Chronic urticaria associated with coeliac disease.
Explore the source record for details and available documents.
Celiac Disease↗
Biomedical subjects
W J Stevens
Publications and source records attributed to W J Stevens.
Antibodies of the IgE and IgG isotype, serum IgE and circulating immune complexes in schistosomiasis intercalatum.
Individuals in an advanced phase of infection by Schistosoma intercalatum in whom viable ova are still present in the rectal mucosa but not excreted in detectable quantity, can be distinguished clinically from a younger group of individuals excreting S. intercalatum ova in their faeces. This clear-cut distinction is underlined by findings in parameters of humoral response. The ratio of anticercarial to anti-adult worm antibodies was higher in the group excreting eggs with probably more recent infection. Levels of total serum immunoglobulin were higher in this group, with the exception of serum IgA, which was lower as long as eggs were being excreted. In a later stage of the disease, relatively more IgG seems to be bound in circulating immune complexes. It is postulated that these stage specific patterns of humoral immune response represent the evolution of the host-parasite relationship during the infection.
Adolescent↗
Systemic mastocytosis, an unusual cause of osteoporosis.
A 45-year-old patient is described presenting with severe axial osteoporosis. The presence of maculopapular skin lesions and the combination of osteolytic and osteoblastic bone lesions led to the tentative diagnosis of systemic mastocytosis. This diagnosis was confirmed by measurement of urinary histamine metabolites and by bone biopsy showing increased numbers of mast cells and fibroblast-like cells. The importance of these diagnostic procedures in this rare cause of osteoporosis is discussed.
Axis, Cervical Vertebra↗
Differential diagnosis in a patient with secondary Sjögren's syndrome and neuromuscular complications.
Explore the source record for details and available documents.
Aged↗
Nebulization treatment with saline compared to bromhexine in treating chronic sinusitis in asthmatic children.
Twenty children aged 3 to 14 years with a history of bronchial asthma complicated by chronic sinusitis were studied in a double-blind study. Patients received, at random, over a period of 2 weeks, either 2 ml saline or 2 ml bromhexine (2 mg/ml) t.i.d. by means of a home nebulizer. A significant decline of clinical symptoms during both nebulization treatments as compared to the pretreatment symptom score was observed (mean score of 1.5 +/- 0.7 and 0.5 +/- 0.8, respectively, P less than 0.01). Both types of nebulization were equally efficient in reducing the symptom score. Radiological abnormalities were significantly more reversed after saline nebulization as compared with bromhexine (P less than 0.05), although both treatments showed radiological improvement (P less than 0.01). The present study indicates that nebulization with saline may have some beneficial effect on chronic sinusitis in asthmatic children. Bromhexine was not superior to saline for this purpose.
Adolescent↗
Paranasal sinus pathology in allergic and non-allergic respiratory tract diseases.
Two hundred and seventy patients with asthma and/or rhinitis (162 or 60% allergic, 108 or 40% non-allergic) were studied for sinus pathology by means of standard X-rays and tomograms. Sinus pathology was defined as abnormal sinus X-rays, either on standard or tomography. Fifty-four percent of the X-rays were classified as abnormal based on mucosal thickening, loss of translucency of the cavities of polyps. Asthma was significantly more often associated with sinus X-ray abnormalities (65.1%) than rhinitis and/or chronic cough (44.4%). Loss of translucency of the cavities is more frequent in children, whereas mucosa thickening becomes more frequent with progressing age. Since in this prospective study the taking of X-rays of the sinuses was not dependent on or related to temporarily occurring symptoms which could be attributed to acute sinusitis, the presence of sinus abnormalities on X-rays can be considered as an indicator of the chronicity of airways diseases and might provide an indication for prophylactic therapy of the associated airway disease in a continuous way. The importance of sinus tomograms is stressed, since only 32.5% of the patients with mucosa thickening could be detected on standard X-rays.
Adolescent↗
Comparative evaluation of the multiple RAST and discrete RAST for inhalant allergy.
With the conventional, discrete RAST various tests are required to detect IgE of different specificities in the same serum. To overcome this problem and to reduce the costs, a multiple RAST with seven different mixtures was compared with the individual mixture constituents and with the 12 individual allergens currently in use in our department. One grass pollen mixture (gx3), two weed pollen mixtures (wx3, wx4), two tree pollen mixtures (tx5, tx6), one mould mixture (mx1) and one epithelial mixture (ex1) were used. A mixture of mites was not evaluated as there is only one important pathogenic organism in our regions (Dermatophagoides pteronyssinus or House dust mite). For grasses the gx3 mixture offered no advantage over the discrete RAST. The weed mixture wx3 was more sensitive than the most common discrete RAST's but at the cost of specificity. The wx4 mixture should not be used because the specificity is too low. The tree mixtures were not significantly more sensitive than the most common individual tree allergens, and were less specific. Mould mixtures should not be used because there is little cross-reactivity between the individual allergens, thus using a mixture would necessitate the subsequent determination of individual allergens, and the number of tests and the cost would be even higher. Neither should a mixture be used for epithelia because one wants to detect allergies to individual allergens. Moreover, the sensitivity of the epithelial mixture was too low. In general, we suggest the use of a limited panel of discrete RAST's instead of mixtures.
Allergens↗
Purpura fulminans in pneumococcal sepsis.
Two cases of pneumococcal sepsis in splenectomized patients were complicated by purpura fulminans. In addition, acute renal failure developed in both patients, and myolysis in one. Immunological findings in the patient with myolysis suggest a possible role of pneumococcal antigen-containing circulating immune complexes in the pathogenesis of these complications.
Acute Kidney Injury↗
ELISA HTLV retrovirus antibody reactivity associated with malaria and immune complexes in healthy Africans.
A serological survey of 250 outpatients in rural Zaire showed that the prevalence of antibody against HTLV-I, HTLV-II, and HTLV-III, as detected by enzyme-linked immunosorbent assay, correlated strongly with level of antibodies against Plasmodium falciparum. The age curve for the prevalence of antibody against these retroviruses and high titres of antibodies against P falciparum were similar. Tests with control sera obtained from HTLV-III seropositive homosexual men and American subjects repeatedly infected with malaria who had high antibody titres against P falciparum indicated that there was no cross-reactivity between P falciparum and these retroviruses. Immune-complex levels, but not IgG, IgM, or IgE levels, also correlated strongly with seropositivity in the ELISA HTLV-I and HTLV-III assay, although immune-complex-positive control samples were negative. Possible explanations include coincidental distribution paralleling malaria; similar mode of transmission; virus activation and/or enhanced antibody production due to the effect of malaria on the immune system; and false-positive reactivity in the ELISA assay due to cross-reactive antibodies or other unknown factors.
Adolescent↗
Endemic African Kaposi's sarcoma is not associated with immunodeficiency.
Twenty-seven histologically confirmed Kaposi sarcoma (KS) patients resident in the Kivu Lake area of eastern Zaire were examined for immune competence. Only KS cases of the endemic African type have been observed in this high-incidence area. The median duration of the symptoms was 6 years and ranged from 1 to 38 years. Forty-one controls matched for age, sex and tribe and unrelated to the KS patients were selected from the community. Thirteen additional controls were first-degree relatives of the KS patients. No evidence of immune suppression among KS patients was found and there were no significant differences in the immune status between KS patients and controls. Total lymphocytes, B and T cells, and OKT4+ and OKT8+ cells varied within the normal range. Grouping of the KS patients in categories according to duration and disease extent did not reveal significant differences in their immune status. The number of KS patients reacting positively in a skin test to 5 recall antigens and I mitogen was similar to that of controls, except in the case of candidin, to which a higher number of KS patients were negative. The serum levels of immunoglobulins, complement factors and circulating immune complexes were comparable in KS patients and controls. Indicators of inflammatory processes [white blood cells (WBC), complement-reactive protein (CRP)] were positive in 27% of the KS patients. The prevalence and mean titer of antibody against cytomegalovirus (CMV), Epstein-Barr virus (EBV), hepatitis B virus (HBV) and syphilis were similar in KS patients and in controls.
Acquired Immunodeficiency Syndrome↗
A theoretical model for the binding of cis-Pt(NH3)2(+2) to DNA.
The binding of cis-Pt(NH3)2B1B2 to the bases B1 and B2, i.e., guanine (G), cytosine (C), adenine (A), and thymine (T), of DNA is studied theoretically. The components of the binding are analyzed and a model structure is proposed for the intrastrand binding to the dB1pdB2 sequence of a kinked double helical DNA. Quantum mechanical calculations of the ligand binding energy indicates that cis-Pt(NH3)2(+2) (cis-PDA) binds to N7(G), N3(C), O2(C), O6(G), N3(A), N7(A), O4(T) and O2(T) in order of decreasing binding energy. Conformational analysis provides structures of kinked DNA in which adjacent bases chelate to cis-PDA. Only bending toward the major groove allows the construction of acceptable square planar complexes. Examples are presented for kinks of -70 degrees and -40 degrees at the receptor site to orient the base pairs for ligand binding to B1 and B2 to form a nearly square planar complex. The energies for complex formation of cis-PDA to the various intra-strand base sites in double stranded DNA are estimated. At least 32 kcal/mole separates the energetically favorable dGpdG.cis-PDA chelate from the dCpdG.cis-PDA chelate. All other possible chelate structures are much higher in energy which correlates with their lack of observation in competition with the preferred dGpdG chelate. The second most favorable ligand energy occurs with N3(C). A novel binding site involving dC(N3)pdG(N7) is examined. Denaturation can result in an anti----syn rotation of C about its glycosidic bond to place N3(C) in the major groove for intrastrand binding in duplex DNA. This novel intrastrand dCpdG complex and the most favored dGpdG structure are illustrated with stereographic projections.
Base Sequence↗
Clinical and biological evaluation of semi-rush and ordinary immunotherapy schemes in type I allergic respiratory diseases.
Forty-three patients with type I allergic respiratory diseases received aqueous grass pollen immunotherapy in a prospective study designed to compare the clinical and biological effects of a semi-rush hyposensitization (20 patients) with ordinary hyposensitization (23 patients). Before the start of the therapy (end of previous grass pollen season, t1) and before (t2) and after the next grass pollen season (t3), total serum IgE (tIgE), grass pollen-specific IgE (GPsIgE), grass pollen-specific IgG (GPsIgG) and complement factors C3 and C4 were determined. GPsIgE and GPsIgG levels increased significantly more during immunotherapy in patients receiving the semi-rush scheme as compared with the ordinary scheme. There were no significant changes between the two schemes at any times for tIgE, C3 and C4. GPsIgG was already higher in allergic patients before the start of therapy as compared with non-allergic patients and controls. Clinical improvement was the same in patients treated with the semi-rush scheme as in the ordinary group. The number of side effects was not statistically different between the two groups. In neither group was there a correlation between the change in biological parameters and change in clinical symptoms. As the semi-rush scheme gives the same results immunologically as well as clinically, it could be used in a number of patients since it reduces the time course of the initial therapy by about 2 months.
Adult↗
IgE deposition in normal skin of patients with rheumatoid arthritis in relation to clinical and laboratory findings.
Biopsy specimens from apparently normal skin of 28 patients with classical or definite rheumatoid arthritis (RA) were examined for the presence of IgE deposition by a direct immunofluorescence technique. IgE deposition was found in 12 patients (43%) and in none of the 10 controls. This deposition was mainly localised on mast cells, and in three patients perivascular IgE staining was also noted. The skin from nine of the 12 patients also showed deposition of IgM and complement C3 or C4 factor, or both. All 12 patients with skin IgE deposition had raised levels of IgM rheumatoid factor (RF) in the serum. Nine of these also had IgE RF. IgE-containing circulating immune complexes (IgE CIC), raised serum IgE levels, and extra-articular (EA) manifestations were present in respectively 10, nine, and eight skin IgE positive patients. It is suggested that IgE and IgE CIC may be involved in the pathogenesis of RA and its EA manifestations.
Adult↗
IgG-containing and IgE-containing circulating immune complexes in patients with asthma and rhinitis.
In looking for an additional mechanism that could cause inflammation and therefore be important in the pathogenesis of asthma and rhinitis, IgG- and IgE-CIC were determined in a number of patients that were suffering from asthma and/or rhinitis. Patients were further subdivided into allergic (type I allergy) and nonallergic patients on the basis of history, skin testing with common inhalant allergens, RAST, and, if necessary, allergen provocation. In addition, a control group and patients that were undergoing allergen-specific hyposensitization were studied also. The mean level and frequency of elevated IgG-CIC were significantly increased in all three patient groups as compared to controls. The frequency of IgE-CIC was only significantly elevated in both allergic groups, and the difference between allergic and nonallergic patients was highly significant. IgG- and IgE-CIC did not increase during long-term allergen hyposensitization. Since there was no significant increase of IgE-CIC 10 min after bronchial allergen challenge nor at the moment that symptoms such as urticaria, bronchial obstruction, or rhinorrhea appeared during rush hyposensitization in asthmatic patients, we think that CIC are not involved in classic type I allergic reactions. The possible role of IgG- and IgE-CIC in inducing inflammatory, mediator release from eosinophils and macrophages via binding of Fc receptors on these cells is discussed.
Antigen-Antibody Complex↗
Adult Still's disease caused by Yersinia enterocolitica infection.
Clinical and biologic features of adult Still's disease developed in a patient who had high antibody titers against Yersinia enterocolitica during his illness. Immunocomplexes containing antibodies against Yersinia antigens were isolated at the beginning of the disease. Yersinia was not isolated from blood or stool specimens probably because we observed the patient during the secondary phase of the disease.
Adult↗
Evaluation of delayed cutaneous hypersensitivity to antigens and a mitogen methodological aspects.
Explore the source record for details and available documents.
Adolescent↗
Serum IgA, IgG, IgM and IgD in allergic (type I) and non-allergic respiratory diseases.
Serum immunoglobulin levels A, G, M, D have been studied in 902 patients suffering from allergic or non-allergic asthma, rhinitis and cough or various combinations of these disorders. In addition, a control group of asymptomatic persons was included. Serum IgA and IgD levels were significantly lower in both the allergic and non allergic groups of patients as compared to the control group, indicating that this decrease is a common feature for all patient groups studies. Serum IgA was significantly increased in amount in smokers. Serum IgA and IgG levels increased significantly with age. Females showed significantly higher serum IgM levels as compared to males. Atopic eczema did not seem to influence the serum level of immunoglobulin classes A, G, M or D.
Adolescent↗
Effect of chemotherapy and reinfection on IgE-containing and IgG-containing circulating immune complexes, serum IgE and IgE antibodies in patients chronically infected with Schistosoma mansoni and Schistosoma haematobium.
The effect of chemotherapy and reinfection on circulating immune complexes (CIC), serum IgE, and parasite-specific IgE antibodies was studied in patients concomitantly infected with Schistosoma mansoni and Schistosoma haematobium. Before chemotherapy IgE- and IgG-containing CIC were present in high concentrations in all patients and IgE antibodies to S. mansoni and to S. haematobium in almost 80% of the cases. Serum IgE was excessively high (median 4,900 ku/1), but decreased to half of its initial value 2 months after chemotherapy. When reinfection with S. haematobium occurred onwards from month 4, the serum IgE reincreased and reached almost the pretreatment level at month 16. Effective chemotherapy was also followed by a rapid decrease of IgE-containing CIC and a slower, but significant, decrease of IgG-containing CIC. However, in contrast to IgE and IgE antibodies, the reinfection did not lead to a reincrease of CIC. It was interesting to note that the concentration of IgE as well as that of IgE-containing CIC was significantly correlated to the intensity of the infection. These investigations demonstrated that high levels of IgE- and IgG-containing CIC are present in chronic human schistosomiasis, but that the concentrations of CIC fall to normal values, when the parasites are eliminated by chemotherapy.
Antigen-Antibody Complex↗