Showing papers by "Thomas Daikeler published in 2004"
TL;DR: A 34 year old male patient with a 16 year history of psoriatic arthropathy with mutilating bilateral lesions of the wrists, metacarpal, proximal and distal interphalangeal and metatarsal, and lower extremity interphalanges joints is reported on.
Abstract: Transplantation of peripheral blood stem cells (PBSCT) is currently explored in patients with refractory autoimmune diseases,1,2 and results so far show that about two thirds of patients who receive a transplant benefit from this procedure.3 Transplant related mortality in patients with autoimmune disease is similar to that seen in patients with non-Hodgkin’s lymphoma.4
We report on a 34 year old male patient with a 16 year history of psoriatic arthropathy with mutilating bilateral lesions of the wrists, metacarpal, proximal and distal interphalangeal and metatarsal, and lower extremity interphalangeal joints, who was refractory to treatment with multiple disease modifying, immunosuppressive substances, including gold, methotrexate (MTX), MTX plus sulfasalazine, cyclosporin A (CSA), mycophenolate mofetil (MMF) alone or in combination with CSA, steroids, and a combination of CSA, MTX, and MMF. IgA κ monoclonal gammopathy of unknown significance developed later in the course of …
14 citations
01 Jan 2004
TL;DR: Measuring thymopoietic capacity only on the basis of phenotyping naive T-cells is of limited value as CD45RA+ T- Cells may immediately convert into memory T- cells, may proliferate antigen-independently or may persist most of their life span.
Abstract: Myeloablative chemotherapy followed by stem cell transplantation is often associated with a prolonged and substantial, potentially detrimental period of T-cell immunodeficiency (1). The depletion of T-cells by intensive chemotherapy may lead to an increased number of viral and fungal infections. For a complete reconstitution of immunity, the generation of de novo T-cells in the thymus with a broad T-cell receptor repertoire is essential (2). However, the thymus is gradually replaced by adipose tissue and its activity is age-dependent (3). Additional factors that influence the thymic activity are graft-versus-host disease and direct damage from chemo- and radiotherapy. Measuring thymopoietic capacity only on the basis of phenotyping naive T-cells is of limited value as CD45RA+ T-cells may immediately convert into memory T-cells, may proliferate antigen-independently or may persist most of their life span. As an alternative approach to monitor thymic activity, the frequency of T-cell receptor excision circles among peripheral blood cells can be determined (4).
TL;DR: The antiphospholipid syndrome is characterized by thromboembolic events and recurrent miscarriages in the presence of anticardiolipin antibodies and/or a lupus anticoagulant.
Abstract: The antiphospholipid syndrome is characterized by thromboembolic events and/or recurrent miscarriages in the presence of anticardiolipin antibodies and/or a lupus anticoagulant. Anticardiolipin antibodies are detected by ELISA whereas lupus anticoagulant detection includes a variety of coagulometric tests. However, a large number of patients with suspected antiphospholipid syndrome are anticoagulated with either heparin or coumadin when evaluated for the presence of a lupus anticoagulant and false positive test results may ensue, thus making coagulometric testing unreliable in this situation. Modifications of standard coagulometric tests have been suggested in order to circumvent this problem and studies of several patient cohorts have shown that the majority of patients with the antiphospholipid syndrome are anticardiolipin positive. However diagnosis in patients receiving anticoagulation remains a difficult task.