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Oliwa A, Langlands G, Sarkozy A, Munot P, Stewart W, Phadke R, Topf A, Straub V, Duncan R, Wigley R, Petty R, Longman C, Farrugia ME. Glycogen storage disease type IV without detectable polyglucosan bodies: importance of broad gene panels. Neuromuscul Disord 2023; 33:98-105. [PMID: 37598009 DOI: 10.1016/j.nmd.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 07/10/2023] [Accepted: 07/18/2023] [Indexed: 08/21/2023]
Abstract
Glycogen storage disease type IV (GSD IV) is caused by mutations in the glycogen branching enzyme 1 (GBE1) gene and is characterized by accumulation of polyglucosan bodies in liver, muscle and other tissues. We report three cases with neuromuscular forms of GSD IV, none of whom had polyglucosan bodies on muscle biopsy. The first case had no neonatal problems and presented with delayed walking. The other cases presented at birth: one with arthrogryposis, hypotonia, and respiratory distress, the other with talipes and feeding problems. All developed a similar pattern of axial weakness, proximal upper limb weakness and scapular winging, and much milder proximal lower limb weakness. Our cases expand the phenotypic spectrum of neuromuscular GSD IV, highlight that congenital myopathy and limb girdle weakness can be caused by mutations in GBE1, and emphasize that GSD IV should be considered even in the absence of characteristic polyglucosan bodies on muscle biopsy.
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Affiliation(s)
- Agata Oliwa
- Undergraduate Medical School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4HH, UK.
| | - Gavin Langlands
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Anna Sarkozy
- The Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Pinki Munot
- The Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children, London, WC1N 3JH, UK
| | - Willie Stewart
- Department of Neuropathology, Laboratory Medicine Building, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Rahul Phadke
- Department of Neuropathology, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, WC1N 3BG, UK
| | - Ana Topf
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 3BZ, UK
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, NE1 3BZ, UK
| | - Roderick Duncan
- Department of Orthopaedics, Royal Hospital for Sick Children, Glasgow, G51 4TF, UK
| | - Ralph Wigley
- Department of Chemical Pathology, Great Ormond Street Hospital Trust, London, WC1N 3JH, UK
| | - Richard Petty
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
| | - Cheryl Longman
- West of Scotland Regional Genetics Service, Queen Elizabeth University Hospital, Glasgow, G51 4TF, UK
| | - Maria Elena Farrugia
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK
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Buch AE, Musumeci O, Wigley R, Stemmerik MPG, Eisum AV, Madsen KL, Preisler N, Hilton‐Jones D, Quinlivan R, Toscano A, Vissing J. Energy metabolism during exercise in patients with β-enolase deficiency (GSDXIII). JIMD Rep 2021; 61:60-66. [PMID: 34485019 PMCID: PMC8411107 DOI: 10.1002/jmd2.12232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/28/2021] [Accepted: 05/10/2021] [Indexed: 11/08/2022] Open
Abstract
AIM To investigate the in vivo skeletal muscle metabolism in patients with β-enolase deficiency (GSDXIII) during exercise, and the effect of glucose infusion. METHODS Three patients with GSDXIII and 10 healthy controls performed a nonischemic handgrip test as well as an incremental cycle ergometer test measuring maximal oxidative consumption (VO2max) and a 1-hour submaximal cycle test at an intensity of 65% to 75% of VO2max. The patients repeated the submaximal exercise after 2 days, where they received a 10% iv-glucose supplementation. RESULTS Patients had lower VO2max than healthy controls, and two of three patients had to stop prematurely during the intended 1-hour submaximal exercise test. During nonischemic forearm test, all patients were able to produce lactate in normal amounts. Glucose infusion had no effect on patients' exercise capacity. CONCLUSIONS Patients with GSDXIII experience exercise intolerance and episodes of myoglobinuria, even to the point of needing renal dialysis, but still retain an almost normal anaerobic metabolic response to submaximal intensity exercise. In accordance with this, glucose supplementation did not improve exercise capacity. The findings show that GSDXIII, although causing episodic rhabdomyolysis, is one of the mildest metabolic myopathies affecting glycolysis.
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Affiliation(s)
- Astrid Emilie Buch
- Copenhagen Neuromuscular Center, Rigshospitalet, University of CopenhagenCopenhagenDenmark
| | - Olimpia Musumeci
- Neurology and Neuromuscular Disorders Unit, Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - Ralph Wigley
- Enzyme Laboratory, Department of Chemical PathologyCameilia Botnar Laboratories, Great Ormond Street Hospital for Sick ChildrenLondonUK
| | | | - Anne‐Sofie Vibæk Eisum
- Copenhagen Neuromuscular Center, Rigshospitalet, University of CopenhagenCopenhagenDenmark
| | - Karen Lindhardt Madsen
- Copenhagen Neuromuscular Center, Rigshospitalet, University of CopenhagenCopenhagenDenmark
| | - Nicolai Preisler
- Copenhagen Neuromuscular Center, Rigshospitalet, University of CopenhagenCopenhagenDenmark
| | - David Hilton‐Jones
- Department of Clinical NeurologyWest Wing, John Radcliffe HospitalOxfordUK
| | - Ros Quinlivan
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children NHS Foundation TrustLondonUK
| | - Antonio Toscano
- Neurology and Neuromuscular Disorders Unit, Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly
| | - John Vissing
- Copenhagen Neuromuscular Center, Rigshospitalet, University of CopenhagenCopenhagenDenmark
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Scalco RS, Stemmerik M, Løkken N, Vissing CR, Madsen KL, Michalak Z, Pattni J, Godfrey R, Samandouras G, Bassett P, Holton JL, Krag T, Haller RG, Sewry C, Wigley R, Vissing J, Quinlivan R. Results of an open label feasibility study of sodium valproate in people with McArdle disease. Neuromuscul Disord 2020; 30:734-741. [PMID: 32811700 DOI: 10.1016/j.nmd.2020.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 04/21/2020] [Accepted: 04/28/2020] [Indexed: 12/13/2022]
Abstract
McArdle disease results from a lack of muscle glycogen phosphorylase in skeletal muscle tissue. Regenerating skeletal muscle fibres can express the brain glycogen phosphorylase isoenzyme. Stimulating expression of this enzyme could be a therapeutic strategy. Animal model studies indicate that sodium valproate (VPA) can increase expression of phosphorylase in skeletal muscle affected with McArdle disease. This study was designed to assess whether VPA can modify expression of brain phosphorylase isoenzyme in people with McArdle disease. This phase II, open label, feasibility pilot study to assess efficacy of six months treatment with VPA (20 mg/kg/day) included 16 people with McArdle disease. Primary outcome assessed changes in VO2peak during an incremental cycle test. Secondary outcomes included: phosphorylase enzyme expression in post-treatment muscle biopsy, total distance walked in 12 min, plasma lactate change (forearm exercise test) and quality of life (SF36). Safety parameters. 14 participants completed the trial, VPA treatment was well tolerated; weight gain was the most frequently reported drug-related adverse event. There was no clinically meaningful change in any of the primary or secondary outcome measures including: VO2peak, 12 min walk test and muscle biopsy to look for a change in the number of phosphorylase positive fibres between baseline and 6 months of treatment. Although this was a small open label feasibility study, it suggests that a larger randomised controlled study of VPA, may not be worthwhile.
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Affiliation(s)
- Renata S Scalco
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom; CAPES Foundation, Ministry of Education, Brazil
| | - Mads Stemmerik
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Nicoline Løkken
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Christoffer R Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Karen L Madsen
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Zuzanna Michalak
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom
| | - Jatin Pattni
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom
| | - Richard Godfrey
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom; Centre for Human Performance, Exercise and Rehabilitation, Brunel University London, Uxbridge, United Kingdom
| | - George Samandouras
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom
| | | | - Janice L Holton
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom
| | - Thomas Krag
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Ronald G Haller
- Department of Neurology, The University of Texas Southwestern Medical Center and Neuromuscular Centre, Institute for exercise and environmental medicine, Dallas, Texas, 75231, USA
| | - C Sewry
- RJAH Orthopaedic Hospital NHS Foundation Trust Oswestry, United Kingdom
| | - Ralph Wigley
- Great Ormond Street Hospital, London, United Kingdom
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Ros Quinlivan
- UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square, United Kingdom.
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Wigley R, Scalco RS, Gardiner AR, Godfrey R, Booth S, Kirk R, Hilton‐Jones D, Houlden H, Heales S, Quinlivan R. The need for biochemical testing in beta-enolase deficiency in the genomic era. JIMD Rep 2019; 50:40-43. [PMID: 31741825 PMCID: PMC6851005 DOI: 10.1002/jmd2.12070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 11/18/2022] Open
Abstract
Glycogen storage disease type XIII (GSDXIII) is a very rare inherited metabolic myopathy characterized by autosomal-recessive mutations in the ENO3 gene resulting in muscle β-enolase deficiency, an enzymatic defect of the distal part of glycolysis. Enzyme kinetic studies of two patients presenting with exertion intolerance and recurrent rhabdomyolysis are reported. Next generation sequencing confirmed patient 1 was homozygous for p.E187K in ENO3, while patient 2 was homozygous for p.C357Y. ENO3 variants pathogenicity was confirmed by functional studies in skeletal muscle. p.E187K caused extremely low total enolase activity. p.C357Y was associated with a higher level of residual activity but kinetic studies showed a lower maximum work rate (V max). This study illustrates that GSDXIII may be caused by either null mutations leading to β-enolase deficiency or by mutations that alter the enzyme's kinetic profile. This study highlights the importance of carrying out functional studies as part of the diagnostic process following the identification of variants with next generation sequencing.
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Affiliation(s)
- Ralph Wigley
- Enzyme Laboratory, Department of Chemical Pathology, Cameilia Botnar LaboratoriesGreat Ormond Street Hospital for Sick ChildrenLondonUK
| | - Renata S. Scalco
- MRC Centre for Neuromuscular Diseases and Department of Molecular NeuroscienceUniversity College London Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
- CAPES FoundationMinistry of EducationBrazil
| | - Alice R. Gardiner
- MRC Centre for Neuromuscular Diseases and Department of Molecular NeuroscienceUniversity College London Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Richard Godfrey
- MRC Centre for Neuromuscular Diseases and Department of Molecular NeuroscienceUniversity College London Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
- Centre for Human Performance, Exercise and RehabilitationBrunel University LondonUxbridgeUK
| | - Suzanne Booth
- MRC Centre for Neuromuscular Diseases and Department of Molecular NeuroscienceUniversity College London Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Richard Kirk
- Sheffield Diagnostic Genetic ServiceSheffield Children's NHS Foundation TrustSheffieldUK
| | - David Hilton‐Jones
- Department of Clinical NeurologyWest Wing, John Radcliffe HospitalOxfordUK
| | - Henry Houlden
- MRC Centre for Neuromuscular Diseases and Department of Molecular NeuroscienceUniversity College London Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Simon Heales
- Enzyme Laboratory, Department of Chemical Pathology, Cameilia Botnar LaboratoriesGreat Ormond Street Hospital for Sick ChildrenLondonUK
| | - Ros Quinlivan
- MRC Centre for Neuromuscular Diseases and Department of Molecular NeuroscienceUniversity College London Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
- Dubowitz Neuromuscular CentreGreat Ormond Street Hospital for Children, NHS Foundation TrustLondonUK
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Scalco R, Manole A, Chatfield S, Booth S, Wigley R, Pattni J, Michalak Z, Desikan M, Godfrey R, Houlden H, Murphy E, Quinlivan R. Exercise profile in patients with SLC2A9 homozygous mutation and a history of exercise induced kidney failure. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.410] [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: 11/30/2022]
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Bathgate D, Wigley R, Gorman G, Horvath R, Chinnery PF. Childhood presentation of “adult” polyglucosan body disease. Ann Neurol 2013; 73:317-8. [DOI: 10.1002/ana.23854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 11/01/2012] [Accepted: 11/16/2012] [Indexed: 11/09/2022]
Affiliation(s)
- Deborah Bathgate
- Department of Neurology; James Cook University Hospital; Middlesbrough
| | - Ralph Wigley
- Camelia Botnar Laboratories; Chemical Pathology Great Ormond Street Hospital; London; United Kingdom
| | - Grainne Gorman
- Wellcome Centre for Mitochondrial Research; Institute of Genetic Medicine, Newcastle upon Tyne; London; United Kingdom
| | - Rita Horvath
- Wellcome Centre for Mitochondrial Research; Institute of Genetic Medicine, Newcastle upon Tyne; London; United Kingdom
| | - Patrick F. Chinnery
- Wellcome Centre for Mitochondrial Research; Institute of Genetic Medicine, Newcastle upon Tyne; London; United Kingdom
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Wigley R. Can fibromyalgia be separated from regional pain syndrome affecting the arm? J Rheumatol Suppl 1999; 26:515-6. [PMID: 10090154] [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: 02/11/2023]
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Zhang N, Wigley R, Zeng Q. [Rheumatic diseases in China]. Zhonghua Nei Ke Za Zhi 1995; 34:79-83. [PMID: 7796661] [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: 01/27/2023]
Abstract
To determine the prevalence of rheumatic diseases in Chinese of Han nationality in the north and the south of China, samples of 4,192 adults in Beijing (north) and 5,057 in Shantou (south) area were studied. The same questionnaire was administered to each subject surveyed. Physical examinations were done in all who gave positive answers. For those who gave positive response to certain set of questions, blood antinuclear antibody and rheumatoid factor tests and radiographs of hand and/or sacroiliac joint were done. The prevalence of definite rheumatoid arthritis (RA) was 0.34% in the north (95% confidence interval 0.20-0.51) and 0.32% (0.95% CI 0.16-0.47) in the south and ankylosing spondilitis was noted in 0.26% of both samples (95% confidence interval in the north 0.11-0.42 and in the south 0.14-0.40). Only 3 cases of systemic lupus erythematosus in the north and one in the south were identified. General rheumatic pain was reported more frequently in the north. Lumbar problems were recorded on examinations 5 times more commonly in the north than in the south (men 25.0% vs 5.3%, women 38.0% vs 6.5%) and knee problems 10 times (men 24.0% vs 1.8%, women 36.0% vs 3.4%) more commonly in the north; the difference was greatest in the age of 55-64. A further study in the south is planned to assess the contribution of inter-observer error and/or difference in cultural response to the north/south difference observed in the prevalence of general rheumatic symptoms and back pain. A search for environmental risk factors such as climate, diet, degeneration or overuse would then be indicated to explain these differences.
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Affiliation(s)
- N Zhang
- Peking Union Medical College Hospital, Beijing
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Wigley R. Primary prevention of rheumatic disease. J Rheumatol 1993; 20:605-6. [PMID: 8496850] [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: 01/31/2023]
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Wigley R, Manahan L, Muirden KD, Caragay R, Pinfold B, Couchman KG, Valkenburg HA. Rheumatic disease in a Philippine village. II: a WHO-ILAR-APLAR COPCORD study, phases II and III. Rheumatol Int 1991; 11:157-61. [PMID: 1784884 DOI: 10.1007/bf00332554] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.4] [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: 12/28/2022]
Abstract
Many difficulties were encountered in a population survey of rheumatic complaints in a remote village area in the Philippines affecting the reliability of estimates of population prevalence. In phase I, a simple questionnaire identified 269 adults out of 950 who had rheumatic symptoms. In Phase II, 234 or 87% of positive respondents were requestioned using a more detailed pro forma. There were 196 with peripheral joint pain, 67 with neck pain and 137 with back pain. One third attributed their symptoms to work and 127 subjects had to stop work because of their complaints. Disability, including an inability to carry loads, affected nearly 1.8% of the population. Questions designed to detect rheumatoid arthritis and gout were not satisfactorily answered. Of those with complaints, 82% indicated that they still required help for their symptoms. In phase III, 166 subjects were medically examined. Osteoarthritis of the knee was found in 25 and 17 had Heberden's nodes. There were 16 with epicondylitis; 16 had rotator cuff pain and 35 had levator scapulae insertion pain. Three of these and three others had neck or shoulder swellings related to carrying loads on poles. Definite rheumatoid arthritis was diagnosed in two subjects and gout in five. No case of ankylosing spondylitis was identified. Thus, rheumatic complaints were common in this rural community and were frequently severe enough to cause disability and loss of time from work. Health worker education is required on how to handle these problems.
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Affiliation(s)
- R Wigley
- Research Laboratory, Public Hospital, Palmerston North, New Zealand
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Iversen O, Fowles M, Vlieg M, Smidt N, Wigley R. Sustained release indomethacin: a double blind comparison with indomethacin suppositories. N Z Med J 1981; 93:261-2. [PMID: 7019782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A double-blind crossover comparison of sustained release indomethacin capsules and indomethacin suppositories showed no efficacy advantage to either preparation. In other respects the two preparations were found to be comparable. More patients preferred the convenience of the oral route of medication when given the choice after the study was concluded.
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Wigley R, Borman B. Medical geography and the aetiology of the rare connective tissue diseases in New Zealand. Soc Sci Med Med Geogr 1980; 14:175-83. [PMID: 7414356 DOI: 10.1016/0160-8002(80)90060-x] [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] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Abstract
In a rheumatism clinic study in Brisbane, the consumption of aspirin and phenacetin compounds (APC) containing more than one kilogram of aspirin and phenacetin was significantly associated with overt renal papillary necrosis (RPN) and with a renal score, but when more than one kilogram of aspirin was taken without phenacetin there was no such association. Analysis and comparison with the parallel New Zealand study showed an overall risk of RPN of at least 10-6% when more than one kilogram of aspirin was taken in APC form, and 0-3% when aspirin was taken without phenacetin. An additive interaction of phenacetin and aspirin is postulated. It is concluded that phenacetin use should be severely restricted.
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