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Konstantia-Maria Chavele, Deepa Shukla, Tracey Keteepe-Arachi, Judith Anna Seidel, Dietmar Fuchs, Charles D Pusey, Alan D Salama
OBJECTIVE: T lymphocytes have been implicated in the pathogenesis of antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Patients with myeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA) experience relapses less frequently than those with proteinase 3 ANCA, suggesting greater immune regulation. This study was undertaken to investigate MPO-specific T cell reactivity during disease remission and the factors regulating their responsiveness. METHODS: MPO-specific T cells were quantified by enzyme-linked immunospot assay with additional Treg cell depletion or exogenous interleukin-2...
May 2010: Arthritis and Rheumatism
Joseph Prandota
Mollaret meningitis (MM) occurs mainly in females and is characterized by recurrent episodes of headache, transient neurological abnormalities, and the cerebrospinal fluid containing mononuclear cells. HSV-2 was usually identified as the causative agent. Recently, we found that recurrent headaches in non-HIV-infected subjects were due to acquired cerebral toxoplasmosis (CT). The aim of the study was therefore to focus on molecular pathomechanisms that may lead to reactivation of latent CT and manifest as MM...
2009: International Journal of Neuroscience
Sung Wook Park, Ju Yeon Ban, Kyung Lim Yoon, Hak Jae Kim, Jun Young Chung, Jae Woo Yi, Bong Jae Lee, Joo-Ho Chung
Kawasaki disease (KD) is an acute vasculitis of childhood that predominantly affects the coronary arteries. We investigated single nucleotide polymorphisms (SNPs) of the tryptophan hydroxylase 2 (TPH2) gene as risk factors for KD with coronary artery lesions (CALs) in Korean children. We genotyped two SNPs [rs7305115 (exon 7) and rs4290270 (exon 9)] using direct sequencing in 101 KD and 256 control subjects. To analyze the genetic data, SNPStats, SNPAnalyzer, and Helixtree programs were used. The genotype analysis of rs7305115 and rs4290270 showed no significant differences between KD and control groups...
April 2010: European Journal of Pediatrics
Ravi Kumar Kurup, Parameswara Achutha Kurup
The isoprenoid pathway including endogenous digoxin was assessed in systemic lupus erythematosis (SLE). All the patients with SLE were right-handed/left hemispheric dominant by the dichotic listening test. This was also studied for comparison in patients with right hemispheric and left hemispheric dominance. The isoprenoid pathway was upregulated with increased digoxin synthesis in patients with SLE and in those with right hemispheric dominance. In this group of patients (i) the tryptophan catabolites were increased and the tyrosine catabolites reduced, (ii) the dolichol and glycoconjugate levels were elevated, (iii) lysosomal stability was reduced, (iv) ubiquinone levels were low and free radical levels increased, and (v) the membrane cholesterol:phospholipid ratios were increased and membrane glycoconjugates reduced...
November 2003: International Journal of Neuroscience
M Schneider, M Gaubitz, A Perniok
Immunoadsorption offers some advantages over plasmapheresis; until recently the primary advantage has been avoidance of substitution fluids. In collagen vascular disorders, immunoadsorption is performed for the same indications as plasma exchange; most often adsorbers with binding capacities for IgG and circulating immune complexes are used. Tested ligands are protein A, anti-IgG antibodies, Clq, phenylalanine, and tryptophan. Human IgG was utilized to adsorb rheumatoid factor and dextran sulfate, DNA, or specific anti-idiotypes for anti-DNA antibodies in systemic lupus erythematous (SLE)...
May 1997: Therapeutic Apheresis
J D Elliott, C M Lockwood, G Hale, H Waldmann
The treatment of renal limited systemic vasculitis usually involves a combination of cytotoxic drugs and steroids. As shown by randomised prospective controlled trial, plasmapheresis may be of additional benefit for the management of patients with renal involvement severe enough to require dialysis support. Recently, growing evidence has suggested that autoantibodies to neutrophil cytoplasm (ANCA) may play a role in the pathogenesis of the primary vasculitides by promoting neutrophil mediated endothelial cell cytotoxicity...
1998: Autoimmunity
J S de Oliveira, S B Auerbach, K M Sullivan, G E Sale
A 16-year-old white male with acute biphenotypic leukemia developed evidence of the eosinophilia myalgia syndrome associated with total parenteral nutritional support with solutions containing tryptophan, which were given during his initial induction chemotherapy and also after autologous marrow transplantation. He developed pronounced eosinophilia and a vasculitic skin rash, myalgias of the abdomen, upper trunk, and neck, and died of respiratory distress with no evidence of an infectious etiology. Autopsy revealed diffuse vasculitis involving the heart, lungs, kidneys, testes, spleen, liver, skin, gut wall and marrow with neuritis of gut wall nerves and ganglia...
February 1993: Bone Marrow Transplantation
H D Tazelaar, J L Myers, J G Strickler, T V Colby, J Duffy
L-tryptophan (LT) has been implicated as a causal agent in the recently recognized eosinophilia-myalgia syndrome (EMS). Pulmonary complications occur in up to 60% of patients. Lung biopsies have shown chronic interstitial pneumonia, mild eosinophilia, vasculitis and perivasculitis, and hypertensive pulmonary arteriopathy. Open lung biopsies from two women who developed respiratory symptoms associated with LT EMS were studied with a panel of antibodies to lymphoid cells, by transmission electron microscopy and by direct immunofluorescence for immunoglobulin and complement...
January 1993: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
G S Spear
BACKGROUND: Eosinophilic carditis with peripheral eosinophilia has been observed in a number of clinical situations. This report describes this association in patients undergoing heart transplantation and offers a possible explanation. METHODS: The clinical records and explanted hearts of 31 consecutive patients who received primary orthotopic heart transplants were reviewed. Clinical features particularly analyzed included the following: age, cardiac status and assistance devices, catheterizations, medical or surgical disorders including parasites, tryptophane exposure, medications, and peripheral blood counts...
July 1995: Journal of Heart and Lung Transplantation
T Saito, T Sugai, J Ito
No abstract text is available yet for this article.
August 1967: Journal of Investigative Dermatology
L D Kaufman, A F Finn, R J Seidman, J Pampati, N S Peress, F Miller, L Sokoloff, B L Gruber
Four cases are described of a clinical syndrome which developed in the setting of L-tryptophan ingestion. The major manifestations consisted of myalgias, neuropathy, weakness, and profound eosinophilia. Pathologically a vasculitis involving predominantly small veins was observed along with a mixed cellular infiltrate in the perimysium and epineurium. Clusters of eosinophils were characteristically noted in the tissue specimens. The clinical course appears to be chronic although further longterm followup will be required...
June 1990: Journal of Rheumatology
J J Namey, R L DiGiovanni, R E Sobonya
We have reported a case of eosinophilia-myalgia syndrome associated with tryptophan ingestion. Our case meets the Centers for Disease Control surveillance definition of eosinophilia-myalgia syndrome. Our report describes clinical, laboratory, electromyographic and histologic findings that suggest this entity is a small vessel nonnecrotizing vasculitis.
June 1990: Southern Medical Journal
H D Tazelaar, J L Myers, C W Drage, T E King, S Aguayo, T V Colby
Tablets and capsules containing the essential amino acid L-tryptophan are currently being investigated as a cause of the newly recognized eosinophilia/myalgia syndrome. In the five histologically documented cases reported herein, L-tryptophan ingestion was associated with prominent pulmonary complications. All patients were women ranging from 34 to 65 years, and all presented with respiratory symptoms that began after one to nine months of L-tryptophan therapy. Peripheral eosinophilia was present in four patients as were bilateral interstitial infiltrates on chest roentgenograms...
May 1990: Chest
D J Clauw, D J Nashel, A Umhau, P Katz
Seven patients who developed a syndrome of eosinophilia, connective-tissue disease, and cutaneous abnormalities while ingesting tryptophan were examined. Other clinical manifestations commonly seen were pulmonary symptoms, fever, lymphadenopathy, and the development of myopathy. Laboratory features included mild elevations of aldolase and lactate dehydrogenase levels, with essentially normal creatine kinase levels, erythrocyte sedimentation rates, and C-reactive protein levels. Biopsy findings included features of scleroderma, small-vessel vasculitis, fasciitis, and myopathy...
March 16, 1990: JAMA: the Journal of the American Medical Association
W D Travis, M E Kalafer, H S Robin, F J Luibel
No abstract text is available yet for this article.
February 15, 1990: Annals of Internal Medicine
S A Smith, R I Roelofs, E Gertner
The eosinophilia-myalgia syndrome associated with the ingestion of L-tryptophan was recognized in late 1989. We describe our pathologic study of skin, fascial, and muscle biopsies from 21 patients evaluated by light microscopy, histochemistry, and electron microscopy. A perivascular, lymphocytic infiltrate with eosinophils was present in the dermis, fascia, and skeletal muscle. Lymphocytic infiltration of arteries and arterioles was seen. Ultrastructurally, capillary and arteriolar endothelial cell thickening and necrosis was present...
November 1990: Journal of Rheumatology
S L Strongwater, B A Woda, R A Yood, M E Rybak, J Sargent, U DeGirolami, T W Smith, C Varnis, S Allen, K Murphy
Four patients fulfilling the case definition for eosinophilia-myalgia syndrome are described, including one whose disease began in 1986. Each displayed a variety of symptoms: one suffered principally from myalgia and recovered spontaneously on discontinuation of L-tryptophan therapy; one exhibited progressive sclerodermiform skin changes, neuropathy, and myopathy; a third had prominent neuromuscular disease and sclerodermiform skin changes; and the fourth experienced profound weight loss, an axonal polyneuropathy, and perivascular lymphoid infiltrates simulating a lymphoma...
October 1990: Archives of Internal Medicine
L A Criswell, K E Sack
Eight patients who became ill while taking tryptophan had myalgia, fatigue, rash, fever, edema, alopecia, arthralgias, diminished joint motion, skin tightening, muscle cramping, and distal paresthesias. Three had shortness of breath, and one had pulmonary hypertension. Laboratory abnormalities included peripheral eosinophilia, leukocytosis, thrombocytosis, raised erythrocyte sedimentation rate, and elevated serum levels of aldolase, lactate dehydrogenase, and liver enzymes. Of 4 chest radiographs, 3 were abnormal...
September 1990: Western Journal of Medicine
N O Biasotto, R Labowitz
No abstract text is available yet for this article.
July 1990: Delaware Medical Journal
A S Banner, D Borochovitz
This report describes two women who presented with severe respiratory failure and diffuse pulmonary infiltrates in the fall of 1989. Both required prolonged assisted ventilation because of severe shunt physiology. Open lung biopsies on admission revealed a small vessel vasculitis as the sole morphologic abnormality in both patients. Both responded to high dose corticosteroids. Neither patient exhibited evidence of systemic vasculitis, and neither had serologic evidence of an immune disorder. Common to both patients was ingestion of L-tryptophan...
March 1991: American Review of Respiratory Disease
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