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The relationship between HLA antigens (A, B and DR) and nickel contact sensitivity was examined in a series of 26 female patients with unequivocal positive patch-test reactions to nickel. Acomparison of patient antigen frequency versus Yorkshire Region HLA antigen figures showed an increased incidence of HLA-B35 in our patient populations, (P<0.01). The relative risk (RR) for the development of nickel sensitivity was reflected in the increased values for HLA-B35 and BW22 in our patients when compared with Yorkshire frequencies. We found no significant association between DR antigens and RR in our patients. The aetiological fraction (EF) showed no significant association between HLA antigens and nickel contract sensitivity. [ABSTRACT FROM AUTHOR]

Nineteen female and sixteen male patients who have had their heart valves replaced with Lillehei-Kaster valves were investigated for haemolysis four to 18 months after operation. Investigation included serum lactic dehydrogenase, serum haptoglobins, and urine haemosiderin. Red cells survival, using autologous red cells labelled with 51Cr, was measured in 12 patients. No patient showed manifest anaemia. The serum lactic dehydrogenase levels were raised in 66% of the mitral valve patients, 81% of the aortic valve patients, and in all the double valve patients. The serum haptoglobins were decreased in 66% of mitral patients, 68% of aortic valve patients, and in 75% of the double valve patients. All the 12 patients studied had lower than normal red cell survivals. No correlation was found between the incidence of haemolysis and the size of the valve. In isolated mitral valve replacement 66% showed compensated haemolysis compared with 42% in Björk-Shiley valves (p less than 0.05), 85% in Starr-Edwards valves (composite seat) (p less than 0.01), and none in frame-mounted irradiated homografts (previous study) (p less than 0.001). [ABSTRACT FROM AUTHOR]

A study of histocompatibility (HLA) antigens in 69 patients with discoid lupus erythematosus (DLE) showed an increased incidence of HLA-B7 and HLA-B8 related to the age at onset and sex of the patient. Young females and males aged 15-39 years at onset were associated with HLA-B7 and females aged over 40 years with HLA-B8. This supports previous studies concerning sex and age specific onset rates in DLE which suggested that there is more than one genotype in this disorder. Female patients with systemic lupus erythematosus (SLE) at all ages of onset showed a significant association with HLA-B8. Female patients, with onset 15-39 years, with either SLE or DLE which has transformed to SLE, show a significant increase in HLA-B8 compared with the females in the same age at onset group who have the discoid disease. The presence of HLA-B8 in a young female with DLE may represent a risk factor for the development of the systemic disease. [ABSTRACT FROM AUTHOR]

Immunological studies were performed on 84 children with steroid-sensitive nephrotic syndrome as part of an investigation of the relationship between steroid-responsive nephrotic syndrome and allergy. Serum total IgE levels tended to be raised, particularly in children who had frequent relapses of nephrotic syndrome. Ten children had extremely high levels (greater than 1500 IU/ml) and several of them had neither a history of atopy nor any other identifiable cause. 25% of the children had at least one positive test for specific IgE antibody. IgE was not detected by immunofluorescence in renal biopsy tissue from 25 children, regardless of whether the child was in remission or relapse at the time of biopsy. Serum IgG and IgA levels were depressed particularly at the time of a relapse. Serum IgM tended to be raised and to remain so, even in children who had been in remission for more than a year. No clinically useful relationship was found between the frequency of HLA antigens and the occurrence or course of the syndrome, whether or not accompanied by atopy. Clinical and immunological features of atopy are more common in children with idiopathic nephrotic syndrome. This may be a causal or non-causal association. Pollen sensitivity is a rare cause of nephrotic syndrome; careful search for provocative agents may show other causes. [ABSTRACT FROM AUTHOR]

Neointimal hyperplasia and thrombosis initiated by platelet activity may contribute to the failure of femoropopliteal Dacron bypass grafts. We have therefore undertaken a randomised prospective double blind trial comparing the efficacy of a combination of acetyl salicylic acid (ASA) 330 mg and dipyridamole (DPM) 75 mg three times daily, with placebo in maintaining the patency of femoropopliteal Dacron bypass grafts implanted to relieve disabling claudication. Patients received either ASA/DPM or placebo commencing pre-operatively and continuing for 12 months. Seventy-three double velour (Microvel) grafts in 65 patients were studied, 38 grafts in the placebo group and 35 grafts in the active group. The following were measured pre-operatively and at 3, 6, 9 and 12 months postoperatively: maximum walking distance (MWD); ankle/brachial systolic pressure index (ABSPI); graft patency; platelet adhesion and aggregation; template bleeding time; ASA and DPM levels. After 1 year, 10 patients had been withdrawn (9 ASA/DPM: 1 placebo) and 4 out of 26 grafts in the active group and 15 out of 37 in the placebo group had occluded ( P < 0.05 Chi square test). We conclude that inhibition of platelet function by the use of a combination of ASA and DPM improved the patency rate of femoropopliteal Dacron bypass grafts. [ABSTRACT FROM AUTHOR]

Using diagnostic criteria which are currently accepted as most reliable we have found that 19% (9/47) of patients with dermatitis herpetiformis (DH) have no evidence of coeliac disease. The incidence of HL-A8 in the DH patients was 78%, which is considerably greater than that in healthy controls and no different from that reported in coeliac disease. Furthermore, the incidence of HL-A8 was just as much increased in those DH patients without evidence of coeliac disease suggesting that HL-A8 is associated with DH per se--that is, regardless of its association with coeliac disease. [ABSTRACT FROM PUBLISHER]

Twenty-six patients with a pauciarticular arthritis have been studied clinically, radiologically and with histocompatibility typing. An increased frequency of HLA B27 was found (p = 1.87 x 10(-12)). Low back and buttock pain, Achilles tendinitis and dactylitis of the toes were more frequent in HLA-B27 positive patients. It is suggested that histocompatibility testing may be of some value in diagnosis and in the investigation of the possible 'reactive' nature of this type of arthritis. [ABSTRACT FROM AUTHOR]

Histocompatibility (HL-A) antigen typing was performed on 82 patients with psoriatic arthritis. The prevalance of HL-AB27 was increased (28%) compared with that in a control group (7-5%), and this was most marked in those with spinal changes. The prevalence in patients with sacroiliitis and syndesmophytes was 75%, with sacroiliitis alone 78%, but with syndesmophytes and normal sacroiliac joints only 36%. The overall prevalence in psoriatic spondylitis was 60%, with a prevalence of 71% in those fulfilling the New York criteria for anklosing spondylitis. The prevalence was not increased in those with only peripheral arthritis (11%). The prevalence of HLA-B13 was decreased in those with psoriatic spondylitis, though this was not statistically significant. The overall prevalence of HLA-BW17 was increased, this being particularly so in those with syndesmophytes, but values were not significant. [ABSTRACT FROM PUBLISHER]

The HLA (Human Leucocyte Antigen) types and B were studied in 80 patients diagnosed as schizophrenic. There was an increased incidence of HLA-BW5 and a decrease in HLA-AW29 and HLA-BW17 as compared with healthy controls. In the sub-group of patients exhibiting Schneider's first-rank symptoms there was an increased incidence of HLA-A1 with a decrease in HLA-A2 and HLA-BW17. [ABSTRACT FROM AUTHOR]

The paradox of the survival of the foetal allograft remains unresolved as does the aetiology of pre-.eclampsia/eclampsia -- the principle disease of pregnancy. In a prospective study of very severe cases of pre-eclampsia we have found significantly reduced antibody to paternal histocompatibility antigens. Lowered immune response to the foetal allograft may play a role in severe cases of pre-eclampsia. [ABSTRACT FROM AUTHOR]