Six or more months after treatment, 2 children are in remission, 2 children and 2 adults are stable requiring no therapy with platelet counts of approximately 50,000 and 30,000, respectively, 3 children require maintenance IVIgG therapy at 2-10-wk intervals, and 1 child and 2 adults have become refractory to further IVIgG. Splenectomy was not performed in 4 children. Two adults were able to discontinue daily prednisone. The 3 patients who became unresponsive to Swiss Red Cross gamma-globulin (IgSRK) therapy did so in conjunction with a markedly elevated platelet-associated IgG and IgM. Serum IgM increased an average of 103 mg/dl after the IVIgG infusions. No significant side effects were seen.

Adolescent↗
PubMed1982

Build-up maintenance of IgG serum concentrations with intravenous immunoglobulin in patients with primary humoral immunodeficiency.

6 patients with antibody deficiency disease had intravenous immunoglobulin substitution and their serum IgG levels were monitored for at least 6 months. After three IgG infusions of 6-12 g each at intervals of 3 or 4 weeks, the IgG serum concentrations were between 300 and 500 mg/dl in 3 patients. In the 3 other patients, higher serum levels were obtained after considerably more IgG infusions given at intervals of 8 days or less. Maintenance of subnormal levels was achieved by replacement of approximately 10 mg/kg body weight/day. In 1 patient, the serum IgG was kept at about 1,000 mg/dl by replacement of 54 mg/kg/day, i.e. by infusions of 9 g every 3-4 days.

Adolescent↗
PubMed1982

Correlations between enzymatic and immunologic properties of human peripheral blood mononuclear cells. I. Ectoenzymes of normal and immunodeficient peripheral blood mononuclear cells.

The activity of plasma membrane marker enzymes which are involved in purine metabolism (5'-nucleotidase, alkaline 5'-nucleotide phosphodiesterase), in active ion transport (Na-K-Mg-adenosine triphosphatase, ouabain-sensitive Na-K-adenosine triphosphatase), in aminoacid transport (gamma-glutamyltranspeptidase), and in basic physiologic functions (alkaline phosphomonoesterase) were assayed in mononuclear cells isolated from peripheral blood of normal donors and of patients with primary immunodeficiency. Irrespective of the clinical classification of the immunodeficiency, the cells of patients were characterized by significantly diminished 5'-nucleotidase and to a certain extent by lower alkaline phosphomonoesterase activities. Average activity levels of other enzymes were similar in cells of patients and controls, but scattering was more pronounced in the first group. Determination of substrate affinity revealed different kinetic properties of 5'-nucleotidase in cells from patients and normal donors; however, the extent of inhibition by beta-glycerophosphate or alpha, beta-adenosine-methylene diphosphate was comparable for both types of cells. The presence of inhibitory compounds in patients' serum was excluded by mixing experiments. When activities of the various plasma-membrane-associated enzymes were compared with each other, significant correlations emerged in normal lymphocytes. Most of these correlations were absent in cell membranes of immunodeficient patients. The findings indicate that the plasma membrane of lymphocytes from patients with immunodeficiency may be characterized by an altered distribution of enzymatic constituents.

5'-Nucleotidase↗
PubMed1981

[Immunoglobulin substitution in the treatment of neonatal septicemia].

The therapeutic effect of a polyvalent immunoglobulin preparation for intravenous use was tested in 82 newborns with bacterial infections. 35 of the children had neonatal sepsis, whereas in the other 47 bacteremia was not detectable. Treatment consisted either of antibiotics only or of antibiotics combined wih immunoglobulin SRK on an alternating basis for the first six days. Immunoglobulin substitution was tolerated without complications. In the group of infants with neonatal sepsis, two of 20 (10%) who were substituted with immunoglobulin and four of 15 (26%) who received no immunoglobulin died. Likewise, in the group of patients without detectable bacteremia, two of 21 on immunoglobulin substitution (10%) and four of the 26 who were not substituted (15%) died. The low mortality observed in the present study was attributed to efforts at early diagnosis and conventional early treatment on the one hand, and to immunoglobulin substitution on the other. To detect possible late sequelae of immunoglobulin therapy, particularly in hypogammaglobulinemic premature newborns, clinical and immunological investigations were performed in the septic patient group at the age of one to four years. There were no indications that administration of immunoglobulins during the neonatal period might have had an adverse effect on psychomotor and somatic development or on the immunological maturation of the infants.

Anti-Bacterial Agents↗
PubMed1981

High-dose intravenous gammaglobulin for idiopathic thrombocytopenic purpura in childhood.

Seven children with chronic or intermittent and six with acute idiopathic thrombocytopenic purpura (ITP) were treated with large intravenous doses of polyvalent, intact immunoglobulin (Ig). In all patients the platelet count rose sharply within 5 days, but the initial response and the subsequent course varied from patient to patient. Among children with chronic ITP the initial response was more marked in splenectomised than in non-splenectomised patients. Among those with acute ITP the two who remained Ig dependent had a smaller initial response than the four patients who required no maintenance treatment. During the 90-110 days of observation five of six patients with chronic ITP could be maintained with Ig alone. No untoward effects of Ig therapy were observed.

Child↗
PubMed1981

High-dose intravenous gammaglobulin therapy of refractory, in particular idiopathic thrombocytopenia in childhood.

A new immunoglobulin (Ig) for intravenous use was given in high doses to 4 children with refractory idiopathic thrombocytopenic purpura (ITP) and 2 children with idiopathic aplastic anemia (IAA). Within 5-10 days after initiation of Ig therapy the platelets of the children with ITP rose to 300,000-650,000/mm3 and could be maintained at normal levels with one Ig infusion every 1-3 weeks. No reaction was observed in the 2 patients with IAA.

Adolescent↗
PubMed1980

[New possibilities for immunoglobulin substitution in antibody deficiency syndrome].

The effect of an unmodified immunoglobulin for intravenous substitution in patients with antibody deficiency syndrome (ADS) has been studied. Over 100 doses of Sandoglobulin were administered to ADS patients without any sign of anaphylactoid reaction. There is no upper limit on the quantity infused. Peak values and basal values can be calculated and therapy can be adjusted accordingly. The halflife of the preparation equals that of native IgG in a healthy person. Comparing days with temperature above 38 degrees C (100.4 degrees F), days under antibiotics, and absence from work during equal periods with and without Sandoglobulin, the beneficial effect of this preparation is obvious. Sandoglobulin can be recommended for longterm therapy in ADS.

Antibodies↗