Objective: To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly diagnosed immune thrombocytopenic purpura and a platelet count < 20,000/μ L, to determine whether a...Objective: To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly diagnosed immune thrombocytopenic purpura and a platelet count < 20,000/μ L, to determine whether anti- D immune globulin (anti- D) is as effective as intravenous immune globulin (IVIg). Study design: Eligible patients received either a single intravenous dose of 50 μ g/kg anti- D (anti- D50), 75 μ g/kg anti- D, (anti- D75), or 0.8 g/kg IVIg,(IVIg). Patients were monitored for response to treatment and adverse events. Results: By 24 hours after treatment 50% , 72% , and 77% of patients in the anti- D50, anti- D75, and IVIg groups, respectively, had achieved a platelet count > 20,000/μ L (P = 0.03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti- D50, anti- D75, and IVIg groups, respectively. Headache, fever, or chills occurred least often in the anti- D50 group. Conclusions: A single 75μ g/kg dose of Anti- D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard- dose anti- D and as effectively as IVIg, with an acceptable safety profile.展开更多
Immunoglobulin A （IgA） nephropathy is one of the most common glomerulonephritis and its frequency is probably underestimated because in most patients the disease has an indolent course and the kidney biopsy is essen...Immunoglobulin A （IgA） nephropathy is one of the most common glomerulonephritis and its frequency is probably underestimated because in most patients the disease has an indolent course and the kidney biopsy is essential for the diagnosis. In the last years its pathogenesis has been better identifed even if still now several questions remain to be answered. The genetic wide association studies have allowed to identifying the relevance of genetics and several putative genes have been identified. The genetics has also allowed explaining why some ancestral groups are affected with higher frequency. To date is clear that IgA nephropathy is related to auto antibodies against immunoglobulin A1 （IgA1） with poor O-glycosylation. The role of mucosal infections is confirmed, but which are the pathogens involved and which is the role of Toll-like receptor polymorphism is less clear. Similarly to date whether the disease is due to the circulating immunocomplexes deposition on the mesangium or whether the antigen is already present on the mesangial cell as a “lanthanic” deposition remains to be clarifed. Finally also the link between the mesangial and the podocyte injury and the tubulointerstitial scarring, as well as the mechanisms involved need to be better clarifed.展开更多
Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a dis...Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a disease evolution and to prescribe the right therapy to the right patients. Indeed, in addition to patients with a stable disease with no trend to evolution or even with a spontaneous recovery, patients with an active disease and patients with a rapidly evolving glomeru-lonephritis are described. Several histopathological, biological and clinical markers have been described and are currently used to a better understanding of patients at risk, to suggest the right therapy and to monitor the therapy effect and the IgAN evolution over time. The clinical markers are the most reliable and allow to divide the IgAN patients into three categories： The low risk patients, the intermediate risk patients and the high risk patients. Accordingly, the therapeutic measures range from no therapy with the only need of repeated controls, to supportive therapy eventually associated with low dose immunosuppression, to immunosuppressive treat-ment in the attempt to avoid the evolution to end stage renal disease. However the current evidence about the different therapies is still matter of discussion. New drugs are in the pipeline and are described. They are object of randomized controlled trials, but studies with a number of patients adequately powered and with a long follow up are needed to evaluate effcacy and safety of these new drugs.展开更多
Forty-six cases of Behcet's disease were randomly divided into two groups. The 26 cases in the treatmentgroup were treated by acupuncture and the 20 cases in the control group with the drugs. The level ofL-chain (...Forty-six cases of Behcet's disease were randomly divided into two groups. The 26 cases in the treatmentgroup were treated by acupuncture and the 20 cases in the control group with the drugs. The level ofL-chain (κ) of IgM and the level of the trace element Zn were determined before and after treatment inthe treatment group. The results showed that the recurrence rate in the treatment group was significantlylower than that in the control group (P＜0.01), and the differences in the level of L-chain (κ) of IgM andlevel of Zn in the treatment group before and after treatment were very significant (P＜0.01). These twoindexes tended to become normal after treatment.展开更多
IgA nephrosis, with an incidence of 38%-49% in the primary glomerulopathy in China, is one of the main causes for the late renal failure. In view of the fact that there are no specific Western remedies for IgA nephros...IgA nephrosis, with an incidence of 38%-49% in the primary glomerulopathy in China, is one of the main causes for the late renal failure. In view of the fact that there are no specific Western remedies for IgA nephrosis characterized by hematuria, the researches on TCM differential treatment of IgA nephrosis have been listed in the major projects of 'the Scientific Technologies in thel0th 5-year plan of China'.展开更多
文摘Objective: To conduct a randomized prospective trial of immune globulin treatment for 105 Rh+ children with newly diagnosed immune thrombocytopenic purpura and a platelet count < 20,000/μ L, to determine whether anti- D immune globulin (anti- D) is as effective as intravenous immune globulin (IVIg). Study design: Eligible patients received either a single intravenous dose of 50 μ g/kg anti- D (anti- D50), 75 μ g/kg anti- D, (anti- D75), or 0.8 g/kg IVIg,(IVIg). Patients were monitored for response to treatment and adverse events. Results: By 24 hours after treatment 50% , 72% , and 77% of patients in the anti- D50, anti- D75, and IVIg groups, respectively, had achieved a platelet count > 20,000/μ L (P = 0.03). By day 7, hemoglobin concentrations decreased by 1.6 g/dL, 2 g/dL, and 0.3 g/dL in the anti- D50, anti- D75, and IVIg groups, respectively. Headache, fever, or chills occurred least often in the anti- D50 group. Conclusions: A single 75μ g/kg dose of Anti- D raised the platelet count in children with newly diagnosed immune thrombocytopenic purpura more rapidly than standard- dose anti- D and as effectively as IVIg, with an acceptable safety profile.
文摘Immunoglobulin A （IgA） nephropathy is one of the most common glomerulonephritis and its frequency is probably underestimated because in most patients the disease has an indolent course and the kidney biopsy is essential for the diagnosis. In the last years its pathogenesis has been better identifed even if still now several questions remain to be answered. The genetic wide association studies have allowed to identifying the relevance of genetics and several putative genes have been identified. The genetics has also allowed explaining why some ancestral groups are affected with higher frequency. To date is clear that IgA nephropathy is related to auto antibodies against immunoglobulin A1 （IgA1） with poor O-glycosylation. The role of mucosal infections is confirmed, but which are the pathogens involved and which is the role of Toll-like receptor polymorphism is less clear. Similarly to date whether the disease is due to the circulating immunocomplexes deposition on the mesangium or whether the antigen is already present on the mesangial cell as a “lanthanic” deposition remains to be clarifed. Finally also the link between the mesangial and the podocyte injury and the tubulointerstitial scarring, as well as the mechanisms involved need to be better clarifed.
文摘Immunoglobulin A nephropathy （IgAN） is characterized by different clinical manifestations and by long-term different outcomes. Major problem for the physicians is to understanding which patients are at risk of a disease evolution and to prescribe the right therapy to the right patients. Indeed, in addition to patients with a stable disease with no trend to evolution or even with a spontaneous recovery, patients with an active disease and patients with a rapidly evolving glomeru-lonephritis are described. Several histopathological, biological and clinical markers have been described and are currently used to a better understanding of patients at risk, to suggest the right therapy and to monitor the therapy effect and the IgAN evolution over time. The clinical markers are the most reliable and allow to divide the IgAN patients into three categories： The low risk patients, the intermediate risk patients and the high risk patients. Accordingly, the therapeutic measures range from no therapy with the only need of repeated controls, to supportive therapy eventually associated with low dose immunosuppression, to immunosuppressive treat-ment in the attempt to avoid the evolution to end stage renal disease. However the current evidence about the different therapies is still matter of discussion. New drugs are in the pipeline and are described. They are object of randomized controlled trials, but studies with a number of patients adequately powered and with a long follow up are needed to evaluate effcacy and safety of these new drugs.
文摘Forty-six cases of Behcet's disease were randomly divided into two groups. The 26 cases in the treatmentgroup were treated by acupuncture and the 20 cases in the control group with the drugs. The level ofL-chain (κ) of IgM and the level of the trace element Zn were determined before and after treatment inthe treatment group. The results showed that the recurrence rate in the treatment group was significantlylower than that in the control group (P＜0.01), and the differences in the level of L-chain (κ) of IgM andlevel of Zn in the treatment group before and after treatment were very significant (P＜0.01). These twoindexes tended to become normal after treatment.
文摘IgA nephrosis, with an incidence of 38%-49% in the primary glomerulopathy in China, is one of the main causes for the late renal failure. In view of the fact that there are no specific Western remedies for IgA nephrosis characterized by hematuria, the researches on TCM differential treatment of IgA nephrosis have been listed in the major projects of 'the Scientific Technologies in thel0th 5-year plan of China'.
