Beter laat dan nooit

Historisch overzicht van de klinische immunologi

Behandeling van nefritis bij systemische lupus erythematodes

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Plasma-exchange in the treatment of severe thyrotoxicosis in pregnancy

Three female patients with severe thyrotoxicosis, two of them pregnant 22 and 16 wk, respectively, were treated with plasma-exchange (PE) combined with anti-thyroid drugs. In both pregnant patients PE was an effective adjunct to therapy with low-dose carbimazol. They were both delivered of normal babies at 37 and 40 wk, respectively. One newborn was euthyroid, the other had transient neonatal thyrotoxicosis. In the non-pregnant patient an ominous situation of thyrotoxic crisis was rapidly reversed by a single PE. During PE an influx of thyroid hormones occurs from the extra- to the intravascular compartment, which increases the efficacy of PE. The 5% albumin solution derived from human donor plasma, used as replacement fluid, contained substantial amounts of thyroid hormones. A 5% albumin solution from human placental origin lacks these hormones and is therefore recommended as replacement fluid for PE in thyrotoxicosis. There are no valid arguments for advocating replacement with donor plasma

Sequential mapguided endocardial resection for ventricular tachycardia improves outcome

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Chorea in systemic lupus erythematosus and “lupus-like” disease: Association with antiphospholipid antibodies

Twelve patients with chorea from a population of 500 patients with SLE and “lupus-like” disease were reviewed. Clinical histories, including time relationships of chorea to the systemic illness and other neurologic manifestations, are reported. Chorea appeared early in the course of disease in most patients, but the development of cerebral infarctions or TIAs occurred subsequently in seven of nine patients demonstrating antiphospholipid antibodies. The relationship of chorea to the presence of these antibodies in nine of 12 patients and the therapeutic outcome are briefly discussed