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Biomedical subjects

T K Burnham

Publications and source records attributed to T K Burnham.

At least 19 recordsLinked to original sources
PubMed1987

Large speckle-like thready and thready antinuclear antibody patterns as markers for different clinical presentations in lupus erythematosus.

Fifty-one patients with lupus erythematosus were studied retrospectively. They were chosen on the basis of their antinuclear antibody (ANA) immunofluorescent pattern. Only those with the thready or the large speckle-like thready patterns were studied. Autoantibody profiles consisting of ANA, anti-single-stranded deoxyribonucleic acid (ssDNA) antibody, and anti-extractable nuclear antigen (ENA) antibody determinations were obtained. The patients with the thready ANA pattern and anti-ENA (Sm) antibodies had a significantly higher incidence of pulmonary, joint, and renal involvement than the anti-ENA negative patients with the large speckle-like thready pattern. There was also a significantly higher incidence of Raynaud's phenomenon in patients with the thready pattern than in those with the large speckle-like thready pattern. Photosensitivity was seen significantly more frequently in the patients with the large speckle-like thready pattern than in those with the thready pattern.

Antibodies, Antinuclear↗
PubMed1986

Lichen planus and coexisting lupus erythematosus versus lichen planus-like lupus erythematosus. Clinical, histologic, and immunopathologic considerations.

A middle-aged black woman presented initially with painful cutaneous plaques that were located at various sites and that were diagnosed histologically as lichen planus. Standard light microscopic examination showed histopathologic variants of lichen planus. Direct immunofluorescence of a skin lesion had negative results for any of the lupus erythematosus bands but did reveal hyaline bodies in the deep cellular layer of the epidermis and the superficial layer of the dermis. These findings were compatible with either lichen planus or lupus erythematosus. However, both the clinical course of the eruption and the antinuclear antibody tests showed that the immunofluorescent antinuclear antibody pattern of large, speckle-like threads were consistent with lupus erythematosus. Furthermore, the large, speckle-like, thready antinuclear antibody pattern, which has been shown to be a marker for a benign subset of lupus erythematosus, is not seen in lichen planus. Lichen planus--like lupus erythematosus was therefore the more likely diagnosis.

Antibodies, Antinuclear↗
PubMed1985

Antinuclear antibodies as indicators for the procainamide-induced systemic lupus erythematosus-like syndrome and its clinical presentations.

Fifty patients on a regimen of procainamide were studied in regard to the association between antinuclear antibodies (ANA) and the development of drug-induced systemic lupus erythematosus (SLE)-like syndrome. Four groups were identified: Group 1 was ANA-positive, with clinical manifestations (serologic and clinical findings); Group 2 was ANA-positive, without clinical manifestations (serologic findings only); Group 3 was ANA negative (no patients with clinical manifestations); and Group 4 had SLE persisting after discontinuance of procainamide. The leukocyte-specific ANA (LSANA) patterns were predominant, with peripheral LSANA confined to Groups 1 and 4. Furthermore, the titer of the homogeneous LSANA, to which peripheral LSANA converts on dilution, was clinically significant. A homogeneous LSANA titer of 160 or greater was seen essentially only in patients with clinical manifestations of the SLE-like syndrome. Serial ANA determinations are therefore necessary to monitor patients receiving procainamide.

Antibodies, Antinuclear↗
PubMed1983

Serologic profiles as immunologic markers for different clinical presentations of lupus erythematosus.

The clinical and laboratory features of 55 patients with lupus erythematosus (LE), grouped on the basis of six nuclear immunofluorescent pattern results commonly encountered in this disease were examined. Serologic profiles of antinuclear antibodies (ANA), anti-DNA and anti-ENA results can serve as immunologic markers in LE for a benign subset and two other groups with a different incidence of certain clinical characteristics. The large speckle-like thready pattern without antibodies to DNA or ENA is an immunologic marker for a benign LE subset, with generalized skin lesions with or without joint involvement only. Significant levels of the anti-DNA antibodies with the shrunken peripheral, peripheral, or leukocyte-specific ANA with a particulate pattern are markers for severe systemic involvement. The thready pattern with antibodies to ENA (Sm antigen) and leukocyte-specific ANA without a particulate pattern, with or without antibodies to DNA or ENA, indicate less severe systemic disease.

Adolescent↗
PubMed1983

Anticentromere and anticentriole antibodies in the scleroderma spectrum.

We studied serum samples from 106 patients, including 80 in the scleroderma spectrum, by indirect immunofluorescent microscopy, using PtK1 rat kangaroo tissue culture cells as substrate. Anticentromere (Kinetochore) antibodies were present in 28 patients, and anticentriole antibodies were present in four patients. Anticentromere antibodies were usually present in patients with a benign, chronic form of systemic scleroderma, which has been termed the CREST (Calcinosis, Raynaud's phenomenon, esophageal involvement, sclerodactyly, and telangiectasia) syndrome. The four patients with a previously undescribed anticentriole antibody were all in the scleroderma spectrum. Possibly, these antibodies may have diagnostic and prognostic importance. Further, they will be useful in studying the structure and function of these cellular organelles.

Antibodies↗
PubMed1982

Systemic lupus erythematosus and coexisting bullous pemphigoid: immunofluorescent investigations.

An 18-year-old black woman with systemic lupus erythematosus (SLE) who subsequently developed a bullous eruption is presented. Direct immunofluorescent studies of a bulla and peribullous skin demonstrated a tubular band at the dermoepidermal junction diagnostic for bullous pemphigoid (BP). However, an atrophic plaque clinically and histologically characteristic for lupus erythematosus (LE) also demonstrated a tubular band instead of one of the LE bands. Indirect immunofluorescent studies employing normal human skin revealed peripheral, homogeneous, and particulate antinuclear antibody patterns with anti-IgG but were negative for circulating anti-basal zone antibodies. Therefore BP was dominant cutaneously, whereas SLE prevailed serologically. This case illustrates the diagnostic problems of a bullous eruption in an SLE patient and points out some unusual immunofluorescent findings.

Adolescent↗
PubMed1982

Antinuclear antibodies as immunologic markers for a benign subset and different clinical characteristics of scleroderma.

Antinuclear antibody (ANA) test results were correlated with the clinical status of 56 patients with systemic scleroderma. Three groups were identified. (1) The speckled pattern represented a benign clinical subset. Acrosclerosis, Raynaud's phenomenon, calcinosis, and esophageal dysmotility characterized this group. None of these patients had pulmonary, renal, or cardiac disease. (2) Two patterns and ANA-negative test results were associated with a different incidence of certain clinical characteristics. The thready pattern was associated with pulmonary involvement. Diffuse skin involvement and Raynaud's phenomenon were found with the nucleolar pattern. Patients with ANA-negative test results had the most severe disease, including renal failure. (3) Two patterns were not associated with different clinical characteristics. These were the small speckle-like thready pattern and the homogeneous pattern. This study supports the theory that ANA patterns may be used as immunologic markers for different clinical characteristics of patients with scleroderma as they have already been used in lupus erythematosus.

Antibodies, Antinuclear↗
PubMed1982

Case for diagnosis: vesicular pemphigoid?

A 47-year-old man was diagnosed as having dermatitis herpetiformis (DH) in 1957. His failure to respond to therapy and the advent of immunofluorescent techniques led to a subsequent tentative diagnosis of vesicular pemphigoid (VP). High-titered, antibasal zone antibodies were present. However, unlike previously reported cases, direct immunofluorescence microscopy initially showed a DH-like and, later, an atypical granular band instead of a tubular (linear) band but with bullous pemphigoid (BP)-like immunoglobulin composition. No IgA was present. The patient's serum antibasal zone antibodies reacted with his perilesional skin despite granular deposits present at the same site, suggesting concomitant BP- and DH-like immunologic phenomena. The non-IgA-containing atypical granular band might be an immunologic marker for a subset of VP or another distinct disease entity demonstrating an immunologic overlap between BP and DH.

Dermatitis Herpetiformis↗
PubMed1981

Immunofluorescence microscopy studies of the granular and keratin layers of normal human skin.

Granular and keratin layer fluorescence of normal human skin has been found to be very different, depending on whether the indirect or the direct fluorescent antibody technique is used. These layers fluoresce more brightly with the indirect than with the direct technique. These differences were interpreted as being caused by in vitro binding of antibodies such as anti-stratum corneum antibodies. The purpose of this study was to see if these differences were, in part, artifacts. on serum dilution, the appearance with the indirect technique consistently converted to that of the direct technique, but no microscopic structural differences were found between the skins subjected to the different technical procedures. Therefore, it was concluded that the indirect appearance is caused only by antibodies binding to the keratin and granular layers and is not a methodological artifact.

Antibodies↗
PubMed1980

Elevated levels of antibodies to polyuridylic acid detected and quantitated in systemic scleroderma patients by solid phase radioimmunoassay.

A solid support radioimmunoassay has been developed to detect immunoglobulin specific circulating antibodies to polyuridylic acid (Pol U), single-stranded RNA (ss RNA), and single-stranded DNA (ss DNA) in scleroderma and other connective tissue diseases. The assay system uses flex-vinyl microtiter plates on which bovine methyl albumin, the respective polynucleotide, a 1:80 dilution of patient serum, and tritiated high affinity anti-IgG, -IgA, or -IgM are layered. The individual wells containing the sandwich assay are then counted for the presence of labeled immunoglobulins and the results are reported in microgram/ml. Of the 30 scleroderma patients tested, only patients with diffuse systemic scleroderma had antibody levels reactive to Poly U > 4.0 microgram/ml and to ss RNA < 3.0 microgram/ml. Patients with linear scleroderma or morphea had antibody levels to Poly U < 3.0 microgram/ml and very little antibody to ss DNA or ss RNA in their sera. Partial cross reactivity to Poly U was found only in SLE patients with high levels of Ab to ss DNA. Insignificant levels of Poly U antibody were found in patients with other connective tissue diseases and in normal controls. High levels of serum antibody in patients which reacted with Poly U suggest active diffuse systemic scleroderma.

Antibodies↗
PubMed1979

Significance of levels of specific immunoglobulins to DNA in SLE patients' sera detected by solid phase radioimmunoassay.

A solid phase radioimmunoassay was developed for detecting the quantity of double-stranded and single-stranded DNA antibodies in patients with systemic lupus erythematosus and other connective tissue diseases. The assay system employs a solid support 96-well, flex-vinyl microtiter plate to which bovine methyl albumin is layered, followed by denatured or native calf thymus DNA. A 1:80 dilution of patients' sera was added to respective wells followed by tritiated high affinity anti-IgG, -IgA, or IgM. Denatured DNA (single-stranded DNA) bound to methylated bovine serum albumin had less than 5% reannealment to the double-stranded form and provided a better substrate for Ab binding than double-stranded DNA, producing a linear binding curve. Of 58 patients diagnosed as having systemic lupus erythematosus (SLE), only 11 having active SLE had IgG antibody levels of greater than 5.0 microgram/ml to single-strand DNA. Renal involvement of some degree was found in all 11 with the high concentrations of IgG antibodies to DNA correlating with severe involvement. Patients with IgM antibodies to DNA alone had more benign types of SLE with little renal involvement. No abnormal levels of IgA Ab to either single-strand DNA or double-strand DNA were found in SLE patients' sera. Corticosteroid and/or immunosuppressant treatment caused a marked drop in the IgM Ab level to DNA within 10 days while IgG Ab to DNA remained high for up to 30 days. Quantitation of IgG and IgM Ab to single-strand DNA provides a useful method for diagnosing severe SLE with possible renal involvement and monitoring the course of the disease during therapy.

Antibody Specificity↗
PubMed1978

Antinuclear antibodies: a simplified classification of the nuclear immunofluorescent patterns.

The key to a simplified classification of the nuclear immunofluorescent patterns is to separate out only two patterns, the speckled and nucleolar, from the nonhomogeneous particulate group (showing stained particles). There are only six categories divided into two major groups: nonparticulate and particulate. The nonparticulate group consists of the (1) peripheral, (2) homogeneous, and (3) leukocyte specific patterns. The particulate group is divided into (1) nucleolar, (2) speckled, and (3) "other particulates." The major diagnostic and prognostic values of of the test are retained by the simple expedient of separating out only two morphologically distinct and diagnostically important patterns from the particulate group, the nucleolar and speckled patterns, seen mainly in scleroderma but not in lupus erythematosus.

Antibodies, Antinuclear↗