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Vaiopoulos AG, Samarkos M, Kanakis MA, Vaiopoulos G, Kaklamanis PG, Zouboulis CC. Late-onset Adamantiades-Behçet's disease-systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2024; 38:e238-e241. [PMID: 37793879 DOI: 10.1111/jdv.19550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/29/2023] [Indexed: 10/06/2023]
Affiliation(s)
- A G Vaiopoulos
- Second Department of Dermatology and Venereology, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, Chaidari, Athens, Greece
| | - M Samarkos
- First Department of Medicine, Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M A Kanakis
- Department of Pediatric and Congenital Heart Surgery, Onassis Heart Surgery Centre, Athens, Greece
| | - G Vaiopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Staedtisches Klinikum Dessau, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
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Vaiopoulos AG, Kapsimali V, Kanakis MA, Vaiopoulos G, Samarkos M, Zouboulis CC, Kaklamanis PG. The frequency of arthritis in Adamantiades-Behçet's disease in Greek patients. J Eur Acad Dermatol Venereol 2018; 33:416-420. [PMID: 30394611 DOI: 10.1111/jdv.15326] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 10/04/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND/OBJECTIVES Musculoskeletal manifestations are frequent in Adamantiades-Behçet's disease (ABD) but only represent non-specific clinical findings. They have not been included in the two commonly used sets of classification criteria. The occurrence of musculoskeletal manifestations at ABD onset may even delay or obscure the diagnosis; therefore, detailed knowledge of the different musculoskeletal manifestations is essential. Our objective was to describe musculoskeletal signs and their clinical course in Greek ABD patients. METHODS We conducted a retrospective cohort study, which included all patients with ABD, who had been examined in our Rheumatology Outpatient Division from 1995 to 2010. The study included 224 ABD patients (140 male, 84 female) that fulfilled the International Criteria for the diagnosis of BD. For statistical analysis, we have used chi-square and Fisher's exact tests. RESULTS Arthritis as a presenting sign was seen in 10.2% of our patients. During the follow-up period, the frequency of arthritis was 58.4%. Monoarthritis was found in 32.8% and 22.6% of male and female patients, respectively (ns). During the follow-up period, polyarthritis was only occasionally observed in male patients (2.14%). Oligoarthritis was assessed in 20.0% and 41.6% of male and female patients, respectively (P < 0.001), and was the only significantly different manifestation between sexes. CONCLUSIONS Musculoskeletal manifestations are common in ABD both at presentation and during the disease course. The most frequent sign is mooarthritis. Oligoarthritis was the only significantly different articular manifestation between sexes (more common in women) in our study group.
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Affiliation(s)
- A G Vaiopoulos
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - V Kapsimali
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M A Kanakis
- Department of Pediatric and Congenital Heart Surgery, Onassis Heart Surgery Centre, Athens, Greece
| | - G Vaiopoulos
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - M Samarkos
- First Department of Medicine, Laikon Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - P G Kaklamanis
- Athens Medical Centre, Rheumatology Clinic, Athens, Greece
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Tsavaris N, Tsigalacis D, Kosmas C, Koufos C, Vaiopoulos G, Tzivras M, Kouraklis G, Papadimas V, Georgoulis V, Archimandritis A, Sechas M. Preliminary Evaluation of the Potential Prognostic Value of Serum Levels of Immunoglobulins (IgA, IgM, IgG, IgE) in Patients with Gastric Cancer. Int J Biol Markers 2018; 13:87-91. [PMID: 9803356 DOI: 10.1177/172460089801300204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sixty patients with advanced gastric carcinoma who refused to receive cytotoxic chemotherapy were examined for serum immunoglobulin levels (IgG, IgM, IgA, IgE). Three samples were obtained every two months thereafter. The group of patients who had above-normal values of one or more of the examined immunoglobulins had a longer survival than the other (p<0.024). Immunoglobulin values were independent of the Helicobacter pylori antibody titer and of acute phase reactants. It is concluded that survival potentially correlates with serum immunoglobulin levels. Further studies including larger numbers of patients and correlating serum immunoglobulin levels with specific clinical parameters are needed to establish the prognostic role of serum immunoglobulins in patients with gastric carcinoma.
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Affiliation(s)
- N Tsavaris
- Department of Pathophysiology, University of Athens School of Medicine, Laiko General Hospital, Greece
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Christopoulos G, Christopoulou V, Routsias JG, Babionitakis A, Antoniadis C, Vaiopoulos G. Greek rheumatoid arthritis patients have elevated levels of antibodies against antigens from Proteus mirabilis. Clin Rheumatol 2016; 36:527-535. [DOI: 10.1007/s10067-016-3441-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 09/26/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
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Alexoudi I, Kapsimali V, Vaiopoulos A, Kanakis M, Vaiopoulos G. Toll-like receptors pathways implication in common autoimmune diseases and therapeutic perspectives. GIORN ITAL DERMAT V 2015; 150:255-260. [PMID: 25876147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Toll-like receptors (TLRs) are a category of receptors that recognize and activate their signaling pathways to defend against the pathogen factors. However, an alteration in the proper activation might occurr, resulting in the production of proinflammatory cytokines. This improper activation is the beginning of an autoimmune disease. The inhibition of the implicated receptors or their pathways may prevent the induction of autoimmunity. This paper describes in detail new therapeutic opportunities based on the alteration of the TLR activation for rheumatoid arthritis and systemic lupus erythematosus.
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Asimakopoulos J, Terpos E, Giakoumis A, Kampouropoulou O, Papageorgiou L, Petevi K, Vaiopoulos G, Vassilakopoulos T, Angelopoulou M, Konstantopoulos K, Meletis J. AB0047 Cd55 Red-Cell Expression in Systemic Autoimmune Disease Reflects Its Impact on Erythropoiesis through Immune-Mediated Bone Marrow Insufficiency. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gialafos E, Konstantopoulou P, Voulgari C, Giavri I, Panopoulos S, Vaiopoulos G, Mavrikakis M, Moyssakis I, Sfikakis PP. Abnormal spatial QRS-T angle, a marker of ventricular repolarisation, predicts serious ventricular arrhythmia in systemic sclerosis. Clin Exp Rheumatol 2012; 30:327-331. [PMID: 22510222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 10/26/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Cardiac involvement may be under-diagnosed in asymptomatic patients with systemic sclerosis (SSc). Standard electrocardiography-derived spatial QRS-T angle (spQRS-Ta) is an established marker of ventricular repolarisation heterogeneity, and a strong independent predictor of cardiac morbidity and mortality, including sudden death, in the general population. We examined whether spQRS-Ta is abnormal in asymptomatic SSc patients and assessed its predictive value for possibly concurrent, serious ventricular arrhythmia. METHODS SpQRS-Ta and 24-hour Holter recordings were obtained from 69 SSc patients (aged 51±13 years, 63 women) without clinically evident cardiac involvement and having left ventricular ejection fraction at least 50% by echocardiography. 'Healthy' subjects matched 1:1 with patients for age, gender and body mass index served as controls. RESULTS SpQRS-Ta was wider in SSc (median value 15.6°, interquartile range 10.6-24.3°) than controls (10.5°, 7.3-13.5°, p=0.0001) and not associated with skin fibrosis extent or specific clinical manifestations and autoantibodies. Twenty-four-hour Holter recordings revealed couplets of ventricular beats in six (Lown class IVa) and non-sustained ventricular tachycardia in five patients (Lown class IVb); spQRS-Ta was wider in those eleven patients with serious ventricular arrhythmia than the remaining patients (24.9°, 14.9-31.3° vs. 14.4°, 9.6-22.3°; p=0.02). A spQRS-Ta>19.3° demonstrated 80% sensitivity and 68% specificity (area under the curve 0.81, p=0.02) to predict the presence of non-sustained ventricular tachycardia in Holter monitoring. CONCLUSIONS Ventricular repolarisation heterogeneity, as reflected by wider spQRS-Ta, is common in SSc. Increased spQRS-Ta could serve as a simple screening test for further investigation to identify patients at risk or prone to develop life-threatening ventricular arrhythmia.
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Affiliation(s)
- E Gialafos
- First Department of Propaedeutic and Internal Medicine, Athens University Medical School, Greece.
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Makras P, Vaiopoulos G, Lyritis GP. 2011 guidelines for the diagnosis and treatment of osteoporosis in Greece. J Musculoskelet Neuronal Interact 2012; 12:38-42. [PMID: 22373950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- P Makras
- Department of Endocrinology and Diabetes, 251 Hellenic Air Force and VA General Hospital, Athens, Greece
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Vaiopoulos G, Konstantopoulou P, Evangelatos N, Kaklamanis P. The spectrum of mucocutaneous manifestations in Adamantiades-Behçet’s disease in Greece. J Eur Acad Dermatol Venereol 2010; 24:434-8. [DOI: 10.1111/j.1468-3083.2009.03435.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Arida A, Vaiopoulos G, Markomichelakis N, Kaklamanis P, Sfikakis PP. Are clusters of patients with distinct clinical expression present in Behçet's disease? Clin Exp Rheumatol 2009; 27:S48-S51. [PMID: 19796533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Studies from Israel and Turkey have proposed that patient clusters with discriminating clinical features may exist in Behçet's disease (BD); such clusters could help to better understand pathogenetic mechanisms and guide therapeutic decisions. Herein, we searched for specific associations between each disease manifestation to all other manifestations in Greek patients with BD. METHODS Specific clinical features were retrospectively recorded in 142 consecutive patients (80 men) fulfilling the International Study Group criteria, seen between 2000-2008 in our Departments (mean follow-up of 37 months). All possible associations between distinct clinical features were examined; further analysis in relation to HLA-B51 status and pathergy test positivity, available in 89 patients, was performed. RESULTS No significant associations between various manifestations of BD were found, either among all patients, or among men or women analysed separately. Uveitis was present more frequently in men, but not women, who were HLA-B51 carriers (p<0.02). A positive pathergy reaction was associated with oral ulcers (p<0.001) and central nervous involvement (p=0.008) in women, and folliculitis in men (p=0.046). CONCLUSION In contrast to studies from other countries, no subgroups of patients with distinct positive or negative associations between clinical features were found. HLA-B51 may have some prognostic significance in men only. Whether differences in disease expression between geographical areas may reflect different triggers of pathogenetic mechanisms operating among ethnic groups could be further explored in comparative studies.
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Affiliation(s)
- A Arida
- First Department of Propedeutic and Internal Medicine, Athens University Medical School, Athens, Greece
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Mantzourani MG, Chantziara K, Thanopoulou I, Variami H, Vaiopoulos G, Pangalis GA. Coexistence of Behcet's disease and chronic myelomonocyte leukemia with trisomy 8: a case report and review of the literature. Clin Exp Rheumatol 2009; 27:S85-S87. [PMID: 19796540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Behçet's disease (BD) is a multisystem inflammatory vasculitis of unknown etiology and pathogenesis. Coexistence of BD along with hematological malignancies is extremely rare. We describe a patient diagnosed with BD and chronic myelomonocytic leukaemia (CMML) with trisomy 8. This case suggests that trisomy 8 may be involved in the concurrent manifestation of myelodysplastic syndrome (MDS) and BD with gastrointestinal ulcers.
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Affiliation(s)
- M G Mantzourani
- First Department of Internal Medicine, University of Athens, Athens, Greece
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Karanikolas G, Charalambopoulos D, Vaiopoulos G, Andrianakos A, Rapti A, Karras D, Kaskani E, Sfikakis PP. Adjunctive anakinra in patients with active rheumatoid arthritis despite methotrexate, or leflunomide, or cyclosporin-A monotherapy: a 48-week, comparative, prospective study. Rheumatology (Oxford) 2008; 47:1384-8. [DOI: 10.1093/rheumatology/ken223] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moyssakis I, Gialafos E, Tentolouris N, Floudas CS, Papaioannou TG, Kostopoulos C, Latsi P, Vaiopoulos G, Votteas V, Rapti A. Impaired aortic elastic properties in patients with systemic sarcoidosis. Eur J Clin Invest 2008; 38:82-9. [PMID: 18226041 DOI: 10.1111/j.1365-2362.2007.01906.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Systemic sarcoidosis (Sar) is a granulomatous disorder involving multiple organs. Widespread vascular involvement and microangiopathy are common in patients with Sar. In addition, subclinical cardiac involvement is increasingly recognized in patients with Sar. However, data on the effect of Sar on the elastic properties of the arteries and myocardial performance are limited. In this study we looked for differences in aortic distensibility (AoD) which is an index of aortic elasticity, and myocardial performance of the ventricles, between patients with Sar and healthy subjects. In addition, we examined potential associations between AoD and clinical, respiratory and echocardiographic findings in patients with Sar. MATERIALS AND METHODS A total of 83 consecutive patients (26 male/57 female, mean age 51.1 +/- 13.3 years) with Sar, without cardiac symptoms, were included. All patients underwent echocardiographic and respiratory evaluation including lung function tests. Additionally, 83 age- and sex-matched healthy subjects served as controls. AoD was determined non-invasively by ultrasonography. RESULTS AoD was lower in the Sar compared to the control group (2.29 +/- 0.26 vs. 2.45 +/- 0.20 .10(-) (6) cm2 x dyn(-1), P < 0.01), while left ventricular mass (LVM) was higher in the Sar group (221.3 +/- 50.2 vs. 195.6 +/- 31.3 g, P = 0.007). Furthermore, myocardial performance of both ventricles was impaired in the Sar group. Multivariate linear regression analysis in the total sample population demonstrated a significant and independent inverse relationship between AoD and the presence of Sar (P < 0.001). The same analysis in the Sar patients showed that AoD was associated significantly and independently with the stage of Sar, age, systolic blood pressure, LVM and myocardial performance of both ventricles. No significant relationship was found between AoD and disease duration, pulmonary artery pressure or lung function tests. CONCLUSIONS Presence and severity of Sar are associated with reduced aortic distensibility, irrespective of the disease duration, pulmonary artery pressure and lung function. In addition, patients with Sar have increased LVM and impaired myocardial performance.
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Affiliation(s)
- I Moyssakis
- Department of Cardiology, Medical School, National University of Athens, Laiko Hospital, Athens, Greece.
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Fotiou K, Vaiopoulos G, Lilakos K, Giannopoulos A, Mandalenaki K, Marinos G, Koritsiadis G, Sourdis J, Konstantinidou E, Konstantopoulos K. Serum ceruloplasmin as a marker in prostate cancer. MINERVA UROL NEFROL 2007; 59:407-411. [PMID: 17947957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM Serum acid phosphatase and prostate specific antigen have been utilized as disease markers in prostate cancer, one of the commonest cancers of the elderly. Serum ceruloplasmin (Cp) increases in cancer patients; it may be a reliable marker for prostate cancer, but few data are available on specificity and sensitivity of Cp values. METHODS Serum prostate specific antigen (PSA) and Cp was determined in Greek patients suffering from histologically proven prostate carcinoma or benign hyperplasia. The results were compared with those in controls matched for sex and age. RESULTS In all studied subjects with a prostate cancer, serum Cp values were higher than age-matched healthy controls; they were also higher in cases with benign hyperplasia. No difference in serum Cp was noted among patients with earlier and advanced stages of the tumor. No difference in Cp was also found between benign hyperplasia and normal controls. There exists a significant difference in serum PSA between both prostate cancer and benign hyperplasia cases. There exists also a difference between benign hyperplasia cases and controls. CONCLUSION It is suggested that serum Cp may complement the biochemical screening in prostate carcinoma, especially in cases where this cancer is not accompanied by elevation of serum PSA. However, it is not of help in differentiating prostate cancer from prostate benign hyperplasia.
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Affiliation(s)
- K Fotiou
- Division of Medicine I, Laikon General Hospital, University of Athens School of Medicine, Athens, Greece.
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Kasparian A, Floros A, Gialafos E, Kanakis M, Tassiopoulos S, Kafasi N, Vaiopoulos G. Raynaud's phenomenon is correlated with elevated systolic pulmonary arterial pressure in patients with systemic lupus erythematosus. Lupus 2007; 16:505-8. [PMID: 17670849 DOI: 10.1177/0961203307080629] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In patients with Systemic lupus erythematosus (SLE), Raynaud phenomenon (RP) is frequently present and associated with pulmonary hypertension (PHT). Elevated pulmonary artery systolic pressure (PASP) is an indicator of PHT and can be estimated noninvasively. We attempt to explore the significance of RP in SLE and to correlate it with clinical and serological parameters of the disease. The study population consisted of 34 patients (age, sex and disease duration matched) who fulfilled the revised SLE criteria of the American College of Rheumatology, and were categorized into two groups: Group 1 had patients having SLE and RP (2 males/15 females, mean age 45 +/- 18 years) and group 2 had patients with SLE but without RP (3 males/14 females, mean age 40 +/- 14 years. Detailed cardiac ultrasound was performed including measurement of PASP, while clinical and serological features of both groups were collected and correlated. Significant differences were shown in the presence of arterial hypertension (P < 0.05), arthralgias (P < 0.005), arthritis (P < 0.05), myalgias (P < 0.05), alopecia (P < 0.05) and PASP (P < 0.0001). No difference was observed among the cardiac ultrasound indices and the ejection fraction between the two groups. PASP was significantly correlated with RP, while no correlation was observed regarding the disease duration. In patients with SLE, the presence of RP was associated with elevation in PASP. Further investigation is needed to clarify the significance of this relation.
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Affiliation(s)
- A Kasparian
- Department of Cardiology, Laikon General Hospital, Univ. of Athens, School of Medicine, Athens, Greece
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Elezoglou A, Kafasi N, Kaklamanis PH, Theodossiadis PG, Kapsimali V, Choremi E, Vaiopoulos G, Sfikakis PP. Infliximab treatment-induced formation of autoantibodies is common in Behçet's disease. Clin Exp Rheumatol 2007; 25:S65-S69. [PMID: 17949554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To study autoantibody formation in patients with Behçet's disease (BD) who received long-term treatment with the anti-TNF monoclonal antibody infliximab. METHODS Serial sera from infliximab-treated patients (5 mg/kg at weeks 0, 4, 8, and every 6-8 weeks thereafter) were tested for various autoantibodies, using commercially available methods, at baseline and at 6 months (n = 20), at 12 months (n = 16), and at 18 months post-baseline (n = 12). Thirty-five age- and sex-matched BD patients, not treated with infliximab, served as controls. RESULTS Autoantibodies were rarely seen in controls, as well as in infliximab treated patients at baseline. Formation of antinuclear antibodies (ANA) at low titers was evident in 13/20 (65%) patients at 6 months post-baseline; one additional patient developed anti-beta2 glycoprotein-I IgM antibodies (anti-beta(2)GPI). Of the 13 ANA-positive sera, low titers-IgM of anti-dsDNA or anti-beta(2)GPI were detected in 7 (35%) and 6 (30%) patients, respectively. Additional measurements at 12 and 18 months showed that the persistence and/or increasing titers of these autoantibodies depended on continuation of treatment. Antibodies to extractable nuclear antigens (anti-RNP, anti-SS-A/Ro, anti-SS-B/La, anti-Sm), rheumatoid factors, anti-cyclic citrullinated peptide antibodies and antineutrophil cytoplasmic antibodies, were never detected. No antibody-related symptoms, lupus-like disease, or thrombosis were observed in any patient up to 18 months of follow-up. CONCLUSION Early induction of ANA and specific autoantibodies is common in BD patients treated with infliximab, including low titers of non-pathogenic anti-dsDNA and anti-Beta<inf>2</inf>GPI antibodies. A possible clinical significance of these findings needs to be documented in further studies, including more patients and longer follow-up periods.
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Affiliation(s)
- A Elezoglou
- Department of Internal Medicine, Laikon Hospital, Athens University Medical School, Athens, Greece
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Abstract
Heterophilic antibodies (HA) may interfere in some immunoassays, causing falsely high hormone values, of which practitioners should be aware when measuring calcitonin (CT) used as tumor marker for medullary thyroid carcinoma (MTC). We studied four patients with thyroid nodules, three of whom underwent surgical neck exploration, after an erroneous diagnosis of MTC because of falsely high serum CT eventually proved to be due to HA. One patient had a lingual thyroid, two autoimmune thyroiditis and the fourth a colloid goiter. The minimal incremental CT response to calcium infusion raised our suspicion of possible false high CT values due to HA. There was no linearity of the CT values obtained by testing serial dilutions of the sera in the CT assay, which employs two monoclonal mouse anti-CT antibodies. Addition of normal mouse gamma globulin eliminated the interference by HA in the sera of two patients. Serum assayed in a polyclonal radioimmunoassay using goat anti-CT antibodies gave normal CT values. Finally, incubation of the sera in Heterophilic Blocking Tubes (HBT) eliminated the false CT immunoreactivity. A spontaneous change of the CT serum concentrations was noticed in three patients over several months, apparently due to changing titles of HA. We suggest that, in patients a) whose CT response to calcium or pentagastrin infusion is minimal despite high basal CT values, b) with autoimmune thyroiditis and c) in whom an unexpected change in serum CT concentrations occurs, the possibility of spuriously high CT values because of circulating HA should be considered.
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Affiliation(s)
- P D Papapetrou
- Second Division of Endocrinology, Alexandra Hospital, Athens, Greece.
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Gogas H, Polyzos A, Stavrinidis I, Frangia K, Tsoutsos D, Panagiotou P, Markopoulos C, Papadopoulos O, Pectasides D, Mantzourani M, Middleton M, Vaiopoulos G, Fountzilas G. Temozolomide in combination with celecoxib in patients with advanced melanoma. A phase II study of the Hellenic Cooperative Oncology Group. Ann Oncol 2006; 17:1835-41. [PMID: 16980601 DOI: 10.1093/annonc/mdl311] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND There is now increasing evidence that a constitutive expression of cyclooxygenase (COX)-2 plays a role in the development and progression of malignant epithelial tumors. Expression of COX-2 is seen in 93% of melanomas, as determined by immunohistochemistry. Temozolomide (TMZ) has demonstrated activity against melanoma and has been investigated as single agent or in combination. We designed a phase II study to assess the efficacy and toxicity of the combination of TMZ and celecoxib (a COX-2 inhibitor) in patients with advanced melanoma. PATIENTS AND METHODS From January 2003 to July 2004, 52 patients were enrolled in the study. Nineteen patients were M1a, six M1b and 27 M1c. Patients received TMZ 200 mg/m(2) per day p.o. for 5 consecutive days every 4 weeks and celecoxib 400 mg b.i.d. p.o. for a maximum of six cycles. Celecoxib was continued until progression. RESULTS The median age was 63 years. There were 29 males and 23 females. Among 50 assessable patients, there were 11 (21.5%) objective responses including five complete responses and six partial responses. Twenty patients (38.5%) had stabilization of their disease, and 19 (36.5%) progressed. The median time to progression was 4.6 months and the median survival 9.5 months. Twenty-two patients (41.5%) completed all cycles of treatment. Median relative dose intensity of TMZ was 0.99 (range 0.6-1.2). Most commonly seen toxic effects included anemia (27.5%), neutropenia (17.5%), thrombocytopenia (33%), nausea/vomiting (75%), gastrointestinal (52%) and fatigue (46.5%). One patient discontinued due to severe toxicity. COX-2 was determined by immunohistochemistry and was expressed in all cases. CONCLUSION The combination of TMZ and celecoxib is safe and potentially effective in the treatment of metastatic melanoma. Randomized studies are needed to explore the role of celecoxib in combination with chemotherapy or as maintenance treatment in these patients.
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Affiliation(s)
- H Gogas
- First Department of Medicine, University of Athens, Medical School, Athens, Greece.
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Sideris P, Tassiopoulos S, Sakellaropoulos N, Androulaki A, Variami E, Gogas H, Kanakis M, Vaiopoulos G. Unusual radiological findings in a case of myelofibrosis secondary to polycythemia vera. Ann Hematol 2006; 85:555-6. [PMID: 16673126 DOI: 10.1007/s00277-006-0131-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2005] [Accepted: 12/20/2005] [Indexed: 11/26/2022]
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21
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Konstantopoulos K, Kanta A, Meletis I, Vaiopoulos G. AA amyloidosis and pyrin gene mutations. Ann Saudi Med 2005; 25:263. [PMID: 16119533 PMCID: PMC6147997 DOI: 10.5144/0256-4947.2005.263a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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22
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Tassiopoulos S, Benopoulou O, Mytilineou E, Andreopoulos A, Vaiopoulos G. Late onset of long-lasting fever as a sole complication of treatment with anti-TNFalpha. Clin Exp Rheumatol 2005; 23:122-3. [PMID: 15789902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Gogas H, Ignatiadis T, Markopoulos C, Karageorgopoulou S, Floros D, Vaiopoulos G. Solitary spleen metastasis and amyloidosis in a patient with endometrial cancer. EUR J GYNAECOL ONCOL 2004; 25:391-3. [PMID: 15171329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND In contrast to autopsy findings, solitary splenic metastases from solid tumors are extremely rare. It may occasionally be the first manifestation of recurrent solid cancers, and in particular of gynecologic malignancies. Secondary amyloidosis is also found in malignancy. CASE A 52-year-woman originally diagnosed with a Stage IB, grade 2 endometrial carcinoma presented two and a half years later with a paroxysmal non-productive cough, weakness, loss of appetite and daily afternoon fever. On clinical examination wheezing on forced exhalation and painful splenomegaly was found. After an extensive work-up the patient underwent an explorative laparotomy and a splenectomy was performed. Histologic examination showed solitary spleen metastasis with amyloidosis. All symptoms resolved. As the patient had received a full course of postoperative irradiation after a total abdominal hysterectomy, six cycles of combination chemotherapy were administered. The patient remains free of recurrence, 46 months later. CONCLUSION A case of solitary spleen metastasis with amyloidosis in a patient with endometrial cancer is presented.
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Affiliation(s)
- H Gogas
- 1st Department of Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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25
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Psarra K, Kapsimali V, Vaiopoulos G, Nikolopoulou M, Kaklamanis P, Palimeris G, Kaklamani E, Papasteriades C. Immunophenotype and Th1/Th2 cytokines in patients with Adamantiades-Behçet's disease. Adv Exp Med Biol 2003; 528:249-53. [PMID: 12918701 DOI: 10.1007/0-306-48382-3_50] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Affiliation(s)
- K Psarra
- Department of Immunology and Histocompatibility, Evangelismos Hospital, Athens, Greece
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26
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Petrikkos G, Skiada A, Sambatakou H, Toskas A, Vaiopoulos G, Giannopoulou M, Katsilambros N. Mucormycosis: ten-year experience at a tertiary-care center in Greece. Eur J Clin Microbiol Infect Dis 2003; 22:753-6. [PMID: 14605941 DOI: 10.1007/s10096-003-1035-y] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Presented here are the results of a retrospective analysis of all mucormycoses infections recorded at a tertiary hospital in Greece during the last 10 years. A total of 24 patients were identified, 15 male and 9 female, with ages ranging from 37 to 80 years. Twelve of the patients had soft tissue infections (2 with concomitant pulmonary infections), and 12 had rhinocerebral infections. Transmission could be traced in two cases; to nitroglycerin patches in one patient and to a lemon-tree-thorn scratch in the other. Among the 17 patients who underwent surgery, 11 survived. All seven patients on whom surgery was not performed died. Rapid diagnosis and treatment of mucormycosis are essential for patient survival. The severity of the patient's underlying condition, the degree of immunosuppression, and prompt surgical treatment are the most important factors contributing to the outcome.
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Affiliation(s)
- G Petrikkos
- Laiko General Hospital, First Department of Propaedeutic Medicine, Infectious Diseases Laboratory G.K. Daikos, Athens University, 17 Agiou Thoma Street, 115 27 Athens, Greece.
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27
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Anargyrou K, Paterakis G, Boutsis D, Politou M, Papadhimitriou SI, Siakandaris M, Vassiliadis J, Androulakis A, Meletis J, Rombos J, Tassiopoulou A, Vaiopoulos G. An unusual case of CD4+ CD7+ CD56+ acute leukemia with overlapping features of type 2 dendritic cell (DC2) and myeloid/NK cell precursor acute leukemia. Eur J Haematol 2003; 71:294-8. [PMID: 12950240 DOI: 10.1034/j.1600-0609.2003.00098.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Type 2 dendritic cell (DC2) acute leukemia has been recently described. We report here an unusual case of a 17-yr-old adolescent with overlapping features of DC2 and myeloid/NK cell precursor acute leukemia as defined by Suzuki et al. The patient presented with lymphadenopathy and hepatosplenomegaly without extranodal manifestations in skin or elsewhere. The morphologic, cytochemical and immunophenotypic features were compatible with those described in DC2 acute leukemia, with co-expression of CD4, CD56 and CD123 antigens. The novel markers BDCA-4 and BDCA-2 considered specific for DC2s were co-expressed. However, bright CD7 positivity along with a dim expression of CD33 (57%) and CD117 (27%) were also noted. Additionally, there was bright expression of NG2 monoclonal antibody 7.1, a frequent finding in myeloid/NK cell precursor acute leukemia. The interpretation of the immunophenotypic profile leads to the hypothesis on the existence of borderline cases between DC2 and myeloid/NK cell precursor acute leukemia. Still, other hypotheses can not be overlooked, such as the possibility for a kind of variant monoblastic leukemia or of another rare entity of acute unclassified leukemia.
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MESH Headings
- Adolescent
- Antigens, CD/biosynthesis
- Antigens, CD7/biosynthesis
- Antigens, Differentiation, Myelomonocytic/biosynthesis
- Antigens, Surface/blood
- Bone Marrow Cells
- CD4 Antigens/biosynthesis
- CD56 Antigen/biosynthesis
- Dendritic Cells/cytology
- Flow Cytometry
- Humans
- Immunophenotyping
- Killer Cells, Natural/cytology
- Lectins, C-Type/blood
- Leukemia/blood
- Leukemia/metabolism
- Leukemia, Myeloid, Acute/blood
- Leukocyte Common Antigens/biosynthesis
- Male
- Membrane Glycoproteins
- Proto-Oncogene Proteins c-kit/biosynthesis
- Receptors, Immunologic
- Sialic Acid Binding Ig-like Lectin 3
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Affiliation(s)
- K Anargyrou
- First Department of Internal Medicine, Laikon General Hospital, University of Athens, Athens, Greece
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Zouboulis CC, Vaiopoulos G, Marcomichelakis N, Palimeris G, Markidou I, Thouas B, Kaklamanis P. Onset signs, clinical course, prognosis, treatment and outcome of adult patients with Adamantiades-Behçet's disease in Greece. Clin Exp Rheumatol 2003; 21:S19-26. [PMID: 14727454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
OBJECTIVES To examine the onset signs, clinical course, prognosis, treatment and outcome of Adamantiades-Behçet's disease in adult Greek patients during a 10-year follow-up period, and to compare the results with those of other series reported. METHODS The studied population consisted of 82 adult patients (54 male and 28 female) of Greek origin. Patients filled out a standard questionnaire and were followed up regularly. The findings during the follow-up of these patients were compared with those of other series. RESULTS The most frequent onset sign was oral aphthae, both in our patients and in those of other published series. Eye involvement, joint involvement, genital ulcers and skin lesions followed in frequency. During a 10-year follow-up differences were observed between men and women, with arthritis being more frequent in females compared to males and with an overall more severe course in males. Eye involvement occurred earlier than neurological and vascular manifestations. A few differences were found in the clinical parameters in comparison to previously reported ethnic series. HLA-B51 positive patients presented an odds ratio of 9.5, the activity index was 5.17 +/- 2.56 and the mean severity score 5.96 +/- 2.32. Early treatment led to improvement of the disease. CONCLUSION The pattern of Adamantiades-Behçet's disease in adult Greek patients provides major similarities when compared to patterns in various other national groups.
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Affiliation(s)
- C C Zouboulis
- Department of Dermatology, University Medical Center Benjamin Franklin, Free University of Berlin, Berlin, Germany
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29
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Anargyrou K, Petrikkos GL, Suller MTE, Skiada A, Siakantaris MP, Osuntoyinbo RT, Pangalis G, Vaiopoulos G. Pulmonary Balantidium coli infection in a leukemic patient. Am J Hematol 2003; 73:180-3. [PMID: 12827655 DOI: 10.1002/ajh.10336] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 59-year-old woman suffering from chronic lymphocytic leukemia developed pulmonary lesions; bronchoalveolar lavage was performed for possible systemic fungal infection. However, direct microscopic analysis revealed ciliated protozoa identified as Balantidium coli. B. coli is the only known pathogenic ciliate, and is usually associated with intestinal infection in areas associated with pig rearing. On very rare occasions the organisms may invade extra-intestinal organs, in this case the lungs of an immunocompromised patient. This case is unusual as balantidiasis is rare in Europe, the patient had no obvious contact with pigs, and there was no history of diarrhea prior to pulmonary colonization. Metronidazole was rapidly administered, and the condition improved after 24-48 hr.
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Affiliation(s)
- K Anargyrou
- Hematology Section, 1st Department of Internal Medicine, Athens University School of Medicine, Laikon General Hospital, Goudi, Athens, Greece
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30
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Samarkos M, Vaiopoulos G, Andreopoulos A, Chatzidimitriou D, Alevizou-Terzaki V, Aessopos A. Association of protein-losing enteropathy and cryoglobulinaemia. Scand J Gastroenterol 2003; 38:334-6. [PMID: 12737452 DOI: 10.1080/00365520310000744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We describe a case of protein-losing enteropathy in association with cryoglobulinaemia. No underlying disorder could be definitively diagnosed, but several clinical and laboratory findings suggested an immune mediated or autoimmune disorder. We propose that the mechanism of the protein-losing enteropathy in our case was immune complex formation, complement activation and endothelial damage.
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Affiliation(s)
- M Samarkos
- First Dept. of Internal Medicine, University of Athens School of Medicine, Laikon Hospital, Athens, Greece.
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31
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Filiotou A, Vaiopoulos G, Capsimali V, Stavrianeas N, Kaloterakis A. Acute intermittent porphyria and systemic lupus erythematosus: report of a case and review of the literature. Lupus 2002; 11:190-2. [PMID: 11999885 DOI: 10.1191/0961203302lu159cr] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The case of a Greek woman with acute intermittent porphyria (AIP) associated with systemic lupus erythematosus (SLE) is described and the literature on this association is reviewed. The coexistence of these two diseases may be determined by unknown mechanisms or could be fortuitous.
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Affiliation(s)
- A Filiotou
- Second Department of Internal Medicine, Hippocration General Hospital, Athens, Greece.
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32
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Vaiopoulos G, Sideris P, Anargyrou K, Melas P, Plessas N, Konstantopoulos K. Transient monoclonal hypergammaglobulinemia during the course of a rickettsia infection. Infection 2002; 30:249-50. [PMID: 12236573 DOI: 10.1007/s15010-002-2119-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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33
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Vaiopoulos G, Konstantopoulos K, Kittas C, Hatzakis A, Bogdanos K, Mastrovassilopoulos A, Meletis J, Loukopoulos D. Histological and functional changes in the salivary glands in thalassaemia major. Haematologia (Budap) 2002; 27:33-8. [PMID: 12051294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Oral salivary secretion and oral histology in 15 multi-transfused adult thalassaemia homozygotes was studied. Iron stores of minor salivary glands were also histochemically determined. Salivary secretion in multi-transfused thalassaemia patients was subclinically decreased, but no clear correlation was evident between salivary secretion impairment and salivary gland destruction by iron deposition, lymphocyte infiltration and fibrosis. The underlying mechanism remains to be determined.
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Affiliation(s)
- G Vaiopoulos
- Department of Medicine, University of Athens School of Medicine, Greece
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34
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Pangalis GA, Dimopoulou MN, Angelopoulou MK, Tsekouras C, Vassilakopoulos TP, Vaiopoulos G, Siakantaris MP. Campath-1H (anti-CD52) monoclonal antibody therapy in lymphoproliferative disorders. Med Oncol 2002; 18:99-107. [PMID: 11778765 DOI: 10.1385/mo:18:2:99] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2000] [Accepted: 10/16/2000] [Indexed: 11/11/2022]
Abstract
Campath-1H is a humanized monoclonal antibody targeted against the CDw52 membrane antigen of lymphocytes, which causes complement and antibody-dependent cell-mediated cytotoxicity. Campath-1H has been used in B-chronic lymphocytic leukemia (B-CLL), T-prolymphocytic leukemia (T-PLL), and low-grade non-Hodgkin's lymphoma (LGNHL). Campath-1H is administered intravenously thrice weekly for up to 12 wk, at an initial dose of 3 mg, escalated to 10 and 30 mg. The responses (complete [CR] and partial [PR]) obtained in untreated B-CLL patients are of the order of 90%. In previously treated B-CLL patients, responses are of the order of approximately 40%, with 2-4% CRs. Responses are more prominent in the blood and bone marrow compared to the lymph nodes. The median duration of response is 9-12 mo. Because of the antibody's higher activity on circulating lymphocytes, it has been used for in vivo purging of residual disease in B-CLL, followed by autologous stem-cell transplantation. In heavily pretreated advanced stage LGNHL, response is achieved only in 14% of cases with B-phenotype; a 50% response rate is noted in mycosis fungoides. In T-PLL, the CR rate is approximately 60%. Promising results have been reported in a small number of patients with refractory autoimmune thrombocytopenia of lymphoproliferative disorders. The main complications of Campath-1H treatment are caused by tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 release, usually during the first intravenous infusion, and include fever, rigor, nausea, vomiting, and hypotension responsive to steroids. These side effects are usually less severe with subsequent infusions and can be prevented by paracetamol and antihistamines. Immunosupression resulting from normal B- and T-lymphocyte depletion is frequent, resulting in an increased risk for opportunistic infections. More clinical trials in a larger number of patients are necessary to determine the exact role and indications of Campath-1H in lymphoproliferative disorders.
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MESH Headings
- Alemtuzumab
- Antibodies, Monoclonal/adverse effects
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal/therapeutic use
- Antibodies, Monoclonal, Humanized
- Antibodies, Neoplasm/adverse effects
- Antibodies, Neoplasm/pharmacology
- Antibodies, Neoplasm/therapeutic use
- Antineoplastic Agents/adverse effects
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Dose-Response Relationship, Drug
- Humans
- Immunosuppression Therapy
- Infections
- Infusions, Intravenous
- Interleukin-6/adverse effects
- Interleukin-6/metabolism
- Leukemia, B-Cell/drug therapy
- Leukemia, Prolymphocytic/drug therapy
- Lymphoma, Non-Hodgkin/drug therapy
- Phenotype
- Risk Factors
- Treatment Outcome
- Tumor Necrosis Factor-alpha/adverse effects
- Tumor Necrosis Factor-alpha/metabolism
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Affiliation(s)
- G A Pangalis
- 1st Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Greece.
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35
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Tsavaris N, Karargyris G, Pikazis D, Vadiaka M, Kosmas C, Sakellaropoulos N, Vaiopoulos G. Adenocarcinoma of the colon presenting as polymyositis: case report. J Chemother 2002; 14:102-5. [PMID: 11892892 DOI: 10.1179/joc.2002.14.1.102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The relationship between polymyositis and malignancy is well known. Several types of tumors can be complicated with myositis and/or more frequently dermatomyositis. It has been suggested that tumors of the large bowel are rarely complicated by myositis. We describe a patient with adenocarcinoma of the colon presenting as polymyositis and review the available literature.
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Affiliation(s)
- N Tsavaris
- Department of Pathophysiology, University of Athens School of Medicine, Laikon General Hospital, Greece.
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36
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Stavroyianni N, Stamatopoulos K, Viniou N, Vaiopoulos G, Yataganas X. Autoimmune hemolytic anemia during alpha-interferon treatment in a patient with chronic myelogenous leukemia. Leuk Res 2001; 25:1097-8. [PMID: 11684283 DOI: 10.1016/s0145-2126(01)00093-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vassilakopoulos TP, Angelopoulou MK, Siakantaris MP, Kontopidou FN, Dimopoulou MN, Barbounis A, Grigorakis V, Karkantaris C, Anargyrou K, Chatziioannou M, Rombos J, Boussiotis VA, Vaiopoulos G, Kittas C, Pangalis GA. Prognostic factors in advanced stage Hodgkin's lymphoma: the significance of the number of involved anatomic sites. Eur J Haematol 2001; 67:279-88. [PMID: 11872075 DOI: 10.1034/j.1600-0609.2001.00561.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Advanced Hodgkin's lymphoma (HL) is curable by conventional chemotherapy in 60--70% of patients. The pretreatment identification of a sizeable subgroup of patients with sufficiently low failure-free survival (FFS) to be eligible for investigational treatment is necessary. OBJECTIVES To determine the prognostic significance of the number of involved sites (NIS) in patients with advanced HL and its relationship to the International Prognostic Score (IPS). METHODS A retrospective review of patients with advanced HL, defined as Ann Arbor stage (AAS) IB, IIB, III or IV, treated with anthracycline-based regimens. The end-point was FFS. RESULTS We identified 277 patients with a median age of 32 yr (14--78), 57% of whom were males. AAS was I in 4% of patients, II in 29%, III in 38% and IV in 29%. B-symptoms were recorded in 81%. Most patients had nodular sclerosis (64%) and mixed cellularity (26%) histology. IPS was greater-than-or-equals 3 in 44% of 242 evaluable patients. The NIS was greater-than-or-equals 5 in 32% of the patients and 20% of all patients had both greater-than-or-equals 5 involved sites and IPS greater-than-or-equals 3. The 10-yr FFS was 67%, being 76% vs. 50% for patients with less-than-or-equals 4 vs. greater-than-or-equals 5 involved sites (P < 0.0001). The NIS (greater-than-or-equal 5), AAS IV and anemia were independent predictors of FFS in multivariate analysis. The NIS remained significant along with IPS, when the latter was included in the analysis. Patients with greater-than-or-equals 5 involved sites and IPS greater-than-or-equals 3 had 10-yr FFS overall, and relapse-free survival of 41%, 45% and 49%, respectively. CONCLUSIONS The NIS was associated with FFS in advanced HL, was independent of IPS, and led to the identification of a sizeable subgroup of patients with 10-yr FFS of approximately 40%. This factor should be evaluated during the development of prognostic systems.
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Affiliation(s)
- T P Vassilakopoulos
- Hematology Section, First Department of Internal Medicine, National and Kapodistrian University, School of Medicine, Laikon General Hospital, Athens, Greece
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38
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Viniou N, Terpos E, Rombos J, Vaiopoulos G, Nodaros K, Stamatopoulos K, Meletis J, Yataganas X. Acute myeloid leukemia in a patient with ataxia-telangiectasia: a case report and review of the literature. Leukemia 2001; 15:1668-70. [PMID: 11587230 DOI: 10.1038/sj.leu.2402210] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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39
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Ioakim-Liossi A, Karakitsos P, Markopoulos C, Aroni K, Athanassiadou P, Delivelioti K, Athanassiades P, Vaiopoulos G. p53 protein expression and oestrogen and progesterone receptor status in invasive ductal breast carcinomas. Cytopathology 2001; 12:197-202. [PMID: 11380561 DOI: 10.1046/j.1365-2303.2001.00315.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
p53 protein expression and oestrogen and progesterone receptor status in invasive ductal breast carcinomas The p53 protein expression and oestrogen and progesterone receptors status was investigated in correlation to the grade of malignancy of primary breast carcinomas. Our material constituted imprints from surgical biopsies of 75 invasive ductal breast cancer cases. The p53 protein expression was investigated immunocytologically using the monoclonal antibody p53 DO-7 (DAKO). A biochemical DCC method was applied for the detection of oestrogen and progesterone receptors for all tumours. Fifty-one percent of breast cancer cases were p53 protein positive. A statistically significant association of p53 protein expression and high tumour grade was found (chi2=23.72, d.f.=2, P < 0.001). A statistically significant association was also found between oestrogen and progesterone receptor positive cases and the grade of malignancy (P < 0.001). A negative association between p53 protein expression and oestrogen (ER) and progesterone receptors (PgR) positivity was found. From our results it appears that it is possible to distinguish from grade II tumours two subgroups of cases, one with low malignancy potential and p53 (-), ER (+), PgR (+), and another subgroup with high malignancy potential and phenotype p53 (+), ER (-), PgR (-). The last subset of patients could actually benefit from adjuvant therapy.
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40
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Tassiopoulos S, Kontos A, Konstantopoulos K, Hadzistavrou C, Vaiopoulos G, Aessopos A, Tassiopoulos T. Erythropoietic response to hypoxaemia in diffuse idiopathic pulmonary fibrosis, as opposed to chronic obstructive pulmonary disease. Respir Med 2001; 95:471-5. [PMID: 11421504 DOI: 10.1053/rmed.2001.1070] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to assess the erythropoietic response to hypoxaemia in patients with diffuse idiopathic pulmonary fibrosis (DIPF), and to speculate on the underlying mechanisms. Patients on an established chronic respiratory failure due to DIPF or chronic obstructive pulmonary disease (COPD) were studied. The erythropoietic response to hypoxaemia in both conditions was assessed. We studied 18 patients with DIPF and 29 patients with COPD in respiratory failure in a stable stage, free from acute infection and congestive heart failure. Blood gases, erythrocytic parameters, as well the serum levels of iron, ferritin and erythropoietin were determined. All the DIPF patients studied, apart from two, had normal or subnormal haematocrit values. The patients with COPD had an inconsistant response to hypoxaemia; 12 had normal or subnormal haematocrit values and the remaining 17 were erythraemic. The mean value of erythropoietin (EPO) in both DIPF and COPD patients was significantly higher than normal. In conclusion, patients with DIPF exhibit a lack of erythropoietic response to hypoxaemia, despite the augmented erythropoietin levels. This may reflect a defective bone marrow erythropoietic response in DIPF patients. It is suggested that the pathophysiology of DIPF underlies this mechanism.
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Affiliation(s)
- S Tassiopoulos
- First Department of Internal Medicine, Laikon Hospital, Athens, Greece
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Terpos E, Palermos J, Viniou N, Vaiopoulos G, Meletis J, Yataganas X. Pamidronate increases markers of bone formation in patients with multiple myeloma in plateau phase under interferon-alpha treatment. Calcif Tissue Int 2001; 68:285-90. [PMID: 11683535 DOI: 10.1007/bf02390835] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Bisphosphonates are potent inhibitors of osteoclastic activity and reduce the disease-related skeletal complications when they are used in combination with chemotherapy in patients with multiple myeloma (MM). Pamidronate also inhibits apoptosis of primary osteoblastic cells and probably induces apoptosis on human MM cells and osteoclasts. It has been reported that interferon-alpha (IFN-alpha) decreases bone resorption and that low doses of IFN-alpha result in a significant increase in serum osteocalcin (OSC). The aim of this study was to determine the effects of pamidronate treatment on biochemical markers of bone resorption [cross-linked N-telopeptides of type I collagen (NTx)], bone formation [bone alkaline phosphatase (BAP) and OSC], disease activity [beta2-microglobulin, CRP, paraprotein], and interleukin-6 (IL-6) in patients with MM in plateau phase under IFN-alpha maintenance. The above parameters were evaluated in 28 patients (13 M, 15 F, median age 70 years) during maintenance treatment, before the addition of pamidronate and after 1, 3, 6, 9, 12, and 14 months of the combined therapy. The addition of pamidronate to maintenance treatment resulted in a significant reduction of NTx, IL-6, beta2-microglobulin, CRP from the 3rd month and paraprotein from the 6th month of treatment, whereas BAP and OSC were significantly increased from the 6th month. These changes continued during the 14-month follow-up of the combined treatment. Multivariate analysis showed a significant negative correlation between changes of BAP and OSC and the patients' age. The greater increase of the bone formation markers was observed in younger patients. These results suggest that, in addition to the inhibition of osteoclastic activity, pamidronate in combination with IFN-alpha was shown to induce bone formation in patients with MM in the plateau phase.
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Affiliation(s)
- E Terpos
- First Department of Internal Medicine, University of Athens Medical School, Laiko General Hospital, Greece
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Vassilakopoulos TP, Nadali G, Angelopoulou MK, Siakantaris MP, Dimopoulou MN, Kontopidou FN, Rassidakis GZ, Doussis-Anagnostopoulou IA, Hatzioannou M, Vaiopoulos G, Kittas C, Sarris AH, Pizzolo G, Pangalis GA. Serum interleukin-10 levels are an independent prognostic factor for patients with Hodgkin's lymphoma. Haematologica 2001; 86:274-81. [PMID: 11255274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Interleukin-10 (IL-10) is a pleiotropic cytokine which increases bcl-2 levels and protects cells from steroid or doxorubicin-induced apoptosis. Hodgkin and Reed-Sternberg (HRS) cells bear functional IL-10 receptors. Thus serum IL-10 (sIL-10) might inhibit apoptosis in HRS cells, which could occur as a result of either chemotherapy or the crippled immunoglobulin genes. DESIGN AND METHODS We determined sIL-10 levels in 122 patients with Hodgkin's lymphoma (HL), treated with ABVD or equivalent regimens with or without radiotherapy, and correlated them with presenting clinical and laboratory features, as well as failure-free survival (FFS) and overall survival. RESULTS Elevated sIL-10 levels ( > or = 10 pg/mL) were detected in 55 patients (45%), and were correlated with advanced stage and elevated serum b2-microglobulin levels. At 7 years FFS was 85% vs. 63% for patients with normal vs. elevated sIL-10 levels, respectively (p=0.01); overall survival was 97% vs. 73% (p=0.005). Multivariate analysis with Cox's proportional hazards model demonstrated that elevated sIL-10 levels were the strongest independent predictor of FFS, and were also associated with inferior overall survival. INTERPRETATION AND CONCLUSIONS We conclude that sIL-10 levels are elevated in 45% of patients with HL, and are associated with inferior FFS and overall survival, independently of other established prognostic factors.
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Affiliation(s)
- T P Vassilakopoulos
- Hematology Section, First Department of Internal Medicine, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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Konstantopoulos K, Kapsimalis V, Vaiopoulos G, Kokkinis C, Papadaki T, Psarra K, Ekonomidou J. Simultaneous appearance of mycosis fungoides and chronic lymphocytic leukemia in the same patient. Haematologia (Budap) 2001; 30:41-3. [PMID: 10841324 DOI: 10.1163/15685590051129878] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A patient is presented having simultaneously chronic lymphocytic leukemia with a monoclonal B-lymphocyte population and mycosis fungoides with atypical T-cell population in the skin lesion and in the enlarged lymphoid nodes confirmed by detailed phenotyping.
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Affiliation(s)
- K Konstantopoulos
- First Department of Internal Medicine, Athens University Medical School at Laikon Hospital, Greece
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Vaiopoulos G, Terpos E, Viniou N, Nodaros K, Rombos J, Loukopoulos D. Behcet's disease in a patient with chronic myelogenous leukemia under hydroxyurea treatment: a case report and review of the literature. Am J Hematol 2001; 66:57-8. [PMID: 11426495 DOI: 10.1002/1096-8652(200101)66:1<57::aid-ajh1010>3.0.co;2-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Behcet's disease (BD) is a chronic, relapsing vasculitis of unknown etiology. Its association with chronic myelogenous leukemia (CML) is extremely rare, and typical manifestations of BD were observed in a very few patients with CML, mainly under interferon-alpha (IFN-alpha) treatment. Skin pathergy test, being positive in about 50% of patients with BD, is also positive in some IFN-alpha-treated patients with CML without any evidence of BD symptoms. We describe a 62-year-old woman with CML who developed characteristic features of BD, including a positive skin hyperactivity test, during treatment with hydroxyurea. Hydroxyurea has been implicated in the appearance of skin vasculitic ulceration, but this is the first case, according to our knowledge, where the development of BD was observed during hydroxyurea maintenance in the chronic phase of CML.
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Affiliation(s)
- G Vaiopoulos
- First Department of Internal Medicine, University of Athens Medical School, Laiko General Hospital, Greece
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Abstract
Sjögren's syndrome (SS) is a chronic autoimmune disease of unknown etiology characterized by lymphocytic infiltration of the exocrine glands and a polyclonal B-cell activation; it is demonstrated by the presence of multiple autoantibodies against organ- and non-organ-specific autoantigens. SS is associated with malignant lymphomas, Waldenstrom's macroglobulinemia and benign monoclonal gammopathy, while its relationship with multiple myeloma is extremely rare. The association between multiple myeloma and rheumatoid arthritis and other autoimmune diseases has been established, but it is not clear why a B-cell proliferation like myeloma occurs more rarely than other B-cell disorders in patients with SS. We describe a patient who presented with multiple myeloma and SS that might have existed for at least 2 years prior to the appearance of myeloma.
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Affiliation(s)
- E Terpos
- First Department of Internal Medicine, University of Athens Medical School, Laikon Hospital, Greece.
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Papadaki HA, Vardakis C, Vaiopoulos G, Nanas J, Eliopoulos GD. Extensive calcification of the pericardium in a patient with primary amyloidosis. Ann Hematol 2000; 79:405-6. [PMID: 10965791 DOI: 10.1007/s002770000171] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Karargyris G, Stamatopoulos K, Kittas C, Loukopoulos D, Vaiopoulos G. Sjögren's syndrome co-existing with limited Wegener's granulomatosis. Rheumatology (Oxford) 2000; 39:805-6. [PMID: 10908703 DOI: 10.1093/rheumatology/39.7.805] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Abstract
PURPOSE We study the clinical features of epididymo-orchitis in patients with Behçet's disease. MATERIALS AND METHODS Of 57 men with Behçet's disease 7 had epididymo-orchitis during the course of disease. A questionnaire was applied to all cases and the clinical features were recorded. HLA class 1 was determined and a pathergy test was performed. RESULTS All 7 patients fulfilled the international study group criteria for Behçet's disease. All patients had recurrent oral ulcers, skin lesions (folliculitis, erythema nodosum-like lesions) and uveitis, and 6 had recurrent genital ulcers, 2 arthritis, 1 vasculitis and 4 central nervous system involvement. The pathergy test was positive in 4 patients and all had B5(51). The allele B5101 was present in 6 patients and 1 had B5102. Recurrences were observed in 5 patients. Concurrent symptoms with epididymo-orchitis consisted of oral ulcers, fever, uveitis, arthritis and penile ulcer. Colchicine, glucocorticoids, nonsteroidal anti-inflammatory drugs and cyclosporine were administered. CONCLUSIONS Epididymo-orchitis in patients with Behçet's disease is not as infrequent as believed. It was not the first manifestation of the disease but developed during followup. In any patient with epididymo-orchitis Behçet's disease should be considered, particularly in regions with a high prevalence of the disease.
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Affiliation(s)
- V G Kaklamani
- Newton Wellesley Hospital, Boston, Massachusetts, USA
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Tatsis G, Vaiopoulos G, Tassiopoulos T, Votsiou A, Peristerakis A, Jordanoglou J. Lung function in Adamantiades-Behçet disease. Rheumatology (Oxford) 1999; 38:1018-9. [PMID: 10534558 DOI: 10.1093/rheumatology/38.10.1018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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