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PubMed1991

Efficacy of cyclophosphamide in toxic epidermal necrolysis. Clinical and pathophysiologic aspects.

In this article we describe the immunocytochemical and electron microscopic findings in five patients with toxic epidermal necrolysis. They indicate the occurrence of necrotic keratinocytes with nuclear disintegration associated with apposed dendritic cells with the nuclear chromatin configuration of T lymphocytes. These findings, including the presence of blebbing of the keratinocytes and membrane defects associated with cytoplasmic processes from these apposed lymphoid cells, fit known electron microscopic criteria that suggest the involvement of T lymphocyte-mediated cytolysis of drug-altered target keratinocytes in toxic epidermal necrolysis. The effector cell appears to be a dendritic subset, with the phenotypic characteristics (CD3+, CD4-, CD8+, CD2+, DR+) of a T cell subset. There is some evidence that tumor necrosis factor alpha, secreted by activated macrophages, may play a role in necrolysis of the epidermis. The dramatic response of our patients to cyclophosphamide, which is known to inhibit cell-mediated cytotoxicity by inhibiting both the recognition and lethal hit stages, together with the rapid regrowth of the epidermis within 4 days to a week in patients who received adequate dosage of the drug, supports the preceding concepts.

Adult↗
PubMedDate not supplied

[Sleep apnea synrome : effects of chlorimipramine in subjects with stable body weight (author's transl)].

Beneficial effects have been attributed to Chlorimipramine in the treatment of sleep apnea syndrome (SAS). However, there were no quantitative evaluations of these effects. Polygraphic studies were made before and after chlorimipramine treatment (75 mg per day for 3 to 16 months). The 3 SAS subjects, whose weight remained stable throughout the course of treatment, showed no evidence of reduced hypopnea and apnea during sleep.

Adult↗