37 results on '"Gross WL"'
Search Results
2. Genetics of toll like receptor 9 in ANCA associated vasculitides.
- Author
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Husmann CA, Holle JU, Moosig F, Mueller S, Wilde B, Cohen Tervaert JW, Harper L, Assmann G, Gross WL, Epplen JT, and Wieczorek S
- Subjects
- Adult, Case-Control Studies, Female, Genotype, Humans, Linkage Disequilibrium, Male, Polymorphism, Single Nucleotide, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis genetics, Genetic Predisposition to Disease genetics, Toll-Like Receptor 9 genetics
- Abstract
Objectives: To investigate the contribution of genetic polymorphisms of toll like receptor (TLR) 9 and related genes on the susceptibility and clinical manifestation of anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitides (AAV)., Methods: Four single nucleotide polymorphisms (SNPs) in TLR9 were genotyped in 863 German AAV cases and 1344 healthy controls. Significant results were replicated in a cohort of 426 Dutch and British AAV cases. 11 polymorphisms in TLR9 related genes were studied concomitantly., Results: A strong association of TLR9 genotypes and haplotypes with granulomatosis with polyangiitis was observed as well as a contrariwise association with microscopic polyangiitis. The association was confirmed when cases were compared according to ANCA status rather than to clinical entity. This was partly replicated in the second cohort leading to a striking overall difference in TLR9 allele/haplotype frequencies between proteinase 3 (PR3) ANCA+ and myeloperoxidase (MPO) ANCA+ cases (p=0.00000398, pc=0.000016, OR 1.68 (95% CI 1.35 to 2.1) for rs352140; p=0.000011, pc=0.000044, OR 1.64 (95% CI 1.31 to 2.04) for a 3-SNP haplotype). No significant association or epistatic effect was detected for TLR9 related genes: interleukin 6, interleukin 23 receptor, myeloid differentiation primary response 88, TNF receptor-associated factor 6, interleukin-1 receptor-associated kinase 4, discs large homolog 5 and nucleotide-binding oligomerisation domain containing 2., Conclusions: We provide further evidence that PR3-ANCA+ AAV differs genetically from MPO-ANCA+ AAV. TLR9 signalling may be involved in disease pathology, favouring models of infectious agents triggering AAV development.
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- 2014
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3. A vasculitis centre based management strategy leads to improved outcome in eosinophilic granulomatosis and polyangiitis (Churg-Strauss, EGPA): monocentric experiences in 150 patients.
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Moosig F, Bremer JP, Hellmich B, Holle JU, Holl-Ulrich K, Laudien M, Matthis C, Metzler C, Nölle B, Richardt G, and Gross WL
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- Azathioprine therapeutic use, Churg-Strauss Syndrome mortality, Churg-Strauss Syndrome physiopathology, Cohort Studies, Cyclophosphamide therapeutic use, Female, Humans, Immunosuppression Therapy methods, Isoxazoles therapeutic use, Leflunomide, Male, Methotrexate therapeutic use, Middle Aged, Remission Induction methods, Retrospective Studies, Secondary Prevention, Treatment Outcome, Anti-Inflammatory Agents therapeutic use, Churg-Strauss Syndrome drug therapy, Immunosuppressive Agents therapeutic use, Prednisolone therapeutic use
- Abstract
Objective: To evaluate a vasculitis centre based management strategy for eosinophilic granulomatosis and polyangiitis (Churg-Strauss, EGPA)., Methods: A retrospective cohort study at a vasculitis referral centre was performed. All EGPA patients admitted from 1990 to 2009 were included. A structured interdisciplinary work-up for proof of diagnosis, Disease Extent Index and Birmingham Vasculitis Activity Score was performed. Immunosuppressive therapy was initiated and regularly adapted. Treatment targets were induction and maintenance of remission according to definitions given by the European League Against Rheumatism and the European Vasculitis Study Group. Outcomes were mortality, rate of remission, relapses, adverse events and prednisolone-dose., Results: Out of 269 patients with suspected EGPA 150 fulfilled the inclusion criteria. Of those, 104 had more than one follow-up visit resulting in a mean follow up of 53±4.9 months. By using additional data sources the follow-up concerning survival was extended to 92±5 month. Severe organ manifestations occurred at heart (46%), kidney (18%) and lungs (10%). Cyclophosphamide was used in 107 patients (71%). The prednisolone-doses of all patients were within the targeted range (i.e. ≤7.5 mg) in 69% of the total follow-up time; the median dose at end of follow-up was 5mg/d. The 10-year survival rate was 89% resulting in mortality comparable to the general population (SMR 1.29). Only patients with cardiac failure associated with EGPA had an increased mortality (SMR 3.06)., Conclusions: Regular re-evaluation and target-orientated adaption of therapy may lead to normalization of life expectancy and attenuation of disease progression. Continued centre based interdisciplinary treatment should be standard of care.
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- 2013
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4. Association of ferritin autoantibodies with giant cell arteritis/polymyalgia rheumatica.
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Baerlecken NT, Linnemann A, Gross WL, Moosig F, Vazquez-Rodriguez TR, Gonzalez-Gay MA, Martin J, Kötter I, Henes JC, Melchers I, Vaith P, Schmidt RE, and Witte T
- Subjects
- Adult, Aged, Autoantigens immunology, Biomarkers blood, Enzyme-Linked Immunosorbent Assay methods, Enzyme-Linked Immunosorbent Assay standards, False Positive Reactions, Female, Giant Cell Arteritis epidemiology, Humans, Immunoglobulin G blood, Male, Middle Aged, Polymyalgia Rheumatica epidemiology, Protein Array Analysis, Seroepidemiologic Studies, Staphylococcus epidermidis immunology, Apoferritins immunology, Autoantibodies blood, Giant Cell Arteritis immunology, Polymyalgia Rheumatica immunology
- Abstract
Objectives: Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are relatively common inflammatory disorders. Establishing the diagnosis however may be difficult, since so far no specific biomarkers of the disorders are available., Methods: As a screening procedure, the authors used protein arrays for the detection of new autoantigens in GCA and PMR. The results of the protein array were confirmed by different ELISAs detecting IgG antibodies against the human ferritin heavy chain, N-terminal 27 amino acids of the human ferritin heavy chain or the homologous peptide of Staphylococcus epidermidis. Sera of patients with only GCA (n=64), only PMR (n=47) and both PMR and GCA (n=31) were used., Results: In the ELISA using the human ferritin peptide, the sensitivity of IgG antibodies against ferritin was 92% in 36 GCA and/or PMR patients before initiation of treatment, 22/32 (69%) in patients with disease flares and 64/117 (55%) in the total cohort including treated and inactive patients. In controls, the false positive rate was 11/38 (29%) in systemic lupus erythematosus, 1/36 (3%) in rheumatoid arthritis, 0/31 (0%) in late onset rheumatoid arthritis, 3/46 (6.5%) in B-non-Hodgkin's lymphoma and 1/100 (1%) in blood donors. In the ELISA using the ferritin peptide of S epidermidis, 89% of 27 patients with untreated GCA and PMR were positive., Conclusion: Antibodies against the ferritin peptide were present in up to 92% of untreated, active GCA and PMR patients. They can be useful as a diagnostic marker of PMR and GCA.
- Published
- 2012
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5. Rituximab for refractory granulomatosis with polyangiitis (Wegener's granulomatosis): comparison of efficacy in granulomatous versus vasculitic manifestations.
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Holle JU, Dubrau C, Herlyn K, Heller M, Ambrosch P, Noelle B, Reinhold-Keller E, and Gross WL
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- Adult, Aged, Antibodies, Monoclonal, Murine-Derived administration & dosage, Antibodies, Monoclonal, Murine-Derived adverse effects, Biomarkers blood, Blood Sedimentation, C-Reactive Protein metabolism, Drug Administration Schedule, Drug Evaluation, Drug Therapy, Combination, Female, Granulomatosis with Polyangiitis diagnosis, Humans, Immunosuppressive Agents administration & dosage, Immunosuppressive Agents adverse effects, Male, Middle Aged, Recurrence, Retrospective Studies, Rituximab, Severity of Illness Index, Treatment Outcome, Young Adult, Antibodies, Monoclonal, Murine-Derived therapeutic use, Granulomatosis with Polyangiitis drug therapy, Immunosuppressive Agents therapeutic use
- Abstract
Objective: First, to investigate the overall efficacy and safety of rituximab (RTX) in refractory granulomatosis with polyangiitis (GPA) in a tertiary referral centre. Second, to compare the efficacy of RTX in granulomatous and vasculitic manifestations in GPA., Patients and Methods: This study comprised a retrospective, standardised data collection from all patients who received RTX for refractory Wegener's granulomatosis from 2002 to 2010. Patients were assessed by a standardised interdisciplinary diagnostic procedure (including ear, nose and throat and ophthalmology assessment, MRI, immunodiagnostics, B-cell levels and Birmingham Vasculitis Activity Score) and were treated by standardised therapeutic regimens according to available evidence., Results: 59 patients received 75 cycles of RTX. 9.3% achieved complete remission. A response was documented in 61.3% (improvement in 52%, unchanged disease activity in 9.3%), 26.7% had refractory disease. Birmingham Vasculitis Activity Score, disease extent index, erythrocyte sedimentation rate, C-reactive protein and prednisolone demand decreased significantly. All patients achieved B-cell depletion. Granulomatous manifestations such as orbital granuloma and pachymeningitis were more frequently refractory to RTX than vasculitis or other granulomatous manifestations. Thus, for example, complete remission/improvement was found in 89.2% of patients with renal disease and in only 44.4% of those with orbital masses (p=0.003). The relapse rate was 44.4% after a median period of 13.5 months. Adverse events occurred in 29%, pneumonia in 15% and death in 3%., Conclusion: The overall response rate of refractory GPA to RTX was high (61.3% complete remission or improvement). Response rates of vasculitic manifestations were excellent; failure of response/progress was mostly due to granulomatous manifestations, especially orbital masses. Relapse rates were high (40%) despite maintenance treatment.
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- 2012
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6. Correlation of serum level of high mobility group box 1 with the burden of granulomatous inflammation in granulomatosis with polyangiitis (Wegener's).
- Author
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Henes FO, Chen Y, Bley TA, Fabel M, Both M, Herrmann K, Csernok E, Gross WL, and Moosig F
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- Antibodies, Antineutrophil Cytoplasmic blood, Biomarkers blood, Female, Granuloma diagnostic imaging, Granuloma metabolism, Granuloma pathology, Granulomatosis with Polyangiitis metabolism, Granulomatosis with Polyangiitis pathology, HMGB1 Protein metabolism, Humans, Male, Middle Aged, Severity of Illness Index, Tomography, X-Ray Computed, Granulomatosis with Polyangiitis diagnosis, HMGB1 Protein blood
- Abstract
Objectives: To investigate the correlation of serum levels of high mobility group box 1 (HMGB1) with the extent of granulomatous inflammation in granulomatosis with polyangiitis (GPA)., Methods: From 169 patients with GPA, 17 patients with granulomatous inflammation, without evidence of vasculitis were identified and 36 patients without measurable 'granuloma' formation. HMGB1 serum levels were determined and compared between the two groups, using a Mann-Whitney U test. Serum levels of 26 healthy individuals served as controls. In a further 21 patients with GPA with a pulmonary granulomatous manifestation from the study population, CT volumetry of 'granuloma' was performed. Volumes were compared with serum levels of HMGB1 (Spearman rank order test)., Results: Serum levels of HMGB1 were significantly higher in patients with predominant granulomatous disease than in patients without measurable 'granuloma' manifestations (6.44 ± 4.53 ng/ml vs 3.85 ± 2.88 ng/ml; p=0.0107). In both groups, levels of HMGB1 were significantly higher than in controls (2.34 ± 2.01 ng/ml; p<0.01). A positive correlation of HMGB1 serum levels with volumes of pulmonary 'granuloma' (r=0.761, p<0.0017) was seen., Conclusions: HMGB1 serum levels are significantly higher in GPA with predominant granulomatous manifestations and correlate with volumes of pulmonary 'granuloma'. HMGB1 may be used as a marker of the burden of granulomatous inflammation in GPA.
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- 2011
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7. Successful use of bortezomib in a patient with systemic lupus erythematosus and multiple myeloma.
- Author
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Fröhlich K, Holle JU, Aries PM, Gross WL, and Moosig F
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- Bortezomib, Female, Humans, Middle Aged, Protease Inhibitors therapeutic use, Treatment Outcome, Antineoplastic Agents therapeutic use, Boronic Acids therapeutic use, Lupus Erythematosus, Systemic drug therapy, Multiple Myeloma drug therapy, Pyrazines therapeutic use
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- 2011
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8. Granulomatosis with polyangiitis (Wegener's): an alternative name for Wegener's granulomatosis.
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Falk RJ, Gross WL, Guillevin L, Hoffman G, Jayne DR, Jennette JC, Kallenberg CG, Luqmani R, Mahr AD, Matteson EL, Merkel PA, Specks U, and Watts R
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- Humans, International Cooperation, Granulomatosis with Polyangiitis diagnosis, Terminology as Topic
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- 2011
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9. Are there specific genetic risk factors for the different forms of ANCA-associated vasculitis?
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Arning L, Holle JU, Harper L, Millar DS, Gross WL, Epplen JT, and Wieczorek S
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- Case-Control Studies, Gene Frequency, Genetic Predisposition to Disease, HLA-DP Antigens genetics, HLA-DP beta-Chains, Humans, Risk Factors, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis genetics
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- 2011
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10. Prospective long-term follow-up of patients with localised Wegener's granulomatosis: does it occur as persistent disease stage?
- Author
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Holle JU, Gross WL, Holl-Ulrich K, Ambrosch P, Noelle B, Both M, Csernok E, Moosig F, Schinke S, and Reinhold-Keller E
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- Adolescent, Adult, Aged, Antibodies, Antineutrophil Cytoplasmic blood, Biomarkers blood, Disease Progression, Female, Follow-Up Studies, Granulomatosis with Polyangiitis drug therapy, Granulomatosis with Polyangiitis pathology, Humans, Immunosuppressive Agents therapeutic use, Male, Middle Aged, Phenotype, Prognosis, Recurrence, Young Adult, Granulomatosis with Polyangiitis diagnosis
- Abstract
Objective: To identify patients with localised Wegener's granulomatosis (locWG) to assess whether it occurs as a long-term disease stage or phenotype and to characterise its outcome., Methods: Patients in a 'localised stage' with histological criteria compatible with WG and a follow-up period of ≥1 year were included. They were prospectively followed at the Vasculitis Center Schleswig-Holstein from 1989 to 2009 and the clinical manifestations, antineutrophil cytoplasmic autoantibodies (ANCA) status and damage were evaluated. Immunosuppression was adapted to disease activity and severity in a step-up regimen., Results: Of 1024 patients with suspected WG, 99 were clinically diagnosed with locWG and 50 fulfilled the inclusion criteria (72% women, median age 43 years, 46% ANCA-positive). The median follow-up was 48 months. All achieved a response to treatment, 34% achieved complete remission, 1-4 relapses occurred in 46%, 5 (10%) had generalised disease (median 6 years after onset). ANCA status was not associated with relapse (p=0.98), transition to generalised disease (p=0.51) or refractory manifestations (p=0.60). 47% required cyclophosphamide for localised manifestations, 36% of them for pulmonary masses and 24% for orbital masses. 66% developed organ damage, mostly due to bony destruction or space obturation (28% saddle nose, 24% septal perforation, 10% orbital wall destruction). There were two deaths that were not related to WG., Conclusion: There is evidence that locWG is a long-term disease stage or phenotype (5% of all patients with WG), 46% of whom are ANCA-positive. LocWG is characterised by destructive and/or space-consuming lesions associated with high relapse rates (46%) and local damage.
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- 2010
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11. Serum HMGB1 levels are increased in active Wegener's granulomatosis and differentiate between active forms of ANCA-associated vasculitis.
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Wibisono D, Csernok E, Lamprecht P, Holle JU, Gross WL, and Moosig F
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- Biomarkers blood, Diagnosis, Differential, Humans, Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis diagnosis, Granulomatosis with Polyangiitis diagnosis, HMGB1 Protein blood
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- 2010
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12. Are anti-cyclic citrullinated peptide autoantibodies seromarkers for rheumatoid vasculitis in a cohort of patients with systemic vasculitis?
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Laskari K, Ahmadi-Simab K, Lamken M, Csernok E, Gross WL, and Hellmich B
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- Aged, Biomarkers blood, Cohort Studies, Female, Humans, Male, Middle Aged, Sensitivity and Specificity, Autoantibodies blood, Peptides, Cyclic immunology, Rheumatoid Vasculitis diagnosis
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- 2010
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13. Clinical evaluation of hsPR3-ANCA ELISA for detection of antineutrophil cytoplasmatic antibodies directed against proteinase 3.
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Holle JU, Csernok E, Fredenhagen G, Backes M, Bremer JP, and Gross WL
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- Biomarkers blood, Enzyme-Linked Immunosorbent Assay methods, Humans, Prospective Studies, Antibodies, Antineutrophil Cytoplasmic blood, Myeloblastin immunology, Rheumatic Diseases diagnosis
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- 2010
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14. Severe impaired respiratory ciliary function in Wegener granulomatosis.
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Ullrich S, Gustke H, Lamprecht P, Gross WL, Schumacher U, Ambrosch P, and Laudien M
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- Analysis of Variance, Autoimmunity physiology, Case-Control Studies, Cilia ultrastructure, Female, Granulomatosis with Polyangiitis drug therapy, Granulomatosis with Polyangiitis pathology, Humans, Immunosuppressive Agents therapeutic use, Male, Microscopy, Electron, Middle Aged, Mucociliary Clearance, Nasal Mucosa pathology, Time Factors, Cilia physiology, Granulomatosis with Polyangiitis physiopathology, Nasal Mucosa ultrastructure
- Abstract
Objective: The pathogenesis of granulomatous inflammation in the respiratory tract and autoimmunity in Wegener granulomatosis (WG) are poorly understood. Since mucociliar clearance represents the first major line of defence in the respiratory tract and its breakdown facilitates chronic inflammation, we investigated ciliary beat frequency (CBF) in WG., Methods: Nasal epithelial cells were obtained from 30 patients with WG with involvement of the upper respiratory tract, 12 patients with other inflammatory rheumatic disease and 10 healthy controls. CBF was measured at 5 and 24 h after collection., Results: were correlated with clinical data. Results: CBF was significantly reduced in WG compared to disease and healthy controls after 5 and 24 h. In WG, CBF almost stagnated after 24 h. Reduction of CBF correlated with the cumulative number of immunosuppressive agents in WG, but not in disease controls. No correlation was found between CBF impairment and cyclophosphamide levels, disease extent, disease activity, disease duration, serological and microbiological findings, or inflammation markers., Conclusion: CBF is severely impaired in WG, potentially influenced by immunosuppressive treatment. To what extent CBF impairment and subsequent barrier dysfunction are caused by other factors still has to be elucidated. Supportive measures to improve mucociliary clearance should be discussed in patients with WG.
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- 2009
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15. Outcomes from studies of antineutrophil cytoplasm antibody associated vasculitis: a systematic review by the European League Against Rheumatism systemic vasculitis task force.
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Mukhtyar C, Flossmann O, Hellmich B, Bacon P, Cid M, Cohen-Tervaert JW, Gross WL, Guillevin L, Jayne D, Mahr A, Merkel PA, Raspe H, Scott D, Witter J, Yazici H, and Luqmani RA
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- Churg-Strauss Syndrome drug therapy, Churg-Strauss Syndrome immunology, Cyclophosphamide therapeutic use, Evidence-Based Medicine, Glucocorticoids therapeutic use, Granulomatosis with Polyangiitis drug therapy, Humans, Immunosuppressive Agents therapeutic use, Recurrence, Remission Induction, Risk Factors, Survival Analysis, Treatment Outcome, Vasculitis immunology, Antibodies, Antineutrophil Cytoplasmic blood, Vasculitis drug therapy
- Abstract
Objectives: We undertook a systematic literature review as a background to the European League Against Rheumatism (EULAR) recommendations for conducting clinical trials in anti-neutrophil cytoplasm antibody associated vasculitis (AAV), and to assess the quality of evidence for outcome measures in AAV., Methods: Using a systematic Medline search, we categorised the identified studies according to diagnoses. Factors affecting remission, relapse, renal function and overall survival were identified., Results: A total of 44 papers were reviewed from 502 identified by our search criteria. There was considerable inconsistency in definitions of end points. Remission rates varied from 30% to 93% in Wegener granulomatosis (WG), 75% to 89% in microscopic polyangiitis (MPA) and 81% to 91% in Churg-Strauss syndrome (CSS). The 5-year survival for WG, MPA and CSS was 74-91%, 45-76% and 60-97%. Relapse (variably defined) was common in the first 2 years but the frequency varied: 18% to 60% in WG, 8% in MPA, and 35% in CSS. The rate of renal survival in WG varied from 23% at 15 months to 23% at 120 months., Method: used to assess morbidity varied between studies. Ignoring the variations in definitions of the stage of disease, factors influencing remission, relapse, renal and overall survival included immunosuppressive therapy used, type of organ involvement, presence of ANCA, older age and male gender., Conclusions: Factors influencing remission, relapse, renal and overall survival include the type of immunosuppressive therapy used, pattern of organ involvement, presence of ANCA, older age and male gender. Methodological variations between studies highlight the need for a consensus on terminology and definitions for future conduct of clinical studies in AAV.
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- 2008
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16. MRI and FDG-PET in the assessment of inflammatory aortic arch syndrome in complicated courses of giant cell arteritis.
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Both M, Ahmadi-Simab K, Reuter M, Dourvos O, Fritzer E, Ullrich S, Gross WL, Heller M, and Bähre M
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- Aged, Aged, 80 and over, Aortic Arch Syndromes diagnostic imaging, Aortic Arch Syndromes drug therapy, Aortitis diagnostic imaging, Aortitis drug therapy, Biomarkers blood, Blood Sedimentation, C-Reactive Protein analysis, Female, Fluorodeoxyglucose F18, Follow-Up Studies, Giant Cell Arteritis diagnostic imaging, Giant Cell Arteritis drug therapy, Humans, Immunosuppressive Agents therapeutic use, Magnetic Resonance Angiography methods, Male, Middle Aged, Positron-Emission Tomography methods, Radiopharmaceuticals, Aortic Arch Syndromes diagnosis, Aortitis diagnosis, Giant Cell Arteritis diagnosis
- Abstract
Objectives: To evaluate the use of MRI and FDG-PET for the diagnosis and measurement of disease activity of inflammatory aortic arch syndrome in patients with complicated giant cell arteritis., Methods: MRI and FDG-PET were performed for 25 patients with giant cell arteritis who presented with a complicated disease course despite immunosuppressive therapy. Disease activity of the thoracic aorta and the supra-aortic arteries as assessed by both modalities was compared with serological (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR)) and clinical findings (Birmingham vasculitis activity score (BVAS.2)). Additionally, the usefulness of MRI for assessment of vessel wall thickening, aneurysms and stenoses was evaluated., Results: In 17/25 patients, MRI disclosed structural vessel lesions suspicious for vasculitis. Active disease was detected by MRI, thoracic PET, and whole body PET in 22, 14 and 20 patients, respectively. While serological and clinical findings correlated significantly with each other, there was no concordance with MRI and only low, non-significant correlation of PET with CRP (r(s) = -0.158, 0.136), ESR (r(s) = -0.232, 0.320) and BVAS.2 (r(s) = -0.064, 0.221) for disease activity., Conclusions: MRI and PET are unreliable for assessing large-vessel inflammation in patients with giant cell arteritis and pre-existing immunosuppressive therapy. MRI is valuable for its ability to detect morphological vessel lesions, such as aneurysms and stenoses.
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- 2008
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17. The Wegener's granulomatosis quantitative trait locus on chromosome 6p21.3 as characterised by tagSNP genotyping.
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Heckmann M, Holle JU, Arning L, Knaup S, Hellmich B, Nothnagel M, Jagiello P, Gross WL, Epplen JT, and Wieczorek S
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- Antibodies, Antineutrophil Cytoplasmic blood, DNA-Binding Proteins genetics, Gene Frequency, Genetic Predisposition to Disease, Genotype, Granulomatosis with Polyangiitis immunology, HLA-DP Antigens genetics, HLA-DP beta-Chains, Haplotypes, Histocompatibility Testing methods, Humans, Polycomb Repressive Complex 1, Chromosomes, Human, Pair 6 genetics, Granulomatosis with Polyangiitis genetics, Polymorphism, Single Nucleotide, Quantitative Trait Loci
- Abstract
Background: A genomic region on chromosome 6p21.3, including HLA-DPB1, has been linked to Wegener's granulomatosis (WG). The basis of this association is difficult to evaluate because of the complex haplotype block architecture of this region., Objective: To identify the causative molecular genetic variation(s) using a detailed HapMap based fine-mapping approach., Methods: 282 patients with WG and 380 healthy controls were genotyped for HLA-DPB1 as well as for 35 informative single nucleotide polymorphisms (SNPs) within the respective region. 25 of these SNPs have been selected as tagging SNPs for another 219 associated SNPs. Allele and genotype frequencies were analysed separately by contingency tables and logistic regression. Finally, the coding region of RING1 was directly sequenced in subjects who carried haplotypes that were correlated with contrasting WG risks., Results: The previously reported strong association of WG with the HLA-DPB1*0401 allele was confirmed in an independent WG sample (n = 108, p(c) = 6.4 x 10(-8)). When the complete cohort (n = 282) was considered, the association remained highly significant in ANCA-positive (p(c) = 1.26 x 10(-22)), but not in ANCA-negative patients. An SNP 3' of HLA-DPB1 yielded the smallest p value and was associated with WG partly independently from the HLA-DPB1 alleles. Another informative SNP in the vicinity of RING1 showed significant WG association that was also partly independent of HLA-DPB1. RING1 sequencing, however, did not show any variation potentially predisposing to WG., Conclusions: The HLA-DPB1/RING1 region is strongly associated with WG in ANCA-positive subjects. Further analyses of potential cis regulatory sequences of candidate genes HLA-DPB1, RING1 and RXRB appear warranted.
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- 2008
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18. The low-penetrance R92Q mutation of the tumour necrosis factor superfamily 1A gene is neither a major risk factor for Wegener's granulomatosis nor multiple sclerosis.
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Jenne DE, Aries PM, Einwächter S, Akkad AD, Wieczorek S, Lamprecht P, and Gross WL
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- Case-Control Studies, Granulomatosis with Polyangiitis immunology, Humans, Multiple Sclerosis immunology, Odds Ratio, Risk, Granulomatosis with Polyangiitis genetics, Multiple Sclerosis genetics, Mutation, Penetrance, Receptors, Tumor Necrosis Factor, Type I genetics
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- 2007
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19. EULAR recommendations for conducting clinical studies and/or clinical trials in systemic vasculitis: focus on anti-neutrophil cytoplasm antibody-associated vasculitis.
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Hellmich B, Flossmann O, Gross WL, Bacon P, Cohen-Tervaert JW, Guillevin L, Jayne D, Mahr A, Merkel PA, Raspe H, Scott DG, Witter J, Yazici H, and Luqmani RA
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- Biomarkers analysis, Europe, Humans, International Cooperation, Quality of Life, Recurrence, Remission Induction, Research Design standards, Treatment Outcome, Vasculitis diagnosis, Vasculitis immunology, Antibodies immunology, Clinical Trials as Topic standards, Cytoplasm immunology, Guidelines as Topic, Neutrophils immunology, Vasculitis therapy
- Abstract
Objectives: To develop the European League Against Rheumatism (EULAR) recommendations for conducting clinical studies and/or clinical trials in systemic vasculitis., Methods: An expert consensus group was formed consisting of rheumatologists, nephrologists and specialists in internal medicine representing five European countries and the USA, a clinical epidemiologist and representatives from regulatory agencies. Using an evidence-based and expert opinion-based approach in accordance with the standardised EULAR operating procedures, the group identified nine topics for a systematic literature search through a modified Delphi technique. On the basis of research questions posed by the group, recommendations were derived for conducting clinical studies and/or clinical trials in systemic vasculitis., Results: Based on the results of the literature research, the expert committee concluded that sufficient evidence to formulate guidelines on conducting clinical trials was available only for anti-neutrophil cytoplasm antibody-associated vasculitides (AAV). It was therefore decided to focus the recommendations on these diseases. Recommendations for conducting clinical trials in AAV were elaborated and are presented in this summary document. It was decided to consider vasculitis-specific issues rather than general issues of trial methodology. The recommendations deal with the following areas related to clinical studies of vasculitis: definitions of disease, activity states, outcome measures, eligibility criteria, trial design including relevant end points, and biomarkers. A number of aspects of trial methodology were deemed important for future research., Conclusions: On the basis of expert opinion, recommendations for conducting clinical trials in AAV were formulated. Furthermore, the expert committee identified a strong need for well-designed research in non-AAV systemic vasculitides.
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- 2007
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20. Balloon angioplasty of arteries of the upper extremities in patients with extracranial giant-cell arteritis.
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Both M, Aries PM, Müller-Hülsbeck S, Jahnke T, Schäfer PJ, Gross WL, Heller M, and Reuter M
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- Aged, Arterial Occlusive Diseases diagnostic imaging, Arterial Occlusive Diseases etiology, Combined Modality Therapy, Female, Follow-Up Studies, Giant Cell Arteritis complications, Giant Cell Arteritis diagnostic imaging, Humans, Immunosuppressive Agents therapeutic use, Middle Aged, Radiography, Recurrence, Treatment Outcome, Vascular Patency, Angioplasty, Balloon methods, Arterial Occlusive Diseases therapy, Giant Cell Arteritis therapy, Upper Extremity blood supply
- Abstract
Objectives: To evaluate the outcome of balloon angioplasty in the arteries of the upper extremities in patients with giant-cell arteritis (GCA) and stenosing extracranial involvement., Methods: Percutaneous transluminal angioplasty (PTA) for symptomatic upper limb artery stenoses (n = 29) and occlusions (n = 1) resistant to medical treatment was carried out in 10 patients (all women, mean age 65 years) with GCA. Vascular lesions were located in the subclavian (n = 4), axillary (n = 10) and brachial (n = 16) arteries. Interventional treatment was accompanied by immunosuppressive drugs in all patients. Follow-up included clinical and serological examination, magnetic resonance angiography and colour duplex ultrasound., Results: Initial technical success of angioplasty was achieved in the case of all vascular lesions. In five patients, marked recurrent stenoses (vascular territories; n = 10/30) were found during follow-up (mean 24 months). The cumulative primary patency rate was 65.2%. All recurrent lesions developed in the territories of the initial long-segment stenoses. Repeated PTA (vascular territories, n = 8; patients, n = 5) provided a cumulative secondary patency rate of 82.6% and a cumulative tertiary patency rate of 89.7%., Conclusions: Despite a tendency to restenoses, balloon angioplasty of the upper-extremity artery, in combination with immunosuppressive treatment, is an efficient method for the treatment of extracranial GCA.
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- 2006
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21. Successful treatment of refractory adult onset Still's disease with rituximab.
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Ahmadi-Simab K, Lamprecht P, Jankowiak C, and Gross WL
- Subjects
- Adult, Antibodies, Monoclonal, Murine-Derived, B-Lymphocytes immunology, Humans, Interleukin-1 antagonists & inhibitors, Lymphocyte Depletion, Rituximab, Antibodies, Monoclonal therapeutic use, Immunologic Factors therapeutic use, Still's Disease, Adult-Onset drug therapy
- Published
- 2006
- Full Text
- View/download PDF
22. B lymphocyte maturation in Wegener's granulomatosis: a comparative analysis of VH genes from endonasal lesions.
- Author
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Voswinkel J, Mueller A, Kraemer JA, Lamprecht P, Herlyn K, Holl-Ulrich K, Feller AC, Pitann S, Gause A, and Gross WL
- Subjects
- Aged, Aged, 80 and over, Case-Control Studies, Cloning, Molecular, DNA Mutational Analysis, Disease Progression, Female, Gene Expression, Genetic Markers, Humans, Immunohistochemistry methods, Lymphocyte Activation, Male, Middle Aged, Myeloblastin, Polymerase Chain Reaction methods, Sequence Analysis, DNA, Serine Endopeptidases immunology, Statistics, Nonparametric, B-Lymphocytes immunology, Genes, Immunoglobulin Heavy Chain, Granulomatosis with Polyangiitis immunology, Nasal Mucosa immunology
- Abstract
Background: Anti-neutrophil cytoplasmic antibodies (ANCA) directed against proteinase 3 (PR3) are highly specific for Wegener's granulomatosis (WG). Evidence for a pivotal role of PR3-ANCA in the induction of vasculitis has been demonstrated. B cell clusters have been observed within endonasal biopsy specimens., Objectives: To determine whether B cell selection and maturation take place in granulomatous lesions of WG., Methods: Granulomatous lesions and the immunoglobulin (VH) gene repertoire from nasal tissue of six WG patients-two active and two smouldering localised WG (ANCA negative, restricted to respiratory tract), plus one active and one smouldering PR3-ANCA positive generalised WG-were characterised by immunohistochemistry, polymerase chain reaction, cloning, DNA sequencing and database comparison., Results: B lymphocyte-rich, follicle-like areas were observed proximal to PR3 positive cells and plasma cells in granulomatous lesions; 184 VH genes from these granulomatous lesions were compared with 84 VH genes from peripheral blood of a healthy donor. The mutational pattern of VH genes from active WG resembled memory B cells. Structural homologies of VH genes from granulomatous lesions to PR3-ANCA encoding genes were detected. Significantly more genes (55%, 45%, and 53%, respectively) from active WG compared with the healthy repertoire carried mutations to negatively charged amino acids within the binding site coding regions, favouring affinity to the positively charged PR3., Conclusions: Selection and affinity maturation of potentially PR3-ANCA producing autoreactive B cells may start in granulomatous lesions, thereby contributing to disease progression from ANCA negative localised to PR3-ANCA positive generalised WG.
- Published
- 2006
- Full Text
- View/download PDF
23. Lack of efficacy of rituximab in Wegener's granulomatosis with refractory granulomatous manifestations.
- Author
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Aries PM, Hellmich B, Voswinkel J, Both M, Nölle B, Holl-Ulrich K, Lamprecht P, and Gross WL
- Subjects
- Adult, Antibodies, Monoclonal, Murine-Derived, B-Lymphocytes immunology, Blood Sedimentation, Child, Preschool, Cyclophosphamide therapeutic use, Drug Therapy, Combination, Female, Granulomatosis with Polyangiitis immunology, Granulomatosis with Polyangiitis pathology, Humans, Immunosuppressive Agents therapeutic use, Lymphocyte Count, Magnetic Resonance Imaging, Male, Methotrexate therapeutic use, Middle Aged, Orbit pathology, Rituximab, Treatment Outcome, Antibodies, Monoclonal therapeutic use, Granulomatosis with Polyangiitis drug therapy, Immunologic Factors therapeutic use
- Abstract
Objective: To investigate the safety and efficacy of rituximab (RTX) in patients with refractory Wegener's granulomatosis (WG)., Patients and Methods: Eight consecutive patients with active refractory WG were included. In all patients disease activity had persisted despite standard treatment with cyclophosphamide and prednisolone, as well as tumour necrosis factor alpha blockade 3 months before inclusion in the study. Patients had particular granulomatous manifestations like retro-orbital granulomata (n=5), nodules of the lungs (n=1), and subglottic stenosis (n=2). RTX was given intravenously every 4th week in combination with the standard treatment in five patients and with methotrexate in two others. Disease extent and activity were monitored clinically by interdisciplinary care, immunodiagnostics (ANCA serology, B cells by flow cytometry), and magnetic resonance imaging., Results: Beneficial response and a reduction in disease activity were seen in three patients, two of whom went into complete remission. In three other patients, disease activity remained unchanged while the disease progressed in the remaining two patients. In all patients peripheral blood B cells fell to zero during treatment with RTX. cANCA titres remained unchanged in all except one patient., Conclusion: In this pilot study, B lymphocyte depletion was not associated with a change of the ANCA titres or obvious clinical improvement of refractory granulomatous disease in patients with WG. Further studies are needed to evaluate the role of RTX in WG.
- Published
- 2006
- Full Text
- View/download PDF
24. Lack of association of mannose binding lectin variant alleles with systemic lupus erythematosus.
- Author
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Momot T, Ahmadi-Simab K, Gause A, Gross WL, Gromnica-Ihle E, Peter HH, Manger K, Zeidler H, Schmidt RE, and Witte T
- Subjects
- Adult, Alleles, Cardiovascular Diseases etiology, Cardiovascular Diseases genetics, Case-Control Studies, Female, Follow-Up Studies, Humans, Lupus Erythematosus, Systemic complications, Male, Middle Aged, Risk Factors, Lupus Erythematosus, Systemic genetics, Mannose-Binding Lectin genetics
- Published
- 2006
- Full Text
- View/download PDF
25. Variations in performance characteristics of commercial enzyme immunoassay kits for detection of antineutrophil cytoplasmic antibodies: what is the optimal cut off?
- Author
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Holle JU, Hellmich B, Backes M, Gross WL, and Csernok E
- Subjects
- Adult, Aged, Biomarkers blood, Enzyme-Linked Immunosorbent Assay methods, Epidemiologic Methods, Female, Fluorescent Antibody Technique, Direct, Humans, Male, Middle Aged, Myeloblastin, Peroxidase immunology, Reagent Kits, Diagnostic, Serine Endopeptidases immunology, Antibodies, Antineutrophil Cytoplasmic blood, Granulomatosis with Polyangiitis diagnosis, Vasculitis diagnosis
- Abstract
Background: Previous studies have shown considerable variation in diagnostic performance of enzyme linked immunosorbent assays (ELISAs) for measuring antineutrophil cytoplasmic antibodies (ANCA) specific for proteinase 3 (PR3) and myeloperoxidase (MPO)., Objective: To analyse the performance characteristics of different commercially available direct ANCA ELISA kits., Methods: ELISA kits for detecting PR3-ANCA and MPO-ANCA from 11 manufacturers were evaluated. Serum samples were taken from patients with Wegener's granulomatosis (15), microscopic polyangiitis (15), other vasculitides (10), and controls (40)., Results: were compared with data obtained by indirect immunofluorescence (IFT). The diagnostic performance of the tests was analysed and compared by receiver operating characteristic (ROC) curve analysis.Results: Applying the manufacturers' cut off resulted in great variation in sensitivity of the commercial PR3-ANCA kits for diagnosing Wegener's granulomatosis (ranging from 13.3% to 66.7%), and of the MPO-ANCA kits for diagnosing microscopic polyangiitis (ranging from 26.7% to 66.7%). Specificities were relatively constant (from 96.0% to 100%). IFT was superior to all ELISAs (C-ANCA for Wegener's granulomatosis: sensitivity 73.3%, specificity 98%; P-ANCA for microscopic polyangiitis: sensitivity 86.7%, specificity 98%). The sensitivities of PR3-ANCA and MPO-ANCA ELISA kits were increased by lowering the cut off values. This reduced specificity but increased overall diagnostic performance., Conclusions: The low sensitivity of some commercial kits reflects the high cut off levels recommended rather than methodological problems with the assays. Comparative analyses using sera from well characterised patients may help identify optimum cut off levels of commercial ANCA ELISA tests, resulting in better comparability of results among assays from different manufacturers.
- Published
- 2005
- Full Text
- View/download PDF
26. Peripheral neuropathy in patients with systemic rheumatic diseases treated with leflunomide.
- Author
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Metzler C, Arlt AC, Gross WL, and Brandt J
- Subjects
- Adult, Aged, Female, Humans, Leflunomide, Male, Middle Aged, Retrospective Studies, Antirheumatic Agents adverse effects, Isoxazoles adverse effects, Peripheral Nervous System Diseases chemically induced, Rheumatic Diseases drug therapy
- Published
- 2005
- Full Text
- View/download PDF
27. Pachymeningitis in mixed connective tissue disease.
- Author
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Ahmadi-Simab K, Lamprecht P, Reuter M, and Gross WL
- Subjects
- Female, Humans, Hydrocephalus etiology, Magnetic Resonance Imaging, Middle Aged, Meningitis etiology, Mixed Connective Tissue Disease complications
- Published
- 2005
- Full Text
- View/download PDF
28. Leucoencephalopathy after treatment of Churg-Strauss syndrome with interferon {alpha}.
- Author
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Metzler C, Lamprecht P, Hellmich B, Reuter M, Arlt AC, and Gross WL
- Subjects
- Female, Humans, Middle Aged, Brain Diseases chemically induced, Churg-Strauss Syndrome drug therapy, Interferon-alpha adverse effects
- Published
- 2005
- Full Text
- View/download PDF
29. Successful treatment of refractory anterior scleritis in primary Sjogren's syndrome with rituximab.
- Author
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Ahmadi-Simab K, Lamprecht P, Nölle B, Ai M, and Gross WL
- Subjects
- Antibodies, Monoclonal, Murine-Derived, Antigens, CD20 immunology, B-Lymphocytes immunology, Female, Humans, Middle Aged, Rituximab, Scleritis immunology, Sjogren's Syndrome immunology, Antibodies, Monoclonal therapeutic use, Immunosuppressive Agents therapeutic use, Scleritis drug therapy, Sjogren's Syndrome drug therapy
- Published
- 2005
- Full Text
- View/download PDF
30. Periostitis as the initial manifestation of systemic vasculitis.
- Author
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Aries PM, Reuter M, Lamprecht P, and Gross WL
- Subjects
- Adult, Anterior Compartment Syndrome etiology, Female, Humans, Leg blood supply, Periostitis etiology, Vasculitis complications
- Published
- 2005
- Full Text
- View/download PDF
31. Small vessel vasculitis and relapsing panniculitis in tumour necrosis factor receptor associated periodic syndrome (TRAPS).
- Author
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Lamprecht P, Moosig F, Adam-Klages S, Mrowietz U, Csernok E, Kirrstetter M, Ahmadi-Simab K, Schroder JO, and Gross WL
- Subjects
- Aged, Antirheumatic Agents therapeutic use, Etanercept, Female, Humans, Immunoglobulin G therapeutic use, Male, Middle Aged, Mutation, Panniculitis drug therapy, Panniculitis immunology, Panniculitis, Nodular Nonsuppurative drug therapy, Panniculitis, Nodular Nonsuppurative immunology, Receptors, Tumor Necrosis Factor therapeutic use, Syndrome, Vasculitis drug therapy, Vasculitis immunology, Panniculitis genetics, Panniculitis, Nodular Nonsuppurative genetics, Receptors, Tumor Necrosis Factor, Type I genetics, Vasculitis genetics
- Abstract
Case Reports: A 66 year old female patient had relapsing fever and non-suppurative panniculitis suggestive of enigmatic "Weber-Christian disease" (WCD). Antineutrophil cytoplasmic antibodies with specificity for human leucocyte elastase (HLE-ANCA) were detected. A biopsy showed small vessel vasculitis and panniculitis. A 53 year old man had recurrent episodes of abdominal pain, erythematous rash, and myalgia. Fever attacks had stopped a few years ago. A biopsy showed panniculitis and fasciitis. In both patients mutations (R92Q, T50M) of the tumour necrosis factor receptor super family (TNFRSF) 1A gene were disclosed. Mutations of the TNFRSF 1A gene are the cause of tumour necrosis factor receptor associated periodic syndrome (TRAPS). Both patients responded favourably to treatment with the human soluble p75 TNF alpha receptor fusion protein etanercept (2 x 25 mg subcutaneously/week)., Discussion: Small vessel vasculitis and panniculitis have not been reported in TRAPS so far. The cases underline the importance of TNF alpha regulation in inflammatory processes including vasculitis. Genetically determined causes of fever may account for some cases of WCD.
- Published
- 2004
- Full Text
- View/download PDF
32. Urinary bladder cancer in Wegener's granulomatosis: is it more than cyclophosphamide?
- Author
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Hellmich B, Kausch I, Doehn C, Jocham D, Holl-Ulrich K, and Gross WL
- Subjects
- Granulomatosis with Polyangiitis drug therapy, Humans, Mesna therapeutic use, Protective Agents therapeutic use, Urinary Bladder Neoplasms prevention & control, Cyclophosphamide adverse effects, Granulomatosis with Polyangiitis complications, Immunosuppressive Agents adverse effects, Urinary Bladder Neoplasms etiology
- Published
- 2004
- Full Text
- View/download PDF
33. Progression of lupus nephritis during treatment with mycophenolate mofetil.
- Author
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Ahmadi-Simab K, Lamprecht P, and Gross WL
- Subjects
- Disease Progression, Humans, Middle Aged, Treatment Failure, Immunosuppressive Agents therapeutic use, Lupus Nephritis drug therapy, Mycophenolic Acid analogs & derivatives, Mycophenolic Acid therapeutic use
- Published
- 2004
- Full Text
- View/download PDF
34. Rituximab induces remission in refractory HCV associated cryoglobulinaemic vasculitis.
- Author
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Lamprecht P, Lerin-Lozano C, Merz H, Dennin RH, Gause A, Voswinkel J, Peters SO, Gutzeit O, Arlt AC, Solbach W, and Gross WL
- Subjects
- Antibodies, Monoclonal, Murine-Derived, Antiviral Agents therapeutic use, Drug Resistance, Neoplasm, Drug Resistance, Viral, Female, Humans, Interferon alpha-2, Interferon-alpha therapeutic use, Middle Aged, Recombinant Proteins, Remission Induction, Ribavirin therapeutic use, Rituximab, Antibodies, Monoclonal therapeutic use, Antineoplastic Agents therapeutic use, Cryoglobulinemia drug therapy, Hepatitis C, Chronic drug therapy, Lymphoma, Non-Hodgkin drug therapy, Vasculitis drug therapy
- Abstract
Objectives: To report the successful induction of remission with the monoclonal anti-CD20 antibody rituximab in a patient with hepatitis C virus (HCV) associated cryoglobulinaemic vasculitis and a non-Hodgkin's lymphoma (NHL) resistant to previously advocated conventional treatments., Case Report: The patient was a 45 year old woman with HCV associated cryoglobulinaemic vasculitis, with purpura, arthralgia, constitutional symptoms, and a polyneuropathy. A malignant NHL was found as underlying lymphoproliferative disease. At this stage the disease was refractory to interferon alpha2b and ribavirin and to subsequent immunosuppressive treatment with cyclophosphamide. Six rituximab infusions targeting the CD20 antigen on cells of the B cell lineage induced remission of the vasculitis. Bone marrow biopsy disclosed absence of the NHL. Remission has subsequently been maintained and HCV eliminated with the new pegylated interferon alpha2b and ribavirin for nearly one year., Conclusions: Transition of the underlying "benign" lymphoproliferative disease to a malignant lymphoma may result in difficult to treat HCV associated cryoglobulinaemic vasculitis. Rituximab offers a new possibility for inducing remission in refractory HCV associated cryoglobulinaemic vasculitis and the lymphoproliferative disorder. After remission, HCV may subsequently be eliminated with pegylated interferon alpha2b and ribavirin.
- Published
- 2003
- Full Text
- View/download PDF
35. Immunological and clinical follow up of hepatitis C virus associated cryoglobulinaemic vasculitis.
- Author
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Lamprecht P, Moosig F, Gause A, Herlyn K, Csernok E, Hansen H, and Gross WL
- Subjects
- Antibodies, Antinuclear blood, Biomarkers, Blood Sedimentation, Complement C3c analysis, Complement C4 analysis, Complement Hemolytic Activity Assay, Cryoglobulinemia blood, Cryoglobulinemia drug therapy, Female, Hepatitis C, Chronic blood, Hepatitis C, Chronic drug therapy, Humans, Intercellular Adhesion Molecule-1 blood, Interferon-alpha therapeutic use, Ki-1 Antigen blood, Male, Middle Aged, Receptors, Interleukin-2 blood, Rheumatoid Factor blood, Severity of Illness Index, Statistics, Nonparametric, Treatment Outcome, Vasculitis blood, Vasculitis drug therapy, Cryoglobulinemia etiology, Hepatitis C, Chronic complications, Vasculitis etiology
- Abstract
Objective: To study immunological markers and compare these markers with standard measures for the clinical and immunological follow up of vasculitis activity in hepatitis C virus (HCV) associated cryoglobulinaemic vasculitis (CV)., Methods: Serial serum samples from eight patients with newly diagnosed HCV associated CV were followed during interferon alpha treatment induced remission of the CV. Vasculitis activity and disease extent were evaluated with the Birmingham vasculitis activity score (BVAS) and disease extent index (DEI). Cryoglobulinaemia, complement levels (C3c, C4, and CH50), rheumatoid factor (RF), autoantibodies such as antinuclear antibodies, soluble interleukin 2 receptor (sIL2r), soluble intercellular adhesion molecule-1 (sICAM-1), and soluble CD30 (sCD30) were determined., Results: All patients achieved either complete or partial remission of their CV during interferon alpha treatment. There was a significant reduction in vasculitis activity and disease extent (BVAS, DEI), cryoglobulinaemia, RF, sIL2r, sICAM-1, and sCD30. Complement C3c levels increased significantly during this period. Erythrocyte sedimentation rate and levels of complement C4 and CH50 did not change significantly. Both clinical measures (BVAS and DEI) correlated significantly only with C3c and sCD30., Conclusions: Although this study was of only a small group of patients, it shows that BVAS and DEI as clinical measures and C3c and sCD30 as immunological markers may be useful in the follow up of disease activity of HCV associated CV. The data indicate that activity of the humoral (cryoglobulinaemia, RF, autoantibodies) and cellular (sIL2r, sICAM-1, sCD30) immune response and endothelial damage (sICAM-1) are found in HCV associated CV.
- Published
- 2001
- Full Text
- View/download PDF
36. Antineutrophil cytoplasmic antibodies and the eosinophilia myalgia syndrome.
- Author
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Schnabel A, Gross WL, Berg PA, Klein R, and Lehnert H
- Subjects
- Adult, Aged, Antibodies, Antineutrophil Cytoplasmic, Biomarkers blood, Chronic Disease, Female, Humans, Male, Middle Aged, Autoantibodies blood, Eosinophilia-Myalgia Syndrome immunology
- Published
- 1995
- Full Text
- View/download PDF
37. Relapsing polychondritis as a secondary phenomenon of primary systemic vasculitis.
- Author
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Handrock K and Gross WL
- Subjects
- Antibodies, Antineutrophil Cytoplasmic, Female, Granulomatosis with Polyangiitis complications, Humans, Male, Recurrence, Autoantibodies analysis, Immunoglobulin G analysis, Polychondritis, Relapsing etiology, Vasculitis complications
- Published
- 1993
- Full Text
- View/download PDF
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