1/10. Heterotopic ovarian splenoma: report of a first case.We present a case of ovarian splenoma, a form of heterotopic splenic hamartoma consisting of red pulp tissue. The hamartoma was located in ovarian stroma in an otherwise normal ovary. The histology showed interanastomosing vascular channels of splenic sinusoidal red pulp lined by cells that were immunoreactive for antibodies to von Willebrand antigen and CD8, findings consistent with splenic lining cells. The sinuses were lined by cuboidal to flattened cells with ovoid and grooved bland-looking nuclei. Ultrastructurally, the tumor cells showed weibel-palade bodies and lysosomes. To our knowledge, this is the first case of splenic tissue arising in an ovary, and it underlines the trend noted in the literature that splenic hamartoma,although a rare entity, can arise in many retroperitoneal organs, including the ovary.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/10. Case report. Mycotic arteritis due to aspergillus fumigatus in a diabetic with retrobulbar aspergillosis and mycotic meningitis.A 74-year-old man with diabetes mellitus type II, retinopathy and polyneuropathy suffered from exophthalmus, ptosis and diplopia. magnetic resonance imaging and computer tomography showed a space-occupying process in the right orbital apex. An extranasal ethmoidectomy accompanied by an orbitotomia revealed the presence of septated hyphae. aspergillus fumigatus was grown from the tissue. After surgical removal of the fungal masses, therapy with amphotericin b (1 mg kg(-1) body weight) plus itraconazole (Sempera, 200 mg per day) over 6 weeks was initiated. Five months later the patient's condition deteriorated again, with vomiting, nausea and pain behind the right eye plus increasing exophthalmus. Antifungal therapy was started again with amphotericin b and 5-fluorocytosine. neutropenia did not occur. The patient became somnolent and deteriorated, a meningitis was suggested. Aspergillus antigen (titre 1:2, Pastorex) was detected in liquor. Anti-Aspergillus antibodies were not detectable. Both the right eye and retrobulbar fungal masses were eradicated by means of an exenteratio bulbi et orbitae. However, renal insufficiency and an apallic syndrome developed and the patient died. At autopsy, a mycotic aneurysm of the arteria carotis interna dextra was detected. The mycotic vasculitis of this aneurysm had caused a rupture of the blood vessel followed by a massive subarachnoidal haemorrhage. In addition, severe mycotic sphenoidal sinusitis and aspergillosis of the right orbit were seen, which had led to a bifrontal meningitis.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/10. Autoimmunotherapy of type II diabetes with soluble low-molecular-mass antigens: a case report.AIMS: To study whether autoimmunization of patients suffering from non-insulin-dependent Type II diabetes with soluble low-molecular-mass antigens (LMA) isolated from their serum will activate the immune system and improve clinical status. MATERIALS AND methods: From March 1998 to July 2000, the patient was treated, under observation, with LMA isolated from that same patient. Doses for injections varied between 2 and 5 mg of LMA. injections were performed at weekly or monthly intervals. Biochemical studies were performed before injections and 1 to 2 weeks after them. The following biochemical parameters were determined in the blood: levels of glucose, insulin-competitive auto-antibodies (ICAA), a-glutamine acid decarboxylase (GAD), total concentration of LMA and of the 66 kDa and 51 kDa proteins as main representatives of the LMA isolated. RESULTS: The patient suffered from high blood glucose levels (BGL), ICAA, GAD, hemoglobin Alc and, especially, of LMA and their proteins. Shortarm immunotherapy did not improve the parameters studied. However, a regular monthly injection of LMA at a dose of 3.5 to 4 mg significantly decreased BGL and reduced the concentrations of LMA and their proteins. The whole clinical status of the patient improved and became more stable. CONCLUSION: We suggest that vaccination of a diabetic patient with LMA activates the host immune system, thereby preventing progress of the disease.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
4/10. A case of insulin allergy: the crystalline human insulin may mask its antigenicity.We report an unusual case of insulin allergy. A 48-year-old man with non-insulin-dependent diabetes mellitus receiving biosynthetic isophane human insulin (Humulin N) developed itchy wheal-and-flare reactions at the sites of injection. When Humulin N was changed to a semi-synthetic crystalline human insulin zinc (Novolin U), the allergic reactions completely disappeared. Evaluation of his serum showed a high level of insulin-specific IgE. skin testing with all commercially available insulins showed immediate local reactions to all agents tested except for Novolin U. In addition, decrystallized Novolin U prepared by lowering the pH with acetic acid also induced a positive reaction. These observations suggest that the crystallized structure of human insulin may mask its antigenicity for allergic reactions.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
5/10. Linkage analysis between maturity-onset type diabetes in young people (MODY) and HLA.Linkage analysis between HLA-A, B, C, D-antigens and maturity-onset diabetes of young people (MODY) was performed in a large kindred including 16 affected members. Close linkage could be excluded. The highest z-value was 0.279 for a recombination fraction of theta = 0.05.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/10. Immunotactoid glomerulopathy with unusually thick extracellular microtubules and nodular glomerulosclerosis in a diabetic patient.It has recently been suggested that immunotactoid glomerulopathy be separated from much more common fibrillary glomerulonephritis by ultrastructural features of highly organized immune deposits containing tubules of more than 30 nm in diameter. We report and discuss the results of a light, immunofluorescence and electron microscopic study of a needle renal biopsy from a 75-year-old, non-insulin dependant diabetic female presented with nephrotic syndrome, hypertension and a progressive renal failure. A unique coexistence of nodular glomerulosclerosis, as traditionally ascribed to diabetes with a peculiar type of immunotactoid glomerulopathy was confirmed by the exclusion of amyloidosis, monoclonal gammopathies, systemic autoimmune diseases and cryoglobulinemia. Mesangial, scattered subepithelial and segmentally prominent subendothelial immune deposits were found highly organized in mostly parallel arrays of 40 to 91 nm thick tubules. The average thickness of 67 nm exceeds the average diameter of tubules in all other 11 published cases of immunotactoid glomerulopathy to date. By immunofluorescence, predominantly capillary wall, thick, ribbon-like glomerular deposits contained IgG, IgM, kappa and lambda light chains of equal intensity, C3, C4 and fibrin related antigens. Mild to moderate glomerular cell proliferation associated with nodular sclerosis has been assumed to be causally related to immunotactoid deposits.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/10. A case of newly diagnosed non-insulin-dependent diabetes associated with immediate-type allergy against human insulin.A case of newly diagnosed non-insulin-dependent diabetes mellitus with immediate-type allergy against semisynthetic human insulin is reported. She experienced immediate-type allergy 2 months after initial insulin treatment. A skin test showed that she had allergy against the insulin itself but not the additives. The amino acid sequence of the semisynthetic human insulin was identical to that of endogenous native insulin and, moreover, the patient had not been treated with animal-derived insulin previously, so a structural change to the semisynthetic formulation at the injected subcutaneous site might have antigenicity. An H1 histamine blocker markedly diminished the skin reaction to insulin, and her plasma glucose and glycosylated hemoglobin AIc became well controlled. In summary, we experienced a diabetic patient with human insulin allergy at the time of initial insulin treatment, emphasizing that the possibility of human insulin allergy should be considered whenever a patient is started on insulin therapy.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/10. An early-onset recessive cerebellar disorder with distal amyotrophy and, in two patients, gross myoclonia: a probable ataxia telangiectasia variant.We report a family of 4 siblings from a non-consanguineous marriage, presenting with an early onset recessive cerebellar ataxia and progressive distal limb wasting. Ocular or other telangiectasias were absent. There were neither frequent infections nor immunodeficiencies. The two youngest patients exhibited an incapacitating myoclonus which abated markedly after 20 years. Late onset diabetes was demonstrated in 3 patients. hypogonadism was not a feature and there was a prolonged survival in the 4 patients. The oldest sibling died of a pancreatic adenocarcinoma. alpha-Fetoprotein was elevated with normal carcinoembryonic antigen values in three patients. cytogenetic analysis and radioresistant dna synthesis was compatible with the diagnosis of ataxia-telagiectasia. This family probably represents a rare variant of ataxia-telangiectasia.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
9/10. lung abcess complicating legionella micdadei pneumonia in an adult liver transplant recipient: case report and review.legionella micdadei (Pittsburgh pneumonia agent) is the second most common cause of legionella pneumonia, and occurs predominantly in immunocompromised hosts. L micdadei is the cause of nosocomial pneumonia in renal transplant recipients, but has not been described in other adult solid organ transplant recipients. This report describes the first case of L micdadei pneumonia in an adult liver transplant recipient on immunosuppressive therapy. Importantly, this case highlights the difficulties in establishing the diagnosis, as the legionella urinary antigen is negative, and special culture conditions are required. Furthermore, this case illustrates several atypical clinical features of L micdadei pneumonia in a transplant recipient, including a community acquired mode of transmission, occurrence several years after organ transplantation, and lung abcess formation. The patient was successfully treated with limited surgical resection and quinolone antimicrobial monotherapy.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/10. Clinical courses and changes of pancreatic beta-cell function in young-onset diabetics: report of two cases.Accurate classification of diabetes in some young patients is difficult but clearly of importance in deciding the appropriate treatment. We report the different clinical courses and beta-cell function changes in 2 young-onset diabetics. In the beginning, each of them was considered to be a patient with insulin-dependent diabetes mellitus (IDDM) and was treated with insulin. Then, treatment was shifted from insulin to oral hypoglycemic agents (OHA) because each patient's beta-cell function was comparable to that of patients with non-insulin-dependent diabetes mellitus (NIDDM). In case 1, the patient's glycemic control and beta-cell function progressively deteriorated and finally insulin therapy was required. In case 2, the patient was continuously treated with OHA. Although his blood glucose was not well-controlled, his beta-cell function had been well-preserved. Recently he achieved near-normoglycemia by improving his diet and OHA compliance. Clearly, case 1 was a slowly progressive Type 1 DM patient and case 2 was a young Type 2 DM patient. This classification was further supported by the finding that the patient in case 1 had human leukocyte antigen (HLA)-DR3, but the patient in case 2 did not.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
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