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Biomedical subjects

S Todesco

Publications and source records attributed to S Todesco.

At least 55 records · Page 3Linked to original sources
PubMed1995

Anticardiolipin antibodies and antiphospholipid syndrome in chronic discoid lupus erythematosus.

Anticardiolipin antibodies (aCL) of immunoglobulin (Ig) G and M classes were determined in 28 patients affected with chronic discoid lupus erythematosus (CDLE), comparing their prevalence and levels to those in 60 healthy subjects matched for age and sex. A high and significant frequency of IgG (67.8%) and IgM (50.0%) aCL together with prevalence of high antibody levels was found in CDLE patients, while healthy controls had IgG and IgM aCL in 1.6% and 3.3% of cases respectively. Clinical features in keeping with the diagnosis of antiphospholipid syndrome were found in one patient (3.5%), which, as the first manifestation of the syndrome, showed a pulmonary thromboembolism which appeared some days after prolonged exposure to the sun. These results provide additional data on autoimmune phenomena in CDLE and suggest that aCL test should be considered as useful aids in immunological diagnosis of CDLE.

Adult↗
PubMed1995

Lacrimo-auricolo-dento-digital syndrome mimicking primary juvenile Sjögren's syndrome.

We describe a 24 year old female patient affected with symptoms of severe xerostomia and keratoconjunctivitis sicca since her childhood. She also had several malformations involving face and digits as well as cup shaped ears, enamel dysplasia and absence of lacrimal puncta. Hence, the diagnosis of Lacrimo-Auricolo-Dento-Digital (LADD) syndrome was made. The main differences between this rare, inherited disease and primary juvenile Sjögren's syndrome are pointed out.

Abnormalities, Multiple↗
PubMed1995

[Diagnostic value of labial salivary biopsy in Sjogren's syndrome: report of 182 cases].

Various sets of criteria have been suggested in order to establish a diagnosis of Sjögren's syndrome (SS) in as much as evaluation of the salivary component is highly controversial. Our study was aimed at investigating both sensitivity and specificity of labial salivary gland biopsy (LSGB), as well as at comparing this method with other diagnostic procedures commonly employed in SS. LSGB was performed in 182 patients (174 female and 8 male, mean age 51.2) with xerostomia, dry eyes, parotid swelling and/or serological abnormalities such as positive rheumatoid factors, antinuclear antibodies, leukopenia and hypergammaglobulinemia. Diagnosis of SS was made according to the criteria recently proposed by Vitali et al. (1993). Severity of histologic changes was graded according to the Chisholm and Mason scoring system. Bioptic samples were considered abnormal when at least one focus of mononuclear cells/4mm2 was observed. The following parameters were also assessed in each patient: questionnaire of symptoms, Saxon test, sialography, salivary dynamic scintiscan, Schirmer-I-test, rose Bengal score, ANA, anti-SSA/SSB antibodies and rheumatoid factors. According to the above diagnostic criteria, 108 out of 182 patients had SS, 90 primary and 18 secondary. For 74 there were not enough data for a definite diagnosis of SS. In 9 cases (4 with and 5 without SS) LSGB was excluded because no glandular tissue was found in the specimens. Among the remaining 173, Grades 3 or 4 were found in 74 patients (71.2%) with SS and only in 1 case (1.4%) without SS. LSGB showed a very high specificity (98.6%) and a rather good sensitivity (72.5%). However, biopsy was crucial for diagnosis in only 11 cases (14.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1994

Interrelationships between interleukin (IL)-1, IL-6 and IL-8 in synovial fluid of various arthropathies.

High levels of many cytokines, including interleukin (IL)-1, IL-6 and IL-8, were found in various arthropathies suggesting that they play a role in the pathogenesis of disease, although their relationship with the type and activity of disease is still not clear. The synovial fluid (SF) of 24 patients with rheumatoid arthritis (RA), 19 with psoriatic arthritis (PA) and 33 with osteoarthritis (OA) was analyzed for IL-1 beta, IL-6 and IL-8. The highest concentration of the three cytokines was found in the SF of RA. IL-beta detectable levels (> or = 20 pg/ml) were observed in 8/24 (33.3%) patients with RA, in one patient with PA but in no patient with OA. IL-6 (mean +/- SD) (1610.37 +/- 1781.65 pg/ml) was higher in RA than in PA (672.47 +/- 867.40 pg/ml, p = 0.043) and OA (89.45 +/- 120.52 pg/ml, p = 0.0001). IL-8 (1042.72 +/- 698.64 pg/ml) was higher in RA than in PA (660.36 +/- 625.11 pg/ml, p = 0.03) and OA (89.9 +/- 45.88 pg/ml, p = 0.0001). A correlation between IL-1 beta, IL-6 and IL-8 was found in RA. In all patients a correlation between IL-6 and IL-8 levels was found; moreover, these two cytokines were associated with SF indices of inflammation, such as white blood cells (WBC) count and total protein (TP) concentration. Our findings suggest that these interrelationships play a role in the evolution of more severe erosive arthropathy such as RA.

Arthritis↗
PubMed1994

A catastrophic antiphospholipid syndrome: the importance of high levels of warfarin anticoagulation.

We report the clinical observation of a 23-year-old woman affected by the so-called 'catastrophic antiphospholipid syndrome'. Within a 3-month period she suffered a number of thrombotic events and haemolytic anaemia with thrombocytopenia and had high levels of immunoglobulins G and M and anticardiolipin antibodies associated with lupus anticoagulant activity. The severity of the clinical and laboratory changes is described and diagnostic and therapeutic difficulties are discussed. The apparent control of thrombotic events only with high levels of warfarin anticoagulation is stressed.

Adult↗
PubMed1994

Prospective sonographic and arthroscopic evaluation of proliferative knee joint synovitis.

The objective of this study was to verify the accuracy of ultrasonography in assessing the topography, morphology, and extent of synovial proliferation in rheumatoid and psoriatic knee joint synovitis. Findings were compared to those obtained using prospective arthroscopy as the gold standard; in addition, topographically defined sonographic findings before and after arthroscopic synovectomy were compared. Sonographic examination was performed in 12 patients with rheumatoid arthritis (13 knees) and 13 patients with psoriatic arthritis (14 knees) who had synovitis of the knee using an electronic linear transducer (7.5 MHz) or a mechanical sector transducer (10 MHz). This examination was followed within 1 week by arthroscopy, to compare the topography (intra-articular localization) and the morphology (sonographic patterns) of synovial proliferation. In 15 knees undergoing arthroscopic synovectomy, preoperative sonographic measurement of synovial thickness in the suprapatellar, medial parapatellar, and lateral parapatellar recesses was compared with arthroscopic visualization of synovial proliferation; 13 knees were reevaluated 2 months after arthroscopic synovectomy by sonography at the same sites. Three distinct sonographic patterns of synovial proliferation were confirmed by arthroscopic examination: a villonodular aspect in 12 knees; uniform thickening in eight knees, and overlapping layers in seven knees. About 50% of the knees showed more than one sonographic pattern, with no differences in pattern distribution between rheumatoid arthritis and psoriatic arthritis patients. A significant correlation was found between sonographic and arthroscopic evaluations of synovial thickness in the suprapatellar (P < 0.02) and medial parapateoffr recesses (P < 0.02), the sites of maximal synovial proliferation in our patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Special considerations in the use of NSAIDs in the elderly.

As the number of elderly patients with rheumatic conditions continues to increase, rheumatologists are faced with the challenge of providing more effective but safer therapy to their geriatric patients. In 1991, nonsteroidal anti-inflammatory drugs (NSAIDs) accounted for more than 29 million prescriptions worldwide. The elderly are at increased risk for NSAID-associated toxicity, particularly gastrointestinal side effects. Predisposing factors include age-related physiologic changes, underlying conditions, and polypharmacy. Clinical experience shows etodolac, 300 mg twice daily, given to elderly patients with osteoarthritis for 4 weeks, to be effective and well tolerated in this population. Additionally, etodolac may favourably affect mood and cognitive function. With judicious individualisation of therapy and careful monitoring, NSAID therapy can provide a favourable risk-benefit ratio in elderly patients.

Aged↗
PubMed1994

[Paget's disease of bone associated with autoimmune thyroiditis and joint chondrocalcinosis].

A case of scapular Paget's disease of bone with concurrent autoimmune thyroiditis and articular chondrocalcinosis is reported. Although infrequent, this combination suggests the involvement of common pathogenic mechanisms: thyroiditis and Paget's disease may stem from the same viral infection and/or autoimmune disorder, whereas chondrocalcinosis may be the consequence of thyroiditis-related hypothyroidism. In contrast, the association of Paget's disease and chondrocalcinosis may be fortuitous, since both disorders are common.

Chondrocalcinosis↗
PubMed1994

Antiphospholipid antibody syndrome associated with ovarian cancer. A new paraneoplastic syndrome?

We describe a 41-year-old woman, in whom antiphospholipid antibody syndrome (APS) occurred at presentation, before the detection of an ovarian endometrial adenocarcinoma. This syndrome was characterized by widespread and worsening thromboembolism and it did not respond to conventional anticoagulant treatment. The paraneoplastic nature of this APS was strongly suggested by the disappearance of both thromboembolism and antiphospholipid antibodies only after surgical removal of the cancer.

Adenocarcinoma↗
PubMed1994

Efficacy and tolerability of etodolac in aged patients affected by degenerative joint disease (osteoarthritis) in its active phase.

Three-hundred-and-fifteen patients, aged 60 or more years, affected by degenerative joint disease (DJD) in the active stage, the majority with concomitant pathological conditions of various organs and systems and undergoing various combined drug treatments, were treated with 300 mg b.i.d. etodolac in order to assay its efficacy and safety profile in an aged population more exposed to the occurrence of adverse events. In a subset of these patients, the impact of etodolac treatment on cognitive function and mood was studied. All clinical assessments revealed highly significant improvement after etodolac treatment. Significant improvement was found also for what concerns mood, whereas only the less aged patients showed improvement in cognitive abilities after treatment with etodolac. Only 30 patients (9.5%) showed side-effects, resulting in suspension of treatment in 10 cases (3.17%). In all cases, adverse reactions subsided with no consequences. Laboratory tests performed at the end of the study yielded mean values comprised within the normal range and were not statistically different from the same examinations performed before starting treatment. Occult blood in stool turned positive after treatment with etodolac only in six patients (2%). In conclusion, etodolac proved to be effective and well-tolerated in the treatment of risk-aged patients with active DJD.

Administration, Oral↗
PubMed1993

Soluble tumor necrosis factor receptors in human inflammatory synovial fluids.

OBJECTIVE: To test synovial fluid (SF) for the presence of soluble fragments originating from distinct tumor necrosis factor receptors (TNF-sR55 and TNF-sR75) which bind to TNF and inhibit its biologic activity. METHODS: TNF-sR55 and TNF-sR75 were measured in 62 SF samples by specific immunoassays using monoclonal antibodies. RESULTS: Both TNF-sR were present in all of the SF tested. Their concentrations were higher in SF from patients with seropositive rheumatoid arthritis than in patients with other inflammatory arthritides. The relative amount of TNF-sR75, as compared with TNF-sR55, was higher in seropositive RA SF than in other SF. CONCLUSION: The balance between TNF and its specific inhibitors may be critical to the biologic outcome mediated by this cytokine.

Humans↗
PubMed1993

Early phenotypic activation of circulating helper memory T cells in scleroderma: correlation with disease activity.

OBJECTIVES: The differential expression of several accessory/activation molecules (CD26, CD29, CD45RA, CD25, MLR4, HLA-DR) on peripheral blood CD4+ and CD8+ T lymphocytes in patients with scleroderma was compared with that in controls and patients with other connective systemic diseases to look for evidence of the involvement of T cells in the disease process of scleroderma. METHODS: The two colour expression of surface molecules by circulating T cells was analysed with a panel of monoclonal antibodies and flow cytometry in 17 patients with scleroderma, 10 patients with systemic lupus erythematosus, and five patients with rheumatoid arthritis, and the results compared with those for 10 normal controls. The two colour T CD4+ phenotype was further compared between patients with active and quiescent disease in these patients with scleroderma. The coexpression of surface molecules by CD4+ T cells was also analysed by three colour flow cytometry in eight patients with scleroderma. RESULTS: Patients with scleroderma showed increased CD4+CD26+ and CD4+CD25+ percentages and absolute numbers and decreased CD8+CD29+ percentages compared with controls. Moreover, a significant correlation between the higher CD4+CD26+ T cell percentage and absolute cell numbers with disease activity was observed. Most of the CD4+ peripheral blood T cells from patients with scleroderma showed the CD26+CD45RA- phenotype by three colour flow cytometry analysis. CONCLUSIONS: The distinctive pattern of early helper memory T cell activation in these patients with rapidly evolving scleroderma supports the role of a T cell mediated mechanism in the progression of scleroderma.

Adult↗
PubMed1991

Anti-thyroid microsomal antibody in synovial fluid as a revealing feature of seronegative autoimmune thyroiditis.

Two cases of recurrent monoarthritis are described in which antithyroid microsomal (antiMi) autoantibody (Ab) was found in synovial fluid (SF) before any clinical or serological evidence of thyroid disease. Subsequently, the follow-up of the two patients showed the appearance of thyroiditis within 2-5 years. The presence of anti-Mi Ab in SF might anticipate the appearance of autoimmune thyroiditis even in the absence of serum detectable antithyroid Ab, as was later observed in these two cases.

Adult↗
PubMed1991

Prevalence and characteristics of anti-single-stranded DNA antibodies in localized scleroderma. Comparison with systemic lupus erythematosus.

Prevalence, levels, and immunoglobulin classes of anti-single-stranded DNA antibodies were determined by an enzyme-linked immunosorbent assay in 52 patients with localized scleroderma (33 with morphea, four with generalized morphea, and 15 with linear scleroderma), in 60 healthy controls, and, for comparison, in 31 patients with systemic lupus erythematosus. Localized scleroderma revealed a significant prevalence of anti-single-stranded DNA antibodies, mainly characterized by high levels and IgM and IgA isotypes. Comparison of antibody characteristics in different clinical forms of localized scleroderma showed some significant differences (levels and immunoglobulin isotypes). Comparison with systemic lupus erythematosus showed that frequency, high levels, and IgG isotype of anti-single-stranded DNA antibodies significantly prevailed in systemic lupus erythematosus, while the IgM isotype significantly prevailed in localized scleroderma. However, generalized morphea and linear scleroderma did not significantly differ from systemic lupus erythematosus as regards antibody frequency and prevalence of high antibody levels.

Adult↗
PubMed1991

Esophageal involvement in mixed connective tissue disease.

A study of esophageal symptoms and function was performed in 21 patients with mixed connective tissue disease (MCTD). Esophageal involvement was found in 18 cases (85%), in 14 (66%) with typical symptoms, in 15 (71%) with manometric abnormalities and in 11 (57%) with both. The manometric pattern was characterized by reduction of amplitude and coordination of peristaltic waves throughout the esophageal body and reduction of lower esophageal sphincter (LES) competency. In comparison, 38 patients with systemic sclerosis showed a similar but more severe pattern, particularly at the level of the distal esophagus and LES. Thus, although similar, the esophageal involvement in MCTD was not exactly the same as that of systemic sclerosis. Furthermore, in MCTD a correlation between manometric abnormalities and cutaneous involvement was lacking, and this suggests that esophageal disorders are not always linked with clinically evident scleroderma-like features of this disease. Since the diagnosis of MCTD is made in the presence of the clinical picture of more than one connective tissue disease, the detection of esophageal involvement by a sensitive technique such as esophageal manometry in a patient with suspected MCTD may be a useful diagnostic aid.

Adult↗