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Circulating immune complexes in Hodgkin's disease
DNA antibody
Lupus nephritis
hormone levels
Systolic clicks
Continued
on page A94
Five patients with rheumatic mitral stenosis were observed to have mid-systolic clicks with murmurs of mitral regurgitation after mitral commissurotomy. The systolic clicks were often loud and, in two cases, coincided with an unusually rapid posterior deflection of the mitral valve recorded echocardiographically. It is speculated that the functional anatomy of the mitral valve apparatus is distorted by the rheumatic process, the surgery and progressive fibrosis. During systole, ventricular conformational changes in the face of marginal coaptation of thickened, mitral leaflets may allow the leaflets to be forced abruptly towards the left atrium, producing a loud click. Unusually loud mid-systolic clicks can occur in patients after mitral commissurotomy and may be accompanied by a distinctive echocardiographic appearance of the mitral valve.
Mitral commissurotomy
Levels of circulating immune complexes (CIC) in the serum of 73 patients with Hodgkin’s disease were measured by the Raji cell radioimmunoassay. Elevated levels were detected in 50 per cent of the untreated patients, whereas 5 per cent of the patients had elevated levels after treatment. Recurrent disease developed in two of the 39 patients with normal post-treatment CIC levels and in one of the two patients with elevated post-treatment levels during the follow-up period. Elevated CIC levels, which did not correlate with B symptoms or the histologic subtype, were detected in patients with stages I, II and Ill Hodgkin’s disease but not in stage IV Hodgkin’s disease. Our data indicate that serial measurements of the CIC level are of value in monitoring the response to treatment and may prove useful in the detection of recurrent disease.
Rheumatic mitral stenosis
Mitral valve prolapse
The effect on thyroid status of changing from thyroid USP to sodium L-thyroxine was evaluated in 40 patients. With thyroid, abnom-rally high triiodothyronine (T3) levels were seen in most patients and, compared to sodium L-thyroxine, the serum T3 was higher (289 f 15 ng/dl versus 176 f 9 ng/dl, P <0.0005) and the thyroxine (T4) lower (7.4 f 0.3 wg/dl versus 11.6 f 0.5 &dl; P
Gottdiener JS, Sherber HS, Harvey WP: Mid-systolic click and mitral valve prolapse following mitral commissurotomy. Am J Med 64: 295-300, 1978.
Circulating immune complexes
Thyroid Sodium L-thyroxine Trilodothyronine Thyroxine
Jackson IMD, Cobb WE: Why does anyone still use desiccated thyroid USP? Am J Mad 64: 284-288, 1978.
Hypothryoidism
Dessicated thyroid
Brown CA, Hall CL, Long JC, Carey K, Weitzman SA, Aisenberg AC: Circulating immune complexes in Hodgkin’s disease. Am J Med 64: 289-294. 1978.
Raji ceil radioimmunoassay
Hodgkin’s disease
A prospective study was carried out in 25 patients with SLE on the effect of normalizing serum complement and anti-DNA on lupus nephritis. Serum complement was normalized in 16 patients with tolerated doses of prednisone, with or without azathioprine. In these 16 patients, urinary protein excretion decreased or remained low in all. Repeat renal biopsies in 10 disclosed stabilization or subsidence of glornerular disease in eight. In nine patients in whom complement could not be normalized, urinary protein increased, and repeat renal biopsies disclosed worsening of glomerular disease in five of six. No definite correlation was found between serum anti-DNA levels and proteinuria or the course of glomerular disease. Continuous normalization of serum complement by therapy is associated with stabilization or subsidence of glomerular disease in patients with lupus nephritis.
Appel AE, Sablay LB, Golden RA, Barland P. Grayzel Al, Bank N: The effect of normalization of serum complement and anti-DNA antibody on the course of lupus nephritis. A two year prospective study. Am J Med 64: 274-283, 1978.
Serum complement
Lupus nephritis
hormone levels
Systolic clicks
Continued
on page A94
Five patients with rheumatic mitral stenosis were observed to have mid-systolic clicks with murmurs of mitral regurgitation after mitral commissurotomy. The systolic clicks were often loud and, in two cases, coincided with an unusually rapid posterior deflection of the mitral valve recorded echocardiographically. It is speculated that the functional anatomy of the mitral valve apparatus is distorted by the rheumatic process, the surgery and progressive fibrosis. During systole, ventricular conformational changes in the face of marginal coaptation of thickened, mitral leaflets may allow the leaflets to be forced abruptly towards the left atrium, producing a loud click. Unusually loud mid-systolic clicks can occur in patients after mitral commissurotomy and may be accompanied by a distinctive echocardiographic appearance of the mitral valve.
Mitral commissurotomy
Levels of circulating immune complexes (CIC) in the serum of 73 patients with Hodgkin’s disease were measured by the Raji cell radioimmunoassay. Elevated levels were detected in 50 per cent of the untreated patients, whereas 5 per cent of the patients had elevated levels after treatment. Recurrent disease developed in two of the 39 patients with normal post-treatment CIC levels and in one of the two patients with elevated post-treatment levels during the follow-up period. Elevated CIC levels, which did not correlate with B symptoms or the histologic subtype, were detected in patients with stages I, II and Ill Hodgkin’s disease but not in stage IV Hodgkin’s disease. Our data indicate that serial measurements of the CIC level are of value in monitoring the response to treatment and may prove useful in the detection of recurrent disease.
Rheumatic mitral stenosis
Mitral valve prolapse
The effect on thyroid status of changing from thyroid USP to sodium L-thyroxine was evaluated in 40 patients. With thyroid, abnom-rally high triiodothyronine (T3) levels were seen in most patients and, compared to sodium L-thyroxine, the serum T3 was higher (289 f 15 ng/dl versus 176 f 9 ng/dl, P <0.0005) and the thyroxine (T4) lower (7.4 f 0.3 wg/dl versus 11.6 f 0.5 &dl; P
Gottdiener JS, Sherber HS, Harvey WP: Mid-systolic click and mitral valve prolapse following mitral commissurotomy. Am J Med 64: 295-300, 1978.
Circulating immune complexes
Thyroid Sodium L-thyroxine Trilodothyronine Thyroxine
Jackson IMD, Cobb WE: Why does anyone still use desiccated thyroid USP? Am J Mad 64: 284-288, 1978.
Hypothryoidism
Dessicated thyroid
Brown CA, Hall CL, Long JC, Carey K, Weitzman SA, Aisenberg AC: Circulating immune complexes in Hodgkin’s disease. Am J Med 64: 289-294. 1978.
Raji ceil radioimmunoassay
Hodgkin’s disease
A prospective study was carried out in 25 patients with SLE on the effect of normalizing serum complement and anti-DNA on lupus nephritis. Serum complement was normalized in 16 patients with tolerated doses of prednisone, with or without azathioprine. In these 16 patients, urinary protein excretion decreased or remained low in all. Repeat renal biopsies in 10 disclosed stabilization or subsidence of glornerular disease in eight. In nine patients in whom complement could not be normalized, urinary protein increased, and repeat renal biopsies disclosed worsening of glomerular disease in five of six. No definite correlation was found between serum anti-DNA levels and proteinuria or the course of glomerular disease. Continuous normalization of serum complement by therapy is associated with stabilization or subsidence of glomerular disease in patients with lupus nephritis.
Appel AE, Sablay LB, Golden RA, Barland P. Grayzel Al, Bank N: The effect of normalization of serum complement and anti-DNA antibody on the course of lupus nephritis. A two year prospective study. Am J Med 64: 274-283, 1978.
Serum complement