Lymphocytaphereses using the Fenwal CS 3000 cell separator were performed in three patients with far advanced disease of Sézary-syndrome that was refractory to standard form of therapy. Patients underwent cytapheresis two to three times per week until the WBCs counts were regressed. Thereafter, one pheresis per week was performed for a total of 29 (Pat. A), 18 (Pat. B) to 70 (Pat. C) procedures during periods of 13 (A), 4 (B) to 19 (C) months. During each pheresis the volume of blood processed was 6-7000 mls. The cytaphereses resulted in an average WBCs reduction of 25 to 35% and of 35-56% of the original peripheral blood Sézary-cell counts. Lymphocytes counts dropped by 47 +/- 12% and 87 to 95% of the collected cells were lymphocytes. In addition to the fall in absolute numbers of circulating lymphocytes a change in the relative portions of lymphocytes subpopulations was observed. T-cells were reduced and concurrently B-cells increased. Significant side effects did not occurred during or following cytaphereses. Long-term pheresis can effectively treat symptmoms also in older patients resulting in preferential loss of T-cells and Sézary-cells without exposing the patients to dangerously large shifts in fluid volume. The results suggest also that there may be selected patients for whom lymphocytapheresis is an useful therapy, but no in vitro test can reliably separate responders from non-responders, and some patients become refractory to further cytapheresis-therapy after initial clinical remission.(ABSTRACT TRUNCATED AT 250 WORDS)
A new immunoassay system utilizing new automatic instrumentation, new software for evaluation of data, and reagents updated for increased speed and accuracy was evaluated. Six clinical studies included 894 consecutive patients. Major symptoms were rhinoconjunctivitis, asthma, atopic dermatitis, and urticaria. The prevalence of inhalant allergy was 54–69%. Phadiatop®, detecting atopic sensitization to common inhalant allergens, agreed with clinical diagnosis in 764/836 cases (91.4%). TTie clinical sensitivity and specificity were 93% and 89%, respectively The clinical sensitivity and specificity of UniCAP specific IgE derived from 5170 comparisons with clinical diagnosis were 89% and 91 %, respectively Specific IgE measurements in UniCAP and in the Pharmacia CAP System agreed in 266/274 cases (97%). A comparison of the sensitivity and specificity of Pharmacia CAP System RAST in 1987 and with UniCAP specific IgE in 1995 showed equivalent performance without change of efficacy or degradation of IgE antibodies after 8 years. The systems were equivalent also in terms of measured values (r=0.96, slope=1.12), confirming the standardization of allergens and of assay calibration. UniCAP is an efficient laboratory system for routine diagnostic testing of allergy and a valuable tool for basic studies on allergens and antibodies.
Es wird über bandförmige Osteolysen in den Endphalangen des Handskeletts berichtet, die spezifisch für ein sklerodermieähnliches Krankheitsbild sind. Die Kausalität für die Erkrankung ist durch die berufliche Tätigkeit (Autoklavenreinigung in PVC-Betrieben) gegeben und nach den bisherigen Beobachtungen als gesichert anzusehen. Im Gegensatz zur progressiven Sklerodermie soll das Krankheitsbild reversibel sein.
Background Clinical manifestation of hepatic involvement in sarcoidosis can vary from asymptomatic disease to severe complications such as liver cirrhosis and portal hypertension. However, data on hepatic sarcoidosis are limited and evidence-based recommendations are lacking. Our study aimed to assess the features and clinical course of hepatic sarcoidosis in a predominantly Caucasian cohort.
Introduction Definitions of acute-on-chronic liver failure (ACLF) are diverse. Whereas the APASL-definition focuses on the liver, EASL-CLIF- and NACSELD-definitions concentrates on extrahepatic organ failures. In the present study, we therefore determined associations of ACLF and correlated these with inflammatory molecules, clinical parameters and outcome of patients.
