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Biomedical subjects

T Bardin

Publications and source records attributed to T Bardin.

At least 109 records · Page 6Linked to original sources
PubMed1987

[Amyloidosis in hemodialysis patients].

Amyloidosis in long-term haemodialysis patients mainly involves the osteo-articular system. It is held responsible for carpal tunnel syndrome, chronic arthralgia and various types of arthropathy, chronic synovitis and tenosynovitis, haemarthrosis, subacute polyarthritis and destructive arthropathies of the limbs and spine. Radiologically, amyloidosis may appear as bone cavities, particularly visible in the hips and wrists. Its frequency increases with the duration of haemodialysis. Biochemically, amyloidosis consists of beta 2-microglobulin (beta 2-M). This protein accumulates in uraemic patients under dialysis and seems to play a major role in the pathogenesis of amyloid deposits. The accumulation is due to renal impairment, being maximum in anuric patients. However, the unsatisfactory clearance of beta 2-M by dialysis methods also contributes to its retention: the production and elimination of beta 2-M seems to vary according to the extrarenal clearing technique. These data suggest that improvements in clearing techniques will eventually prevent dialysis amyloidosis.

Amyloidosis↗
PubMed1987

Hemodialysis-associated amyloidosis and beta-2 microglobulin. Clinical and immunohistochemical study.

The beta-2 microglobulin type of amyloidosis was identified in articular and para-articular tissues of 14 patients with non-amyloid nephropathies undergoing long-term hemodialysis. Ten patients had carpal tunnel syndrome, 13 had juxta-articular radiolucent cysts (complicated by spontaneous fractures of the femoral neck in three), and six had destructive arthropathies of the large joints of the limbs. Massive amyloid deposits were found in the synovium, capsule, ligaments, articular cartilage, and/or bone. They were characterized by Congo red-induced green birefringence that was sensitive to potassium permanganate treatment. They reacted with anti-beta-2 microglobulin antiserum, whereas they did not react with antibodies directed against AA protein, prealbumin, or immunoglobulins. These data suggest that the potentially disabling arthropathy of hemodialysis is due to amyloid lesions. The persistently elevated plasma beta-2 microglobulin levels may play a role in the pathogenesis of this recently recognized complication, and if so, this complication should be preventable.

Aged↗
PubMed1987

HLA haplotypes in non-familial rheumatoid arthritis.

The frequencies of HLA-A, B, C, DR, and BF haplotypes in 44 unrelated Caucasian patients with definite seropositive rheumatoid arthritis (RA) were compared with haplotype frequencies in controls. Overall, the patients had an increased risk for HLA-DR4, DR3, and DR2 antigens, but frequencies of certain DR4 or DR3 haplotypes were not increased, suggesting the importance of other HLA loci for the evaluation of risk. The presence of DR4 alone was not found to produce an increased risk for RA since the frequencies of certain DR4 haplotypes were similar in patients and controls. Increased frequencies of HLA-B18, DR4, HLA-B15, DR4, and HLA-A1, B8, Cw7, DR3 haplotypes were found in patients. RA susceptibility has been found to be associated with the last two haplotypes in some studies of multiple case families, suggesting that similar genetic mechanisms may underlie the disease in familial and sporadic forms.

Arthritis, Rheumatoid↗
PubMed1987

[Alizarin red staining of articular fluids. Comparison of the results with electron microscopy and clinical data].

Coloration of articular fluids with alizarin S red has been proposed as a method of sensitive detection of calcium microcrystals, especially apatite crystals. We are reporting the results of a study of 230 non-selected fluids. The results of the coloration were quantified into negative, slightly positive, moderately positive and strongly positive. Study of X-Rays of the tapped joint and of the hospital file was done in 199 patients. Electron microscope study, of 44 fluid samples, shows that the coloration with alizarin red permits a reliable detection of calcium microcrystals in the articular fluid, only if the strongly positive results are taken into account. But the coloration is not specific for apatite: 5 strongly positive fluids out of 14 contain only, in electron microscopy, crystals of dihydrated calcium pyrophosphate. 10.8% of the stained fluids give a strongly positive result. In two cases, it concerns destructive arthropathies of the shoulder with periarticular calcifications. The other strongly positive results are found in chondrocalcinosis (52 p. cent), in arthrosis (17 p. cent) and in rheumatoid polyarthritis (15 p. cent). As a whole, the results are correlated with age and the degree of radiological destruction. The similar percentage of strongly positive fluids observed in arthrosis and rheumatoid polyarthritis, is not in favor of a specific role of apatite microcrystals in the pathogenesis of arthrosis. Since the majority of strongly positive fluids come from joints which are very destroyed, regardless of the arthropathy concerned (rheumatoid polyarthritis, chondrocalcinosis or arthrosis), it is possible to think that it is mostly the destruction of the sub-chondral bone which explains these results.

Anthraquinones↗
PubMed1987

Tissue distribution of dialysis amyloidosis.

Twenty-three uremic patients on intermittent hemodialysis for eight to eighteen years provided the material for the present pathological study. In all of them, there was evidence for dialysis related amyloidosis based on previous clinical or histological findings or both. The material examined consisted of nine skin biopsies, five abdominal fat aspirates, eight trans-iliac bone biopsies and numerous post-mortem specimens of various visceral organs from eight cases. None of the skin biopsies or fat aspirates showed amyloid deposits. In only one bone biopsy could a small Congo red positive area be recognized that showed characteristic birefringence under polarizing light. Autopsy material findings were negative except for one case: this patient had been dialyzed for 18 years. Very minute amyloid deposits with a positive immunofluorescence staining for beta 2-microglobulin (beta 2-M) were found in the walls of small vessels from her lung, heart, liver and intestine. Thus, in chronic hemodialysis patients the accumulation of beta 2-M amyloid fibrils in tissues other than joints and juxta-articular structures appears to have a low incidence, to occur lately and to be of limited size. Although extra-articular amyloid deposits may progressively occur and extend with increasing survival time on dialysis, tiny deposits such as those observed in only two of our patients will hardly lead to serious complications.

Aged↗
PubMed1987

[Fiessinger-Leroy-Reiter syndrome in Greenland. Clinical and epidemiological aspects].

A clinical and epidemiological study of the Fiessinger Leroy Reiter syndrome was undertaken in Inuits from four Greenland cities, because of the frequency of HLA B27 antigen and venereal diseases in this population. A mean prevalence of 0.67 p. cent was found in Inuits from the west coast, of which 27.5 p. cent are carriers of the HLA B27 antigen. In Amassalik, on Greenland's east coast, where the frequency of B27 was estimated at 6.5 p. cent, the prevalence of the syndrome is 0.32 p. cent. Immunogenetic and preliminary familial data show that HLA B27 is present in 87.5 p. cent of the patients and that 34 p. cent have a close relative with the disease. Clinical data are comparable to those reported in the literature. Evolution is marred by frequent recurrences: 85 p. cent of the patients followed for more than ten (10) years present at least one recurrence. The total frequency of ankylosing spondylarthritis is 16.7 p. cent. It increases, in retrospect, to reach 45 p. cent in 22 patients followed for more than 15 years.

Adolescent↗
PubMed1986

[HLA system and complications of the treatment of rheumatoid polyarthritis with D-penicillamine].

The data of the literature concerning the relationship between complications of D-penicillamine treatment and the HLA system are discussed. This relationship particularly concerns the renal complications which are associated with HLA antigens B8 and DR3, although this relation is not sufficiently strong to be used in practice in the indications for treatment with D-penicillamine.

Arthritis, Rheumatoid↗
PubMed1986

[Arthropathies of patients on hemodialysis for more than 10 years: retrospective study].

Joint problems have been retrospectively analyzed in 10 uremic patients (mean age, 61.9 years; range, 50-70) undergoing long-term hemodialysis treatment for more than 10 years. All the patients suffered from arthralgias which were mainly localized in the shoulder region (9 patients). The arthralgias began 2-9 years after the initiation of intermittent hemodialysis. Eight out of the 10 patients had the carpal tunnel syndrome. Only three patients had evidence of marked secondary hyperparathyroidism but nine had aluminum intoxication. Juxta-articular calcium deposits were observed in 8 patients one of whom had pseudo-tumoral calcifications made of hydroxyapatite crystals. These soft tissue calcium deposits occurred 1-8 years after starting hemodialysis. Conspicuous X-ray abnormalities were found in 8 patients: destructive arthropathy in 5 cases, arthropathies of large joints in 5 cases consisting of sub-chondral lacunae and joint space narrowing or even disappearance. Prosthetic joint replacement was required in 4 patients: replacement of the hip in 3 and of the knee in 1. Massive amyloid deposits could be demonstrated in removed joints of 3 patients and in carpal tunnel of the 7 patients operated upon. They were located in the synovium, articular capsula and juxta-articular epiphyseal bone. It is probable that this is a new type of amyloidosis made of beta 2-microglobulin. The underlying pathogenetic mechanisms of these arthropathies remain to be defined by further studies.

Aged↗
PubMed1985

Synovial amyloidosis in patients undergoing long-term hemodialysis.

Synovial amyloid deposits were found in 18 patients with end-stage renal failure due to various nonamyloid nephropathies, who had been treated with long-term, periodic hemodialysis (mean 116 months). All patients had carpal tunnel syndrome, which was bilateral in 14 of them; 4 patients also had finger flexor tenosynovitis. In 2 patients, destructive arthropathies required surgical replacement of the hip. Amyloid deposits were demonstrated by light microscopy in the synovium of the finger flexor tendon and/or transverse carpal ligament of all patients who had surgery for carpal tunnel syndrome, and in the synovium and capsula of the 2 surgically removed hips. Transmission electron microscopy of synovial samples from 6 patients demonstrated the characteristic fibrillar ultrastructure of amyloid deposits, the biochemical nature of which is still unknown. In addition, 9 patients had cystic radiolucencies of bone, which were interpreted as having resulted from local amyloid deposits, involving carpal bones, humeral heads, femoral heads, acetabula, or tibial plateaus. Our results show that amyloidosis is a frequent histologic finding in dialysis patients receiving surgical management of carpal tunnel syndrome, and that it can also be associated with cystic radiolucencies of bones and with destructive arthropathies.

Adult↗
PubMed1985

HLA antigens and seronegative rheumatoid arthritis.

HLA antigens and clinical features in a series of 46 Caucasian patients (40 females, 6 males) and definite repeatedly seronegative rheumatoid arthritis (RA) of more than two years' duration (mean 11.6 years) were compared with those in 77 seropositive RA patients and 110 controls of the same ethnic and geographic origin. Seronegative RA appeared to be less often erosive than seropositive RA, and seronegative patients had fewer extra-articular features. The frequency of the HLA antigen DR1 was raised in seronegative patients as compared with controls (p = 0.006, relative risk = 3) and with seropositive patients (p less than 0.05). HLA-DR4 was slightly increased in seronegative patients compared with controls (p less than 0.05) but was clearly less so than in seropositive patients (p less than 0.005). Early onset of disease was very significantly associated with HLA-DR1 in seronegative patients (p = 0.007), whereas HLA-DR4 was present more frequently in seropositive patients with onset prior to age 35 (p less than 0.05). No correlation between HLA antigens and intolerance to drugs was found in seronegative patients, whereas in seropositive patients side effects to gold salts were associated with DR3. These results suggest that seropositive and seronegative RA have distinct HLA-DR associations, especially in disease of early onset, in addition to well established clinical differences.

Adolescent↗