RESUMEN
El distiroidismo espontáneo autoinmune (DE) tiene agregación familiar positiva. Se ha identificado distiroidismo en pacientes que reciben amiodarona (DIA). Hemos observado que este grupo muestra predisposición genética y ahora se analizó en forma prospoectiva, la presencia de autoanticuerpos y la historia familiar para identificar factores de riesgo en 140 enfermos que reciben amiodarona (A), 40 de estos con DIA y 30 sujetos con DE. Se estudió tambíen un grupo testigo formado por personas sanas, y sin historia familiar de distiroidismo. En todos se investigaron los antecedentes de distiroidismo en familiares de primer grado y se buscaron anticuerpos anti-tiroglobulina, músculo liso mucosa gástrica, miocardio, mitocondrias, sustancia intercelular del epitelio y membrana basal epitelial, así como anticuerpos antinucleo y factores reumatoides. Los anticuerpos anti-tiroglobulina, mucosa gastríca y miocardio se encontraron con mayor frecuencia en los tres grupos de enfermos que entre los testigos (P < 0.05). Los Ac anti tiroglobulina fueron iguales en frecuencia en los individuos que reciben A, tengan o no distiroidismo. La estratificación pronóstica de las dos poblaciones con A indicó que la presencia de este antoanticuerpo es independiente del sexo, edad, dosis o tiempo de tratamiento con la droga. La expresión clínica del padecimiento tiroideo, depende de la predisposición genética individual, los antecedentes familiares de distiroidismo se encontraron con mayor frecuencia en las familias de los pacientes con DE y DIA que en ls sujetos que reciben la droga y no alteraron la función (P < 0.005). El análisis de asociación entre antecedentes familiares y la manifestación clínica de distiroidismo secundario al tratamiento con A indicó riesgo mayor en los pacientes con uno o más familiares distiroideos (riesgo relativo 7.6)
Asunto(s)
Niño , Adolescente , Adulto , Persona de Mediana Edad , Humanos , Masculino , Femenino , Amiodarona/efectos adversos , Hipotiroidismo/inducido químicamente , Enfermedades de la Tiroides/genética , Autoanticuerpos/análisis , Enfermedades de la Tiroides/inmunologíaRESUMEN
Spontaneous autoimmune thyroid disease (SATD) shows familial aggregation. Some patients receiving amiodarone treatment have been found to develop thyroid dysfunction. Previously, we reported genetic predisposition among this group of patients, now we inform a prospective study which includes the search for autoantibodies and family history to identify risk factors in amiodarone treated patients, 40 of them with amiodarone related thyroid disfunction, and 100 without it; for comparison, 30 patients with SATD and a control group of healthy subjects were also studied. We looked for the presence of autoantibodies against thyroglobulin, smooth muscle, gastric mucosa, myocardium, mitochondria, epithelial intercellular substance, and basal membrane as well as antinuclear antibodies and rheumatoid factors; in addition the history of thyroid disease in first degree relatives was investigated. Organ-specific antibodies anti-thyroglobulin, gastric mucosa and myocardium were found with increased frequency in the three groups of patients compared with controls (p less than 0.05). The frequency of antihydroglobulin antibodies was similar in patients receiving amiodarone with or without thyroid dysfunction. Prognostic stratification revealed that this finding is independent of sex, age, dosage or duration of treatment. A family history of thyroid dysfunction was found more frequently among patients with SATD and amiodarone related dysthyroidism in comparison with patients receiving amiodarone without altered thyroid function (p less than 0.005). The appearance of clinical thyroid disease depends on individual genetical predisposition. In patients with a positive family history, the risk of developing clinical, thyroid disease is 7.6 when treated with amiodarone.
Asunto(s)
Amiodarona/efectos adversos , Enfermedades Autoinmunes/inducido químicamente , Enfermedades de la Tiroides/inmunología , Adolescente , Adulto , Anciano , Enfermedades Autoinmunes/genética , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Tiroides/inducido químicamente , Enfermedades de la Tiroides/genéticaRESUMEN
Under-agarose random migration, chemokinesis and chemotaxis of monocytes from 36 patients with Down's syndrome were compared to those of monocytes from 42 healthy, age-matched control children. Random migration of monocytes from patients with Down's syndrome was comparable to that of controls. In contrast, chemotaxis of monocytes from patients with Down's syndrome was significantly decreased (P less than 0.001) when compared to that of controls, even though chemokinesis was significantly increased (P less than 0.001). Age, sex, and physical development of patients with Down's syndrome or of control children included in this study had no apparent effect upon monocyte mobility.
Asunto(s)
Quimiotaxis de Leucocito , Síndrome de Down/sangre , Monocitos/fisiología , Niño , Preescolar , Síndrome de Down/inmunología , Femenino , Humanos , Inmunidad Innata , Lactante , Masculino , FagocitosisRESUMEN
Concanavalin A and wheat germ agglutinin, lectins that interact with serum glycoprotein in a manner similar to the antigen--antibody reaction, were used as "antibodies" in a single radial immunodiffusion technique to test a coded serum panel (from the National Cancer Institute, Bethesda, Md., and the Mayo Clinic, Rochester, Minn.) containing a) 99 serum samples from patients with different types of malignant neoplasms of the gastrointestinal tract, prostate gland, and lung, b) 50 samples from patients with benign diseases of the same organs as those affected in the cancer patients, and c) 50 samples from apparently healthy smokers. The resulting precipitation rings were not correlated to serum protein concentration, and the differences (demonstrated by Student's t-test and with a generalization of the one-sided two-sample Kolmogorov-Smirnov statistic for evaluating diagnostic tests) established that serum glycoproteins are glycosylated differently in cancer patients than in people without cancer.