41. Untitled Diffuse Pulmonary Hemorrhage in microscopic polyangiitis. ClinicalCourse. Abdominal pain - appedectomy - Hematuria, albuminemia http://kstr.radiology.or.kr/chest/2002 Imaging Conference Spring/case6/discussio

Diffuse Pulmonary Hemorrhage in Microscopic Polyangiitis Clinical Course - Abdominal pain - appedectomy - Hematuria, albuminemia - Anemia - Rapid resolution of pulmonary opacity - Biopsy from appendectomy specimen: Necrotizing small vessel vasculitis, consistent with microscopic polyangiitis Brief Discussion Causes of Diffuse Pulmonary Hemorrhage - Anti-basement membrane antibody disease(Goodpasture s syndrome) Immune complex disease (SLE, WG, MPA, PAN, HS disease, RA, MCTD) Idiopathic - Bleeding disorders - Drug, chemicals Microscopic Polyangiitis - Necrotizing vasculitis affects small vessels - Pathogenesis unclear, no immune complex deposition - Involvement: kidney, lung, skin, GI - P-ANCA (majority), anti-PR3, C-ANCA (occ.) - Histology: intra-alveolar hemorrhage / hemosiderin-laden macrophage / interstitial edema Radiology: patchy, bilateral air-space opacities / pleural effusion (16 %) / pulmonary edema (6 %) Tx: corticosteroid and cyclophosphamide - Prognosis.: high mortality in pts with pulmonary hemorrhage

42. Arthritis Research Campaign | Vasculitis every year, including the more severe types such as polyarteritis nodosa, Wegener’sgranulomatosis, ChurgStrauss syndrome and microscopic polyangiitis. http://www.arc.org.uk/newsviews/arctdy/107/vasc.htm

scotland + n. ireland north wales + midlands east + southeast ... south + southwest Vasculitis Professor David Scott, of the Norfolk and Norwich Hospital, explains the various diseases classed as vasculitis, and highlights ever-improving treatments. What it is Blood vessels carry blood and, therefore, oxygen to all organs and tissues in the body, so any part of the body can be involved in vasculitis. The consequences, therefore, depend on the site of the blood vessels involved, the size of the blood vessels involved and also the number of blood vessels involved. When small arteries are involved the inflammation often causes the artery to become blocked so the tissues supplied by that artery will die (i.e. become gangrenous). Surprisingly, when larger vessels are involved only part of the wall may become inflamed which can become weak and, because of the high pressure inside arteries, this weakness can cause the wall to expand forming an aneurysm (swelling) which can occasionally rupture with severe bleeding into the surrounding tissues. When patients first develop vasculitis they undergo tests for a number of reasons.

43. Anti-neutrophil Cytoplasmic Antibodies: microscopic polyangiitis. unknown antigens, HIV. microscopic polyangiitis. Thisis a pauci-immune necrotizing vasculitis involving small-sized vessels. http://medicine.wustl.edu/~labmed/1996vol4no1.html

Laboratory Medicine Newsletter January 1996, Volume 4 Number 1 Anti-neutrophil cytoplasmic antibodies: Current diagnostic potential John D. Pfeifer, M.D., Ph.D. Robin G. Lorenz, M.D., Ph.D. Introduction - The anti-neutrophil cytoplasmic antibodies (ANCA) represent a group of antibodies directed against cytoplasmic components of neutrophil granulocytes and monocytes. They were first described by Davies in 1982 (Davies et al., 1982), and Hall in 1984 (Hall et al., 1984) in patients with segmental necrotizing glomerulonephritis. This observation was confirmed in 1985 by van der Woude, who first reported the association between Wegener's granulomatosis and ANCA (van der Woude et al., 1985). Since these original studies, an enormous amount of data on ANCA disease associations and antigen specificity has been reported. The purpose of this newsletter is to provide an understanding of the method of ANCA determination and its current diagnostic potential. I ndirect Immunofluorescence Determination of ANCA ANCA Target Antigens (Table I) - The neutrophil contains two main kinds of granules, the primary (alpha or azurophilic) granules and the secondary (specific) granules. The main azurophilic granule proteins are the enzyme myeloperoxidase (MPO) and the serine proteases, elastase, cathepsin-G, and proteinase 3 (PR3) (Hagen et al., 1993). Monocytes possess similar granules. The secondary granules contain lysozyme, lactoferrin, and vitamin B12-binding protein.

44. Johns Hopkins Arthritis ACR Highlights 1999 II patients were positive by IF, none of the patients in these groups who did nothave Wegener’s Granulomatosis or microscopic polyangiitis were positive for http://www.hopkins-arthritis.som.jhmi.edu/edu/college_of_rhuematology/vasculitis

John Stone, M.D., M.P.H. Advances in Diagnosis and Treatment A variety of noteworthy studies pertaining to vasculitis were reported at the 1999 American College of Rheumatology meetings in Boston.  The following summary focuses on the major studies related to the diagnosis and treatment of these conditions. Two studies focused on the refinement of testing for anti-neutrophil cytoplasmic antibodies (ANCA) in clinical settings.  A common problem encountered in the diagnosis of “ANCA-associated” Vasculitides (AAV) is that numerous common conditions may mimic the presentation of AAV.  The test characteristics of ANCA assays in patients with clinical mimickers of AAV are not well-described.  Abstract 627 Prevalence of Antineutrophil Cytoplasmic Antibodies (ANCA) in Patients with Various Pulmonary Diseases or Multi-organ Dysfunction”. D Vassilopoulos, JL Niles, A Villa-Forte, AC Arroliga, EJ Sullivan, PA Merkel, GS Hoffman Overview of study:   This study evaluated the use of immunofluorescence (IF) and enzyme-linked immunosorbent assays (ELISA) in 3 groups of patients: Group I, 29 Pulmonary Clinic outpatients with a variety of lung conditions (interstitial lung disease, cancer, sarcoidosis, actinomycosis, and bronchiectasis); Group II, 99 Intensive Care Unit patients with multi-organ system dysfunction (including 91 with either pulmonary or renal dysfunction, or both); and Group III, 18 patients with biopsy-proven Wegener’s Granulomatosis.

45. Prevalence Of ANCA In Patients With Connective Tissue Disease ANCA) are associated with a number of vasculitides, including Wegener granulomatosis,ChurgStrauss syndrome, microscopic polyangiitis and idiopathic http://www.journalclub.org/vol2/a48.html

Prevalence of antineutrophil cytoplasmic antibodies in a large inception cohort of patients with connective tissue disease Authors: Merkel P, Polisson R, Chang Y, Skates S, Niles J. Source: Annals of Internal Medicine. 126:866-73. June 1, 1997. Institution: Harvard Medical School. Financial support: None indicated. Summary Background Antineutrophil cytoplasmic antibodies (ANCA) are associated with a number of vasculitides, including Wegener granulomatosis, Churg-Strauss syndrome, microscopic polyangiitis and idiopathic necrotizing and crescentic glomerulonephritis. A number of connective tissue diseases (CTD's) present with similar findings to the vasculitides. If ANCA is specific to the vasculitic syndromes and remains negative in the CTD's, this would greatly enhance its utility. This study was designed to look at the results of several types of ANCA assays in patients with various connective tissue diseases. Methods Subjects Patients with connective tissue diseases were part of the Early Undifferentiated Connective Tissue Disease project, funded by the NIH. These patients were enrolled within one year of the onset of signs, symptoms or serology suggesting CTD, and were studied at entry and at years 1, 3 and 5. For the purpose of the current study, serum from 386 patients, obtained at baseline and stored frozen, was obtained and examined for ANCA antibodies. The CTD diagnoses for these 386 patients, determined at the final 5-year visit, were:

46. Wgart.1 3. Relapse Rate, Renal Survival, and Cancer Morbidity in Patients with Wegener'sGranulomatosis or microscopic polyangiitis with Renal Involvement. http://www.btinternet.com/~wegeners.uk/wgart.1.htm

Wegener's Granulomatosis UK Giving Support to Patients and Carers Articles Wegener's Granulomatosis: Increased Incidence or Increased Recognition? D.M.Carruther, R.A.Watts, D.P.M.Symmons, and D.G.I.Scott. The aim was to calculate the annual incidence of Wegener's Granulomatosis in Norfolk, UK, and to compare the clinical spectrum of disease to that seen in tertiary centres in both the UK and USA. Tertiary centres see patients mainly by referral and do not have a precisely defined catchment population. The seasonal onset of symptoms was also examined. The study covered all the patients presenting with WG to a district hospital, in the Norwich Health Authority, with a well-defined stable population of 515,000 during the period 1st February 1988 and 31st January 1994. All patients seen in the Rheumatology, ENT, Chest and Renal Departments, between the dates mentioned above, with a new diagnosis of WG were entered prospectively onto a vasculitis register. Also the clinical records of all patients previously diagnosed with WG or necrotizing vasculitis were reviewed. Only patients who met the 1990 American College of Rheumatology criteria, and who were registered with a GP in the Norwich Health Authority, were included. The records of all these patients were retrieved and the relevant data was collected and compared with similar data from the tertiary referral centres in Birmingham, UK, and NIH in USA. The annual incidence for WG in the adult population was found to be 8.5 per million per annum. These are the first incidence figures for a well-defined population and are higher than previously published. The clinical spectrum of disease in Norfolk was similar to that seen in tertiary centres. The onset of symptoms was found to be least common in autumn, most common in the winter months (December to February), and intermediate in spring and summer.

47. Clin-Path Associates, P.C. - May 2000 Newsletter important serologic markers for primary systemic small vessel vasculidites (PSVV)including Wegener’s granulomatosis, microscopic polyangiitis, renal limited http://www.clin-path.com/html/newsletters/may2000.html

May 2000 Newsletter PSA Consult Volume III No. 5 May 31, 2000 ANCA AND ASSOCIATED DISEASE: UPDATE INTRODUCTION: Antibodies reacting with the cytoplasm of neutrophils were first noted in patients with necrotizing glomerulonephritis by Davies in 1982. Subsequent observations have identified ANCAs as specific antibodies to antigens in neutrophil granules and monocyte lysosomes. ANCA results are universally accepted as important adjuncts to the diagnosis of primary systemic small vessel vasculitis, however, neither the American College of Rheumatology (1990) nor the Chapel Hill Consensus Conference (1994) classification schemes of vasculitis currently use ANCA or ANCA-related antigen specificity as part of their diagnostic criteria. The Chapel Hill systemic vasculitis classification scheme is currently being revised to allow for ANCA and ANCA-associated antigen specificity. ANCA are also useful in monitoring disease activity, relapses, and response to treatment. Table I lists the current clinical indications for ANCA testing. Problems with ANCA testing and test interpretation have resulted in incorrect diagnoses, errors in management and nonuniformity of test results. An International Consensus Conference Statement on testing and reporting of ANCA was published in the Am J Clin Path in 1999. This statement recommends a combination of indirect immunofluorescence (IIF) with neutrophils and enzyme-linked immunosorbent assays (ELISAs) that detect the ANCA specific antigens, proteinase 3 (PR3) and myeloperoxidase (MPO), to demonstrate ANCA-associated disease.

48. Advanced Search ANCA­associated smallvessel vasculitis includes microscopic polyangiitis, Wegener'sgranulomatosis, Churg-Strauss syndrome, and drug-induced vasculitis. http://www.aafp.org/afp/20020415/1615.html

Advanced Search ISHAK A. MANSI, M.D., PH.D., ADRIANA OPRAN, M.D., and FRED ROSNER, M.D. Mount Sinai Services at Queens Hospital Center, Jamaica, New York and the Mount Sinai School of Medicine, New York, New York A PDF version of this document is available. Download PDF now (6 pages / 79KB). More information on using PDF files. V asculitis is a process caused by inflammation of blood vessel walls and results in a variety of disorders. A good and accepted classification system for vasculitis has not emerged, although it may be categorized by the size or type of the involved blood vessel as large-, medium-, or small-vessel vasculitis. Small-vessel vasculitis is defined as vasculitis that affects vessels smaller than arteries (i.e., arterioles, venules, and capillaries); however, small-vessel vasculitis can also involve medium-sized arteries. Figure 1 Clinical FIGURE 1. Major classifications of vasculitis. (ANCA = anti-neutrophilic cytoplasmic antibodies) Information from references 1-3.

49. Rheumatology Division, Hospital For Special Surgery, Arthritis, Lupus, Osteoporo vasculitides. This includes Wegener's granulomatosis, microscopic polyangiitisand ChurgStrauss disease. History and Biases of Research. http://www.rheumatology.hss.edu/phys/gr/calabrese_lec_tran.asp

Home For Physicians Grand Rounds Email a Friend ... Audio Version New Treatment Strategies for Systemic Vasculitis (October 10, 2001) Leonard H. Calabrese, DO Vice-Chairman, Department of Rheumatic and Immunologic Diseases, Cleveland Clinic Foundation History and Biases of Research Goals of Treatment Gold Standard for Therapy Improving the Gold Standard ... Questions and Answers Stephen A. Paget, MD: It is a pleasure today to introduce a good friend, Leonard Calabrese, who is the Director of Clinical Immunology at the Cleveland Clinic Foundation and a Professor of Medicine at Ohio State University. Len is world renowned for his interest and focus for many years relating to immunologic and autoimmune diseases. But one of his particular interests, and one I know he has spoken on quite a bit in the past, are the vasculitides. He has given us some of the most basic information on primary angiitis of the brain, and today he will talk about new treatment strategies for vasculitis. It is a pleasure to welcome you to HSS and New York. Leonard H. Calabrese, DO:

50. Polyarteritis Nodosa -- New Treatments, February 5, 2003 The term microscopic polyangiitis (microscopic polyarteritis) describesthe. Incidence And Prevalence. Pan is an uncommon disorder. http://www.medical-library.org/journals2a/polyarteritis_nodosa.htm

This page has moved. Click here to view. Polyarteritis Nodosa Definition Classic polyarteritis nodosa (PAN) is a multisystem, necrotizing vasculitis of small and medium-sized muscular arteries in which involvement of the renal and visceral arteries is characteristic. PAN does not involve pulmonary arteries, although bronchial vessels may be involved; granulomas, significant eosinophilia, and an allergic diathesis are not part of the classic syndrome. The term microscopic polyangiitis (microscopic polyarteritis) describes the Incidence And Prevalence Pan is an uncommon disorder. The mean age at onset in reports of PAN is 48 years, and the male-to-female ratio is Pathophysiology And Pathogenesis The vascular lesion in classic PAN is a necrotizing inflammation of small and medium-sized muscular arteries. The lesions are segmental and tend to involve bifurcations and branchings of arteries. They may spread circumferentially to Multiple organ systems are involved, and the clinicopathologic findings reflect the degree and location of vessel involvement and the resulting ischemic changes. As mentioned above, pulmonary arteries are not involved in classic PAN , and bronchial artery involvement is uncommon, whereas pulmonary capillaritis occurs frequently in microscopic polyangiitis. The pathology in the kidney in classic

51. Serum Levels Of SIL-2R In Patients With ANCA Associated Vasculitis These patients were classified as 7 cases of Wegener's granulomatosis(WG) and 12 cases of microscopic polyangiitis (MPA). Elevated http://www.geocities.com/oarranzli/jnsIL2R.htm

Serum levels of soluble interleukin-2 receptor in patients with ANCA-associated vasculitis ANCA Vasculitis Moléculas de adhesión Técnicas de laboratorio Detección de ANCA Otras Publicaciones Sobre ANCA Del autor Recomendados El autor ... Créditos Serum levels of soluble interleukin-2 receptor in patients with ANCA-associated vasculitis Oscar Arranz, Jordi Ara, Rosa Rodríguez, Anna Saurina, Eduard Mirapeix, Alejandro Darnell - Nephrology Service, Hospital Clinic, University of Barcelona, IDIBAPS, Barcelona - Spain JNEPHROL 2000; 13: 59-64 ABSTRACT: Key words: Soluble interleukin-2 receptor, Vasculitis, Wegener's granulomatosis, Microscopic polyangiitis, anti-neutrophil cytoplasmic antibodies Introduction Considered an early marker of lymphocytic activation, the interleukin-2 receptor (IL-2R) has been found in several cell lines such as T and B lymphocytes, macrophages and natural killer (NK) cells. The interaction of IL-2 with IL-2R leads to the stimulation of a complex set of signal transduction pathways resulting in T cell proliferation, T and B cell growth, generation of lymphokine-activated killer cells, and the augmentation, proliferation and maturation of NK cells (1). Rubin et al (2) described a soluble form of the IL-2R (sIL-2R) which appeared in chemically activated lymphocyte culture supernatants when IL-2R cell surface expression began to decline.

52. The Health Library — Cardiovascular HenochSchonlein PurpuraMedicineNet. microscopic polyangiitisJohns Hopkins VasculitisCenter. microscopic polyangiitiseMedicine. Occlusive Vascular Diseases, http://healthlibrary.stanford.edu/resources/internet/bodysystems/cardiovascular5

Diseases and Disorders Use these links to jump directly to your topic of interest: Anatomy Aneurysms Angiomas Aortic Diseases ... Varicose Veins Cardiovascular: Page 1 Page 2 Page 3 Page 4 ... Page 6 Inflammatory Vascular Diseases Vasculitis, General Vasculitis: MEDLINEplus What Is Vasculitis?: Johns Hopkins Vasculitis Center Vasculitis:American Autoimmune Related Diseases Association An Approach to Diagnosis and Initial Management of Systemic Vasculitis:American Academy of Family Physicians Arteritis Giant Cell Arteritis:Johns Hopkins Vasculitis Center Polyarteritis Nodosa:Johns Hopkins Vasculitis Center Polyarteritis Nodosa:American Autoimmune Related Diseases Association Polymyalgia Rheumatica:Aetna InteliHealth ... Temporal Arteritis/Giant Cell Arteritis:American Autoimmune Related Diseases Association Behcet's Disease Behcet's Syndrome:MEDLINEplus Behcet's Disease:NIAMS Behcet's Disease:Johns Hopkins Vasculitis Center Behcet's Disease:American Autoimmune Related Diseases Association Churg-Strauss Syndrome Churg-Strauss Syndrome:Johns Hopkins Vasculitis Center Churg-Strauss Syndrome :American Autoimmune Related Diseases Association Kawasaki Disease Kawasaki Disease:Lucile Packard Children's Hospital Kawasaki Disease: A Parent's Guide:Kawasaki Disease Foundation Phlebitis (Thrombophlebitis) See Embolism and Thrombosis Wegener's Granulomatosis Wegener's Granulomatosis:MEDLINEplus Wegener's Granulomatosis:NIAID Wegener's Granulomatosis:Johns Hopkins Vasculitis Center Wegener's Granulomatosis:American Autoimmune Related Diseases Association Vasculitis, Other

53. Disease Diagnosis syndrome Asthma Chronic allograft nephropathy Cryoglobulinemia Graves' diseaseLiver transplant rejection microscopic polyangiitis Pemphigus Polyarteritis http://www.upcmd.com/dot/dot_topic_list.html

Home Pages UPCMD Disease Diagnosis Abnormal Test Results Testing in Psychiatry Use Information Guide To Use Technical Advice Authors-Editors Search Disease Diagnosis Internet Resources Current Topic List Disease Groups: Approaching Comprehensive Disease Groups: Most Major Common Diseases Disease Groups: Limited with Most in Development Disease Groups: Available Topics Approaching Comprehensive Coagulation Infectious Disease, Bacterial Endocrine Infectious Disease, Fungal ... Pancreas Coagulation Factor Deficiencies Factor II deficiency Factor V deficiency Factor V Leiden mutation Factor VII deficiency Factor VIII deficiency (Hemophilia A) Factor IX deficiency (Hemophilia B) Factor X deficiency Factor XI deficiency (Hemophilia C) Fibrinogen deficiency Drug-induced or Acquired Coagulopathy Acquired coagulation disorder, heparin Acquired coagulation disorder, warfarin Antiphospholipid antibody syndrome Heparin-induced thrombocytopenia Low molecular weight heparins (LMWH) coagulopathy Uremic bleeding Thrombophilic Disorders Activated protein C resistance Antithrombin deficiency Heparin cofactor II deficiency Hyperhomocysteinemia Plasminogen deficiency Protein C deficiency Protein S deficiency Prothrombin G20210A mutation Endocrine Adrenal Disorders Adrenal insufficiency Congenital adrenal hyperplasia, 21-hydroxylase deficiency

54. Return To Arthritis Rheumatism Page Arthritis Rheumatism Editorial. 508. Treatment of Polyarteritis Nodosa, microscopic polyangiitis,and ChurgStrauss Syndrome Where Do We Stand? Carol A. Langford. 513. http://www.rheumatology.org/ar/2001/03march.html

Official Journal of the American College of Rheumatology VOLUME 44 March 2001 NO. 3 Special Articles Review: Involvement of the Hypothalamic-Pituitary-Adrenal/Gonadal Axis and the Peripheral Nervous System in Rheumatoid Arthritis: Viewpoint Based on a Systemic Pathogenetic Role Rainer H. Straub and Maurizio Cutolo Editorial Treatment of Polyarteritis Nodosa, Microscopic Polyangiitis, and Churg-Strauss Syndrome: Where Do We Stand? Carol A. Langford Winners of the 2000 American College of Rheumatology Slide Competition Catherine M. Meyer and the ACR Audiovisual Aids Subcommittee Rheumatoid Arthritis A Randomized Two-Year Study of the Effects of Dynamic Strength Training on Muscle Strength, Disease Activity, Functional Capacity, and Bone Mineral Density in Early Rheumatoid Arthritis Arja Hakkinen, Tuulikki Sokka, Antero Kotaniemi, and Pekka Hannonen Increased Mortality in Adults With a History of Juvenile Rheumatoid Arthritis: A Population-Based Study Anthony R. French, Tom Mason, Audrey M. Nelson, W. Michael O'Fallon, and Sherine E. Gabriel

55. Springer LINK Zeitschrift Für Rheumatologie - Abstract Volume Translate this page Summary The primary ANCA associated vasculitides, Wegener`s granulomatosis (WG),Churg Strauss syndrome (CSS) and microscopic polyangiitis (MPA), frequently http://link.springer-ny.com/link/service/journals/00393/bibs/1060004/10600219.ht

56. SpringerLink: Journal Of Gastroenterology - Abstract Volume 36 Issue 4 (2001) Pp Table of Contents. Abstract Volume 36 Issue 4 (2001) pp 264270. case reportmicroscopic polyangiitis complicated with massive intestinal bleeding. http://link.springer-ny.com/link/service/journals/00535/bibs/1036004/10360264.ht

Journal of Gastroenterology ISSN: 0944-1174 (printed version) ISSN: 1435-5922 (electronic version) Table of Contents Abstract Volume 36 Issue 4 (2001) pp 264-270 case report : Microscopic polyangiitis complicated with massive intestinal bleeding Shigehiko Ueda (1), Masami Matsumoto (1), Tatsuichi Ahn (1), Satoru Adachi (1), Kazumi Oku (1), Masahiro Takagi (1), Hiroshi Fukui (2), Masahide Yoshikawa (3) (1) Department of Internal Medicine, Nara Prefectural Gojo Hospital, 197 Nohara, Gojo, Nara 637-8511, Japan (2) Third Department of Internal Medicine, Nara Medical University, Kashihara, Japan (3) Department of Parasitology, Nara Medical University, Kashihara, Japan Received: November 15, 1999 / Accepted: June 23, 2000 Key words: Article in PDF format (838 KB) Online publication: April 19, 2001 SpringerLink Helpdesk

57. UpToDate: Sample Topic Reviews failure; Human immunodeficiency virus and dialysis; Treatment of Wegener'sgranulomatosis and microscopic polyangiitis; Treatment of http://www.uptodate.com/topics/index.asp

Click to read more testimonials Home About Us ... Site Map Our topic reviews are written exclusively for UpToDate by physician experts in each specialty and are specifically designed to make it quick and easy for clinicians to find the answers they need. Notice that the topic reviews contain links to other related topics and are fully illustrated and referenced. You can view related charts, x-rays, photographs, movies and Medline abstracts by clicking on the associated links. You also have complete access to our extensive drug database. Take a look at the following sample topic reviews: Adult Primary Care and Internal Medicine Approach to acne vulgaris Anticoagulation to prevent embolization in atrial fibrillation Screening for colorectal cancer Treatment of multiple sclerosis ... Evaluation of the patient with shoulder complaints Cardiovascular Medicine Antithrombotic therapy following intracoronary stent implantation Management of high-risk patients with vascular disease prior to major noncardiac surgery ACE inhibition or angiotensin II receptor antagonism in patients at high risk for a cardiovascular event Treatment of dyslipidemia in diabetes mellitus ... Rhythm control versus rate control with anticoagulation in atrial fibrillation: Clinical trials Endocrinology and Diabetes

58. ClinicalTrials.gov - Linking Patients To Medical Research: Study Details Patients 10 to 80 years of age with active Wegener's granulomatosis, polyarteritisnodosa, ChurgStrauss vasculitis, or microscopic polyangiitis overlap may be http://www.clinicaltrials.gov/ct/gui/show/NCT00001256?order=4

59. INTRAVENOUS IMMUNOGLOBULIN (IVIg) IN AUTOIMMUNE DISEASES The patients included in the caseseries of IVIg in vasculitis had Wegener's granulomatosis,microscopic polyangiitis, rheumatoid vasculitis, parvovirus B19 http://www.aarda.org/research20.html

American Autoimmune Related Diseases Association Intravenous Immunoglobulin (IVIg) In Autoimmune Diseases Expanding Indications and Increasing Specificity Yaniv Sherer, Yair Levy, Yehuda Shoenfeld Department of Medicine 'B' and the Research Unit of Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, and Sackler Faculty of Medicine, Tel-Aviv University, Israel Correspondence to : Y. Shoenfeld M.D., Department of Medicine ‘B', Sheba Medical Center, Tel-Hashomer, 52621, Israel. Tel: 972-3-5302652. Fax: 972-3-5352855. E-mail: Shoenfel@post.tau.ac.il IVIg are composed of immunoglobulins, mainly of the IgG isotype, produced from numerous donors. Whereas its first indication was various immunodeficiency states, it is currently an accepted treatment also for immune thrombocytopenic purpura, Kawasaki disease, Guillain-Barre syndrome, and polymyositis/dermatomyositis. IVIg in autoimmune diseases - expanding indications In addition to the above-mentioned diseases, there are several reports of IVIg use in other autoimmune diseases. The persistent reports of clinical success in the treatment of autoimmune diseases with IVIg, combined with the understanding of the mechanisms of action of IVIg, result in expansion of the possible indications for its use as an immunomodulating agent (Fig. 1). Literature review Personal experience Conclusion Nowadays IVIg is an immunomodulating agent used for the treatment of a few autoimmune diseases. However, the indications for IVIg use progressively expand. Since patients respond differently to IVIg, and currently there is no reliable way to predict who would benefit from this treatment, an effort should be carried out in order to predict who might enjoy from IVIg. The means of increased specificity of IVIg therapy should include both patient-related variables (clinical manifestations, laboratory parameters, response to other therapeutic modalities) and drug-related characteristics such as specific idiotypes' concentration within IVIg.

60. Wilhelm H. Schmitt, Ernst C. Hagen And Fokko J. Van Der Woude; T this form of treatment is still limited, preliminary data indicate that patientswith active Wegener´s granulomatosis and microscopic polyangiitis do respond http://www.birkhauser.ch/books/biosc/pir/pir6147_6.html

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